Nursing Practice Today

Exploring the possibility of meta-analysis in exploratory factor analysis: A methodological commentary

Hamid Sharif-Nia — 2025-06-10

Meta-analysis is a vital statistical tool in psychometric research, enabling the synthesis of multiple studies to enhance the reliability and validity of measurement instruments. This study applies meta-analytic techniques to exploratory factor analysis (EFA) to establish a structured framework for aggregating factor structures across psychological and health-related assessments. Given the variations in factor solutions due to methodological and sample differences, a systematic synthesis is essential. The study outlines key methodological considerations, including data extraction, effect size computation using Epsilon-Squared (ω²), heterogeneity analysis, and statistical synthesis via a random-effects model. Findings indicate that meta-analysis can improve the generalizability of factor structures, with Factor 1 accounting for an average ω² of 0.72 across studies. The results highlight the importance of refining statistical approaches to address factor heterogeneity and enhance psychometric meta-analytic practices. This research contributes to the advancement of valid and reliable measurement frameworks in psychological and health sciences.

Interventions to enhance mental health outcomes of persons with schizophrenia during the COVID-19 pandemic: A systematic review

Sudaporn Stithyudhakarn — 2025-06-02

Background & Aim: Schizophrenia is a chronic mental disorder requiring continuous care. During the COVID-19 pandemic, people with schizophrenia (PLWS) faced disproportionate challenges due to healthcare disruptions. Ensuring continuity of care is essential, and understanding the types of interventions implemented during this period can inform future support strategies. This systematic review aimed to identify, describe, and synthesize reported outcomes of interventions implemented to support the mental health of PLWS during the COVID-19 pandemic.
Methods & Materials: The protocol was registered on PROSPERO. A comprehensive search was conducted in MEDLINE, Embase, CINAHL, and ScienceDirect for studies published between 2019 and 2023. Eligible studies included experimental (randomized controlled trials and quasi-experimental studies) and non-experimental (observational) designs investigating the effects of interventions on mental health outcomes in PLWS aged 18 years and older. A narrative synthesis was used to report findings, and the quality of included studies was assessed.
Results: Of the 1,738 records screened, eleven studies met the inclusion criteria, comprising seven experimental and four non-experimental studies. Interventions included virtual and in-person guided walking, smartphone apps, animated audio-visual videos, animal-assisted therapy, nutritional programs, and incentivized community health worker models. Non-experimental studies reported on telehealth-delivered psychotherapies, vitamin D supplementation, and dietary interventions. These interventions were associated with reported improvements in physical activity, cognitive and social functioning, quality of life, and health behaviors, along with reductions in illness severity, self-stigma, and metabolic risk.
Conclusion: This review highlights a range of interventions reported to support the mental health of PLWS during the COVID-19 pandemic. While experimental studies suggest promising outcomes, findings from non-experimental designs require cautious interpretation. These insights may inform the development of flexible, evidence-informed strategies for PLWS in future public health crises.

Nurses’ perceived demands and burnout level in the critical care units during the COVID-19 pandemic crisis

Samah Abdulwahed Ali — 2025-06-02

Background & Aim: The coronavirus disease (COVID-19) pandemic challenged the physical and psychological well-being of critical care nurses because of the increasing number of infected patients, demands of care, and shortage of healthcare front-liners, particularly nurses. This study determined nurses’ perceived demands and the significant predictors of their burnout level in critical care units of tertiary hospitals in Saudi Arabia during the COVID-19 pandemic crisis.
Methods & Materials: This study used a cross-sectional research design. It was conducted from November to December 2021. Two hundred seventy nurses working in critical care units of tertiary hospitals in Saudi Arabia were surveyed using adopted questionnaires.
Results: The findings of this study revealed that the nurses’ demands concerning safety, communication, and relationships between team members, and psycho-socio-emotional aspects were moderate, whereas their demands concerning organization and decision-making were slight. Furthermore, nurses’ levels of emotional exhaustion and depersonalization/ loss of empathy were high, and personal accomplishment was low, which indicates a high level of occupational burnout. Interestingly, the correlations between the dimensions of burnout and perceived demands were highly significant (p<0.001).
Conclusion: The safety demands of critical care nurses significantly predicted emotional exhaustion due to an increased workload during COVID-19. The demands were significant predictors of depersonalization and personal accomplishment due to their perception that staff shortage, imbalanced workload, increasing care demand, and fatigue might have compromised the quality of patient care. Nurses experienced increased emotional distress and frustration in conveying their feelings of exhaustion, which led to high burnout levels during COVID-19.

Effects of red light on sleep quality in cardiac intensive care unit patients: A randomized controlled trial

Seyed Mahdi Motahary — 2025-05-31

Background & Aim: Sleep disturbances are prevalent in cardiac intensive care units. Due to the side effects of sleep medications, this study aimed to assess the impact of red light on the sleep quality of patients in cardiac intensive care units.
Methods & Materials: In a randomized clinical trial, 80 patients in both study groups were admitted to the coronary care unit of Shahid Beheshti Hospital in Kashan, Iran. In the intervention group, red light replaced the white light in the room for two consecutive nights. The sleep quality, insomnia severity, and frequency of insomnia causes of the patients in both groups were assessed before the intervention and on the first and second days after the intervention using the St. Mary's Hospital Sleep Quality Questionnaire.
Results: The sleep quality score of patients in the intervention group was higher after the intervention than in the control group (p=0.001). A statistically significant difference was observed between the two groups in the first and second days after that for sleep quality score, frequency of insomnia, and insomnia severity (P= 0.001). Comparing the scores of the dimensions of the Sleep Quality Questionnaire before and after the intervention in the two groups showed that the two groups did not have a statistically significant difference in these dimensions (p>0.017).
Conclusion: Red light led to an improvement in sleep quality scores and a reduction in the severity and frequency of insomnia in patients admitted to the cardiac intensive care units. Its simplicity and low cost make it a recommended approach for improving their sleep.

Preserving patient dignity in critical care units: A qualitative content analysis

Alireza Arman — 2025-04-23

Background & Aim: Patient dignity is a fundamental aspect of human rights, particularly when individuals are most vulnerable. Although maintaining patient dignity seemed to be challenging in Critical Care Units due to the complexity of medical procedures and critical condition of patients, a paucity of evidence exists exploring dignity preservation in Critical Care Units as well as its requirements from the patients' perspective. Thus, we aimed to explore patients’ dignity in Critical Care Units and the requirements for its preservation.
Methods & Materials: This qualitative study was conducted on 20 patients selected from the Critical Care Units of Imam Khomeini Hospital, Tehran, Iran, through purposeful sampling. Data were collected via semi-structured interviews and were analyzed using Graneheim and Lundman’s conventional content analysis method. Interviews explored patients' experiences and expectations regarding dignity preservation.
Results: The analysis revealed three main categories and nine subcategories essential for preserving patient dignity in Critical Care Units: (1) Care Ethics: Informed Decision-Making, Respecting Patient Concerns, and realistic interaction; (2) Humanity Preservation: Empathetic Acceptance, Avoiding Objectification, and Maintaining Patient Privacy; and (3) Personalized Care: Identifying Needs Proactively, Adapting Care to Individual Conditions, and Ensuring Comfort and Well-being. Participants emphasized the importance of empathetic communication, respect for their personal values and preferences, and maintaining a clean, comfortable environment.
Conclusion: The findings highlight the necessity for healthcare professionals to engage in ethical care, foster empathetic patient interactions, and proactively address the unique needs of each patient to enhance dignity preservation in critical care settings.