Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 10 14 367 376 Ahmadreza Rafiei Department of Neurosurgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran Reza Majidazar Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Sadeghi Department of Medicine, Islamic Azad University, Najafabad, Iran Mahdi Nabi Foodani Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran 2026 08 26 2026 10 12 Background & Aim: Suprasellar cavernous hemangioma is an exceptionally rare intracranial vascular malformation that can mimic more common sellar and suprasellar lesions. In patients with complex neurological conditions, continuity of nursing care may also be important for coordinating multidisciplinary management and supporting patient safety. This case report aims to describe the clinical presentation, diagnostic challenges, Nursing care, and surgical management of suprasellar cavernous hemangioma. Case Report: A 72-year-old woman presented with progressive right-eye visual impairment, followed by intermittent headaches, imbalance, gait instability, and recurrent falls. Brain MRI revealed a heterogeneous suprasellar lesion compressing the optic chiasm and right cavernous sinus, while digital subtraction angiography showed no vascular abnormalities. A thrombosed aneurysm and other suprasellar masses were considered in the differential diagnosis. Surgical resection was performed, and histopathological examination confirmed a cavernous hemangioma. During hospitalization, Primary Nursing was implemented to coordinate individualized neurological and functional assessments, fall prevention, perioperative care, postoperative monitoring, patient and family education, multidisciplinary communication, and discharge planning. Conclusion: This case highlights the diagnostic challenges of suprasellar cavernous hemangioma, particularly when progressive visual impairment is the initial and predominant manifestation. Persistent visual symptoms accompanied by headache, balance disturbances, or gait instability should prompt consideration of an intracranial cause and appropriate neuroimaging. The case also illustrates how Primary Nursing can provide a structured framework for continuity, individualized assessment, multidisciplinary communication, patient education, and safe transitions of care in patients undergoing complex neurosurgical treatment. https://npt.tums.ac.ir/index.php/npt/article/view/5617 https://npt.tums.ac.ir/index.php/npt/article/download/5617/711

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 09 01 377 390 EN Nor Nadiya Ab Ghani Department of Nursing, SEGi College Kuala Lumpur, Kuala Lumpur, Malaysia Aniawanis Makhtar Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Pahang, Malaysia Sharifah Munirah Syed Elias Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia Norfadzilah Ahmad Department of Professional Nursing Studies, Kulliyyah of Nursing, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Pahang, Malaysia Norliza Suut Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Sarawak, Malaysia 2026 05 11 2026 07 27 Background & Aim: Family caregivers of stroke survivors often assume complex responsibilities with limited preparation, while evidence on how best to support them remains fragmented. This review aimed to map evidence on family caregiver preparedness in stroke care and use the findings to develop a conceptual framework. Methods & Materials: A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to guidance for scoping reviews. MEDLINE via Ovid, PubMed, Scopus, ProQuest, and ScienceDirect were searched for peer-reviewed English-language studies published from 2014 to 2025. Quantitative, qualitative, and mixed-methods studies examining preparedness, related frameworks, tools, or interventions were included. Studies involving paid caregivers, paediatric stroke, or psychosocial outcomes without reference to preparedness were excluded. Findings were synthesised descriptively and thematically. Results: Twenty-two studies met the inclusion criteria. Four examined frameworks, assessment tools, or interventions, and 18 reported preparedness levels and associated factors. Preparedness was generally low to moderate. Three contextual domains shaped caregiving demands: stroke survivor clinical characteristics, caregiving roles and responsibilities, and family caregiver characteristics. Psychosocial and emotional factors and social and supportive resources moderated the relationship between demands and preparedness. These domains were integrated into a framework describing preparedness as a changing balance between caregiving demands and available resources across the stroke care continuum. Conclusion: Family caregiver preparedness is multidimensional and changes over time. The proposed framework may support assessment, follow-up, and intervention design, but requires empirical and stakeholder validation. https://npt.tums.ac.ir/index.php/npt/article/view/5156 https://npt.tums.ac.ir/index.php/npt/article/download/5156/712

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 09 26 391 403 Dwi Handayani Faculty of Public Health, Hasanuddin University, Makassar, Indonesia AND Department of Nursing, Pelamonia Institute of Health Sciences, Makassar, Indonesia Stang Stang Faculty of Public Health, Hasanuddin University, Makassar, Indonesia Masyita Muis Faculty of Public Health, Hasanuddin University, Makassar, Indonesia Veni Hadju Faculty of Public Health, Hasanuddin University, Makassar, Indonesia Ansariadi Ansariadi Faculty of Public Health, Hasanuddin University, Makassar, Indonesia Kadek Erika Department of Pediatric Nursing, Faculty of Nursing, Hasanuddin University, Makassar, Indonesia 2026 06 08 2026 06 29 Background & Aim: Hypertension remains a major global health challenge associated with cardiovascular morbidity and mortality. Brisk walking is widely recommended as a non-pharmacological strategy for blood pressure control; however, maintaining long-term adherence remains challenging. The integration of electronic health technologies into walking interventions may enhance motivation and behavioral engagement. This scoping review aimed to map digital behavior features and Behavior Change Techniques within eHealth-supported walking interventions for hypertension management. Methods & Materials: This scoping review followed the Arksey and O’Malley framework and adhered to PRISMA-ScR guidelines. Literature searches were conducted across PubMed, Scopus, ScienceDirect, ProQuest, and Google Scholar for studies published between 2016 and 2025. Eligible studies included adults with hypertension receiving electronic health-supported walking interventions incorporating digital behavior features and/or Behavior Change Techniques. Data were synthesized narratively. Results: A total of 21 studies were included. Frequently used eHealth technologies included mobile applications, wearable activity trackers, telemonitoring systems, and web-based platforms. Common digital behavior features included step monitoring, reminders, motivational messaging, personalized feedback, coaching support, and gamification. Frequently identified Behavior Change Techniques based on the Behavior Change Technique Taxonomy version 1 included goal setting, self-monitoring, feedback on behavior, prompts/cues, action planning, and social support. Most studies reported improved walking adherence, increased physical activity, enhanced self-management behaviors, and reduced blood pressure. Conclusion: Electronic health-supported walking interventions demonstrate potential for improving hypertension self-management through integrated digital behavior change strategies. Future studies should emphasize theory-driven intervention design and standardized Behavior Change Technique reporting. https://npt.tums.ac.ir/index.php/npt/article/view/5297 https://npt.tums.ac.ir/index.php/npt/article/download/5297/713

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 10 10 404 423 EN Maryam Imani Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran AND Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Monir Nobahar Department of Nursing, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran AND Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran 2026 07 22 2026 10 04 Background & Aim: Frailty is a common but heterogeneous geriatric syndrome, and numerous instruments have been developed for its assessment. Although several have been applied to older adults in Iran, their use has not been comprehensively mapped. This scoping review aimed to map frailty assessment instruments used among Iranian older adults and describe their characteristics and patterns of use. Methods & Materials: Following the methodological framework of Arksey and O'Malley and reported in accordance with PRISMA-ScR guidelines, we searched Scopus, PubMed, Web of Science, Embase, SID, and Magiran, supplemented by Google Scholar and reference-list screening. Primary studies involving adults aged ≥60 years in Iran that used a specific instrument or approach to assess frailty were eligible for inclusion. Studies published in Persian or English with accessible full text were considered, regardless of publication date. Results: Of 719 records identified, 77 studies met the eligibility criteria, identifying 13 instruments. The Fried Frailty Phenotype was most frequently used (31 studies; 40.3%), followed by the Tilburg Frailty Indicator (17; 22.1%) and Frailty Index (8; 10.4%); most instrument applications were community-based (54; 67.5%). Only nine instruments had independent psychometric evaluation in Iran (13 studies), while the FRAIL Scale, Clinical Frailty Scale, PRISMA-7, and Frailty Index for Elders had none. The Comprehensive Frailty Assessment Instrument-Plus covered the broadest range of frailty domains among the identified instruments but was infrequently used in Iranian studies. Conclusion: Frailty assessment in Iran relies mainly on the physical phenotype tool in community-dwelling older adults, with limited multidimensional coverage. No instrument was developed for this population, and several widely used tools lack local validation. Tool choice should match the assessment's purpose, and future studies should cover under-researched settings such as hospitals and nursing homes. https://npt.tums.ac.ir/index.php/npt/article/view/5462 https://npt.tums.ac.ir/index.php/npt/article/download/5462/714

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 09 01 424 436 Fatemeh Ghaedi-Heidari Department of Psychiatric Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Samira Abbasi Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Alireza Irajpour Department of Nursing and Midwifery, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Michael Linden Department of Psychosomatic Medicine, Charité University Medicine Berlin, Berlin, Germany Zahra Taheri Department of Sociology, Faculty of Social Sciences, Imam Khomeini International University, Qazvin, Iran 2026 05 21 2026 08 11 Background & Aim: Patients with mental disorders frequently experience limitations in activity and social participation, potentially disrupting recovery and social reintegration. Accurate assessment of these limitations is essential for treatment planning and rehabilitation. This study aimed to determine the validity and reliability of the Persian version of the Mini International Classification of Functionality, Disability and Health Rating for Activity and Participation Disorders in Psychological Illnesses. Methods & Materials: This methodological study was conducted in 2025 among patients discharged from the psychiatric wards. Following forward–backward translation, face and content validity were assessed by 11 experts. Construct validity was evaluated using Exploratory Factor Analysis, followed by Confirmatory Factor Analysis in 193 patients. Reliability was assessed using Cronbach's alpha and the Intraclass Correlation Coefficient. Results: All items demonstrated satisfactory face and content validity, with no item removed. Content Validity Ratio values ranged from 0.63 to 1.00, while the overall Scale-level Content Validity Index was 0.88, indicating acceptable but slightly below-threshold content validity. Exploratory Factor Analysis identified a three-factor structure explaining 51.13% of the total variance. Confirmatory Factor Analysis showed acceptable model fit. Cronbach's alpha was 0.76 overall, and the Intraclass Correlation Coefficient for the total scale was 0.796, indicating satisfactory internal consistency and stability. Conclusion: The Persian Mini International Classification of Functionality, Disability and Health Rating for Activity and Participation Disorders in Psychological Illnesses demonstrates acceptable face, content, and three-factor structural validity. However, the low internal consistency of the third factor and suboptimal Tucker–Lewis Index fit warrant caution in interpreting subscale scores. https://npt.tums.ac.ir/index.php/npt/article/view/5232 https://npt.tums.ac.ir/index.php/npt/article/download/5232/715

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 09 26 437 451 Sheraz Khan Center of Excellence for Enhancing Well-being in Vulnerable and Chronic Illness Populations, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand Ratsiri Thato Center of Excellence for Enhancing Well-being in Vulnerable and Chronic Illness Populations, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand 2026 05 16 2026 09 03 Background & Aim: Sexual health communication is central to adolescent nursing care, but its meaning remains conceptually inconsistent across nursing settings and adjacent disciplines. This conceptual ambiguity limits assessment, education, measurement, and service design. This study aimed to clarify sexual health communication in adolescent nursing care and identify its defining attributes, antecedents, consequences, and empirical referents. Methods & Materials: Walker and Avant's eight-step method guided the analysis. CINAHL, PubMed/MEDLINE, Scopus, ERIC, and the Cochrane Library were searched for English-language literature published from January 2000 to December 2025. A focused update through June 2026 used PubMed and backward and forward citation tracking. Full texts were assessed against predefined conceptual and disciplinary eligibility criteria, and data were extracted into a structured matrix. Nursing-specific evidence was prioritized for defining the concept. Thirty substantive sources were included. Results: Six defining attributes were identified: purposeful initiation and reciprocal adolescent participation; confidentiality enactment and interactional safety; accurate, clear, and developmentally responsive information exchange; responsive relational engagement during the encounter; timely, continuous, and care-linked communication; and contextually responsive and power-aware communication. Antecedents occurred at adolescent, professional, organizational, and sociocultural levels. Potential consequences included enhanced understanding, comfort and disclosure, follow-up, help-seeking, continued communication, and informed decision-making. Broader outcomes, including service access and equitable care, were considered potential distal implications. Existing measures capture selected components but not the complete nurse-adolescent concept. Conclusion: Sexual health communication in adolescent nursing care is a purposeful, reciprocal, confidentiality-protective, developmentally responsive, and clinically integrated nurse-adolescent interaction. The clarified concept provides a nursing-specific basis for education, clinical assessment, intervention design, and measure development and future validation across diverse cultures and nursing settings. https://npt.tums.ac.ir/index.php/npt/article/view/5179 https://npt.tums.ac.ir/index.php/npt/article/download/5179/716

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 09 26 452 464 EN Vachira Posai Division of Nursing, Ministry of Public Health, Nonthaburi, Thailand Uraiporn Janta-Um-Mou Division of Nursing, Ministry of Public Health, Nonthaburi, Thailand Kanogporn Jamsomboon Division of Nursing, Ministry of Public Health, Nonthaburi, Thailand Chanokporn Jitpanya Faculty of Nursing, Suan Dusit University, Bangkok, Thailand Jinpitcha Sathiyamas Faculty of Nursing, Kasetsart University, Bangkok, Thailand Niphon Watada Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand Nachaphat Jeenlakroy Boromarajonani College of Nursing, Sawanpracharak Nakhon Sawan, Faculty of Nursing, Praboromarajchanok Institute, Nakhon Sawan, Thailand 2026 06 06 2026 08 24 Background & Aim: Work-related stress can adversely affect nurses’ well-being, workforce stability, and quality of care. However, a culturally appropriate and psychometrically validated instrument for assessing psychosocial work-related stress among Thai nurses is needed. This study aimed to translate, culturally adapt, and psychometrically refine the Work-Related Stress Questionnaire (WRSQ) for Thai registered nurses. Methods & Materials: This two-phase methodological study translated and culturally adapted the WRSQ following international guidelines. The instrument was evaluated by five experts and pilot-tested with 30 nurses. Psychometric evaluation was conducted among 276 registered nurses from Ministry of Public Health hospitals, randomly allocated to exploratory and confirmatory samples. Exploratory factor analysis (EFA) examined factor structure and item performance, followed by confirmatory factor analysis (CFA) of competing models. Convergent validity, discriminant validity, and internal consistency were assessed. Results: The Thai WRSQ demonstrated excellent content validity (I-CVI and S-CVI/Ave = 1.00). EFA initially identified four factors broadly corresponding to the original WRSQ; however, the Job Demand domain lacked structural coherence. A revised 10-item, three-factor model excluding this domain showed the best CFA fit (χ²/df=1.66, CFI = 0.96, TLI= 0.94, RMSEA= 0.07, SRMR= 0.05). The retained domains demonstrated satisfactory convergent validity (CR= 0.79–0.85; AVE= 0.56–0.66), discriminant validity (AVE>MSV; HTMT= 0.09–0.79), and internal consistency (overall α = 0.82; ω = 0.85). Conclusions: The revised 10-item Thai WRSQ is a valid and reliable instrument for assessing psychosocial work-related stress among Thai registered nurses. https://npt.tums.ac.ir/index.php/npt/article/view/5286 https://npt.tums.ac.ir/index.php/npt/article/download/5286/721

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 10 06 465 479 Said Mubarak Alhakmani School of Nursing, College of Health Sciences, University of Nizwa, Nizwa, Oman Maryam Rassouli School of Nursing, College of Health Sciences, University of Nizwa, Nizwa, Oman Hadis Ashrafizadeh School of Nursing, Dezful University of Medical Sciences, Dezful, Iran Oscar Maramg Turingan School of Nursing, College of Health Sciences, University of Nizwa, Nizwa, Oman Salem Said Al Touby School of Nursing, College of Health Sciences, University of Nizwa, Nizwa, Oman 2026 07 25 2026 09 21 Background & Aim: Providing comprehensive, holistic care is a fundamental goal of healthcare systems, and palliative care constitutes an essential component of such care. Nurses' and physicians' attitudes may influence the integration of palliative care into routine clinical practice. This study aimed to characterize nurses' and physicians' knowledge of and attitudes toward palliative care, assess the relationship between these variables, and identify factors independently associated with attitudes in a secondary referral hospital in Oman. Methods & Materials: A cross-sectional descriptive correlational study was conducted among 280 nurses and physicians recruited through convenience sampling from clinical departments at Nizwa Hospital, Oman. Data were collected using a demographic questionnaire and the Health Care Providers' Knowledge and Attitude of Palliative Care Questionnaire. Descriptive statistics, nonparametric tests, Spearman's rank-order correlation, and hierarchical multiple linear regression were performed using IBM SPSS Statistics version 26.0. Results: The mean attitude and knowledge scores were 140.20 ± 13.47 and 18.60 ± 4.11, respectively. Knowledge and attitude scores showed a statistically significant, positive, moderate correlation (rₛ = 0.348, p < 0.001). In the final hierarchical regression model, higher knowledge scores were independently associated with higher attitude scores (β = 0.353, p < 0.001), and the model accounted for 21.0% of the variance in attitude scores. Conclusion: Knowledge was positively and moderately associated with attitudes toward palliative care, and this association persisted after adjustment for the examined variables. These findings may inform educational planning at the study hospital; however, given the cross-sectional design, they do not establish that higher knowledge leads to more favorable attitudes or improved quality of care. The effectiveness of educational programs should be evaluated in intervention studies. https://npt.tums.ac.ir/index.php/npt/article/view/5479 https://npt.tums.ac.ir/index.php/npt/article/download/5479/718

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 10 07 480 492 EN Faida Annisa Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand Penpaktr Uthis Center of Excellence for Enhancing Well-being in Vulnerable and Chronic Illness Populations, Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand 2026 05 25 2026 09 03 Background & Aim: Help-seeking is central to youth mental health research and nursing practice, yet existing models and instruments often assume that youth recognize distress as a problem requiring support. This concept analysis aimed to clarify youth mental health help-seeking, focusing on problem recognition as an early and rarely assessed component. Methods & Materials: Walker and Avant's eight-step method was used. Searches of PubMed, EBSCO, and Google Scholar focused on literature published during 2011-2026, with earlier seminal works retained. Thirty-two core sources were analyzed to examine conceptual uses, defining attributes, cases, antecedents, consequences, and empirical referents. Results: Help-seeking was conceptualized as a progressive process involving three defining attributes: recognition of a problem, intentional decision-making, and engagement with appropriate support sources. Antecedents included psychological distress or functional difficulty, mental health literacy, beliefs and stigma, trusted relationships, service accessibility, and support pathways. Consequences included improved mental health, enhanced coping, increased self-efficacy, normalization of help-seeking, and strengthened social connection. Empirical referents were identified for each attribute, although existing measures commonly assess attitudes, intentions, or behaviors and rarely assess problem recognition directly. Conclusion: Clarifying problem recognition as a defining attribute strengthens the conceptual foundation of youth mental health help-seeking and informs nurses' early assessment, therapeutic communication, mental health education, and timely referral across school, university, community, and clinical settings. https://npt.tums.ac.ir/index.php/npt/article/view/5241 https://npt.tums.ac.ir/index.php/npt/article/download/5241/719

Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 4 2026 10 13 493 515 Agung Waluyo Department of Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia Ikhwan Amirudin Department of Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia Anggri Zahra Department of Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia Chiyar Edison Department of Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia Liya Arista Department of Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia Bona Hutahaean Towards Healthy Mind, Body, and Sexuality Laboratory, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia Muh Taslim Department of Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia 2026 08 27 2026 10 04 Background & Aim: Spiritual conflict among LGBT individuals living with HIV may arise from intersecting sexual or gender identity, religious beliefs, and illness-related meanings. This study explored lived experiences of spiritual conflict in Lampung, Bengkulu, and Depok, Indonesia. Methods & Materials: This descriptive phenomenological study used Colaizzi’s seven-step method. Twenty purposively recruited participants (14 gay men, three bisexual men, and three transgender women) completed in-depth interviews from July to August 2026. Interviews addressed faith, identity, HIV diagnosis, spiritual struggle, coping, and reconciliation. Analysis identified significant statements, formulated meanings, clustered themes, and developed an essential structure. Trustworthiness was supported by member checking, reflexive journaling, peer debriefing, expert review, and an audit trail. Results: Five themes and 17 subthemes emerged: (1) recognizing the contradiction between faith and desire; (2) living with guilt and spiritual distress; (3) interpreting HIV as a spiritual turning point; (4) negotiating identity and faith; and (5) seeking reconciliation with God. Participants described tension between religious teachings and identity, guilt, self-blame, fear of divine punishment, spiritual distance, meaning reconstruction, and reconciliation. Spiritual conflict was overlapping and recursive rather than uniform or sequential. Participants moved between guilt and hope, spiritual distance and religious engagement, and self-rejection and acceptance. HIV diagnosis often prompted reflection, although its spiritual meaning varied. Conclusion: Spiritual conflict involved ongoing identity negotiation, moral interpretation, meaning reconstruction, and reconciliation. Spirituality could be both a source of distress and a resource for adaptation. https://npt.tums.ac.ir/index.php/npt/article/view/5627 https://npt.tums.ac.ir/index.php/npt/article/download/5627/720