Jiao Sun

Introduction: In German-speaking countries, where geriatric care faces a persistent nursing shortage, nursing students are expected to play a key role in addressing future workforce needs. Currently, there is a lack of valid and reliable instruments to assess nursing students’ willingness to work with older adults. This cross-sectional study aimed to validate the German version of the Willingness to Work with Elderly People (WEPS-D) Scale and examine factors associated with the willingness to work with older adults to support geriatric workforce development in nursing education. Methods: A convenience sample of 207 German-speaking nursing students completed the survey, including 52 students who participated in a 4-week retest. Structural validity was evaluated using exploratory factor analysis (EFA), while convergent validity was assessed through correlations with the Kogan Attitudes toward Older People Scale (KAOP), Age Stereotypes (AS), and Future Self-views (FS). Internal consistency and test–retest reliability were examined. In addition, multiple linear regression was used to identify factors independently associated with willingness to work with older adults. Results: EFA identified a four-factor structure (intention, perceived behavioral control, attitude, and subjective norm) with 20 items, explaining 49.01% of the total variance. Convergent validity was supported at the factor level, with factor 3 (Attitude) showing a moderate correlation with the KAOP ( r = 0.515, p < 0.01), while the total WEPS-D score showed a lower correlation ( r = 0.385, p < 0.01) that did not meet the pre-specified criterion. At the scale level, internal consistency (Cronbach’s α = 0.894, McDonald’s ω = 0.902) and test–retest reliability (ICC = 0.882) were good, although factors 3 (Attitude) and 4 (Subjective norm) showed relatively low internal consistency. Multiple linear regression showed that higher education and negative or neutral attitudes toward aging were significantly associated with lower WEPS-D scores compared with vocational training and positive attitudes, respectively. Conclusion: The WEPS-D is a valid and reliable tool for assessing nursing students’ willingness to work with older adults. It can be used in schools to identify the potential workforce in geriatric nursing and guide early educational interventions.

BACKGROUND Liver transplant candidates and recipients require continuous care throughout the transplant trajectory, including pretransplant prehabilitation and long-term posttransplant management. Conventional care models are constrained by time, distance, and limited health care resources and may therefore be insufficient to meet patients’ needs across the continuum of care. Digital health technologies offer new approaches to remote care delivery and self-management support in liver transplantation. OBJECTIVE This scoping review aimed to map the technological modalities, intervention components, outcome measures, and implementation issues associated with digital health technologies used across the care continuum for adult liver transplant candidates and recipients and to inform the development of specialty-specific digital continuity-of-care interventions. METHODS Nine English- and Chinese-language databases—PubMed, Embase, CINAHL, Web of Science, the Cochrane Library, CNKI (China National Knowledge Infrastructure), Wanfang Data, VIP Database, and SinoMed—were searched from inception through July 10, 2026. Original quantitative, qualitative, and mixed methods studies involving adult liver transplant candidates or recipients and the use of mobile health technologies for care beyond conventional in-person settings were eligible. The review followed the Arksey and O’Malley framework, refined using Joanna Briggs Institute (JBI) methodology for scoping reviews, and was reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. RESULTS The search identified 7,746 records, of which 28 studies were included. The technologies comprised mobile health apps (n=8), telehealth platforms or remote management systems (n=24), intelligent robots (n=3), portable wearable or mobile devices (n=4), and internet-based communication technologies (n=20); several studies combined multiple modalities. Intervention components included remote education (n=22), remote data monitoring or health assessment (n=16), teleconsultation (n=14), psychosocial support (n=10), and remote rehabilitation (n=8). Reported outcomes covered physiological or functional status (n=7), psychosocial outcomes (n=5), clinical and health service use outcomes (n=10), self-management–related outcomes (n=17), health-related quality of life (n=7), and implementation outcomes or patient experience (n=15). The evidence suggested potential value for patient education, follow-up communication, self-management support, medication management, and rehabilitation. However, substantial heterogeneity in intervention models, follow-up periods, outcome measures, and assessment instruments precluded quantitative synthesis and firm conclusions. CONCLUSIONS Digital health technologies have potential to support continuity of care across the liver transplant trajectory. However, the evidence base remains limited by small samples, frequent single-center designs, methodological inconsistency, and heterogeneous outcomes. Future research should use rigorous multicenter designs, standardized intervention frameworks and outcome reporting, and stage-specific strategies that account for patients’ digital health literacy and access.

Aim: To examine the association between advanced practice nursing roles and outcomes among individuals with chronic kidney disease. Background: Chronic kidney disease presents major health challenges. Advanced practice nurses in nephrology can improve patients’ quality of life and reduce health‐care costs, although inconsistent findings in the literature have hindered widespread adoption of such nursing. Design: A systematic review following the Cochrane Collaboration guidelines. Search Strategy: Randomized controlled trials on advanced practice nurses and individuals with chronic kidney disease were included. Databases (PubMed, Web of Science, CINHAL, Embase, Cochrane Database, Joanna Briggs Database, and Scopus) were searched from inception to November 2025. Results: Eight randomized controlled trials and one secondary analysis were included. The roles of advanced practice nurses were delineated into two models: a collaborative model of management with physicians and an extended model of leading specific interventions. Thirty‐two outcomes were identified, comprising 31 patient outcomes and one organizational outcome. Positive effects were observed for certain patient outcomes, including blood pressure control, renal endpoint reduction, and patient experience; however, these findings were inconsistent across studies. No significant effects were found for organizational outcomes. Conclusion: Advanced practice nurses demonstrate potential for improving selected patient outcomes in patients with chronic kidney disease, although evidence for organizational outcomes remains limited. Implications for Nursing: Policymakers and hospital administrators should explore care models for individuals with chronic kidney disease and expand the scope of practice for advanced practice nurses. Implications for Health Policy: Policymakers should clarify the scope of practice and prescribing authority for advanced practice nurses, establish sound certification and continuing education systems, develop reasonable reimbursement mechanisms, and promote standardized interprofessional collaboration.