Evans Appiah Osei

Background: Clinical rotation, also known as national service in Ghana, is a compulsory one-year program in which newly qualified nurses transition into professional practice. However, this period is often marked by several challenges that newly qualified nurses must navigate. Aim/objective: This study explored the experiences of newly qualified nurses during their clinical rotation in Ghana, with particular attention to supervisory practices, financial challenges, living and commuting conditions, and nurses’ perceptions of the rotation program. Methods: A qualitative exploratory design was employed. Participants were selected using purposive sampling technique. Data were collected through face-to-face in-depth interviews with 36 rotation nurses from the Western Region of Ghana using a semi-structured interview guide. The sample size was determined by data saturation. Content analysis was performed to identify themes and subthemes. Results: Three main themes emerged: Supervisory Experiences During Clinical Rotation: Most participants experienced stringent supervision and were often assigned tasks outside their clinical duties. Financial Struggles and Living Conditions: Some nurses faced delays and inadequacies in financial compensation, high living costs, and geographical barriers. Perceptions of the Clinical Rotation Program: While some viewed rotation as essential for professional development, others felt exploited as cheap labor. Conclusion: Participants described clinical rotation as both an important learning period and a time of significant strain. Strict supervision, financial hardship, and a sense of being undervalued were common experiences that shaped their daily work. These accounts highlight the need for rotation practices that better reflect and respond to the realities newly qualified nurses face as they enter the profession.

Background: Artificial intelligence (AI) is increasingly used in mental health care to address rising demand, workforce shortages and access barriers; however, evidence remains scattered across multiple systematic reviews, limiting synthesis and practical application. Objective: To synthesise evidence on AI applications in mental health care, including trends, uses, benefits, challenges and risk‐mitigation strategies, guided by an ethics of care framework. Methods: This umbrella review of systematic reviews followed the PRISMA 2020 guidelines. Five databases (Web of Science, Scopus, PubMed, PsycINFO and CINAHL) were searched for peer‐reviewed studies published between 2021 and 2025, with additional studies identified through backward and forward citation tracking. Eligible studies were systematic reviews examining artificial intelligence (AI) applications in mental health care involving human participants. Exclusion criteria included non‐systematic reviews, non‐AI studies, grey literature and non‐English publications. Three reviewers independently screened titles, abstracts and full texts according to predefined inclusion and exclusion criteria. Methodological quality was assessed using the AMSTAR‐2 tool, and data were extracted on AI type, mental health focus, end‐user applications, benefits and challenges. Extracted data were analysed thematically using an iterative coding process to identify recurring patterns on AI type, mental health focus, applications, benefits and challenges. Results: Twenty‐seven systematic reviews with over 14 million participants were included. Findings converged across four primary themes. First, AI enhances early detection and risk stratification, particularly for depression, anxiety, stress, PTSD and suicidal ideation. Second, AI‐enabled digital tools, such as chatbots and mobile platforms, expand access and engagement by supporting symptom monitoring, self‐management and continuity of care. Third, structural and ethical fragilities were noted, including data bias, limited external validity, methodological heterogeneity and insufficient transparency. Fourth, AI demonstrated greatest value when embedded within human‐centred, hybrid care models that preserve clinical judgement, relational care and accountability. Evidence supporting AI applications was stronger for screening and predictive tasks than for sustained therapeutic interventions. Among the 54 reviews assessed for methodological quality, 27 achieved moderate or high confidence ratings on the AMSTAR‐2 tool, with stronger evidence observed in reviews evaluating AI interventions for early detection and risk prediction. Conclusion: Artificial intelligence (AI) has significant potential to enhance mental health nursing by supporting early identification of symptoms, improving access to care and strengthening clinical decision‐making. For nursing practice, responsible implementation requires rigorous validation, equity‐focused design, transparency and sustained human oversight. Integrating AI within an ethics‐of‐care framework ensures that these technologies support person‐centred, relational nursing care rather than replacing the critical role of nurses in therapeutic engagement and clinical judgement.

Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are rising public health concerns in low- and middle-income countries such as Ghana, where late diagnosis and limited access to renal replacement therapy are common. Qualitative evidence on their lived experiences in Ghana remains limited. Aim: To explore the lived experiences and challenges of patients with CKD and ESRD receiving hemodialysis in Ghana. Methods: An exploratory descriptive qualitative study was conducted with 17 patients with CKD/ESRD on hemodialysis for at least six months at Ho Teaching Hospital, Ghana. Data were collected through face-to-face semi-structured interviews (July–August 2025), audio-recorded, transcribed verbatim, and analyzed using conventional content analysis. Reflexivity and team-based coding ensured rigor. Results: Three themes emerged: (1) Structural and health system failures shaping illness trajectories, encompassing delayed and misdiagnosis, perceived neglect, limited dialysis availability, and severe financial hardship; (2) Fear of death and loss of self, reflecting persistent mortality anxiety, and identity disruption and (3) Endurance through relationships, faith, and treatment-related hope, highlighting the critical role of family support, spiritual coping, and temporary symptom relief from dialysis in sustaining resilience. Conclusion: Patients with CKD/ESRD in Ghana face significant structural, financial, and psychosocial challenges that affect their illness experience and treatment engagement. Although family support, faith, and symptom relief promote resilience, they do not compensate for gaps in renal care. Improving early diagnosis, equitable dialysis access, psychosocial integration, and policy reform is essential to enhance outcomes and quality of life.

Background: Nurses constitute the largest segment of the healthcare workforce, yet they are frequently undervalued within health systems and society. This study explored how nurse managers empower registered nurses and how such empowerment shapes nursing practice, professional identity and care delivery within a resource-constrained Ghanaian hospital. Methods: A qualitative descriptive exploratory design was used. Seventeen registered nurses were purposively sampled. Data were collected through semi-structured, face-to-face interviews and analysed using qualitative content analysis, supported by reflexivity, peer debriefing and data saturation. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guided the reporting of the study. Results: Two themes were identified: (1) Nurse Empowerment in Low-Resource Clinical Settings and (2) Organisational and Leadership Influences on Empowerment. Empowerment enhanced retention, advocacy, autonomy and quality care. Supportive leadership, recognition, training and shared decision-making facilitated empowerment; whereas autocratic leadership, favouritism, limited resources and gender-related challenges hindered empowerment. Conclusion: Nurse manager-led empowerment strengthens nurses’ confidence, autonomy and care quality. Culturally responsive leadership, equitable recognition, staff development and inclusive decision-making are essential for sustaining the nursing workforce and improving patient outcomes through advocacy, high-quality care and error reduction in Ghana.

Stillbirth remains a profound public health, psychological, and social concern, particularly in low- and middle-income settings where bereavement support i

Background: Research is essential for evidence-based nursing practice. However, in low- and middle-income countries like Nigeria, clinical nurses face multiple barriers to engaging in research, emphasis on research-informed care, and recognition of the need for culturally specific nursing research. Objective: This study examined factors influencing clinical nurses’ research involvement in Nigerian practice settings, guided by Bandura’s Social Cognitive Theory. Methods: A qualitative Interpretive Phenomenological Analysis (IPA) approach was used. Data were gathered via in-depth semi-structured interviews with 28 clinical nurses at a Nigerian tertiary hospital. Thematic analysis was informed by Social Cognitive Theory. Results: Three major themes were identified: (1) lack of cultural recognition and structural barriers, including systemic constraints and weak organisational leadership; (2) profession-related barriers, such as low research confidence, perceived irrelevance to clinical work, and motivation tied to academic demands and (3) practice-related barriers, involving peer influence, a weak nursing research culture, and shift work challenges. These factors impact nurses’ attitudes, motivation, and ability to participate in research. Conclusion: Clinical nurses’ research participation is hindered by structural, personal, and organisational barriers. Enhancing institutional support, research training, mentorship, and accommodating work environments can improve engagement. Building research self-efficacy and fostering a culture that rewards research may further sustain involvement.

Male first responders face high occupational stress and health risks, influenced by structural barriers and masculine norms. This cross-sectional study examined men’s health knowledge, perceived barriers to care, traditional masculinity norms, and health behaviors among 102 male first responders. Descriptive statistics were computed, and nonparametric tests and Spearman correlations evaluated associations with key outcomes, including omission of pertinent health information during clinical encounters. Scale reliability was strong (men’s health knowledge α = 0.92; barriers α = 0.77; masculinity norms α = 0.78). Mean age was 44.9 years ( SD 13.5); mean BMI was 30.8 ( SD 5.6, n = 84), with 53.6% classified as obese/severely obese. A total of 22.0% ( n = 91) endorsed Yes/Maybe to having omitted pertinent health information from a provider. Men endorsing omission reported higher overall barriers (Mann–Whitney, p = .0268, r = .325), driven by lack of time (pFDR = .0055, r = .453) and limited awareness of services (pFDR = .0467, r = .332). Traditional masculinity norms differed by occupation (Kruskal–Wallis, p = .00211, ε ² = .117), with police scoring higher than firefighters and EMS. Provider satisfaction was inversely associated with barriers (ρ = −.273, pFDR = .0206) and masculinity norms (ρ = −.295, pFDR = .0142). Diet and exercise correlated positively with self-rated health and body image, whereas BMI correlated negatively. Findings support MANifest Health Theory: selective disclosure is shaped by “maintenance friction” (time/awareness barriers) interacting with masculinity-aligned identity needs. Interventions reducing access friction and framing care as readiness maintenance may improve disclosure.

Background: Financial stress can lead to emotional and psychosocial distress among informal caregivers of older adults and can have a profound impact on their overall well-being. While social support may buffer financial stress, the role of gender in moderating these relationships is less understood. This study examined whether gender moderates the associations between psychosocial distress, social support, and financial well-being among informal caregivers of older adults. Methods: A cross-sectional survey was conducted between December 2023 and March 2024 among 589 informal caregivers of older adults residing in twelve rural states in the North Central United States. After applying listwise deletion for missing data, 533 caregivers with complete responses were retained for the final analysis. Financial well-being was measured using the Consumer Financial Protection Bureau (CFPB) Financial Well-Being Scale, psychosocial distress with a five-item distress scale, and social support with the OSSS-3. Gender, sociodemographic characteristics, and caregiving status were also collected. Independent t-tests, ANOVA, Pearson correlations, and multivariable linear regressions with interaction terms were used to assess the relationships among the study variables. Results: Male caregivers reported significantly higher financial well-being than females (52.66 vs. 50.12, p = 0.036). Stronger social support was associated with greater financial well-being (mean difference = 11.80, p < 0.001). Psychosocial distress was negatively correlated with financial well-being (r = –0.49, p < 0.001). Regression analyses revealed significant gender moderation: distress reduced financial well-being more sharply for males, while strong social support benefited females more substantially than males. Older age, higher income, and better self-rated health were also positively associated with financial well-being. Conclusions: Findings highlight gender-specific patterns in how psychosocial distress and social support influence financial well-being among informal caregivers. Future programs should consider gender-specific needs while addressing psychosocial and financial well-being of informal caregivers of older adults.

Black/African American women with breast and gynecologic cancers face stark end-of-life (EOL) inequities rooted in structural racism, gendered oppression, and financial toxicity. Despite abundant evidence of outcome gaps, theory-driven guidance for equitable, culturally responsive EOL care is limited. This narrative review argues for integrating Critical Race Theory (CRT) and Critical Feminist Theory (CFT) into EOL care frameworks to address the cultural and financial needs of Black/African American women. Drawing on interdisciplinary literature from healthcare, philosophy, sociology, and economics, we examined systemic barriers at the end of life, critiqued current care models, and illustrated how CRT and CFT provide transformative frameworks for clinical practices, research, and policy reform. We summarize philosophical views of death and dying and cultural perspectives on grief and end-of-life practices, then analyze disparities in death, dying, and EOL care especially financial inequities and roles of structural racism and gender-based oppression. Finally, we presented how CRT and CFT illuminate the complex interplay of race, gender, and socioeconomic status and inform structural transformation. Embedding CRT and CFT in healthcare systems is essential to advancing inclusive, justice-oriented EOL care models that reflect lived realities and promote dignity, equity, and culturally attuned support.