Santo Imanuel Tonapa

Background: Nursing education requires innovative approaches to develop core competencies in knowledge, skills, and attitudes. Gamified learning interventions offer promising alternatives to traditional teaching methods for enhancing outcomes in undergraduate nursing education. Purpose: This systematic review and meta-analysis was conducted to evaluate the effectiveness of gamified learning interventions on knowledge acquisition, skill performance, and attitude enhancement among undergraduate nursing students and to investigate the differences in effects achieved across different gamification categories. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a comprehensive search was conducted across six databases (A+ Education, CINAHL, Embase, ERIC, PubMed, and Web of Science) on March 18, 2025. This search targeted randomized controlled trials designed to compare gamified learning with traditional teaching methods in undergraduate nursing education. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool, and evidence certainty was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. Results: The findings of randomized controlled trials involving a total of 1,698 participants demonstrated significantly positive effects favoring gamified learning across all key domains, including knowledge acquisition (standardized mean difference [SMD]=0.81, 95% CI [0.55, 1.07]), skill performance (SMD=1.64, 95% CI [0.96, 2.32]), and attitude enhancement (SMD=0.54, 95% CI [0.07, 1.00]). The subgroup analysis revealed differential effectiveness across gamification categories, with serious games demonstrating large and consistent effects on knowledge acquisition (SMD=0.84, 95% CI [0.43, 1.25], I ² =61%), while gamified web and mobile learning interventions showed moderate effects with greater variability (SMD=0.55, 95% CI [0.23, 0.87], I ² =70%). Skill performance exhibited the largest overall effect sizes, although substantial heterogeneity was observed across all outcome domains ( I ² =82–95%). The results of the GRADE assessment support moderate-certainty evidence for all learning outcomes. Conclusions: The results of this systematic review and meta-analysis provide robust evidence that gamified learning interventions significantly enhance undergraduate nursing education across the knowledge, skills, and attitudes domains. Serious games demonstrated superior consistency for knowledge acquisition, while the strongest overall effects were identified for skill performance. The substantial heterogeneity observed underscores the critical importance of selecting appropriate gamification approaches based on specific educational objectives, institutional technological capabilities, and implementation contexts. These findings support the strategic integration of evidence-based gamified learning into nursing curricula as an effective supplement to traditional teaching methods. Future research should focus on assessing long-term competency retention and developing standardized implementation frameworks to guide the widespread adoption of effective gamified learning approaches in nursing education.

This study aimed to evaluate the effectiveness of interprofessional collaborative practice interventions in improving activities of daily living, quality of life, length of stay, and in reducing mortality among older adults with hip fractures. Systematic review and meta‐analysis of randomized controlled trials. Eight databases including AgeLine, PubMed, Embase, CINAHL Ultimate, Scopus, MEDLINE Ultimate, Web of Science, and the Cochrane Library were searched from inception to November 2025. Two reviewers independently screened studies and assessed risk of bias using Cochrane Risk‐of‐Bias 2.0. Random‐effects meta‐analyses were performed. Certainty of evidence was evaluated using GRADE. Twelve randomized controlled trials met inclusion criteria. Interventions typically involved nurses working alongside geriatricians, orthopedic surgeons, and physiotherapists within structured co‐management pathways. Interprofessional collaborative practice was associated with a shorter hospital stay by a mean of 2.26 days. Activities of daily living improved by 4.86 points at 6 months and 3.92 points at 12 months on the Barthel Index. Health‐related quality of life improved modestly (Hedges’ G = 0.194), though this was not robust to sensitivity analysis. Mortality evidence was inconclusive at in‐hospital and 6‐month follow‐up. Certainty of evidence ranged from very low to low across outcomes. Interprofessional collaborative practice appears to improve functional recovery and may shorten hospital stay among older adults with hip fractures, though any mortality benefit remains unproven. Clinicians should consider adopting interprofessional hip fracture pathways spanning team rounds, early mobilization, medication reconciliation, and discharge planning, while future trials clarify effects on survival. Trial Registration: PROSPERO registration number: CRD42024573834

Preregistration nursing students may witness neonatal resuscitation during clinical placements, exposing them to high-intensity, life-and-death situations with potential emotional impact. The study aimed to describe the lived experiences of preregistration nursing students witnessing neonatal cardiopulmonary resuscitation in real clinical settings. A descriptive phenomenological study using a Husserlian approach was conducted in tertiary neonatal units in Indonesia. Twenty students were purposively sampled. Data were collected through semi-structured interviews and analyzed using Colaizzi’s method. The results of the study revealed 5 themes with 10 subthemes: (1) overwhelmed during neonatal resuscitation; (2) role uncertainty in neonatal resuscitation; (3) lingering emotional burden after resuscitation; (4) rebuilding coping and professional readiness through support; and (5) insufficient institutional support and stigma affecting help-seeking. Students experienced a profound gap between simulation and real-life exposure, marked by sensory overload, role ambiguity, and enduring emotional responses. Witnessing neonatal resuscitation represents an early confrontation with life-and-death care, generating emotional and moral challenges. Structured preparation, defined student roles, and systematic debriefing are essential to support students’ psychological well-being and professional development.

Introduction: This review aimed to synthesize the evidence on the effectiveness of dMBIs in reducing burnout, depression, and mindfulness among healthcare workers. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted according to the PRISMA 2020 guidelines. Six databases were searched through June 25, 2025. Eligible studies evaluated dMBIs among healthcare workers with burnout as a primary or secondary outcome. Standardized mean differences (SMDs) were pooled using a random-effects model. The risk of bias was assessed using the Cochrane Risk of Bias tool, version 2.0. Results: Nine RCTs were included, with 1,603 participants contributing to the analyzable data. dMBIs reduced emotional exhaustion (SMD = −0.34; 95% CI: −0.60 to −0.07) and depersonalization (SMD = −0.31; 95% CI: −0.55 to −0.07), and increased personal accomplishment (SMD = 0.48; 95% CI: 0.16 to 0.80). The dMBIs also improved mindfulness (SMD = 0.44; 95% CI: 0.07 to 0.82) and reduced depressive symptoms (SMD = −0.20; 95% CI: −0.37 to −0.03). The heterogeneity was moderate to high, and most studies were at a high risk of bias. Conclusions: dMBIs may improve burnout, mindfulness, and depression in healthcare workers, and their flexible digital format may support their use in workplace wellness programmes. However, the heterogeneity was moderate to high, and most trials were at a high risk of bias; therefore, the findings should be interpreted cautiously. Further high-quality trials are needed to confirm these effects and to identify the best delivery formats and engagement strategies.

Introduction: Although community-based traditional Chinese exercises (CTCEs) are increasingly recognized for their benefits on sleep, their effectiveness among community-dwelling older adults across diverse settings remains unclear. This study aimed to synthesize the effects of CTCEs on sleep disturbance in this population. Methods: Seven databases were searched for relevant articles published up to August 2025. Studies were appraised using the Cochrane risk-of-bias tool. A pairwise meta-analysis, subgroup analysis, and meta-regression were conducted using Comprehensive Meta-Analysis software. Results: Thirteen studies met criteria. CTCEs are effective in reducing sleep disturbance among older adults. Both Qigong and tai chi improved sleep; Qigong showed a slightly larger effect size than tai chi, but the difference between modality was not significant. Meta-regression detected no significant moderators. Conclusion: As a nonpharmacological strategy, CTCEs appear to reduce sleep disturbance in community-dwelling older adults. These findings support their integration into community-based health initiatives for aging populations.

Background: Persistent postinjury symptoms such as pain, depressive symptoms, and reduced quality of life can impede rehabilitation and delay recovery in older adults with limb fractures. Digitally enhanced, nurse‐led discharge teaching presents a promising approach to address these challenges, yet its effectiveness in geriatric limb trauma remains underexplored. This study evaluated the effects of a digitally enhanced nursing discharge teaching program on pain intensity, depressive symptoms, and quality of life in older adults with limb fractures. Methods: A nonrandomized, single‐blind, parallel‐group controlled trial enrolled 90 older adults with limb fractures at a tertiary center from January 2023 to February 2024; 76 completed all assessments. The experimental group received nurse‐led discharge teaching using a teach‐back method and an interactive digital book, delivered in person three days before discharge and reinforced through telephone follow‐up over two weeks. The control group received standard discharge care. Quality of life was the primary outcome; depressive symptoms and pain intensity were secondary outcomes. Outcomes were measured at baseline, two weeks, and six weeks postdischarge. Generalized estimating equations were used to assess group‐by‐time interaction effects. Results: Of 76 completers (mean age: 69.25 ± 3.76 years; 81.6% female), attrition was nondifferential (seven per group, 15.6%). Compared to the control group at six weeks, the experimental group showed greater reductions in pain intensity ( B = −1.95, 95% CI: [‐2.90, −0.99], p < 0.001) and depressive symptoms ( B = −1.05, 95% CI: [‐1.68, −0.42], p = 0.001), and greater improvement in quality of life ( B = 12.50, 95% CI: [4.34, 20.66], p = 0.003). No significant between‐group differences were found at the two‐week follow‐up. Conclusion: Digitally enhanced, nurse‐led discharge teaching improved pain, depressive symptoms, and quality of life in older adults with limb fractures over a six‐week period. Although short‐term effects were limited, the intervention shows promise in enhancing recovery outcomes. Additional refinement and long‐term evaluation are required before it can be implemented more widely. Implications for Nursing Management: This study highlights the value of integrating digitally enhanced nursing discharge teaching into transitional care planning, which may improve post‐injury outcomes and support recovery management in older adult patients. Trial Registration: ClinicalTrials.gov identifier: NCT05176054

Background: Working-age individuals with mild traumatic brain injury (mTBI) often experience persistent postconcussion symptoms (PCSs) that significantly impair their quality of life (QoL). Posttraumatic stress disorder (PTSD) may act as a psychological mechanism linking PCSs to a poorer QoL, whereas illness perception may influence the extent to which PCSs lead to PTSD; these relationships have not been tested. Establishing this moderated mediation pathway is critical for identifying patients at a heightened psychological risk and informing early intervention strategies to optimize postacute rehabilitation outcomes. Objective: This study examined the mediating role of PTSD in the relationship between PCSs and QoL, as well as the moderating effect of illness perception on these associations. Methods: A longitudinal study was conducted among 120 working-age individuals with mTBI in Indonesia. PCSs and illness perception were assessed at discharge, PTSD was measured at 1 month, and QoL was measured at 3 months postdischarge. A moderated mediation analysis was performed using Hayes' macro, PROCESS Model 7. Results: PCSs at discharge were associated with poorer QoL at 3 months, with PTSD fully mediating this relationship. Illness perception moderated the effect of PCSs on PTSD, with more negative perceptions intensifying symptoms. The indirect effect of PCSs on QoL through PTSD was stronger among individuals prone to negative illness perception. Discussion: PTSD plays a critical role in mediating the relationship between PCSs and QoL, whereas negative illness perception further amplifies this indirect effect, leading to a poorer QoL 3 months postinjury. These findings confirm the presence of a moderated mediation pathway, highlighting the need for early psychological screening and targeted interventions that address both PTSD and negative illness perception. Integrating these strategies into postacute rehabilitation may improve long-term recovery outcomes in working-age individuals with mTBI.

Purpose: Despite evidence supporting nurse‐led digitalized diabetes interventions, gaps persist in understanding their specific impact on community‐dwelling patients with type 2 diabetes mellitus (T2DM). Prior reviews lacked a quantitative synthesis of these interventions' effects on outcomes like self‐care, HbA1c, and quality of life (QoL), limiting their applicability to clinical practice. This study aimed to systematically evaluate and quantify the effectiveness of nurse‐led digitalized diabetes management programmes for community‐dwelling adults with T2DM. Methods: We searched six databases to identify relevant articles from their inception to June 2024. Randomized controlled trials that evaluate the effects of nurse‐led digitalized diabetes management programs for community‐dwelling patients with T2DM were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise the included studies. The pairwise meta‐analysis was performed through the software Comprehensive Meta‐Analysis Version 3.0. Results: Eleven RCTs were included, encompassing 2943 participants from various regions. Nurse‐led digitalized programs significantly improved self‐care behaviors (SMD = 1.15; 95% CI: 0.49 to 1.81), and QoL (SMD = 0.65; 95% CI: 0.37 to 0.94). The interventions also demonstrated a clinically meaningful reduction in HbA1c levels (MD = ‐0.25%; 95% CI: −0.43 to −0.06), highlighting their potential in improving glycaemic control. Heterogeneity across studies was substantial for self‐care but moderate for HbA1c and QoL. Conclusions: Nurse‐led digitalised diabetes management programmes effectively enhance self‐care behavior, reduce HbA1c levels, and improve QoL among community‐dwelling patients with T2DM. These findings underscore the potential of digitalised interventions as scalable and accessible alternatives to traditional diabetes management, particularly in non‐institutionalized settings. Clinical Relevance: Nurse‐led digitalised diabetes management programmes can empower community‐dwelling patients with T2DM to achieve better health outcomes by enhancing self‐care and glycaemic control while improving QoL. Their integration into routine clinical practice could address barriers to care, optimize diabetes management, and reduce the long‐term burden of the disease. Review Registration: The International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42024594874