Sharifah Shafinaz Sh Abdullah

Background: Although various educators integrate technological, pedagogical, and content knowledge (TPACK) into their teaching, limited evidence exists on its use and effectiveness among nurse educators in relation to students’ learning outcomes. Objective: To evaluate the learning outcomes of nursing students following the implementation of lessons redesigned by nurse educators using a TPACK-based teaching module (TPACK-N). Method: A pre-post intervention study was conducted from March to June 2026, involving a single group of 63 nursing students taught by nurse educators who had completed six hours of training. The educators restructured lessons from their own teaching modules to align with TPACK-N materials. Assessments aligned with lesson objectives were administered before and after the redesigned teaching, and scores were converted to percentages. Paired differences were examined using a two-tailed paired-samples t-test, with Cohen’s dz used to estimate effect size. Results: The paired difference scores did not significantly deviate from normality (Shapiro–Wilk W = .970, p = .134). The mean pre-test score was 73.46 (SD = 7.09), increasing to 88.70 (SD = 7.49) at post-test. The mean increase was 15.24 points (95% CI: 14.33–16.14), t(62) = 33.60, p < .001. The within-participant effect size was large (Cohen’s dz = 4.23, 95% CI: 3.45–5.01). Conclusion: The intervention used in this study improved students' learning outcomes. Further controlled studies with larger and more diverse cohorts are recommended to confirm causality and evaluate longer-term outcomes in nursing education.

Background: Multidimensional frailty is highly prevalent among older adults residing in long-term care facilities (LTCFs). However, the structural interrelationships among physical, psychological, social, cognitive, and functional health domains remain insufficiently understood. Objective: To characterize the network structure of multidimensional frailty domains and related health indicators among institutionalized older adults. Methods: This cross-sectional study included 272 LTCF residents from Liaoning, China. Eleven theoretically selected health indicators were modeled using a Mixed Graphical Model with ℓ1-regularized neighborhood regression and model selection based on the Extended Bayesian Information Criterion (γ = 0.25). This approach estimates sparse conditional dependence structures among mixed data types. Strength centrality was used as the primary descriptive metric. Network accuracy and stability were evaluated using non-parametric and case-dropping bootstrap procedures. Results: The strongest conditional association emerged between age and cognitive impairment (edge weight = 0.68). Substantial associations were also observed between physical frailty and ADL dependency (edge weight = 0.43), and between psychological frailty and depressive symptoms (edge weight = 0.45). Physical frailty, ADL dependency, and depression exhibited relatively high strength centrality values; however, bootstrap difference tests indicated that these nodes were not statistically more central than several other highly connected indicators. The correlation stability coefficient for strength centrality was 0.75, indicating good stability of strength centrality estimates within this sample. Conclusion: The network revealed an interconnected pattern linking functional dependency, physical frailty, and psychosocial health among LTCF residents. Because the data were cross-sectional, the observed conditional associations should not be interpreted as causal or temporal pathways. These findings highlight the potential value of multidomain nursing assessment in long-term care settings and may inform hypothesis generation for future longitudinal or interventional nursing studies.

Anaemia during pregnancy continues to be a major public health concern worldwide, affecting a substantial proportion of expectant mothers and contributing to adverse maternal and neonatal outcomes. This scoping review explores the role of antenatal education in reducing the risk of anemia by examining the types of educational strategies used, their reported outcomes, and existing gaps in current practice. The review was guided by the Arksey and O’Malley framework and reported in line with PRISMA-ScR recommendations. Relevant experimental studies published between 2000 and 2024 were identified from four electronic databases. Following a rigorous screening process, 11 studies were included. Overall, the findings suggest that antenatal education delivered through approaches such as community-based counseling, digital communication, visual or art-based methods, and home visits can improve maternal knowledge, increase adherence to iron and folic acid supplementation, and raise hemoglobin levels. However, the effectiveness of these interventions appears to vary depending on contextual factors, including cultural background, literacy levels, and the extent to which behavioural theories are applied. In conclusion, while antenatal education shows clear potential in reducing anaemia risk, future interventions should place greater emphasis on theory-driven design, cultural relevance, and long-term evaluation. Digital platforms, in particular, may offer practical opportunities to enhance accessibility and engagement, especially in resource-limited settings.

Introduction: Spiritual care is essential in holistic nursing; however, nursing students often feel less confident and reflective in providing it. Innovative teaching methods combining active learning and reflection are needed to fill this gap. Objective: This study evaluated the impact of reflective, flipped-classroom spiritual care training on students' self-efficacy and reflective thinking. Methods: A quasi-experimental pretest–posttest design with a control group was conducted among 82 undergraduate nursing students from two universities in Indonesia. Participants were allocated to an intervention group (n = 41) or a control group (n = 41) based on existing class enrollment. The intervention consisted of a 16-week reflective flipped classroom supported by an interactive e-module, while the control group received conventional lecture-based instruction. Self-efficacy and reflective thinking were measured at baseline and post-intervention. Data normality was assessed using the Shapiro–Wilk test. Within-group differences were analyzed using the Wilcoxon signed-rank test or paired sample t-test as appropriate, and between-group differences were examined using the Mann–Whitney U test. Results: Within-group analyses showed statistically significant improvements in self-efficacy and reflective thinking in the intervention group (p < 0.001). In the control group, changes in reflective thinking were not statistically significant (p = 0.062). Between-group post-test comparisons demonstrated significantly higher self-efficacy and reflective thinking scores in the intervention group than in the control group (p < 0.001), with a large effect (r = 0.67 for self-efficacy and r = 0.61 for reflective thinking). Conclusion: The findings indicate that a reflective flipped classroom approach is associated with higher self-efficacy and reflective thinking among nursing students in spiritual care education. While causal conclusions cannot be drawn, the results support the educational value of reflective and interactive learning strategies in undergraduate nursing curricula.

Introduction: The COVID-19 pandemic triggered an abrupt global transition to Online Distance Learning (ODL), posing significant challenges for nursing education, which depends heavily on hands-on clinical experiences. Although nursing students reported varying degrees of satisfaction with online learning, the extent to which these perceptions influenced academic success remained unclear. Methods: A cross-sectional study was conducted among 164 undergraduate nursing students at Universiti Kuala Lumpur Royal College of Medicine Perak (UniKL RCMP) between August 2023 and January 2024. Participants completed a sociodemographic questionnaire, a validated 20-item Learning Satisfaction Scale, and provided their cumulative Grade Point Average (GPA). Descriptive statistics were used to summarise participant characteristics and satisfaction levels, while Spearman’s rank-order correlation assessed the relationship between learning satisfaction and academic performance. Results: Most participants were female (82.3%) and aged between 18 and 25 years (93.3%). The majority reported average internet stability (62.2%) and financial burden (63.4%) during ODL. Overall, 70.7% of students demonstrated moderate learning satisfaction, while 29.3% expressed low satisfaction. The mean GPA was 3.37 ± 0.32, with 60.4% achieving satisfactory and 34.7% excellent performance. Correlation analysis revealed no significant association between total learning satisfaction and GPA (rs = 0.033, p = 0.672), indicating that satisfaction did not influence academic performance. Conclusion: Although nursing students maintained satisfactory academic results, their overall learning satisfaction remained moderate. Academic performance during ODL may have been shaped more by motivation, adaptability, and institutional support. Continuous improvement in instructional design, interaction, and learner support is vital to enhance satisfaction and academic outcomes in future blended or online nursing education.

The coronavirus disease of 2019 (COVID-19) predominantly impacts the pulmonary system; however, it also has harmful consequences for the cardiovascular system through the occurrence of myocardial injury. This retrospective study analysed 119 COVID-19 patients admitted to Al-Sultan Abdullah Hospital (HASA) from March until December 2020. Demographics, medical histories, admission laboratory results, electrocardiogram (ECG), echocardiogram (echo), were captured from the hospitals' health records. Myocardial injury is an injury to the myocardium that can be diagnosed by elevated cardiac troponin T or I level above the 99th percentile upper reference limit (URL), an abnormal ECG, and an abnormal echo. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 27. From this study, it was founded that the prevalence of myocardial injury is 36.1% (43 subjects out of 119). The risk factors are older age (odds ratio, 2.347; p=0.028), males (odds ratio, 2.019; p=0.125), Indians (odds ratio, 3.659; p=0.296), hypertension (odds ratio, 2.776; p=0.009), diabetes mellitus (odds ratio, 1.732; p=0.155) and category 4 and 5 COVID-19 patients (odds ratio, 2.325; p=0.038). Myocardial injury is prevalent among patients affected by COVID-19 and is associated with older age, hypertension and category 4 and 5 COVID-19. The researchers suggested conducting a more thorough investigation of the sizable population in multiple settings and conducting a prospective study where all infected COVID-19 patients have to undergo several tests, such as ECG, troponin T, and echocardiogram.

The outbreak of the novel coronavirus (COVID-19) pandemic has rapidly spread across the globe, causing hugedisruptions to everyday lifestyles, including in Malaysia. The government-enforced movement control order (MCO)forced the closure of all public and private educational institutions, affecting all the physical learning sessions asthey must be shifted to online and distance learning (ODL). This has created stress among lecturers due to theseunanticipated changes. A total of 12 participants were involved in this qualitative phenomenology design to exploretheir experiences of the ODL and how they cope with their stress. Face-to-face interviews were carried out with theguidance of a semi-structured interview format. Thematic analysis of the in-depth interview transcriptions foundthere were 6 themes, and 15 subthemes representing feelings, challenges, and ways of dealing with ODL. The studyconcluded that ODL during the COVID-19 pandemic can affect mental health and well-being among participants.

Coronary heart disease (CHD) is the top killer globally, including in Malaysia. Patients with symptoms of chest pain are recommended to get an electrocardiogram immediately, in less than 10 minutes, to detect necrosis of heart tissue due to acute myocardial infarction (AMI). This cross-sectional study conducted among nurses at the National Heart Institute (NHI), Kuala Lumpur, Malaysia was aimed to identify the level of knowledge and practice of ECG interpretation among nurses at NHI. This current study used convenient sampling and involved 255 participants. Overall, 239 participants (93.7%) have good ECG interpretation knowledge and 88.2% (n = 225) have good practice on ECG. There was an association between the level of knowledge and practice regarding ECG readings (p = 0.01). In conclusion, the level of knowledge and practice among nurses in NIH was considered good.

This study was conducted to examine the correlation between job satisfaction with performance, commitment, and motivation among nurses at Hospital Sultanah Bahiyah, Kedah, Malaysia. A cross-sectional study involving nurses was conducted via an online survey using a questionnaire adapted from the Index of Work Satisfaction (IWS). 310 nurses participated in the survey with the majority of them having more than 10 years of working experience in the shifting job. Further analysis showed that there is a significant correlation between job satisfaction and performance (r-value = 0.598, P < 0.001), commitment (r-value = 0.540, P < 0.001), and motivation (r-value = 0.452, P < 0.001). Job satisfaction is significantly correlated to employee performance, commitment, and motivation in the organization. This research also gives insight into how to improve the overall job and create a better job perception.