Aug 2026· Hu li za zhi The journal of nursing· Vol 73 4· 0 citations
Medicine
TL;DR
A comprehensive four-stage nursing engagement framework is proposed that spans the entire DTx lifecycle of design, implementation, evaluation, and ethical governance, highlighting the indispensable role of nurses in the clinical deployment of DTx.
This commentary is deliberately framed as a focused extension of the original study’s individual-level findings to the institutional level, rather than a stand-alone organizational literature review, and its scope has been kept correspondingly concise.
Digital transformation is reshaping healthcare systems globally, influencing clinical practice, education, leadership, and patient engagement. Nurses, as the largest segment of the healthcare workforce, play a pivotal role in adopting, implementing, and optimizing digital health technologies. This narrative review explores the expanding role of nurses in digital transformation, focusing on electronic health records (EHRs), mobile health (mHealth), telehealth and telerehabilitation, artificial intelligence (AI), automation technologies including robotics and drones, and wearable devices. Literature from 2015 to 2024 was reviewed to examine benefits, challenges, and implications for nursing practice. Digital technologies enhance patient-centered care, improve decision-making, enable real-time monitoring, and streamline workflows. However, issues such as digital divide, data privacy concerns, usability challenges, burnout, and inadequate training remain significant barriers. Strengthening digital literacy, leadership engagement, curriculum integration, and supportive organizational policies are essential to maximizing the potential of digital transformation. Nurses remain central to shaping safe, ethical, and effective digital healthcare systems.
Nandigama Vandana, S. K. Mohanasundari, Kasturi Vasanth kumar et al.· Asian Journal of Nursing Edu...· 0 citations
IntroductionWisdom is frequently invoked as a hallmark of good nursing, yet its meaning and practical implications remain conceptually under-specified. Grounded in virtue ethics and the Aristotelian notion of phronesis, this paper aims to clarify the concept of "wisdom in nursing care" to support ethically grounded nursing practice.MethodsA concept analysis was conducted using the Walker and Avant method. The literature search was carried out in January 2026 using the PubMed and CINAHL databases, focusing on uses of the concept of wisdom relevant to the nursing profession. Twenty-five publications were included and analyzed to identify multidisciplinary uses, defining attributes, antecedents, consequences, and empirical referents of wisdom in nursing.ResultsThe analysis delineates wisdom as a morally grounded, relational, and practice-based capacity. Defining attributes include deliberation and context-sensitive judgment oriented toward fairness and patient wellbeing; morally informed action (praxis) undertaken for the right reasons; open-mindedness and humility regarding the limits of knowledge; perceptiveness and moral perception of ethically salient features of situations; reflexivity; empathy and moral imagination; emotional regulation; self-awareness; and understanding of others. Antecedents are organized into personal conditions (values, learning orientation, knowledge base, clinical experience, and mentorship) and environmental conditions (context familiarity, situational awareness, and informational resources). Consequences include progression toward expert practice, integration of theoretical and practical knowledge, ethically attentive navigation of uncertainty, and reinforcement of nursing's commitment to human flourishing.DiscussionThis conceptual clarification supports education, leadership, and ethical practice by rendering wisdom more teachable, discussable, and amenable to study in nursing care. The integration of rigor and compassion positions wisdom as both steward and guide of the person within nursing practice.
PurposeTo develop a professional nursing professional practice model (PPM) to guide performance at a university hospital.DesignSequential multimethod design for theory development.MethodThe study was executed in four sequential phases: (1) identification of the need for a PPM; (2) preliminary model design; (3) internal and peer validation; and (4) evaluation against international standards.FindingsThis PPM prioritizes holistic care for patients and their families to ensure clinical excellence and safety in nursing services. It integrates synergistic management, organizational structures, and continuous quality improvement to address contemporary healthcare challenges within a holistic care philosophy.ConclusionsThe "Bonds that Transform, Care that transcends" model provides a new framework for holistic hospital nursing practice. Grounded in humanistic perspectives, the model posits that therapeutic relationships transcend clinical procedures through high-quality interactions among staff, patients, and families. By fostering mutual growth, this care extends beyond the hospital to transform individuals, strengthen autonomy, and dignify the human condition. Broadly, this framework bridges theoretical holism with clinical pragmatism, promoting nursing leadership, facilitating education, advancing research, and offering a scalable roadmap for humanizing high-complexity healthcare institutions.
Alejandra Parisotto, Maria Marta Palermo, Alicia Valentina García et al.· Journal of Holistic Nursing· 0 citations
"Ethical decision-making is one of the critical challenges faced by professional nurses, particularly in providing end-of-life care for gender-diverse individuals. These patients often encounter barriers related to legal, cultural, and social acceptance. This article aims to analyze the complexities of ethical decision-making for nurses caring for gender-diverse individuals at the end of life, focusing on the application of ethical theories and frameworks, such as deontological ethics, moral development theory, and the ethical tree framework. The process involves five steps: information gathering, identifying ethical dilemmas, evaluating alternatives, decision-making, and outcome assessment.
The study highlights the importance of respecting patients’ gender identity, recognizing their unique needs, and aligning nursing practices with contemporary contexts. Practical recommendations include promoting advance directives, educating nurses about the legal rights and end-of-life care considerations for gender-diverse individuals, and establishing support systems to facilitate appropriate ethical decision-making.
In summary, addressing the challenges of ethical decision-making in caring for gender-diverse individuals at the end of life is a significant responsibility for professional nurses. It requires both knowledge and skills to deliver personalized care, reduce disparities, and enhance patients’ quality of life. This approach ensures dignity, the safe expression of gender identity, autonomy in decision-making alongside families, and effective responses to the rapidly evolving societal context surrounding end-of-life care"
"การตัดสินใจเชิงจริยธรรมเป็นหนึ่งในความท้าทายสำคัญของพยาบาลวิชาชีพ โดยเฉพาะในบริบทของการดูแลผู้ป่วยระยะสุดท้ายที่มีความหลากหลายทางเพศ ซึ่งมักเผชิญอุปสรรคด้านกฎหมาย วัฒนธรรม และการยอมรับทางสังคม บทความนี้มีวัตถุประสงค์เพื่อวิเคราะห์ความซับซ้อนในการตัดสินใจเชิงจริยธรรมของพยาบาลสำหรับผู้ป่วยที่มีความหลากหลายทางเพศ ในระยะสุดท้ายของชีวิต โดยเน้นการประยุกต์ใช้แนวคิดและทฤษฎีจริยธรรม เช่น ทฤษฎีจริยศาสตร์ ทฤษฎีพัฒนาการทางจริยธรรม และทฤษฎีต้นไม้จริยธรรม ผ่านกระบวนการตัดสินใจเชิงจริยธรรม 5 ขั้นตอน ได้แก่ การรวบรวมข้อมูล การระบุประเด็นขัดแย้ง การพิจารณาทางเลือก การตัดสินใจ และการประเมินผล
บทความยังชี้ให้เห็นความสำคัญของการเคารพอัตลักษณ์ทางเพศ ความต้องการเฉพาะของผู้ป่วยระยะสุดท้ายที่มีความหลากหลายทางเพศและความจำเป็นในการพัฒนาแนวทางปฏิบัติที่สอดคล้องกับบริบทปัจจุบัน เช่น การส่งเสริมให้ผู้ป่วยทำพินัยกรรมชีวิต การอบรมพยาบาลให้เข้าใจกฎหมายและสิทธิของผู้ป่วยระยะสุดท้ายที่มีความหลากหลายทางเพศรวมถึงการสร้างระบบสนับสนุนที่เอื้อต่อการตัดสินใจเชิงจริยธรรมที่เหมาะสม
สรุปได้ว่า ความท้าทายการตัดสินใจเชิงจริยธรรมในกลุ่มผู้ป่วยระยะสุดท้ายที่มีความหลากหลายทางเพศเป็นบทบาทที่สำคัญของพยาบาลวิชาชีพ ซึ่งต้องการทั้งความรู้ ทักษะ เพื่อให้การดูแลผู้ป่วยตอบสนองต่อความต้องการเฉพาะบุคคลอย่างครบถ้วน และช่วยลดความเหลื่อมล้ำในผู้ป่วยที่มีความหลากหลายทางเพศไปสู่คุณภาพชีวิตที่ดีขึ้น เคารพในศักดิ์ศรีของความเป็นมนุษย์ ได้รับการเปิดเผยตัวตนทางเพศที่สอดคล้องกับความปลอดภัยในสถานพยาบาล ความปรารถนาที่จะรักษาอิสระในการตัดสินใจร่วมกับครอบครัวเกี่ยวกับการดูแลระยะท้ายของชีวิตด้วยตนเอง และตอบสนองต่อความท้าทายในสังคมที่เปลี่ยนแปลงอย่างรวดเร็ว"
ชัชพงศ์ สมุทรอาลัย, นวภัทร คงดี, โชติกา ธนมี et al.· Journal of Nursing Research,...· 0 citations
Nursing leadership has become an almost unquestioned imperative in contemporary discourse on healthcare systems. It is invoked in policy documents, educational frameworks, and organizational strategies as a key competence for managing complexity, improving outcomes, and ensuring the sustainability of care systems. However, despite this broad legitimization, the concept of leadership in nursing is often treated in predominantly functional terms. It is frequently approached as a neutral and intrinsically positive construct, increasingly articulated in relation to skills, organizational influence, and professional functions. 1 When leadership is reduced to a set of competencies or managerial capacities, it risks losing its moral foundation. In this way, it becomes detached from the very foundations of nursing practice, which is intrinsically ethical, relational, and value-oriented. The central argument proposed here is that nursing leadership cannot be adequately understood as a technical or organizational competence. Rather, it must be reclaimed as an ethical expression of professional identity, emerging from the internalization of professional values and deontological principles. The dominant discourse on nursing leadership reflects a strong orientation toward functionality and performance. Transformational leadership, for example, is widely associated with improved organizational outcomes, greater staff satisfaction, and enhanced team performance, and is often presented as a desirable and teachable style. 2 Similarly, evidence-based leadership emphasizes the integration of the best available evidence into decision-making processes, aligning leadership with the goals of quality and patient safety. 3 Authentic leadership, in turn, introduces attention to the moral and relational dimensions, underscoring the importance of coherence between values and actions. 4 Although these models offer relevant contributions, they share a common limitation. When critically examined, these models risk reducing leadership to a set of developable and measurable competencies, neglecting the identity-related and ethical dimensions that sustain professional practice. In this way, they risk fragmenting the phenomenon,