NURSEARCHER (Journal of Nursing & Midwifery Sciences)

Assessment of Nurses’ Knowledge Regarding Early Recognition and Management of Patients with Acute Coronary Syndrome at Tertiary Hospitals in Karachi

Farrukh Ahmed Siddiqui — 2026-06-30

Cardiovascular diseases are the leading cause of mortality worldwide, with Acute Coronary Syndrome (ACS) representing a significant proportion of these cases. Nurses play a critical role in the early recognition and management of ACS; however, knowledge gaps may compromise patient outcomes and timely interventions. Objectives: To assess practicing nurses' knowledge in recognizing and managing patients with Acute Coronary Syndrome (ACS) at tertiary care centers in Karachi. Methods: A descriptive cross-sectional study was conducted with 240 registered nurses recruited from CCU, ICU, HDU, and Emergency Departments of three tertiary care hospitals using purposive sampling. Data were collected using a structured 20-item questionnaire. Normality was assessed using the Kolmogorov-Smirnov test (age: KS=0.087, p=0.068; knowledge scores: KS=0.092, p=0.052), and associations were examined using chi-square tests, with significance set at p<0.050. Results: Among 240 participants, 132 (55%) demonstrated excellent knowledge, 60 (25%) good knowledge, 24 (10%) average knowledge, and 24 (10%) poor knowledge. Significant associations were found between knowledge level and age (p=0.003), gender (p=0.045), and qualification (p=0.043), while experience showed no significant association (p=0.660). However, the borderline significance of gender (p=0.045) and qualification (p=0.043) associations should be interpreted cautiously, as p-values close to the 0.050 threshold indicate that relatively small changes in sample composition or data distribution could potentially affect statistical significance. Conclusions: While 80% of nurses demonstrated satisfactory ACS knowledge, notable deficiencies in ECG interpretation and pharmacological management require targeted educational interventions. Regular continuing education, simulation-based training, and competency assessment programs are recommended to enhance nursing competencies in ACS care at tertiary care settings.

Association and Demographic Differences in Individual and Organizational Factors Affecting Evidence-Based Practice among Nurses in Mirpur, AJK

Safia Noreen — 2026-06-30

Evidence-based practice (EBP) is critical in improving patient care outcomes, enhancing nursing practice, and fostering informed decision-making in healthcare settings. Objectives: To examine the association between organizational and individual factors affecting the implementation of EBP and to assess demographic differences in these factors. Methods: This is a secondary analysis of data from a larger cross-sectional study on barriers to EBP implementation among nurses. A quantitative analytical study was conducted at a tertiary care hospital in Mirpur, AJK, among 120 registered nurses from various departments with more than one year of clinical experience, was selected by using simple random sampling techniques. The sample size was determined using the Yamane formula. A developed questionnaire assessing barriers to the implementation of EBP was adapted and modified for use in this study after ensuring reliability and validity. Results: Regression analysis showed a moderate positive association between organizational and individual barriers. Individual barriers were linked to educational attainment and work experience. No significant mean differences were found regarding age at the time of implementing EBP. Conclusions: The study found a significant positive association between organizational and individual barriers to EBP among nurses. To support EBP, policymakers and executives in the healthcare industry are encouraged to give priority to educational programs, expand access to resources, and strengthen organizational support.

Relationship between Perceived Social Support and Self-esteem in Patients with Lower Limb Amputation

Neelum Naz — 2026-06-30

Lower limb amputation significantly disturbs an individual's physical, psychological, and social functioning. Amongst the psychological concerns, reduced self-esteem is a critical concern that can hamper rehabilitation and adaptation. Objectives: To investigate the relationship between perceived social support, self-esteem, and psychological well-being in patients with lower limb amputations, focusing on how these factors influence psychological well-being. Methods: A cross-sectional analytical study was conducted at the Artificial Limb Center, Fouji Foundation Hospital, Rawalpindi, Pakistan. Data were collected from 120 lower limb amputees using standardized tools: the Rosenberg Self-Esteem Scale (RSES) and the Multidimensional Scale of Perceived Social Support (MSPSS). Participants were selected through consecutive sampling. Data were analyzed using SPSS version 26.0, including descriptive statistics and Pearson correlation to analyze the relationship between variables. Results: Findings showed that a majority of participants had low to moderate levels of self-esteem and perceived social support. A statistically significant positive correlation was identified between self-esteem and perceived social support (0.597, p<0.001), indicating that individuals perceiving higher social support are likely to have higher self-esteem. Gender differences were prominent. Employment status, age, educational level, and income level also showed significant mean differences with self-esteem levels. Conclusions: The study supports a strong and significant relationship between perceived social support and self-esteem in lower limb amputees. Increasing perceived social support through targeted psychosocial interventions may add positively to the psychological well-being and rehabilitation outcomes of amputees. These findings highlight the importance of family, peer, and significant others' support systems in raising self-esteem during post-amputation change and recovery.

Factors Associated with Academic Burnout and Its Prevalence among Nursing Students in Karachi, Pakistan

James Watt — 2026-06-30

There are many concerns regarding academic burnout among nursing students worldwide, including their academic performance, mental health, and future professional competency. Nursing education is a rigorous program that involves both classroom and clinical practice, which increases students' risk. But there is limited information regarding the prevalence of academic burnout among nursing students in Pakistan. Objectives: To find the prevalence of academic burnout and its relationship with sociodemographic factors among nursing students in Karachi, Pakistan. Methods: The study design was analytical cross sectional and the duration of the study was from March to May 2026, during which 194 nursing students from two nursing institutes of Karachi were selected as subjects. The convenience sampling method was used for selecting participants. The validated Oldenburg Burnout Inventory-Student Version (OLBI-S) was used to gather data. Independent t-tests and ANOVA were used for statistical analysis. Results: Most students reported low (56.7%) and moderate (41.2%) levels of academic burnout, with a small minority (2.1%) reporting high academic burnout. There was a significant correlation between family income and burnout scores (p=0.017), with lower-income families having higher burnout scores. There were no significant associations between age, gender, marital status, academic year, family type, place of residence, or substance abuse. Conclusions: Stress management workshops and financial assistance schemes should be developed in nursing institutions specifically. Longitudinal studies are recommended for research to investigate causal relationships and the effectiveness of interventions.

Knowledge, Attitude, and Practices Regarding Body Weight Management Among Overweight and Obese Female Participants in Tertiary Care Hospitals, Peshawar

Aurang Zeb — 2026-06-30

The primary health problem in the world is overweight and obesity. It contributes to morbidity and mortality and hurts health, such as increasing the risk of type 2 diabetes, cardiovascular diseases, and other non-communicable diseases. Objectives: To explore the Knowledge, Attitude, and Practice (KAP) of overweight and obese women about Body Weight Management. Methods: The study design was a quantitative, analytical, cross-sectional study conducted in September-November 2025 at two tertiary care hospitals in Peshawar. The sample size was calculated through public health voice cross sectional sample size calculator, which was 312. Data were collected from female participants, including both OPD and admitted, through a pre-designed, structured questionnaire via convenient sampling techniques. Data were analysed by using SPSS version 27.0. Results: The study revealed positive knowledge, neutral attitudes, and moderate practices in managing body weight. The study showed a significant association between knowledge categories and education, income, and BMI, with p-values of 0.009, 0.003, and 0.048, respectively. There were significant associations between attitudes and income (p-value of <0.001), as well as obesity related diseases and a p-value of 0.008, respectively. Conclusions: Overweight and obese female participants have good knowledge regarding body weight management; however, they have neutral attitudes and moderate practices. The findings showed that socioeconomic factors influence weight management behaviors. To improve attitudes and encourage healthy behaviors, health education initiatives should be reinforced.

Knowledge, Attitudes, and Practices Regarding Antibiotic Resistance among Undergraduate Nursing Students

. Meghraj — 2026-06-30

Antimicrobial resistance (AMR) is one of the serious global health threats of the twenty-first century, driven primarily by inappropriate antibiotic use. Nursing students, as frontline healthcare providers, play a significant role in promoting rational antibiotic use and antimicrobial stewardship. Objectives: To assess the knowledge, attitudes, and practices regarding antibiotic resistance among undergraduate nursing students. Methods: A cross-sectional study was administered among 239 undergraduate nursing students from three nursing institutions in Mirpurkhas, Pakistan. Participants were recruited using convenience sampling and proportionate sampling allocation. Data collection was done using a self-structured and self-developed questionnaire assessing knowledge, attitudes, and practices regarding antibiotic resistance. Data were analyzed using SPSS version 31.0. Descriptive statistics and inferential analysis, including the Chi-square and one-way analysis of variance (ANOVA), were applied to evaluate associations between study variables. A p-value of less than 0.050 was considered statistically significant. Results: The knowledge mean was 3.12 ± 1.19, showing a moderate level of knowledge; the attitude mean score was 19.87 ± 2.72, and the practice mean was 21.97 ± 3.21, indicating that attitude and practice levels were higher than knowledge. Good knowledge was seen in 35.1% of students, whereas 56.9% of students showed positive attitudes and 80.3% of students demonstrated good practices. However, statistical significance was found between gender and practice (p=0.002), with female students exhibiting better practices than male students. Conclusions: As nursing students exhibit moderate knowledge and a relatively higher level of appropriate practices and positive attitudes towards antibiotic resistance, a significant gap was observed between knowledge and practice.

Knowledge and Practices Regarding Infection Control Among Nurses in Hospitals Multan, Pakistan

Muhammad Idrees — 2026-06-30

Nurses are at the frontline of patient care and play a pivotal role in preventing healthcare-associated infections (HAIs), yet institution-level data on their knowledge and practice of infection prevention and control (IPC) remain limited in Pakistan. Objective: To assess the knowledge and practice of nurses regarding HAI control measures at a tertiary care hospital in Multan, Pakistan. Methods: A descriptive cross-sectional study was conducted among 50 nurses (BSN, diploma, and post-RN) working at Medicare Hospital, Multan, selected through non-probability consecutive sampling; the minimum sample size was calculated using the Raosoft sample size calculator at a 95% confidence level with a 9% margin of error. Data were collected using an adapted, self-administered questionnaire (Cronbach's α = 0.79 for knowledge items and 0.83 for practice items) covering sociodemographic characteristics, IPC knowledge (9 items) and IPC practice (16 items), and were analyzed descriptively using SPSS version 26. Results: Overall, 98% of nurses demonstrated good knowledge, and 98% demonstrated good practice regarding IPC. Item-level analysis, however, revealed specific gaps: only 58% and 56% of nurses correctly reported using chemical and physical sterilization techniques, respectively; 50% believed gloves could replace hand hygiene; only 30% washed hands without soap when soap was unavailable; and only 60% avoided recapping needles before disposal. Conclusions: Although most nurses demonstrated satisfactory overall knowledge and practice of IPC, specific and clinically important gaps persist in sterilization technique, hand hygiene, and sharps safety. Continuous in-service training, adequate provision of protective and hand hygiene supplies, and structured supervision are recommended to translate knowledge into consistent, safe bedside practice.

Assessment of Nurses' Knowledge and Self-Reported Beliefs Regarding Inhaler Therapy in Bronchial Asthma and Chronic Obstructive Pulmonary Disease

Muhammad Adnan — 2026-06-30

Bronchial asthma and chronic obstructive pulmonary disease (COPD) are important diseases to treat with inhaled medications, but their effectiveness relies on proper device use. Objective: To evaluate nurses' knowledge and self-reported beliefs regarding inhalation therapy devices, metered dose inhalers (MDIs), spacers, and dry powder inhalers (DPIs) in two hospitals in Multan, Pakistan. Methods: The descriptive cross-sectional study was done with Consecutive sampling for six months. A total of 115 nurses were enrolled in the sample. Nurses were given a self-developed 20-item yes/no questionnaire with a Cronbach's alpha of 0.78 in the two hospitals: Medicare Hospital and Nishtar Hospital. Patients were excluded if they were nursing students or non-clinical staff, and registered nurses were included who had worked with patients for ≥1 year. Results: There was a significant lack of knowledge. As far as general knowledge was concerned, 58.3% of them thought inhalers are addictive, 43.5% believed inhalers to be a “last resort”, and more than 67% were misinformed about inhalers leading to weight gain and stunted growth. The critical technique errors were common: 61.7% thought patients should breathe in before pressing the MDI canister, and 16.5% did not know that MDIs should be shaken before use. Only 26.1% had good knowledge. The best predictor of adequate knowledge was prior training (p=0.002). Conclusions: The nurses were found to have poor knowledge of inhaler therapy. There is an urgent need for structured, device-specific training, along with supervised competency assessment, to address patient education and improve treatment outcomes.

Effects of Mindfulness Intervention on Anxiety among Female Nursing Students

Yasir Ali — 2026-06-30

Nursing students face higher levels of stress and anxiety than other college students due to the combined pressures of classroom and clinical responsibilities, and meditation is the process of training your mind to focus and redirect your thoughts. Objective: To examine the impact of mindfulness intervention on nursing students' anxiety at a public sector college of nursing. Methods: A quasi-experimental pre- and post-single group study was conducted at a public sector female nursing institute, including 32 nursing students of BS Nursing, while students from the auxiliary nursing discipline were excluded from the study. The duration of the study was 6 months (November 2025 to April 2026) after the required approvals. Sample size was calculated using G*Power 3.1.9.4 with a paired sample t-test at a 5% level. The final sample size was 32, after adding a 10% attrition rate. A stratified random sampling technique was used to collect data. Furthermore, written informed consent was obtained, and confidentiality and privacy were protected. Data were analysed through SPSS version 21.0. Appropriate statistical tests were applied for the analysis. Results: The mean BAI score reduced significantly from 36.68 ± 6.79 to 21.26 ± 4.47 following the intervention, with a statistically significant reduction (p<0.001). Overall, the intervention was successful in lowering anxiety across the majority of demographic features. Conclusions: The results of the study showed a statistically significant reduction in the level of anxiety following the intervention; for that reason, mindfulness could be included in routine activities of the nursing students.

Invest in Nursing: Empowering the Frontline of Healthcare

. Badil — 2026-06-30

Nurses are known as the backbone of any health care system. Nurses deliver high-quality nursing care to patients and are integral to the provision of safe, compassionate, quality care in hospitals, primary health care, and the community, and during emergencies. The healthcare industry is relatively sophisticated these days. Given chronic diseases, the new problems of infectious diseases, and the ever-changing nature of technology, it is essential that nursing investment be focused on clinical practice, research, nursing education, decision making, and nursing leadership [1].

Moreover, the pandemic has demonstrated the value of a strong nursing workforce to bolster resilient health systems. Nurse investment is not a cost; it is an investment for decades in improved health care, healthy communities, and sustainable health care systems. There should be collaboration among governments, health care providers, academic institutions, and nursing organizations to support, value, and strengthen the environment in which nurses practice. To support nurses is to give them huge opportunities for professional learning outside their nursing scope and great opportunities for professional development. In addition, an integral part of the nurse's role is as a leader. Staff empowerment, quality improvement, and patient safety are increasingly becoming critical, with low levels of staff development invested, resulting in slower staff growth. This highlights the importance of developing strategic leadership competencies for nursing management [2].

Nurses are fundamental members of the healthcare system at the forefront of patient care, making critical decisions that influence patient outcomes and the overall quality of healthcare. Empowering nurses to make informed decisions leads to better patient outcomes, greater collaboration among health care professionals, and improved health care system performance [3].

A recent study has demonstrated the importance of nursing education in building the competence and confidence required to prepare future healthcare professionals. Respect and self-determination, skills training to enhance competence, and mentorship and facilitation of collaborative learning environments are significant factors in improving academic achievement in the nursing profession. Consequently, there is an improvement in self-efficacy, job satisfaction, and academic success that positively affects patient care [4].

Eventually, nurses are empowered in nursing research to promote a culture of evidence-based practice, innovation, and ongoing improvement. The research-active nurse is better prepared to identify clinical issues, to develop evidence from the context of the issue, and to make interventions to enhance patient safety and improve the quality of health care. Furthermore, their participation in research also supports decisive critical thinking, decision-making in practice, professional independence, and influence on health policies and practice. Ultimately, nurse investment as a researcher leads to robust and noticeable patient outcomes, more efficient health systems, and the evolution of the nursing profession [5].

As we move forward into the future of healthcare, there is one obvious thing to invest in: nursing, which is to invest in healthcare and therefore everyone's health. A strong healthcare system is built on the strength of its frontline workers, and nurses are the most important asset in a healthcare system. Nurses should be given leadership, policy-making, research, and decision-making authority. Thus, the outcome of the healthcare system will be better, and this can translate to optimal and significant patient outcomes.