Background: Cardiovascular diseases, with their high mortality rates, significantly impact patients' quality of life, contribute to disability, and impose a substantial financial burden on society.

Aims and Objectives: This study aimed to illuminate patients' experiences before undergoing cardiac surgery during the COVID‐19 pandemic.

Design: This is a qualitative interview study.

Methods: A purposive sampling technique was employed, with participants recruited from Department Cardiovascular surgery and interviewed to explore their experiences. An inductive thematic analysis was conducted, and reporting adhered to the EQUATOR guideline: COREQ.

Results: The study identified numerous challenges faced by patients during the preoperative period. Consequently, two prominent themes emerged from the patients' experiences while awaiting cardiac surgery during the COVID‐19 pandemic: the feeling of loneliness and the feeling of losing oneself.

Conclusions: The psychological vulnerability of patients during the perioperative phase, intensified by circumstances such as a pandemic, can lead to emotional and behavioural instability, significantly impacting the patient negatively.

Relevance to Clinical Practice: Prioritising the patient's experience is crucial in fortifying presurgical care. Delving into the nuanced perspectives of patients fosters a comprehensive understanding that transcends conventional approaches. This research underscores the significance of giving prominence to the patient perspective, offering opportunities for healthcare professionals to elevate the standard of patient care. Recognising and addressing the challenges faced by patients awaiting cardiac surgery can contribute to a more holistic and patient‐centered approach in clinical practice.

Patient or Public Contribution: Patients contributed by sharing their experiences during interviews, providing first‐hand insights that are presented in the study results.

OBJECTIVE: To examine the self-reported adherence of ambulance nurses to acute chest pain guidelines and analyse how demographic and professional characteristics influence this adherence.

DESIGN: Cross-sectional study.

SETTING: Regional ambulance service in southern Sweden (18 ambulance stations).

PARTICIPANTS: Ambulance nurses (registered and specialist nurses). Of the 397 ambulance nurses invited, 261 responded (65.7%) in 2023.

DATA ANALYSIS: Descriptive statistics; independent-samples t-tests and χ2 tests for group comparisons; Pearson correlation; and stepwise linear regression to identify predictors of adherence.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary: adherence to the prehospital acute chest pain guideline, measured with the 5-item Self-Reported Adherence scale (5-25). Secondary: medication-specific adherence; guideline-access sources.

METHOD: A cross-sectional study involving 261 ambulance nurses from 18 ambulance stations in southern Sweden. Adherence to acute chest pain guidelines was assessed using a validated instrument. Data collected in autumn 2023 were analysed using descriptive and inferential statistics, including stepwise linear regression analysis.

RESULTS: The study revealed an average self-reported adherence score of 19.2 out of 25 for acute chest pain guidelines. Mobile applications were the most commonly used source for accessing acute chest pain guidelines, while ambulance managers were the least used. Notably, older and more experienced ambulance nurses reported higher adherence scores. Additionally, a positive attitude towards the guidelines was correlated with higher adherence. Prioritisation of guidelines and age were predictors of adherence. In contrast, other demographic variables, such as sex and specialist nursing education, were not found to be associated with adherence.

CONCLUSION: The study indicates that self-reported adherence to acute chest pain guidelines among ambulance nurses is influenced by how highly they prioritise these guidelines and by their attitudes towards them, as well as their age and professional experience. Enhancing educational programmes and digital resources, particularly for younger and less experienced nurses, may improve adherence and patient outcomes in prehospital settings.

Background/Objectives: Informal caregivers play an important role in the palliative care of terminally ill family members at home. However, they often lack sufficient professional support, particularly in coping with emotional, spiritual, and practical challenges. This study aimed to explore caregivers’ experiences of providing care to a terminally ill family member at home. Methods: A qualitative approach was used to collect information from informal caregivers. Data were collected through interviews, and thematic analysis was used to identify the main challenges, coping mechanisms, and perceptions related to palliative care. Results: The study resulted in three themes: Involvement of professionals; The reality and dignity of death, and Life after death. Caregivers often associate palliative care exclusively with the last days of life, leading to delayed involvement of the mobile palliative care team. They stated that they preferred home care to hospital care and associated this with more positive experiences at the end of life. However, many reported feelings of loneliness and emotional distress, indicating a lack of appropriate psychological support. Spiritual care is often confused with religious practices, indicating a need for further education. Conclusions: The early involvement of mobile palliative care teams improves coping, facilitates a more humane dying process at home, and can reduce the emotional burden on caregivers.

Informal caregivers provide essential support to cancer patients from diagnosis through treatment, palliative care, and end-of-life care. While their practical contributions are widely acknowledged, the emotional and psychological experiences of caregivers remain underexplored, particularly in home-based palliative care settings. Understanding these experiences is crucial to improving support and interventions for caregivers. This study explored the emotional and subjective experiences of informal caregivers providing home-based palliative care for family members with cancer, using retrospective data collected after the patient’s death. A qualitative exploratory study was conducted using semi-structured interviews with 12 informal caregivers recruited from Primorsko-Goranska County, Croatia. Interviews were conducted face-to-face, audio-recorded, transcribed verbatim, and analyzed using thematic analysis to capture patterns and insights in caregivers’ experiences. Analysis revealed one overarching theme, “Still Invisible but Essential,” and 2 major themes: “Confronting the reality of an incurable cancer diagnosis” and “Facing the paradox – choosing between length and quality of life,” encompassing 5 sub-themes. Caregivers described both rewarding and stressful aspects of care, including emotional challenges, communication difficulties, decision-making burdens, and unmet needs for professional support, alongside practical caregiving responsibilities. Informal caregivers are indispensable to home-based palliative care, yet their emotional and subjective experiences are often overlooked. Findings highlight the need for tailored interventions and support services addressing both practical and emotional aspects of caregiving, informing policy, clinical practice, and caregiver support in Croatia and similar contexts.

Pozadina: Usklađivanje kompetencija specijaliziranih medicinskih sestara diljem Europe postalo je sve važnije zbog sve većeg oslanjanja na medicinske sestre specijaliste, posebno u regijama koje se suočavaju s nedostatkom medicinskih stručnjaka. To oslanjanje odražava trend prema specijaliziranoj skrbi za rješavanje raznolikih i složenih izazova u zdravstvu.

Cilj: Sustavno mapirati i sintetizirati postojeću literaturu i okvire o kompetencijama medicinskih sestara specijalista u Europi, uz istovremeno identificiranje nedostataka i mogućnosti za usklađivanje.

Metode: Ovaj pretražni pregled slijedi metodologiju Instituta Joanna Briggs te se o njemu izvještava u skladu sa smjernicama za pretražni pregled pod nazivom Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, uključujući dijagram toka.

Pozadina: Medicinske sestre specijalisti igraju ključnu ulogu u rješavanju složenih zdravstvenih potreba Europe, uključujući starenje stanovništva, porast kroničnih bolesti i nedostatak zdravstvenih djelatnika. Međutim, razvoj uloga medicinskih sestara specijalista diljem Europe i dalje je fragmentiran, sa značajnim razlikama u obrazovanju, kompetencijama i priznavanju među zemljama. Iako međunarodni modeli pružaju dobro uspostavljene okvire za naprednu sestrinsku praksu, europski napori za usklađivanje specijalističkih sestrinskih kompetencija bili su nedosljedni. Cilj je ovog pregleda bio mapirati i sintetizirati dostupnu literaturu i okvire o specijalističkim sestrinskim kompetencijama u Europi. Metode: Ovaj pretražni pregled slijedio je JBI metodologiju i smjernice za izvještavanje PRISMA-ScR. Uključene su studije i strateški dokumenti usmjereni na medicinske sestre specijaliste, njihove ključne kompetencije i obrazovne okvire u Europi, uz relevantnu sivu literaturu. Pretrage su provedene u CINAHL-u, MEDLINE-u, PsycArticles, Web of Science, PubMed-u, Cochrane Library, ProQuest-u i Google Scholaru. Dva recenzenta su neovisno pregledala i izdvojila podatke, a nalazi su sintetizirani narativno. Rezultati: Ukupno je uključeno deset studija, koje su obuhvaćale analize pojedinačnih zemalja (npr. Škotska, Finska) i višedržavne europske i međunarodne inicijative. Većina studija usredotočila se na razvoj uloga, identifikaciju kompetencija ili dizajn kurikuluma za specijalizirane i visokoobrazovane medicinske sestre. Identificirana uobičajena područja kompetencija uključivala su kliničku skrb, vodstvo, komunikaciju, obrazovanje i istraživanje. Dokazi iz studija izvedivosti i evaluacije pokazali su da uloge visokoobrazovanih i specijaliziranih medicinskih sestara poboljšavaju dostupnost, kontinuitet i kvalitetu skrbi, posebno u primarnoj zdravstvenoj zaštiti i zdravstvenoj skrbi u zajednici. Unatoč razlikama u obrazovnim putovima i regulatornim okvirima, studije su dosljedno podržavale izvedivost i nužnost uloga napredne prakse te naglašavale potrebu za većom usklađenošću diljem Europe. Zaključci: Medicinske sestre specijalisti daju mjerljiv doprinos sigurnosti pacijenata, dostupnosti skrbi, zadovoljstvu i potencijalnoj isplativosti. Unatoč tome, razlike u regulativi, priznavanju uloga i opsegu prakse i dalje predstavljaju izazov za usklađivanje među zemljama i profesionalnu mobilnost. Kako bi se u potpunosti iskoristio potencijal medicinskih sestara specijalista u postizanju zdravstvenih prioriteta EU, ključno je održivo ulaganje u razvoj politika, usklađivanje zakonodavstva i istraživanja temeljena na rezultatima.

Background:Harmonizing specialist nursing competences across Europe has become increasingly important due to the growing reliance on specialist nurses, particularly in regions facing shortages of medical professionals. This reliance reflects a trend towards specialized care to address diverse and complex healthcare challenges. The aim of this study is to systematically map and synthesize existing literature and frameworks on specialist nurse competencies in Europe, while identifying gaps and opportunities for harmonization.

Methods:This scoping review follows the Joanna Briggs Institute methodology and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, including the flow diagram.

Background: Specialist nurses play a pivotal role in addressing Europe’s complex health needs, including aging populations, rising chronic diseases, and shortages of healthcare professionals. However, the development of specialist nursing roles across Europe remains fragmented, with significant variation in education, competencies, and recognition between countries. While international models provide well-established frameworks for advanced nursing practice, European efforts to harmonize specialist nursing competencies have been inconsistent. This scoping review aimed to map and synthesize the available literature and frameworks on specialist nursing competencies in Europe. Methods: This scoping review followed the JBI methodology and PRISMA-ScR reporting guidelines. Studies and policy documents focusing on specialist nurses, their core competencies, and educational frameworks in Europe were included, alongside relevant grey literature. Searches were conducted in CINAHL, MEDLINE, PsycArticles, Web of Science, PubMed, Cochrane Library, ProQuest, and Google Scholar. Two reviewers independently screened and extracted data, and findings were synthesised narratively. Results: A total of ten studies were included, spanning single-country analyses (e.g., Scotland, Finland) and multi-country European and international initiatives. Most studies focused on role development, competency identification, or curriculum design for specialist and advanced practice nurses. Common competency domains identified included clinical care, leadership, communication, education, and research. Evidence from feasibility and evaluation studies demonstrated that advanced and specialist nursing roles improve accessibility, continuity, and quality of care, particularly in primary and community health settings. Despite variation in educational pathways and regulatory frameworks, the studies consistently supported the feasibility and necessity of advanced practice roles and underscored the need for greater harmonisation across Europe. Conclusions: Specialist nurses make a measurable contribution to patient safety, care accessibility, satisfaction, and potentially cost-effectiveness. Nonetheless, differences in regulation, role recognition, and practice scope continue to challenge cross-country harmonisation and professional mobility. To fully leverage the potential of specialist nurses in achieving EU health priorities, sustained investment in policy development, legislative alignment, and outcome-based research is crucial.

Pozadina : Klimatske promjene nisu više samo udaljena prijetnja, već neposredna i rastuća javnozdravstvena kriza s katastrofalnim posljedicama za ljudsko zdravlje i preživljavanje. Kako se ovi izazovi povećavaju, medicinske sestre specijalisti pojavljuju se kao ključni, ali nedovoljno prepoznati akteri na prvim crtama klimatske krize. Njihove uloge šire se daleko izvan kliničke skrbi: reagiraju na bolesti povezane s vrućinom, liječe respiratorne bolesti pogoršane onečišćenjem zraka, podržavaju zajednice raseljene zbog katastrofa i nude psihosocijalnu skrb nakon klimatske traume.

Metode: Napravljen je pregled literature kako bi se analizirale trenutne studije o utjecaju zdravstvene skrbi na klimatske promjene. Tijekom 7. kongresa Europske organizacije medicinskih sestara specijalista od 29. do 31. svibnja 2025., održana je radionica s intenzivnom raspravom o globalnoj klimatskoj krizi i medicinskim sestrama specijalistima.

Rezultati : Kao rezultat pregleda literature te nakon radionice, odlučeno je da se sastavi Zagrebačka deklaracija o klimatskim promjenama i utjecaju medicinskih sestara specijalista te osnuje Odbor za klimatske promjene koji će raditi na daljnjim istraživanjima.

Zaključci : Klimatske su promjene ovdje – remete živote, preopterećuju zdravstvene sustave i pojačavaju patnju. U ovoj rastućoj krizi, medicinske sestre specijalisti nisu samo njegovatelji; one su svjedoci, zagovornici, edukatori i zaštitnici. Obrazovni sustavi moraju ugraditi zdravlje okoliša u svaku razinu obuke medicinskih sestara. Zdravstvene ustanove moraju omogućiti medicinskim sestrama da vode inicijative održivosti i uključiti ih u planiranje i donošenje politika u slučaju katastrofa. Vlade moraju prepoznati medicinske sestre specijaliste kao ključne aktere u nacionalnim i međunarodnim klimatskim strategijama.

Background:Nurses play a vital role in educating patients about health and nutrition, empowering them to make informed dietary choices. This study aimed to develop a questionnaire to assess European nurses’ knowledge and awareness of nutrition and malnutrition, particularly in relation to oncology and vulnerable patient populations.

Methods:A cross-sectional survey design was employed between February to April 2025. A structured questionnaire was developed based on existing frameworks and distributed to registered nurses across various European countries. Participants were recruited using a stratified random sampling approach to ensure diversity in geographical location, hospital size, and professional experience. The questionnaire assessed nurses’ education and training, clinical practices, collaboration with other professionals, sources of information, perceived barriers, and suggestions for improvement. Descriptive analyses were performed, reporting absolute frequencies, percentages, and means.

Results:A total of 98 nurses participated in the survey. The majority recognized nutrition as a vital component of patient care, with 91% acknowledging awareness of the nutritional challenges faced by patients. Despite this, only 48% reported routinely screening for malnutrition, and the use of validated screening tools was inconsistent. While 83% of respondents felt familiar with dietary requirements, just 47% had received formal training in nutritional interventions. Reported barriers to effective nutritional care included lack of time, limited professional autonomy, and inconsistent or conflicting sources of information. Participants expressed a strong interest in further education, particularly in specialized areas such as percutaneous endoscopic gastrostomy (PEG) feeding, nutrition in dementia care, and food labeling.

Conclusions:The findings highlight a clear need for standardized, accessible nutrition education for nurses across Europe. Limitations include the small, highly educated, and self-selected sample, which may limit generalizability. Findings highlight the need for standardized nutrition education, institutional support, and enhanced interdisciplinary collaboration. Enhancing nurses’ competencies through targeted training, institutional support, and interprofessional collaboration can significantly improve the delivery of nutritional care, particularly for oncology patients and other vulnerable populations.