International Journal of Nursing Information

Addressing the Obesity-Diabetes Continuum in Cambodia: A Critical Review of Health Policy, Regulation, and Care Delivery System Readiness

2026-02-20T08:57:30+00:00

Cambodia is undergoing a rapid epidemiological transition marked by an escalating continuum of obesity and type 2 diabetes mellitus (T2DM). This study evaluates Cambodia’s health policy responsiveness, regulatory frameworks, and care delivery system readiness to address this shifting chronic disease burden. Synthesizing national data from the Cambodia Demographic and Health Survey 2021–22 and the STEPS Survey 2023 alongside national strategic frameworks, this review provides a critical macro-level policy-linked analysis, filling a vital literature gap by bridging clinical epidemiology with health systems governance. Findings confirm a severe metabolic burden, with 31.7% of adult women overweight/obese, 15.2% experiencing abdominal adiposity, and T2DM prevalence reaching 6.4%. Crucially, 50% of T2DM cases remain undiagnosed, a systemic failure rooted in primary care unreadiness, diagnostic stockouts of HbA1c and lipid panels, and historical prioritization of acute infectious management. Socioeconomic disparities compound this risk, as individuals with no formal education exhibit the highest T2DM prevalence (11.2%). On the regulatory front, current fiscal policies like sugar-sweetened beverage taxation require aggressive strengthening, while financial frameworks like the Health Equity Fund lack preventative screening mandates. This review contributes a novel, multi-level evaluation framework that transitions Cambodia’s public health discourse from passive clinical reporting to active, systemic healthcare reorientation. Ultimately, mitigating this metabolic crisis demands restructuring primary care into chronic care models, expanding financial protection for preventative services, and enforcing multi-sectoral dietary regulations.

Integrating Artificial Intelligence Technologies into Health Workforce Education: A Scoping Review of Digital Health Tools in Nursing Curricula

2026-03-14T04:33:40+00:00

The rapid expansion of digital health demands a transformation in health workforce education, yet the mapping of Artificial Intelligence (AI) modalities and their structural integration in nursing curricula remains fragmented. To address this gap, this scoping review aimed to systematically map global AI applications in nursing education from 2020 to 2026, offering a distinct contribution by synthesizing pedagogical innovations and structural implementation barriers to guide future curriculum design. Guided by the PRISMA-ScR framework, a systematic screening was conducted across Scopus, PubMed, and CINAHL databases. Results mapped five core AI technologies, including intelligent tutoring systems, virtual patient simulations, adaptive platforms, natural language processing, and predictive analytics, which significantly enhance students' clinical reasoning, critical thinking, and professional competence without compromising patient safety. However, global adoption is geographically skewed and heavily hindered by deficient technological infrastructure, high financial costs, ethical data privacy issues, and a pronounced gap in faculty digital readiness. This study concludes that successful AI integration must shift from ad-hoc usage toward structured, policy-driven curricular frameworks. Ultimately, this review provides a critical strategic benchmark for educational administrators and policy makers to standardize digital health competencies, mitigate regional educational disparities, and safely future-proof the next generation of the healthcare workforce.

Retooling the Aging Health Workforce: A Phenomenological Study of Older Nurse Educators’ Digital Training and Productivity Needs

2026-03-21T15:08:08+00:00

The rapid digitization of higher education introduces operational complexities for the aging academic workforce, particularly within the tactile domain of nursing education. This descriptive phenomenological study explored the authentic lived experiences of older adult nurse educators navigating learning management systems within private higher education institutions, mapping their digital training and productivity needs. Guided by the COREQ guidelines, purposive sampling selected six informants aged 60 to 72 years with up to 20 years of academic tenure in Cebu City, Philippines. In-depth, semi-structured face-to-face interviews were evaluated using Colaizzi’s seven-step phenomenological approach, achieving data saturation at 100% code duplication. Five definitive themes emerged: overwhelming immediate exposure to varied digital tools, a sense of vulnerability and powerlessness, convenience in information exchange, adverse online teaching-learning encounters, and a proactive plea to meet productivity needs. The findings reveal a technological paradox where the administrative convenience of instant data exchange is deeply compromised by severe technostress, operational dependency, and pedagogical erosion during virtual clinical psychomotor evaluations. This inquiry concludes that technological vulnerability is a structural consequence of non-age-friendly environments rather than individual incompetence. Consequently, higher education administrators must transition from uniform technology mandates toward age-friendly human resource policies, incorporating structured reverse mentoring, dedicated instructional design support, and real-time helpdesks to optimize faculty retention, restore professional self-efficacy, and safeguard downstream patient safety.

Training the Extended Health Workforce: A Controlled Quasi-Experimental Study on Pre-School Teachers’ Attitudes Toward Autism Using the WHO mhGAP Framework

2026-05-27T14:56:15+00:00

In low- and middle-income countries, a critical shortage of child mental health specialists necessitates innovative task-shifting strategies. This study evaluated the effectiveness of an adapted World Health Organization Mental Health Gap Action Programme (WHO mhGAP) educational intervention on preschool teachers’ attitudes toward Autism Spectrum Disorder (ASD) in Kano, Nigeria. Utilizing a controlled quasi-experimental design, 140 preschool teachers were systematically allocated to an intervention group (n = 70) or a control group (n = 70). The intervention cohort received an eight-week training adapted from WHO mhGAP guidelines, whereas controls received no training. Attitudes were evaluated using the Autism Attitude Scale for Teachers across baseline, mid-intervention, and 16-week post-baseline phases, with data analyzed via Chi-square tests and Multivariate Analysis of Covariance (ANCOVA). At baseline, negative attitudes predominated across both study arms (71.4% study vs 75.7% control; p = 0.565). Post-intervention, positive attitudes in the study group surged to 98.6%, compared to 22.9% in the control group (χ² = 84.120, p < 0.001). ANCOVA confirmed a statistically significant primary treatment effect (F(1, 137) = 345.11, p < 0.001, η²_p = 0.716), explaining 71.6% of adjusted post-training attitude variance. This study provides a novel empirical contribution by establishing that adapting clinical WHO mhGAP guidelines for early childhood educators creates a scalable, task-shifting interprofessional framework. This approach directly bridges the child mental health treatment gap and advances community nursing practice in resource-constrained environments.

Developing a Triadic Implementation Framework for Adolescent HIV Status Disclosure in Resource-Limited Settings: A Mixed-Methods Study in Kenya

2026-06-09T23:58:11+00:00

HIV status disclosure to adolescents living with HIV (ALHIV) remains a critical yet inconsistently implemented component of paediatric HIV care in resource-limited settings. Despite policy guidance promoting developmentally appropriate disclosure, routine practice continues to lag. This study formulates an evidence-informed triadic implementation framework grounded in empirical data and aligned with global guidelines. A convergent parallel mixed-methods design was conducted in Western Kenya, involving 310 caregiver–adolescent dyads, eight focus group discussions (n=64), and ten key informant interviews with healthcare providers. Multivariable logistic regression identified independent predictors of disclosure using a quadratic age term for non-linear dynamics, while thematic analysis explored contextual drivers across existing policy frameworks. Overall disclosure prevalence was 74.5%, but dropped to 1.8% among early adolescents (10–12 years), demonstrating a threshold effect (aOR=0.70, 95% CI: 0.59–0.83, p<0.001). Primary predictors included caregiver training (aOR=15.61), confidence (aOR=2.42), peer support access (aOR=3.33), and perceived adolescent maturity (aOR=1.52), whereas fear of psychological harm reduced disclosure odds (aOR=0.27). Disclosure was associated with improved ART adherence (93.9%) and emotional well-being (92.6%), despite initial distress (34.6%). The resulting Triadic Model conceptualizes disclosure as the convergence of adolescent readiness, caregiver capacity, and health system support. It operationalizes normative guidelines into five actionable mechanisms: structured readiness assessment, anticipatory caregiver preparation, family-engaged planning, health system enabling, and post-disclosure follow-up. This framework provides a scalable model to bridge the policy-practice gap in resource-constrained health systems.

Advancing Health Workforce Education: Development and Psychometric Validation of the Challenges in Team-Based Learning Questionnaire (CTBLQ) in Vietnam

2026-05-30T08:50:22+00:00

Although Team-Based Learning (TBL) is widely adopted in health professions education to strengthen collaborative competencies, instruments specifically designed to identify barriers to its implementation remain limited, particularly in transitioning educational contexts. This study aimed to develop and psychometrically validate the Challenges in Team-Based Learning Questionnaire (CTBLQ) among undergraduate nursing students in Vietnam. A methodological research design was employed involving 280 undergraduate nursing students selected through stratified simple random sampling. The 18-item questionnaire underwent expert content evaluation and linguistic review before reliability testing and exploratory factor analysis. The CTBLQ demonstrated excellent internal consistency (Cronbach’s α = 0.910), and all corrected item–total correlations exceeded the recommended threshold of 0.30. Sampling adequacy was confirmed by a Kaiser–Meyer–Olkin value of 0.853, while Bartlett’s test of sphericity was statistically significant (χ²(153) = 4098.257, p < 0.001). Exploratory factor analysis supported a three-factor structure explaining 68.10% of the total variance, comprising learning preparation, participation, and motivation challenges; interpersonal and social conflict challenges; and learning benefit and team harmony challenges. Overall, the CTBLQ demonstrated satisfactory psychometric properties and provides a standardized diagnostic instrument for identifying barriers to Team-Based Learning implementation. The instrument may support evidence-informed curriculum evaluation, educational planning, and future research in nursing education while contributing to the advancement of health workforce education through improved implementation of collaborative learning.