Digital Commons Network^™

Innovative Teaching Strategies: Ai Chatbots To Prepare Nursing Students For Difficult Conversations, Lindsay Iverson, Tamara Oliver, Steven Fernandes, Mandy Kirkpatrick, Kara Morgan, Lauren Guthrie, Trisha Beiermann, Melissa Taylor

International Nursing Research Congress (INRC)

Background and Significance: Therapeutic communication is a core competency in nursing and a consistently prioritized workforce requirement (Broeckelman-Post et al., 2022; McGunagle & Zizka, 2020; AACN, 2021). As AI and digital learning technologies advance, nursing programs are exploring technology-enabled strategies to better prepare students for emotionally complex patient interactions. Although AI chatbots have shown value in clinical training and simulation (Chang et al., 2021; Srinivasan et al., 2024), limited evidence exists on their use to prepare students for difficult or sensitive conversations. Addressing this gap supports student resilience and prepares future nurses for communication-intensive roles.

Purpose and Aims: This study …

Developing Ethical Reasoning And Teamwork In Nursing Students Via Organ Donation Simulation, Miranda M. Smith, Melissa Miasek, Laura Dunaway, Joseph Chamness, Mary Deason, Shikha Modi

International Nursing Research Congress (INRC)

Background: Organ donation is a critical healthcare priority, with 140,964 transplants performed worldwide in 2018 (Lewis et al., 2021). Nursing students often report limited exposure to donor referral processes, brain death determination, and communication with organ procurement organizations. Low baseline knowledge and confidence highlight the need for structured educational interventions (Alwesmi et al., 2023; Bertocchi et al., 2025). Evidence shows teaching and simulation-based learning enhance knowledge, attitudes, and competence in end-of-life donation care (Lewis, 2023). Simulation provides psychological safety, supporting teamwork, communication, clinical judgment, and emotional readiness for ethically complex situations (Masgaard & Svellingen, 2025).

Purpose/Methods: This study examined senior …

The Impacts Of Emotions On Thirst Among Heart Failure Patients, Chieh-An Yang, Hsing-Mei Chen, Tsung-Neng Tsai, Chieh-Yu Liu, Hui-Ju Lu, Ting-Ti Lin

International Nursing Research Congress (INRC)

Purpose: Thirst, characterized by sensations of oral dryness and a craving to drink, is a ubiquitous experience among heart failure (HF) patients. Besides reduced cardiac output, the clinical treatments for HF patients (e.g., diuretics, fluid restriction) may activate the renin-angiotensin-aldosterone system (RAAS), exacerbating their thirst distress.

Negative emotions are commonly experienced among heart failure patients. Previous studies have suggested that emotions (e.g., anxiety, depression) may activate the sympathetic nervous system, reducing the secretion of saliva, which, in turn, may increase sensations of dry mouth among HF patients. However, the relationship between emotions and thirst distress remains unclear. Therefore, the aim …

The Impact Of Covid-19 On The Mental Health And Well-Being Of Black And Latinx Nurses In California, Jerry John Ouner, Patience Afulani, David A. Asakitogum, Nneka Umeh, Monica Getahun, Jaffer Okiring, Michael Denyu, Orlando Harris, Osamuedeme Odiase

International Nursing Research Congress (INRC)

On January 31, 2020, Santa Clara County reported California’s (CA) first COVID-19 case. As the pandemic unfolded, health systems were severely strained, and health care workers faced dual exposure risks from their communities and households alongside heightened occupational risk from direct patient care.1,2 For Black and Latinx nurses, COVID-19’s disproportionate impact on their communities intensified stress, fear, and uncertainty, and when combined with the demands of frontline work, greatly increased their risk of psychological distress and burnout. We examined COVID-19’s impact on the mental health and well-being of Black and Latinx nurses in CA.

Method: We conducted an explanatory sequential …

Enhancing Nursing Narrative Interoperability: Omop-Cdm Representation Of Concern Features, Sujin Gan, Rae Woong Park, Youngjin Lee

International Nursing Research Congress (INRC)

Purpose: This study aims to standardize inpatient nursing narratives by mapping their semantic units to CONCERN features and implementing a structured, interoperable representation of nursing documentation within the OMOP-CDM.

Background: Nursing narratives capture nuanced assessments, clinical reasoning, and early signs of deterioration, yet remain unstructured and inconsistently represented across institutions, limiting interoperability and secondary use. The OMOP Common Data Model (CDM) provides a standardized framework for harmonizing clinical data, but nursing documentation has not been systematically incorporated. The CONCERN framework, developed to identify early deterioration signals from narrative nursing data, offers an appropriate conceptual basis. This study adopted CONCERN features …

Using Simulation To Translate Theory Into Practice: Lessons Learned & Next Steps, Margarett Alexandre, Fern Baudo, Vanessa Carew

International Nursing Research Congress (INRC)

NIH notes adverse events can be avoided (Patient Safety, 2023). Simulations using high-fidelity mannequins offer an interactive environment for students to learn critical thinking skills. Simulations allow students to practice skills in a safe environment before working with real patients (Zenani, 2023; Durham & Alden, 2008). Saylor, Graber, and Trinkaus (2024) note that simulation-based learning experiences can increase confidence in undergraduate nursing students.

Purpose: To explore the impact of increase simulation with senior nursing students in an upper-level med/Surg course, incorporating guided reflective journaling to address students’ assessment of knowledge, understanding of theoretical and practical skills learned, and reflect on …

Impact Of Debriefing Methods On Psychological Outcomes In End-Of-Life Simulation, Jennifer A. Wentzel, Julie Steele, Desireé Hensel

International Nursing Research Congress (INRC)

Introduction: Nursing students do not feel adequately prepared to care for patients at the end of life (EOL) (Yoong et al., 2023). Current EOL education focuses on students’ learning outcomes instead of their psychological needs (Harder & Harwood, 2019). This is the first study to compare the impact of debriefing methods on psychological outcomes in EOL nursing education.

Purpose: Guided by the Transactional Model of Stress and Coping and Kolcaba’s Comfort Theory, this study examined the impact of the Trauma-informed, Psychologically Safe (TiPS) debriefing method on coping with death, attitudes toward care of the dying, and debriefing experience in undergraduate …

Factors Influencing Pediatric Palliative Care Utilization: A 12-Year Retrospective Study In Taiwan, Tzu-Ying Yang, Wei-Wen Wu, Frank Leigh Lu, Shao-Yi Cheng, Tsung-Hsien Yu, Kristin Berg

International Nursing Research Congress (INRC)

Background and objective: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions and their families by addressing physical, psychological, and spiritual needs. Despite increasing recognition of its benefits, PPC remains underutilized, particularly in Asian contexts where early integration and service accessibility are still limited. This study aimed to examine trends and factors influencing PPC utilization among deceased children in a tertiary children’s hospital in Taiwan from 2012 to 2023, to provide evidence on predictors for more equitable access to PPC.

Methods: A retrospective study was conducted using medical records of children aged 1–18 years who …

More Than A Voice: Interpreters As Cultural Brokers In Serious Illness Conversations, Katherine Doyon, Sadia Abdulkadir, Sarah Darney, Sunny Smart, Hannya Ornelas, Alice Mwamba, Adebusola Oluwatoba-Adeyemi

International Nursing Research Congress (INRC)

Background: In serious illness and end-of-life care, effective communication is critical to honoring patients’ values and goals. For patients with refugee backgrounds, healthcare encounters may also evoke distress or (re)traumatization due to past experiences of displacement, persecution, or medical mistrust. Interpreters are essential in facilitating understanding and emotional safety. Yet, their role often extends beyond that of neutral language conduits, they act as cultural brokers, bridging cultural and religious divides, buffering emotions, and fostering trust between refugees and the healthcare team.

Objective: To explore how medical interpreters experience their role as cultural brokers in serious illness conversations.

Methods: A 126-minute …

Assessing Nursing Students’ Palliative Care Competence To Inform Course And Curriculum Design, Wen-Wen Li, Jung Eun Kim, Derrick Huang

International Nursing Research Congress (INRC)

Purpose: This project evaluated undergraduate nursing students’ competency and knowledge in palliative care (PC) before a semester-long course. Findings informed curriculum design to strengthen students’ understanding and application of PC concepts in clinical practice.

Background/Significance: Palliative care is vital in nursing education, yet integration into undergraduate curricula remains inconsistent (Lippe & Becker, 2021). Developing PC competence enhances patients’ and families’ quality of life (Alhaddar et al., 2025). Assessing students’ baseline knowledge helps identify learning gaps and align curricula with the American Association of Colleges of Nursing [AACN] CARES Competencies (AACN, 2021) in PC education.

Methods: A cross-sectional study was conducted …

Virtual Reality Simulation For End-Of-Life Communication: Case Development And Pilot Implementation, Kathryn M. Ledwin, Kylene Abraham, Karen Parker

International Nursing Research Congress (INRC)

Background: Registered nurses have reported feeling unprepared and lacking proper skills for critical end-of-life discussions with patients and their families (Kerr et al., 2020). Virtual reality (VR) simulation presents a novel approach to providing immersive opportunities to support learning and skill development (Liu et al, 2023; Sinurat et al.,2025). VR has been successfully integrated into nursing education to support clinical skill development (Foronda et al. 20220; Liu et al, 2023), however less research has focused on specific applications for complex medical discussions.

Purpose: This project aimed to develop and examine the feasibility of using VR simulation as an educational intervention …

“I Started Healing Myself”: Black Mothers’ Grief Journeys After Stillbirth, Carrie J. Henry, Sara Kaylor, Mallory Scogin

International Nursing Research Congress (INRC)

Introduction: Stillbirth (fetal death after 20 weeks gestation) occurs twice as often for Black mothers compared to White in the United States (Gregory et al., 2024), yet limited research has explored how Black mothers cope with stillbirth-related grief and distress (Boyden et al., 2014; Henry et al., 2023). Evidence suggests coping behaviors after perinatal loss differ across cultural and racial groups (Henry et al., 2024; Moore et al., 2022), yet most studies reflect mostly White samples. Understanding how Black mothers navigate the grieving process is essential to inform culturally responsive care and bereavement support (Fenstermacher & Hupcey, 2019; Henry et …

Ecological Momentary Assessment Of Caregiver Distress In Home Hospice Caregivers: A Study Protocol, Tuzhen Xu, Ya-Ching Huang

International Nursing Research Congress (INRC)

Background: Caregivers of hospice patients, often family or close friends, provide continuous support for individuals with a life expectancy of six months or less. In 2022, 1.72 million Medicare beneficiaries received hospice care, most at home, with an average stay of 98 days. Caregivers manage medications, symptoms, personal care, emotional support, and provider coordination, placing them at high risk for fatigue, anxiety, depression, sleep disturbance, and burnout. Traditional surveys or single-point interviews often fail to capture the dynamic nature of distress, especially during nighttime care or crises.

Purpose: To characterize real-time patterns of physical and psychological distress among home hospice …

Psychometric Evaluation Of The Chinese Version Of The Death Literacy Index Among Nursing Students, Shu-Fen Wu, Li-Er Hung, Hsiu-Chen Liao, Shih-Ting Lo, Chia-Yu Chen

International Nursing Research Congress (INRC)

Background: Death literacy encompasses the knowledge and skills enabling individuals and communities to access, understand, and act on end-of-life care options. For nurses, it influences communication, decision-making, and palliative care quality. However, few studies have examined death literacy among healthcare providers, and no validated Chinese instruments exist for its assessment.

Purpose: To translate the Death Literacy Index (DLI) into Chinese and examine its reliability and validity among nursing students in Taiwan.

Methods: A cross-sectional correlational study was conducted. The DLI underwent translation and back-translation to ensure conceptual and linguistic equivalence, followed by expert review for content validity. Convenience sampling was …

Parent Perspectives On The Potential For And Process Of Infant Organ Donation, Julia St Louis, Amy L. Wright, Sonny Dhanani, Charles Keown-Stoneman, Jennifer Woolfsmith, Danielle Joseph, Kimberley Widger

International Nursing Research Congress (INRC)

Introduction: Despite the potential to shorten waitlists for life-saving transplants, infant organ donation is rare globally (1). Infant donors (less than one year of age) can reduce waitlist mortality for both infants and children who require size-matched organs like hearts and lungs, and adults who can receive kidney transplants from infant donors (2). Infants can donate their organs after death by circulatory criteria (DDCC) (i.e., the heart stops beating)(1) if the death follows the withdrawal of life-sustaining measures (WLSM) (i.e., mechanical ventilation and hemodynamic supports like vasopressors). However, donation rates are very low(2). Providers have reported rarely offering donation due …

Impact Of High-Fidelity Simulation On Nursing Students’ Attitudes Toward Care Of The Dying, Meredith Joyner

International Nursing Research Congress (INRC)

Background: End-of-life (EOL) care is a vital yet often underemphasized component of nursing education. Limited clinical opportunities to engage with dying patients can leave nursing students unprepared to provide compassionate care. High-fidelity simulation provides an evidence-based, immersive learning environment that allows students to practice communication, decision-making, and emotional responses in a safe setting.

Research Question/Aims: This study aimed to determine whether participation in a high-fidelity simulation focused on EOL care would improve nursing students’ attitudes toward caring for dying patients. It was hypothesized that simulation participation would positively impact student attitudes as measured by a validated instrument.

Methods: A quantitative …

Improving Healthcare Provider Knowledge & Satisfaction With The Organ Procurement Process, Brooke Judd, Sandra Rogers

International Nursing Research Congress (INRC)

Introduction / Background:
Most people understand the term death. However, in the world of organ donation, death can have different meanings. Donation after brain death (DBD) is when there is irreversible cessation of all brain activity due to lack of blood and/or oxygenation, a condition commonly referred to as being “brain dead.” The other form is donation after circulatory death (DCD) in which the patient has not deteriorated to brain death but there still may be an opportunity for families to opt for organ donation. Research has shown that healthcare providers working in intensive care units (ICUs) are not always …

Lessons Learned: Creation Of A Global Classroom Initiative, Kim Alexander Decker

International Nursing Research Congress (INRC)

Creating global classroom initiatives are incredibly important for future health care providers as they enter a rapidly changing and complex health care environment as demonstrated by the recent pandemic. Global classroom initiatives promote student readiness to become global citizens. This presentation will describe an international academic experience between a school of nursing in the Midwestern United States and a school of nursing in the United Kingdom. The goal was to add an international dimension to a senior level community health nursing didactic course (USA) and a baccalaureate nursing honors course (UK) without leaving their campuses. Both courses focused on the …

Research Findings Describing Home-Based Nurses’ International Scope And Standards Of Practice, Susan M. Hinck, Mary C. Narayan

International Nursing Research Congress (INRC)

Background. The International Home Care Nurses Organization and the American Nurses Association (ANA) are collaborating to develop the International Scope and Standards of Home-Based Nursing Practice. The first step was to conduct research with home-based nurses (HBNs; nurses who provide care for patients in their homes) to develop an evidence-base for the international scope and standards document.

Methodology. This IRB-reviewed study consisted of a literature review to locate key documents (e.g.; ICN, 2021; Narayan et al., 2017; Nursing and Midwifery Council, 2024; Rusli et al., 2021, Saari et al., 2024) and four surveys: 1) status of country’s Home-Based Nursing …

Assessing And Addressing Distress For Informal Caregivers Caring For Oncology Patients, Megan Bridget Murphy

International Nursing Research Congress (INRC)

Background: Distress clearly impacts cancer patients, but it also impacts their loved ones, their informal caregivers (ICG). Not only do these ICGs experience distress, but ICGs often experience even more distress than patients receiving treatment (Amonoo et al., 2022; Wang et al., 2023). Despite the prevalence of ICG distress, they are often not screened for distress or provided resources to help them cope (Nightingale et al., 2024).

Purpose: This quality improvement project aims to assess the effect of implementing a distress screening tool for informal caregivers in an outpatient regional cancer system. Distress levels of ICGs will be noted in …

Effects Of Continuing Nursing Care For Patients With Total Laryngectomy: Rct, Kumiko Kotake, Kaori Haba, Mami Kurita, Kazuyo Iwanaga, Yoko Ishibashi, Aya Takahashi, Ichiro Kai, Yoshimi Suzukamo, Yoriko Hara, Ichiro Ota, Hiroyuki Uemura

International Nursing Research Congress (INRC)

Purpose: The objective of the study was to clarify whether informational/psychological nursing intervention could improve the quality of life of laryngectomized patients 3 months after hospital discharge compared to the provision of information only, and to examine whether the nursing intervention could continue to improve the quality of life at twelve months after discharge.

Methods: Randomization was performed according to Consolidated Standards of Reporting Trials guidelines. Hospitalized pharyngeal and laryngeal cancer patients who underwent laryngectomy had agreed to participate in the study.
They were randomly assigned to two groups: we offered relevant information including the distribution and conducted interviews on …

Empowering Nurses: A Strategic Approach To Retention And Professional Growth, Rachel A. Hutton

International Nursing Research Congress (INRC)

Post-pandemic, nursing recruitment has been crucial for workforce staffing solutions. However, retaining qualified and experienced professionals is now more vital than ever to care for a growing, sick, and complex patient population. According to the Bureau of Health Workforce, the average years of experience for RNs is 2.8 years. Literature suggests that nurses leave their current organizations due to a lack of access to professional growth aligned with their career goals.

Identifying the need to retain experienced nurses and increase their organizational commitment. Leaders and Nursing Professional Development (NPD) partnered to identify sustainable strategies for growing internal nurses. The aim …

Readiness For Advance Care Planning In Patients With Chronic Kidney Disease: A Cross-Sectional Study, Jie-Ru Hsu, Yu-Chi Chen, Cheng-Pei Lin, Chih-Ching Lin, Chieh-Yu Liu

International Nursing Research Congress (INRC)

Background: Chronic Kidney Disease (CKD) patient often face unpredictable progression, leading to sudden deterioration that impair communication of medical preferences in emergencies. Without Advance Care Planning (ACP), treatments may conflict with patient values, causing decisional conflicts and excessive interventions. While ACP helps ensure patient autonomy, there is limited understanding of CKD patients' readiness for ACP restricts healthcare providers from delivering timely and appropriate supportive care.

Purpose: This study aims to identify factors influencing ACP readiness in CKD patients to inform strategies for patient-centered care.

Methods: A cross-sectional study was conducted with non-dialysis CKD patients using the validated Chinese version of …

There Are No Words: What Do You Call A Parent Who Has Lost A Child, Sandra K. Cesario

International Nursing Research Congress (INRC)

Background: There is no commonly used English word to describe a parent whose child is deceased. A child who has no parents is an orphan and a person who has lost a spouse is a widow(er). Absence of terminology to describe parents after the death of a child may contribute to difficulty in adapting to a new identity and alter societal expectations for grieving. Vilomah, a word borrowed from the Sanskrit language meaning "against the natural order," has emerged in non-nursing literature to describe a parent whose child has died. It is derived from the concept that parents …

End-Of-Life Training In Us Nurse Practitioner Programs: A National Study, Derek Cegelka, Jessica Nishikawa, Victoria Wagner-Greene, Xavier Heidelberg

International Nursing Research Congress (INRC)

Background: Nurse practitioners (NPs) work in a wide array of healthcare settings, including hospitals, primary care clinics, long-term care facilities, and specialty clinics. Historically very few nursing programs and nursing texts offered content related to EOL care (D’Antionio, 2017). At the graduate level, the American Association of Critical Care Nurses (AACN) Essentials contain elements of EOL care such as effective communication and professionalism, but do not explicitly delineate it as a distinct competency or sub-competency (AACN, 2023). Previous research found that most NP programs offer little to no instruction on palliative care and that palliative care training for nurses remains …

Bridging Theory-Practice Gaps: Military Nurses' Combat Palliative Praxis And Care Competency, Deborah Kenny, Sean Reed

International Nursing Research Congress (INRC)

Background/Purpose: Evidence-based national guidelines establish traditional palliative care standards, yet there are gaps in applying competencies amidst combat nursing complexity, frontline fluctuations, and mass casualties. During the most recent wars, nurses related reluctance in triaging and not knowing how to care for severely ill and dying young service members (Kenny & Kelley, 2019; Kelley, Kenny, & Donley, 2017). Relevant nursing theory integration is lacking to guide this distinctly difficult context marked by severity and suffering, requiring theoretical nursing models attuned to combat conditions.

Aims/Outcomes: This presentation aims to describe an ongoing study using an adapted unitary caring science model (Reed …

Validity And Reliability Of The Mongolian Version Of Functional Assessment Of Cancer Therapy, Gelegjamts Gelgersuren, Gaalan Khulan, Kim Jin Sun

International Nursing Research Congress (INRC)

Background: The health-related quality of life (HRQOL) is an important indicator for determining the health outcomes of cancer treatment. The Functional Assessment of Cancer Therapy-General (FACT-G) scale, which was developed in the USA and validated in many countries, is widely used to measure the HRQOL in cancer patients. In Mongolia, there is no valid and reliable instrument to measure HRQOL for cancer patients. The purposes of this study was to empirically validate the FACT-G scale with Mongolian cancer patients.

Methods: This study was a methodological study. The English version of FACT-G was translated into the Mongolian language using the Functional …

Family Caregiver's Burden Of Women With Breast Cancer And Relation With Social Support, Self-Efficacy, Anoud Said Al Abdulsallam, Sulaiman Al Sabei, Fawwaz Alaloul

International Nursing Research Congress (INRC)

Background: Due to the rising incidence of breast cancer and shorter length of hospital stays, more pressure is being placed on family members to care of their close relatives who are ill. However, studies investigating caregivers’ burdens in Middle Eastern countries, including Oman, are limited. Objectives: To assess the level of burden among family caregivers of women with breast cancer and examine its relationship with caregivers' social support and self-efficacy. Methods: A descriptive cross-sectional design was used. Patients and their family caregivers were recruited. Zarit Burden Interview scale, the Multidimensional Scale of Perceived Social Support, and the General Self-Efficacy scale …

Exploring Ai In Hospice And Palliative Care: An Integrative Review, Tuzhen Xu, Gloria M. Rose, Caiyi Liu, Lin Li, Sen Zhu

International Nursing Research Congress (INRC)

Background: Artificial Intelligence (AI) is increasingly transforming the healthcare industry by integrating various algorithmic models into electronic health records and wearable health technologies. These advancements support healthcare providers in making evidence-based decisions and predicting patient outcomes, ultimately enhancing the quality of care. This integrative literature review synthesizes peer-reviewed research on the application of AI in palliative and hospice care, aiming to identify both the implications and barriers to practice and research in this vital area.

Methods: We conducted a comprehensive search across nine databases—Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PubMed, Medline, Web …

Caregiver Comfort With Tele-Hospice, Patricia L. Cameron

International Nursing Research Congress (INRC)

Tele-hospice is changing the provision of on-demand hospice and palliative care. A retrospective, descriptive study was completed examining comfort and emotional support that caregivers of community-based hospice patients derived from using electronic tablets. 667 survey responses were obtained. Data analysis included Pearson product moment correlations and Wilcoxon signed ranks tests.