Mader-e-Milat International Journal of Nursing and Allied Sciences

Nurses’ Perception of Futile Care: A Systematic Review

Hamza Zarine — 2025-12-30

Background: Advances in medical technology have improved patient survival; however, the continuation of treatment at the end of life often raises ethical and professional concerns, particularly when such care is perceived as futile. Nurses, due to their continuous bedside presence, are frequently involved in and affected by decisions related to futile care.

Methods: This review aimed to synthesize existing literature on nurses’ perceptions of futile care, including how futility is defined, factors influencing these perceptions, and the professional outcomes associated with providing such care. A systematized systematic review was conducted in accordance with PRISMA guidance. PubMed, Medline, ProQuest, and Google Scholar were searched for relevant English-language studies published between 1980 and 2020. Qualitative, quantitative, and mixed-methods studies focusing on nurses’ perceptions of futile care were included. Due to methodological diversity among studies, findings were synthesized narratively.

Results: Twenty-two studies met the inclusion criteria. Across settings, nurses’ perceptions of futile care ranged from moderate to high. Futile care was commonly described as treatment lacking physiological benefit, prolonging the dying process, or failing to improve quality of life. Factors influencing perception included family insistence on continued treatment, cultural and religious values, interprofessional conflict, and organizational constraints. Perceived futile care was consistently associated with moral distress, emotional exhaustion, burnout, and reduced job satisfaction among nurses.

Conclusion: In conclusion, nurses frequently encounter and perceive futile care in critical care environments, with notable ethical and occupational consequences. Interventions focusing on education, communication, multidisciplinary decision-making, and institutional support may help reduce moral distress and improve the quality of end-of-life care.

Perceived Barriers in Implementation of Nursing Process in Public Sectors of South Punjab-Pakistan

Rabia Khadim — 2025-12-30

Background: The nursing process is a universal system that is essential to the nursing profession and is absolutely vital in the provision of the high quality and patient centered care. Its practical use elevates the level of patient care, whereas the inability to implement it effectively might harm the patient care outcomes. It is also important that the perceived barriers be understood individually and organizationally among nurses to facilitate the practical application of the nursing process.

Methods: A descriptive cross sectional study was used to establish the barriers in the implementation of the nursing process within the institutions of the public sector in South Punjab, Pakistan. The nurses working in Intensive Care Unit (ICU) and High Dependency Unit (HDU) of four tertiary care teaching hospitals as Nishtar Hospital Multan, Bahawal Victoria Hospital Bahawalpur, Sheikh Zayed Hospital Rahim Yar Khan and Teaching Hospital Dera Ghazi Khan were sampled to collect the data. There was also an application of a structured questionnaire to measure individual and organizational barriers.

Findings: Two hundred and thirty nurses took part in the research. In terms of the individual-level barriers, 60 percent of the nurses said they were highly hindered, and 40 percent had low perceptions. On the same note, 57% of respondents indicated that they are high of organizational barriers, and 43% of respondents indicated that they are low. These findings demonstrate that the adoption of nursing process entails major challenges in the provision of healthcare services in the general population.

Conclusions: The research points to the significant personal and institutional barriers to the implementation of the nursing process in the hospital of the South Punjab in the public sector. It is essential to mitigate these obstacles using specific interventions to enhance the nursing care and patient care outcomes.

Influence of Continuous Training on Nurses Knowledge and Attitude Toward Safe Patient Care at Bahawal Victoria Hospital (BVH), Bahawalpur-Pakistan

Hafiza Nain Tara — 2026-02-23

Background: Ongoing professional education is one of the key pillars of patient care and safety. Nevertheless, there is a lack of evidence on its effects on the knowledge and attitudes of nurses working in tertiary hospitals in Pakistan.

Purpose: To determine the impact of continuous training on the knowledge of nurses and their attitudes towards providing safe patient care at Bahawal Victoria Hospital, Bahawalpur.

Methods: A cross-sectional study in a descriptive design was introduced on 150 RNs using a structured questionnaire that contained demographic information, training exposure, knowledge tests, and attitude scales. Analysis of data was done using SPSS with the level of significance of p < 0.05.

Findings: The attendance of nurses in training was found to be 70 per cent in the last year. The perceptions of knowledge were moderate (mean = 7.4 ± 1.9) and high in 46.7% and 40% of the participants respectively. Attitude scores showed positive attitude towards patient safety (mean= 38.6 +6.2) and the scores were much higher among trained nurses (p < 0.05). The workload (63.3%), the staffing shortage (53.3%), and the limited time (46.7%), were major obstacles to training.

Conclusion: On-going training is found to be a major improvement in patient safety knowledge and attitude among the nurses at BVH. These results require institutional support, proper scheduling and management participation.

Recommendation: To enhance the culture of patient safety, BVH management should formalize routine and context-specific training and establish policy structures that guarantee participation, assessment, and follow-up on patient safety.

Perceived Impact of Artificial Intelligence Usage on Academic Performance Among Undergraduate Health Science Students in Mirpurkhas, Sindh-Pakistan: A Multi-Center Study

Samia Khalil Ahmed — 2025-12-30

Background: Many medical and nursing students are increasingly utilizing artificial intelligence tools such as Telemedicine, Jeni.AI, Gemini, and ChatGPT to support both academic and clinical activities. These tools offer rapid responses and can save valuable time. However, there is growing concern that students in cities like Mirpurkhas may become overly reliant on AI, which could potentially compromise the development of critical thinking, problem-solving, and research skills.

Methods: A descriptive cross-sectional study was conducted among undergraduate health science students at selected public and private centers in Mirpurkhas. Stratified random sampling was used to recruit a total of 197 participants, and data were collected via Google Forms from January to February 2026. An adapted questionnaire was employed, with minor modifications based on expert review to ensure validity. The collected data were analyzed using SPSS version 27.0, and descriptive statistics were generated for demographic subgroups.

Findings: Among the 197 participants, the majority were BSN students (76.1%), aged 18–22 years (67.5%), and enrolled in private institutions (63%). Most students had a CGPA between 3.01–3.50. High perception scores were observed for General Use of AI (3.79 ± 0.40), Future of AI in Education (3.75 ± 0.46), and Impact on Student Skills (3.65 ± 0.48). Effectiveness of AI in Education was rated moderately high (3.49 ± 0.45), while Accuracy and Reliability received a moderate score (2.60 ± 0.50). These findings suggest that students generally find AI tools easy to use; however, they also express concerns about potential erosion of their natural skills and critical thinking.

Conclusion: The healthcare undergraduate students demonstrated a high level of acceptance and utilization of artificial intelligence (AI) as a supportive academic tool. While AI use was generally associated with enhanced academic performance, concerns regarding accuracy and potential over-reliance remain. Implementation of structured training programs and clear ethical guidelines is recommended to ensure responsible and effective integration of AI in healthcare academia.