{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:42:06Z","timestamp":1789544526518,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n To systematically map the determinants, expressions and implications of nurses' clinical autonomy in Palestinian healthcare settings.<\/jats:p>\n <\/jats:sec>\n \n Background\/Introduction<\/jats:title>\n Nurses' autonomy is crucial for quality care, job satisfaction and patient safety. In Palestine, the healthcare system operates under unique political instability and resource constraints, yet a comprehensive synthesis of nursing autonomy in this context is lacking.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A scoping review was conducted following PRISMA\u2010ScR guidelines. PubMed, Scopus, CINAHL, PsycINFO, Google Scholar, ProQuest, Al\u2010Manhal and Arab World Research Source were searched for literature published between January 2019 and March 2025. A total of 3916 records were identified across all databases, of which 1203 duplicates were removed, leaving 2713 unique records for screening. After title\/abstract screening, 178 records proceeded to full\u2010text review, and nine studies meeting the inclusion criteria were synthesized thematically.<\/jats:p>\n <\/jats:sec>\n \n Results\/Findings<\/jats:title>\n Palestinian nurses conceptualize autonomy as independent clinical decision\u2010making, patient advocacy and participation in organizational processes, often exercised within significant constraints. Key determinants include education level, clinical experience, leadership styles and resource availability. Major barriers were physician\u2010dominated hierarchies and the impacts of political conflict. Enhanced autonomy was associated with improved job satisfaction and patient safety reporting.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n The findings align with international research on determinants like education and leadership but highlight the profound, context\u2010specific influence of political conflict and resource scarcity in Palestine. These factors create a practice environment where autonomy is often reactive and improvisational. Although formal quality appraisal was not conducted, consistent with scoping review methodology, Oxford Levels of Evidence were assigned to each study to aid interpretation of evidence strength. Readers should note that most included studies are cross\u2010sectional or qualitative, which limits causal inference.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Nurses' autonomy in Palestine is multifaceted and contextually embedded. Strengthening it requires multilevel strategies that address individual, organizational and systemic barriers, particularly those arising from the unique sociopolitical context.<\/jats:p>\n <\/jats:sec>\n \n Implications for Nursing<\/jats:title>\n Nurse leaders should adopt transformational leadership styles and create formal structures for nursing input in decision\u2010making to empower staff and foster professional growth.<\/jats:p>\n <\/jats:sec>\n \n Implications for Nursing and Health Policy<\/jats:title>\n Policymakers must develop clear national standards for autonomous nursing practice and invest in sustainable resources and staffing. International partners should support professional development and advocate for the protection of healthcare workers in conflict zones.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n This review adhered to the PRISMA\u2010ScR (Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses extension for Scoping Reviews) guidelines.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n This study did not include patient or public involvement in its design, conduct or reporting.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/nop2.70652","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:35:43Z","timestamp":1781757343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring Professional Autonomy Among Palestinian Nurses: A Comprehensive Scoping Review of Determinants, Barriers and Clinical Practice Implications"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6339-9176","authenticated-orcid":false,"given":"Ibrahim","family":"Aqtam","sequence":"first","affiliation":[{"name":"Department of Nursing Nablus University for Vocational and Technical Education Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3494-1028","authenticated-orcid":false,"given":"Saqr","family":"Alkorom","sequence":"additional","affiliation":[{"name":"Department of Nursing Nablus University for Vocational and Technical Education Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0560-9327","authenticated-orcid":false,"given":"Mustafa","family":"Shouli","sequence":"additional","affiliation":[{"name":"Department of Nursing Nablus University for Vocational and Technical Education Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.17532\/jhsci.2025.2818"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010019\u20104374\u20109"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/NNA.0000000000000245"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.70004"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010023\u201001390\u2010x"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.22201\/fca.24488410e.2023.3049"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102018\u2010026788"},{"issue":"3","key":"e_1_2_16_10_1","first-page":"123","article-title":"Nursing Unit Characteristics and Patient Outcomes","volume":"35","author":"Boyle D. K.","year":"2017","journal-title":"Nursing Economics"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732312452938"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2018.04.016"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.13181"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010024\u201006196\u2010y"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/23779608251374155"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44197\u2010025\u201000489\u20105"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2008.28.6.58"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(18)30386\u20103"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20105\u201069"},{"issue":"1","key":"e_1_2_16_20_1","first-page":"17","article-title":"Why Nurses Leave Their Work From Governmental Hospitals to Primary Health Care Centers in Gaza Governorates","volume":"24","author":"Mesmeh A. M.","year":"2016","journal-title":"Journal of the Islamic University of Gaza for Economic and Administrative Studies"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.12756"},{"key":"e_1_2_16_22_1","unstructured":"Oxford Centre for Evidence\u2010Based Medicine.2011.\u201cLevels of Evidence.\u201dhttps:\/\/www.cebm.ox.ac.uk\/resources\/levels\u2010of\u2010evidence\/oxford\u2010centre\u2010for\u2010evidence\u2010based\u2010medicine\u2010levels\u2010of\u2010evidence\u2010march\u20102009."},{"key":"e_1_2_16_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_16_24_1","volume-title":"Annual Health Report 2023","author":"Palestinian Ministry of Health","year":"2023"},{"key":"e_1_2_16_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000072.pub3"},{"key":"e_1_2_16_26_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v7.24701"},{"key":"e_1_2_16_27_1","doi-asserted-by":"publisher","DOI":"10.15171\/jcs.2017.033"},{"key":"e_1_2_16_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102834.2009.00999.x"},{"key":"e_1_2_16_29_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18\u20100850"},{"key":"e_1_2_16_30_1","unstructured":"World Health Organization.2016.\u201cGlobal Strategic Directions for Strengthening Nursing and Midwifery.\u201dhttps:\/\/www.who.int\/publications\/i\/item\/9789241510455."},{"key":"e_1_2_16_31_1","unstructured":"World Health Organization.2020.\u201cState of the World's Nursing 2020 Investing in Education Jobs and Leadership.\u201dhttps:\/\/www.who.int\/publications\/i\/item\/9789240003279."}],"container-title":["Nursing Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70652","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nop2.70652","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70652","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:51:54Z","timestamp":1782273114000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nop2.70652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/nop2.70652"],"URL":"https:\/\/doi.org\/10.1002\/nop2.70652","archive":["Portico"],"relation":{},"ISSN":["2054-1058","2054-1058"],"issn-type":[{"value":"2054-1058","type":"print"},{"value":"2054-1058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70652"}}