{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:59:18Z","timestamp":1790315958433,"version":"4.1.0"},"reference-count":67,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"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 in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Effective nursing handover is essential for ensuring patient safety and continuity of care, particularly in critical care settings where patients are highly complex and clinical decisions must be made rapidly. Occupational stress is prevalent among critical care nurses and has been associated with impaired performance and communication failures. Clinical decision\u2010making is a core professional competency that may influence how stress affects handover quality; however, limited evidence has examined its combined effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the impact of job stress and clinical decision\u2010making on handover competency among critical care nurses and to test the mediating role of clinical decision\u2010making in this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A multicentre cross\u2010sectional descriptive study was conducted in six hospitals in Egypt. Using a convenience sampling approach, participants completed self\u2010administered, self\u2010report questionnaires. Data were analysed using descriptive statistics, correlation analysis, multiple linear regression and mediation analysis with Hayes' PROCESS Macro (Model 4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 410 critical care nurses were recruited for the study. They reported moderate levels of job stress, strong clinical decision\u2010making abilities and high handover competency. Job stress was negatively correlated with both clinical decision\u2010making (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.242,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and handover competency (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.218,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while clinical decision\u2010making was positively correlated with handover competency (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.332,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Regression analysis showed that higher educational level, rotating shifts and stronger clinical decision\u2010making predicted higher handover competency, whereas higher job stress predicted lower competency. Mediation analysis revealed that clinical decision\u2010making partially mediated the relationship between job stress and handover competency, with significant direct, indirect and total effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical decision\u2010making plays a pivotal mediating role in the relationship between job stress and handover competency among critical care nurses. Job stress directly and indirectly impairs handover performance by diminishing nurses' decision\u2010making capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Interventions aimed at reducing job stress and strengthening clinical decision\u2010making, such as stress\u2010management programs, simulation\u2010based training and structured handover protocols, may enhance communication quality and patient safety in critical care settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70682","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:13:51Z","timestamp":1790313231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Job Stress and Handover Competency Among Critical Care Nurses: The Mediating Role of Clinical Decision\u2010Making in a Multicentre Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"31","author":[{"given":"Shaimaa Mohamed","family":"Amin","sequence":"first","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing Qassim University  Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0316-1374","authenticated-orcid":false,"given":"Ibrahim","family":"Alasqah","sequence":"additional","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing Qassim University  Buraydah Saudi Arabia"},{"name":"School of Health, University of New England  Armidale New South Wales Australia"},{"name":"Nursing Services Department Qassim University Medical City  Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2666-6797","authenticated-orcid":false,"given":"Mostafa Mohamed","family":"Zanaty","sequence":"additional","affiliation":[{"name":"Nursing Sciences Department, College of Applied Medical Sciences Prince Sattam Bin Abdulaziz University  Wadi Alddawasir City Saudi Arabia"},{"name":"Critical Care and Emergency Nursing Department, Faculty of Nursing Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8538-5250","authenticated-orcid":false,"given":"Sameer A.","family":"Alkubati","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Nursing, College of Nursing University of Ha'il  Ha'il City Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Yasser","family":"Hammouda","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Nursing Department, Faculty of Nursing Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5518-0892","authenticated-orcid":false,"given":"Mohamed H. 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