{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T09:25:18Z","timestamp":1771579518763,"version":"3.50.1"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["2023.02974.BD"],"award-info":[{"award-number":["2023.02974.BD"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nurs"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>While it is acknowledged that effectively managing uncertainty in nursing clinical practice is imperative for ensuring safe healthcare delivery, there remains a scarcity of guidance on enhancing uncertainty management within the clinical reasoning of nurses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Aims<\/jats:title>\n            <jats:p>To describe strategies that nurses in post-anesthesia care units use to manage uncertainty in clinical reasoning; and to map these strategies within the Integrative Framework of Uncertainty Management, and the clinical realities of Wiedenbach\u2019s Prescriptive Theory.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Material &amp; methods<\/jats:title>\n            <jats:p>A descriptive qualitative study. Fourteen nurses from a post-anesthesia care unit of a third-level hospital at the center region of Portugal were recruited using a convenience sampling method. Data were collected through semi-structured interviews and analyzed using thematic analysis using MAXQDA software. Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting. Ethical approval was obtained from the relevant Ethics Committee, with informed consent, confidentiality, and data protection measures in place to ensure participant anonymity and compliance with the Declaration of Helsinki.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The major theme \u2018uncertainty management strategies in clinical reasoning of nurses in Post-anesthesia Care Units\u2019 included four themes: ignorance-focused strategies, uncertainty-focused strategies, response-focused strategies, and person-focused strategies. These themes were mapped within key domains of nursing care: recipient, skills, policies, techniques, time sequence, agent, happenings, and supportive relationships. The domains encompassed various approaches such as person-centered care, evidence-based practice, postgraduate training, conflict management, critical thinking, continuous improvement projects, in-service team training, contingency planning, case discussions, simulation, self-reflectiveness, emotion self-regulation, optimizing working conditions, positive cognitive reframing, seeking support, fostering team reflection, and collaborative communication.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Nurses in the Post-anesthesia Care Unit employed a range of uncertainty management strategies, which were effectively categorized within the Integrative Framework of Uncertainty Management (IFUM). Emphasizing nursing as a process, as described in Wiedenbach\u2019s Prescriptive Theory, these strategies were aligned with addressing the clinical realities tailored to each strategy. More research is needed to understand how the use of different strategies can promote nurses\u2019 wellbeing and enhance the safety of nursing care.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trial registration<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12912-025-03193-8","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T07:56:55Z","timestamp":1748419015000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Uncertainty management strategies in clinical reasoning: perceptions of nurses in post-anesthesia care units"],"prefix":"10.1186","volume":"24","author":[{"given":"Lara Daniela Matos","family":"Cunha","sequence":"first","affiliation":[]},{"given":"Paul K. J.","family":"Han","sequence":"additional","affiliation":[]},{"given":"Filipa","family":"Ventura","sequence":"additional","affiliation":[]},{"given":"M\u00e1rcia","family":"Pestana-Santos","sequence":"additional","affiliation":[]},{"given":"Lurdes","family":"Lomba","sequence":"additional","affiliation":[]},{"given":"Margarida Reis","family":"Santos","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"issue":"6","key":"3193_CR1","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.nedt.2009.10.020","volume":"30","author":"T Levett-Jones","year":"2010","unstructured":"Levett-Jones T, Hoffman K, Dempsey J, Jeong SY-S, Noble D, Norton CA, Roche J, Hickey N. The \u2018five rights\u2019 of clinical reasoning: an educational model to enhance nursing students\u2019 ability to identify and manage clinically \u2018at risk\u2019patients. Nurse Educ Today. 2010;30(6):515\u201320.","journal-title":"Nurse Educ Today"},{"issue":"5","key":"3193_CR2","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1111\/j.1365-2648.2010.05262.x","volume":"66","author":"B Simmons","year":"2010","unstructured":"Simmons B. Clinical reasoning: concept analysis. J Adv Nurs. 2010;66(5):1151\u20138.","journal-title":"J Adv Nurs"},{"key":"3193_CR3","volume-title":"Critical thinking, clinical reasoning and clinical judgment: A practical approach","author":"R Alfaro-LeFevre","year":"2016","unstructured":"Alfaro-LeFevre R. Critical thinking, clinical reasoning and clinical judgment: A practical approach. pageburst E-book on kno: Elsevier Health Sciences; 2016."},{"issue":"7220","key":"3193_CR4","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1136\/bmj.319.7220.1279","volume":"319","author":"LL Weed","year":"1999","unstructured":"Weed LL, Weed L. Opening the black box of clinical judgment\u2014an overview. BMJ. 1999;319(7220):1279.","journal-title":"BMJ"},{"issue":"2","key":"3193_CR5","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1080\/13561820.2022.2061928","volume":"37","author":"S Berger","year":"2023","unstructured":"Berger S, Krug K, Goetz K. Encountering uncertainty and complexity in decision-making: an observational study of clinical reasoning among medical and interprofessional groups of health care students. J Interprof Care. 2023;37(2):262\u201371.","journal-title":"J Interprof Care"},{"issue":"3","key":"3193_CR6","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1213\/ANE.0000000000004826","volume":"131","author":"MH Tsai","year":"2020","unstructured":"Tsai MH, Kimatian SJ, Duguay JR, Tanniru MR, Sarraf E, Hudson ME. Rethinking operating room management: why clinical directors should embrace complexity. Anesth Analgesia. 2020;131(3):984\u20138.","journal-title":"Anesth Analgesia"},{"issue":"5","key":"3193_CR7","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1016\/j.jopan.2019.02.005","volume":"34","author":"C de Santana Lemos","year":"2019","unstructured":"de Santana Lemos C, de Brito Poveda V. Adverse events in anesthesia: an integrative review. J PeriAnesthesia Nurs. 2019;34(5):978\u201398.","journal-title":"J PeriAnesthesia Nurs"},{"issue":"3","key":"3193_CR8","doi-asserted-by":"publisher","first-page":"e649","DOI":"10.1002\/hsr2.649","volume":"5","author":"B Abebe","year":"2022","unstructured":"Abebe B, Kifle N, Gunta M, Tantu T, Wondwosen M, Zewdu D. Incidence and factors associated with post-anesthesia care unit complications in resource\u2010limited settings: an observational study. Health Sci Rep. 2022;5(3):e649.","journal-title":"Health Sci Rep"},{"issue":"11","key":"3193_CR9","doi-asserted-by":"publisher","first-page":"3696","DOI":"10.1111\/jan.15348","volume":"78","author":"M Sanclemente-Dalmau","year":"2022","unstructured":"Sanclemente-Dalmau M, Galbany\u2010Estragu\u00e9s P, Palomar\u2010Aumatell X, Rubinat\u2010Arnaldo E. Defining competencies for nurse anaesthetists: A Delphi study. J Adv Nurs. 2022;78(11):3696\u2013709.","journal-title":"J Adv Nurs"},{"issue":"2","key":"3193_CR10","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1111\/inm.12963","volume":"31","author":"T Maguire","year":"2022","unstructured":"Maguire T, Garvey L, Ryan J, Willetts G, Olasoji M. Exploration of the utility of the nursing process and the clinical reasoning cycle as a framework for forensic mental health nurses: A qualitative study. Int J Ment Health Nurs. 2022;31(2):358\u201368.","journal-title":"Int J Ment Health Nurs"},{"issue":"2","key":"3193_CR11","first-page":"e32","volume":"35","author":"LDM Cunha","year":"2022","unstructured":"Cunha LDM, Pestana-Santos M, Lomba L, Reis Santos M. Uncertainty in post-anaesthesia nursing clinical reasoning: an integrative review in the light of the model of uncertainty in complex health care settings. J Perioperative Nurs. 2022;35(2):e32\u201340.","journal-title":"J Perioperative Nurs"},{"issue":"3","key":"3193_CR12","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1177\/0272989X21992340","volume":"41","author":"PK Han","year":"2021","unstructured":"Han PK, Strout TD, Gutheil C, Germann C, King B, Ofstad E, Gulbrandsen P, Trowbridge R. How physicians manage medical uncertainty: a qualitative study and conceptual taxonomy. Med Decis Making. 2021;41(3):275\u201391.","journal-title":"Med Decis Making"},{"key":"3193_CR13","doi-asserted-by":"crossref","unstructured":"Wiedenbach E. Nurses\u2019 wisdom in nursing theory. Am J Nurs 1970:1057\u201362.","DOI":"10.1097\/00000446-197005000-00037"},{"issue":"5","key":"3193_CR14","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1080\/0142159X.2019.1579308","volume":"42","author":"G Gheihman","year":"2020","unstructured":"Gheihman G, Johnson M, Simpkin AL. Twelve tips for thriving in the face of clinical uncertainty. Med Teach. 2020;42(5):493\u20139.","journal-title":"Med Teach"},{"issue":"7","key":"3193_CR15","doi-asserted-by":"publisher","first-page":"2490","DOI":"10.3390\/ijerph17072490","volume":"17","author":"SK Lam","year":"2020","unstructured":"Lam SK, Kwong EW, Hung MS, Chien W-t. Investigating the strategies adopted by emergency nurses to address uncertainty and change in the event of emerging infectious diseases: A grounded theory study. Int J Environ Res Public Health. 2020;17(7):2490.","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"3193_CR16","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1002\/nur.22265","volume":"45","author":"LC Copel","year":"2022","unstructured":"Copel LC, Lengetti E, McKeever A, Pariseault CA, Smeltzer SC. An uncertain time: clinical nurses\u2019 first impressions during the COVID-19 pandemic. Res Nurs Health. 2022;45(5):537\u201348.","journal-title":"Res Nurs Health"},{"key":"3193_CR17","doi-asserted-by":"crossref","unstructured":"Han PK. Uncertainty in medicine: A framework for tolerance. Oxford University Press; 2021.","DOI":"10.1093\/oso\/9780190270582.001.0001"},{"key":"3193_CR18","doi-asserted-by":"crossref","unstructured":"Shabestari MM, Tabrizi FJ, Roshangar F, Ghahramanian A, Zamanzadeh V, Sarbakhsh P, Agom DA. Nurses\u2019 perception of uncertainty in clinical decision-making: A qualitative study. Heliyon 2024;10(16).","DOI":"10.1016\/j.heliyon.2024.e36228"},{"issue":"5","key":"3193_CR19","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1177\/1744987119880234","volume":"25","author":"L Doyle","year":"2020","unstructured":"Doyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443\u201355.","journal-title":"J Res Nurs"},{"issue":"2","key":"3193_CR20","first-page":"72","volume":"1","author":"J Golzar","year":"2022","unstructured":"Golzar J, Noor S, Tajik O. Convenience sampling. Int J Educ Lang Stud. 2022;1(2):72\u20137.","journal-title":"Int J Educ Lang Stud"},{"key":"3193_CR21","unstructured":"Schick L, Windle PE. Perianesthesia nursing core curriculum: preprocedure, phase I, and phase II PACU nursing. (No Title) 2010."},{"issue":"2","key":"3193_CR22","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jopan.2014.05.010","volume":"30","author":"JM McLaren","year":"2015","unstructured":"McLaren JM, Reynolds JA, Cox MM, Lyall JS, McCarthy M, McNoble EM, Petersen VR. Decreasing the length of stay in phase I postanesthesia care unit: an evidence-based approach. J PeriAnesthesia Nurs. 2015;30(2):116\u201323.","journal-title":"J PeriAnesthesia Nurs"},{"issue":"4","key":"3193_CR23","first-page":"1073","volume":"7","author":"MAA Majid","year":"2017","unstructured":"Majid MAA, Othman M, Mohamad SF, Lim SAH, Yusof A. Piloting for interviews in qualitative research: operationalization and lessons learnt. Int J Acad Res Bus Social Sci. 2017;7(4):1073\u201380.","journal-title":"Int J Acad Res Bus Social Sci"},{"issue":"3","key":"3193_CR24","first-page":"1","volume":"20","author":"M Bearman","year":"2019","unstructured":"Bearman M. Eliciting rich data: A practical approach to writing semi-structured interview schedules. Focus Health Prof Education: Multi-Professional J. 2019;20(3):1\u201311.","journal-title":"Focus Health Prof Education: Multi-Professional J"},{"key":"3193_CR25","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","volume":"52","author":"B Saunders","year":"2018","unstructured":"Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, Burroughs H, Jinks C. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52:1893\u2013907.","journal-title":"Qual Quant"},{"issue":"2","key":"3193_CR26","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1177\/160940690900800206","volume":"8","author":"C Davidson","year":"2009","unstructured":"Davidson C. Transcription: imperatives for qualitative research. Int J Qualitative Methods. 2009;8(2):35\u201352.","journal-title":"Int J Qualitative Methods"},{"key":"3193_CR27","unstructured":"Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins; 2008."},{"key":"3193_CR28","unstructured":"Howitt D, Cramer D. Introduction to qualitative methods in psychology. 2010."},{"issue":"2","key":"3193_CR29","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qualitative Res Psychol"},{"issue":"6","key":"3193_CR30","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349\u201357.","journal-title":"Int J Qual Health Care"},{"key":"3193_CR31","unstructured":"Lincoln YS. Naturalistic inquiry. Volume 75. sage; 1985."},{"issue":"2","key":"3193_CR32","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1080\/14780887.2013.853855","volume":"11","author":"D Sousa","year":"2014","unstructured":"Sousa D. Validation in qualitative research: general aspects and specificities of the descriptive phenomenological method. Qualitative Res Psychol. 2014;11(2):211\u201327.","journal-title":"Qualitative Res Psychol"},{"key":"3193_CR33","doi-asserted-by":"crossref","unstructured":"Regulation GDP. General data protection regulation (GDPR). Intersoft Consulting Accessed Oct 2018;24(1).","DOI":"10.63451\/ti.v1i10.104"},{"issue":"4","key":"3193_CR34","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1097\/ACM.0000000000002512","volume":"94","author":"MR Tonelli","year":"2019","unstructured":"Tonelli MR, Upshur RE. A philosophical approach to addressing uncertainty in medical education. Acad Med. 2019;94(4):507\u201311.","journal-title":"Acad Med"},{"key":"3193_CR35","unstructured":"Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins; 2022."},{"issue":"10","key":"3193_CR36","first-page":"113","volume":"4","author":"N Zagalo","year":"2021","unstructured":"Zagalo N. Problemas Da produ\u00e7\u00e3o de conhecimento:the frontiers of knowledge. What we know about science, history and the Mind(2021) de AC grayling. J Digit Media Interact. 2021;4(10):113\u20136.","journal-title":"J Digit Media Interact"},{"key":"3193_CR37","doi-asserted-by":"crossref","unstructured":"Wagoner JA, Hogg MA. Uncertainty-identity theory. Encyclopedia Personality Individual Differences 2017:1\u20138.","DOI":"10.1007\/978-3-319-28099-8_1195-1"},{"issue":"4","key":"3193_CR38","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1177\/1368430219846990","volume":"23","author":"EU Choi","year":"2020","unstructured":"Choi EU, Hogg MA. Self-uncertainty and group identification: A meta-analysis. Group Processes Intergroup Relations. 2020;23(4):483\u2013501.","journal-title":"Group Processes Intergroup Relations"},{"issue":"2","key":"3193_CR39","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1037\/a0034418","volume":"140","author":"L Sharma","year":"2014","unstructured":"Sharma L, Markon KE, Clark LA. Toward a theory of distinct types of impulsive behaviors: a meta-analysis of self-report and behavioral measures. Psychol Bull. 2014;140(2):374.","journal-title":"Psychol Bull"},{"issue":"5","key":"3193_CR40","doi-asserted-by":"publisher","first-page":"e0233435","DOI":"10.1371\/journal.pone.0233435","volume":"15","author":"N Far\u010di\u0107","year":"2020","unstructured":"Far\u010di\u0107 N, Bara\u0107 I, Plu\u017eari\u0107 J, Ilakovac V, Pa\u010dari\u0107 S, Gvozdanovi\u0107 Z, Lovri\u0107 R. Personality traits of core self-evaluation as predictors on clinical decision-making in nursing profession. PLoS ONE. 2020;15(5):e0233435.","journal-title":"PLoS ONE"},{"issue":"5\u20136","key":"3193_CR41","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1111\/jocn.14708","volume":"28","author":"SP Rasheed","year":"2019","unstructured":"Rasheed SP, Younas A, Sundus A. Self-awareness in nursing: A scoping review. J Clin Nurs. 2019;28(5\u20136):762\u201374.","journal-title":"J Clin Nurs"},{"issue":"8","key":"3193_CR42","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1177\/0969733020940371","volume":"27","author":"M Linton","year":"2020","unstructured":"Linton M, Koonmen J. Self-care as an ethical obligation for nurses. Nurs Ethics. 2020;27(8):1694\u2013702.","journal-title":"Nurs Ethics"},{"key":"3193_CR43","doi-asserted-by":"publisher","first-page":"667821","DOI":"10.3389\/fpubh.2021.667821","volume":"9","author":"M Bartzik","year":"2021","unstructured":"Bartzik M, Bentrup A, Hill S, Bley M, von Hirschhausen E, Krause G, Ahaus P, Dahl-Dichmann A, Peifer C. Care for joy: evaluation of a humor intervention and its effects on stress, flow experience, work enjoyment, and meaningfulness of work. Front Public Health. 2021;9:667821.","journal-title":"Front Public Health"},{"key":"3193_CR44","doi-asserted-by":"crossref","unstructured":"Arakelian E. What Makes It Tip Over and How Can It Be Prevented? Challenges in Psychosocial and Organisational Work Environment Faced by Perioperative Nurses, Anaesthesiologists and Nurse Assistants. 2023.","DOI":"10.5772\/intechopen.109244"},{"issue":"7","key":"3193_CR45","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1111\/jan.15153","volume":"78","author":"Y Turgut","year":"2022","unstructured":"Turgut Y, G\u00fcd\u00fcl \u00d6z H, Akg\u00fcn M, Boz \u0130, Yang\u0131n H. Qualitative exploration of nurses\u2019 experiences of the COVID-19 pandemic using the reconceptualized uncertainty in illness theory: an interpretive descriptive study. J Adv Nurs. 2022;78(7):2111\u201322.","journal-title":"J Adv Nurs"},{"key":"3193_CR46","doi-asserted-by":"crossref","unstructured":"Pickler RH. Knowledge Neglect. In., LWW. 2022;71:419\u2013420.","DOI":"10.1097\/NNR.0000000000000617"},{"issue":"3","key":"3193_CR47","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1080\/13561820.2019.1636007","volume":"34","author":"E Schot","year":"2020","unstructured":"Schot E, Tummers L, Noordegraaf M. Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. J Interprof Care. 2020;34(3):332\u201342.","journal-title":"J Interprof Care"},{"issue":"3","key":"3193_CR48","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1080\/13561820.2019.1641476","volume":"34","author":"H Wei","year":"2020","unstructured":"Wei H, Corbett RW, Ray J, Wei TL. A culture of caring: the essence of healthcare interprofessional collaboration. J Interprof Care. 2020;34(3):324\u201331.","journal-title":"J Interprof Care"}],"container-title":["BMC Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12912-025-03193-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12912-025-03193-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12912-025-03193-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T07:57:03Z","timestamp":1748419023000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnurs.biomedcentral.com\/articles\/10.1186\/s12912-025-03193-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3193"],"URL":"https:\/\/doi.org\/10.1186\/s12912-025-03193-8","relation":{},"ISSN":["1472-6955"],"issn-type":[{"value":"1472-6955","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]},"assertion":[{"value":"11 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for the study was obtained from Coimbra Hospital and University Center (CHUC) (Approval Number: [No: 260\/CES, Date: 14\/04\/2022]). Informed consent to participate was obtained from all participants prior to their involvement in the study, and all procedures adhered to the ethical guidelines outlined in the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"605"}}