Background and objectives: The chronic nature of heart failure requires long-lasting consumption of various medications. Despite the therapeutic benefits of heart failure medications, about 50% of patients with heart failure don’t adequately adhere to their medications as prescribed globally. This study aimed to determine medication adherence levels among Jordanians with heart failure and its influencing factors. Materials and Methods: A cross-sectional study was conducted among 164 patients with heart failure attending cardiac clinics in the north of Jordan. The Medication Adherence Scale was used to measure medication adherence. Results: Overall, 33.5% of patients had high adherence, and 47% had partial to poor adherence. The proportion of patients with good to high adherence was significantly higher among patients younger than 60 years, having >high school level of education, being married, living with somebody, and having insurance. Conclusions: Patient-centered approach, targeting age, level of education, marital status, and health insurance coverage, should be developed using evidence-based guidelines to enhance adherence to medication and health outcomes in Jordanian patients with heart failure. The development and implementation of new and feasible strategies, particularly suited to Jordan’s healthcare system capabilities, is important to improve medication adherence.

Clinical decision-making in the context of nursing practice is considered an essential skill for nursing practitioners. Nonetheless, various factors, such as the work environment and nurses’ psychological empowerment (PE), may negatively influence their decision-making ability. Therefore, this study assessed the relationship between clinical decision-making (CDM) and the nursing work environment (NWE), focusing on the mediating role of PE among clinical nurses in Hail Province, Saudi Arabia. This cross-sectional study used a self-administered questionnaire to collect data from 298 nurses at five hospitals in Hail Province, Saudi Arabia, from January to March 2025. Besides demographic characteristics, the questionnaire included the following tools: the CDM, the NWE-questionnaire, and the PE Scale. Multiple linear regression was used to identify significant predictors of both CDM and PE. The mediating role of PE on the relationship between NWE and CDM was examined using Hayes’ Process Macro program v4.2 (Model 4). Multiple linear regression revealed that being a head nurse and perceiving a more positive NWE were significant predictors of higher scores of nurses’ PE (P < 0.05). On the other hand, being a registered or head nurse, working more than five days per week, and perceiving a more supportive NWE were significant predictors of higher levels of nurses’ CDM (P < 0.05). Conversely, working regular night shifts was a significant predictor of lower scores of nurses’ CDM. A significant positive direct effect and total effect were found between NWE and nurses’ CDM (B = 0.136, P = 0.017 and B = 0.273, P < 0.001, respectively). The indirect effect (B = 0.137), based on 5,000 bootstrap resamples, had a bootstrap confidence interval above zero (0.021 to 0.263), indicating a partial positive mediating role of PE in the relationship between NWE and CDM. PE plays a vital role in fostering CDM and promoting a supportive NWE for nurses in clinical settings across Hail Province. These insights emphasize the need for establishing psychologically empowering conditions in the workplace to level up nurses’ self-perceived competence and confidence in CDM. Not applicable.

This study examined the levels of shared leadership and missed nursing care and their relationship among nurses in Egypt. A cross-sectional survey was conducted. From February to April 2024, 340 nurses worked in all inpatient care units at Alexandria Main University Hospital. The Shared Leadership and Missed Nursing Care Survey was used for evaluation. The overall score of shared leadership was (72.62 ± 4.30), which imitates a high perception of shared leadership among nurses; the dimension of delegation achieved the highest average mean score (3.66 ± 0.26), followed by collaboration (3.64 ± 0.31), the vision dimension scored the lowest mean score (3.59 ± 0.33). The elements of missed nursing care had a total score of (46.72 ± 5.69), and the dimension of secondary care achieved the highest average mean score (3.74 ± 0.31). The reasons for missed nursing care had a total mean score of (22.40 ± 1.59), and the dimension of labor resources achieved the highest average mean score (3.20 ± 0.22). Male nurses, less than 30 years old, married, held a bachelor’s degree in nursing sciences, less than five years of experience in the nursing profession, and less than five years of experience in the current working unit had higher total scores of the shared leadership and lower total scores of missed nursing care (P < 0.001). A negative correlation existed between shared leadership and two dimentisons (the elements of nursing care [r = −0.383], the reasons for missing nursing care [r = −0.047]) (P < 0.001). The study’s findings can help as a theoretical underpinning for nursing leaders to stand in an environment that reduces the incidence of missed nursing care by encouraging teamwork, responsibility, workload management, and empowerment among nurses.

Background: Understanding medication adherence and its relationship with quality of life (QoL) is essential for improving health outcomes in patients with heart failure (HF). Objective: This study aimed to investigate the predictors of poor quality of life and its relationship with medication adherence among patients with heart failure. Methods: A cross-sectional correlational study was performed on 229 patients with HF receiving care at the Cardiac Center of King Salman Specialist Hospital from March to June 2024. Data were collected using a structured questionnaire comprising patient demographics, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to assess QoL, and the General Medication Adherence Scale (GMAS) to measure medication adherence. Results: The mean medication adherence score among patients with heart HF was 17.53 f 6.94. The level of adherence was moderate among most patients (47.2%), high (29.7%), and poor (23.1%). Regarding QoL, the mean total score for overall QoL was 42.16 f 20.53. Specifically, the mean scores were 15.24 f 8.65 and 10.53 f 5.82 for the physical and emotional dimensions of QoL, respectively. More than half of the patients experienced poor QoL, while moderate QoL was observed in 31.9% and good QoL in 17% of patients. Furthermore, there were moderate negative correlations between medication adherence and physical QoL (r= -0.51), emotional QoL (r = -0.59), and overall QoL (r = -0.59), all of which were statistically significant (p <0.001). Conclusion: Moderate-to-poor levels of medication adherence and QoL were found among HF patients receiving care in Hail City. Therefore, interventions to improve medication adherence among patients with HF must be prioritized to enhance health outcomes and QoL. It is also crucial to address the factors that negatively influence medication adherence to overcome the barriers that hinder optimal medication adherence.