Background: Moral Distress (MD) is a unique form of distress that occurs when people believe they know the ethically correct action to take but are constrained from doing so. Limited clinical experience and insufficient ethical knowledge contribute to nursing students’ MD, which can potentially cause negative outcomes. The aims of this study are: (1) to describe the MD intensity of nursing students, and (2) to analyze differences and associations between MD intensity and socio-demographic and academic variables. Methods: A cross-sectional study design with a convenience sample of the second, third, and delayed graduation students was included; only students willing to participate and who had attended their scheduled internships in the last six months were eligible for inclusion. To measure the level of MD, we used the It-ESMEE. We collected socio-demographic and academic variables. The data collection occurred from January 2024 to March 2024. Results: The students who adhered to the collection were N = 344. The findings reveal that the students perceived a high level of MD in situations related to clinical internship and class. They perceived higher levels of MD when nursing was not their first career choice, were separated or divorced, did not have children, and were not an employed student. The overall MD score is statistically significantly lower among students who had nursing as their first career choice (β = −0.267, p < 0.05), have children (β = −0.470, p < 0.01), and are employed (β = −0.417, p < 0.01). In contrast, being separated or divorced (β = 0.274, p < 0.01) was associated with a higher MD score. Conclusions: This study has some limitations: data reflect a local context, and the findings may not be generalizable to other regions or educational environments. Additionally, students’ recollections of their experiences could be influenced by the passage of time, and there may be a selection bias since only students willing to participate were included. The findings suggest that nursing education programs should incorporate more robust training in ethical decision-making and stress management to better prepare students for the moral challenges in their professional practice.

Introduction The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research. Methods and analysis This scoping review will be conducted following Arksey and O’Malley’s framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit. Ethics and dissemination This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals. Registration details The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7).

Background: Health literacy and eHealth literacy are core competencies for nursing students, yet their distribution across training pathways remains insufficiently explored. Objective: This study aimed to examine HL and eHL levels among nursing students across different years of the educational programme and identify distinct subgroups of students. Methods: A cross-sectional study was conducted among undergraduate nursing students enrolled in all years of a single Italian university programme. Literacy profiles were assessed using validated questionnaires. A Two-Step Cluster Analysis was applied to identify homogeneous literacy profiles. Group differences were examined using appropriate statistical tests. Results: Four distinct clusters were identified, showing heterogeneous patterns of literacy profiles across the training course. Significant differences emerged in demographic and educational variables across clusters. Conclusions: The findings highlight the coexistence of diverse literacy profiles among nursing students and suggest the need for tailored educational strategies. Due to the cross-sectional design, causal inferences cannot be drawn.

Background/Objectives: Heart transplantation is a life-saving treatment for advanced cardiac disease, but post-transplant adaptation may involve psychosocial, identity-related, and existential change. Some recipients interpret these changes as corresponding to donor characteristics, although the nature and evidence base of these reports remain unclear. This review mapped post-transplant changes reported by adult heart transplant recipients, perceived donor–recipient correspondences, and the explanatory frameworks proposed for these phenomena. Methods: A scoping review was conducted following the Arksey and O’Malley framework, Joanna Briggs Institute guidance, and PRISMA-ScR reporting standards. PubMed, Web of Science, Scopus, CINAHL, and PsychINFO were searched in August 2026. Quantitative, qualitative, mixed-methods, conceptual, opinion, and review articles were eligible. Findings were synthesized descriptively. Results: Sixteen sources published between 1992 and 2025 were included. Empirical studies reported changes in preferences, emotional and personality-related experiences, social and physical functioning, sexuality, identity and embodiment, sensory and memory-like experiences, and spirituality. Some changes were attributed by recipients to donor characteristics, whereas correspondences supported by independently obtained donor information were reported in a limited subset of studies. Proposed explanations ranged from psychological, pharmacological, physiological, and sociocultural processes to cellular, molecular, neurocardiac, energetic, and transpersonal hypotheses. Donor-transfer hypotheses were developed in the secondary literature and were not empirically established. Methodological quality varied substantially across sources. Conclusions: Post-transplant changes and perceived donor–recipient correspondences are meaningful phenomena, but current evidence does not support the transfer of donor memory, personality, or identity through the transplanted heart. Future prospective, longitudinal, and methodologically rigorous studies should distinguish reported experience, donor attribution, and proposed explanations.

Background: HL and eHL are essential for future nurses. Their low levels in adults are linked to poorer outcomes and higher healthcare costs, emphasizing the need to assess these skills in nursing education. Aim: This study examined HL and eHL levels among nursing students across different years of a Bachelor of Nursing programme and identified subgroups of students. Methods: A cross-sectional study was conducted among students enrolled in all academic years. HL and eHL were assessed using the Health Literacy Questionnaire and the eHealth Literacy Scale (eHEALS). Descriptive statistics summarized participant characteristics and literacy levels. Differences across academic years were examined, and cluster analysis was performed to identify homogeneous student groups. Results: HL and eHL varied across the nursing curriculum. Four distinct clusters emerged: (1) older students, concurrently employed; (2) young, on-track second-year students; (3) students with prior university education; and (4) first-year students without an academic background. ANOVAs indicated significant differences in eight HL dimensions, with Cluster 2 consistently achieving the highest scores and Cluster 4 the lowest. Conclusions: HL and eHL among nursing students appear to be dynamic competencies shaped by sociodemographic and academic factors. Identifying student profiles supports the development of differentiated instructional strategies in nursing education. Although previous research has examined HL and eHL in nursing students, no study to date has defined these competencies in relation to the structure of the nursing curriculum or used cluster analysis to identify subgroups. This represents the main innovative contribution of the current study.