Journal of Modern Multidisciplinary Research
Journal of Modern Multidisciplinary Research (JMMR) is a peer-reviewed, open-access journal publishing high-quality research across diverse disciplines, including science, engineering, health, social sciences, business, and humanities. The journal welcomes original research articles, review papers, and short communications that advance knowledge and practice through multidisciplinary perspectives. JMMR is committed to research integrity, editorial transparency, and timely publication.
The Determinants of Fintech Adoption; A Systematic Review
Financial technology (FinTech) has transformed the delivery of financial services by improving accessibility, convenience, transaction speed, and cost efficiency. However, the adoption of FinTech services varies considerably across users, organizations, and national contexts. This systematic review aims to identify, classify, and synthesize the main determinants of FinTech adoption reported in recent academic literature. Peer-reviewed studies published between 2020 and 2024 were identified through two complementary search strings. After removing duplicates and applying predefined inclusion and exclusion criteria, 23 studies were included in the final review. Their characteristics, theoretical foundations, research methods, contexts, and findings were examined using narrative and thematic synthesis. The findings identified six major categories of determinants: technological factors, trust and security, perceived risk, individual characteristics, social factors, and institutional or organizational conditions. Perceived usefulness and perceived ease of use were the most prominent technological determinants, confirming the continued relevance of technology acceptance theories. Trust also emerged as a central predictor, particularly when services involved sensitive personal and financial information. Perceived financial, privacy, security, and technological risks generally discouraged adoption, although their effects varied across contexts. Financial literacy, digital competence, personal innovativeness, and awareness strengthened users’ readiness to adopt FinTech. Social influence, facilitating conditions, government support, and regulatory protection also contributed to adoption by creating a supportive and credible environment. The review concludes that successful FinTech adoption requires more than technological development. Providers and policymakers must combine accessible and useful platforms with consumer protection, financial education, transparent practices, reliable infrastructure, and effective regulation. These findings provide an integrated foundation for future research and practical initiatives designed to promote secure, inclusive, and sustained FinTech adoption.
The Determinants of Information Technology Capabilities: A Systematic Review
Information technology (IT) capabilities have become central to organizational competitiveness, innovation, agility, and digital transformation. However, the factors that contribute to the development of these capabilities remain dispersed across different theoretical perspectives, organizational contexts, and research streams. This systematic review aims to identify, classify, and synthesize the determinants of IT capabilities and to clarify their strategic significance for organizations operating in dynamic and technology-intensive environments. A systematic literature review was conducted using a structured search, screening, eligibility assessment, and study-selection process guided by PRISMA 2020 principles. Thirty studies meeting the inclusion criteria were retained for analysis. A literature review matrix was used to code the studies according to IT capabilities, technological factors, organizational factors, leadership and management, human capital and IT competencies, knowledge and learning, IT governance and strategic alignment, environmental and contextual factors, innovation and digital transformation, and organizational performance. The review shows that IT capabilities are shaped by multiple interrelated determinants rather than by technological investment alone. The principal determinants include technological infrastructure and architecture, organizational conditions, leadership and managerial support, human capital, knowledge and learning processes, governance and strategic alignment, and environmental context. The findings also demonstrate that strong IT capabilities contribute to organizational performance, innovation, agility, resilience, and digital transformation. IT capability development should be understood as a multidimensional and dynamic organizational process involving the coordinated interaction of technological, managerial, human, knowledge-based, governance, and contextual factors. The review provides an integrated framework for understanding these determinants and highlights the need for future longitudinal, multilevel, and context-sensitive research.
EFFECTIVENESS of a PAGE-FLIP TRAINING MODULE to IMPROVE CRITICAL NURSES’ EMERGENCY PREPAREDNESS and QUALITY of CARE during HAJJ
Hajj is a major annual event attended by millions and puts a significant strain on the health system, especially critical care nurses caring for trauma, heat-related illness, infection control and emergencies. Gaps in preparedness, workload, stress, communication and unmet nursing needs can impact emergency preparedness and quality of care. The aim of this study was to assess the impact of a Page-Flip Training Module on critical care nurses' emergency preparedness and quality of care during Hajj. The study adopted a systematic review method to review studies published from 2020 to 2026. A search of literature was conducted in PubMed, Scopus, ScienceDirect, CINAHL, Web of Science and Google Schol. The literature selection process used PRISMA guidelines and a quality assessment tool was used to assess the studies' quality. Moreover, a research matrix was created to gather information about each study, including their findings and significance. The reviewed literature has moderate levels of preparedness gaps among nurses during Hajj due to lack of practical training, role ambiguity, workload, stress, communication, and staffing issues. There is evidence that training programs, simulation exercises, flipped learning, ICT-based learning, and psychological support enhance nurses' preparedness, confidence, decision-making, response time, adherence to protocol and quality of care. The Page-Flip Training Module could be a valid, convenient, and tailored educational strategy for enhancing critical care nurses' emergency readiness and quality of care during Hajj.
The Determinants of Nursing Technological Readiness: A Systematic Review
This systematic review synthesises evidence on the determinants of nursing technological readiness across educational and clinical settings. Technological readiness was operationalised as the combined capability, willingness, and contextual enablement of nursing students and practising nurses to understand, evaluate, accept, and use digital health technologies, nursing informatics systems, and artificial intelligence safely in education or care. A PRISMA-informed search and citation-verification process applied to the 2015-2025 eligibility window identified 59 eligible primary empirical studies, published between 2018 and 2025. Evidence was appraised using the Mixed Methods Appraisal Tool and design-specific Joanna Briggs Institute criteria, extracted into a structured ledger, and coded across fifteen recurrent determinants. Knowledge/Literacy, Attitudes, Education/Training, Prior Exposure, and Digital Skills received the greatest research attention, whereas Innovation Orientation, Social Influence, and Ease of Use were examined less frequently. Across the evidence base, higher Knowledge/Literacy, Digital Skills, Self-Efficacy, Perceived Usefulness, constructive Attitudes, and relevant Prior Exposure were generally associated with greater Technological Readiness. Anxiety/Resistance and unresolved Ethics/Privacy concerns constrained readiness, whereas Organisational Support and Infrastructure/Resources shaped whether individual capability translated into routine adoption. The synthesis integrates the Technology Acceptance Model, the Unified Theory of Acceptance and Use of Technology, the Technology Readiness Index, and the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability framework. It distinguishes student readiness from workforce readiness, separates frequency of examination from consistency of reported influence, and identifies priorities for longitudinal, multilevel, intervention, and measurement research.
The Determinants of Digital Health Implementation: A Systematic Review
This systematic review identifies and synthesises determinants that shape the implementation of digital health technologies across clinical, organisational, and health-system settings. A PRISMA-informed evidence reconstruction was conducted using a publicly archived corpus derived from documented PubMed/MEDLINE and Scopus searches and supplementary citation tracking. The present review independently re-screened the corpus, restricted inclusion to primary empirical reports published within the 2015-2025 window and included 64 studies for MMAT-informed appraisal and narrative synthesis. Fourteen recurrent determinants were coded: acceptance, digital skills, perceived value, workflow fit, leadership, organisational readiness, training, financing, governance, usability, interoperability, infrastructure, privacy and security, and equity and access. Acceptance was examined in 56 studies, infrastructure in 46, equity and access in 44, digital skills in 43, perceived value in 41, workflow fit and financing in 37 each, governance in 35, training in 30, privacy and security in 27, leadership in 25, usability in 23, organisational readiness in 14, and interoperability in nine. The evidence indicates that implementation is rarely shaped by a single factor. Sustainable integration depends on alignment among user confidence, clinical usefulness, workflow compatibility, leadership, resourcing, regulation, secure and interoperable infrastructure, and equitable access. The synthesis distinguishes frequency of examination from evidential weight and identifies priorities for longitudinal, multilevel, implementation-stage-specific, and comparative research.
Determinants of Nurse Managers' Servant Leadership: A Systematic Review
This systematic literature review synthesizes evidence on factors that may predispose, develop, enable, reinforce, or constrain servant leadership among nurse managers. The evidence base comprises 49 English-language publications issued within the predefined eligibility window, identified through a PRISMA-informed search of bibliographic databases, publisher platforms, Google Scholar, and supplementary citation sources. Because the corpus includes direct nursing studies as well as adjacent healthcare leadership and professional-preparation evidence, conclusions are strongest for nurse-manager samples and more tentative when transferred from related settings. Thematic narrative synthesis and frequency mapping produced four interdependent domains: personal moral-service orientation, relational leadership capability, developmental preparation, and organizational-contextual conditions. Organizational support was the most frequently represented factor, followed by service values, cultural context, empowerment practice, and relational trust; emotional intelligence, leader humility, and formal leadership training received comparatively limited attention. The synthesis indicates that servant leadership is neither a fixed trait nor a training outcome in isolation. Its enactment depends on the interaction of ethical service motives, relational competence, development opportunities, psychological safety, manageable demands, and institutional reinforcement. The review offers an integrated determinant framework while distinguishing literature coverage from causal evidence and identifying priorities for longitudinal, multilevel, comparative, and intervention research.
Determinants of Nurses’ Emotional Well-Being: A Systematic Review
This systematic review synthesises evidence on the determinants of nurses’ emotional well-being across clinical settings and clarifies how occupational demands, organisational resources, relational conditions, personal capacities, ethical pressures, and work-family circumstances shape adverse and positive outcomes. A PRISMA-informed search of the predefined 11-year publication window, supplemented by a subsequent update, identified 47 eligible studies. Evidence was appraised, extracted, and coded across fourteen determinants, then examined through frequency mapping and theory-informed narrative synthesis. Excessive workload, inadequate staffing, long or irregular shifts, workplace violence, moral distress, and work-family conflict were consistently associated with exhaustion, burnout, psychological distress, or reduced satisfaction. Supportive leadership, organisational and peer support, autonomy, recognition, healthy work climates, resilience, and mindfulness generally operated as protective resources, although individual capacities offered limited protection when harmful organisational conditions persisted. The synthesis integrates Job Demands-Resources theory, Conservation of Resources theory, self-determination theory, and moral resilience scholarship. It distinguishes research frequency from evidential influence, identifies underexamined determinants, and establishes priorities for longitudinal, multilevel, comparative, intervention, and measurement-focused research on nursing workforce well-being.
Determinants of Nursing Decision-Making: A Systematic Literature Review
Nursing decision-making is a dynamic clinical process in which nurses identify salient cues, interpret incomplete or uncertain information, select a course of action, and evaluate its consequences. This systematic literature review synthesized primary empirical evidence on determinants of nursing decision-making published during the prespecified eleven-year eligibility period. A PRISMA-informed search of MEDLINE via PubMed, Europe PMC, OpenAlex, and the Directory of Open Access Journals, supplemented by backward and forward citation tracing, identified 118 records. After 18 duplicates were removed, 100 records were screened, 76 full-text reports were assessed, and 47 studies met the eligibility criteria. Methodological quality was appraised with the Mixed Methods Appraisal Tool, and findings were coded across thirteen inductively consolidated determinants. Experience was examined in 40 studies (85.1%), knowledge in 37 (78.7%), work environment in 32 (68.1%), and team support in 28 (59.6%). By contrast, evidence and technology were examined in only eight studies (17.0%). Narrative thematic synthesis indicated that effective decisions arise from interactions among experiential pattern recognition, analytical reasoning, accessible knowledge, psychological readiness, collaborative support, professional autonomy, workload conditions, and patient-specific ethical complexity. Individual capability was often insufficient when information systems, staffing, hierarchy, or communication constrained action. The evidence supports a multilevel account of nursing decision-making but remains limited by heterogeneous constructs, predominantly cross-sectional and self-report designs, single-reviewer screening, and weak linkage to patient outcomes. Future research should prioritize longitudinal, multilevel, intervention, and measurement studies and should evaluate digital decision support in ways that preserve accountable professional judgment.
Determinants of Nursing Clinical Skills and Clinical Competence: A Systematic Review
This systematic review synthesises evidence on the determinants of nursing clinical skills and broad clinical competence among pre-licensure nursing students, new graduate nurses, and licensed nurses. Using a PRISMA-informed process, the review searched the predefined eleven-year eligibility window and identified 531 records. After duplicate removal, title-and-abstract screening, and full-text assessment, 54 primary empirical studies met the inclusion criteria. Fourteen determinants were inductively coded and organised into four interrelated domains: contextual-relational, experiential-pedagogical, personal-cognitive, and professional-development. The determinants most frequently examined were self-efficacy, learning environment, practice exposure, education and training, and experience or tenure. Across the evidence base, stronger competence was generally associated with supportive clinical learning environments, effective supervision, constructive staff interaction, repeated authentic practice, structured simulation, actionable feedback and debriefing, reflective learning, and appropriately calibrated self-efficacy. Stress and anxiety were generally associated with poorer performance or less favourable competence ratings, although the direction and magnitude of these relationships varied by context and measurement approach. Workforce studies additionally emphasised educational preparation, clinical tenure, professional identity, and organisational conditions. Considerable heterogeneity in populations, study designs, settings, instruments, and outcome definitions precluded defensible quantitative pooling; narrative synthesis was therefore used. The review distinguishes the frequency with which determinants were studied from the strength of their evidential influence, preserves analytical separation between student and workforce findings, and identifies priorities for longitudinal, multi-site, objectively assessed, and theory-driven research.
The Determinants of Eco-System Sustainability; A Systematic Review
Concerns with system sustainability have arisen because entrepreneurial, innovative, business systems, social-enterprise systems, and regional systems must create long-lasting systems and value while preserving the environment, social systems, and participation, as well as maintaining the legitimacy of various institutions and the ability to adjust. This systematic review aims to identify, classify, and integrate determinants of system sustainability. The review was guided by the PRISMA framework, and studies were selected from high-ranking scientific databases and published within the predefined review period. The selected studies also included citation searches and a systematic review approach. The final sample was comprised of 55 studies, of which seven were from the targeted search. The thematic coding review and the binary approach to the literature review identified 16 determinants, grouped into nine higher-order categories. The synthesis highlighted the determinants that shaped the innovation ecosystem and the emerging sustainability from the integration of various systems. The synthesis also highlighted the lack of evidence regarding the determinants of digital governance and circularity, and developed a detailed agenda for future research on the integration of various systems.
Advancing Sustainable Manufacturing through AI, IIoT, and Digital Twins: A Systematic Review of Emerging Technologies
This systematic literature review investigates the possibilities of artificial intelligence, the Industrial Internet of Things, and digital twins for promoting sustainable manufacturing by utilizing the interrelated digital capabilities, operational mechanisms, and socio-technical conditions. Based on the 59 studies included in the predefined review window, and using the PRISMA approach, this review identifies, screens, appraises, codes, and synthesizes the studies. The results show that the IIoT provides the functions of constant sensing and connectivity, and that artificial intelligence transforms industrial data into the realm of the predictable and optimal. Finally, digital twins aid in the modeling, contextualization, simulation, and reasoning of a system’s lifecycle. The collaborative usage of these technologies improves the dimensions of sustainable manufacturing such as predictive maintenance, process optimization, quality control, and the efficient use of resources with an emphasis on waste and circularity. The gain of these improvements is conditional on a plethora of factors. Most notably, data governance, interoperability, and cybersecurity, as well as the validity of models and the capability of the workforce. The literature predominantly focuses on operational gains. Therefore, this review synthesizes an integrated taxonomy of capabilities, mechanisms, outcomes, and enabling conditions and suggests longitudinal, multi-site, lifecycle-focused studies with sustainability indicators along with sustainable technology configurations in diverse manufacturing contexts. It also identifies gaps in the existing literature by clarifying the state of existing evidence.
The Determinants of Prevalence of Low Back Pain; A Systematic Review
Low back pain (LBP) is one of the most prevalent musculoskeletal disorders worldwide and a leading cause of disability, imposing a significant burden on individuals and healthcare systems. This study aimed to systematically review the determinants influencing the prevalence of LBP across diverse populations. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed across PubMed, Scopus, Web of Science, and Google Scholar to identify relevant studies published up to 2025. Studies reporting the prevalence and/or determinants of LBP among adult populations or specific occupational groups were included, and the findings were synthesized qualitatively. A total of 20 studies met the inclusion criteria. The results demonstrated that the prevalence of LBP varies widely depending on population characteristics and occupational exposure, with higher rates consistently reported among healthcare workers and other high-risk occupational groups. Occupational factors such as prolonged sitting, heavy lifting, and repetitive movements were the most frequently identified determinants. Psychological factors, including stress and job dissatisfaction, were also strongly associated with LBP. In addition, demographic factors such as age and gender, lifestyle factors such as physical inactivity and smoking, and clinical conditions including degenerative spinal disorders and obesity were identified as significant contributors. Overall, LBP is a multifactorial condition influenced by a complex interaction of physical, behavioral, and psychosocial factors. These findings highlight the need for comprehensive and multidisciplinary approaches to prevention and management, with particular emphasis on workplace interventions, lifestyle modification, and psychological support to reduce the global burden of LBP.
Authentic Nursing Leadership: A Concept Analysis
Authentic nursing leadership has become increasingly important in contemporary healthcare because nursing teams work in conditions shaped by workforce shortages, ethical pressure, emotional exhaustion, and expectations for safe, person-centered care. Although the concept is widely used in nursing leadership literature, it is sometimes applied broadly to describe positive, supportive, ethical, or transformational leadership behavior, which can obscure its distinctive meaning. This concept analysis clarifies authentic nursing leadership by identifying its defining attributes, antecedents, consequences, empirical referents, and conceptual boundaries. Walker and Avant’s concept analysis approach guided the analysis, supported by a structured synthesis of literature on authentic leadership in nursing and healthcare. Thirty studies and methodological sources were selected and synthesized to preserve the structure and scope of the selected article template. The analysis identified five defining attributes of authentic nursing leadership: self-awareness, relational transparency, internalized moral perspective, balanced processing, and genuine caring alignment with professional nursing values. Key antecedents included ethical organizational culture, psychological empowerment, leadership education, reflective practice, role clarity, feedback systems, and supportive work environments. Consequences were evident at individual, team, patient-care, and organizational levels, including increased trust in managers, stronger work engagement, higher job satisfaction, improved caring behavior, enhanced psychological safety, reduced burnout, lower turnover intention, and better safety climate. Empirical referents included the Authentic Leadership Questionnaire, Authentic Nurse Leadership Questionnaire, Authentic Leadership Inventory, nurse work environment scales, trust measures, safety climate tools, burnout instruments, work engagement scales, and performance measures. Overall, authentic nursing leadership emerged as a multidimensional and measurable leadership construct grounded in ethical self-regulation, transparent relationships, balanced decision-making, and value-congruent professional action. The findings provide a foundation for nursing education, leadership development, workforce retention strategies, unit-level assessment, and future empirical research on leadership practices that strengthen nurses and improve care quality.
The Determinants of Nurse Manager Competencies; A Systematic Review
Nurse managers play a pivotal role in healthcare organizations by influencing nursing workforce performance, practice environments, and patient care outcomes. However, the determinants that shape nurse manager competencies remain dispersed across the literature. This study aims to systematically review the determinants influencing nurse manager competencies and examine their associated organizational and clinical outcomes. A systematic review methodology was employed following the PRISMA guidelines. Relevant studies were identified through comprehensive searches of major electronic databases, and studies focusing on nurse manager competencies, leadership capabilities, and related determinants were included. After applying predefined inclusion and exclusion criteria, a total of 30 peer-reviewed studies were included in the final synthesis. The findings reveal that nurse manager competencies are influenced by a combination of behavioral, professional, and organizational determinants. Key determinants include leadership competency, managerial skills, communication competence, decision-making ability, leadership style, education and training, professional experience, organizational support, and work environment conditions. These determinants collectively shape the effectiveness of nurse managers in leading nursing teams and managing healthcare operations. The review also demonstrates that nurse manager competencies are strongly associated with important organizational outcomes such as staff job satisfaction, turnover intention, and patient care quality. Effective nurse manager leadership contributes to improved workplace environments, greater workforce stability, and enhanced healthcare service delivery. Overall, the findings highlight the importance of developing integrated leadership development strategies that strengthen nurse manager competencies through professional training, supportive organizational environments, and leadership development initiatives. Strengthening nurse manager competencies is essential for improving nursing leadership capacity and achieving better healthcare outcomes.
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Nurse Manager Competencies, Nurse Engagement and Work Environment Toward Nurses' Performance: Conceptual Framework
Nursing staff performance is a critical component of the quality of health care, patient safety, and the efficiency of health care organizations. Nurse managers play a pivotal role in influencing the work environment and professional practice of nurses in a context of growing complexity and turbulence that characterises health systems. This conceptual study presents an integrated framework of relationships to explore how nurse manager competencies, nurse engagement and the nursing work environment might impact nurse performance. Using leadership theories, the Job Demands-Resources (JD-R) model, and the magnet framework as a foundation, the study conceptualizes nurse manager competencies as multidimensional attributes of a nurse managers capacity including but not limited to leadership, communication, emotional intelligence, and clinical expertise. Nurse engagement, meanwhile, is framed as a mediating component of nurse emotional commitment and employee involvement with their work. Similar to the approaches of climate for sustainable development and performance practices, the organizational environment; in terms of support for climate, staffing adequacy, and autonomy, is treated as a contextual moderator that can act either as an enhancing or suppressing factor for performance outcomes. By establishing these linkages, the framework offers a theoretically informed foundation for empirical investigation and practical action to maximise the impact of the workforce on health systems. It anticipates that this conceptual model will inform future empirical studies and policy initiatives aimed at strengthening leadership development, enhancing nurse engagement, and improving organizational climates toward achieving excellence in nursing performance.
Factors Influencing the Effectiveness of Construction Safety Assessment Models: A Systematic Literature Review
The existing body of research on construction safety assessments is fragmented along the lines of technology, safety hazards, and assessment methods. This fragmentation prevents a systematic understanding of the conditions under which safety assessment models become valid, usable, and timely. The purpose of this review is to address this gap, by systematically identifying, assessing, and analyzing the factors that determine the assessment models’ effectiveness in construction safety. This review was based on 52 studies published within the predefined review period, drawn from an initial pool of 326 studies, and conducted a thematic synthesis of the studies, which included a synthesis of various assessment criteria, a method of counting studies, and the construction of a binary matrix on the coverage of the studies. According to the studies reviewed, the factors that determine the assessment models’ effectiveness can be grouped in the following domains: integrity of the evidence; contextual, and socio-organizational; and digital. The study results are based on the research of construction safety models and provide an auditable taxonomy of determinants, and an integrated interpretation of construction safety models, based on the technical, contextual, digital, and organizational needs, and can support design, validation, governance, and cross-context application of safety models and proactive construction safety governance.
The Determinants of Organizational Agility; A Systematic Review
Organizational agility has become a critical capability for organizations operating in uncertain, technology-driven, and highly competitive environments. Although previous studies have examined agility from different perspectives, the determinants of organizational agility remain fragmented across digital transformation, dynamic capabilities, leadership, knowledge management, technology, and contextual factors. This systematic review aims to identify, classify, and synthesize the key determinants of organizational agility and examine the major outcomes associated with agility in contemporary organizations. A systematic review approach was adopted to analyze 30 selected studies related to organizational agility. The review followed a structured identification, screening, eligibility, and inclusion process. The selected studies were analyzed using a literature review matrix and thematic synthesis to classify the main determinant categories and outcomes. The findings show that organizational agility is shaped by several interconnected determinants, including digital transformation, Industry 4.0, dynamic capabilities, leadership, organizational culture, knowledge management, organizational learning, IT capabilities, big data analytics, workforce agility, and contextual factors such as market turbulence and environmental uncertainty. The review also found that organizational agility is associated with improved performance, innovation, competitive advantage, resilience, sustainability, and market responsiveness. Organizational agility is a multidimensional strategic capability that depends on the interaction of behavioral, organizational, technological, and contextual determinants. Organizations seeking to remain competitive and resilient should develop integrated agility-building practices that combine digital capability, adaptive leadership, learning systems, knowledge sharing, and flexible structures.
The Determinants of Digital Innovation; A Systematic Review
Digital innovation has become a critical concern for organizations seeking to improve competitiveness, adaptability, service delivery, and value creation in increasingly digital environments. However, existing research on the determinants of digital innovation remains fragmented across different sectors, theoretical perspectives, and organizational contexts. This systematic review aims to synthesize existing literature on the determinants of digital innovation and identify the main technological, organizational, human, strategic, and contextual factors that influence digital innovation outcomes. A systematic review approach was adopted to examine 30 selected studies related to digital innovation, digital transformation, digital capabilities, organizational capabilities, leadership, culture, human capital, business model innovation, and performance outcomes. The studies were analyzed using a literature review matrix and thematic synthesis. The review process followed identification, screening, eligibility, and inclusion stages consistent with PRISMA 2020 logic. The findings show that digital innovation is shaped by multiple interacting determinants, including digital capabilities, technological capabilities, organizational capabilities, human capital, digital skills, leadership, organizational culture, agility, dynamic capabilities, and contextual conditions. The reviewed studies also indicate that digital innovation contributes to innovation performance, firm performance, competitive advantage, business model renewal, sustainable innovation, public-sector service transformation, and ecosystem development. Digital innovation should be understood as an integrated organizational process rather than a purely technological activity. Successful digital innovation requires alignment among technology, capabilities, people, strategy, culture, and context.
The Determinants of Renewable Energy Project Delays; A Systematic Review
The rapid expansion of renewable energy projects has become essential for achieving global sustainability goals, reducing greenhouse gas emissions, and improving energy security. Despite increasing investments in renewable energy infrastructure, many projects continue to experience significant delays during planning, financing, construction, and operational stages. These delays negatively affect project performance, increase implementation costs, reduce investor confidence, and hinder national energy transition objectives. Therefore, understanding the determinants contributing to renewable energy project delays is critical for improving project delivery efficiency and sustainability outcomes. This study systematically reviews the major determinants influencing renewable energy project delays by synthesizing evidence from existing academic literature. A systematic review methodology was adopted to identify, evaluate, and analyze peer-reviewed studies related to renewable energy project implementation challenges and delay factors. Following the application of predefined inclusion and exclusion criteria, 20 studies published between 2020 and 2025 were selected and analyzed. The findings revealed that renewable energy project delays are influenced by interconnected financial, regulatory, technical, managerial, stakeholder-related, and external factors. Financial constraints such as inadequate funding, high capital costs, and investment uncertainty were identified as major delay determinants. Regulatory barriers, including bureaucratic approval procedures and unstable governmental policies, also significantly affected project implementation. In addition, technical limitations, poor project planning, ineffective stakeholder coordination, and inadequate risk management practices contributed substantially to implementation inefficiencies. Social factors such as public opposition and limited community engagement further influenced project continuity, while external disruptions, particularly the COVID-19 pandemic, intensified project vulnerabilities through supply chain interruptions and operational challenges. The study concludes that renewable energy project delays require integrated management approaches involving effective financial planning, stable regulatory frameworks, stakeholder collaboration, and adaptive risk management strategies. The findings provide valuable insights for policymakers, project managers, investors, and researchers seeking to improve renewable energy project implementation and sustainability performance.
The Determinants of E-Governance Excellence; A Systematic Review
E-governance excellence has become a key priority for public-sector institutions seeking to improve service delivery, transparency, accountability, citizen trust, and administrative performance through digital transformation. However, its determinants remain fragmented across research streams such as e-government adoption, digital service quality, organizational readiness, digital inclusion, cybersecurity, artificial intelligence, and public value. This systematic review aims to identify, synthesize, and classify the main determinants of e-governance excellence into clear thematic categories that explain how governments can enhance digital public services and governance outcomes. A systematic review approach was used to examine relevant studies on e-governance, e-government, digital government, public-sector digital transformation, smart governance, citizen satisfaction, trust, transparency, inclusion, and public value. The review followed a structured selection process based on identification, screening, eligibility, and inclusion. A total of 30 studies were analyzed using a literature review matrix and thematic synthesis. The findings show that e-governance excellence is shaped by the interaction of technological, organizational, human, institutional, and contextual factors. Therefore, governments need integrated strategies that combine reliable digital systems, strong institutional governance, capable leadership, cybersecurity, citizen-centered service design, digital inclusion, and continuous performance improvement.
Nursing Leadership Competencies; A Concept Analysis
An abstract summarizes the major aspects of a paper. It should state a short introduction of background study, problem statement, purpose of the research, briefing about the used method, principal results and major conclusions. Citation or references and non-standard or uncommon abbreviations should be avoided in the abstract. The number of words should not exceed Nursing leadership competencies are essential for effective healthcare delivery, workforce sustainability, and patient safety; however, the concept remains inconsistently defined across nursing literature. This study aimed to clarify the concept of nursing leadership competencies using Walker and Avant’s concept analysis method. A systematic examination of nursing leadership literature was conducted to identify the uses of the concept and to determine its defining attributes, antecedents, consequences, and empirical referents. The analysis revealed that nursing leadership competencies constitute a multidimensional construct encompassing effective communication, relational and interpersonal competence, ethical and professional integrity, strategic and organizational capability, and leadership self-efficacy. Antecedents included leadership education, professional experience, organizational support, and individual motivation, while consequences were evident at individual, organizational, and patient-care levels, including leadership aspiration, improved work environments, and enhanced patient safety. Empirical referents comprised leadership competency frameworks, assessment instruments, and observable leadership behaviors. Clarifying this concept provides a coherent theoretical foundation to inform nursing leadership education, development, and future research.
Professional Training, Job Satisfaction and Self-Efficacy on Nursing Leadership Competencies; A Conceptual Framework
This paper presents a conceptual framework that examines the interconnections among professional training, job satisfaction, self-efficacy, and nursing leadership competencies. The framework is anchored in motivational and behavioral perspectives, integrating elements of Social Cognitive Theory, Herzberg’s Two-Factor Theory, and Transformational Leadership Theory. It argues that professional training functions as a critical foundation for developing leadership capacity by equipping nurses with the skills, confidence, and motivation necessary to manage complex healthcare challenges. Job satisfaction and self-efficacy are positioned as mediating mechanisms that explain how professional training translates into enhanced leadership competence. When nurses perceive their professional environment as supportive and fulfilling, and when they believe in their capability to lead effectively, they are more likely to demonstrate transformational behaviors that strengthen team performance and organizational outcomes. The proposed model offers both theoretical and practical value by linking continuous learning and psychological empowerment to leadership growth. It provides a pathway for healthcare leaders, educators, and policymakers to design evidence-based professional development strategies that foster empowerment, retention, and performance excellence in the nursing workforce, contributing to sustainable healthcare transformation and quality leadership practices.
Barriers to Adherence to Clinical Practice Guidelines in the Non-Surgical Management of Knee Osteoarthritis among Older Adults: A Systematic Review
Knee osteoarthritis (KOA) is a leading cause of pain, disability, and reduced independence among older adults. Although clinical practice guidelines consistently recommend education, structured exercise, weight management, and other non-surgical strategies as first-line care, implementation remains inconsistent. This systematic review identified and synthesised barriers to adherence with guidelines for non-surgical KOA management among adults aged 60 years and older. Guided by a pre-specified protocol and PRISMA reporting principles, searches were conducted in PubMed/MEDLINE, CINAHL, Embase, and Web of Science from database inception to December 2025. Eligible studies examined factors limiting guideline-concordant care. Two reviewers independently screened records, extracted data, and mapped barriers to the Theoretical Domains Framework, followed by narrative synthesis. Twenty-two studies were included. Barriers were concentrated in four areas: limited clinician knowledge and skills; beliefs and expectations regarding exercise, weight management, passive care, or surgery; social and professional influences, including inconsistent interdisciplinary messages; and environmental constraints, such as brief consultations, fragmented referral pathways, limited allied health access, and reimbursement barriers. Findings indicate that guideline adherence is shaped by interacting clinician, patient, professional, and system-level factors. Effective implementation requires integrated educational, behavioural, and service-redesign strategies tailored to older adults.
The Determinants of Low Back Pain; A Systematic Review
Low back pain is a highly prevalent and disabling musculoskeletal condition that imposes a substantial clinical, social, and economic burden worldwide. This systematic review aimed to synthesize current evidence on the prevalence, determinants, and outcomes of low back pain, with particular emphasis on behavioral, occupational, and contextual influences. Following PRISMA 2020 guidelines, relevant peer-reviewed studies were systematically identified, screened, and analyzed using predefined eligibility criteria, and findings were synthesized narratively and through structured evidence mapping. The reviewed literature indicates that low back pain affects diverse populations, with higher prevalence among older adults, women, and individuals exposed to physically demanding or ergonomically unfavorable work environments. Behavioral and psychosocial factors, including maladaptive pain beliefs, emotional distress, and reduced self-efficacy, alongside lifestyle factors such as obesity, physical inactivity, and poor sleep quality, were consistently associated with increased risk, pain chronicity, and functional limitation. Occupational exposures and adverse sociodemographic contexts further amplified disability, reduced quality of life, and increased healthcare utilization. Overall, the findings highlight the multifactorial and interdependent nature of low back pain, underscoring the need for integrated, biopsychosocial approaches to prevention, assessment, and management to reduce long-term disability and improve patient outcomes.
The Determinants of Digital Quality and Safety Education for Nurses (QSEN); A Systematic Review
The rapid advancement of digital technologies has transformed nursing education and expanded the ways nurses and nursing students develop quality and safety competencies. Digital learning, e-learning, virtual simulation, informatics-based education, and other technology-supported approaches are increasingly used to prepare nurses for safe, patient-centered, evidence-based, and high-quality care. Quality and Safety Education for Nurses (QSEN) provides a competency-based framework that emphasizes patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. However, the determinants influencing digital QSEN education remain dispersed across nursing education, informatics, patient safety, quality improvement, and digital learning literature. Therefore, this systematic review aimed to identify and synthesize the determinants of digital QSEN education among nurses and nursing students. Relevant studies addressing QSEN competencies, digital nursing education, e-learning, virtual simulation, informatics competence, patient safety education, teamwork, adverse event reporting, quality improvement, and digital self-efficacy were reviewed. A total of 30 studies were included and organized using a literature review matrix. The findings were synthesized narratively into educational, individual, clinical, organizational, and technological determinants. The review revealed that effective digital QSEN education is shaped by competency-based curriculum design, active digital learning strategies, informatics competence, digital health literacy, technology readiness, clinical relevance, leadership support, patient safety culture, and organizational readiness. Clarifying these determinants supports stronger digital nursing education and guides future research, curriculum development, and clinical practice planning.
The Antecedents of Patient Safety Competency; A Systematic Review
The increasing emphasis on safe, high-quality healthcare has made patient safety competency a core requirement for nursing practice and healthcare education. Patient safety competency refers to the knowledge, attitudes, skills, communication behaviors, teamwork abilities, and error-management practices required to prevent avoidable harm and respond effectively to adverse events. Although this competency is widely recognized as essential, its antecedents remain dispersed across educational, clinical, organizational, and individual contexts. Therefore, this systematic review aimed to identify, categorize, and synthesize the antecedents of patient safety competency among nurses, nursing students, and healthcare professionals. A systematic review approach guided by PRISMA 2020 was used to identify and screen relevant studies. Studies focusing on patient safety competency, its determinants, predictors, or related outcomes were included. Data were extracted, organized using a literature review matrix, and synthesized narratively and thematically. A total of 30 studies were included. The findings revealed that patient safety competency is shaped by educational, individual, clinical, organizational, and communication-related antecedents. Key antecedents included patient safety education, curriculum integration, simulation, e-learning, case discussion, adverse event analysis, knowledge, attitudes, self-efficacy, clinical competence, professionalism, systems thinking, compassion competence, experience, safety culture, leadership, teamwork, psychological safety, speaking up, organizational support, and error reporting. The review concludes that patient safety competency is multidimensional, requiring integrated education, clinical learning, leadership support, teamwork, psychological safety, and nonpunitive reporting cultures.
The rapid advancement of digital health technologies has significantly transformed healthcare delivery and expanded the use of remote healthcare services. Telerehabilitation has emerged as an important approach for providing rehabilitation services through information and communication technologies, enabling healthcare professionals to deliver assessment, intervention, monitoring, and patient education remotely. Despite its increasing adoption across healthcare systems, the concept of telerehabilitation remains inconsistently defined in the literature, leading to variability in its interpretation and implementation. Therefore, this study aimed to analyze and clarify the concept of telerehabilitation using the Walker and Avant concept analysis framework. A review of relevant literature addressing telerehabilitation, digital rehabilitation technologies, and remote rehabilitation services was conducted to identify the defining attributes, antecedents, consequences, and empirical referents of the concept. The analysis revealed five key defining attributes of telerehabilitation: remote delivery of rehabilitation services, the use of information and communication technologies, interaction between healthcare professionals and patients, monitoring and feedback mechanisms, and the implementation of structured therapeutic rehabilitation interventions. The findings also identified important antecedents, including technological infrastructure, access to digital devices, trained healthcare professionals, and institutional support, while the main consequences included improved access to rehabilitation services, enhanced patient engagement, and clinical outcomes comparable to traditional face-to-face rehabilitation. Clarifying the concept of telerehabilitation contributes to a stronger theoretical understanding of remote rehabilitation services and supports the development of standardized definitions and clinical frameworks that may guide future research and practice in rehabilitation sciences.
The Determinants of Knee Osteoarthritis Management; A Systematic Review
Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders worldwide and represents a major cause of pain, disability, and reduced functional capacity among adults. Effective management of knee osteoarthritis typically involves a combination of therapeutic approaches aimed at reducing symptoms and improving joint function; however, treatment outcomes are often influenced by multiple determinants related to patient behavior, rehabilitation strategies, and healthcare delivery. This systematic review aimed to identify and synthesize the key determinants influencing the management of knee osteoarthritis. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. A comprehensive literature search was performed across four major electronic databases: PubMed, Scopus, Web of Science, and CINAHL, using keywords related to knee osteoarthritis, management strategies, exercise therapy, rehabilitation, treatment adherence, and self-management. A total of 237 records were initially identified, and after screening and eligibility assessment, 20 studies were included in the final synthesis. The findings indicate that exercise-based management and physiotherapy interventions represent fundamental components in improving pain reduction and physical function among individuals with knee osteoarthritis. Psychosocial factors, including motivation, beliefs about treatment effectiveness, and perceived barriers to physical activity, were also identified as important determinants influencing patient engagement in rehabilitation programs. In addition, treatment adherence plays a critical role in determining the effectiveness of management strategies. Emerging evidence also highlights the potential role of digital self-management and telehealth-based interventions in improving patient participation and access to rehabilitation services. Overall, the management of knee osteoarthritis is influenced by multiple interrelated determinants, and integrating these factors into patient-centered management strategies may enhance treatment effectiveness and improve long-term clinical outcomes.
The Determinants of Quality Management Systems; A Systematic Review
Quality Management Systems have become important organizational mechanisms for improving process consistency, service quality, customer satisfaction, compliance, and organizational performance. However, the effectiveness of QMS implementation varies across sectors because organizations differ in leadership commitment, quality culture, resources, employee involvement, process control, and external pressures. This systematic review aimed to identify, classify, and synthesize the main determinants influencing the implementation and effectiveness of Quality Management Systems across organizational contexts. A systematic review approach was used to identify and synthesize relevant studies on QMS, ISO 9001, total quality management practices, implementation barriers, success factors, and performance outcomes. The review process followed the logic of PRISMA 2020, including identification, screening, eligibility assessment, and inclusion. A total of 30 studies were included and summarized using a literature review matrix. The findings showed that QMS implementation is shaped by managerial, organizational, human, technical, and external determinants. Leadership and management commitment, quality culture, employee involvement and training, resources, process documentation, audit and monitoring systems, customer focus, external factors, and implementation barriers were the most frequently reported themes. QMS was also associated with outcomes such as operational performance, customer satisfaction, service quality, stakeholder satisfaction, sustainability, environmental innovation, risk reduction, and organizational learning. QMS effectiveness depends on integrated implementation rather than certification alone. Organizations are more likely to achieve positive outcomes when QMS is supported by leadership, quality culture, employee capability, adequate resources, process discipline, and continuous monitoring.
Nurse Commitment: A Concept Analysis Using Walker and Avant’s Method
Nurse commitment is frequently linked to retention, quality of care, and patient safety, yet the concept is applied inconsistently across nursing and health services research. This concept analysis clarifies “nurse commitment” using Walker and Avant’s method by identifying defining attributes, antecedents, consequences, and empirical referents. A search was conducted in PubMed, CINAHL, Scopus, Web of Science, and Google Scholar for English-language, peer-reviewed sources published between 2021 and January 2026 addressing nurses’ professional commitment, organizational commitment, or commitment-related outcomes. Findings indicate that nurse commitment is a multidimensional psychological bond integrating professional and organizational orientations. Five defining attributes emerged: emotional attachment to nursing, sustained investment in professional development, alignment with nursing values, intention to remain in nursing practice, and dedication to patient-care excellence. Common antecedents included transformational leadership, perceived organizational support, adequate staffing and supportive work environments, professional values, autonomy, and effective socialization. Reported consequences encompassed lower turnover intention, reduced missed nursing care, improved patient safety and quality, and stronger organizational performance. Nurse commitment is distinct from job satisfaction or engagement and reflects an enduring professional–organizational bond shaped by leadership and work conditions and expressed in care excellence and intent to remain.