Purpose: This study evaluated the validity and reliability of therapeutic communication responses generated by GPT-5 by comparing different prompt-engineering strategies and identifying optimal methods for psychiatric nursing education. Methods: A methodological design compared four strategies—Zero-shot, Few-shot, Chain-of-Thought (CoT), and Role-prompt—applied to ten psychiatric nursing communication questions. Fourteen experts with over ten years of combined clinical and educational experience rated 40 anonymized responses using a 4-point scale. Inter-rater reliability was assessed with Fleiss' κ and Krippendorff's ⍺ from 400 repeated outputs. Semantic consistency was examined using cosine similarity. Analyses were conducted in Python. Results: Role-prompt showed the highest content validity (mean=3.54±0.39, S-CVI/Ave=0.95), followed by CoT and Zero-shot. Inter-rater agreement was slight (κ=0.07; ⍺=0.15). Semantic consistency was highest for CoT (0.76±0.12) and Role-prompt (0.75±0.11). A Friedman test indicated significant differences among strategies (x2(3)=11.88, p=.008). Conclusion Role-prompt yielded the most valid therapeutic responses, while CoT produced the most consistent outputs. These findings support the use of Role-prompt and CoT strategies to enhance the validity and reliability of therapy.

Vancomycin variable Enterococcus (VVE) bacteria are phenotypically susceptible to vancomycin, but they harbor the vanA gene. We aimed to ascertain the prevalence of VVE among clinically isolated vancomycin-susceptible Enterococcus faecium (VSE) isolates, as well as elucidate the molecular characteristics of the vanA gene cluster within these isolates. Notably, we investigated the prevalence and structure of the vanA gene cluster of VVE. Between June 2021 and May 2022, we collected consecutive, non-duplicated vancomycin-susceptible Enterococcus faecium (VSE) samples. Real-time PCR was performed to detect the presence of vanA, vanB, and vanC. Overlapping PCR with sequencing and whole -genome sequencing were performed for structural analysis. Sequence types (STs) were determined by multilocus sequence typing. Exposure testing was performed to assess the ability of the isolates to acquire vancomycin resistance. Among 282 VSE isolates tested, 20 isolates (7.1%) were VVE. Among them, 17 isolates had partial deletions in the IS1216 or IS1542 sequences in vanS (N = 10), vanR (N = 5), or vanH (N = 2). All VVE isolates belonged to the CC17 complex and comprised five STs, namely ST17 (40.0%), ST1421 (25.0%), ST80 (25.0%), ST787 (5.0%), and ST981 (5.0%). Most isolates were related to three hospital-associated clones (ST17, ST1421, and ST80). After vancomycin exposure, 18 of the 20 VVEs acquired vancomycin resistance. Considering the high reversion rate, detecting VVE by screening VSE for vanA is critical for appropriate treatment and infection control.

Vancomycin variable Enterococcus (VVE) bacteria are phenotypically susceptible to vancomycin, but they harbor the vanA gene. We aimed to ascertain the prevalence of VVE among clinically isolated vancomycin-susceptible Enterococcus faecium (VSE) isolates, as well as elucidate the molecular characteristics of the vanA gene cluster within these isolates. Notably, we investigated the prevalence and structure of the vanA gene cluster of VVE. Between June 2021 and May 2022, we collected consecutive, non-duplicated vancomycin-susceptible Enterococcus faecium (VSE) samples. Real-time PCR was performed to detect the presence of vanA, vanB, and vanC. Overlapping PCR with sequencing and whole -genome sequencing were performed for structural analysis. Sequence types (STs) were determined by multilocus sequence typing. Exposure testing was performed to assess the ability of the isolates to acquire vancomycin resistance. Among 282 VSE isolates tested, 20 isolates (7.1%) were VVE. Among them, 17 isolates had partial deletions in the IS1216 or IS1542 sequences in vanS (N = 10), vanR (N = 5), or vanH (N = 2). All VVE isolates belonged to the CC17 complex and comprised five STs, namely ST17 (40.0%), ST1421 (25.0%), ST80 (25.0%), ST787 (5.0%), and ST981 (5.0%). Most isolates were related to three hospital-associated clones (ST17, ST1421, and ST80). After vancomycin exposure, 18 of the 20 VVEs acquired vancomycin resistance. Considering the high reversion rate, detecting VVE by screening VSE for vanA is critical for appropriate treatment and infection control.

Vancomycin variable Enterococcus (VVE) bacteria are phenotypically susceptible to vancomycin, but they harbor the vanA gene. We aimed to ascertain the prevalence of VVE among clinically isolated vancomycin-susceptible Enterococcus faecium (VSE) isolates, as well as elucidate the molecular characteristics of the vanA gene cluster within these isolates. Notably, we investigated the prevalence and structure of the vanA gene cluster of VVE. Between June 2021 and May 2022, we collected consecutive, non-duplicated vancomycin-susceptible Enterococcus faecium (VSE) samples. Real-time PCR was performed to detect the presence of vanA, vanB, and vanC. Overlapping PCR with sequencing and whole -genome sequencing were performed for structural analysis. Sequence types (STs) were determined by multilocus sequence typing. Exposure testing was performed to assess the ability of the isolates to acquire vancomycin resistance. Among 282 VSE isolates tested, 20 isolates (7.1%) were VVE. Among them, 17 isolates had partial deletions in the IS1216 or IS1542 sequences in vanS (N = 10), vanR (N = 5), or vanH (N = 2). All VVE isolates belonged to the CC17 complex and comprised five STs, namely ST17 (40.0%), ST1421 (25.0%), ST80 (25.0%), ST787 (5.0%), and ST981 (5.0%). Most isolates were related to three hospital-associated clones (ST17, ST1421, and ST80). After vancomycin exposure, 18 of the 20 VVEs acquired vancomycin resistance. Considering the high reversion rate, detecting VVE by screening VSE for vanA is critical for appropriate treatment and infection control.

Vancomycin variable Enterococcus (VVE) bacteria are phenotypically susceptible to vancomycin, but they harbor the vanA gene. We aimed to ascertain the prevalence of VVE among clinically isolated vancomycin-susceptible Enterococcus faecium (VSE) isolates, as well as elucidate the molecular characteristics of the vanA gene cluster within these isolates. Notably, we investigated the prevalence and structure of the vanA gene cluster of VVE. Between June 2021 and May 2022, we collected consecutive, non-duplicated vancomycin-susceptible Enterococcus faecium (VSE) samples. Real-time PCR was performed to detect the presence of vanA, vanB, and vanC. Overlapping PCR with sequencing and whole -genome sequencing were performed for structural analysis. Sequence types (STs) were determined by multilocus sequence typing. Exposure testing was performed to assess the ability of the isolates to acquire vancomycin resistance. Among 282 VSE isolates tested, 20 isolates (7.1%) were VVE. Among them, 17 isolates had partial deletions in the IS1216 or IS1542 sequences in vanS (N = 10), vanR (N = 5), or vanH (N = 2). All VVE isolates belonged to the CC17 complex and comprised five STs, namely ST17 (40.0%), ST1421 (25.0%), ST80 (25.0%), ST787 (5.0%), and ST981 (5.0%). Most isolates were related to three hospital-associated clones (ST17, ST1421, and ST80). After vancomycin exposure, 18 of the 20 VVEs acquired vancomycin resistance. Considering the high reversion rate, detecting VVE by screening VSE for vanA is critical for appropriate treatment and infection control.

Purpose: This study aimed to define coaching in nursing clearly and elucidate its essential role within the context of contemporary nursing education in clinical settings. Methods: A concept analysis was conducted using Rodgers’ evolutionary method. Literature was extracted from databases such as Web of Science, Medline (PubMed) and CINAHL. Results: Results of analysis led to the development of an operational definition of coaching in nursing characterized as an educational approach focusing on nursing tasks. Coaching in nursing is a systematic and formalized process that can enhance the learning experience through interactive engagement rather than direct instruction. The analysis identified five core attributes of coaching in nursing: nursing task-focused, educational, facilitative, processive, and interactive. Conclusion The purpose of this concept analysis was to propose a comprehensive definition of coaching in nursing that could align with its theoretical foundation within modern nursing practice. Using Rodgers' evolutionary concept analysis method, related terms, attributes, antecedents, and outcomes were identified, culminating in a detailed definition. This concept analysis provides a contemporary definition of coaching in nursing, clarifying its meaning, ensuring applicability, and offering guidance for future research, education, and clinical practice.

Purpose: This study aimed to define coaching in nursing clearly and elucidate its essential role within the context of contemporary nursing education in clinical settings. Methods: A concept analysis was conducted using Rodgers’ evolutionary method. Literature was extracted from databases such as Web of Science, Medline (PubMed) and CINAHL. Results: Results of analysis led to the development of an operational definition of coaching in nursing characterized as an educational approach focusing on nursing tasks. Coaching in nursing is a systematic and formalized process that can enhance the learning experience through interactive engagement rather than direct instruction. The analysis identified five core attributes of coaching in nursing: nursing task-focused, educational, facilitative, processive, and interactive. Conclusion The purpose of this concept analysis was to propose a comprehensive definition of coaching in nursing that could align with its theoretical foundation within modern nursing practice. Using Rodgers' evolutionary concept analysis method, related terms, attributes, antecedents, and outcomes were identified, culminating in a detailed definition. This concept analysis provides a contemporary definition of coaching in nursing, clarifying its meaning, ensuring applicability, and offering guidance for future research, education, and clinical practice.