Association Between ChatGPT Reliance, Self-Directed Learning, and Problem-Solving Competencies Among Nursing Students: The Mediating Role of Academic Self-Efficacy in an Analytical Cross-Sectional Design Mohamed E. H. Elzeky, Sulaiman Alanazi, Noha F. M. Shahine Nursing Forum, 2026 Background Although prior research has highlighted problematic patterns of artificial intelligence (AI) use in education, including overreliance on AI tools, the academic implications of such reliance among nursing students remain insufficiently explored. Aim To examine the associations between reliance on ChatGPT (ROC) during nursing education and academic self‐efficacy (ASE), self‐directed learning (SDL), and problem‐solving ability (PSA) among nursing students. Methods A cross‐sectional design was employed. Data were collected from undergraduate nursing students using validated self‐report measures assessing ROC, ASE, SDL, and PSA. Structural path analysis using maximum likelihood estimation was conducted to examine direct and indirect relationships among the study variables, with ASE specified as a mediator. Indirect effects were tested using bias‐corrected bootstrapping (5000 resamples). Multigroup analysis was performed to explore gender differences. Results ROC was significantly and negatively associated with ASE ( β = −0.248, p < 0.001). ASE was positively associated with SDL ( β = 0.742, p < 0.001) and negatively associated with problem‐solving difficulties (PSA) ( β = −0.569, p < 0.001). Indirect effects indicated that ROC was associated with lower SDL ( B = −0.185, 95% CI [−0.200, −0.099]) and higher problem‐solving difficulties ( B = 0.145, 95% CI [0.095, 0.191]) through reduced ASE. Gender differences were observed, with a stronger negative association between ChatGPT reliance and ASE among female students, and a stronger positive association between ASE and SDL among male students. Conclusions ChatGPT reliance was associated with nursing students’ academic competencies primarily through its relationship with ASE. These findings raise concerns about the potential erosion of critical thinking and learning autonomy associated with uncritical AI use. The results highlight the need for structured and ethically guided integration of AI in nursing education to support SDL and preserve core professional competencies.
Factors predicting fatigue among patients undergoing hemodialysis Bahia Galal Abd Elrazik Siam, Wafaa G. M. Ali, Mohamed E. H. Elzeky, Eman H. Y. Heggy Frontiers of Nursing, 2025 Objective To evaluate the factors predicting fatigue among patients undergoing hemodialysis (HD). Fatigue is a common health problem in patients receiving HD. Understanding the factors that predict fatigue is crucial for helping patients to manage their weariness. Methods A descriptive design was utilized with a convenient sample of 200 subjects who were on HD therapy at the Mansoura University Hospital and Mansoura International Hospital in Mansoura, Egypt, for at least 3 months. Four tools were utilized in collecting data. Results The study subjects had a moderate level of fatigue regarding all sub-dimensions of the Piper Fatigue Scale (PFS). Among the total subjects, 78.5% suffered from anxiety, and 31.0% had depression. A positive correlation was found between fatigue and anxiety, depression, and overall symptoms of distress, while a negative correlation was found between perception of the ability to manage symptoms and fatigue. The factors predicting fatigue included anxiety (β = 0.274, P < 0.001), depression (β = 305, P < 0.001), and the overall symptoms of distress (β = 0.248, P < 0.001), while the perceived ability to manage symptoms did not predicted. Conclusions Fatigue was ranked as the top distressing symptom among HD patients, with psychological factors such as anxiety, depression, and the overall symptoms of distress predicting fatigue. Regular screenings of these factors and psychological therapies to modulate them might decrease fatigue severity and its related disability in HD clients. Multidimensional nurse-led interventions involving physical and psychological therapies are required to manage fatigue in HD patients.
Assessment of Endometriosis Knowledge and Its Determinants Among Nurses in Al-Jouf Region, Saudi Arabia Nadia Bassuoni Elsharkawy, Afrah Madyan Alshammari, Osama Mohamed Elsayed Ramadan, Enas Mahrous Abdelaziz, Mohamed E. H. Elzeky, et al. Healthcare Switzerland, 2025 Background/Objectives: Endometriosis, a chronic and debilitating gynecological disorder, exacts a heavy clinical and socioeconomic toll on women’s lives. Despite its prevalence, its timely diagnosis and effective management are hindered by pervasive knowledge gaps among frontline nursing professionals, and these are especially pronounced in under-researched regions such as Al-Jouf, Saudi Arabia. Aim: Guided by the Knowledge–Attitude–Practice model, this study aimed to assess the level of endometriosis-related knowledge among nurses in the Al-Jouf region of Saudi Arabia and to identify the sociodemographic and professional determinants of knowledge levels. Methods: A cross-sectional, descriptive-analytical design was employed between January and July 2024, enrolling 215 nurses from a principal maternity and children’s hospital and two primary healthcare centers in Sakaka. A rigorously validated, bilingual 20-item questionnaire assessing four domains (definition, risk factors, clinical manifestations, and treatment goals) was administered. Data were analyzed using descriptive statistics, multiple linear regression, and binary logistic regression to elucidate predictors of knowledge. Results: A concerning picture emerged: 61% of participants scored below 60% (indicative of low knowledge), with only 6% achieving high scores. Higher educational attainment proved the strongest predictor (β = 0.415, p < 0.001), followed by age (β = 0.232, p < 0.001), years of experience (β = 0.149, p = 0.041), and direct patient care exposure (β = 0.168, p = 0.021). Collectively, these factors explained 37.6% of the variance in knowledge scores, underscoring a critical deficit in endometriosis management preparedness. Conclusions: The stark deficiencies in endometriosis knowledge among nurses in Al-Jouf call for immediate, tailored educational and policy interventions. Strengthening clinical competencies is essential for fostering early diagnosis and improving care outcomes for women burdened by this complex condition.
The effect of virtual reality distraction on haemodialysis patients’ pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial Mohamed EH Elzeky, Basma Salameh, Fadia Ahmed Abdelkader Reshia, Alaa A Sabry, Noha FM Shahine, et al. Journal of Research in Nursing, 2024 Background: Pain and anxiety during arteriovenous fistula (AVF) puncture are crucial factors affecting haemodialysis (HD) patients’ quality of life. Aim: The aim of this study is to assess the effect of virtual reality (VR) distraction on pain, anxiety, satisfaction and haemodynamics during AVF puncture. Methods: This randomised controlled trial study was conducted in a Haemodialysis unit at Mansoura University Hospital. Ninety-six patients were randomly divided into the intervention ( n = 48) and control ( n = 48) groups. Six minutes prior to the puncture, patients in the intervention group used VR glasses to experience a 360° ‘Relax River VR tour’, whereas patients in the control group received no intervention. Results: Following the intervention, pain, anxiety, systolic blood pressure and heart rate were significantly lower, and satisfaction scores were significantly higher in the intervention group than in the control group ( p < 0.05). Conclusion: VR distraction may help alleviate pain, anxiety and increase satisfaction. It may be considered a safe and cost-effective non-pharmacological therapy for HD patients undergoing AVF puncture.
Validation of the Arabic Version of Burn Specific Health Scale-Brief: A Psychometric Analysis OE Elsherbiny, AH El-Sabbagh, ME Elzeky Journal of Burn Care & Research, irag066 , 2026 2026
Psychometric Validation and Measurement Invariance of the Arabic Version of the Problem-Solving Inventory–20: An Instrument Validation Study in AI-Supported Learning MEH Elzeky, N Alsadaan, NFM Shahine Nurse Education in Practice, 104798 , 2026 2026
Reliance on ChatGPT in learning: Construction and validation of a reliance on ChatGPT scale for nursing students (ROCS-NS): Using structural equation modeling (SEM) MEH Elzeky, NFM Shahine Nurse Education in Practice, 104696 , 2025 2025
Arabic translation and validation of the gameful experience scale among Saudi Arabian nursing students: psychometric properties and measurement invariance across gender MEH Elzeky, ME Abdelgawad, M Shaban, ER Machaly, EMM Shoukr, ... Nurse Education in Practice, 104492 , 2025 2025 Citations: 3
Assessment of endometriosis knowledge and its determinants among nurses in Al-Jouf Region, Saudi Arabia NB Elsharkawy, AM Alshammari, OME Ramadan, EM Abdelaziz, ... Healthcare 13 (12), 1386 , 2025 2025 Citations: 3
Nursing students’ knowledge, attitudes, and behaviors toward aging and ageism in Palestine BM Hammad, B Salameh, FA Eqtait, K Maysa, IH Fashafsheh, AJ Ayed, ... BMC geriatrics 25 (1), 296 , 2025 2025 Citations: 11
Effects of gamified versus pedometer-based walking intervention on physical activity, fatigue, and sleep quality among hemodialysis patients: a quasi-experimental study MEH Elzeky, RH Ramadan El-Shaboury, B Salameh, E Samaan, ... BMC nephrology 26 (1), 108 , 2025 2025 Citations: 3
Psychometric testing of the Arabic version of the arrhythmia-specific questionnaire in tachycardia and arrhythmia among older adult arrhythmic patients MEH Elzeky, OME Ramadan, NFM Shahine Geriatric Nursing 62, 81-88 , 2025 2025 Citations: 2
The effect of virtual reality distraction on haemodialysis patients’ pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial MEH Elzeky, B Salameh, FAA Reshia, AA Sabry, NFM Shahine, ... Journal of Research in Nursing 29 (6), 421-434 , 2024 2024 Citations: 11
Evaluate Nurses knowledge and Adherence to Infection Prevention Control Measures during Caring for Covid19 Patients O Ghalb, A Shebl, M Elzeky Mansoura Nursing Journal 10 (1), 421-438 , 2023 2023
Effects of an educational program using a virtual social network on nurses’ knowledge and performance of blood pressure measurement: a randomized controlled trial MEH Elzeky, NFM Shahine BMC nursing 21 (1), 365 , 2022 2022 Citations: 15
Effect of gamified flipped classroom on improving nursing students’ skills competency and learning motivation: a randomized controlled trial MEH Elzeky, HMM Elhabashy, WGM Ali, SME Allam BMC nursing 21 (1), 316 , 2022 2022 Citations: 95
Adherence to Preventive Measures and Suspected Covid19 Symptoms Development Among Nursing Students During Written Exams WGMA mohamed elsayed hamed elzeky Egyptian journal of health care 11 (4), 715-725 , 2020 2020 Citations: 1
Effect of Pedometer based aerobic walking program on steps count and resting heart rate among atrial fibrillation patients MEH Elzeky, W Sherief, H Salama Mansoura Nursing Journal 5 (1), 17-32 , 2018 2018 Citations: 2
Evaluation of Warfarin Knowledge in Patients With Chronic Atrial Fibrillation in Outpatient Cardiovascular Clinics At Specialized Medical Hospital MEH Elzeky, WI Sherief, AMS Abd Ellateef, HMM Soliman Mansoura Nursing Journal 2 (1), 83-96 , 2015 2015 Citations: 2
MOST CITED SCHOLAR PUBLICATIONS
Effect of gamified flipped classroom on improving nursing students’ skills competency and learning motivation: a randomized controlled trial MEH Elzeky, HMM Elhabashy, WGM Ali, SME Allam BMC nursing 21 (1), 316 , 2022 2022 Citations: 95
Effects of an educational program using a virtual social network on nurses’ knowledge and performance of blood pressure measurement: a randomized controlled trial MEH Elzeky, NFM Shahine BMC nursing 21 (1), 365 , 2022 2022 Citations: 15
Nursing students’ knowledge, attitudes, and behaviors toward aging and ageism in Palestine BM Hammad, B Salameh, FA Eqtait, K Maysa, IH Fashafsheh, AJ Ayed, ... BMC geriatrics 25 (1), 296 , 2025 2025 Citations: 11
The effect of virtual reality distraction on haemodialysis patients’ pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial MEH Elzeky, B Salameh, FAA Reshia, AA Sabry, NFM Shahine, ... Journal of Research in Nursing 29 (6), 421-434 , 2024 2024 Citations: 11
Arabic translation and validation of the gameful experience scale among Saudi Arabian nursing students: psychometric properties and measurement invariance across gender MEH Elzeky, ME Abdelgawad, M Shaban, ER Machaly, EMM Shoukr, ... Nurse Education in Practice, 104492 , 2025 2025 Citations: 3
Assessment of endometriosis knowledge and its determinants among nurses in Al-Jouf Region, Saudi Arabia NB Elsharkawy, AM Alshammari, OME Ramadan, EM Abdelaziz, ... Healthcare 13 (12), 1386 , 2025 2025 Citations: 3
Effects of gamified versus pedometer-based walking intervention on physical activity, fatigue, and sleep quality among hemodialysis patients: a quasi-experimental study MEH Elzeky, RH Ramadan El-Shaboury, B Salameh, E Samaan, ... BMC nephrology 26 (1), 108 , 2025 2025 Citations: 3
Psychometric testing of the Arabic version of the arrhythmia-specific questionnaire in tachycardia and arrhythmia among older adult arrhythmic patients MEH Elzeky, OME Ramadan, NFM Shahine Geriatric Nursing 62, 81-88 , 2025 2025 Citations: 2
Effect of Pedometer based aerobic walking program on steps count and resting heart rate among atrial fibrillation patients MEH Elzeky, W Sherief, H Salama Mansoura Nursing Journal 5 (1), 17-32 , 2018 2018 Citations: 2
Evaluation of Warfarin Knowledge in Patients With Chronic Atrial Fibrillation in Outpatient Cardiovascular Clinics At Specialized Medical Hospital MEH Elzeky, WI Sherief, AMS Abd Ellateef, HMM Soliman Mansoura Nursing Journal 2 (1), 83-96 , 2015 2015 Citations: 2
Adherence to Preventive Measures and Suspected Covid19 Symptoms Development Among Nursing Students During Written Exams WGMA mohamed elsayed hamed elzeky Egyptian journal of health care 11 (4), 715-725 , 2020 2020 Citations: 1
Validation of the Arabic Version of Burn Specific Health Scale-Brief: A Psychometric Analysis OE Elsherbiny, AH El-Sabbagh, ME Elzeky Journal of Burn Care & Research, irag066 , 2026 2026
Psychometric Validation and Measurement Invariance of the Arabic Version of the Problem-Solving Inventory–20: An Instrument Validation Study in AI-Supported Learning MEH Elzeky, N Alsadaan, NFM Shahine Nurse Education in Practice, 104798 , 2026 2026
Reliance on ChatGPT in learning: Construction and validation of a reliance on ChatGPT scale for nursing students (ROCS-NS): Using structural equation modeling (SEM) MEH Elzeky, NFM Shahine Nurse Education in Practice, 104696 , 2025 2025
Evaluate Nurses knowledge and Adherence to Infection Prevention Control Measures during Caring for Covid19 Patients O Ghalb, A Shebl, M Elzeky Mansoura Nursing Journal 10 (1), 421-438 , 2023 2023