Conectar
To examine workplace experiences, perspectives on coming out at work, organisational climate and mental health status of lesbian, gay, bisexual, transgender, queer/questioning and other sexual, and gender minority healthcare providers (LGBTQ+ HCPs) within an East Asian cultural context.
Observational, cross-sectional study.
An online cross-sectional survey was conducted among 173 Taiwanese LGBTQ+ HCPs between May and August 2024.
Most of the 173 respondents did not disclose their LGBTQ+ identities to any colleagues, and approximately two-fifths met the clinically significant threshold for depressive symptoms. Furthermore, compared to LGBTQ+ HCPs who disclosed to all, most, about half or a few colleagues, those who had not disclosed to any colleagues reported higher levels of depressive symptoms, lower self-esteem, less comfort with disclosure, greater perceived necessity to conceal their LGBTQ+ identities, lower scores for job stability or security, poorer interpersonal relations and lower agreement that an LGBTQ+-inclusive workplace climate would influence their willingness to remain in their current jobs. Although approximately 80% of the LGBTQ+ HCPs reported that they were familiar with national workplace antidiscrimination laws and that their organisations had grievance mechanisms, nearly two-fifths did not trust the grievance systems or procedures within their organisations.
Results emphasise the urgent need to create an LGBTQ+-inclusive workplace environment with clear and enforceable antidiscrimination policies and inclusive organisational practices to improve both disclosure safety and mental health outcomes for LGBTQ+ HCPs.
The study results extend existing knowledge by identifying the relationship between different levels of disclosure and mental health status among LGBTQ+ HCPs. They also highlight the importance of establishing support groups, a comprehensive mental health referral system and enforcement mechanisms that safeguard legal rights without compromising the privacy or safety of LGBTQ+ HCPs.
No patient or public contribution.
To describe the lived decision-making experiences of parents during the first 6 months after their children's new cancer diagnoses.
Descriptive phenomenological study.
This study was conducted from 2022 to 2023 at an academic teaching hospital in Taiwan. Parents of children newly diagnosed with cancer within the previous 6 months were recruited using purposive sampling. Data were collected via in-depth interviews with 18 participants and subsequently analysed using the Giorgi method.
Three major themes emerged: (1) making decisions without choices, with the subthemes of parallel universes and realities and overwhelming information and unanswered questions; (2) deferring decisions to expert judgements, with the subthemes of trust in professionals, working together, and seeing the future; and (c) balancing quality of life and survival, with the subthemes of confronting and suffering, mental preparation and worry, and being a strong supporter and carrying burdens. Hope for their children's survival sustained parents, empowering them to become steadfast sources of strength and support. Through hope, they transitioned from feeling helpless to actively advocating and assuming the primary caregiver role.
After deciding to proceed with their children's cancer treatment, hope for survival becomes the strongest factor motivating parents to navigate, explore, and move forward in an environment filled with uncertainty. Psychological preparation and understanding ease parental anxiety.
The development of clear, structured care plans is recommended to help parents feel supported and transition early from novices to confident guides.
The findings of this study highlight the shift in parents' roles following children's cancer diagnoses from facing unavoidable decision-making to actively striving to balance children's quality of life with treatment outcomes. They provide guidance for the support of parents' engagement with decision-making plans in clinical practice.
Standards for Reporting Qualitative Research.
None.
Palliative care reduces caregiver burden, alleviates patient symptoms, and supports treatment decision-making. However, despite these benefits, there is limited evidence on the effectiveness of palliative care interventions for caregivers of individuals with advanced dementia.
To integrate and analyze data on the effectiveness of palliative care interventions in improving caregiver outcomes in order to ensure that both patients and caregivers receive the support necessary for optimal care experiences, quality of life management, and advanced care planning.
A systematic search was conducted of six databases to identify relevant studies published from database inception to 12 December 2024. Randomized controlled trials (RCTs) investigating palliative care interventions for caregivers of people with advanced dementia were included. Version 2 of the Cochrane Risk of Bias tool was used to assess the risk of bias in the methodology of each study. Standardized mean differences (SMDs) between each intervention and control group were calculated. A random-effects DerSimonian and Laird model was applied to generate pooled SMD estimates for each outcome and assess its heterogeneity. A leave-one-out sensitivity analysis was performed to ensure the stability of the pooled effect sizes.
Eight RCTs were included in the final analysis. Palliative care interventions appeared to reduce conflict in decision-making among caregivers of people with advanced dementia.
Palliative care interventions were successful in reducing conflict in decision-making of caregivers of people with advanced dementia. However, the modality's effects on caregiver satisfaction and caregiver distress need further investigation.
Future palliative care interventions for caregivers of advanced dementia patients should focus on developing the contents of palliative care materials based on evidence-based evaluations and explore strategies to improve engagement between patients, caregivers, and healthcare professionals.
To investigate the clinical outcomes and predictors associated with the severity of new-onset pressure injuries in hospitalised patients with multiple comorbidities.
Retrospective cohort study.
We retrospectively collected data on hospitalized patients. The severity of pressure injury was defined as per the National Pressure Injury Advisory Panel. Outcome measures included short-term mortality and discharge to extended care facilities.
A total of 2150 hospitalised patients were screened, and 186 (8.7%) developed new-onset pressure injuries, including 84 classified as stage I and 102 as stage II. The Braden scale score and time from admission to pressure injury onset were significantly associated with new-onset stage II pressure injuries. Patients with stage II pressure injuries had a significantly higher risk of being discharged to extended care facilities compared to those with stage I pressure injuries (24% vs. 12%, p = 0.041). The short-term mortality rate was high in the total cohort (34%) but was not significantly different between the two groups. The worse Braden scale, lower body mass index, history of stroke and presence of stage II pressure injuries were significant predictors of discharge to extended care facilities.
New-onset Stage II pressure injuries significantly increased the risk of discharge to extended care facilities. Furthermore, this study expands the potential clinical utility of the Braden Scale by demonstrating its association not only with the risk of pressure injury development but also with the initial severity of injuries once they occur. These findings support its role in early risk stratification and targeted nursing interventions.
This study highlights the importance of early identification and prevention of pressure injuries and the potential role of the Braden scale in minimizing injury severity, reducing healthcare utilization, and improving quality of life.
STROBE guidelines.
None.
To describe unit leadership and climates for evidence-based practice implementation and test for differences in unit leader and staff nurses' perceptions within maternal–infant units.
A cross-sectional descriptive study.
A convenience sample of maternal–infant unit leaders and nurses (labour, postpartum, neonatal intensive care, paediatrics) from four Midwestern United States hospitals completed a survey including the Implementation Leadership Scale (ILS) and Implementation Climate Scale (ICS). Descriptive statistics described items, subscales and total scores. Independent t-tests with Bonferroni correction tested for differences in perceptions.
A total of 470 nurses and 21 unit leaders responded, representing 17 units. Ratings of unit leadership and climates for implementation were modest at best [ICS: M = 2.17 (nurses), 2.41 (leaders); ILS: M = 2.4 (nurses), 2.98 (leaders)]. Unit leader ratings were statistically significant and higher than nurse ratings.
This study is one of the first to describe unit leadership and climates for implementation in maternal–infant health. To improve outcomes and equity in maternal–infant health, attention on leadership behaviours and unit climates for evidence-based practice implementation is needed.
Nurse leaders are encouraged to evaluate their leadership behaviours and the unit climates they facilitate, and work to improve areas of concern or where staff perceptions differ. Staff nurses should work with their leaders to identify resources and rewards/recognition which support and facilitate EBP implementation.
This study addressed a gap in research examining the social dynamic factors of unit leadership and climate for evidence-based practice implementation in maternal–infant units. Leadership behaviours for implementation and unit climate were rated moderately by both staff and leaders. Unit leaders rated their implementation leadership and climates higher in almost all items. This study is relevant to unit leaders and nurses in maternal–infant units in the United States.
This study adhered to STROBE guidelines.
No patient or public contribution.
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