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To critically examine the structural exclusion of Doctor of Nursing Practice (DNP)-prepared faculty from academic advancement and promotion pathways and to propose reforms grounded in Boyer's model of scholarship.
The DNP is a practice-focused doctorate established in the United States, distinct from the research-oriented PhD. Similar professional doctorates in the United Kingdom and Australia share the goal of integrating clinical expertise with scholarly inquiry. Despite the rapid growth of DNP programs and the increasing recognition of applied scholarship, many universities continue to privilege traditional research metrics in academic tenure and promotion. This narrow focus on discovery-based outputs marginalises the contributions of DNP faculty in implementation science, systems leadership, and education.
Discursive position paper.
Analysis of policy reports, faculty promotion guidelines, AACN Essentials, and peer-reviewed literature on doctoral education, professional doctorates, and academic equity, 2000–2025.
Current academic evaluation systems sustain hierarchical norms that undervalue practice-based scholarship. This misalignment restricts the career trajectories of DNP-prepared faculty and constrains nursing's leadership in applied innovation. Reframing scholarly legitimacy through Boyer's model of discovery, integration, application, and teaching enables recognition of diverse expertise without compromising academic rigour.
Fully integrating professional doctorates into academic structures requires deliberate reforms in evaluation frameworks, mentorship programs, and institutional policies. Such changes would advance equity, reflect the realities of modern nursing, and align doctoral education with the evolving needs of healthcare systems.
This paper contributes to the international discourse on the future of doctoral education by offering a practical model for inclusive faculty advancement. It also advocates adopting pluralistic definitions of scholarship to support diverse academic career paths in nursing.
No patients, service users, caregivers, or members of the public were involved in the development of this discursive paper. The analysis synthesises existing scholarship, policy documents, and theoretical frameworks and does not draw on primary data requiring patient or public involvement.
Identify desired training content for shift-working nurses to improve their sleep and fatigue.
A descriptive qualitative design.
We recruited night shift nurses (N = 23) to provide feedback during virtual focus groups/interviews. Data collection occurred in the U.S. between March and June 2024. Participants were presented with sleep and fatigue topics derived from the literature. Focus group/interview data were collected and transcribed. Data were analysed using a hybrid deductive-inductive manifest content analysis with an a priori coding schema based on topics shared during data collection. Data not fitting the schema, yet informing content, were analysed inductively.
Three themes aligned with literature-derived topics. Theme 1, Why We Sleep and Why Should Nurses Care, explains the importance of sleep to health. Theme 2, Sleep Practices for Nurses to Support Health and Social Relationships, describes healthy strategies to promote sleep for enhanced quality of life. Theme 3, Fatigue and Work, illustrates the significance of nurse sleep and fatigue risk mitigation to safe working conditions and patient care.
Study findings highlight night shift nurses' interest in gaining evidence-based information to promote their sleep. Sleep education and training could fill a knowledge and skills gap, not often offered in school or workplace.
Identifying themes relevant to nurses may help increase the development and availability of sleep education and training currently tailored for nurses.
Study findings describe content night shift nurses' desire for sleep and fatigue training, serving as an important first step in developing programmes most relevant to shift-working nurses. Our analysis found the findings largely align with key components workers should receive in sleep education and training and reinforced the need for employers to offer such training. This study could benefit the nursing workforce and employers who expect rested, high-functioning nurses to care for patients.
Standards for Reporting Qualitative Research.
No patient or public contribution.
Clinicaltrials.gov, NCT06105307
To explore the feasibility and acceptability of acoustic monitoring and real-time recommendations for stress detection and management (i.e., smarthealth intervention).
This qualitative study used a framework of acceptability for healthcare interventions.
From January 2021 to December 2023 in the U.S.A., we interviewed 10 family caregivers who had completed the 4-month smarthealth intervention. The caregivers shared their user experiences and feedback on the system's feasibility and acceptability. Data were analysed using abductive thematic analysis, incorporating the framework of acceptability for healthcare interventions and the collected data.
Seven themes and 19 categories emerged: attitudes, burden, ethicality, intervention adherence, intervention coherence, perceived effectiveness and suggestions. Feedback on the smarthealth intervention was mixed. Some found it beneficial, citing accuracy, ease of use and increased awareness. However, others felt burdened during its use, primarily due to time constraints.
The smarthealth intervention can potentially improve caregivers' awareness of themselves and caregiving situations.
Future directions should involve adapting the smarthealth intervention to consider diverse caregiving scenarios and incorporating a larger sample of caregivers.
This is the first study to offer a voice detection system and real-time stress management recommendations to caregivers of people living with dementia. An individualised approach should be considered to improve the system's effectiveness. This includes providing personalised intervention components, considering caregivers' time and establishing a user-friendly system with high accessibility. The findings can be a cornerstone for smarthealth interventions influencing dementia caregivers' self-care and emotional regulation.
Standards for Reporting Qualitative Research.
Members of the public and service users from a memory clinic and social media platforms contributed to the study by reviewing recruitment materials.
Trial Registration: This trial's study protocol was registered with ClinicalTrials.gov (ID No. NCT04536701) on 3 September 2020 (https://classic.clinicaltrials.gov/ct2/show/NCT04536701)
To analyse the concept of psychological burnout among nurses in the context of terminal care.
Concept analysis.
The study was conducted according to the eightstep conceptual analysis procedure suggested by Walker and Avant.
Articles published in English or Korean between January 2014 and 2024 were reviewed in March 2024. A total of eight search engines were used for the literature review, including PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PsycINFO. A total of 19 articles were finally selected for the analysis based on criteria.
The attributes of psychological burnout among nurses providing terminal care are depletion of energy, emotional numbness, disengagement, sense of powerlessness and emotional repression. Seven antecedents and six consequences of the concept were identified in this study.
The result of this study provides a foundation for the development of tailored interventions and further research related to the occurrence of psychological burnout among nurses providing terminal care. Additionally, considering the characteristics of terminal care, we suggest additional studies to confirm the attributes of burnout in this context across various cultural and religious backgrounds.
This study helps clarify the concept of psychological burnout among nurses in terminal care and informs the development of various interventions, educational programmes and related policies.
No patients or public contribution.
To review the evidence on the experiences and perceptions of culturally and linguistically diverse informal carers supporting older adults during transitions from hospital to home, including their interactions with transitional care interventions.
Scoping review guided by Arksey and O'Malley's framework.
We searched CINAHL, MEDLINE, Embase, Emcare, AMED, PsycINFO, Global Health, Social Work Abstracts, JBI EBP, Scopus, Web of Science Core Collection, ProQuest and Informit for studies published between January 2010 and November 2024.
Two reviewers independently screened studies and extracted data. Analysis followed the Patterns, Advances, Gaps, Evidence for Practice and Research recommendations framework.
Seventeen studies involving 1275 carers were included. Carer experiences were summarised into four themes: (1) cultural and communication barriers; (2) role ambiguity and practical challenges; (3) limited involvement in discharge planning and (4) barriers to accessing support and services. Perceptions of transitional care interventions were mixed. While some interventions improved carer preparedness and reduced stress, most lacked cultural tailoring and did not address carers' psychosocial and communication needs.
Culturally and linguistically diverse informal carers face challenges navigating transitional care. While involving them in care planning improves outcomes, implementation remains inconsistent. Emotional support and culturally tailored services are insufficient.
There is a need for culturally and linguistically tailored transitional care programmes that prioritise carer education and communication support. Key areas for improvement include: (1) health literacy and system navigation; (2) involvement in care planning; (3) communication with providers; (4) psychosocial and emotional support and (5) culturally appropriate services. Future research should explore the unique emotional and psychosocial needs of these carers to inform targeted support strategies.
This review follows the PRISMA guideline for reporting.
No patient or public contribution.
This study aimed to explore culturally and linguistically diverse (CALD) fathers' early parenting support needs in the perinatal period in Australia.
A qualitative descriptive research study. Participant fathers were recruited using purposive and snowball sampling who self-identified as CALD.
Data were collected through semi-structured telephone interviews with 15 Australian fathers aged between 29 and 56 years in July–November 2022. Data were analysed using Braun and Clarke's six stages of thematic analysis to code, categorise and identify themes from the data.
Four major themes and six sub-themes emerged from the data, ‘Under pressure’, ‘Slipping through the cracks’, ‘Gaining knowledge and support by health professionals’, and ‘Path ahead: changed roles and being supported by peers’ that encompassed fathers' early parenting experiences and support needs in the perinatal period.
Culturally and linguistically diverse fathers experience challenges in navigating maternal health care settings and at times interactions with health professionals. However, findings from this study showed that fathers were determined to navigate resources, services and networks that supported their transition to fatherhood in the early postpartum weeks. There is a need for maternity settings to be a ‘father-inclusive’ environment where informational and practical support is readily available to them. Legislation reform is needed that recognises fathers as parents who require adequate ‘paid’ parental leave entitlements that foster family relationships and recognises the role fathers play in the development of their child.
This study provides insights into the support needs of CALD fathers in the perinatal period. Findings from this study have the potential to shape and design culturally appropriate health services and interventions tailored to CALD fathers that meet their nuanced needs through the lens of cultural competence and trauma informed maternity care.
What problem did the study address?: The study explored the support needs of CALD fathers in the perinatal period. What were the main findings?: The findings revealed CALD fathers feel a sense of responsibility and pressure to live up to socio-cultural expectations and support the family unit while engaging in paid employment to earn a living. At times fathers were not encouraged to be parenting partners by health professionals, and there was an expectation that they would be familiar and have knowledge about pregnancy, labour, birth and the transition to fatherhood. Some fathers struggled with their transition to parenthood either due to lack of paid parental support or limited to no family support. However, some fathers found alternatives to manage and adjust in the early weeks postpartum, which included peer support groups and online information. Where and on whom will the research have an impact?: The research has the potential to impact all fathers, as the findings may be transferrable across a number of communities. The research also has the potential to influence cultural competence training for health care professionals and inform policy development that employs a family centred model of maternity care inclusive of culturally diverse families.
The paper has adhered to the EQUATOR COREQ reporting guideline.
This study did not include patient or public involvement in its design, conduct or reporting.
To examine factors, including symptom burden profiles and self-care, associated with quality of life among individuals with heart failure and multimorbidity.
A cross-sectional design.
353 adults aged 50 years or older with heart failure and at least one additional chronic condition were recruited from a university-affiliated hospital. Three symptom burden groups were identified (low, moderate, and high) through latent profile analysis of the Edmonton Symptom Assessment Scale scores. The Heart Failure Self-care Index and EuroQoL-5D-5L measured self-care behaviours and quality of life. This study examined group differences and associations overall and stratified by symptom burden groups via multivariable linear regression.
A higher disease burden and the high symptom burden group compared to the low symptom burden group were associated with lower quality of life. Self-care maintenance was positively associated with a higher quality of life, but not in the high-burden group. Among individual symptoms, pain and depression were associated with lower quality of life. In the high-burden group, older age was positively associated with quality of life. Higher symptom burden groups included a greater proportion of women and middle-aged adults.
Symptom burden and self-care maintenance show significant associations with quality of life in multimorbidity. Symptom burden profiles identified through latent profile analysis may complement conventional approaches by targeting high-risk individuals, such as middle-aged individuals and women with high symptom burden, for follow-up and integrated multimorbidity management.
For healthcare providers, including nurses, these findings underscore the importance of holistic, symptom-based care approaches combined with routine support for self-care maintenance. Adopting a life-course approach, through early identification and management of high-risk individuals, may help promote aging in place with a better quality of life for those with heart failure and multimorbidity.
STROBE checklist.
No patient or public contribution.
(1) To determine the mediating effects of children's transition readiness, which reflects self-management skill acquisition, and family resilience on the relationship between parenting stress and the quality of life (QOL) of parents and children with spina bifida (SB). (2) To conduct an exploratory analysis of the differences in the mediating pathways based on the presence of SB-related clinical characteristics.
A cross-sectional study.
Data were collected from a single centre in South Korea between October 2022 and July 2024. Participants included children aged 7–13 years diagnosed with myelomeningocele, lipomyelomeningocele or tethered cord syndrome, along with their parents. Statistical analysis was conducted using SPSS and the MEDYAD macro for actor–partner interdependence mediation model analysis.
Family resilience significantly mediated the relationship between parenting stress and both child and parent QOL. However, transition readiness was not a significant mediator in the overall sample. Among children with SB-related clinical characteristics, transition readiness significantly mediated the association between parenting stress and child QOL. In contrast, family resilience mediated the relationship between parenting stress and parent QOL. No significant mediators were found in children without SB-related clinical characteristics.
This study highlights the mediating role of family resilience and transition readiness in improving the QOL of children with SB, particularly those with clinical characteristics. The findings suggest that interventions should be tailored to address both family resilience and transition readiness, especially for children with SB-related clinical challenges.
These findings are valuable for nurses supporting children with SB, as the results highlight the importance of transition education tailored to SB-related clinical characteristics. In particular, nurse-led transition education may play a key role in enhancing transition readiness and improving the QOL of children with SB who have clinical characteristics.
None.
STROBE Checklist for cross-sectional studies.
To explore the key advice healthcare professionals would give colleagues regarding end-of-life care delivery in hospitals, thereby informing training needs.
Exploratory qualitative study.
Free-text responses from medical, nursing, and allied health professionals who completed online end-of-life care education modules (n = 597) from August 2022 to September 2023 were analysed using inductive content analysis. Results were explored and separated into two key findings: themes that were shared by all professional groups and themes that were profession specific.
Five themes were consistent across all three professional groups: prioritise patient comfort, proactive communication, collaboration and inclusion, human approach and support and wellbeing, each with their own subthemes. Several profession specific subthemes were also identified.
The identification of common themes across healthcare professions helps to support the development of interprofessional training initiatives.
This research contributes valuable insights for developing targeted end-of-life care education programs. Results also underscore the potential of online learning platforms in providing accessible, evidence-based, continuing professional development in end-of-life care.
In Australia, most deaths occur in acute hospital settings. To inform and shape future training, this study collected the key advice healthcare professionals would give colleagues regarding end-of-life care delivery. The themes generated covered a range of potential training topics shared across all professionals, including prioritise patient comfort, proactive communication, collaboration and inclusion, human approach and support and wellbeing. Several profession-specific subthemes were also identified, providing additional insights for designing training for professional groups. Results underscore the potential of online learning platforms in providing accessible, evidence-based, continuing professional development in end-of-life care.
Standards for Reporting Qualitative Research (SRQR).
None.
To explore neonatal unit policy and practice, and neonatal healthcare workers' experiences, beliefs and perceptions of twin cobedding in Australia.
A two-part convergent mixed methods design was used. Part 1 data were collected via an online survey of neonatal units. Part 2 data were collected by focus groups and interviews with healthcare workers. Findings were integrated to create final results.
21 neonatal units, and 17 healthcare workers participated in this study. Significant variations in twin cobedding practices were reported within and across neonatal units. Practice variation was influenced by several interlinked factors, captured in four themes: (1) Policy-Driven Practitioners in a Policy Vacuum; (2) Evidence, Knowledge and Education; (3) Personal Beliefs and Practice Observations; and (4) “The Parent Owns that Baby”—Being Family-Centred.
Due to widespread practice and policy variations, and a lack of evidence-based education for staff, healthcare workers appear to be making individual decisions regarding cobedding practice, potentially creating confusion for twin families navigating care.
Improvements to twin cobedding practice education are needed to enable clinicians to support twin families in their care. Separation of twins in neonatal units needs to be addressed, regardless of twin cobedding practice. Research identifying benefits and any potential risks of twin cobedding practice is required.
Neonatal healthcare workers are policy-driven practitioners who value clear evidence and education to confidently support the families in their care. It is important that evidence-based guidelines for twin cobedding are developed to support them in family-centred clinical practice.
MMAT guidelines were used to prepare this manuscript.
No Patient or Public Contribution.
To investigate factors affecting the quality of life of parents of children with spina bifida and examine how family resilience mediates between parental depression and quality of life.
Cross–sectional study.
Secondary data analysis was performed using first-year data from a five-year spina bifida cohort project (2022–2026) in South Korea. The study included 162 parents of children aged 4–12 years with spina bifida. Data were collected using the Korean version of the Family Resiliency Scale, the Center for Epidemiologic Studies Depression Scale, and the WHO Quality of Life Scale.
Factors were found to have a statistically significant influence on the quality of life of parents of children with spina bifida: the child's need for enemas, parental stress, parental depression, and family resilience. Baron & Kenny's mediation analysis and bootstrap analysis in SPSS further confirmed that family resilience plays a mediating role between parental depression and quality of life. The indirect effect of parental depression on quality of life through family resilience was statistically significant, with a 95% confidence interval of [−0.2615, −0.0516].
The quality of life of parents with children with spina bifida is significantly influenced by both their child's daily symptom management and their psychological health. Family resilience plays a positive mediating role between parental depression and quality of life.
These findings support a two-track approach to family resilience building programs and the development of core intervention strategies to enhance the quality of life in spina bifida families.
This study adhered to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
There was no direct patient involvement in the study design, data collection, or analysis.
Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors associated with fall occurrence and fall frequency among community-dwelling older adults in Korea, with particular emphasis on SDOH.
A cross-sectional study design.
We used a large nationwide sample (n = 9746) from the 2023 National Survey of Older Koreans. The number of falls in the past year served as the dependent variable. Independent variables included a range of socioeconomic and environmental variables as SDOH, alongside biological and behavioral variables. A zero-inflated negative binomial (ZINB) regression analysis was employed to address excess zeros and overdispersion in fall count data.
Among participants, 94.8% experienced no falls, 3.2% reported a single fall, and 1.9% reported recurrent falls. In the logit model for fall occurrence, higher household income level, absence of age-friendly housing, higher access to parks, and lower access to welfare centers were associated with higher risk of fall occurrence. In the count model for fall frequency, higher education level, presence of age-friendly housing, and outdoor mobility barriers were associated with higher fall frequency within the at-risk group.
The findings provide empirical evidence on the critical roles of SDOH in falls among community-dwelling older adults. Specifically, a ZINB regression analysis identified distinct sets of SDOH associated with fall occurrence versus fall frequency, highlighting the complex and multifaceted nature of fall patterns among older adults.
Healthcare providers and policymakers seeking to reduce falls should implement tailored, SDOH-integrated strategies by addressing the different mechanisms underlying fall occurrence and fall frequency.
To describe the latest information on types of psychosocial interventions and their effectiveness on loneliness reduction among older adults in community and residential care settings, and the experience with these interventions.
Umbrella review.
The Joanna Briggs Institute methodology for umbrella reviews.
Cochrane Database of Systematic Reviews; Cumulative Index of Nursing and Allied Health Literature; Medline; Embase; Emcare; PsycINFO; ProQuest Dissertation & Thesis Global; Ovid Nursing Database; MedRxvi.
Twenty-two reviews were included. Seven major types of psychosocial intervention were identified: (1) social facilitation interventions, (2) psychological therapies, (3) health and social care provision, (4) animal-assisted interventions, (5) befriending interventions, (6) leisure and skill development, and (7) other interventions. Social facilitation interventions that provide synchronised interaction, psychological therapies, health and social care provision, and animal (−assisted) interventions demonstrated positive effects while leisure/skill development and befriending interventions warrant more rigorous evidence. Group settings, synchronised interaction and purpose-driven are identified as facilitators, whereas technological issues and safety issues are barriers to participation.
Seven types of psychosocial interventions are currently available for loneliness among community-dwelling older adults, and a positive effect in reducing loneliness was demonstrated in some types. Facilitators and barriers to their participation were synthesised. Two future research directions are suggested: (1) reviews on meaning-centred interventions to provide a comprehensive understanding and (2) implementation studies employing community-based paraprofessionals to promote programme scalability and accessibility.
Health and social care practitioners (e.g., nurses), researchers and policymakers are recommended to employ social facilitation interventions with synchronised interaction, psychological therapies, health and social care provision and animal-assisted interventions to address loneliness among community-dwelling older adults.
This review provided empirical information on available effective interventions to address loneliness among community-dwelling older adults. It also provided information for nurses to implement psychosocial interventions in the community.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
This study did not include patient or public involvement in its design, conduct or reporting.
PROSPERO CRD 42023482852, registered 25/11/2023
Considering that suicide has remained a public health challenge in South Korea since 2009, the development of a real-time monitoring system for suicide risk is urgently needed, especially for those living in the community. The aims of this study were to explore the 28-day longitudinal pattern of suicidal ideation, compare momentary depression, anxiety and stress between different risk groups, and identify the association of suicidal ideation with momentary indicators in community-dwelling outpatients at risk of suicide.
Observational and longitudinal investigation.
A total of 50 community-dwelling psychiatric outpatients were included herein. Those with a history of suicide attempts were classified into the high-risk group (n = 40, 80%), whereas the rest were classified into the low-risk group (n = 10, 20%). Real-time data on depression, anxiety, stress and suicidal ideation were collected from May 2021 to July 2023 based on ecological momentary assessment. Each participant provided reports at least three times a day for 4 weeks. A total of 3195 ecological momentary assessment responses were collected, among which 1345 with the highest mood intensity per day were selected for analysis. Panel mixed-effect linear regression models examined differences in ecological momentary assessment responses between high- and low-risk groups and elucidated the separate effects of depression, anxiety and stress on suicidal ideation in each risk group.
Momentary depression, anxiety and stress were positively associated with momentary suicidal ideation in both risk groups, with these associations being higher among the high-risk group. In both risk groups, momentary suicidal ideation was more strongly associated with momentary depression than with momentary anxiety and stress.
Psychosocial stress indicators were associated with momentary suicidal ideation. Moreover, a strong association was observed between momentary depression and suicide attempts. Further research with larger samples should be conducted to evaluate whether depression interventions could reduce momentary suicidal ideation.
No Patient or Public Contribution.
To establish the suitability of self-determination theory as a theoretical framework to inform research and design of digital applications for nurses' well-being.
This discursive paper describes the background and core premises of self-determination theory and explains its relevance as a theoretical framework to support research and the design of digital applications to promote nurses' well-being.
Increasing numbers of digital applications are being used by nurses, but few are supported by clearly explicated theoretical frameworks. Self-determination theory focuses on how people's innate psychological needs interact and are influenced by the social environments where they live and work. Given the influence the social environment can have on well-being, self-determination theory is well suited as a theoretical framework to inform research and design of digital applications promoting nurses' well-being.
Stress and burnout impact nurses worldwide, to the detriment of staff well-being, their retention in health services, and provision of patient care. The rapid development and ubiquitous use of digital applications by nurses make researching their effectiveness vitally important if nurses' well being is to be supported. Self-determination theory provides a theoretical framework useful for these applications.
Through the lens of self-determination theory, researchers, digital application designers, and organisations can garner further insights to support digital application development and implementation for the well-being of nurses.
This paper has international relevance and can assist researchers, application designers, and organisations interested in promoting nurses' well-being through understanding the applicability and usefulness of self-determination theory as a theoretical framework for the design of digital applications for nurses' well-being.
No Patient or Public Contribution.
To explore peer volunteers' experiences of delivering online support through SMART to at-risk mothers during the perinatal period, to inform future improvements to mobile-health-application (mHealth app) based peer-support interventions.
Descriptive qualitative research.
The study was conducted between February 2024 and June 2025 in a tertiary public healthcare institution in Singapore. Twenty peer volunteers were recruited via convenience and snowball sampling and participated in individual semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.
Four themes were identified: (a) Giving and receiving: the inner world of peer volunteers; (b) Navigating relational complexity in digital peer support; (c) Facilitating connection and continuity in digital peer support; and (d) Building better connections through supportive ecosystems.
Peers reported experiencing reciprocal benefits, such as a sense of fulfilment and achievement, while supporting mothers. Shared experiences and psychosocial vulnerabilities enhanced relatability, reassurance and rapport, which sustained supportive relationships. Challenges encountered by peers highlighted the need for strengthening both intervention design and peer training.
Regular check-ins by programme facilitators, alongside clear information, flexible guidelines and reassurance, can improve peer volunteers' motivation and resilience, thereby ensuring consistent and sustainable support for at-risk mothers.
Examined peer volunteers' experiences in providing online perinatal support to mothers with diverse psychosocial vulnerabilities. Peers offered emotional, informational and practical support, while mothers benefited from learning how peers had coped with their psychosocial vulnerabilities. Shared experiences fostered confidence and reassurance among mothers that they, too could overcome similar adversities. Valuable in providing both medically accurate perinatal information and meaningful social support to perinatal mothers.
The reporting of the study adheres to the standards outlined in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
Mothers and peer volunteers contributed valuable insights and suggestions that helped in the design of the intervention.
To explore the optimal timing of patient-reported outcome assessment, defined as the collection and use of patient-reported outcomes at clinically meaningful points such as before or during encounters, treatment initiation and follow-up, and to identify the facilitators and barriers to timely use.
A qualitative analysis of semi-structured interviews with healthcare professionals across diverse US health systems.
Thematic analysis was used to identify key themes related to the timing and implementation of patient-reported outcomes assessments. Interviews were analysed iteratively to develop a coding framework and synthesise overarching themes.
Fourteen healthcare professionals, including nurse practitioners, cardiologists and health informatics experts across seven U.S. health systems from academic and community hospitals, were interviewed in February 2024. Three major themes emerged: (1) value proposition of timely patient-reported outcome data collection (2) key facilitators for timely implementation and (3) multilevel barriers. The value proposition focused on the use of patient-reported outcomes for prevention and active disease management. Critical facilitators for the timely implementation of patient-reported outcomes included the involvement of research and clinical coordinators, strategies for pre-visit and on-site patient-reported outcome collection, the use of standardised templates within EHRs and the alignment of patient-reported outcome collection with patients' long-term treatment goals. Finally, multilevel barriers included time constraints, patient-level challenges (e.g., fatigue, literacy, language) and systemic issues (e.g., technical limitations, lack of reimbursement and unclear guidelines).
Timely collection and use of patient-reported outcomes is critical for improving symptom monitoring and supporting patient-centered clinical decision-making. However, multilevel barriers hinder consistent implementation across health care settings.
Integrating patient-reported outcomes into clinical workflows can improve the patient-centeredness of patient-healthcare professional interactions, and provide a more holistic picture of a patient's health status. Addressing barriers to patient-reported outcome implementation, including lack of time, poor health literacy and workflow integration barriers, is crucial for improving clinical outcomes.
This study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist, in accordance with EQUATOR Network guidelines.
No patient or public involvement: This study did not include patient or public involvement in its design, conduct or reporting.
To examine residential aged care staff's experience of death and grief, and their support needs.
A mixed-methods sequential explanatory design, using an online cross-sectional survey that included the Texas Revised Inventory of Grief and the Grief Support in Health Care Scale. Followed by semi-structured interviews with direct care workers and managers working in residential aged care homes were conducted.
Over 60% of participants experienced five or more resident deaths in the previous 12 months. Although, different levels of grief were experienced among different roles, the importance of open communication and opportunities for farewells after resident death was highlighted. Participants suggested support and education to normalise grief and promote self-care.
Recognising staff grief following the resident death is important. Providing support and education may help improve staff wellbeing and contribute to the delivery of high-quality care for both residents and their families.
Staff grief after a resident death needs to be recognised, and continuing education and support are required for their wellbeing.
The STROBE and SRQR checklists were applied.
No Patient or Public contribution.
The aim of this study is to identify the factors associated with nurses' perceptions and behaviours related to climate change and health (PBCH) according to their PBCH levels.
A cross-sectional study was used.
This study included a sample of 499 Korean nurses and adhered to the STROBE checklist. Data were collected from March 23 to May 10, 2023. Quantile regression analysis was performed, and PBCH levels were measured using the Korean version of the Climate Health and Nursing Tool.
Across all quantile groups, the experience of extreme weather events and awareness of climate change-coping facilitators were associated with PBCH. Differences were observed in factors associated with PBCH levels. Significant associations with PBCH were observed within the 75th percentile group, for having a religion, household income, and workplace climate friendliness. In the 25th percentile group, having a child, the number of sources for climate change–health-related information, and experience in setting climate change–health goals and strategies significantly influenced PBCH.
We propose a differentiated strategy by elucidating the factors associated with high and low quantiles of PBCH levels.
By verifying specific factors associated with PBCH levels, nurses can enhance their preparedness to respond to the health risks posed by climate change in their clients.
Identifying common factors associated with all quantiles of nurses is important for establishing universal PBCH characteristics. Recognising the distinctions between high and low PBCH levels can aid in developing tailored nursing strategies to enhance PBCH among nurses.
This study adhered to the STROBE guidelines.
No Patient or Public Contribution.
FreshRSS 