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Spirituality is a crucial yet complex element of holistic nursing care, particularly when providing care for older adults with depression. In Thailand, depression poses a significant mental health challenge. Thai cultural values are deeply interwoven with individuals' beliefs, making spirituality a critical factor in addressing the care of older adults with depression. This study aimed to explore how older adults with depression experience spirituality and construct meaning from it in their daily lives.
An interpretative phenomenological study.
In-depth interviews of 30 older Thai adults living with depression (aged 60–85 years) from an outpatient psychiatric clinic in southern Thailand were conducted using semi-structured interview questionnaires. Interpretive phenomenological analysis was employed. Data were collected from June to August 2024.
Five themes emerged from the phenomenological data analysis: (1) elusiveness of spiritual meaning, (2) holding oneself together through inner power, (3) finding acceptance through faith in a higher power, (4) family ties shaping peace and despair, and (5) being guided and cared for.
This study highlights that older adults with depression perceive spirituality as essential for their well-being. Personal practices, such as meditation and chanting, played a key role in strengthening spirituality and reducing the risk of relapse in depressive symptoms, which are distinct for each older adult. Understanding spirituality's role in mental health guides nurses to develop strategies for providing more empathetic spiritual care.
Nurses must address depression in older adults through individualized practices to effectively empower their inner strength and coping mechanisms. Understanding each individual's spiritual practices is essential to help them harness their inner strength when coping with depression.
To compare the effectiveness of multifactorial and exercise programs in preventing falls among older adults, with a specific focus on evaluating the individual and combined contributions of their key intervention components.
This study was a systematic review and component network meta-analysis. PubMed, Embase, and Web of Science were searched from inception to February 2025 for randomized controlled trials, focusing on four primary outcomes: fallers, recurrent fallers, injurious fallers, and fractured fallers. Risk of bias was evaluated using the Cochrane tool, and additive component network meta-analysis compared intervention group and component efficacy.
69 randomized controlled studies were included. In multifactorial interventions, traditional health education could increase fall risk (iRR: 1.10, 95% CI [1.03; 1.67]) and recurrent fall risk (iRR: 1.25, 95% CI [1.06; 1.48]). Medication management can increase recurrent fall risk (iRR: 1.35, 95% CI [1.09; 1.67]) and fracture risk (iRR: 2.11, 95% CI [1.48; 3.00]). Exercise (iRR: 1.24, 95% CI [1.01; 1.53]) increased fracture risk, and environment modification (iRR: 0.56, 95% CI [0.61; 0.79]) reduced it. The additive effect of risk assessment and advice, exercise, and environment modification reduced fall risk. In exercise programs, gait and balance (iRR: 0.58, 95% CI [0.36; 0.93]) can reduce recurrent fall risk. An intervention containing two components (gait and balance + strength and resistance) reduced the risk of falls and fall-related injuries.
Environment modification reduced fracture risk, emphasizing the value of creating safe living spaces. The combination of risk assessment, advice, exercise, and environment modification reduced fall risk, suggesting a holistic approach may be effective in preventing falls. Traditional methods of health education and medication management are in urgent need of updating to synergize with other exercise components and enhance the effectiveness of fall prevention. Prospective clinical trials are needed to optimize combinations of exercise components, particularly integrating gait and balance training with strength and resistance exercises.
The review was registered online in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number (CRD42025643530)
To evaluate the impact of a 5-min delay in needle removal after haemodialysis on complications and patient satisfaction in newly created arteriovenous fistulas.
Retrospective cohort study.
This study analysed 109 patients with new arteriovenous fistulas undergoing initial cannulation 8–12 weeks post-surgery. Participants were divided into two cohorts: a conventional group (n = 42) receiving immediate needle removal after pump cessation, and a delayed group (n = 67) retaining needles for 5 min post-pump cessation before removal. Outcomes included haemostasis time, hematoma incidence, 3-month reintervention rates, and patient satisfaction measured by a 5-point scale.
Delaying needle removal by 5 min reduced mean haemostasis time by 32% compared to immediate removal (16.4 min vs. 24.1 min). Hematoma incidence decreased substantially by 76% in the delayed group (3.3% vs. 13.1%). At 3-month follow-up, reintervention rates were 66% lower with delayed removal (9.0% vs. 26.2%). Patients also reported 50% less procedure-related pain and significantly higher satisfaction scores (median 4.5 vs. 2).
A brief 5-min delay in needle removal significantly reduces complications and enhances patient-centered outcomes during early arteriovenous fistula use.
This protocol establishes an evidence-based standard for post-dialysis needle management, directly reducing compression-induced pain and reintervention needs while requiring no additional nursing resources. Implementation can immediately improve vascular access safety in haemodialysis units.
The study addresses high complication rates (26.2%) from immediate needle removal in immature fistulas. Key findings demonstrate 76% fewer hematomas and 66% lower reinterventions with 5-min delayed removal. This evidence may transform global haemodialysis nursing protocols, benefiting a substantial population of patients receiving new fistulas annually.
This study follows the STROBE checklist.
Patients and the public were not involved in the design, conduct, or reporting of this retrospective medical record analysis.
To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.
An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).
Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.
Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.
There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.
Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.
This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.
This study adheres to the STROBE guidelines for reporting observational studies.
In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.
Nanocrystalline silver dressings are increasingly used as alternatives to silver sulfadiazine dressings in burn management, but comparative evidence remains inconclusive. This meta-analysis aimed to compare the efficacy and safety of nanocrystalline silver dressings versus silver sulfadiazine dressings in burn patients.
Systematic review and meta-analysis following PRISMA guidelines. The review was registered with PROSPERO (CRD420251060978).
PubMed, Embase, Cochrane Library and Web of Science were searched from inception through April 2025.
Randomized controlled trials comparing nanocrystalline silver dressings with silver sulfadiazine dressings in burn patients were included. Primary outcomes were wound healing time and adverse events. Secondary outcomes included complete re-epithelialization rates and dressing change frequency. Risk of bias was assessed using the Cochrane risk of bias tool. Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations framework. Meta-analysis was performed using Review Manager 5.4.
Eight randomized controlled trials (724 patients) were included. Nanocrystalline silver dressings significantly reduced wound healing time (mean difference [MD] = −3.29 days, 95% confidence interval [CI]: −3.82 to −2.76; p < 0.00001; I 2 = 0%) and dressing change frequency (MD = −8.76, 95% CI: −12.68 to −4.85; p < 0.00001; I 2 = 94%). No significant differences were found in re-epithelialization rates (odds ratio = 1.08, p = 0.80) or adverse events (risk difference = −0.00, p = 0.99). Evidence certainty was low to very low across all outcomes.
Nanocrystalline silver dressings may offer advantages over silver sulfadiazine dressings in reducing wound healing time and dressing change frequency in burn patients, but the overall certainty of evidence is low to very low. Future well-powered, multicenter trials with standardized outcomes and extended follow-up are needed.
These findings support the consideration of nanocrystalline silver dressings for burn wound management, particularly for reducing wound healing time and nursing workload associated with dressing changes. However, dressing selection should be guided by burn depth, infection risk, patient-specific factors, and resource availability.
We have adhered to relevant EQUATOR guidelines, particularly the PRISMA checklist.
No patient or public contribution.
PROSPERO CRD420251060978.
Chronic diseases are a major global health burden, contributing to morbidity, mortality and healthcare costs. Self-care is essential for effective disease management, with health literacy (HL) and digital health literacy (eHL) playing a role in enabling individuals to engage in health-promoting behaviours. However, the relationship between HL and self-care remains inconclusive, necessitating further investigation to clarify its impact.
To synthesise evidence on the association between HL and self-care in chronic diseases and identify mediating and moderating factors influencing this relationship.
A systematic search was conducted across PubMed, CINAHL, PsycINFO, Embase, Web of Science and Cochrane CENTRAL, supplemented by manual reference checks and author correspondence.
This systematic review and meta-analysis followed PRISMA guidelines, including observational studies and RCTs assessing HL and self-care. Meta-analyses were performed using Fisher's Z transformation. Risk of bias was assessed using ROBINS-E and certainty of evidence was evaluated through GRADE.
A total of 138 studies were included, with 52 meta-analysed. Higher HL was associated with improved self-care behaviours, including medication adherence, disease monitoring and lifestyle modifications across chronic diseases, including type 2 diabetes, heart failure, hypertension, chronic kidney disease, asthma, coronary artery disease, arthritis and COPD. Psychological (self-efficacy, empowerment), cognitive (disease knowledge, decision-making) and social (healthcare communication, social support) factors mediated this relationship, while distress and depression moderated it. Meta-analysis revealed a moderate positive association between HL and self-care (r = 0.29, 95% CI: 0.26–0.31, p < 0.001). Subgroup analyses showed consistent positive effects across conditions. No significant publication bias was detected (Egger's test, p = 0.294). Risk of bias was high in 62 studies, while certainty of evidence ranged from very low to moderate.
HL positively influences self-care in chronic diseases, with its impact shaped by multiple mediators and moderators. Future interventions should integrate tailored education, digital tools and mental health support to enhance HL effectiveness.
PROSPERO (CRD42024488061, registered 20.01.2024).
Skin-to-Skin Contact or Kangaroo Mother Care is an evidence-based intervention proven to enhance breastfeeding rates, improve cardiorespiratory stability and promote neurodevelopment in neonates. While established as a standard of care for stable term infants and increasingly recognised for preterm infants, the implementation of sustained skin-to-skin contact faces significant systemic and clinical challenges, particularly within the intensive care environment. This editorial argues that the focus must shift from when skin-to-skin contact is permitted to how sustained skin-to-skin contact can be universally integrated as a non-negotiable core practice, even for extremely preterm infants. Addressing practical barriers, such as staff training, equipment design, parental support and perceived clinical instability, is essential to realise the full potential of sustained skin-to-skin contact to optimise neurodevelopmental and physiological outcomes for all neonates, closing the gap between compelling evidence and inconsistent global practice.
To systematically synthesise nurses' perspectives on dignified death, providing a culturally informed and comprehensive understanding.
Meta-ethnography.
This study was conducted using Noblit and Hare's approach, which included reciprocal translation, refutational synthesis, and line-of-argument synthesis. Methodological rigour and credibility were evaluated using the Critical Appraisal Skills Program (CASP) checklist. The review included peer-reviewed qualitative studies published in English or Korean that focused on nurses' or nursing students' views on dignified death in end-of-life care.
A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and the Web of Science in August 2023, with an updated search in August 2024. Seventeen qualitative studies published between 2010 and 2024 met the inclusion criteria.
Four interconnected themes emerged: A death that embraces humanity, a death that preserves personal identity, a death that facilitates connection and reconciliation, and a death that affirms acceptance and spiritual serenity. These themes, including eight sub-themes, highlight cultural influences shaping nurses' approaches to dignified death.
The findings emphasise the influence of cultural context in shaping end-of-life care and support the development of culturally sensitive nursing education and guidelines to enhance care quality.
This research provides culturally grounded strategies to improve end-of-life care and strengthen nurses' competencies in delivering holistic support.
This study highlights cultural variations in nurses' approaches to balancing autonomy, family expectations, and spiritual needs, offering practical insights for holistic, patient-centred, and culturally sensitive care.
This review complies with the Equator and improving reporting of meta-ethnography (eMERGe) guidelines.
No patient or public contribution.
To examine the use of triage systems in primary care in the UK.
Integrative literature review and narrative synthesis.
PubMed, EMBASE, CINAHL and Cochrane Library were searched in October 2024.
An integrative literature review was conducted following Whittemore and Knafl's (2005) five-step process. Of 1440 articles retrieved, 305 duplicates were removed, and 1086 excluded after title and abstract screening. Two additional articles were identified through citation and hand searches. Twenty studies were quality-assessed using the Mixed Methods Appraisal Tool, and data were extracted for narrative synthesis.
Twenty studies were selected, including four randomised controlled trials, three quasi-experimental studies, eleven descriptive studies and two qualitative studies. The most common type of triage was telephone triage, most frequently performed by nurses. The most common health outcomes included subsequent patient re-contacts after triage, patient symptoms or complaints, current health status and patient safety. The benefits of triage included high patient satisfaction, workload redistribution, reduced GP workload and emergency department crowding, improved resource utilisation, access to care and communication. The challenges of triage included increased overall contact time, mis-triage issues, recruitment and retention challenges, the unsuitability of the decision support tool for the primary care setting and lower usage among older and less affluent groups.
This review examined the current use of triage in primary care in the UK, identifying common patterns in triage processes and classifications. Several benefits were identified, though some ongoing concerns about triage remain.
This paper provides essential evidence about the current use, effectiveness and challenges of triage in UK primary care. The findings can support healthcare policymakers, practitioners and researchers in planning and improving triage systems.
Integrative review.
To discuss the dyadic and triadic interviewing techniques as distinct approaches to data collection in qualitative research.
Methodological/methodical discussion.
Underpinned by a layered theoretical basis involving interpretivism, social constructivism and symbolic interactionism, dyadic and triadic interviewing approaches represent a tapestry that seeks to illuminate not only what participants think at the individual level, but also how they think together to generate shared, nuanced meanings. Key methodical considerations include participant recruitment and selection to form the dyads or triads, ethical issues, navigating power dynamics, determining saturation at the dyad or triad level and shifting the unit of analysis from the individual level to the dyad or triad level. Notable challenges to using these approaches include logistical complexity, ethical risks and the great need for skilled moderation.
Dyadic and triadic interviewing techniques occupy a vital methodological niche in qualitative studies, particularly within the contexts of health and social care research where relational dynamics and collaborative decision-making are central. By foregrounding co-constructed narratives and real-time interactions, dyadic and triadic interviewing techniques illuminate the interplay of individual agency, power asymmetries and cultural norms, offering insights that transcend the limitations of individual interviews or focus groups.
The increasing complexity of care, treatment pathways, recovery and family-centered decision making warrants engagement beyond individual interviews. Dyadic and triadic interview techniques facilitate this by combining the in-depth benefit of individual interviews and shared interpretations of focus group discussions to capture meanings and experiences.
This methodological/methodical discussion offers clarity to employing dyadic or triadic interviewing approaches to improve their uptake in health and social care research.
Not applicable.
No patient or public contribution.
This study aimed to investigate factors influencing the acceptance of smartphone applications among high-risk pregnant women in the Lao People's Democratic Republic to support continuous care.
An explanatory sequential mixed-methods design.
The quantitative phase included 167 high-risk pregnant women recruited from four tertiary hospitals in Vientiane, Lao PDR. Validated questionnaires were used to measure demographics, digital technology usage, eHealth literacy and anxiety. Data were analysed using descriptive statistics and multiple regression analysis. In the qualitative phase, in-depth interviews with 20 women were conducted to further explore experiences, perceptions and barriers related to smartphone application usage. Interviews were analysed via direct content analysis.
Quantitative findings indicated that smartphone application acceptance was significantly predicted by eHealth literacy (B = 1.53, 95% CI 1.22–1.84, p < 0.001) and pre-existing non-communicable diseases (B = 4.39, 95% CI 1.05–7.73, p = 0.010). Anxiety negatively impacted acceptance (B = −0.28, 95% CI −0.51 to −0.05, p = 0.019). The model explained 53.9% of the variance in smartphone application acceptance (R 2 = 0.539). Qualitative findings highlighted four key themes: awareness of pregnancy risks, unclear health information, perceived benefits of smartphone applications including accessibility and emotional reassurance and practical barriers such as internet costs and limited digital literacy.
Positive perceptions of smartphone applications regarding accessibility and reassurance were observed, alongside significant barriers, such as limited digital literacy and internet costs. Addressing these factors may enhance the adoption and effective utilisation of digital health technologies among high-risk pregnant populations.
No patient or public contribution.
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 analyse the current status of psychological resilience in Parkinson's disease (PD) patients and its correlation with social support and coping style.
A cross-sectional study.
PD patients hospitalized in a tertiary-level hospital in Shijiazhuang, Hebei Province, from March 2022 to March 2023 were selected for the study using the convenience sampling method. A general information questionnaire, psychological resilience scale, Medical Coping Modes Questionnaire and Perceived Social Support Scale were used to investigate 111 cases of PD. SPSS 25.0 software was used for statistical analysis. The data were analysed using independent samples t-test, one-way ANOVA, multiple linear regression analysis and the Pearson correlation coefficient.
Parkinson's disease patients have a moderate level of psychological resilience. The results of the Pearson correlation analyses showed that the level of psychological resilience was positively correlated with social support and confrontation and was negatively correlated with avoidance and acceptance-resignation. The results of multiple linear regression analysis showed that social support and acceptance-resignation were the influencing factors of psychological resilience in PD patients.
The psychological resilience of PD patients is at a moderate level. Social support and acceptance-resignation are the factors influencing the psychological resilience of PD patients.
This study analysed the level of psychological resilience in PD patients and its correlation with social support and coping style from the perspective of positive psychology to provide some reference for targeted clinical interventions. Our study found that social support and acceptance-resignation are influential factors in psychological resilience in PD patients. Medical staff should encourage patients to face the disease positively and their social support should be increased in order to improve their level of psychological resilience.
No patient or public contribution.
To evaluate the impact of game-based teaching on undergraduate nursing students' learning satisfaction, clinical thinking, clinical skills, and anxiety.
Systematic review and meta-analysis.
China National Knowledge Infrastructure, Wanfang, Weipu, SinoMed, CINAHL, PubMed, Web of Science, Cochrane Library, and Embase. Our systematic literature search was conducted up to 31 October 2024 and included all studies published before this date, with no restrictions on publication year.
The study quality was appraised using version 1 of the Cochrane risk-of-bias tool and the JBI Critical Appraisal Tools for Quasi-Experimental Studies. A meta-analysis was performed using STATA version 12.
1712 undergraduate nursing students from 19 studies were included. Meta-analysis showed that game-based teaching improved undergraduate nursing students' learning satisfaction, critical thinking, clinical decision-making, and clinical skills. Game-based teaching did not significantly enhance undergraduate nursing students' problem-solving skills.
Our research findings indicated that game-based teaching had more significant potential to enhance undergraduate nursing students' learning satisfaction, critical thinking, clinical decision-making, and clinical skills. However, game-based teaching did not show a substantial advantage in improving problem-solving skills compared to other teaching methods. Limited studies of the effects of game-based teaching on clinical reasoning and anxiety in nursing students cannot be meta-analysed. Future studies could improve how game-based learning is designed to support undergraduate nursing students' development of these competencies.
This study explores the effects of game-based teaching in nursing education and finds that it promotes learning satisfaction, critical thinking, clinical decision-making, and clinical skills in undergraduate nursing students, while having no significant effect on problem-solving skills. Game-based teaching can be a functional pedagogical approach to guide nursing educators to improve learning outcomes for undergraduate nursing students.
Inapplicable.
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)
Loneliness significantly affects the physical and mental health of older adults, particularly those in long-term care settings. Despite the high prevalence of loneliness, comprehensive reviews on psychosocial interventions targeting loneliness in these populations are scarce.
To evaluate the effects of psychosocial interventions in reducing loneliness among long-term care residents.
A systematic review and meta-analysis.
We conducted a comprehensive search across five databases—CINAHL, EMBASE, PubMed/Medline, PsychINFO and The Cochrane Library—from inception to 14 February 2025. The inclusion criteria encompassed randomised controlled trials, quasi-experimental studies and pilot studies published in English that assessed psychosocial interventions for loneliness amongst long-term care residents. The Effective Public Health Practice Project framework was utilised for the quality assessment.
A total of 19 studies with 1646 participants were included. Results indicated that psychosocial interventions significantly reduced loneliness in long-term care residents. The interventions were categorised into lifestyle and leisure activities, psychological interventions, social support interventions and animal/robot-assisted interventions. Subgroup analyses revealed significant effects for lifestyle and leisure activities, group-based interventions, face-to-face delivery and interventions that less than 8 weeks.
Psychosocial interventions demonstrated a large effect size in reducing loneliness amongst long-term care residents. Interventions that incorporated lifestyle and leisure activities with a physical activity component, delivered face-to-face in group settings and lasted for less than 8 weeks may be particularly effective.
This review provides updated evidence that psychosocial interventions could improve loneliness amongst residents in long-term care settings. Consequently, it offers solid information to inform policy changes and intervention strategies.
The researching results were reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis checklist.
This study is a systematic review with meta-analysis, and such details do not apply to our work.
Trial Registration: This protocol was registered in the PROSPERO database (ID: CRD42024534009)
To explore the prescribing practices and behaviours of Advanced Practice Nurses (APN) and pharmacist prescribers in Singapore, assess their confidence in key prescribing competencies, examine their use of information sources, and understand their views on the consequences of prescribing errors.
Cross-sectional national survey.
A census survey of all registered APN and pharmacist prescribers in Singapore was conducted from February to May 2024 using a validated 96-item instrument. The survey assessed prescribing practices, confidence in prescribing competencies, use of information sources, and prescribing safety. Descriptive statistics were used for analysis.
Ninety-one prescribers (54 APNs, 37 pharmacists) responded (32% response rate), most of whom worked in public medical/surgical settings. Prescribing comprised a median of 75% of their practice. Most time was spent prescribing continued medications, with less on initiating new medicines. Participants reported high confidence in communication, therapeutic partnerships, and working within professional standards. Greatest confidence was seen in educating patients, legal prescribing, and monitoring treatment response. Lower confidence was noted in complementary medicine-related tasks. Professional literature and colleagues were the most valued information sources. Most participants acknowledged the serious consequences of prescribing errors, though many believed such errors would likely be intercepted.
APNs and pharmacists demonstrate strong competencies in safe, holistic prescribing. However, cultural factors may limit patient engagement, highlighting the need to strengthen shared decision-making and collaborative practice.
Refining governance structures, adopting tiered prescriber autonomy, and enhancing training in complex prescribing are essential. Standardising deprescribing, improving access to decision-support tools, and promoting interprofessional collaboration and patient involvement can strengthen care quality and team-based delivery.
This study offers the first national insight into Singapore's Collaborative Prescribing Framework and informs training, policy, and workforce development for non-physician prescribers locally and in similar international contexts.
STROBE checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
FreshRSS 