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To explore the influence of oral health-related knowledge, attitudes and practices on oral health risk-related behaviours of people in custodial settings.
Integrative review.
Scopus, ProQuest Central, Web of Science, Medline, CINAHL, Academic Search Complete, PsycINFO and Education Research Complete were searched in March 2024 and December 2025.
Studies reporting on any individuals in custodial settings, at least one oral health-related knowledge, attitude or practice and at least one oral health risk-related behaviour (either smoking, alcohol, illicit substances or sugar consumption). Data related to custodial population's oral health knowledge, attitudes, or practices and oral health risk-related behaviour were extracted, synthesised narratively and reported thematically.
Findings from the 26 studies reveal that people in custodial settings had a general lack of oral health knowledge, and oral health risk-related behaviours were prevalent. The most common risk-related behaviours reported were tobacco use and free sugar consumption. Oral health knowledge, attitudes and practices of this population were influenced by custodial healthcare systems and attitudes of dental professionals.
This review highlights the influence custodial healthcare and dental professionals have on the knowledge, attitudes, practices and risk-related behaviours of people in custodial settings. Oral health targeted interventions and strategies are required to improve oral health-related knowledge and attitudes thereby encouraging oral health practices among people in custodial settings.
This review will inform targeted oral health promotion programs that can improve oral health outcomes and experiences of this population.
People in custodial settings experience a disproportionate burden of oral diseases. This review underscores the need for proactive interventions and systemic reform to improve correctional healthcare experiences globally.
Preferred Reporting Items for Systematic Reviews and Meta-Analysis, Extension for Scoping Reviews (PRISMA-ScR) 2018.
No patient or public contribution.
Synthesises evidence on influencing factors contributing to poor oral health among people in custodial settings. Highlights impact of healthcare staff and custodial healthcare systems on population health. Highlights the necessity of oral health promotion programs to improve oral health knowledge and to promote oral health protective behaviours.
To explore the perceptions of older female caregivers living in poverty in a high-income country regarding their health and self-care needs.
Descriptive qualitative study.
Seventeen semi-structured interviews were conducted with older female caregivers between October 2023 and March 2024. The reflexive thematic analysis method described by Braun & Clarke was followed, and ATLAS.ti 25 software was used for data analysis.
The analysis identified one main overarching theme, ‘Caring as an expected role that shapes identity and daily life’ and two interrelated themes: (1) ‘The need for a holistic approach to self-care’ and (2) ‘Caring on empty in the context of economic hardship and limited support’.
Self-care among older female caregivers living in poverty is constrained by caregiving expectations and socioeconomic disadvantage. Addressing their health needs requires nursing interventions that recognise caregiving as a central element of their lives and adopt holistic, context-sensitive approaches.
Nursing interventions should comprehensively assess older female caregivers' multidimensional health needs and enhance access to integrated support and services, addressing structural gender and socioeconomic inequities to strengthen health, dignity, and resilience.
Living in poverty exacerbates the challenges older female caregivers face in attending to their own health and self-care, increasing the risk of exhaustion, distress, and chronic illness. Recognising and addressing these needs through equitable, targeted interventions is essential to reduce health inequalities.
The study has been reported following the COREQ guidelines.
Limited patient and public involvement was incorporated, focusing on verification of their transcripts, ensuring accuracy and credibility in the interpretation of their accounts.
To explore how older women experiencing poverty in a high-income country perceive their family caregiver role from a gender perspective.
Descriptive qualitative study.
A convenience sample of seventeen older female caregivers experiencing poverty was interviewed in-depth between October 2023 and March 2024. Reflexive thematic analysis was conducted following the phases described by Braun & Clarke. ATLAS.ti software was used for data analysis.
Three main themes were developed from the data analysis: (1) The duality of family caregiving: between informal female support and structural neglect, (2) family care in later life as a continuation of a life devoted to others, (3) older female family caregiving as a gender issue.
Older female caregivers experiencing poverty have limited formal support and unequal access to resources. Older women experiencing poverty experience both gratitude and despair in their caregiving role, which inevitably deteriorates their health.
Nursing interventions for older female caregivers experiencing poverty should include an assessment of social determinants of health, focusing on gender and socio-economic barriers. Implementing system navigation interventions, such as community-based case management, resource referral programmes, and personalised care coordination, could connect older female family caregivers to essential resources and support networks, thus addressing their mental health needs and promoting equity, which would enhance their overall well-being and dignity.
Experiencing poverty increases the vulnerability of older female caregivers, exacerbating gender inequality. These women often face mental health issues as they face the pressure of meeting their own needs and those of their care recipients with a lack of formal support. This neglect can lead to serious health problems, which emphasises the need for equitable nursing interventions.
The study is reported following the COREQ guidelines.
No patients or public were involved in the study development and implementation.
To assess the care needs of older adults living in poverty in a high-income country and to analyse their relationship with other outcome variables.
A cross-sectional study.
Data were collected between September 2022 and February 2024 from 384 older adults in southeastern Spain. Descriptive statistics were calculated to assess older adults' care needs. A multiple linear regression analysis was carried out to determine the percentage by which the socio-demographic or outcome variables could explain the number of met care needs among older adults in poverty.
Around 20% of the care needs amongst older adults living in poverty were unmet. The most frequently unmet care need was related to money (53.6%). Almost 30% of participants were at risk of malnutrition, 18% felt lonely, and 80% perceived a low level of social support. Age, history of falls, emergency room visits, functionality, perceived social support, quality of life and nutritional status significantly predicted the number of needs met.
The health conditions of older adults living in poverty are suboptimal and may negatively influence their care needs. Nurses should consider these factors when designing, implementing and evaluating interventions to promote the biopsychosocial health of this population.
Nursing interventions to promote health amongst older adults living in poverty should focus on identifying unmet care needs, particularly those related to financial and social support. Interventions should prioritise improving nutritional status, enhancing social support networks and addressing loneliness.
Living in poverty increases older adults' vulnerability due to unmet financial, nutritional and social support needs. These unmet needs can negatively affect older adults' physical and mental health.
The study has been reported following the STROBE guidelines.
The study's participants only participated in the data collection process.
To explore nurse managers' perceptions at first-line, middle and executive levels regarding their transition to first-line management in two divisions of a highly specialised university hospital in Spain.
A qualitative descriptive study.
A purposive sampling technique was employed to conduct four focus groups and two semi-structured interviews with 31 nurse managers across three hierarchical levels in two divisions of a highly specialised university hospital in Spain. Participants included two Chief Nursing Officers, four Nursing Directors and 25 first-line nurse managers. Data were analysed thematically.
Three themes emerged: ‘Bridging the Readiness Gap: Training, Role Clarity, and Institutional Alignment’, revealing the lack of structured transition plans, role ambiguity and gaps in managerial skills, such as human resources, financial management and leadership; ‘Fighting Loneliness: A Common Challenge in Care Management’, highlighting the isolation of first-line nurse managers due to the absence of structured mentorship and peer support; ‘Clinical Expertise as a Cornerstone: The Role of Prior Experience in Nurse Management’, examining how clinical expertise facilitates leadership transitions but also presents challenges, particularly for managers promoted within their teams, where authority negotiation and role redefinition become critical.
Findings underscore the need for structured training and mentorship to address role ambiguity, enhance managerial competencies and support nurse managers' transitions through targeted education.
Structured transition programmes focusing on role clarity, training and institutional alignment can ease transitions, boost leadership confidence and enhance peer collaboration. Providing mentoring and training tailored to first-line nurse managers can improve team dynamics, support professional integration and strengthen organisational cohesion.
Tailored educational interventions are essential in supporting nurse managers' transitions. Structured mentorship and targeted training enhance leadership readiness, adaptability and institutional alignment, strengthening healthcare leadership, efficiency and patient care quality.
No patient or public contribution.
The purpose of this concept analysis is to clarify the meaning of digital health equity beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape.
With the growing spread of digital health, digital health equity should be at the center of healthcare. Health outcomes for equity-deserving groups may be compromised without a clear understanding of digital health equity. Although the concept of ‘health equity’ has been analysed before; no concept analysis has been completed for the concept of ‘digital health equity’.
Concept analysis using Walker and Avant's method.
Articles from PubMed, Scopus and Google Scholar with no limitation on the period of data collection.
Walker and Avant's concept analysis method was used to outline attributes, antecedents, consequences, and empirical referents of the concept digital health equity.
The main attribute of digital health equity is digital health technology that benefits everyone fairly. The antecedents include: (1) appropriate infrastructure; (2) cognitive abilities including digital literacy; (3) intersectionality of multiple vulnerabilities; (4) presence of the core ethical principles in healthcare; (5) digital accessibility with careful consideration of the social determinants of health; and (6) co-creation of digital health technologies. The main consequences are improved patient health outcomes and elimination of the digital divide.
This analysis explored the concept of digital health equity as a means to promote positive health outcomes for equity-deserving groups, highlighting the critical role of nursing practice and research in addressing digital health disparities.
This paper can have an impact on nursing practice, education and wider social and economic issues. First, various barriers encountered by patients when utilising digital health technologies can be understood. Second, clinicians can be encouraged to assess digital health equity, improve interventions for equity-deserving groups, and evaluate the effectiveness of digital health interventions to ensure they are equitable. In the context of educational implications, the understanding of digital health equity can be used to facilitate the creation of appropriate education materials for clinicians. Finally, on a wider social and economic scale, understanding digital health equity can aid in the creation of policies to enable equitable digital health technologies.
No patient or public contribution because this paper is a concept analysis.
Climate change has serious consequences for the morbidity and mortality of older adults.
To identify the effects of climate change on older people's health.
A scoping review was conducted following the Joanna Briggs Institute guidelines and the PRISMA-ScR checklist. Quantitative research and reports from organizations describing the effects of climate change on older people were selected.
Sixty-three full-text documents were selected. Heat and air pollution were the two factors that had the most negative effects on cardiovascular and respiratory morbidity and mortality in older people. Mental health and cognitive function were also affected.
Climate change affects several health problems in older individuals, especially high temperatures and air pollution. Nursing professionals must have the necessary skills to respond to the climate risks in older adults. More instruments are required to determine nursing competencies on climate change and the health of this population group.
No patient or public contribution.
To identify whether nurse practitioners (NPs) in New Zealand (NZ) have the organisational opportunities to make decisions related to performing their role.
A cross-sectional study of self-reported decision-making, social support, psychosocial demands and identification with role in a representative population of NPs employed in a range of practice settings in NZ.
This study utilised the internationally validated Job Content Questionnaire. Reliability and construct validity were assessed using co-efficient α and confirmatory factor analysis. Linear regression analyses were conducted to understand the strength and direction of the relationships between the constructs.
All scales demonstrated acceptable levels of internal reliability. Factor analysis supported a five-factor model, with decision latitude, psychological job demands, co-worker support, supervisor support and job insecurity as the main factors fitting the theoretical model. Regression models suggested that NPs (n = 169) have more control over their decision-making when supported by their colleagues rather than supervisors. NPs perceive improved relationships with healthcare consumers if they feel an increase in support from their colleagues; this relationship is mediated by the freedom to make decisions. NPs in rural settings had more job security when they felt valued and appreciated at work.
The presence of collegial support significantly influences the freedom and autonomy of NPs in making decisions. Workforce policy, the organisation of practice and vocational training may be effective ways of helping NPs expand access to healthcare services.
Collegial and supervisory support are critical for NPs to work to their full scope. A funded, first-year-in-practice vocational training program designed to support role transition, foster collegial support and build a community of practice for newly qualified NPs.
For the first time, nurse practitioner decision-making and autonomy determinants have been described in NZ. These findings should be considered within the context of international evidence and in global nursing workforce policies that seek to create opportunities for NPs to work to the limit of their scope.
The authors have adhered to relevant EQUATOR guidelines—STROBE checklist.
No patient or public contribution.
To develop and pilot test the AdvantAGE transitional care model at a Swiss geriatric hospital.
Multi-method design.
The study progressed in three stages from January 2021 to December 2023: (1) contextual analysis using the Consolidated Framework for Implementation Research, incorporating qualitative interviews, (2) development and pilot testing of transitional care interventions on three acute geriatric wards using a descriptive explorative study design and (3) development and validation of a logic model using an iterative approach involving project interest groups and researchers.
We identified central challenges and needs related to transitions from hospital to home, including insufficient information flow, patient and caregiver insecurities and lacking adherence to recommended treatment. The newly developed transitional care model comprised five core elements: continuous support for patients and caregivers, care coordination with primary care providers, comprehensive health management at home, medication- and self-management with patients and caregivers and advance care planning. Of 137 eligible patients, 62 participated in the 10-month pilot test of the preliminary transitional care intervention, with an average participation duration of 69 days. Findings from the pilot informed the refinement of the intervention elements and the development of a preliminary logic model.
Employing an implementation science approach facilitated the development and refinement of the AdvantAGE model, ensuring alignment with the needs of project interest groups and the specific implementation context.
This study demonstrates the development of a transitional care model tailored to the specific needs and circumstances of the local healthcare context. Findings provide valuable insights for healthcare practitioners, researchers and policymakers, offering implications for developing transitional care practices and policies.
Limited patient and public involvement was incorporated, focusing on the interpretation of the findings of the first step of this study. Further contributions included providing feedback on the development of the elements of the AdvantAGE transitional care model, ensuring the research addressed priorities relevant to patients and primary health care providers in Basel-Stadt.
To synthesise primary qualitative studies reporting experiences of post-hospital recovery for critical care survivors, their family and the healthcare professionals supporting them with a particular focus on physical impairment.
The review was conducted through a meta-ethnography using the seven stages of Noblit and Hare.
Qualitative studies or mixed-method studies which included qualitative research were included if they were based on the phenomenon of interest. Study quality was assessed using the Critical Appraisal Skills Programme checklist and confidence in the findings with the GRADE CERQual framework.
Five electronic databases (PubMed, EMBASE, CINAHL, AMED and PEDro) were searched from inception to February 2022 and updated in November 2024. Grey literature for primary qualitative studies was also searched.
A total of 26,249 studies were initially screened, and 38 eligible studies were analysed. Four themes were distilled describing the experiences of critical care survivors, their family members and staff involved in their care: ‘I survived, but I didn't thrive’, ‘Healthcare was there to save my life, but not for my long-term recovery’, ‘I am a burden on my family, and they feel the weight of carrying me’ and ‘My body still doesn't work like it used to’.
This meta-ethnography is unique in bringing together the experiences of patients recovering from critical illness, their families, and the staff who support them after hospital discharge. Ongoing diverse physical impairments prevented patients from thriving, significantly impacting family members. All groups clearly identified unmet rehabilitation needs following critical illness.
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