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Deficient palliative care coverage and nursing training in Ecuador warrant examining self-efficacy to inform education strategies and strengthen equitable services.
To examine Ecuadorian nurses' self-efficacy in Palliative Care.
A sequential explanatory mixed-methods study was conducted. Convenience samples of nurses completed the Self-Efficacy in Palliative Care Questionnaire and participated in online semi-structured interviews. Descriptive statistics were used for quantitative data. A side-by-side joint display supported integration.
497 nurses completed the questionnaire (90.4% female; 11.47 years of experience). Teamwork scored highest, while communication scored lowest. Eighteen nurses were interviewed (88.8% female; 11.5 years of experience). Participants reported communication difficulties related to emotions, prognosis, denial, collusion of silence and paediatric cases. They expressed strong confidence in pain management but more difficulty with agitation and dyspnoea. Spiritual care was mainly understood as facilitating access to religious figures. Although teamwork was perceived positively, tensions with physicians and an excessive focus on physical aspects were noted.
Quantitative and qualitative findings aligned overall, with dissonances regarding psychological and social communication.
Strengthening communication and comprehensive patient management competencies, as well as addressing interdisciplinary tensions, is necessary to improve and consolidate Palliative Care in Ecuador.
This study adhered to EQUATOR guidelines and used COREQ for qualitative reporting.
No patient or public contribution.
This study aimed to co-design a model of brilliant care for older people that provides clear, actionable principles to guide how brilliant care for older people can be realised.
As the demand for and international importance of care for older people grows, so too does the negative discourse about care for older people. This ongoing focus on deficiencies can have implications for patients, carers, clinicians, health services, and policymakers, overshadowing opportunities for innovation and positive change.
Experience-based co-design informed this study, grounded in the lived experiences of key stakeholders.
Three scaffolded co-design workshops were facilitated, involving lived experience experts, managers, professionals, clinicians, and an academic (n= 13). The data collected during these workshops were analysed using a qualitative descriptive method and documented according to COREQ guidelines to optimise rigour and transparency.
The participants co-designed a model of brilliant care for older people, comprising principles to promote connection and innovation. To promote connection, the model includes protecting staff member time to deliver meaningful care and demonstrating that everyone matters. To promote innovation, it encourages role flexibility, curiosity, small improvements, and the recognition of brilliant practices.
This article presents a co-designed model of brilliant care for older people, incorporating principles of connection and innovation that can be enacted through simple, resource-efficient practices.
For those who manage and deliver care for older people, the model encompasses simple, accessible, and cost-effective principles to: positively deviate from norms within the sector, offering care to older people; and to deliver brilliant care for older people. Furthermore, given that the model was co-designed with lived experience experts, managers, professionals, and clinicians, its principles are imbued with their experiential insights, which served to bring particular priorities to the fore.
The co-designers, who included lived experience experts, were invited to participate in workshops to co-design a model of brilliant care for older people, during which they discussed and critiqued the findings constructed from the data and co-designed the model.
To explore the perspectives of community-dwelling older adults with sarcopenia on exercise engagement and adherence.
Sarcopenia is prevalent among community-dwelling older adults and is associated with a wide range of adverse health outcomes. Encouragingly, it is a treatable and potentially reversible condition through exercise interventions. However, studies on this population's views on exercise are scant, thus limiting the design and delivery of tailored, sustainable exercise interventions in primary care.
A descriptive qualitative study.
Data were collected through semistructured interviews with 27 community-dwelling older adults with sarcopenia from four community care centres in China between October 2023 and February 2024. The data were analysed using thematic analysis.
Four main themes with their respective subthemes were identified from the data analysis and described as: (1) limited capability to identify and engage in appropriate exercise; (2) various motivations influenced by personal values, resilience and habits; (3) exercise behaviour shaped by environmental and social factors; (4) expectations for community-based exercise programmes.
Older adults with sarcopenia often misbelieve muscle issues to be normal ageing, leaving their condition undiagnosed and unmanaged. Limited information about appropriate exercises leads them to engage in simple, unstructured activities. Motivation levels and contextual factors influence their exercise engagement and adherence. Nurse-led tailored, evidence-based and group-based programmes, complemented by home-based exercise resources, are needed to address challenges and support long-term adherence.
This study provides new insights into the perspectives, challenges and expectations of exercise in this specific population. Findings inform nurse-led exercise programmes in primary care that meet the needs and preferences of this population.
This study follows the Consolidated Criteria for Reporting Qualitative Studies.
Participant interviews offered valuable perspectives on exercise engagement and adherence.
In response to global outcries of poor healthcare, organisational interventions have been implemented with the aim of promoting compassionate care. An overall synthesis of qualitative data, including the perspectives of healthcare staff who have attended interventions, can establish ‘what works’ and inform future interventions.
To synthesise existing research exploring how healthcare staff experience organisational interventions for compassionate care.
Qualitative evidence synthesis.
A qualitative evidence synthesis was conducted in August 2023. Five databases were searched: MEDLINE, Academic Search Premier, CINAHL, APA PsycInfo and APA PsycArticles. Articles met the following criteria: (a) reported on the experiences of healthcare staff who had participated in organisational interventions for compassionate care, (b) taken place in a healthcare setting, (c) use of a qualitative or mixed-methods methodology, (d) published in English and (e) published since 2010. A thematic synthesis was conducted using NVivo software to synthesise findings. Data from the complete ‘findings/results’ sections were included in the synthesis. The final search protocol and search strategy were registered on PROSPERO (ID: CRD42023472404) and are reported using the PRISMA guidelines.
Eighteen qualitative or mixed-methods studies were included in the review, encapsulating the experiences of healthcare staff across eight countries. Four themes were identified: (1) holding back, (2) humanising healthcare, (3) values are instilled and (4) sustainability is important.
Organisational interventions for compassionate health care are valued and appreciated by healthcare staff and foster reflection and connection. Interventions facilitate clinical creativity, improve staff well-being and strengthen communication between staff.
The implementation of organisational interventions for compassionate care should be encouraged in healthcare settings. Interventions that consider organisational cultures are driven by organisational values and are embedded with sustainability in mind can improve staff well-being and positively impact the provision of patient care.
PRISMA guidelines were followed in the reporting of this review.
To identify the pain assessment scales with the best psychometric properties to be used by nurses in an inpatient setting.
Umbrella review.
A comprehensive search of four databases was conducted for systematic reviews published from July 2013 to November 2024, focusing on psychometric properties of pain scales used in inpatient settings. Inclusion criteria required scales to assess subjective or behavioural pain and be nurse-administered, while reviews without detailed psychometric data were excluded. Screening, quality appraisal (JBI checklist), and data extraction were performed independently by two researchers. Data synthesis combined qualitative and quantitative approaches, with psychometric properties evaluated using the COSMIN checklist. The study was reported in accordance with the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement.
Seventeen articles met the inclusion criteria, identifying 41 scales used across various patient populations, including critical care, paediatric, postoperative, cancer, cerebral palsy, disorders of consciousness, low back and neck pain, stroke and verbal communication disorders. The Paediatric Pain Profile, the Breakthrough Pain Assessment Tool and the Questionnaire on Pain caused by Spasticity demonstrated adequate psychometric properties, although the positive findings for the latter two should be confirmed by at least one additional study. Most of the scales (n = 36) require further studies to validate their use in clinical practice. For two scales, their clinical use remains questionable.
The Paediatric Pain Profile, the Breakthrough Pain Assessment Tool, and the Questionnaire on Pain caused by Spasticity can be recommended for use. Unidimensional scales should complement, rather than replace, multidimensional scales to ensure a comprehensive pain assessment. Standardising documentation with validated scales enhances clinical decision-making, care quality, research usability, and reduces documentation burden.
To assess the prevalence of malnutrition risk, especially of undernutrition, among patients admitted to the Internal Medicine and Orthopaedics wards at Michele and Pietro Ferrero Hospital, Italy, using the Nutritional Risk Screening 2002 (NRS-2002) tool, administered by trained nursing staff, and to evaluate the adherence to related care interventions.
Cross-sectional study.
We included 248 adult patients, screened by trained nurses for nutritional risk within 48 h of admission using the NRS-2002 tool, which takes into account patients' Body Mass Index, recent weight loss, reduced dietary intake, and disease severity. Information on nursing interventions was also collected.
We identified 36 subjects at risk of malnutrition with NRS ≥ 3. Prevalence was higher in Internal Medicine, reflecting differences in patient characteristics and clinical complexity. Patients at risk were older, had longer hospital stays, and higher risks of falls and pressure sores. Nursing interventions such as proper meal selection, administration of hypercaloric-hyperproteic supplements, and completion of food diary were implemented in most cases, although adherence was not complete. Post-training questionnaire showed that, overall, nurses integrated nutritional screening into practice, but areas for improvement were identified.
Results confirmed the high prevalence of malnutrition risk in hospitalised patients, especially in Internal Medicine. Proper training and empowerment can enable nurses to effectively identify and manage patients at intermediate risk of malnutrition.
Nurses can play key roles in hospital nutritional care by facilitating early identification and appropriate management of patients at malnutrition risk.
Malnutrition is very common among inpatients. Trained and empowered nurses can perform nutritional screening at admission to identify and early manage patients at risk, thereby helping to prevent increased morbidity, mortality and healthcare costs.
STROBE guidelines.
None.
To contextualise an existing suicide prevention programme, and to assess the effectiveness, feasibility and acceptability of the contextualised suicide prevention programme among secondary school students in eastern Nepal.
A multi-method study is planned across four phases. The study will be informed by the Socio-Ecological Model. The first phase is a systematic review to identify available suicide prevention programmes, their effects and their contextualisation status. The second phase will be a descriptive qualitative study to contextualise the safeTALK suicide prevention programme for use among adolescents in a public school of Eastern Nepal, involving adolescents, teachers, parents, healthcare providers and policymakers. The third phase will be a single-group pre-post-test design to test the preliminary effects of the contextualised safeTALK programme among 110 adolescents at the public school. Outcomes measured in the third study will be suicidal ideation and help-seeking behaviours, using the Suicidal Ideation Attributes Scale, and General Help-Seeking Questionnaire. The final phase will evaluate the feasibility and acceptability of the safeTALK suicide prevention programme through in-depth interviews with adolescents, teachers, parents, healthcare providers and policymakers. Quantitative and qualitative data will be analysed using the Statistical Package of Social Sciences v.30 and NVivo v.14 respectively.
Ethical approval has been obtained from the Western Sydney University Human Research Ethics Committee and the Nepal Health Research Council. The findings will be disseminated via conference presentations and peer-reviewed publications.
There are no reported structured suicide prevention programmes for adolescents in low-middle-income countries, including Nepal. This study is expected to assist in mitigating the shortfall of contextualised adolescent suicide prevention programmes in low-middle-income countries. Additionally, evidence will be added to the global nursing literature, helping to contribute to evidence-based nursing practice.
Australian New Zealand Clinical Trials Registry (ANZCTR): 12624000634572
This study aims to synthesise evidence on users' experiences of telephone cancer information and support services (CISS) to identify important service features and inform service development.
A qualitative evidence synthesis.
OVID MEDLINE, EMBASE, CINAHL, PsycINFO and SocINDEX databases were searched for peer-reviewed qualitative literature fitting the inclusion criteria from database inception to 30 March 2023. The included articles were double-screened, and quality appraised using the CASP checklist. GRADE-CERQual was used as a tool to assess the confidence of review findings. Content synthesis combined the qualitative data with the Loiselle cancer experience measurement framework guiding analysis. This paper is reported as per the equator network recommended SRQR checklist.
Of the 607 articles screened, seven studies were included. Four main themes and 14 sub-themes about CISS aspects were identified: psychological well-being (managing emotions/coping, hope/reassurance, supporting close others and a reluctance to call the CISS); knowledge is power (information seeking, the burden of knowledge and empowerment); truth and clarity (adjunct support, credible source and improved understanding and confidence); and service adequacy (operators' ability to connect with users, convenience, service provision and awareness, and the cancer journey).
Findings suggest people with cancer and their carers accessing a CISS value emotional support combined with trusted information, topic expertise and a connection with the service operator. future service provision should address the lack of awareness regarding the range of services and the convenience extended operating hours may offer.
The results add to our understanding of CISS service provision. However, knowledge gaps remain regarding preferences among service features and the hierarchy of CISS characteristics to be prioritised to enhance services.
Focused CISS awareness campaigns will inform communities and healthcare professionals of the available resources to improve the lives of those affected by cancer. Ongoing service review will enable resources to be tailored to callers' needs, potentially easing the burden on existing services that are overwhelmed and under-resourced.
This qualitative evidence synthesis did not directly involve patient or public contribution to the manuscript.
Systematic Review Registration Number (PROSPERO): CRD42023413897
To explore how neonatal nurse leaders sustain human-centred care while implementing digital technologies in neonatal intensive care units (NICUs).
Qualitative descriptive multi-site study across four NICUs in the Eastern Region of Saudi Arabia (November 2024–May 2025), reported in accordance with COREQ.
Purposive maximum-variation sampling recruited 24 neonatal nurse leaders across leadership levels, hospital types and digital maturity stages. Semi-structured interviews were conducted in Arabic or English, transcribed, translated as needed and thematically analysed in NVivo 14 using a hybrid inductive–deductive approach. Directed content analysis of key organisational documents enabled triangulation. Trustworthiness was supported through member checking, peer debriefing, audit trail, external review and double coding of a subset of transcripts.
Four interrelated strategies were identified: (1) embedding a values-based human-centred vision; (2) selecting and customising digital tools to strengthen, not replace, nurse–family connection; (3) redesigning workflows (e.g., device-free openings, protected presence time, family-inclusive portals) to preserve presence and partnership; and (4) fostering team capability and psychological safety for digital–human integration.
Human-centred care in digital NICUs is intentionally led and structurally engineered. The study offers a practice-ready framework that translates values into reproducible routines within complex sociotechnical systems.
The framework supports nurse leaders in aligning digital transformation with family-centred care, protecting nurse–family presence, and enhancing safety, trust and partnership for high-risk neonates.
Addresses risks of relational erosion in digital and AI-enabled NICUs and provides transferable nurse-led strategies to sustain ethical, family-centred practice.
COREQ-compliant qualitative study.
No Patient or Public Contribution.
To explore fathers' views and experiences of providing Kangaroo Care (KC) to their baby cared for in a Neonatal Intensive Care Unit (NICU).
Kangaroo Care has been known to improve the health outcome for preterm, low birth weight and medically vulnerable term infants and achieve the optimal perinatal health wellbeing for parents and infants. Historically, mothers are considered as the dominant KC providers, whereas fathers are spectators and have been overlooked. Little is known about the fathers' perspectives in providing KC in NICUs.
Individual semi-structured interviews were conducted with 10 fathers who delivered KC to their baby when in the NICU. Data were analysed using Braun and Clarke's six-phase thematical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed to report this qualitative study.
Fathers in this study identified they were passing a silent language of love and connecting with their baby by the act of KC in a challenging environment. Three themes emerged: ‘Positive psychological connection’, ‘Embracing father-infant Kangaroo Care’ and ‘Challenges to father-infant Kangaroo Care’.
The findings of this study show KC enhances the bonding and attachment between fathers and infants. The conceptualisation of the paternal role in caregiving to a newborn is evolving as a contemporary practice. Further research is warranted to confirm or refute the study findings. Policies and facilities should be modified to include father–infant KC within the fields of neonatal care.
It is important for nurses and other health professionals to support and enable fathers to give KC. Father–infant KC is recommended in neonatal care settings
FreshRSS 