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To evaluate the artificial intelligence-assisted lymphedema education material in patients undergoing breast cancer surgery.
A comprehensive, successful methodological design was used to evaluate the portability of the expandable, AI-supported lymphedema education material for breast cancer. The study was reported in accordance with the STROBE statement (see Data S1 for the completed STROBE [Strengthening the Reporting of Observational Studies in Epidemiology] checklist). When preparing the AI-supported lymphedema education material managed with breast cancer treatment, it is first determined in the education of patients. Then, the commands of the Chat GBT-4 program are included in the scope of the transferred education content. For the created education content, readability was first evaluated and expert opinion was taken for the final version of the draft.
While preparing the AI-assisted lymphedema education material in the study, expert opinions were obtained, and the educational needs of the patients were determined by scanning the literature. Then, 12 commands were given in the ChatGPT-4 program to create the educational content. Formulas were used to evaluate the readability of the created educational content in Turkish and the readability of the health literature. The validity of the lymphedema education material was presented to 10 experts. The experts evaluated the understandability and actionability of the educational material using the Patient Education Materials Evaluation Tool and the Global Quality Scale, which evaluates the quality of the educational material.
It was concluded that the readability index of the lymphedema education material for Turkish was 67.3, and the Turkish readability level was ‘easily understandable’. The readability index of health literature was found to be 11.28, 9.68, 10.58, 39.0, and 11.26, respectively. When the internal consistency coefficient between the experts was examined, it was found to be 0.74. It was determined that the Patient Education Materials Evaluation Tool understandability score average was 92.10 ± 9.03, and the actionability score average was 81.60 ± 18.47. The Global Quality Scale score average, which evaluates the suitability and quality of the content of the AI-supported educational material, was found to be 4.10 ± 0.87.
At the end of the study, it was determined that the educational material was reasonable regarding understandability and actionability. The Turkish readability level was also reasonable and easily understandable.
This study is one of the proactive attempts to use AI in preparing educational materials for nurses and healthcare professionals.
No patient or public contribution.
To evaluate the research capability of clinical nurses in China and identify the determinants associated with their capability.
As nursing evolves into an increasingly independent discipline, the research capability of clinical nurses has become critical for the development of the profession, advancing evidence-based practice and improving patient care quality.
A multicentre cross-sectional survey was conducted using convenience sampling from September 2023 to February 2024, among clinical nurses in tertiary hospitals across three provinces in China. The Nursing Research Capability Self-Assessment Scale was used to assess the research capability of the nurses. Chi-square tests, one-way analysis of variance and multiple linear regression were used to examine factors associated with research capability. The Strengthening the Reporting of Observational Studies in Epidemiology was followed.
A total of 1074 clinical nurses participated. The mean research capability score was 89.11 ± 27.69, reflecting a moderate level of research capability. However, two dimensions of research questions and literature review received lower scores. Multiple linear regression analysis identified that education level, professional title, administrative position and nursing job title (all p < 0.05) were independent predictors of research capability.
Clinical nurses exhibit moderate research capability, with notable deficiencies in formulating research questions and conducting literature reviews. Key factors influencing research capability include education, professional title, administrative position, and job title. Targeted training and development programmes should address these factors to enhance nurses' research competence and advance nursing science.
To describe self-care behaviours and explore factors associated with self-care behaviours in older adults with multiple chronic conditions (MCCs).
The prevalence of MCCs is increasing in a rising trend. MCCs complicate the self-care behaviours of older adults. There is limited evidence regarding the factors associated with self-care behaviours in older adults with MCCs.
A cross-sectional design was adopted using the convenience sampling method.
Participants were recruited from a community health service centre. Measurements included the Self-Care of Chronic Illness Inventory, a single item for loneliness, the 6-item Lubben Social Network Scale, the 4-item Patient Health Questionnaire, the 15-item Tilburg Frailty Indicator, and a self-developed questionnaire for sociodemographic and disease-related characteristics. Descriptive statistics were used as appropriate. Multiple linear regression and multivariate logistic regression were adopted to examine the influencing factors.
A total of 223 participants were enrolled in this study. Among the 223 participants, 49.3%, 32.7% and 28.7% achieved a cut-off score of ≥ 70 in self-care maintenance, monitoring and management, respectively. The linear regression models indicated that smoking status, frailty and self-care confidence were significantly associated with self-care maintenance; education level, per capita monthly household income and self-care confidence were significantly associated with self-care monitoring; and employment status and self-care confidence were significantly associated with self-care management. In addition, multivariate logistic regression showed that living in cities or towns was significantly associated with higher odds of adequate self-care management.
Three domains of self-care behaviours were influenced by distinct factors, and self-care confidence demonstrated consistent associations with all three domains of self-care behaviours. Self-efficacy-focused interventions may have the potential to promote self-care behaviours in older adults with MCCs.
Healthcare providers need to take into account the pivotal factors influencing self-care behaviours of this cohort to deliver structured and effective education and support. Clinicians should consider adopting confidence-building strategies in routine education for this cohort.
We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
To explore the topics and themes covered in published research studies in nursing about neurodegenerative disease, synthesise the available evidence, and discuss future directions.
Scoping review following the Joanna Briggs Institute guidelines.
A multi-step search strategy was applied across different databases to identify studies published in English or Italian up to September 2023. Data were analysed using a Nursing Data Matrix based on the nursing meta-paradigm and the Child Health and Nutrition Research Initiative (CHNRI) 4D-framework. Screening and data extraction were performed independently by pairs of reviewers; data were extracted and thematically analysed to identify existing research questions and potential priorities.
Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Embase databases were searched for studies published from 2013 to 2023.
A total of 351 studies met inclusion criteria. The majority of studies originated from the United States (35%). Parkinson's disease and Alzheimer's disease were the most studied conditions, while rare diseases were scarcely represented. Most studies focused on nursing care (39%), with limited attention to rehabilitation (0.8%) and cost-effectiveness (1%). Although 70% of articles included at least one nurse author, 22% lacked any nursing authorship despite addressing nursing-related topics. Thematic and matrix analyses revealed an uneven distribution of research, with a predominance of descriptive studies and limited work in discovery-oriented research.
This review provides a comprehensive overview of nursing research in neurodegenerative diseases, highlighting key themes and gaps. The findings informed the preliminary identification of new nursing research priorities in neurodegenerative diseases to guide future studies and enhance evidence-based nursing care.
The study highlights key trends and gaps in nursing research on neurodegenerative diseases, calling for a more inclusive, equitable, and comprehensive research agenda.
PRISMA-ScR guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Review registration was done on Open Science Framework, and can be viewed at https://osf.io/tn5v9 (https://doi.org/10.17605/OSF.IO/TN5V9)
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 analyse the incidence of physical restraint use during painful and stressful procedures in hospitalised children, as well as the factors associated with its use.
Observational, longitudinal and prospective study.
Children aged between 28 days and 10 years in a public hospital in Brazil were each observed undergoing clinical procedures over a 6-h period. Data were collected on demographics, observed pain using validated measures, stress behaviours, and the use of physical restraint. Descriptive and inferential analyses were performed. National ethical guidelines were strictly followed.
1210 procedures were observed on 75 children, including 351 painful and 859 stressful procedures. Physical restraint was used in 270 (22.3%) procedures; of these, 131 (48.5%) were painful procedures and 139 (51.5%) were stressful procedures. In stressful procedures, at least one stress-related behaviour was observed before the initiation of physical restraint. Factors associated with increased use of physical restraint during painful procedures were younger children, with higher levels of care dependency, higher pain scores during procedures, and those who underwent intravenous medication administration, airway suctioning, tube insertion, and fixation changes. In stressful procedures, the factors associated with higher use of physical restraint were younger children, hospitalisation due to respiratory conditions, those who underwent physical examinations, inhaled medication, and nasal lavage; and the child's expression of stress behaviour before the procedure starts. Predictors of physical restraint included morning period, younger age group, male or female sex, and transfer from the Intensive Care Unit.
A high incidence of physical restraints was observed across multiple painful and stressful procedures performed within a 6-h period, associated with variables related to both the child's characteristics and the procedures.
This study aims to encourage reconsideration of the frequent use of physical restraint in paediatric procedures, calling for a reframing of its application as an unquestioned practice toward an approach that prioritises protecting and respecting a child as a subject with needs, rights, and desires.
Strengthening the Reporting of Observational studies in Epidemiology (STROBE).
Although multicomponent exercise is a popular nonpharmacological treatment, its effects on cognition vary across studies because of the diversities in exercise combinations. Identifying the most effective combination is of great importance to the prevention and treatment of cognitive impairment.
To compare and rank the efficacy of various multicomponent exercise interventions on cognition in people with cognitive impairment.
We searched PubMed, Web of Science, Embase, Cochrane, SPORTDiscus and PsycInfo databases up to April 2025 for eligible randomised controlled trials about multicomponent exercise interventions in people with cognitive impairment. Primary outcome was global cognition, with secondary outcomes being executive function and memory. Pairwise and network meta-analyses were performed using random-effects models.
Twenty-five trials involving 2298 participants were included. Pairwise meta-analyses showed multicomponent exercise interventions were effective on global cognition (standardised mean difference (SMD) = 0.59; 95% confidence interval (CI): 0.30, 0.89; p < 0.001) and executive function (SMD = 0.28; 95% CI: 0.12, 0.45; p < 0.001). Network meta-analyses revealed that aerobic exercise (AE) + balance & flexibility (BF) training had the highest probability (70.8%) of being the optimal exercise combination for global cognition (SMD = 1.07; 95% CI: 0.23, 1.90; p = 0.016), and AE + resistance exercise (RE) had the highest probability (43.1%) of being the optimal exercise combination for executive function (SMD = 0.56; 95% CI: 0.03, 0.10; p = 0.042). We did not observe significant effects of multicomponent exercise on memory.
AE + BF training is likely the most effective multicomponent exercise combination for global cognition, while AE + RE showed the optimal effect on executive function in people with cognitive impairment.
Our study contributes to guiding clinical professionals to design and conduct targeted multicomponent exercise interventions as per individual cognitive impairment characteristics to protect individual cognition.
No patient or public contribution applies to this work.
The study protocol was registered with PROSPERO (CRD42023489517).
To examine the association between perceived quality of care and the level of coercion experienced by individuals hospitalised in acute mental health units.
National cross-sectional study.
Data were collected from 255 patients admitted to 12 acute mental health units across Spain. Standardised instruments assessed perceived quality of care and levels of coercion, humiliation and fear at discharge. Multiple linear regression analyses were used to explore associations between care quality dimensions and patients' experiences.
Perceived quality of care was significantly associated with lower levels of perceived coercion and humiliation. All dimensions of care quality showed inverse associations, with the “secluded” dimension showing the strongest association. The association between care quality and perceived fear was less consistent. These findings are particularly relevant for mental health nurses, who play a central role in delivering relational care and ensuring patients' emotional safety.
Higher perceived quality of care is associated with lower levels of coercion, humiliation, and fear during hospitalisation in acute mental health settings.
For mental health nursing, these results underscore the critical role of nurses in creating therapeutic environments that reduce coercive experiences. By fostering trust, promoting patient autonomy, and ensuring emotional and physical safety, nurses can significantly influence the quality of care and patient outcomes.
The study addresses the lack of evidence on how perceived quality of care influences experiences of coercion in acute mental health settings. Better perceived care quality is linked to reduced feelings of coercion, humiliation and fear. The research has direct implications for mental health nurses, clinical educators and healthcare managers aiming to improve patient experiences and reduce coercive practices in psychiatric care.
STROBE reporting guideline.
No patient or public contribution.
Advanced simulation is a methodology that allows the development of technical skills and transversal skills such as teamwork and leadership. There are tools to measure the development of technical competencies and student satisfaction with the methodology, but not to measure the development and use of transversal competencies in the clinical practice setting.
To develop and validate a scale to measure the impact of clinical simulation on the development and application of teamwork and leadership competencies.
A multicentre study was carried out in two Spanish universities in which the Clinical Simulation Learning Teamwork and Leadership Scale was developed and validated.
The study was carried out in several phases: development of the questionnaire using a Delphi method, pilot test and validation of the construct with a sample of 207 nursing students. Reporting of this research adheres to STROBE guidelines.
Content validity was checked according to Aiken's V for the three attributes of the questionnaire. Reliability or internal consistency was assessed with Cronbach's α and the sensitivity analysis showed no significant variation when any item was eliminated. On the other hand, McDonald's Omega statistic was used. Intraobserver reliability was taken from a sample of 47 students, in which it was observed that the intraclass correlation was positive.
The Clinical Simulation Learning teamwork and leadership scale is a valid instrument for measuring the development of transversal competencies.
This scale will provide information to evaluate the weight of the clinical simulation in the students' knowledge.
It is a tool for evaluating transversal skills that is proven valid and will improve the training of students.
The instructions of the STROBE checklist have been followed.
The students have participated in the knowledge transfer self-assessment.
Individuals with systemic lupus erythematosus (SLE) often suffer from sleep disturbance, which exhibits heterogeneity. Whether it could be grouped into different clusters remains unknown, posing challenges to the development of personalised interventions to address sleep disturbance.
To examine clusters of sleep disturbance and associated factors in people with SLE.
Cross-sectional design.
From November 2023 to January 2024, people diagnosed with SLE were recruited by a convenience sampling approach. Data were collected via an online platform Wenjuanxing. Sleep disturbance was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Other information, such as disease activity, pain, fatigue, depression and anxiety was also collected using validated instruments. Latent profile analysis was performed to reveal the distinct clusters of sleep disturbance. Multiple logistic regression analysis was performed to investigate factors associated with the clusters.
A total of 538 participants were included, with a response rate of 85.1% (538/632). Only those with sleep disturbance (PSQI > 5) were included in the final analyses. Participant mean age was 32.9 (SD = 8.4) years and 402 (92.6%) were females. All had sleep disturbance (PSQI > 5) and their mean PSQI was 8.8 (SD = 2.9). Three distinct clusters were identified: mild sleep disturbance with poor sleep quality, adequate sleep duration and good daytime functioning (50.7%), mild sleep disturbance with poor sleep quality, adequate sleep duration and poor daytime functioning (30.9%) and moderate sleep disturbance with poor sleep quality, inadequate sleep duration and impaired daytime functioning (18.4%). There are both overlaps and unique aspects in terms of factors associated with each cluster of sleep disturbance, including age, body mass index, cardiovascular system damage, musculoskeletal system damage, depression and anxiety.
Sleep disturbance in patients with SLE showed three distinct clusters, with each cluster having slightly different predisposing factors.
In clinical practice, nurses are recommended to prioritise assessment and interventions for those at-risk subgroups. They could also use the above information to develop and provide personalised interventions to address the unique needs of each cluster of sleep disturbance.
Checklist for reporting of survey studies.
No patient or public contribution.
To develop and validate a risk prediction model for oral frailty in elderly patients with ischaemic stroke.
A cross-sectional study.
A temporal cohort of 633 elderly isachemic stroke patients from May 2024 to February 2025 was chronologically divided into a training set (n = 443) and validation set (n = 190). Participants were classified into oral frailty and non-oral frailty groups based on the Oral Frailty Index-8. In the training set, feature selection combined least absolute shrinkage and selection operator regression and random forest recursive feature elimination, followed by Nomogram Construction via Binary Logistic Regression. The model underwent internal validation using bootstrap resampling, and its generalizability was assessed with the validation set. The model was comprehensively evaluated using Receiver Operating Characteristic (ROC) curves, the Hosmer-Lemeshow Test, Calibration Plots, and Decision Curve Analysis (DCA).
In both the training and validation sets, the prevalence of oral frailty among elderly ischaemic stroke patients was 63.2% and 62.1%, respectively. Wearing dentures, tooth brushing frequency, dry mouth symptoms, chewing difficulty, swallowing function, oral health literacy, and oral health status were identified as significant predictors of oral frailty. ROC analysis demonstrated strong discriminative ability of the nomogram. The Hosmer-Lemeshow Test confirmed model consistency, and the calibration curve indicated excellent and stable calibration performance. DCA revealed that the model provided significant net clinical benefit in clinical practice. This free, interactive dynamic nomogram is accessible at: https://xiaowen.shinyapps.io/dynnomapp/.
This study presents a reliable, accessible model to assess oral frailty risk in elderly ischaemic stroke patients, facilitating clinical identification of high-risk individuals and providing a scientific foundation for oral health interventions.
The nomogram helps healthcare professionals identify high-risk patients, understand risk factors, and improve oral health management.
TRIPOD-AI checklist.
No patient or public contribution.
Turnover intention among nurses is a well-established predictor of actual turnover. Despite the critical nursing shortages during COVID-19, the relative contributions of individual and organisational factors to increased turnover intention remain insufficiently understood.
This study aimed to identify the determinants of turnover intention among clinical nurses at both individual and organisational levels and to evaluate the independent effects of these factors in infectious situations.
This study conducted a secondary analysis of cross-sectional data collected in Hong Kong between April 2020 and September 2021.
A convenience sample of 188 Chinese registered nurses in Hong Kong was recruited. The survey assessed questions on demographic, organisational and workplace violence-related characteristics, the Post-Traumatic Stress Disorder Checklist-Civilian Version, the Brief Coping Orientation to Problems Experienced Inventory and the Anticipated Turnover Scale. Univariable and structured multi-phase linear regression analyses were performed to identify associated factors and to evaluate the influence of individual- and organisational-level factors. The study followed the STROBE checklist for reporting cross-sectional studies.
The regression model, incorporating individual- and organisational-level factors, explained 22.68% of the variance in turnover intention. Individual-level factors associated with increased turnover intention included younger age, high levels of post-traumatic stress symptoms and low use of accommodation coping strategies. Organisational-level factors included exposure to workplace violence and insufficient support for reporting such incidents.
This study underscores the significance of minimising workplace violence and enhancing workplace safety, in addition to addressing individual-level factors, to reduce nurses' turnover intention—particularly in the context of future pandemics and epidemics.
These findings provide insights into the factors influencing clinical nurses' turnover intention, supporting the development and implementation of targeted clinical protocols and regulations to address modifiable factors and promote a sustainable nursing workforce.
No patient or public contribution.
The purpose of this study was to describe the strategies older adults use to maintain their balance and prevent themselves from falling in the hospital.
The Expanded Health Belief Model served as the theoretical framework for this qualitative descriptive study.
Audio-recorded, semi-structured interviews were conducted with 15 (N = 15) older adults (female 53.3%), mean age of 77 (SD 9.9) admitted to a rural community hospital in the United States. Each transcript was analysed independently by two researchers using content analysis before reaching consensus. Sample size was guided by thematic saturation. Trustworthiness was ensured by using the criteria outlined by Lincoln and Guba.
Four main themes emerged: My Balance Problem is My Personal Responsibility, Self-efficacious Common-Sense Balance Management Strategies, Hospital Staff as Contributors or Disruptors of My Balance Management, and My Needs for Balance Management Support. The older adults used extensive mental efforts in planning and executing personal strategies to maintain balance and viewed this as their personal responsibility. Their self-efficacious balance management strategies included observing the environment, assessing furniture and equipment, staying focused, and moving slowly. Assistance from hospital staff members either supported or disrupted the older adults' balance management efforts. The older adults desired to learn more about fall prevention in the hospital. The older adults found physical guidance, demonstration and verbal guidance to be the preferred method of learning.
Rurally hospitalised older adults employ independent, self-efficacious balance management strategies.
Older adults' personal balance management strategies must be recognised by healthcare workers.
Future inpatient fall prevention interventions and policies must focus on exploring hospitalised older adults' optimal and suboptimal balance management behaviours to develop patient-centred fall prevention interventions to decrease inpatient falls among older adults.
The Consolidated Criteria for Reporting Qualitative Research.
No patient or public contribution.
This study was conducted to determine the impact of regular visits by Generation Z individuals on the psychological well-being and optimism–pessimism levels of elderly people in a nursing home.
The study employed a quasi-experimental design with a single group, utilising pre-test and post-test measurements. “Psychological Well-Being Scale,” and the “Optimism-Pessimism Scale-Adult Form” were used. Study reported in accordance with STROBE Checklist.
The participants (n = 201) had a mean age of 72.40 ± 7.72 years, with most residing in the nursing home for over 5 years. A significant difference was observed between the mean psychological well-being scores of participants before and after the visit. Also, there was a significant difference in the optimism–pessimism dimension scores on the Optimism–Pessimism Scale before and after the visit.
It was established that regular intergenerational visits had a beneficial impact on the psychological well-being of the elderly in nursing homes, resulting in an increase in optimism and a reduction in pessimism.
Intergenerational programs are gaining more and more attention every day due to their potential to benefit young people, older people, and society. Thus, it may be possible to increase the social support levels of the elderly and prevent negative age discrimination.
The effect of prehabilitation on reducing the level of postoperative stress and facilitating recovery has been proven to be controversial in previous studies involving patients with cancer. This review contributes to the improvement of an intervention programme by qualitatively integrating the prehabilitation experiences of patients with cancer.
This review aimed to integrate the individual experiences of patients with cancer who had received prehabilitation interventions to identify the barriers and facilitators to implementation, which can be used to understand patients' adherence behaviours.
This was a qualitative evidence synthesis review.
Articles were systematically searched from inception to February 18, 2025, using four English databases and three Chinese databases. Keywords and Medical Subject Headings were used to identify potential studies written in both Chinese and English. This study was performed using the Joanna Briggs Institute qualitative systematic review methodology.
Twenty-five articles were included in this review. Guided by the Theoretical Domains Framework (TDF), eight synthesised findings were extracted, focusing on the representation of factors influencing the adherence of patients with cancer to prehabilitation, including the domains of knowledge (two facilitators), reinforcement (two facilitators), beliefs about consequences (two facilitators), beliefs about capabilities (two barriers), environmental context and resources (two barriers, one intervention preference factor), social influence (one facilitator, one intervention preference factor), emotion (one barrier, one facilitator) and behavioural regulation (one facilitators, two intervention preference factors).
Our findings indicate that the adherence to prehabilitation among patients with cancer is shaped by a dynamic interplay of determinants. Structured assessments, self-monitoring, tailored interventions and tele-prehabilitation can improve patients' self-efficacy, perceived benefits and access to resources, which in turn can facilitate their completion of prehabilitation.
This study deepens our understanding of behaviours related to adherence to prehabilitation among patients with cancer and provides valuable guidance for the formulation and optimisation of subsequent prehabilitation intervention programmes.
ENTREQ.
No patient or public contributions.
PROSPERO CRD: 42024553972
To (1) describe the characteristics of patients with advanced cancer receiving home-based care, (2) identify the nursing diagnoses associated with 6-month mortality and (3) explore the predictive power of nursing diagnoses on 6-month mortality for patients with an advanced cancer diagnosis.
Nursing diagnoses have been shown to capture the complexity of patients' experiences and the specific nursing care related to patients' responses to illness, including increased mortality risk. However, there is a lack of studies investigating the relationship between nursing diagnoses and mortality among cancer patients receiving home-based care.
Retrospective cohort study.
Between July 2021 and June 2023, patients with advanced cancer were consecutively admitted to a home-based care service. Medical data, prognostic indexes and nursing assessment data, including nursing diagnoses from NANDA International, assigned during the first home visit, were extracted from patient health records. Survival analysis was performed over the first 6 months using the Kaplan–Meier method and Cox proportional hazards model.
Among 344 enrolled patients, the most frequent nursing diagnoses were chronic pain and constipation. The 45.9% of patients died at home within 6 months after discharge. Multivariate Cox regression identified a Palliative Prognostic Index ≥ 5, palliative status, terminal phase of illness and two nursing diagnoses—imbalanced nutrition: less than body requirements and death anxiety—as significant predictors of 6-month mortality.
Survival in advanced cancer patients receiving home care was primarily predicted by the terminal phase of illness, Palliative Prognostic Index, palliative status and two specific nursing diagnoses: imbalanced nutrition: less than body requirements and death anxiety.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.
No Patient or Public Contribution.
To assess Digital Health Literacy (DHL) levels among hypertensive patients.
Cross-sectional study.
The study, conducted from March to August 2024 among hypertensive patients using convenience sampling, employed a 35-item questionnaire assessing: (I) sociodemographic; (II) physical activity, dietary habits, antihypertensive pharmacological treatment and medical history; (III) online health-related information knowledge and confidence; (IV) DHL, through the HLS19-DIGI questionnaire with subscales on: (i) dealing with digital health information (HL-DIGI), (ii) interaction with digital resources (HL-DIGI-INT), (iii) frequency of digital device use for health (HL-DIGI-DD).
Among 311 participants (mean age 63.9 years, SD = 14.8), 42.1% completed high school, 25.4% held a bachelor's degree and 22.8% were physically inactive. While 49.8% were aware of online health-related information, 28.9% were uncertain and 47.6% lacked confidence in using it for health decisions. On average, participants showed a problematic level of DHL in HL-DIGI, a sufficient level in HL-DIGI-INT, and used digital health devices just over once a week. Older age emerged as a predictor of higher online health-related knowledge and DHL, while higher education level predicted higher knowledge, confidence and DHL. Physical inactivity was associated with lower online health-related information knowledge and confidence.
These findings point to the need to design proactive strategies and implement targeted training and educational interventions to improve DHL in hypertensive patients.
Enhancing DHL levels through targeted interventions in patient care allows patients to effectively benefit from digital healthcare, achieve positive health outcomes and reduce disparities in care pathways.
This study adhered to the STROBE checklist for reporting.
Patients were involved as the study population.
Local Ethical Committee of the University Hospital Company of the Marche Region, Italy (protocol: 2023/279, date: 28/09/2023).
To explore the chain-mediating roles of negative emotions and caregiver readiness between self-efficacy and e-health literacy among caregivers of patients with lung cancer.
With the rise of Internet health services, caregivers of patients with lung cancer, who are one of the health decision makers, are encountering new challenges. In order to develop appropriate interventions, it is necessary to explore in depth the various influencing factors associated with them.
A cross-sectional survey.
A total of 293 caregivers of patients with lung cancer were recruited between November 2023 and April 2024 through a convenience sampling method. These participants completed the demographic data questionnaire, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), Caregivers Preparedness Scale (CPS), and eHealth Literacy Scale (eHEALS). Independent samples t-tests and a one-way ANOVA were employed to identify the primary influencing factors. Structural equation modelling was employed to detect the mediating effects of negative emotions and caregiver readiness.
The STROBE checklist was used for this study.
The total e-health literacy score of caregivers of patients with lung cancer was 29.65 ± 7.11, and there was a correlation between self-efficacy, negative emotions, caregiver readiness, and e-health literacy. The results of the path analysis showed that negative emotions and caregiver readiness had chain-mediating roles between self-efficacy and e-health literacy among caregivers of patients with lung cancer, with the total indirect effect accounting for 31.17% of the total effect.
Caregivers of patients with lung cancer exhibit moderate levels of e-health literacy. This research suggests that self-efficacy not only has a direct and positive influence on e-health literacy but may also amplify it by mediating the interplay between negative emotions and caregiver readiness.
Healthcare providers should be cognizant of the negative emotions and readiness displayed by family caregivers in the hospital setting to aid them in cultivating strong health literacy for more efficient management of illness care tasks.
Nurses at the hospitals assisted us in collecting data from family caregivers of patients with lung cancer, and the caregivers actively cooperated in completing the questionnaires.
FreshRSS