Conectar
Chronic diseases require sustained medication adherence, yet nonadherence remains common, leading to poor outcomes and increased healthcare costs. Digital self-management technologies such as mobile health (mHealth) apps, SMS reminders, and web-based platforms offer scalable ways to support adherence, but evidence on their overall effectiveness across diverse contexts is fragmented.
To systematically review and meta-analyze the effectiveness of self-management technologies in improving medication adherence among adults with chronic diseases and to examine potential moderators of intervention impact.
Following PRISMA guidelines, we searched PubMed, Scopus, Web of Science, CINAHL, and JMIR for peer-reviewed studies (January 2010–June 2025) evaluating digital self-management interventions with adherence outcomes and comparator groups. Eligible designs included RCTs, quasi-experimental, and controlled before-after studies in adults with chronic disease. Random-effects meta-analysis estimated pooled effect sizes (Cohen's d). Heterogeneity (I 2), subgroup analyses, and publication bias (Egger's, Begg's, trim-and-fill) were assessed.
Fifty-two studies were included, spanning 2015–2025. Early interventions (2015–2019) focused on feasibility, using SMS and basic web tools; later years (2021–2025) showed technological maturity, dominated by mHealth apps integrating monitoring, reminders, and education. The pooled random-effects effect size was d = 0.268 (95% CI 0.123–0.414, p = 0.0003), indicating a small-to-moderate benefit. Heterogeneity was high (I 2 = 89%). Medium-duration (10.8–24 weeks) interventions had the largest effect (d = 0.50), and effects varied markedly by country (e.g., Iran d = 2.29; Taiwan d = −0.94). Begg's test suggested possible publication bias; trim-and-fill adjustment increased the pooled effect to d = 0.366.
Digital self-management technologies yield a statistically significant, small-to-moderate improvement in medication adherence across chronic diseases, with potential underestimation due to selective reporting. Effectiveness is moderated by temporal trends, geography, intervention duration, and study design, underscoring the need for context-specific adaptation and methodological rigor. Future research should prioritize large, well-controlled trials, pre-registration, and exploration of cultural and systemic determinants to optimize intervention impact.
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 map and synthesise the main recommendations for arterial blood gas (ABG) collection in intensive care units (ICUs).
A scoping review was conducted according to the PRISMA-ScR Checklist, supported with The PAGER framework and guided by the Joanna Briggs Institute methodology to ensure methodological rigour and analytical comprehensiveness.
Data collection was conducted from February to April 2024. The data sources included: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PubMed Central, Scientific Electronic Library Online (SciELO), Web of Science (WoS), SCOPUS, Science Direct, Virtual Health Library (VHL), Excerpta Medica database (Embase), CAPES Thesis and Dissertation Catalogue, Brazilian Digital Library of Theses and Dissertations (BDTD), Scientific Open Access Repository of Portugal (RCAAP), Theses Canada and the Oswaldo Cruz Foundation (Fiocruz) repository.
Key findings recommend the radial artery as the preferred puncture site, an insertion angle of 30° to 45°, the use of 1 or 3 mL syringes and 20G or 23G gauge needles. Transport and storage at room temperature are advised. Cryoanalgesia and subcutaneous analgesia methods were found to be effective for pain management.
The review highlights the best practices for arterial blood gas collection in critical care. The synthesized evidence strengthens clinical practice, informs guidelines for intensive care nursing and promotes safer, higher-quality care for critically ill patients.
The evidence-based recommendations identified can enhance nursing care related to arterial blood gas collection. Adherence to these practices promotes safer, more humanised and evidence-based care during the procedure.
The report of this study followed the PRISMA-ScR Checklist.
There was no patient or public involvement in this scoping review.
To explore the meaning older Asian immigrants attribute to social isolation and loneliness, their management strategies, utilisation of resources and impact on health.
Systematic review of qualitative studies.
AgeLine, CINAHL, MEDLINE, ProQuest, PsycINFO, Scopus, and Web of Science databases were searched in September 2024.
Inclusion criteria: participants were Asian immigrants to Western countries aged 65 and over, community-living and experiencing social isolation and loneliness. Antonovsky's Sense of Coherence was used to frame the thematic analysis.
Ten papers were included and analysed deductively using elements of the sense of coherence framework: • Comprehensibility: Social isolation and loneliness are viewed as multifaceted, influenced by cultural and environmental dislocation, language barriers, intergenerational conflicts, deteriorating health and mobility, and socioeconomic challenges. • Manageability: included engaging in culture-specific community programs, family and ethnic community support and living within ethnic enclaves mitigated isolation and loneliness. • Meaningfulness: Strong family ties, active community involvement, spirituality, volunteerism, and cultural practices fostered resilience. However, accepting the changing values of their new world, living independently, and carving their own niche provided meaning to their transformed reality.
Older Asian immigrants experience social isolation and loneliness through a cultural lens, shaped by migration experiences, language barriers, and shifting family dynamics. Cultural roots, family ties, spirituality, community, acceptance, and independence enhance sense of coherence. Recognising the dynamic interplay between cultural identity, resilience, and adaptation is key to understanding their lived experience.
This review informs culturally sensitive interventions, guiding healthcare, community services, and policy to support social participation, mitigate loneliness through ethno-specific activities, and improve the quality of life for aging immigrant populations in Western countries.
The review was undertaken and reported using the PRISMA guidelines.
None.
PROSPERO (CRD42023425752)
To synthesise evidence on wearable devices for continuous vital signs monitoring in adult hospital inpatients, focusing on clinical effectiveness, nursing perspectives, workflow impact, patient experience and resource implications.
Scoping review.
Joanna Briggs Institute methodology reported using PRISMA-ScR guidelines.
Six databases (CINAHL, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane), Scite.ai, and hand searching for studies published between January 2015 and November 2025. Data were synthesised using reflexive thematic analysis.
Sixty-seven studies from 19 countries were included. Four integrative themes were identified. (1) Enhancing clinical safety through continuous monitoring: wearable devices consistently enable earlier recognition of physiological deterioration; however, downstream outcomes such as length of stay and transfers to intensive care units were mixed and context dependent. (2) Transforming nursing practice and workflow integration highlighted improved situational awareness and potential efficiency gains, alongside challenges related to alarm overload, parallel documentation and implementation workload. (3) Patient experience of wearable monitoring: most patients reported reassurance and perceived safety, though experiences reflected a tension between monitoring as care and monitoring as surveillance; discomfort, anxiety, and privacy considerations were infrequently examined. (4) Economic and organisational consequences: potential system value was suggested through workforce efficiencies, but economic benefits were largely inferred, with infrastructure and training costs often underreported.
Wearable continuous monitoring technologies show clear potential to support nursing observations enabling improved early detection of deterioration. Realising these benefits depends on effective integration into workflows, robust governance, and sustained nursing leadership rather than technological capability alone. Significant evidence gaps remain regarding long-term outcomes, economic evaluation, and large-scale implementation.
Wearable devices for continuous vital signs monitoring have the potential to transform inpatient surveillance by enabling earlier recognition of physiological deterioration and enhancing nurses' situational awareness. This scoping review synthesises international evidence demonstrating that, although wearable monitoring can improve patient safety and workflow efficiency, its impact depends on effective integration into nursing practice, governance structures, and organisational preparedness. Continuous monitoring also introduces new challenges including alert fatigue, data interpretation, and workflow redesigns, highlighting the vital role of nursing leadership in digital health implementation. The review also identifies critical evidence gaps, particularly concerning long-term clinical outcomes, patient experience, and cost-effectiveness, providing priorities for future research and policy to promote safe, ethical, and sustainable adoption.
None.
Hand burns, although often limited in surface area, have a major impact on function and quality of life. Debridement—surgical or enzymatic—is a key component of treatment, with enzymatic debridement increasingly used for its selectivity and potential to preserve viable dermis. To evaluate and compare the functional outcomes of hand burns treated with surgical versus enzymatic debridement, using the DASH/Quick-DASH and Michigan Hand Questionnaire (MHQ) assessment tools. A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251034408). Searches were performed in PubMed, Scopus, and Web of Science without date restrictions. Inclusion criteria focused on studies evaluating hand burn function using DASH, Quick-DASH, or MHQ after enzymatic or surgical debridement in patients aged 16 or older. Methodological quality was assessed using the ROBINS-I tool. Of 547 studies identified, 7 met inclusion criteria: 4 surgical and 3 enzymatic. Functional recovery was generally better in cases where enzymatic debridement preserved viable dermis and avoided grafting. DASH and MHQ scores favoured enzymatic approaches, especially when conservative management followed debridement. However, methodological limitations and clinical heterogeneity limited direct comparison. Enzymatic debridement, through preservation of viable dermis and reduced grafting need, appears associated with improved functional outcomes in hand burns. Whilst surgical debridement remains essential for deeper burns, enzymatic methods may offer functional advantages and support early rehabilitation in appropriate cases.
To examine the contexts and mechanisms that enable compassionate mentorship in healthcare, in order to generate evidence-informed insights for fostering healthier, more sustainable work environments.
A rapid realist review.
Systematic searches were conducted in Ovid MEDLINE (1946–December 2024), Embase (1974–December 2024) and CINAHL (1981–December 2024). Additional sources included Google Scholar searches, reference list scanning and grey literature (e.g., practice guidelines, policy briefs, professional reports). The review was conducted between August 2024 and July 2025.
Realist review methods were applied to answer the question: What works, for whom, under what circumstances and why? The review proceeded in four stages: defining scope and research questions with an expert panel; iterative searching and screening; data extraction and synthesis into context–mechanism–outcome configurations (CMOCs); and development of a programme theory.
Twenty-two documents were included, spanning nursing, medicine, allied health and interdisciplinary contexts. Six CMOCs were identified, encompassing the following themes: (1) relationship compatibility; (2) vulnerability and self-exploration; (3) growth through untapped strengths; (4) anti-oppression and equity; (5) mentors' pride and confidence; and (6) culture of mentorship. The resulting programme theory conceptualises compassionate mentorship as a dynamic, multi-level process with cumulative impacts on individual well-being, professional development and organisational culture.
Compassionate mentorship represents not only a relational practice but also a structural intervention for healthier workplaces. Programmes should prioritise compatibility, cultivate psychological safety, invest in mentee growth, embed equity, recognise mentor contributions and institutionalise mentorship culture.
These strategies offer actionable pathways to strengthen workforce resilience, retention and sustainability.
One co-author is a retired nurse, ethicist and person with lived experience in the healthcare system. This co-author was integral to this project, serving on the scientific steering committee from project conceptualisation and funding application through study conduct and publication.
The international mobility of nurses is a significant component of healthcare systems worldwide, resulting in the global recruitment and adaptation of culturally and linguistically diverse nurses into diverse work environments. CALD nurses face integration challenges, which can potentially compromise their well-being and adjustment to the new setting. Psychological safety is a key component to promoting individual well-being and effective organisational integration.
This systematic review aimed to identify the current evidence on the psychological safety of culturally and linguistically diverse nurses in healthcare work environments and the factors associated with it.
This systematic review was conducted using JBI guidelines. PiCo/PEO format was utilised for inclusion and exclusion criteria, including English/Finnish, without time limitations. The screening process was conducted by two independent researchers, with a third researcher resolving the conflicts. The PRISMA checklist was utilised in reporting. Data were analysed using content analysis for qualitative and data synthesis for quantitative.
CINAHL, PubMed, ProQuest, Scopus and Medic. Search period: 24.10.2024–23.1.2025.
The systematic review yielded 15 qualitative, one mixed-methods and one quantitative article. The content analysis produced 270 codes, 67 subcategories, seven categories and two main categories. Professional growth and acceptance captured inclusion, professional competence and support from colleagues and managers in creating job satisfaction. Marginalised disempowerment reflected factors linked to low psychological safety, contributing to reduced job satisfaction in the workplace.
Healthcare organisations should confront existing inequities on psychological safety in culturally diverse healthcare environments that are structured around professional inequalities to create equitable spaces for CALD nurses. More research is needed to understand psychological safety experiences from the CALD nurse perspective, exploring the equitability of facilitating factors amid systemic disadvantages in the healthcare workplace.
No patient or public involvement.
Prospero registration: CRD42024581860
To provide an overview of quantitative research studies that report inferential statistics on the associations between interruptions and medication administration errors among nurses in hospital settings.
A scoping review guided by the Joanna Briggs Institute methodology for scoping reviews.
Quantitative research studies conducted among nurses in hospital settings and published in English were sought. Covidence software was used by two authors to independently screen titles, abstracts, and full-text articles. Two authors performed an independent data extraction using a standardised extraction template.
Ovid Medline, EMBASE (Elsevier), CINAHL (EBSCOHost), Web of Science, and Scopus databases were searched from the database inception through October 2024. Citation searching was also used to locate relevant studies.
Twenty-two studies met the review criteria. Studies were conducted in nine different countries, often in more than one hospital, and in various nursing units. Definitions of interruption and medication administration error frequently differed across studies or were not provided. Data were collected via direct observation, self-report survey, a combination of direct observation and self-report, or retrospective review of records. Most (n = 16; 73%) studies reported a statistically significant positive association between interruptions and medication administration errors.
Globally, interruptions are prevalent during nurse medication administration, and a majority of studies report a positive association between interruptions and medication administration errors. Continued investigation of this association using standard definitions of interruption and medication administration error, as well as consistent methods, is needed to strengthen research in this area.
The findings from this review can be used to inform future primary research, potential systematic reviews, and the development of targeted interventions to enhance medication safety and nursing practice in hospital environments worldwide.
Reporting was guided by Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews.
No patient or public contributions were made to this scoping review.
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 identify successful strategies and underpinning mechanisms for retaining nurses in home visiting nursing services.
Scoping review.
MEDLINE, CINAHL, Google Scholar, Theses Global Databases (1 January 2000 to 23 November 2023); international nursing organisations websites (January–April 2024).
The methods followed the Joanna Briggs Institute guidance. Two researchers independently screened and reviewed, with disagreements resolved through discussion. Included papers were analysed for underlying mechanisms.
Of 1219 records identified, seven met the criteria. Four papers reported senior administrators' experience of successful multiple types of strategies (unspecified), but none reported retention outcomes. Three papers reported evaluations of initiatives providing clinical and peer support to nurses new to home visiting nursing. All three papers reported improved retention rates at 12 months in comparison to the year previous, although there was no consideration of other potentially influencing factors. We identified eight underlying mechanisms in the seven papers: (1) finance incentives; (2) work schedule flexibility for individuals; (3) team level management; (4) positive feedback on job performance; (5) team level interpersonal relationships; (6) the work organisation and resources; (7) support to individual's development in knowledge, clinical skill and confidence and (8) participation in organisation's decision making.
This review identified noticeable few papers over a time when all countries have been trying to address the growing health needs of the older populations. The gap in evidence as to the most effective combinations of retention strategies for home visiting nursing requires urgent attention. Clinical leaders and managers require evidence to inform their strategies for retaining home visiting nurses in order to provide high quality care as more health care systems increase the provision of acute, chronic, and palliative care in patients' own homes.
This paper conforms to PRISMA reporting guidelines for scoping reviews.
No patient or public contribution.
Communicating a clear, authentic and socially coherent image among nurses and their associations is essential because it helps shape an accurate perception of their role in society. Thus, although each nurse plays a crucial role individually, real transformation in the public perception of the profession requires coordinated and strategic actions by the organisations representing them.
This study explored existing knowledge on how nursing colleges, professional associations and unions communicate with their stakeholders.
A scoping review was performed following the methodological framework proposed by Arksey and O'Malley and the Joanna Briggs Institute. Eight electronic databases were searched, including CINAHL, Cochrane, Dialnet, Scopus, Scielo, PsycINFO, PubMed and Web of Science for both peer-reviewed articles and grey literature (e.g., reports, policy documents), using both MeSH terms and keywords. Data were collected using the Covidence platform, and articles published in English, Spanish, Portuguese and Italian were included. No limitations were applied regarding the publication year of the articles. They were then independently analysed based on their titles, abstracts and full text according to predefined inclusion and exclusion criteria. Conflicts were resolved via discussions with a third reviewer.
In total, 2033 articles were analysed from databases, of which 47 met the inclusion criteria. Eighteen studies used a structured methodology, while 29 were categorised as grey literature. The findings were organised into five key themes: (1) what organisations communicate (e.g., labour conditions, political content, health information); (2) with whom they communicate (e.g., nurses, journalists, political actors, the public); (3) for what purpose (e.g., advocacy, education, recruitment); (4) through what media (e.g., social media, websites, professional journals) and (5) how communication is evaluated (limited but promising insights on effectiveness).
This review provides the first diagnosis of communication management in professional nursing organisations. The lack of communication structures, trained professionals and effective strategies limits the effectiveness of communication among the entities. Studies are necessary to diagnose these shortcomings and design plans to improve the visibility and impact of their messages, positioning nurses as qualified and respected professionals.
A review protocol was developed and registered in the Open Science Framework platform.
Because the research is a scoping review.
To synthesise the evidence on implementation strategies used to implement transitional care interventions for adult surgical patients.
Scoping review.
Medline, CINAHL and EMBASE were searched in August 2023 and updated June 2025, followed by citation searches. Studies were screened independently by two researchers, and one extracted data, another verified its accuracy. Studies about transitional care interventions for adult surgical patients were coded according to the ‘Five classes of implementation strategies’ and the ‘Patterns, Advances, Gaps, Evidence for practice and Research recommendations’ framework, to illuminate the review findings.
Based on 27 studies included in the scoping review, staff education, changes to staffing and electronic systems, and change management techniques were frequently used implementation strategies. Implementation strategies were mostly used with patients undergoing colorectal and cardiac surgery in Asia and the United States. Scale-up strategies and capacity-building initiatives for people in charge of spearheading the change initiatives were less common.
To further the field, future research could focus on capacity-building and scale-up strategies, fidelity reporting, and financial implications of implementation in a wider range of surgical populations and settings. Work is needed to effectively implement surgical transitional care interventions in real-world settings.
Our findings provide strategies for hospital leaders to adopt when implementing transitional care interventions for surgical patients.
Scoping Reviews (PRISMA-ScR) checklist.
Determined review focus, interpreted findings, and contributed to manuscript.
The Open Science Framework.
To explore the direct relationship between financial stress and mental health and wellbeing of nursing students and characterise the effectiveness of available support mechanisms.
Systematic integrative review.
Academic Search Complete, CINAHL, Education Research Complete, MEDLINE, ProQuest Central, PsycNET, Scopus and Web of Science were searched in January and October 2024.
Studies reporting a direct relationship between financial stress and mental health and wellbeing in nursing students were included. Data related to sources of financial stress, mental health impacts, and support mechanisms were extracted, synthesised narratively, and reported thematically.
Findings from nine studies reveal that financial stress significantly affects nursing students' mental health and wellbeing, contributing to emotional distress and reduced quality of life. Financial stress arises from personal, academic and clinical sources, with the intensity varying based on individual demographic profiles and fluctuating throughout their educational journeys. Marginalised and underserved groups experience greater impacts due to pre-existing disadvantages. Current support mechanisms are largely reactive, providing only short-term relief and failing to address root causes. Additionally, students' efforts to alleviate financial stress in one domain often exacerbated it in another.
This review highlights the multifaceted and compounding effects of financial stress on nursing students' mental health and wellbeing. Proactive strategies, including structured employment programs, embedded financial literacy education, and transparent pre-enrolment information offer promising solutions.
While financial stress cannot be fully eradicated, targeted support for at-risk students can mitigate its impacts, improving their mental health and educational outcomes.
This review addresses the critical issue of financial stress among nursing students, highlighting its disproportionate impact on marginalised and underserved groups. It underscores the need for proactive interventions and systemic reform to improve educational experiences globally.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement.
No patient or public contribution.
Trial Registration: PROSPERO: CRD42024514262
To identify the available records surrounding the deployment of perioperative nurses into differing clinical settings during the COVID-19 pandemic.
Integrative review methodology.
Quality appraisal of each record was conducted using a modified Critical Appraisal Skills Programme checklist. Data were extracted and presented based on outlined research objectives.
Six electronic databases (CINAHL Plus, Google Scholar, MEDLINE, Pubmed, Scopus, and Web of Science) were searched, with relevant peer-reviewed records published after 2019 until February 2025 included to differentiate from other respiratory pandemics.
Ten records were included in the review. Opposing discourse exists between perioperative decision makers and those perioperative nurses who underwent deployment to differing clinical areas surrounding perceptions and experiences of deployment during the COVID-19 pandemic.
Few studies exist exploring experiences of perioperative nurse deployment to a different clinical area during the COVID-19 pandemic. Further research is vital to develop strategies that enhance the deployment process and ensure effective patient care across various clinical settings when cared for by deployed perioperative nurses.
Further research exploring transferable perioperative nursing skills and its subsequent influence on safe patient care may enhance and inform nurse deployment practices, enriching future staffing protocols in the event of a future pandemic.
PRISMA guidelines for reporting systematic reviews guided this review.
This study did not include patient or public involvement in its design, conduct, or reporting.
To review current evidence on the implementation and impact of virtual nursing care in long-term aged care.
An integrative rapid literature review.
Medline, CINAHL, Web of Science, Embase, Ageline and Scopus.
The review included studies involving virtual care interventions provided by nurses (or by a multidisciplinary team including nurses) to older people in residential aged care that reported health outcomes or stakeholder experiences. Consistent with PRISMA guidelines, databases were systematically searched in July and August 2024, focusing on literature published since 2014. Studies were screened in Covidence by three team members, with conflicts resolved by additional reviewers. Studies not involving nurses or not set in aged care were excluded.
The search identified 13 studies, which included quantitative, qualitative and mixed-method approaches, conducted in both Australian and international settings, as well as in rural and metropolitan locations. Nurses were often involved as part of an existing virtual care programme, typically located in a hospital setting. The training and credentials of nurses delivering VN varied in terms of specialisation and advanced practice. The model of care in general was ad hoc, though in some cases there were regular, scheduled VN consultations. The time requirements for onsite staff and nurses were not well articulated in any of the studies, and information on the funding models used was also lacking.
There is some evidence that VN interventions in aged care may improve communication, enhance person-centred care and reduce emergency department presentations and hospitalisations.
Rigorous, ongoing evaluation of VN interventions is required to ensure their appropriate application in residential aged care.
To identify adverse outcomes and factors associated with diabetes mellitus among children and youths in East Africa.
This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
No date restrictions were applied to searches of the Ovid MEDLINE, Embase, PubMed, CINAHL, Scopus, Web of Science, Cochrane Library databases and Google Scholar. The review identified and included literature published between 2007 and 2024.
Independent reviewers conducted study selection, data extraction, and quality assessment. Data were organised in Microsoft Excel, detailing study characteristics, demographics, exposures, and outcomes. Narrative synthesis summarised the data, while meta-analysis yielded pooled proportions.
From 3797 publications, 30 studies involving 6109 children and youths with type 1 diabetes were included. Findings revealed that between 39.3% and 99% did not achieve target glycaemic levels. Diabetic ketoacidosis at diagnosis ranged from 35.8% to 78.7%. Pooled estimates indicated mortality in 6.47%, nephropathy in 15.66%, and retinopathy in 27.49% of the cases. Other complications included decreased health-related quality of life, lipodystrophy, psychiatric disorders, and stunting.
This review highlights the need for context-specific, personalised diabetes care for children and youths in East Africa. It underscores the need for healthcare professionals, particularly nurse diabetes educators, to provide personalised, holistic care and education. Policies that strengthen health systems, expand health insurance, and improve access to care are critical priorities to improve outcomes for these populations.
This study provides new information on diabetes-related complications and management challenges among children and youths in East Africa. Findings flag the urgent need for integrated care, standardised diagnostic criteria, and improved access to resources, with implications for healthcare providers, policymakers, and researchers to enhance health outcomes and quality of life.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the perspectives and experiences of maternity care providers regarding obstetric violence across low-, middle-, and high-income countries.
An integrative review of the literature.
A systematic literature search in CINAHL, Medline (via Ovid), SCOPUS, and the Cochrane Library was conducted from 2014 to 2024. Further papers were identified through a review of the reference lists of identified studies and through email alerts from searched databases. Articles were appraised using the applicable Joanna Briggs Institute qualitative or cross-sectional critical appraisal tool.
Title and abstract screen were undertaken on 2748 records. Fifty-four studies using qualitative, quantitative, and mixed-methods designs were included. Maternity providers across all socio-economic levels described witnessing, and/or involvement in both respectful care and incidents of obstetric violence. The most common forms of obstetric violence were verbal and physical abuse, coercion, unconsented and unnecessary interventions, and violations of privacy and autonomy. Women who were socially marginalised, impoverished, and illiterate were vulnerable to obstetric violence. Differences were noted between low- and high-income countries, with detention of women for non-payment, privacy violations due to building design and lack of space, mistreatment due to HIV status, and women who were considered non-compliant being more vulnerable to obstetric violence in low-and low-middle-income countries. Obstetric violence was justified and normalised in the name of saving the baby, with less focus on the psychological health of the mother.
Our findings demonstrate that obstetric violence is a gender-based violence enabled through patriarchal structures and power imbalances. Maternity providers are witnessing or enacting obstetric violence across low-, middle- and high-income countries, with significant impacts on women and maternity care providers alike. This review highlights opportunities for further research and action to develop health and legal frameworks to prevent instances of obstetric violence and improve outcomes for women and maternity care providers.
A woman-centred approach underpinned by respectful maternity care has benefits for pregnant and birthing women. Obstetric violence, including verbal and physical abuse, coercion, and overmedicalisation, is prevalent in maternity services globally. This integrative review explored the perspectives and experiences of maternity care providers regarding obstetric violence across low-, middle-, and high-income countries. This review highlights the similarities and differences of witnessed, enacted, and perceived obstetric violence from the experience of maternity care providers. This review identifies the covert and overt nature of obstetric violence across low-, middle- and high-income countries. Gaining insight into provider perspectives across low-, middle-, and high-income countries may inform policy and practice reforms to eliminate obstetric violence and advance the provision of respectful maternity care.
This integrative review adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.
No patient or public contribution.
Ethnic minoritized women face cultural and systemic barriers in accessing antepartum and intrapartum care. Healthcare providers play a pivotal role in addressing these challenges, but their perspectives and experiences in delivering culturally competent care remain underexplored.
To synthesise healthcare providers' experiences and perspectives on providing culturally competent antepartum and intrapartum care for ethnic minoritised women.
A qualitative meta-synthesis study design was employed. Six electronic databases were searched from their inception date till January 2025. The included studies were assessed using the method of the Critical Appraisal Skills Programme tool, and findings were meta-synthesised using Sandelowski and Barroso's six-step approach. This review was registered via the International Prospective Register of Systematic Reviews.
Overall, 38 studies were included, and three themes emerged. The first theme revealed how providers' biases and professional training distorted their ability to understand and respect cultural practices. The second theme underscored the impact of systemic barriers such as time constraints, resource scarcity and lack of representation among providers. The final theme highlighted healthcare providers' aspirations for improved communication, targeted training and guidance on building trust to enhance care delivery.
Healthcare providers encounter notable challenges in delivering culturally competent antepartum and intrapartum care, but remain hopeful about bridging gaps in communication and understanding. Practical recommendations include implementing mandatory cultural competency training at all levels of healthcare professional education, increasing resources for interpreters and cultural liaisons and fostering diversity within the healthcare workforce. Future research should explore patient-centred interventions and systemic reforms to improve care for ethnic minoritised women. These findings highlight the need for policies and practices that empower providers to deliver equitable, culturally respectful antepartum and intrapartum care.
No patient or public contribution.
To review the evidence on the experiences and perceptions of culturally and linguistically diverse informal carers supporting older adults during transitions from hospital to home, including their interactions with transitional care interventions.
Scoping review guided by Arksey and O'Malley's framework.
We searched CINAHL, MEDLINE, Embase, Emcare, AMED, PsycINFO, Global Health, Social Work Abstracts, JBI EBP, Scopus, Web of Science Core Collection, ProQuest and Informit for studies published between January 2010 and November 2024.
Two reviewers independently screened studies and extracted data. Analysis followed the Patterns, Advances, Gaps, Evidence for Practice and Research recommendations framework.
Seventeen studies involving 1275 carers were included. Carer experiences were summarised into four themes: (1) cultural and communication barriers; (2) role ambiguity and practical challenges; (3) limited involvement in discharge planning and (4) barriers to accessing support and services. Perceptions of transitional care interventions were mixed. While some interventions improved carer preparedness and reduced stress, most lacked cultural tailoring and did not address carers' psychosocial and communication needs.
Culturally and linguistically diverse informal carers face challenges navigating transitional care. While involving them in care planning improves outcomes, implementation remains inconsistent. Emotional support and culturally tailored services are insufficient.
There is a need for culturally and linguistically tailored transitional care programmes that prioritise carer education and communication support. Key areas for improvement include: (1) health literacy and system navigation; (2) involvement in care planning; (3) communication with providers; (4) psychosocial and emotional support and (5) culturally appropriate services. Future research should explore the unique emotional and psychosocial needs of these carers to inform targeted support strategies.
This review follows the PRISMA guideline for reporting.
No patient or public contribution.
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