Syndemics of depression, sick role and activation status among newly diagnosed adults with diabetes mellitus in Bahir Dar, Ethiopia: a 6-month follow-up study protocol

The Power of a Ricoeur‐Inspired Phenomenological‐Hermeneutic Approach to Focus Group Interviews

ABSTRACT

Aim

To justify the use of focus group interviews with patients and healthcare professionals within a phenomenological-hermeneutic approach inspired by the theory of the French philosopher Paul Gustave Ricoeur.

Design and Methods

Methodological guidance and discussion grounded in Ricoeur's theory on narrative, dialogue, threefold mimesis and interpretation.

Results

This phenomenological-hermeneutical approach to focus group interviews yields significant, in-depth understandings of lived experiences from both patients and healthcare professionals.

Conclusions

Ricoeur-inspired phenomenological-hermeneutical focus group interviews with patients and healthcare professionals offer a promising approach for exploring and generating new, valuable insights into the complexities of clinical nursing practice. Thus, this paper argues for an integration of focus group interviews and a phenomenological-hermeneutical approach within nursing science.

Implications for the Profession

The approach has significant implications for nursing practice. By incorporating Ricoeur-inspired dialogue-based collective voices of patients and healthcare professionals in focus group interviews, nursing practices can be refined, leading to improved patient care and more effective clinical interventions. Thus, this approach advocates for a broader adoption of Ricoeur-inspired focus group interviews in nursing research and in health research in general to enhance the understanding and development of clinical models.

Reporting Method

No available EQUATOR guidelines were applicable to this methodological paper, as no new data were created or analysed.

Patient or Public Contribution

As this is a methodological paper, no new patient or public contributions are included.

Commonalities and distinctions of pediatric patient and family engagement in clinical care, education, and research contexts: Protocol for a scoping review

by Brooke Allemang, Francine Buchanan, Pranshu Maini, Dalya Kablawi, Lin Li, Linda Nguyen, Kimberly Courtney, Jessie Cunningham, Carla P. Southward, Kristin Cleverley, Sarah Munce, Alene Toulany

Pediatric patient and family engagement is an active and collaborative process, that involves children, adolescents, and family members with lived experience contributing to the design, implementation, and evaluation of healthcare services. Prior studies have highlighted the patient engagement methods and impact in clinical care, education, and research. However, gaps remain in understanding the commonalities and distinctions of engagement approaches, patient/family partner roles, and outcomes in clinical care, education, and research contexts. Further, research examining the nuances of pediatric patient and family engagement within healthcare delivery, education, and research in pediatric institutions is needed to streamline efforts.

This scoping review will identify the commonalities of and distinctions between pediatric patient and family engagement in clinical care, education, and research contexts in pediatric healthcare institutions.

A scoping review, conducted in collaboration with a team of adolescent, young adult, and family partners, will allow us to systematically map out key concepts, evidence, and knowledge gaps regarding pediatric patient and family engagement in clinical care, education, and research. We will follow the Joanna Briggs Institute framework in the design and conduct of the review and guidance on engaging knowledge users within scoping reviews. The protocol for this scoping review has been registered with the Open Science Framework database (https://osf.io/63qx5).

This study will describe the engagement types, approaches, and outcomes of pediatric patient and family engagement employed within clinical care, education, and research settings, highlighting commonalities and distinctions across contexts. In doing so, it will identify potential opportunities for collaboration and resource-sharing based on the context of engagement and provide needed clarity on streamlining pediatric patient and family engagement approaches within pediatric institutional settings.

It is anticipated that the results will produce preliminary evidence of relevance to pediatric institutions seeking to consolidate engagement practices across clinical care, education, and research domains.

Maternal near-miss prediction model development in Bahir Dar city administration, Northwest Ethiopia

by Yinager Workineh, Getu Degu Alene, Gedefaw Abeje Fekadu

Maternal near-miss is a serious public health concern in impoverished countries such as Ethiopia. Despite its huge burden, the prognostic predictive model of maternal near-miss has received little attention in research in the Ethiopian context. As a result, this study aimed to build and validate (internally) a clinical prediction model of maternal near-miss in Bahir Dar City, Northwest Ethiopia, in 2024.

A prospective follow-up study was conducted among 2110 randomly selected pregnant women in Bahir Dar city between May 1, 2023, and March 6, 2024. Pregnant women with gestational age less than 20 weeks were included in the cohort and followed up to 42 days after delivery. Data were extracted from antenatal care records and collected by an interview-administered questionnaire. The model was developed using the standard Cox regression model, and model fitness was checked using the Schoenfeld assumption test. After applying a stepwise elimination, a p-value of less than 0.15 was used to fit the reduced model. Both discrimination and calibration were used to assess the model’s performance. The model was internally validated through the bootstrapping method. The clinical usefulness of the model was checked using decision curve analysis. A nomogram was used for the model presentation.

Maternal near-miss incidence density rate was 1.94 per 1,000 woman-weeks. Maternal age, residence, decision-making power, intention to pregnancy, time of antenatal initiation, genital mutilation, history of cesarean section, middle upper arm circumference, systolic blood pressure, hemoglobin, and history of obstetric morbidity were identified as important predictors to predict maternal near-miss. The model demonstrated good discriminatory performance with a C-index of 0.82(95%CI: 0.80–0.85), and good calibration with close alignment with 45 degrees. A simplified risk score of 40 maximum points was developed. The model was presented using a nomogram.

The maternal near-miss incidence density rate was high in the present study. Socio-demographic and clinical factors were key variables for predicting maternal near-miss. The model has good discrimination and calibration. The researchers recommend external validation in different settings to assess the model’s generalizability before applying it to clinical settings.

Comorbid cardiovascular diseases and predictors among adults with type 2 diabetes in Bahir Dar city, Ethiopia: a multicentre hospital-based cross-sectional study

Incidence of major adverse kidney events after ICU admission in COVID-19 and non-COVID-19 ARDS patients

Clinical performance and cost‐effectiveness of a Silicone foam with 3DFit™ technology in chronic wounds compared with standard of care: An open randomised multicentre investigation

Abstract

The objective of the study was to show the clinical performance and cost-effectiveness of a Silicone foam dressing with 3DFit™ Technology compared to current standard of care. This was an open-labelled, two-arm, randomised controlled multicentre study conducted from February to December 2023. One hundred and two participants with an exuding, non-infected and chronic ulcer were randomised in a 1:1 fashion and treated with either a Silicone foam with 3DFit™ Technology or standard of care (a filler combined with a secondary dressing), stratified by venous leg ulcers and diabetic foot ulcers. After a 4-week study period, wound size and total costs were evaluated. After 4 weeks of treatment, a comparable percentage in wound area reduction was observed in both treatment arms with mean and 95% confidence interval of 54.3% (37.1%; 71.5%) and 43.0% (26.5%; 59.6%) for the investigational and comparator dressing, respectively. This corresponded to a mean difference of 11.3% ([−10.22; 32.86], p = 0.299). Total mean estimated costs were significantly lower for the investigational dressing (£14.3, 95% confidence interval [£9.6; £19.0]) compared to the two-dressing regime (£21.4 [£16.9; £26.0]), corresponding to a 33% price reduction (p = 0.033) after 4 weeks of treatment. With this RCT, a conforming Silicone foam dressing with 3DFit™ Technology was shown to be clinically comparable and a cost-effective alternative to using a filler and a secondary dressing at a significantly lower cost in both venous leg ulcers and diabetic foot ulcers up to 2 cm in depth.

Tiempos de pandemia: nivel de satisfacción de docentes universitarios en el desarrollo de las clases virtuales

Las TICs permiten que el estudiante acceda al material de estudio y, a su vez, interactúe con el profesor y con otros estudiantes. La pandemia COVID-19 ha obligado a docentes a impartir clases virtuales de urgencia para cumplir con las actividades académicas programadas.

El objetivo es analizar el nivel de satisfacción de docentes en el desarrollo de las clases virtual en tiempos de pandemia. El diseño fue observacional, descriptiva, de corte transversal, enfoque cuantitativo, el universo estuvo compuesto por docentes de la FENOB-UNA Casa Central y Filiales, con una muestra de 114 docentes, la selección se realizó a través de un muestreo no probabilístico de casos consecutivos, la recolección de datos se hizo a través de una encuesta en línea con un cuestionario elaborado por las investigadoras, validada por expertos. Los hallazgos más relevantes fueron: mayoritariamente de sexo femenino, del grupo etario de 36 a 55 años, de estado civil casado, procedentes del departamento Central, son docente catedráticos y ejercen su labor solamente en la FENOB-UNA, cuenta con conexión a internet, utiliza computadora portátil y destina 2 horas para las clases. El análisis entre las características sociodemográficas y el nivel de satisfacción con el desarrollo de las clases virtuales es estadísticamente significativo con la variable edad. Se concluye que el nivel de satisfacción de docentes en el desarrollo de las clases virtuales en tiempos de pandemia fue medianamente satisfecho.

ABSTRACT

ICTs allow the student to access the study material and, in turn, interact with the teacher and other students. The COVID-19 Pandemic has forced teachers to teach emergency virtual classes to comply with scheduled academic activities. The objective is to analyze the level of satisfaction of teachers in the development of virtual classes in times of pandemic. The design was observational, descriptive, cross-sectional, quantitative approach, the universe was made up of teachers from the FENOB- UNA Central House and Subsidiaries, with a sample of 114 teachers, the selection was made through a non-probabilistic sampling of cases. consecutive, data collection was done through an online survey with a questionnaire prepared by the researchers, validated by experts. The most relevant findings were: mostly female, in the age group of 36 to 55 years, with married marital status, from the Central Department, are professors and work only at FENOB-UNA, have an internet connection, He uses a laptop and allocates 2 hours for classes. The analysis between the sociodemographic characteristics and the level of satisfaction with the development of virtual classes is statistically significant with the age variable. It is concluded that the level of satisfaction of teachers in the development of virtual classes in times of pandemic was moderately satisfied.