With the COVID-19 pandemic driving people into social isolation, causing a financial crisis and creating uncertainty, individuals were at an even greater risk of experiencing negative mental health outcomes. Individuals who identify as women living with diabetes mellitus (DM) of low socioeconomic status (SES) are potentially at increased risk of negative mental health outcomes secondary to health-related risks of COVID-19, as well as financial barriers to access to medications and diabetes-care supplies.
The objective of this scoping review is to investigate how the COVID-19 pandemic affected the mental health of those who identify as women living with DM of low SES including the consequences of public health measures put in place to stop the spread of the virus. The review aims to identify what is known about the impact of COVID-19 on this and identify potential areas for further investigation.
The scoping review protocol was developed with guidance from the framework created by Arksey and O’Malley and refinements from the Joanna Briggs Institute and Levac et al published studies employing experimental and correlational designs to collect quantitative and/or qualitative data will be considered. Search strategies were developed for the MEDLINE, Embase and PsycINFO databases to identify relevant sources. Article titles and abstracts will be screened for eligibility by two independent reviewers. Full-text review will be conducted by two reviewers with a third reviewer being included if disagreement must be resolved. Data extraction will be conducted by two reviewers, one extraction and one quality check, and a third will resolve conflict if necessary. Data will be synthesised and reported in a narrative structure that provides a thematic analysis of the currently available literature.
As this is a scoping review, there are no ethical approval requirements. There is to be a full publication of findings and analysis in a peer-reviewed journal.
This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.
A prospective cohort design.
A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.
The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.
We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.
These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.
This study adhered to the STROBE checklist.
Patients and their caregivers contributed by participating in the study and completing the questionnaire.
Marginalised populations—such as racialised groups, low-income individuals, newcomers and those in rural areas—disproportionately experience severe diabetes-related complications, including diabetic foot ulcers, retinopathy and amputations, due to systemic inequities and limited access to care. Although community-based programmes address cultural and accessibility barriers, their isolation from mainstream healthcare systems leads to fragmented care and missed opportunities for early intervention.
Artificial intelligence (AI)-powered technologies can enhance accessibility and personalisation, particularly for underserved populations. However, integrating AI into community settings remains underexplored, with socioethical concerns around inclusion, diversity, equity and accessibility requiring urgent attention.
This realist review aims to examine how, why and under what circumstances AI applications can be effectively integrated into community-based diabetic care for marginalised populations. The review will develop a programme theory to guide ethical, inclusive and effective AI implementation to ensure AI-driven innovations address health disparities and promote culturally sensitive, accessible care for all.
Using the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) extension for Reviews guidelines, this realist review will systematically search MEDLINE, Embase, CINAHL, Cochrane library, Google Scholar and Scopus, alongside grey literature. A two-stage screening process will identify eligible studies, and data extraction will use a developed tool. Synthesis will employ realist logic, analysing relationships between contexts (eg, organisational capacity), mechanisms (eg, AI functionalities) and outcomes (eg, reduced disparities).
Ethics approval is not required for conducting this realist review. Ethics approval will be obtained from the University of Toronto; however, following the completion of the realist review for patients and community members’ engagement to support knowledge mobilisation and dissemination to ensure practical application and reciprocity.
This protocol was registered at PROSPERO (CRD42025636284).
Congenital cytomegalovirus (cCMV) is an important cause of long-term childhood disability. In Australia, the identification and treatment practices and the long-term clinical and neurodevelopmental outcomes of children with cCMV are unknown. The Australasian cCMV Register (ACMVR) is a longitudinal register and resource for research that aims to describe and explore, in Australian children with cCMV: (1) their clinical characteristics over time, (2) antiviral therapy use/prescribing up to 1 year of age and (3) risk factors and potential avenues for prevention of adverse sequelae of the virus.
Children
Ethics and governance approvals, study database and a steering group have been established. Data collection is active in five sites across Australia.
The ACMVR will inform our understanding of the long-term outcomes for children with cCMV in Australia and provide a sampling frame and resource for recruitment in future clinical and epidemiological research to inform practice and policy. New opportunities for the establishment of additional study sites and collaborations with Australian maternity and fetal medicine researchers and with cCMV registries in other countries are currently being explored.
A consensus study to establish a Core Outcome Set for dysarthria after stroke identified four key outcome domains that should be measured in research and clinical practice: (1) intelligibility of speech, (2) ability to participate in conversations, (3) living well with dysarthria and (4) communication partners skills and knowledge (where relevant). This review aimed to systematically identify corresponding measurement instruments and to examine their clinical utility and psychometric properties.
Systematic review conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
CINAHL, EMBASE, MEDLINE, PsycInfo and Cochrane Stroke Group Trials Register, CENTRAL, Linguistics and Language Behavioral Abstracts (LLBA). Major trials registers: WHO ICTRP, ISRCTN registry and ClinicalTrials.gov searched March 2024.
We included trials that developed or used measurement instruments for poststroke dysarthria. We identified studies that could be included in an update of the Cochrane systematic review of interventions for non-progressive dysarthria to identify what measurement instruments were used in therapy trials for poststroke dysarthria.
Records were screened independently by three authors. Psychometric data were extracted, by two authors, from included studies and methodological quality was evaluated using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) and Core Outcome Measures in Effectiveness Trials (COMET) guidance. Assessment of clinical utility followed Outcome Measures in Rheumatology (OMERACT) guidance.
Following screening, 19 publications reporting 12 measurement instruments were identified. According to COSMIN standards, all 19 publications were rated as having low, very low or unknown quality of evidence. Three measurement instruments were identified as having the most relevant clinical utility to the population, the highest quality of evidence and had the potential to measure some specific aspects from three of the four agreed domains, intelligibility, conversations and living well with dysarthria from the patient and clinician perspective. These were the Frenchay Dysarthria Assessment II, the Communication Outcomes After Stroke Scale and the Therapy Outcome Measures for Dysarthria.
This review provides a comprehensive overview and appraisal of dysarthria measurement instruments to align with a Core Outcome Set. We only included English language-based measurement instruments. Many dysarthria measurement instruments were developed for non-stroke populations, including progressive dysarthria, with limited psychometric data for stroke. Measurement instruments with uncertain quality of evidence can still be considered for inclusion with a Core Outcome Set and three have been suggested. There is a need for further psychometric testing of these and the development of new measurement instruments to cover all aspects of intelligibility, conversations, living well with dysarthria and communication partner skills.
CRD42022302998.
To examine the effects of depression on dyadic self-care in stroke patients and their caregivers, as well as the potential mediating role of self-efficacy in this relationship.
A multi-centre cross-sectional study design was employed.
From May to September 2022, stroke patients and their caregivers were recruited from China using a multi-centre stratified sampling method. Data analysis was conducted using a structural equation model based on the Actor-Partner Interdependence Model extended to include mediation. Depression in patients and caregivers was assessed using the Patient Health Questionnaire-9. The self-care self-efficacy scale was utilised to measure patient self-efficacy, while the caregiver self-efficacy in contributing to patient self-care scale was used for caregivers. Patient self-care was evaluated with the Self-Care of Stroke Inventory and caregiver contributions to self-care were assessed using the Caregiver Contributions to Self-Care of Stroke Inventory.
This study followed the STROBE checklist.
306 patient-caregiver dyads were enrolled. The direct effect between depression and dyadic self-care was not confirmed in stroke patients and their caregivers (p > 0.05). Patient self-efficacy had significant indirect actor effects on self-care maintenance (β = −0.173, p < 0.001), monitoring (β = −0.146, p < 0.001) and management (β = −0.186, p < 0.001). Caregiver self-efficacy had an indirect actor effect on caregiver contributions to self-care maintenance (β = −0.096, p < 0.001), monitoring (β = −0.073, p < 0.001) and management (β = −0.106, p < 0.001). The partner effect analysis showed caregiver self-efficacy plays a potential mediating role in the relationship between patient depression and caregiver contributions to self-care maintenance (β = −0.037, p = 0.036), monitoring (β = −0.028, p = 0.032) and management (β = −0.040, p = 0.036). Caregiver depression reduced caregiver self-efficacy, lowering patient self-care monitoring (β = −0.040, p = 0.004) and management (β = −0.047, p = 0.002) levels.
The findings indicate interactive effects between depression, self-efficacy and dyadic self-care among stroke patients and their caregivers. Therefore, the development of targeted dyadic interventions to address depression and enhance self-efficacy in both patients and caregivers should be considered.
Following a stroke, people often receive informal care from friends and family. Some carers adopt the role quickly, whereas others find it more difficult to see themselves as a ‘carer’ and do not access relevant support. To understand the process of how and when informal carers start to see themselves as such, and their preferred terminology and experiences of support in this role.
The study adopted an exploratory qualitative design, collecting data through semistructured interviews with participants and a brief survey of participant demographics. Data were analysed thematically using a template analysis approach. Patient, carer and public involvement collaboration, through a formed carer advisory group, enhanced the study methodology.
The project was a nationwide study, with participants residing across the UK. The study took place from September 2021 to April 2024.
18 adults (aged 18 years and above) who had provided care or support to a friend or family member after a stroke that occurred at least 1 year prior to participation completed the study.
Five main themes were developed: (1) adopting and adjusting to the care role, (2) accessibility of support, (3) perceptions of support, (4) acceptability of care-related language and terminology and (5) function of care-related language and terminology. Facilitators and barriers to participants self-identifying with the care role were identified. Self-identification was found to commonly occur at four key points along the stroke trajectory: instant recognition at the time of the stroke event; at the point of planning discharge from hospital; on initial return home from hospital; and at a later stage in the caregiving experience. Two main contrasting opinions around the acceptability of care-related terminology were shared: a favourable view of care-related language and a depreciative view. Accessibility of support services and suggestions for future support provision were discussed.
Individuals identify as ‘carers’ at different points and to different extents throughout the stroke trajectory. Findings outline the factors that facilitate this self-identification process and those which constitute challenges to adjusting to the role. Recommendations are made relating to the accessibility of support for informal carers of stroke survivors, including: use of more accessible and inclusive care-related language, educational needs relating to what a ‘carer’ is and involvement of carers and wider family in the rehabilitation process.
To systematically search, evaluate and synthesise the most robust evidence regarding pressure injury prevention in orthopaedic patients admitted to general wards.
The present study provides an evidence-based summary of the most robust findings, adhering to the evidence guidelines established by the Center for Evidence-Based Nursing of Fudan University.
According to the “6S” model, a systematic search was conducted for literature on pressure injury prevention among orthopaedic patients in general wards. The types of literature included guidelines, clinical decisions, expert Consensus, evidence summaries, etc. The search period covered the time from the beginning of the database up to December 2023.
The following databases and resources were systematically searched: Up To Date, JBI, NICE, WOCN, NZWCS, etc.
Fifteen literature sources were included, comprising one clinical decision, eight guidelines, one systematic review, and one expert Consensus. In these sources, a comprehensive collection of 34 pieces of best evidence was formed across six key topics: risk assessment, position management, skin care, device used for device-related pressure injury, nutritional assessment, and support, as well as health education and training. Among the evidence gathered, a strong recommendation was made for 18 pieces, while the remaining 16 received a weak recommendation.
This study provides a comprehensive synthesis of the most robust evidence on pressure injury prevention in orthopaedic patients, encompassing 34 pieces of evidence that can serve as valuable references for clinical practice. Before implementing this evidence, it is crucial to evaluate the specific contextual factors within different countries and medical institutions, as well as the facilitators and barriers influencing its application by healthcare professionals and patient's preferences. Furthermore, targeted evidence selection should be conducted through careful screening and subsequent adjustments in implementation, thereby offering a more scientifically grounded basis for clinical nursing practice. Future research endeavours should prioritise investigating strategies for effective evidence utilisation.
The prevention of pressure injuries poses a significant challenge for orthopaedic patients. This study presents a synthesis of 34 pieces of best evidence to provide guidance on preventive measures for pressure injuries in orthopaedic patients. Adhering to and implementing these 34 pieces of evidence can effectively aid in preventing pressure injuries in clinical practice. This evidence encompasses risk assessment, position management, skin care, device usage for device-related pressure injuries, nutritional support and evaluation, and health education and training, establishing a comprehensive and systematic implementation process. Assessing the risk of pressure injuries during interventions serves as an essential prerequisite for developing effective strategies to prevent such injuries among orthopaedic patients. Ultimately, this study will offer valuable guidance to healthcare professionals worldwide regarding preventing pressure injuries in orthopaedic patients.
Upon admission to the hospital, it is essential to conduct a risk assessment and implement evidence-based, individualised prevention measures for pressure ulcers in patients to prevent their occurrence. This study will provide valuable insights into preventing pressure injuries in orthopaedic patients admitted to orthopaedic wards for healthcare workers worldwide.
The PRIMA manifest is utilised during the text preparation process.
Trail Registration: ES20245365