Conectar
by Linda Furness, Janani Pinidiyapathirage, Matthew French, James Ware, Liam Weber, Brendan Carrigan
IntroductionIn rural generalist clinical settings, medical trainees routinely assess patients and discuss their findings with supervisors to plan ongoing care. These interactions termed ‘learning conversations’, serve as important opportunities for workplace-based learning and clinical decision making. However, preliminary evidence and stakeholder feedback indicate a lack of shared understanding regarding how these conversations should be structured, facilitated, and optimised. This study aims to observe current practices, identify supervisor and trainee learning needs, and co-design a model of learning conversations that enhances educational value and supports safe, effective patient care.
Methods and analysisThis study will use an exploratory sequential mixed methods design structured around the 3Cs of co-design (Co-define, Co-design, Co-refine). Phase 1 (co-define) will involve qualitative observation and audio-recording of learning conversations across two rural hospitals to characterise current practice and inform a protype model. In Phase 2 (co-design), supervisor and trainee focus groups will explore perceived needs, expectations, and feedback on the prototype model. A national online survey of rural supervisors and trainees will further inform model refinement. Phase 3 (co-refine) will incorporate national stakeholder input through a workshop, followed by feasibility testing of the refined model during a pilot simulation at a Rural Clinical School. Outcome data will focus on model usability, perceived relevance, applicability across contexts, and users’ experiences of employing the model during simulated learning conversations.
DiscussionThis study will produce a stakeholder-informed model that responds to the specific learning and clinical needs of rural generalist practice. By embedding co-design throughout the research process, the resulting model is expected to strengthen learning conversations, optimise trainee learning, and enhance the quality and safety of patient care. The findings have potential applicability across broader health professional training contexts and can support workforce development in rural healthcare settings.
by Wen-Jui Han, Johanna Carrasco Saravia, Matthias Pollmann-Schult, Tinh Doan, Jianghong Li
Study aimsUsing a cross-country lens, we investigate the links between longitudinal work trajectories and health among parents with children under age 18.
BackgroundEmployment serves as a valuable resource, affording us a decent standard of living. The rising dominance of digital and technology, together with the service economy since the 1980s, has transformed the utility of employment from a resource to a vulnerability, subjecting more families to uncertain, unstable, and insecure work. Nonstandard work schedules or shiftwork, which often fall outside regular 9-to-5 daytime hours and can be unpredictable, carry potential health consequences.
MethodsUsing the longitudinal data from Australia (HILDA), Germany (SOEP), the UK (UKHLS), and the US (NLSY79), we used sequence analysis to first chart parental work schedule patterns between three stages of the life course, 25–34, 35–44, and 45–54, to show the changes and transitions in work patterns. We then conducted multivariate regression analysis to examine how variations in parental work patterns may shape individual health (i.e., physical and mental health) at ages 35/40, 45/50, and 55/60 while controlling for a rich set of sociodemographic characteristics.
ResultsOur sequence analyses uncovered roughly 4–6 work patterns during those three periods, revealing the heterogeneities of parental work trajectories that might correspond to childrearing demands and their sociodemographic backgrounds. We also found that mainly not-working pattern or volatile work arrangements (e.g., switching between daytime and non-daytime hours) were associated with significantly poorer physical and mental health; however, the persistence and magnitude of these associations varied by country.
ConclusionsThis study advances our understanding of the critical role of employment in our health from a cross-country perspective and bears important implications for the intergenerational transmission of employment and health vulnerabilities.
A resurgent methamphetamine epidemic is a major driver of HIV incidence in the USA. Although daily oral pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV acquisition, its effectiveness depends on achieving and maintaining prevention-effective adherence (ie, four or more doses per week). Digital health interventions offer a scalable method to extend the reach of behavioural approaches to HIV prevention, but evidence of their efficacy in improving objectively measured adherence remains limited. Addressing this gap is critical to maximising the clinical and public health benefits of PrEP.
From 26 January 2022 through 17 January 2025, this single-blind, parallel-group randomised controlled trial (RCT) enrolled 239 men taking PrEP who reported problematic stimulant use and who resided in California or Florida. Participants were randomised to receive five individually delivered telehealth sessions of a positive psychological intervention (n=119) or an attention-control condition (n=120), both delivered alongside remote contingency management for directly observed PrEP doses using the Spotlight mobile health application. Participants received US$20 per session and up to US$360 for uploading videos of at least four PrEP doses per week over 3 months. Follow-up assessments at 3, 6 and 12 months included surveys and dried blood spot specimens to quantify tenofovir diphosphate (TFV-DP). The primary outcome is biobehavioural HIV acquisition risk, defined as any recent condomless anal sex in the absence of TFV-DP concentrations consistent with prevention-effective adherence.
This RCT was approved by the University of Miami Institutional Review Board and registered prior to initiation of enrolment. Analyses of primary and secondary outcomes using intent-to-treat principles will be conducted after the completion of TFV-DP assays in June 2026, with results disseminated shortly thereafter through peer-reviewed publications.
This RCT was registered on www.clinicaltrials.gov (
Pilonidal sinus disease (PSD) is associated with substantial morbidity because of wound complications and recurrence after surgery. Adjunct laser hair removal (LHR) has been incorporated into postoperative management in some settings, but real-world outcomes in cohorts treated uniformly with LHR remain incompletely described. This study aimed to characterize postoperative outcomes after PSD surgery in a large integrated healthcare system in which adjunctive LHR was standard practice and to compare outcomes by surgical approach. We performed a retrospective descriptive cohort study of patients aged 14–89 years who underwent operative treatment of PSD with adjunctive LHR at Kaiser Permanente Northern California between 2012 and 2024. Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits. Outcomes were summarized as proportions overall and by surgical approach. Exploratory bivariable logistic regression examined associations between sex or body mass index (BMI) and outcomes. Multivariable modeling was not performed because of low event counts and sparse covariate distributions, which resulted in unstable models. Among 168 patients, the overall repeat procedure rate was 16.7%, the 30-day SSI rate was 14.4%, and 39.3% had at least one unplanned clinic visit. Patients treated with Bascom flap closure had fewer repeat procedures (10.4% vs. 20.8%) and fewer unplanned visits (33.8% vs. 43.6%) than those undergoing pilocystectomy, with similar SSI rates (14.9% vs. 14.0%). In exploratory analyses, sex and BMI were not significantly associated with outcomes in either surgical group. In this real-world cohort managed uniformly with adjunctive LHR, postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR. Controlled comparative studies are needed to determine the contribution of LHR to PSD outcomes.
High-arched feet affect approximately 10%–15% of the general population. Although the relationship between plantar pressure and bilateral symmetry is well studied, there is limited evidence regarding the use of Symmetry Index and pressure platforms. The objective of the study is to compare dynamic foot pressures and Symmetry Index during gait between subjects with Pes Cavus and subjects with normal feet. The analysis of asymmetric pressure patterns could benefit from studies that compare dynamic foot pressures and Symmetry Index values in subjects with high-arched feet and normal feet. This analysis can promote better clinical understanding of gait alterations and help solve biomechanical problems that may lead to pathologies, as well as prevent and treat them. A descriptive case–control study was developed from October to December 2024 with 82 participants, 41 with Pes Cavus and 41 normal feet and 71 females of 25.52 ± 5.99 years through a consecutive nonrandom technique. For this study, a baropodometry platform (Neo-Plate, Herbitas) was used, which acquired dynamic gait with a 2-step protocol. The inclusion criteria regarding the selection of subjects were age 18–65 years; if both cavus feet, Navicular Drop Test (NDT) < 9 mm; neutral feet and no lower limb problem or surgery. Regarding SI use, the PC demonstrated to have large asymmetries compared to the control group. Left anterior pressure was lower (44.93% ± 4.59% vs. 48.60% ± 3.43%, p = 0.014), left posterior pressure was higher (55.07% ± 4.58% vs. 51.40% ± 3.43%, p = 0.013) and the left Initial Contact Phase (ICP) was prolonged (123.34 ± 51.75 ms vs. 91.30 ± 31.86 ms, p = 0.036); right medial pressure was higher (58.18% ± 4.08% vs. 53.77% ± 4.79%, p = 0.034). SI measurements were greater in normal foot group than in the PC group with SI 94.15% ± 5.00% versus 93.75% ± 4.59%, p = 0.001, respectively; ICP and lateral SI were both p = 0.001. Findings confirmed that subjects with cavus feet tend to present greater alterations in bilateral symmetry, specifically posteromedial pressure movements and altered gait phases, which are indicative of more probability of future injuries. For this reason, pressure platforms are excellent tools for understanding, analysing and therefore applying the correct treatment according to the SI.
Equity, diversity and inclusion (EDI), patient engagement and shared decision-making are important considerations throughout clinical trials, including the research ethics review stage. Meaningfully integrating these considerations can enhance the relevance and generalisability of trial results and reduce participation barriers among equity-deserving populations. Presently, it is unclear to what extent such guidance is provided at the ethics application stage for clinical trials. This study aimed to report the degree of guidance on EDI, patient engagement and shared decision-making in clinical trial research ethics documents.
This was an embedded mixed methods study conducted in collaboration with Clinical Trials Ontario.
This study analysed research ethics board (REB) forms and templates from 17 institutions across seven provinces in Canada.
15 REB application forms, 9 protocol templates and 17 informed consent document (ICD) templates were assessed for guidance related to EDI, patient engagement and shared decision-making. The Place of residence, Race, ethnicity, culture and language, Occupation, Gender and sex, Religion, Education, Socio-economic status, Social capital (PROGRESS)-Plus framework, International Association for Public Participation Spectrum of Public Participation, Patient-Oriented Research Level of Engagement Tool, Indigenous Research Level of Engagement Tool and shared decision-making standards guided our coding. We engaged with patients and persons with lived experience to inform interpretation, reporting and dissemination.
EDI guidance from 15 ethics application forms and 9 protocol templates predominantly covered the ‘Race, ethnicity, culture, language’ (n=14; 93.3%), ‘Age’ (n=13; 86.7%) and ‘Gender and sex’ (n=12; 80%) categories of PROGRESS-Plus but lacked nuance on diverse gender identities (n=1; 6.7%). Patient engagement guidance mostly covered the ‘inform’ level (n=7; 46.7%) and applying ‘knowledge in practice’ with non-Indigenous (n=7; 46.7%) or Indigenous communities (n=13; 86.7%). All 17 (100%) ICD templates included guidance on information about options, disclosures, key elements, ethical issues and study design. No guidance was available on time-dependent relationships, empowering patients and communities in co-leading trials or providing structured guidance in making trial participation decisions (all n=0; 0%).
We provided a comprehensive view of EDI, patient engagement and shared decision-making guidance in trial ethics applications in Canada. REB guidance may be strengthened in several areas to support the inclusion of equity-deserving populations in trials, meaningful engagement with patients and Indigenous communities and evidence-informed, values-aligned decisions about trial participation.
To evaluate the quality of action research studies using the Quality Assessment Action Research Checklist (QuARC) and to assess its utility as a tool for quality appraisal.
A hybrid systematic narrative review following Turnbull et al.'s six-stage methodology and reported in accordance with PRISMA 2020 guidance.
Scopus was searched for author self-identified action research studies published between January 2020 and March 2024.
Two reviewers independently selected studies meeting inclusion criteria: health science action research papers addressing any or all of QuARC's four quality factors. A scoring system was used to capture each of QuARC's 17 quality items, which was scored as 0 (absent), 0.5 (partial) or 1 (comprehensive). Narrative synthesis was undertaken across the four QuARC domains.
Thirty-two studies met the inclusion criteria. Reporting frequencies across QuARC were: Context (92.5%, mean = 3.7/4), Quality of Relationships (55% mean = 2.2/4), Quality of Action Research Process (62.5% mean = 2.5/4), and Quality of Outcomes (62.5% mean = 3.1/5). Reporting gaps were most evident in reflexive co-analysis, relational evaluation and explicit theoretical contribution.
Global reporting of rigour and quality in action research remains inconsistent. QuARC functioned both as an appraisal instrument and as an analytic lens, revealing systematic patterns in how action research privileges practical change over theoretical articulation and reflexive relational work. Further refinement and validation are recommended to strengthen its reliability as an appraisal tool.
Findings highlighted a critical need to establish a standardised, validated approach to assess quality in action research. Adoption of QuARC can enhance consistency, clarity and comparability across studies, strengthening the evidence base for action research methodologies.
This first systematic synthesis of QuARC's application provides an evidence base for its further development. This lays foundations for international standards in quality appraisal, strengthening the credibility, reproducibility and influence of action research.
To describe the Knowledge–Attitude–Practices (KAP) of community pharmacy professionals regarding chemsex prevention in the Auvergne-Rhône-Alpes region of France, and to identify associated determinants.
Regional, cross-sectional, web-based, self-administered KAP survey collecting quantitative and qualitative data, analysed using multivariable linear regression and inductive content analysis.
Primary care, community pharmacies in the Auvergne-Rhône-Alpes region of France, February–March 2025.
Of the 276 respondents entering the survey, 261 community pharmacy professionals fully completed it. Inclusion criteria were: (1) age ≥18 years; (2) pharmacists, pharmacy technicians or students in training and (3) employment in a community pharmacy in the Auvergne-Rhône-Alpes region. Exclusion criterion was non-consent.
KAP domain scores derived from survey items; thematic categories identified through qualitative content analysis of open-ended responses; and factors associated with KAP scores.
Participants were predominantly female (69.6%), pharmacists (64.5%), aged 18–29 (41.7%) and working in urban areas (61.6%). Overall, 67.4% were able to define chemsex. Mean (SD) KAP domain scores were 13.8 (4.4) (range 3–27) for knowledge, 9.6 (2.9) (2–16) for attitudes and 9.6 (2.9) (5–16) for perceived resource adequacy/need. Qualitative analysis identified insufficient knowledge or training (28.7%) and the taboo and intimate nature of the topic (21.1%) as the main barriers to discussing chemsex. The most frequently suggested levers for improving care were professional training (57.1%) and broader prevention efforts (36.4%).
Higher knowledge scores were associated with more positive attitudes (p=0.015), male gender (p=0.004) and prior chemsex-related advice requests (p=0.027), while increasing age was negatively associated with knowledge (p=0.029). Positive attitudes were associated with urban practice settings (p
The clinical practicum is a critical component of nursing education. In Spain, it is currently facing systemic challenges that compromise its quality and sustainability. A persistent nursing shortage, combined with increasing pressure on healthcare systems and a growing number of students intended to address this gap, is adding strain to clinical learning environments, which may compromise the capacity of nurses to provide adequate supervision and meaningful learning experiences for nursing students. This not only diminishes the quality of the training experiences, but also negatively affects the well-being of both students and nurses, further worsening the situation. This protocol outlines a study aimed at conducting an in-depth analysis of the current challenges affecting the clinical practicum and proposing a new model that effectively addresses them, with significant potential for adaptation and implementation across different health education fields and geographical locations.
The study will employ a sequential mixed-methods design comprising two integrated phases. In phase I, quantitative, qualitative and scoping review methodologies will be combined to identify current challenges and opportunities. Quantitative data will be obtained by administering questionnaires to nursing students and clinical mentors (CMs) tutoring them in Catalonia, examining potential barriers and facilitators to their mentoring role. Data will be analysed through descriptive and inferential statistics. Qualitative data will emerge from semistructured interviews with CMs and nurse coordinators, as well as from a visual elicitation technique, the ‘Emojional’ Calendar, conducted with students to understand their clinical practicum experiences. These will be analysed through an inductive thematic analysis approach. The scoping review, following the Arksey and O’Malley framework, will identify best practices in clinical practicums in nursing and other health studies globally. Phase II will involve a three-round qualitative Delphi study in which all preceding results will be presented to stakeholders and decision makers in order to redesign the clinical practicum model.
Ethical approval for this study was obtained from Hospital del Mar Clinical Research Ethics Committee (Ref #2023/11123). Results will be disseminated through peer-reviewed journals and conference presentations, as well as via strategic actions (forums and meetings with healthcare managers, deans and policymakers) and general outreach (talks, social media and websites) targeted at professionals, students and the public.
To compare attitudes and perceptions towards opioid use disorder among people with opioid use disorder and emergency providers, describe interactions between the two groups, and identify barriers to providing and receiving care.
Mixed methods observational study.
Participants were recruited from an academic, tertiary care hospital and a community-based harm reduction agency in New England. Emergency healthcare providers (nurses, physicians, and paramedics) and adult people with opioid use disorder were enrolled. Electronic surveys were administered to providers, and semi-structured interviews were conducted with people with opioid use disorder and a subset of providers. Descriptive statistics were calculated for surveys, and directed content analysis was used to analyse semi-structured interviews.
Sixty-eight providers completed the survey, 11 of whom also completed a semi-structured interview. Twenty-two people with opioid use disorder completed the semi-structured interview. Both providers and people with opioid use disorder agreed that addiction is a disease; however, opinions differed on the extent to which personal choice played a role in the onset of opioid use disorder. Participants described how factors such as experiencing homelessness, alongside other personal or familial challenges, contributed to ongoing substance use and presented barriers to accessing healthcare. There was discordance in priorities between providers and people with opioid use disorder, which often drove conflict and perceived stigma. Both groups described physical and emotional trauma from prior interactions, which shaped expectations of future interactions and biases towards each other.
Educational initiatives should arm providers not only with clinical knowledge about opioid use disorder but with skills to recognize implicit biases, navigate unique barriers related to social determinants of health, and effectively deploy shared decision-making techniques. Healthcare organizations should provide support for trauma that emergency care providers are exposed to in caring for people with opioid use disorder.
Consolidated criteria for reporting qualitative studies (COREQ)–32 item checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study aimed to explore informal caregivers' (family members of patients) perspectives on their involvement in ongoing multidisciplinary treatment of diabetes-related foot ulcers in a highly specialised outpatient service with a multidisciplinary team structure that was still evolving. Using focus group interviews and template analysis, we identified patterns in caregivers' experiences, needs, and preferences. The findings suggest considerable potential to improve patient care through earlier caregiver involvement. While some caregivers reported positive experiences, many rarely or never attended consultations and struggled to define involvement in practical terms. However, caregivers consistently expressed a strong wish for earlier involvement—ideally at the time of diabetes diagnosis—to acquire the knowledge and skills needed to support patients between clinical visits. Caregivers play an important role in foot ulcer management, as complex regimens such as wound care, offloading, and lifestyle adjustments require ongoing support outside clinical settings. However, involvement may also create strain. Participants described emotional and practical burden, feelings of guilt, and uncertainty about their roles. The study highlights the need for structured caregiver education, clear communication, and systemic support to balance the benefits of caregiver involvement with the risk of caregiver burden.
This study aimed to understand hospital doctors’ priorities (target use cases and aetiologies) for the development of a new rapid diagnostic test for patients with fever.
A cross-sectional online survey.
Europe-wide.
Secondary and tertiary care doctors involved in patient assessment and diagnosis across Europe.
Online survey from April to September 2024.
Importance of developing a new test on a scale of 1–10 for up to 19 ‘use cases’ (types of febrile presentations in specific demographic groups): use case scores and ranks and differences across subgroups of respondents, with free text to capture additional suggestions; respondents’ preferences (multiple choice) regarding which aetiologies should be included in a new test.
265 respondents from 30 European countries (out of 270 starting the survey) were included in the analysis. Top priorities included febrile immunocompromised patients and fever without a focus for both paediatric and adult use cases, and 1–3 months old febrile infants. Rankings were similar across clinician subgroups despite some differences in average scores. 92% (243/263), 95% CI 89% to 95%, of respondents would find a ‘generic’ test for bacterial aetiology useful, even if it does not differentiate between Gram-positive and Gram-negative aetiologies. 54% (63/116), 95% CI 45% to 63%, of respondents would find a ‘generic’ test for inflammatory aetiology useful when seeking to diagnose children for whom Kawasaki’s disease (KD) is on the differential, even in the absence of any KD-specific test, 83% (96/116), 95% CI 75% to 89%, would find such a ‘generic’ test useful if they could use it alongside a KD test when desired.
Clinicians prioritise the most vulnerable patients (because of age or comorbidities) and unclear presentations (fever without a focus) for the development of a new fever diagnostic test. Even relatively simple (eg, bacterial, inflammatory) tests could provide added value to most clinicians.
Infections are a major cause of morbidity and mortality among individuals with haematological cancers, but the duration of elevated risk in long-term survivors remains uncertain. Although previous attempts to summarise the existing literature on this topic would have been hampered by the sheer volume of studies on cancer and all-cause infections, emerging artificial intelligence tools now offer the ability to streamline the screening process, allowing for broader and more comprehensive reviews.
This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. Eligible studies will include original observational data reporting long-term (≥1 year follow-up from diagnosis) infection-related outcomes in haematological cancer survivors compared with a general or cancer-free population. Screening will be supported by ASReview, an artificial intelligence-based tool for abstract prioritisation. An internal validation step will be conducted by comparing artificial intelligence-assisted screening results with manual review performed by two independent researchers on a subset of abstracts. The primary outcomes of infection incidence and infection mortality will be summarised by type of infection, type of haematological cancer and time since cancer diagnosis. Information on anti-cancer treatments received will also be described. Data synthesis will be mostly narrative due to the broad scope of the review, though meta-analyses will be performed in cases where studies are sufficiently homogenous. Risk of bias will be assessed using the Newcastle-Ottawa Scale.
Ethical approval is not applicable to this study. The results of the review will be disseminated to clinical audiences and submitted to a peer-reviewed journal.
CRD420251047091.
To assess the potential for microbial contamination of open-but-unused portions of wound dressings stored under real-life conditions in healthcare facilities, to inform safer and evidence-based wound care practices. Observational, descriptive, longitudinal, prospective study. Eleven types of non-adhesive wound dressings were sampled after opening and storage under usual clinical conditions in a hospital inpatient unit and a primary care centre in Andalusia, Spain. Samples were collected on six predefined sampling days (Days 0, 2, 3, 4, 5 and 6 after opening), cultured under standardised laboratory conditions and microorganisms were identified using mass spectrometry. Differences in contamination were examined by dressing type, healthcare setting, storage time and handling conditions. Microbial growth was frequently detected in open-but-unused dressings from the first day after opening, particularly after enrichment culture and increased with handling and time. The most frequent microorganisms were coagulase-negative staphylococci and Staphylococcus aureus. Contamination patterns were similar across settings, although microbial diversity was higher in the hospital. Silver-containing dressings showed slightly lower contamination, but not enough to indicate protection. Scissors used for cutting dressings had high microbial loads, suggesting a potential source of cross-contamination. Open-but-unused dressings may become contaminated shortly after opening under routine clinical practice conditions, across different healthcare settings and dressing types.
Despite anatomical correction, people born with oesophageal atresia±tracheoesophageal fistula (OA-TOF) experience lifelong morbidity. Core outcome sets (COSs) are recognised as a means of improving research quality and, as a consequence, improving patient outcomes; one was not available for this population.
The scope of the study was to develop a COS for people born with OA-TOF that would be applicable regardless of age or geographic location.
Patient input was paramount to this study. For long-list generation, in addition to the systematic review (SR), patients and representatives were invited to participate in focus groups, interviews or complete activity packs to ascertain outcomes that matter most to them. International consensus was then sought using a two-step Delphi survey followed by an online consensus meeting.
Eight outcomes were identified through patient events that had not been picked up from SR. 175 people completed the Delphi survey from 26 countries and health care professionals from 13 different disciplines. 24 outcomes met predefined criteria for inclusion and following discussion and voting in the consensus meeting, and 14/24 outcomes were agreed for inclusion in the COS.
14 outcomes have been agreed on to form the COS. 12 of these outcomes are relevant to people of all ages, 1 to paediatric population and 1 to adult cohorts. The COS is, therefore, truly applicable lifelong, which was the scope of the project. This COS will help reduce research heterogeneity, enabling better quality research outcomes and more comparable data.
To explore the impact of multiple long-term conditions (MTLCs) and a comorbid mental health condition on decision-making processes, attendance and engagement in NHS community-based therapy groups.
Qualitative in-depth interviews analysed using reflexive codebook analysis as part of a study within a trial.
Secondary community mental health teams from two UK sites.
Purposive sample of 20 participants recruited to a randomised controlled trial of group therapies (arts therapies and counselling) holding a mental health diagnosis and self-reported as having at least one additional physical health condition.
Six themes were constructed: (1) MLTCs influenced arts modality choices and goals; (2) importance of planning ahead to be organised; (3) the journey loomed over participants; (4) the impact of MLTCs on group attendance and participation; (5) the group was valued and important; (6) determination and fighting to get what I need.
Decisions about arts modalities and group attendance were based on a self-perceived level of felt capability. It was important for participants to plan in advance and feel informed ahead of making commitments, enabling them to prepare and manage symptoms. Travelling to the groups was dreaded, and many participants required support with travel in order to attend. Managing symptoms during the journey and groups was challenging; however, participants had a strong determination to uphold the commitment to attend despite their difficulties, as the group was highly valued.
MLTCs have a large impact on people’s capacity to engage in community groups, requiring additional planning and effort. The scale of this impact is often not recognised. Despite this, the benefits of groups for people with MLTCs are especially important, including motivation to leave the house, opportunities for socialisation and a means of reaching one’s own goals. Clinicians are recommended to accommodate the needs of MLTCs when designing community group interventions and consider multiple attendees with MLTCs in the group composition to improve attendance and group engagement.
Status epilepticus (SE) in adults is a serious neurological emergency that can lead to high morbidity and mortality rates. Although functional outcomes are often assessed using general scoring systems, limited data on health-related quality of life (HRQoL) in patients admitted to intensive care units (ICUs) are still limited. Furthermore, comprehensive evaluations of patient-reported physical, cognitive, mental health and psychological outcomes are lacking in this population. POSEIDON 2 aims to assess HRQoL and cognitive, physical and psychological impairments at 3 and 12 months after ICU discharge following SE and quantify caregiver burden.
POSEIDON 2 is a prospective, multicentre, longitudinal study conducted in 19 French ICUs. The study combines data from the SE ICTAL Registry with data from patients who survived admission to the ICU for SE, who will be recruited for the study. The study also includes patient-reported outcome (PRO) data collected 3 (M3) and 12 (M12) months after discharge from the ICU using validated instruments. The Zarit scale will be used to measure the burden on caregivers at M3 and M12. The primary endpoint is the prevalence of overall HRQOL impairment at M3 and M12, as defined by dichotomous scores on the physical and mental components of the 36-Item Short Form Health Survey compared with those of the general population. Secondary endpoints include domain-specific impairments, such as cognitive function, dependence, mental health and patient experiences. The sample size has been calculated based on an estimated prevalence of 75% for HRQoL impairment, with a planned sample size of 140 patients.
The POSEIDON 2 study protocol received ethical approval from the ethics committee ‘Comité de Protection des Personnes Ouest VI’ on 5 October 2023 (#2023-A01223-42). The study is conducted in accordance with the Declaration of Helsinki, Good Clinical Practice and the regulatory requirements of France. Written informed consent is obtained from participants, who are able to decline participation or withdraw from the study at any time. Findings will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences.
To translate, culturally adapt and validate the first Spanish version of the Person-centred Practice Inventory-Care (PCPI-C) instrument.
Cross-cultural adaptation and psychometric validation.
Two-phase research design: (1) the PCPI-C's translation and cultural adaptation from English to Spanish following the ‘Translation and Cultural Adaptation of Patient-Reported Outcomes Measures-Principles Guide of Good Practice’ tool; and (2) a cross-sectional quantitative survey to assess the Spanish version's psychometric properties.
A sample of 200 patients participated to obtain the PCPI-C's Spanish version. No significant issues arose during the translation process or the consulting sessions. No item exhibited an inadequate value following adjustment via the weighted kappa index (−scale-level content validity average of 0.95 for clarity and 0.97 for relevance). Psychometric evaluation revealed acceptable internal consistency (Cronbach's alpha from 0.67 to 0.84) and strong construct validity. Exploratory and confirmatory factor analyses supported a five-dimensional structure consistent with the domain Person-Centred Processes. Fit indices improved after model refinements, achieving CFI = 0.92, SRMR = 0.05 and RMSEA = 0.07. This study's observed psychometric properties confirm that the PCPI-C's Spanish version retains the original instrument's theoretical integrity, while showing strong reliability and validity in the new context.
The PCPI-C's Spanish translation was psychometrically valid when tested with Spanish patients, thus providing a culturally appropriate, psychometrically sound tool to evaluate Spanish-speaking patients' perception of person-centred care.
This study provides a validated instrument that allows for the assessment of person-centred practice in Spanish-speaking clinical environments. It enables healthcare professionals to measure patients' perceptions, track the implementation of person-centred principles and supports international comparative studies, contributing to the development of more ethical and responsive models of care.
Patients participated in cognitive consultations and completed the survey for psychometric testing, ensuring that the translated items were understandable, culturally appropriate and reflective of their experiences of person-centred care.
To explore the views of community registered general nurses and directors of public health nursing on the current and future role of the community registered general nurse in the Republic of Ireland.
Anonymous cross-sectional descriptive survey.
Two questionnaires were developed; one targeted at community registered general nurses and one targeted at assistant directors of public health nursing or directors of public health nursing who were working with community registered general nurses. Social media was used to recruit participants. Descriptive statistics were used while data from open-ended questions were analysed using NVivo software.
A total of 97 community registered general nurses and 28 assistant directors of public health nursing or directors of public health nursing completed the surveys in 2023. There was consensus that community registered general nurses provide holistic care, including case management of adults with complex health needs living in the community. However, lack of promotional opportunities coupled with poor remuneration has resulted in job dissatisfaction. Respondents felt that community registered general nurses should focus on older adults, whereas public health nurses should focus on child health.
The role of the community registered general nurse needs to be clarified, and a promotional pathway developed to attract new graduates to this post.
This paper outlined the current role and vision for the future role of community registered general nurses.
CROSS guidelines.
No patient or public contribution.
This paper contributes to the challenges community nurses face regarding increased demand for community nursing, lack of career structure for some community nurses, and difficulties with staff retention within the community.
FreshRSS 