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This study aimed to test the psychometric properties of the Self-Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale in patients with cancer.
A multisite cross-sectional validation study was conducted.
Between November 2022 and July 2023, a convenience sample of 318 patients with cancer were enrolled in five Italian inpatient and outpatient facilities. Confirmatory factor analysis was performed on the three scales of the Self-Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale. Internal consistency was tested using Cronbach's alpha for unidimensional scales and McDonald's Omega for multidimensional scales. Construct validity was assessed with the global health status by Pearson's correlation. The COnsensus-based Standards for the selection of health Measurement INstruments reporting guidelines were followed for the reporting process.
Three hundred fourteen patients were included (median age: 55.5 years; male: 53.82%). Confirmatory factor analysis showed supportive fit indices for the three Self-Care of Chronic Illness Inventory scales (CFI: 0.977–1.000; SRMR: 0.004–0.78) and the Self-Care Self-Efficacy scale (CFI: 1.000; SRMR: 0.014). All scales demonstrated adequate internal consistency (0.89–0.99) and test–retest reliability (0.85–0.95). Construct validity was confirmed through correlations between Self-Care Self-Efficacy, each Self-Care of Chronic Illness Inventory scale, and global health status.
The Self-Care of Chronic Illness Inventory and Self-Care Self-Efficacy scales demonstrated excellent psychometric qualities and construct validity when administered to patients with cancer. Future research should explore self-care behaviours across different diseases and cultural contexts.
These tools can help develop targeted educational programs, improving patient outcomes.
Currently, there is a lack of knowledge regarding self-care behaviours in patients with cancer. These tools enable healthcare professionals to identify patient needs, design personalised interventions, and monitor their effectiveness over time.
No patient or public contribution.
This study evaluates the predictive value of the WIfI (Wound, Ischemia, and foot Infection) classification system and pre-amputation transcutaneous oxygen pressure (TcPO2) measurements in forecasting post-amputation complications in major lower limb amputations (MLLA). A retrospective analysis was conducted on 132 MLLA patients with complete WIfI data and 87 patients with documented TcPO2 values. Associations between WIfI stage, TcPO2, and post-amputation outcomes—including healing time, surgical revisions, re-amputation, and wound complications—were assessed using statistical modeling and receiver operating characteristic (ROC) curve analyses. Higher WIfI stages correlated with prolonged healing (WIfI 4 failure rate: 12.8%) but did not significantly predict complications. Unexpectedly, WIfI 2 patients had a 4.4-fold higher risk of revision (p = 0.011) and a 3.1-fold higher re-amputation risk (p = 0.033) compared to WIfI 4. TcPO2 levels showed a significant relationship with healing outcomes, with a 36.9% failure rate in TcPO2 < 15 mmHg. A TcPO2 cut-off of > 46 mmHg optimized healing prediction (HR = 2.81, p = 0.004). TcPO2 is a stronger predictor of post-amputation complications than WIfI staging. A cut-off of > 46 mmHg at the amputation site is recommended to improve healing outcomes.
Photobiomodulation (PBM) has shown promising effects in managing postoperative pain following conventional periapical surgery, although current evidence remains limited. This study aims to assess the effect of PBM on postoperative pain 24 hours after periapical surgery.
A randomised, controlled, double-blind trial will include 34 patients undergoing periapical surgery in the maxillary region, randomly assigned to an experimental group (n=17) or control group (n=17). The experimental group will receive PBM (GaAlAs diode laser, 808 nm, 100 mW, 4 J/cm², applied at five vestibular points) and placebo ibuprofen immediately and 24 hours postoperatively. The control group will receive simulated PBM and active ibuprofen. The primary outcome is postoperative pain assessed by the visual analogue scale at 24 hours. Secondary outcomes include pain at the seventh day, paracetamol intake, oedema, ecchymosis, soft tissue status and temperature at 24 hours and 7 days. Radiographic evaluation of healing will be performed at 1 and 3 months. Statistical analysis will be conducted based on data distribution, using repeated measures ANOVA (Analysis of Variance) or non-parametric equivalents for longitudinal outcomes, and appropriate tests for categorical variables. Significance will be set at p
The study was approved by the Human Research Ethics Committee of Universidad Católica del Uruguay (process no. 220914). Results will be disseminated to participants, healthcare professionals, the public and scientific communities.
by Veli Fahri Pehlivan, Başak Pehlivan, Erdogan Duran, Abdullah Taskın, Ismail Koyuncu, Yusuf Çakmak
BackgroundSepsis, a life-threatening condition resulting from a dysregulated host response to infection, is associated with high mortality and remains a major global health burden. Sepsis is characterized by an imbalance between oxidative stress and inflammation, leading to disruption of thiol–disulfide homeostasis, hematological abnormalities, cytokine dysregulation, and widespread tissue injury.
MethodsAn experimental sepsis model was established in thirty-two male Balb-C mice using lipopolysaccharide administration. Animals were randomized into four groups: control, vitamin E, sepsis, and sepsis plus vitamin E. Serum oxidative stress markers, thiol-disulfide parameters, and inflammatory mediators, including C-reactive protein, interleukin-40, and tumor necrosis factor-alpha, were measured. Hematological indices of systemic inflammation were evaluated (Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio), and lung, liver, and kidney tissues were examined histologically using a semi-quantitative scoring system.
ResultsLipopolysaccharide-induced sepsis caused marked disruption of thiol-disulfide balance, characterized by reduced native and total thiol levels, elevated disulfide levels, increased cytokine release, and severe histopathological injury. Vitamin E supplementation restored thiol-disulfide homeostasis, decreased oxidative stress, and attenuated systemic inflammation. In the sepsis plus vitamin E group, serum thiol levels increased significantly, while disulfide levels declined. Interleukin-40 showed a 24.2% reduction and tumor necrosis factor-alpha a 9.8% reduction compared with untreated septic animals. Histopathological analyses confirmed reduced inflammatory cell infiltration, vascular congestion, and tissue degeneration, particularly in the lungs.
ConclusionsVitamin E demonstrated significant protective effects against sepsis-induced oxidative and inflammatory injury by preserving thiol-disulfide homeostasis and reducing cytokine production. The more pronounced effect on interleukin-40 compared with tumor necrosis factor-alpha suggests selective modulation of inflammatory pathways and highlights interleukin-40 as a potential biomarker and therapeutic target. These findings support vitamin E as a promising adjunctive therapy in sepsis, although further studies are required to define optimal dosing strategies and assess clinical applicability.
In response to the high maternal mortality in Afghanistan, the government emphasised enhancing antenatal care (ANC) coverage to improve skilled birth attendance and reduce maternal mortality. This study aimed to explain how and why ANC interventions worked, for whom, and under what circumstances in Afghanistan between 2000 and 2024.
A rapid realist review was conducted to identify underlying programme theories and examine contextual factors and key mechanisms influencing ANC outcomes, with input from a panel of national experts. Data were extracted using context–mechanism–outcome (CMO) configurations to develop and refine theories for policy recommendations.
From 3502 papers, 1860 duplicates were removed, 63 were screened for full text and 25 were included in the final review. In total, 29 CMOs were inferred across nine interventions, classified at individual, interpersonal, community and institutional levels. We found that ANC interventions could work best by empowering women and healthcare workers (HCWs), involving husbands, hiring female community health workers (CHWs), ensuring regular contact with the same HCWs, endorsing health messages by the government, incentivising CHWs and designing and implementing interventions using participatory approaches. Interventions are less successful when there is a lack of community trust in service quality or HCW qualifications, low decision-making ability among women, discomfort during travel to health facilities, adherence to traditional practices and beliefs, hiring CHWs from outside the community, chronic stress and lack of support among HCWs and unrecognised incentives.
Our evidence synthesis can inform donors, policymakers and implementers on how to design more effective ANC interventions to achieve better health outcomes in Afghanistan. By emphasising intervention evaluation and ANC quality improvement, it highlights the importance of key social elements, such as cultural norms, power dynamics, relationships, beliefs and trust, which are likely to maximise impact. Community involvement is essential for designing and implementing effective and sustainable ANC interventions.
This study aimed to investigate the factors influencing health-related quality of life (HRQoL) in patients undergoing haemodialysis, focusing on the association between HRQoL dimensions and sociodemographic variables, clinical parameters, mental health status and biochemical indicators.
A multicentre cross-sectional study conducted over 30 months.
The study was carried out in secondary care centres across multiple locations in the Community of Extremadura, Spain.
A total of 150 patients undergoing haemodialysis were recruited between March 2022 and September 2023. Inclusion criteria required patients to be diagnosed with chronic kidney disease (CKD) and undergoing haemodialysis. Patients unable to provide informed consent or with severe cognitive impairment were excluded.
HRQoL was assessed using the Kidney Disease Quality of Life 36-item Short Form scale. Mental health parameters, specifically anxiety and depression, were evaluated using the Hospital Anxiety and Depression Scale. Biochemical markers such as haemoglobin and haematocrit levels, as well as sociodemographic and clinical data, were analysed for their influence on HRQoL.
Symptoms of anxiety and depression were prevalent among patients undergoing haemodialysis. Anxiety had the greatest negative effect on HRQoL, being significantly associated with lower scores in the mental component summary (MCS) (β = –2.06; 95% CI –2.78 to –1.33; R² = 0.106; p
Depression and anxiety, along with older age, were identified as key factors negatively affecting HRQoL of patients undergoing haemodialysis. Management of mental health, alongside optimisation of clinical care to minimise complications, could enhance the HRQoL in this patient population. Further research is recommended to develop targeted interventions addressing anxiety and other modifiable factors influencing HRQoL in haemodialysis patients.
To compare in-hospital and long-term outcomes between culprit-only percutaneous coronary intervention (PCI) and multivessel PCI in patients with acute myocardial infarction complicated by cardiogenic shock and multivessel coronary artery disease.
Retrospective subgroup analysis of the multicentre Gulf-Cardiogenic Shock registry.
13 tertiary care centres across six Gulf countries (Saudi Arabia, Qatar, Oman, UAE, Kuwait and Bahrain) between January 2020 and December 2022.
961 patients with angiographically confirmed multivessel coronary artery disease who underwent PCI were included from the Gulf-Cardiogenic Shock registry. Patients were divided into culprit-only PCI group (n=792, 82.4%) and multivessel PCI group (n=169, 17.6%). Patients with single-vessel disease were excluded.
Patients underwent either culprit-only PCI (intervention limited to the culprit artery) or multivessel PCI (immediate intervention to both culprit and non-culprit arteries during the same procedure).
The primary outcome was in-hospital all-cause mortality. Secondary outcomes included reinfarction, cerebrovascular accident, major and minor bleeding events, target lesion revascularisation, target vessel revascularisation, hospital stay duration and freedom from major adverse cardiac and cerebrovascular events (MACCEs) at 6 and 12 months.
Hospital mortality was comparable between multivessel PCI and culprit-only PCI groups (43.2% vs 46.1%; p=0.493). Freedom from MACCE rates at 6 and 12 months were 62% and 46% for multivessel PCI versus 70% and 49% for culprit-only PCI, respectively (log-rank p=0.711). Subgroup analysis revealed that culprit-only PCI was associated with increased hospital mortality in patients older than 70 years (OR 1.55, 95% CI: 1.01 to 2.39). Multivariable analysis of the interaction between revascularisation strategy and the subgroups revealed that culprit vessel revascularisation was associated with increased mortality in patients with left main disease (OR: 1.99 (95% CI: 1.22 to 3.27), p=0.006) and left anterior descending lesions (OR: 1.54 (95% CI: 1.06 to 2.25), p=0.025).
No statistically significant differences in hospital mortality or long-term MACCE-free survival were observed between culprit-only PCI and multivessel PCI strategies in patients with cardiogenic shock complicating acute myocardial infarction. However, patients older than 70 years may benefit from a multivessel PCI approach. These findings support current guideline recommendations favouring culprit-only PCI due to reduced procedural complexity while highlighting the need for individualised treatment strategies based on patient age and clinical factors. Further prospective randomised studies are needed to validate these age-specific findings and identify optimal patient selection criteria for each revascularisation strategy.
Sleep-related breathing disorders have become a significant public health concern due to their negative impact on the population’s quality of life and overall health. Despite being underdiagnosed, their prevalence has increased in recent years, particularly in cases of obstructive sleep apnoea (OSA). Early diagnosis and detection of OSA are essential for timely treatment to mitigate the physical and health consequences. While polysomnography remains the gold standard for diagnosis, its limitations have led to the adoption of nocturnal polygraphy as an alternative for diagnosis. The scientific community is seeking devices that enable continuous monitoring of sleep status and other relevant parameters in this population. This study aims to analyse a wearable device as a complementary tool for monitoring health status and daily activity in people with potential OSA.
This observational and cross-sectional study will be conducted at the Sleep Respiratory Disorders and Home Ventilation Unit of a Hospital Álvaro Cunqueiro in Vigo. The aim is to recruit 246 participants who meet the inclusion criteria. Specific statistical methods will be employed to evaluate the accuracy and quality of the data collected by the Xiaomi Mi Smart Band 9.
This protocol study has been approved by the Pontevedra-Vigo Ourense Research Ethics Committee (process number 2024/260). All participants will sign a statement of informed consent. Study results will be disseminated in peer-reviewed journal articles.
Dysmenorrhoea (period pain) is a global public health issue affecting up to 91% of the 1.8 billion individuals who menstruate. While research has emphasised the improvement of menstrual health in low-middle-income countries, undertreated dysmenorrhoea remains an issue in high-income countries (HICs), where individuals often assume their pain experiences are normal. Studies report that individuals with dysmenorrhoea delay seeking medical care, avoid it entirely or are subjected to diagnostic and treatment delays. Difficulties accessing care are troubling, as individuals may suffer without access to evidence-based techniques, as well as the potential for underlying pathologies (eg, endometriosis, pelvic inflammatory disease) to go undiagnosed.
Many HICs have launched strategies for women’s health to address gaps in care access and knowledge around menstruation. Guided by Levesque and colleagues' (2013) Conceptual Framework of Access to Healthcare, this review will contribute to these strategies by providing an overview of factors affecting healthcare access for dysmenorrhoea in HICs from the point of perceiving a healthcare need to engaging with care, as well as factors affecting perceived quality of care.
This scoping review will follow the Joanna Briggs Institute’s (JBI) guidance for scoping reviews and will be conducted with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist extension for Scoping Reviews. Guided by Levesque and colleagues’ (2013) Conceptual Framework of Access to Healthcare, searching will seek to locate both peer-reviewed studies across PubMed, CINAHL, PsycINFO and Web of Science databases, as well as using web scraping to locate relevant grey literature. Results will be synthesised and mapped to construct a pathway to care, highlighting factors affecting the healthcare access for dysmenorrhoea, as well as factors related to the quality of healthcare interactions.
This review does not require ethical approval, as only existing data will be analysed. Results will be shared using peer-reviewed publications and conference presentations. Datasets emerging from the study will be made available on Open Science Framework.
This review was initially registered on Open Science Framework (https://osf.io/2dsrc/) in February 2024, with an updated protocol registered in February 2025.
This study aims to determine the relationship between successful aging and happiness levels in the elderly and to explore the mediating role of general self-efficacy in this relationship.
This is a quantitative research study designed using a correlational research model between March and May 2022.
The Mini-Mental State Examination, the Descriptive Information Form, the Successful Aging Scale, the Oxford Happiness Questionnaire Short Form and the General Self-Efficacy Scale were filled out by 144 elderly individuals living in a nursing home.
It was determined that the participants had high levels of successful aging behaviours/attitudes and good levels of happiness. It was determined that general self-efficacy had a ‘partial mediating role’ in the relationship between successful aging and happiness.
Due to the ‘partial mediating role’ of general self-efficacy related to happiness and successful aging, increasing self-efficacy may positively impact happiness and successful aging.
Healthcare professionals should prioritise practices and training that support the self-efficacy of the elderly for their successful ageing and happiness. Within this scope, interventions can be made to increase the elderly's participation in self-care, active engagement and intrinsic motivation.
This study determined whether general self-efficacy has an effect on successful aging and happiness in the elderly. It was determined that general self-efficacy has a ‘partial mediating role’ in the relationship between successful aging and happiness. The general self-efficacy of elderly individuals is an important issue to focus on. Successful aging includes functional ability, independence and quality of life aimed at maintaining health and well-being in old age. Self-efficacy, which is thought to have an effect on successful aging, is an important determinant in initiating and maintaining behaviours that improve the health of the elderly.
This study was reported adhering to the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
The elderly individuals residing in a nursing home were included in the study. All participants were selected from a single nursing home. This nursing home accommodates both outpatient and bedridden elderly individuals. One section is reserved for individuals diagnosed with dementia.
Introducción. La anemia ferropénica infantil es uno de los problemas de salud pública a nivel global, constituyendo prioridad en la atención sanitaria, una de las estrategias recomendadas para enfrentarla, es la suplementación con hierro polimaltosado, demostrando una buena tolerabilidad con bajas incidencias de efectos adversos. Objetivo. Determinar la relación entre el conocimiento y la práctica de cuidadores de niños sobre suplementación con hierro polimaltosado.Metodología. Estudio cuantitativo, descriptivo-correlacional y transversal. Participaron 93 cuidadores de niños asistentes a un centro de salud de Lima-Perú y se utilizaron dos instrumentos, un cuestionario y una escala Likert que fueron validados mediante juicio de expertos y una prueba piloto, obteniendo un alfa Cronbach de 0,808 y Kuder Richardson 0,775. Resultados. El nivel de conocimiento sobre suplementación con hierro polimaltosado fue regular (82,7%), seguido por bueno (9,7%), y deficiente (7,5%). En relación a la práctica de los cuidadores, el 90,3% fueron adecuadas mientras que 9,7% fueron inadecuadas. Se encontró una relación directamente proporcional entre el conocimiento y la práctica (Rho=0,481). Discusión. La mayoría de los cuidadores presentó un nivel regular de conocimientos sobre el uso del suplemento, también se mostraron falencias con respecto a las medidas de higiene, la forma de almacenamiento y conservación del suplemento
ABSTRACT
Introduction. Childhood iron deficiency anemia is one of the global public health problems, constituting a priority in health care, one of the recommended strategies to deal with it is polymaltose iron supplementation, demonstrating good tolerability with low incidences of adverse effects. Objective: To determine the relationship between the knowledge and practice of child caregivers on polymaltose iron supplementation. Methodology. Quantitative, descriptive-correlational and cross-sectional study. 93 caregivers of children attending a health center in Lima-Peru participated and two instruments were used, a questionnaire and a Likert scale that were validated by expert judgment and a pilot test, obtaining a Cronbach's alpha of 0.808 and Kuder Richardson 0.775. Results. El nivel de conocimiento sobre suplementación con hierro polimaltosado fue regular (82,7%), seguido por bueno (9,7%), y deficiente (7,5%). A directly proportional relationship was found between knowledge and practice (Rho=0.481). Discussion. Most caregivers presented a regular level of knowledge on the use of the supplement; shortcomings were also shown with regard to hygiene measures, the way of storage, and the conservation of the supplement.
To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free-text nursing documentation.
A descriptive cross-sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross-mapping methodology and nursing professionals' consensus.
Cross-mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de-identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free-text records were mapped to NANDA-I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross-mapping and linkage results using a 4-point Likert-type scale and Kappa's coefficient.
The de-identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self-Care Assistance: Toileting; (1801) Self-Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs.
These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence-based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes.
In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de-identified medical and nursing records to propose and validate linkages for nursing diagnoses.
Objetivo: comprender el significado del no abandono en el adulto mayor de la comunidad. Metodología: estudio cualitativo descriptivo realizado en un municipio de Guanajuato, México de febrero-diciembre 2022. Se eligieron personas mayores de 60 años sin distinción de género; tipo de muestreo por conveniencia con saturación de información con 8 participantes; los datos fueron recolectados mediante entrevistas presenciales semi-estructuradas que fueron audio grabadas. Todos los participantes firmaron un consentimiento informado. Resultados: emergieron cuatro temas: 1. Necesidad de apoyo familiar, 2. Necesidad de sentirse integrado, 3. Necesidad de sentirse funcional y activo y 4. El abandono es soledad. Conclusión: el no abandono está construido a partir de la dinámica familiar y la funcionalidad, cada persona mayor le otorga un significado basado en la comunicación con sus familias, incluso a distancia, siendo reconfortante. Algunos viven solos y eso representa un espacio de satisfacción personal. La integración familiar es imperante, así mismo el mantenerse activos.
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