Conectar
To synthesise evidence on wearable devices for continuous vital signs monitoring in adult hospital inpatients, focusing on clinical effectiveness, nursing perspectives, workflow impact, patient experience and resource implications.
Scoping review.
Joanna Briggs Institute methodology reported using PRISMA-ScR guidelines.
Six databases (CINAHL, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane), Scite.ai, and hand searching for studies published between January 2015 and November 2025. Data were synthesised using reflexive thematic analysis.
Sixty-seven studies from 19 countries were included. Four integrative themes were identified. (1) Enhancing clinical safety through continuous monitoring: wearable devices consistently enable earlier recognition of physiological deterioration; however, downstream outcomes such as length of stay and transfers to intensive care units were mixed and context dependent. (2) Transforming nursing practice and workflow integration highlighted improved situational awareness and potential efficiency gains, alongside challenges related to alarm overload, parallel documentation and implementation workload. (3) Patient experience of wearable monitoring: most patients reported reassurance and perceived safety, though experiences reflected a tension between monitoring as care and monitoring as surveillance; discomfort, anxiety, and privacy considerations were infrequently examined. (4) Economic and organisational consequences: potential system value was suggested through workforce efficiencies, but economic benefits were largely inferred, with infrastructure and training costs often underreported.
Wearable continuous monitoring technologies show clear potential to support nursing observations enabling improved early detection of deterioration. Realising these benefits depends on effective integration into workflows, robust governance, and sustained nursing leadership rather than technological capability alone. Significant evidence gaps remain regarding long-term outcomes, economic evaluation, and large-scale implementation.
Wearable devices for continuous vital signs monitoring have the potential to transform inpatient surveillance by enabling earlier recognition of physiological deterioration and enhancing nurses' situational awareness. This scoping review synthesises international evidence demonstrating that, although wearable monitoring can improve patient safety and workflow efficiency, its impact depends on effective integration into nursing practice, governance structures, and organisational preparedness. Continuous monitoring also introduces new challenges including alert fatigue, data interpretation, and workflow redesigns, highlighting the vital role of nursing leadership in digital health implementation. The review also identifies critical evidence gaps, particularly concerning long-term clinical outcomes, patient experience, and cost-effectiveness, providing priorities for future research and policy to promote safe, ethical, and sustainable adoption.
None.
To determine the predictors of pressure injuries among residents living in Sri Lankan nursing homes.
A prospective multi-site longitudinal cohort study design.
Semi-structured observations and chart audits were used to gather data on 17 predictors of pressure injury from a consecutive sample of 210 residents (aged ≥ 60 years old) from nine nursing homes in Sri Lanka. Data were collected at baseline and followed up every week until the study endpoint: a new pressure injury or reaching the maximum 12 weeks of data collection, from July to October 2023. Validated semi-structured data collection forms and chart audits were utilised. Binary logistic regression was used to identify the predictors of pressure injuries. Generalised linear mixed models were used to assess the association between predictors and the development of new pressure injuries.
The cumulative incidence of pressure injuries was 17.1% (36/210) during the 12 weeks. The number of medical devices and baseline pressure injuries predicted the development of new pressure injuries. Each additional medical device increased the likelihood of developing a pressure injury by 2.3-fold, and individuals with a baseline pressure injury were 2.1 times more likely to develop a new pressure injury.
Multiple medical devices and baseline pressure injuries are predictors of pressure injury in older residents living in nursing homes.
This study provides evidence of pressure injury predictors among older residents living in nursing homes. Early identification of high-risk residents with an existing pressure injury and those with multiple medical devices is important for nurses and managers at nursing homes. Accurately assessing residents' risk of a pressure injury may result in implementing various preventive strategies that may ultimately help prevent future pressure injuries.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cohort studies guidelines.
No patient or public contribution.
Identify desired training content for shift-working nurses to improve their sleep and fatigue.
A descriptive qualitative design.
We recruited night shift nurses (N = 23) to provide feedback during virtual focus groups/interviews. Data collection occurred in the U.S. between March and June 2024. Participants were presented with sleep and fatigue topics derived from the literature. Focus group/interview data were collected and transcribed. Data were analysed using a hybrid deductive-inductive manifest content analysis with an a priori coding schema based on topics shared during data collection. Data not fitting the schema, yet informing content, were analysed inductively.
Three themes aligned with literature-derived topics. Theme 1, Why We Sleep and Why Should Nurses Care, explains the importance of sleep to health. Theme 2, Sleep Practices for Nurses to Support Health and Social Relationships, describes healthy strategies to promote sleep for enhanced quality of life. Theme 3, Fatigue and Work, illustrates the significance of nurse sleep and fatigue risk mitigation to safe working conditions and patient care.
Study findings highlight night shift nurses' interest in gaining evidence-based information to promote their sleep. Sleep education and training could fill a knowledge and skills gap, not often offered in school or workplace.
Identifying themes relevant to nurses may help increase the development and availability of sleep education and training currently tailored for nurses.
Study findings describe content night shift nurses' desire for sleep and fatigue training, serving as an important first step in developing programmes most relevant to shift-working nurses. Our analysis found the findings largely align with key components workers should receive in sleep education and training and reinforced the need for employers to offer such training. This study could benefit the nursing workforce and employers who expect rested, high-functioning nurses to care for patients.
Standards for Reporting Qualitative Research.
No patient or public contribution.
Clinicaltrials.gov, NCT06105307
To synthesise the evidence on implementation strategies used to implement transitional care interventions for adult surgical patients.
Scoping review.
Medline, CINAHL and EMBASE were searched in August 2023 and updated June 2025, followed by citation searches. Studies were screened independently by two researchers, and one extracted data, another verified its accuracy. Studies about transitional care interventions for adult surgical patients were coded according to the ‘Five classes of implementation strategies’ and the ‘Patterns, Advances, Gaps, Evidence for practice and Research recommendations’ framework, to illuminate the review findings.
Based on 27 studies included in the scoping review, staff education, changes to staffing and electronic systems, and change management techniques were frequently used implementation strategies. Implementation strategies were mostly used with patients undergoing colorectal and cardiac surgery in Asia and the United States. Scale-up strategies and capacity-building initiatives for people in charge of spearheading the change initiatives were less common.
To further the field, future research could focus on capacity-building and scale-up strategies, fidelity reporting, and financial implications of implementation in a wider range of surgical populations and settings. Work is needed to effectively implement surgical transitional care interventions in real-world settings.
Our findings provide strategies for hospital leaders to adopt when implementing transitional care interventions for surgical patients.
Scoping Reviews (PRISMA-ScR) checklist.
Determined review focus, interpreted findings, and contributed to manuscript.
The Open Science Framework.
People with type 1 diabetes may be at increased risk of disordered eating, which may increase risk of elevated poor outcomes and high-risk complications. Type 1 diabetes disordered eating (T1DE) services were set-up to integrate diabetes and mental healthcare to better support people with T1DE and improve longer-term outcomes. A rapid evaluation was conducted to explore the implementation of T1DE services. Specifically, we aimed to: describe service delivery models; investigate staff experiences of impact and delivery of implementation; explore patient experiences of T1DE services; and to report health outcomes and associated costs.
Rapid evaluation using mixed methods (service mapping, staff and patient interviews, staff survey, analysis of clinical and economic data). Health outcome data was reported at baseline and 6 months.
This study explored the implementation of five new T1DE services and three existing services.
Staff working within T1DE services and patients who received care from T1DE services.
Assessment of our mixed methods study identified four key findings: (1) T1DE delivery models: The T1DE services displayed modest variation in models of delivery, but similarities were more evident, with a focus on direct delivery to patients involving joint meetings between diabetes and mental health staff. Nevertheless, some services also took on a ‘consultation’ role, providing advice and support to wider staff outside the service also managing these patients. Delayed implementation of the services slowed the formation of fully integrated teams and the ability of services to operate at scale. (2) Staff experience: Workforce issues were a crucial aspect of T1DE pilots. Managing this patient population is associated with high levels of anxiety for staff. Nevertheless, once formed, staff reported a very positive experience of working in integrated teams. (3) Patient experience: Although only a small sample of patients were interviewed, they reported a profoundly different experience to their previous care, which was now perceived as supportive and relationship focused. Although such improvements were aligned with the integrated care model underlying T1DE, it was less clear how such changes in patient experience would feature in decisions about commissioning. (4) Health outcomes and associated costs: There were 139 patients accepted onto the care pathway. Improvements were seen for all health outcomes. Compared with baseline measures, there was a mean 0.97% reduction in HbA1c (glycated haemoglobin) from 11.2% to 10.2% at 6 months. Improvements were also seen in other outcomes, including the diabetes eating problem scale and the diabetes distress scale. However, the number of patients on the care pathway with follow-up at 6 months was relatively small (n=29–47) and definitive statements about clinical or cost-effectiveness were not possible.
Overall, T1DE services were well received by both staff and patients. Due to a number of logistical challenges, the implementation of services was slower than anticipated, resulting in a limited number of patients on the care pathway. Securing local funding for existing services, once national pilot funding ended, was identified as a significant challenge. In order to ensure services are sustainable and commissioned at a local level, consideration may need to be given to alternative service delivery models.
A significant proportion of infants born at ≤29+6 weeks’ gestation develop lung disease during the neonatal period, thus putting them at risk of developing prematurity-associated lung disease in childhood and adulthood. After discharge from the neonatal unit, pre-existing lung disease in preterm-born infants is exacerbated by (often frequent) respiratory viral infections requiring greater health utilisation, including hospital admissions, than their term-born equivalents. Opportunities to prevent viral infections in infancy are largely limited to anti-respiratory syncytial virus (RSV) antibody prophylaxis and recently maternal RSV immunisation, but in term-born infants, trained immunity-based vaccines such as Bactek (MV130, Inmunotek, Spain) are increasingly used. Bactek provides a promising therapeutic avenue for preterm-born infants to target postdischarge respiratory viral infection in this vulnerable group of infants. The BALLOON study aims to assess this treatment in a very/extremely preterm-born population and determine if treatment with the trained immunity-based vaccine Bactek decreases the risk of unscheduled visits to healthcare professionals for lower respiratory tract infections, when compared with placebo. Included infants are born at ≤29+6 weeks’ gestation and treated daily from term-equivalent (37–43 weeks’ postmenstrual age, PMA) or from discharge, if earlier, up to 1 year of corrected age.
542 infants are being recruited prior to discharge by neonatal units in the UK. They are being randomised to receive Bactek or placebo, once daily dose of 2 sprays (each 0.1 mL) of IMP (300 Formazin Turbidity Units), from 37 to 43 weeks’ PMA or discharge if earlier up to 1 year of corrected age. The primary objective is to assess if sublingual Bactek spray decreases the risk of health professional diagnosed lower respiratory tract infections (LRTIs) (unscheduled visits to general practitioners, accident and emergency departments and hospital admissions) between enrolment and 1 year of corrected age. Secondary outcomes include the number of parent-reported, health professional-confirmed unscheduled visits for LRTIs, the time to first parent-reported, health professional-confirmed unscheduled visit for LRTI, parent-reported wheeze episodes (identification aided by WheezeScan (Omron, Japan)), parent-reported use of respiratory medications, growth (weight, length and head circumference), parent(s)/guardian(s) reported time missed from work and/or nursery time missed for the infant and volume of adverse reactions. Viruses associated with LRTIs will also be identified.
Ethics permission has been granted by the Wales Research Ethics Committee 3 (Ref 24/WA/0181), and regulatory permission by the Medicines and Healthcare Products Regulatory Agency (CTA reference 21323/0063/001-0004). The study is registered on ISRCTN (ISRCTN14019493). Findings will be disseminated via national and international peer-reviewed journals, and conferences. Oversight of the study is being provided by an Independent Data Monitoring Committee and an independent Trial Steering Committee (TSC). The Trial Management Group (TMG) meets every month.
To map the current literature on the characteristics of nurse-related medication errors in perioperative healthcare settings.
A scoping review.
This scoping review used the five-stage framework developed by Arksey and O'Malley (2005). The five stages are: (1) Identifying the Research Question; (2) Identifying Relevant Studies; (3) Study Selection; (4) Charting the Data; and (5) Collating, Summarising, and Reporting the Results. Findings were synthesised using the PAGER framework. An Ishikawa diagram was used to illustrate contributing factors of nurse-related medication errors.
In October 2024, using key search terms, five databases (Scopus, EBSCO Cumulative Index to Nursing and Allied Health Literature, OVID Embase, EBSCO Medline, EBSCO PsycInfo) and two grey literature platforms (opengrey, Policy commons) were searched. The articles were imported to the Covidence database from Endnote after removing duplicate literature. Selected article titles and abstracts, and subsequently full-text articles, were screened by two trained reviewers based on a priori inclusion and exclusion criteria. Data were extracted from the included full-text articles by one author, checked by another, and analysed descriptively.
Of the 967 articles identified through the searches, 7 full-text articles were included. The incidence of nurse-related medication errors in perioperative settings ranged from 6.4% to 33.7%, with errors including incorrect medication routes, missed or delayed doses, and miscommunication-related overdoses. Contributing factors were multifaceted, involving workload pressures, communication failures, system flaws, and organisational influences such as leadership and safety culture.
Medication errors in the perioperative setting pose a significant threat to patient safety yet remain underexplored compared to other healthcare contexts. A holistic approach incorporating human factors frameworks, improved communication, workload management, and leadership can help address the complex causes of these errors and guide targeted interventions to enhance perioperative safety and patient outcomes.
Scoping Reviews (PRISMA-ScR) checklist.
No Patient or Public Contribution.
Open science Framework Website. Registration DOI https://doi.org/10.17605/OSF.IO/EXT8C
by Claire L. Chan, Saskia Eddy, Jennie Hejdenberg, Ben Morgan, Heather M. Morgan, Gillian Lancaster, Clare Robinson, Sandra M. Eldridge
BackgroundThe National Institute for Health and Care Research accepts applications for pilot and feasibility studies to their Research for Patient Benefit (RfPB) programme. There has been limited work describing the design practices of these applications and funding status. Knowing some of the qualities which may contribute towards a pilot or feasibility study application successfully gaining funding could help researchers improve the quality of their applications. Therefore, this study describes the protocol for a review looking at the characteristics of funded and non-funded external pilot trial applications. In particular, the primary objective is to describe the planned sample size and sample size justifications.
MethodsThe study will be conducted on 100 applications from Competition 31–37 with a randomised feasibility design, identified and given access to us by RfPB where the lead applicant has consented. We will screen these applications to identify the external pilot trials, first looking through the titles and then the full text. Following this, we will extract data on information such as medical area, study design, objective(s), sample size, sample size justification, and funding outcome stage one and two. Validation will be performed on 20% of the data extracted; discrepancies will be resolved by discussion or a third reviewer will decide if there is no consensus. We will use descriptive statistics to summarise quantitative data, and will analyse qualitative data using thematic analysis. Findings will be summarised through discussion with the project contributors to produce a reader-friendly guidance document.
DiscussionThis work will provide a more complete picture of RfPB external randomised pilot and feasibility trials. The findings will assist researchers when planning their pilot trials, and could help improve the quality of submitted applications.
Protocol RegistrationOpen Science Framework protocol registration DOI: https://doi.org/10.17605/OSF.IO/PYKVG.
Cycling can be beneficial for health, well-being and the environment; however, cycling participation in the UK remains low. Effective and cost-effective strategies are needed to support people in the community to increase cycling. The Cycle Nation Communities randomised controlled trial (RCT) will evaluate whether a 9 week multi-component cycling programme (Cycle Nation) is more effective and cost-effective than an existing national cycle training session on cycling participation, transport use and health and well-being.
This pragmatic, single-blinded, two-arm RCT will recruit ≥268 adults who cycle infrequently. Participants will be randomised to the 9 week multi-component individual/social-level group-based Cycle Nation programme or an existing national standard single group-based cycle training session. Both arms will be delivered by community-based cycling organisations in Glasgow. Participants will complete self-reported measurements at baseline, 12 weeks and 12 months. The primary outcome is the proportion of participants cycling at least weekly at 12 months. Secondary outcomes include proportion of participants cycling at least weekly at 12 weeks; change in weekly number of rides and minutes of cycling and use of private car, taxi, public transport and walking at 12 weeks and 12 months; change in motivation, perceptions of cycling safety, confidence to cycle, self-esteem, vitality, health-related quality of life and perceived general physical health at 12 weeks and 12 months. A within-trial economic evaluation from a National Health Service/personal social service and a broader societal perspective will be undertaken. Pending within-trial results, a long-term model may be developed. An embedded process evaluation will use participant and facilitator interviews, participant acceptability questionnaires, facilitator delivery proforma and session observations.
Ethical approval has been obtained from the University of Glasgow Medical, Veterinary and Life Sciences Ethics Committee (11 April 25). Findings will be published in peer-reviewed journals and communicated to stakeholders and the public.
There are approximately 700 000 autistic people in the UK, and autism is increasingly being diagnosed in adulthood. Diagnosis on its own does not provide adequate information to plan post-diagnostic support for autistic people, and clinicians often plan support without the use of validated standardised tools which may exacerbate inequities in care. This study will evaluate a novel strengths and needs assessment, based on the WHO’s International Classification of Functioning, Disability and Health CoreSet for Autism, for use in adult diagnostic services immediately on receipt of an autism diagnosis. Potential issues, including the length of the assessment, timing of delivery and selection bias, will be explored as part of the trial process evaluation.
A two-arm, multisite, randomised pilot trial design will be used to evaluate the ICF CoreSets for Autism Strengths and Needs Assessment in three diagnostic services in England. A total of 72 newly diagnosed autistic adults will be recruited across the three sites over a 6-month period and randomised into an assessment group (strengths and needs assessment plus standard care) and a treatment as usual group (standard care only). The assessment group will receive a summary report of their strengths and needs on completion of the assessment. Both groups will complete measures of mental health and quality of life at baseline and 3 months follow-up (Patient Health Questionnaire-9, Generalised Anxiety Disorder questionnaire-7, Recovering Quality of Life questionnaire-10, EuroQoL-5D). Acceptability and feasibility will be measured for the strengths and needs assessment and for trial procedures using standardised measures, progression criteria and qualitative data from clinician focus groups and interviews with a subsample of autistic participants. The study design and procedures are being co-produced with an autistic advisor/patient and public involvement lead and with a steering group of autistic adults.
This study was reviewed by the East Midlands—Nottingham 2 Research Ethics Committee and was given Health Research Authority approval on 18 March 2025 (REC reference:25/EM/0041). The results will be disseminated via reports to the funder (NIHR), a peer-reviewed journal paper and academic conferences. We will email a summary report of findings to study participants and will invite participants to an information dissemination event at the end of the study. Links to reports and a lay summary will be provided on the research group’s website: https://sharl.sites.sheffield.ac.uk/home
Microcirculatory dysfunction drives the end-organ pathophysiology of circulatory shock but is not reflected within existing clinical indices of perfusion, such as blood pressure. The choroidal vasculature of the retina can be measured non-invasively and we hypothesised that this may reflect dysfunction in other organs. We tested the feasibility of measuring the choroid in intensive care and explored associations between choroidal measurements and clinical parameters.
A pilot study of optical coherence tomography conducted in a sample of general intensive care unit (ICU) patients.
A tertiary mixed ICU within the UK.
15 patients were recruited. One patient was excluded following withdrawal of active treatment. 12/14 (86%) of the remaining patients had successful baseline imaging and 6 (40%) of these had follow-up imaging within intensive care. These patients had a mean age of 56.3 years, were 71% (10/14) male and mean Acute Physiology and Chronic Health Evaluation 2 (APACHE2) score on ICU admission was 20.4.
Choroidal anatomy, including choroidal and suprachoroidal thickness, as well as volumetric analysis of intrachoroidal blood vessels, was assessed using automated image segmentation along with clinical, physiological and biochemical data at ICU admission and after an interval of 12–72 hours. Feasibility and safety data were assessed throughout ICU admission.
Baseline choroidal vascular index and choroidal thickness were positively associated with fluid balance, and negatively with APACHE2 score, haematocrit and albumin content. A measurable suprachoroidal space was seen in nine (75%) patients (range 25.0–110.0 microns) and was inversely associated with heart rate. There was substantial intraindividual variation in choroidal measurements over time. There were no safety concerns.
Measuring the choroid is feasible in patients with Intensive Care Society Level 2 or Level 3 requirements. The suprachoroidal space may be markedly enlarged in these patients. Exploratory associations with systemic variables suggest that the choroid may provide information about the microvascular function of other major organs. Size and change of choroidal measurements may reflect perfusion pressure and vascular leakage.
To understand how public health practitioners (PHPs) are using parental guidance on talking to children in their work with parents. In 2021, evidence-based guidance was produced for parents of young children to facilitate these conversations, but it is unclear how this guidance is being promoted to parents or used by PHPs.
Qualitative study, consisting of in-depth, semistructured interviews.
Local authority, National Health Service or other healthy weight service providers in the UK.
Participants were PHPs working on children’s healthier lifestyles programmes in the UK as part of the UK’s National Child Measurement Programme (NCMP). Invitations to participate were distributed via the Department of Health and Social Care and regional and national networks.
24 participants were interviewed. Practice varied between organisations with the guidance being used in NCMP letters to parents, in follow-up phone calls with parents and in training NCMP staff and other health or education professionals. Participants valued the evidence-based guidance and its compassionate tone, feeling it gave them and parents, confidence in addressing a sensitive topic. Some felt it was too lengthy for parents with learning disabilities or low literacy levels. Others identified a need for similar guidance for older children. Though helpful, participants acknowledged the guidance was only one small part of a necessary systems-wide approach to promoting healthy weight.
The guidance is a useful tool but needs systematic promotion to increase use and effectiveness. Further work is warranted to develop adapted versions for other populations.
It is widely known that a diagnosis of visual impairment has significant mental health impacts. Proposed approaches to addressing these include cognitive behavioural, problem-solving and stepped care solutions.
Limited research has focused specifically on vision-impaired patients’ preferences for mental health support following diagnosis. This study aimed to address this gap.
The study was qualitative and cross-sectional, involving thematic analysis of semistructured interviews with patients diagnosed with vision impairment.
Twenty vision-impaired patients, aged from 20 to 84 years old and with a range of diagnoses, were interviewed regarding their experience of and recommendations for mental health support at the point of diagnosis and thereafter.
Three main themes were identified: (1) Mapping the Journey: The Critical Role of Accessible Information, (2) Navigating the Emotional Impact: Help-Seeking Attitudes and Experiences and (3) Tailored Mental Health Support: Timing, Delivery and Preferred Providers. Each theme had three subthemes.
It was concluded that clear information about diagnosis, prognosis and available supports is fundamental to promoting and maintaining mental health for vision-impaired patients. Person-centred and/or peer support is highly valued. To be maximally effective, specific mental health support should be informed by knowledge of vision impairment, with standardised treatment programmes not being valued highly. The study results strongly suggest that mental health support needs to be tailored to the unique needs of each individual, and therefore, a stepped care approach may be most helpful, encompassing clear information, practical advice and ongoing peer and professional support.
Hospital falls and associated injuries are a global issue associated with harm and significant costs to individuals and society, especially for older adults. Hospital standards specify the minimum level of care required to optimise patient safety, quality and outcomes. Standards are often used during hospital accreditation. This investigation analysed the content and quality of hospital falls standards across the globe.
Hospital standards were located by searching online databases (PubMed, CINAHL, Google Scholar, MEDLINE), ChatGPT, the grey literature via internet search engines, and websites of accreditation agencies, government agencies, and other relevant organisations. We searched for standards from the 60 largest countries by population plus the 60 countries with the highest gross domestic product (n = 82 after accounting for duplicates). For inclusion, hospital standards had to mention ‘fall/s’. Data were analysed using a deductive framework synthesis and content analysis to identify emergent themes.
Forty-one standards used by at least 72 countries were identified from our search. Sixteen were excluded from detailed analysis because they did not mention falls and 3 could not be retrieved. A total of 22 standards were included in the final detailed analysis. Included standards showed wide variations in content and quality. Seven were assessed as high quality, 12 medium quality, and 3 were deemed to be of low quality. Some lacked details on hospital falls screening, assessment, prevention, and management. Consumer engagement in development, implementation, or evaluation was not mentioned in all standards. Procedures for falls data collection and reporting were seldom documented. Hospital standards infrequently referred readers to contemporary research or clinical practice guidelines.
There are variations in the quality and content of standards on hospital falls. International collaboration is recommended to increase the consistency and validity of hospital falls standards across nations, in order to optimise healthcare outcomes.
The findings of this global analysis of hospital falls standards have the potential to impact falls rates and fall-related injuries in hospital patients by providing data to inform the content, evidence base and use of hospital standards to optimise the safety and quality of care delivery. The findings inform the review, design and implementation of hospital accreditation procedures to improve patient outcomes, patient experiences, and service quality.
To explore women's experience of the period after completion of cancer treatment for gestational trophoblastic neoplasia (GTN): a descriptive exploratory study.
A descriptive exploratory qualitative study.
Women diagnosed with the rare pregnancy-related cancer GTN who had completed their treatment participated in semi-structured telephone interviews. Twenty-two interviews were conducted in June 2024 and digitally recorded and transcribed verbatim. The analysis used reflective thematic analysis.
Complex responses to treatment completion were revealed, described by some as a ‘double-edged sword’. The end of treatment routine, coupled with recovery from physical effects, left space for the impact of all they had experienced to ‘hit home’. Multiple concerns and losses were described, including issues relating to pregnancy, self-identity, confidence, fear of recurrence, work and relationships. Gaps in immediate post-treatment support services created challenges for recovery.
The study provides valuable insight into the physical, emotional and social impact of GTN experienced by patients following treatment. The findings highlight the importance of continuing support in the immediate post-treatment period. This study has identified ways in which services can be improved, recognising the need for an individual-tailored approach to reflect the complex responses of patients to treatment completion.
The findings reveal that many women begin to process the implications of their diagnosis and treatment following the completion of their treatment. The end of treatment can be a time when support from healthcare staff is reduced due to fewer routine contacts with healthcare staff. However, these findings suggest the need for nurses to ensure services continue to provide support during the post-treatment recovery phase.
The interview schedule was reviewed by women previously treated for GTN.
To assess whether transgender women who have sex with men (TGWSM) sampled in men who have sex with men (MSM) biobehavioural surveys in Ukraine experience different levels of sexual risk, stigma, HIV prevalence and engagement in the HIV care than cisgender MSM (CMSM).
Analysis of secondary data from three population-level cross-sectional surveys.
The analysis was conducted on data from three rounds of integrated biobehavioural surveys of MSM in 27 cities of Ukraine from 2013 to 2018.
Data from n=18 621 MSM with n=18 102 CMSM and n=503 TGWSM.
The primary outcomes were differences in sexual risk behaviours, HIV testing and treatment uptake, and the secondary outcomes were differences in lifetime experiences of stigma, coercive sex and physical assault (in the 2018 survey only) between CMSM and TGWSM.
Compared with CMSM, TGWSM were more likely to be clients of non-governmental organisations (adjusted OR, aOR: 1.39, 95% CI 1.15 to 1.67), engage in commercial sex (last month; aOR: 1.28, 95% CI 1.01 to 1.61), have group sex (aOR: 1.31, 95% CI 1.06 to 1.61), more long-term sex partners (last month; adjusted incidence rate ratio: 1.14, 95% CI 1.03 to 1.27), history of imprisonment (aOR: 1.51, 95% CI 1.00 to 2.31) and engage in chemsex (last month, aOR: 1.58, 95% CI 1.12 to 2.23). We found no difference in HIV prevalence (5.17% in TGWSM vs 5.43% in CMSM, p=0.065). In 2018, more TGWSM reported lifetime experience of stigma from family and friends (aOR: 3.58, 95% CI 2.54 to 5.04), general social stigma (aOR: 3.13, 95% CI 2.22 to 4.41), anticipated healthcare stigma (aOR: 3.63, 95% CI 2.53 to 5.16), physical assault (aOR: 2.73, 95% CI 1.85 to 4.03) and coercive sex (aOR: 3.01, 95% CI 1.99 to 4.55) than CMSM.
TGWSM in Ukraine may be at increased risk of HIV acquisition compared to CMSM due to many factors including elevated levels of stigma and violence. Services specifically tailored for transgender people are needed to help reduce these high-risk behaviours.
To describe patient outcomes for patients at high risk of mortality (with a prognosis of three months or less to live) where a Palliative Care Nurse Consultant (PCNC) was embedded in a General Medicine team. To explore patients and/or their carers feedback and allied health, nursing professionals' perspectives on integrating a palliative care approach in the General Medicine ward.
Prospective exploratory study.
SQUIRE reporting guidelines was adopted for the study reporting. This study was conducted over six weeks in a general medicine ward at Monash Medical Centre in Melbourne, Australia. Participants were 20 patients aged > 65 years with non-malignant, chronic conditions at high risk of mortality within three months and had 18 nursing and allied health professionals involved in their care. Quantitative data were analysed descriptively and qualitative survey data were analysed thematically.
Twenty patients participated, with an average age of 87 years. 55% spoke a language other than English. PCNC interventions, focused on care coordination and family liaison, were found to facilitate timely referrals to other support services, improve communication and better address end-of-life care needs. Healthcare professionals recognised the benefits of PCNC involvement; however, a key qualitative theme was staff reluctance to raise palliative care needs due to perceived role boundaries and limited confidence. While PCNC presence improved communication and advocacy, barriers included time constraints and patient/family resistance.
Embedding a PCNC in a general medicine team appears to enhance care coordination and support timely palliative care integration. Addressing barriers and optimising workflow can improve patient, carer and clinician experience as well as improve resource utilisation.
The model has the potential to enhance patient-centred care and clinician support in acute general medicine settings.
The research will have an impact on acute care settings, particularly general medicine units, by informing models of integrated palliative care for patients with complex needs and enhancing staff capability and confidence in providing timely, person-centred care.
Patients or members of the public were not involved in the design, conduct, analysis or manuscript preparation of this study. The project was a prospective observational study with limited scope and resources, which did not include a formal patient or public involvement component.
To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).
Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.
Phase 1: An expert group developed the tool structure and item content. Phase 2: Through a modified Delphi, cancer nursing experts rated the importance of each element of practice and assessed the relevance and clarity of each item. Content Validation Indexes (CVI) were calculated, and a CVI of ≥ 0.78 was required for items to be included. Phase 3: Cancer nurses participated in a survey to test internal consistency (using Cronbach's alpha coefficients) and known-group validity (through Mann–Whitney U tests). This study was reported using the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist.
The CaN-SAT underwent two rounds of Delphi with 24 then 15 cancer nursing experts. All elements of practice were rated as important. Only three items achieved a CVI < 0.78 after round one; however, based on open-ended comments, 26 items were revised and one new item added. After round two, all items received a CVI above 0.78. The final tool consisted of 93 items across 15 elements of practice. Cronbach's alpha coefficients were between 0.92 and 0.98 indicating good reliability. Mann–Whitney U tests demonstrated significant differences between clinical nurses and advanced practice nurses across 13 out of 15 elements of practice.
The CaN-SAT is a comprehensive, valid and reliable tool that can be used for cancer nurses to self-assess current skill levels, identify their learning needs and inform decisions about educational opportunities to optimise cancer care provision.
The research team included three patient advocates from Cancer Voices NSW, who were actively involved in all aspects of the study and are listed as authors.
To explore the experiences of significant others of patients with severe burn injury in the intensive care unit. Specifically, how severe burn injury impacted the significant other and their role within their loved one's life.
This qualitative study employed a Narrative Inquiry approach.
Interviews were undertaken during 2021–2022 with 17 participants who were the significant others of a patient with severe burn injury in the Intensive Care Unit. Recruitment occurred in New South Wales, Australia, from two tertiary hospitals providing care for people with major burns. A narrative inquiry approach was utilised, capturing stories through semi-structured interviews.
Significant others experienced necessary changes in their life in response to the catastrophe. These included advocating, being present and ensuring their loved one's needs were met, while often neglecting themselves. Significant others contemplated their future as a carer to their loved one with severe burn injury, and adjusting their own career, finances and lifestyle, often as a long-term measure. The shifting of their role to carer ultimately transformed and redefined their relationships and lives.
Significant others endure immense trauma when a loved one sustains a severe burn injury. They require support but prioritise the patient by virtue of their critical illness. The life of the significant other is changed as they take on the role of carer and provide support. It is, therefore, imperative that the support needs of significant others are recognised, understood and addressed to ensure their well-being while processing the trauma.
With increased understanding of the significant others' experiences, healthcare providers can adopt a consultative approach, where roles and boundaries can be clearly identified. Through this process, healthcare providers can strengthen rapport and provide targeted support for significant others, as they navigate this traumatic life-altering event.
No patient or public contribution.
Preventing pressure injuries among nursing home residents is a significant challenge that necessitates understanding the barriers and facilitators from the perspective of staff. This qualitative study aimed to describe these factors within Sri Lankan nursing homes. Semi-structured interviews were conducted with 15 nursing home staff members from nine nursing homes in and near the Colombo district, Sri Lanka. The study was informed by the capability, opportunity, motivation, and behaviour model that guided both data collection and analysis. Data were analysed using content analysis. Using deductive coding based on capability, opportunity, and motivation, followed by inductive analysis, four primary categories emerged: focusing on skincare is foundational for pressure injury prevention, pressure injury knowledge is critical for prevention, pressure injury prevention is a low organisational priority, and overcoming challenges to enact pressure injury prevention. Key facilitators included access to skincare products, maintaining clean and dry skin, recognising risk factors, proactively managing risks, and understanding the broader implications of pressure injuries on residents and their families. Conversely, barriers encompassed limited training, varying staff support, inadequate resources, and the complexities of managing multiple tasks. This research highlights that enhancing knowledge and allocating resources effectively can improve the implementation of pressure injury prevention strategies in Sri Lankan nursing homes.
FreshRSS 