Conectar
by Josefine Lampinen, Håkan Littbrand, Ingeborg Nilsson, Annika Toots, Yngve Gustafson, Jerry Öhlin, Henrik Holmberg, Birgitta Olofsson, Anita Ericsson, Mia Conradsson
BackgroundTo meet the complex needs of adults with dementia, a team-based, individualized rehabilitation approach may be required. This randomized controlled pilot trial evaluated the feasibility of a person-centred multidimensional interdisciplinary rehabilitation program for older adults with dementia, in terms of follow-up and response rates, and potential short- and long-term effects in adults with dementia on social participation, loneliness, and mental health.
MethodsParticipants (mean age (SD) 78.7 (±6.6) years), were randomized to an intervention group (n = 31) or usual care (n = 30). The rehabilitation program consisted of a 20-week rehabilitation period and two follow-ups after 5 and 14 months. An interdisciplinary team performed assessments and interventions based on the individual’s goals. Assessors blinded to group allocation performed structured assessments at baseline and after 5, 12, 24, and 36 months.
ResultsInitially, response rates in participants with dementia were high for all assessments in the areas of social participation, loneliness, and mental health. Response rates after 12 months decreased, particularly for cognitively demanding questions with multiple-choice options in the area of social participation. Overall, there were few statistically significant differences between the groups in the outcomes over 36 months, but some of the findings seemed potentially clinically meaningful in favor of the intervention group: increased frequency of active recreation and organized social activities outside the home, as reported by both participants with dementia and caregivers or staff; as well as experienced more frequent visits to family and friends; and short-term reduction in depressive symptoms.
ConclusionsAssessments made of loneliness and mental health in this study over three years seemed feasible. It seemed cognitively demanding for participants with dementia to answer questions regarding social participation over time; therefore it seemed worthwhile to also ask informal caregivers or staff to avoid data loss. The positive findings noted during assessments and potential effects indicate that it is relevant to proceed further to an adequately powered RCT and conducted in additional geographical regions.
Trial registrationISRCTN – The UK’s Clinical Study Registry: http://www.isrctn.com/ISRCTN59155421
The involvement of older adults as active partners in research is increasingly being promoted to improve the relevance and impact of scientific knowledge. However, the evidence base on how older adults have been involved as active partners in healthcare research remains fragmented. To our knowledge, no review of reviews has yet provided a comprehensive overview of this body of evidence. Therefore, this umbrella review aims to synthesise review-level evidence on the involvement of older adults as active research partners. We address three questions: (1) How have older adults been involved as active partners in research? (2) What terminology, models and frameworks have been used? (3) What benefits and challenges have been reported related to involving older adults as active partners in research?
This study will follow the Joanna Briggs Institute (JBI) methodology for umbrella reviews. A comprehensive search will be conducted in Medline, CINAHL, Scopus, PsycINFO, Sociological Abstracts and Web of Science. Eligible reviews will be those reporting on the involvement of older adults (aged 60 years or older) as active partners in research. Two reviewers will independently screen titles, abstracts and full texts and perform data extraction using a standardised form. Methodological quality will be assessed using the JBI Critical Appraisal Checklist for Systematic Reviews. Findings will be synthesised narratively and thematically, with attention to reported roles, terminology, conceptual frameworks and the benefits and challenges of involvement.
As this umbrella review draws exclusively on secondary data from published sources, ethical approval is not required. Older adults, engaged as independent public contributors, have been involved in shaping the review protocol and will take part in interpreting the findings. Results will be disseminated through a peer-reviewed journal and presentations at academic and stakeholder conferences, and used to inform the design of a subsequent mixed-methods study focused on strengthening the involvement of older adults as active partners in research.
CRD420251064947.
To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
To investigate if beliefs about medicines affect the time to the initiation of cardiovascular preventive medications during a 3 year follow-up period.
A questionnaire and register-based cohort study.
Primary care in Sweden, in which people 40, 50 and 60 years old underwent risk factor screening and individual health promotion within the Västerbotten intervention programme (VIP).
People at low/medium risk of cardiovascular disease (CVD) according to the risk factor screening were included in the VIsualiZation of asymptomatic Atherosclerotic disease for optimum cardiovascular prevention—a population-based Pragmatic Randomised Open Blinded End-point trial (PROBE) nested in the Västerbotten Intervention Programme (VIPVIZA), aiming at improved primary prevention of CVD. People participating in the VIPVIZA 3 year follow-up (n=3167 (89.7%)), receiving the Beliefs about medicines questionnaire (BMQ) (n=2314 (73.1%)) and with complete answers to at least one subscale in the BMQ general (n=2258 (97.6%)) were included. Moreover, only those 60 years old at baseline (n=2073 (58.7%)) and without antihypertensive and/or lipid-lowering drugs (n=1769 (50.1%)) 6 months prior to inclusion in the VIPVIZA trial were included. Accordingly, the final study population comprised 888 people without antihypertensive medicines and 1185 without lipid-lowering drugs, respectively.
The primary outcome was time to the binary event of initiating antihypertensives or lipid-lowering agents, identified within the time frame from inclusion in the VIPVIZA study until the study participants’ 3 year follow-up visit. General beliefs about medicines were assessed according to the BMQ. Cox proportional hazards models, adjusted for sex, were conducted to investigate primary outcome.
Participants with stronger general beliefs about medicines being overused had significantly longer time to initiation of antihypertensive drugs in the control group (HR 0.91; 95% CI 0.84 to 0.996) but not in the intervention group (HR 1.05; 95% CI 0.95 to 1.16). No significant associations were found between beliefs about medicines and initiation of lipid-lowering treatment.
A more negative perception of drugs being overused was significantly associated with delayed initiation of antihypertensive drug treatment. Our results suggest that the VIPVIZA intervention may overbridge negative perceptions and affect the initiation of antihypertensive medications in a positive manner.
NCT01849575 (date of registration: 8 May 2013).
The aim of this study is to map nursing publications on the United Nations Sustainable Development Goals (SDG) in Web of Science, highlighting trends, key contributors, and central research themes to identify potential areas for future research.
The globally-spanning 2030 Agenda promotes sustainable development using research technology and scientific innovation. However, research data availability is a challenge. By conducting big data analyses, using all available nursing research literature indexed in the Web of Science database (Core Collection) pertaining to this field, aid in understanding and advancing this area.
This study adopts a cross-sectional descriptive bibliometric study design.
The search yielded 131 publications, comprising 116 articles (89%) and 15 review articles (11%). This can be compared to adjacent disciplines such as Internal General Medicine (n = 360), Nutrition/Dietetics (n = 171), and Paediatrics (n = 152). The leading countries in publication output were the United States, Australia, and the United Kingdom. Among the included publications, only eight SDGs were addressed: SDG3 (Good Health and Well-Being), SDG13 (Climate Action), SDG4 (Quality Education), SDG5 (Gender Equality), SDG6 (Clean Water and Sanitation), SDG16 (Peace, Justice, and Strong Institutions), SDG1 (No Poverty), and SDG9 (Industry, Innovation, and Infrastructure).
The findings indicate a scarcity of articles in nursing publications focusing on the SDGs, suggesting insufficient evidence of nursing's contributions to these goals—particularly beyond SDG3.
This study provides a comprehensive bibliometric review and analysis of existing nursing publications on the SDGs. The results offer valuable insights for future research areas related to the SDGs, particularly for nursing scholars, clinicians, managers, and policymakers concerned with the underrepresentation of nursing publications. To address this gap and advance both the SDGs and quality patient care, action plans should be developed to integrate the SDGs into daily nursing practice.
No Patient or Public Contribution. This study was a bibliometric analysis.
To describe the prevalence of cardiovascular disease (CVD) at the time of diagnosis of adult-onset type 1 (T1D) and type 2 (T2D) diabetes, in a recent cohort and compare to a previous cohort from the same region. Further, to explore factors influencing the prevalence of pre-existing CVD, including age, sex, body mass index (BMI) and C-peptide; in the later cohort also heart failure, hyperlipidaemia, tobacco use and physical activity.
Two prospective cross-sectional cohort studies compared.
All primary health care centres and hospitals in Kalmar and Kronoberg counties in Southeastern Sweden.
Adults with newly diagnosed T1D or T2D (classified by combination of islet antibodies and C-peptide) in 1998–2001 and 2016–2017.
Prevalence of hypertension and CVD at diagnosis of diabetes, and associations with beta-cell function, in two cohorts collected 15 years apart. Further, to explore factors influencing the prevalence of hypertension and CVD, and level of C-peptide.
In patients with newly diagnosed T2D, mean age-at-onset had decreased (66±14.1 years vs 63±12.6, p≤0.001) and mean BMI had increased (29.0±5.4 vs 31.4±5.8 kg/m2, p≤0.001). Prevalence of pre-existing myocardial infarction had decreased in both T1D (18% vs 7%, p=0.03) and T2D (25% vs 11%, p≤0.001). Pre-existing hypertension had increased in both T1D (23% vs 40%, p=0.01) and T2D (44% vs 61%, p≤0.001). C-peptide level was lower and was associated with several cardiovascular conditions in newly diagnosed T2D in 2016–2017 (p=0.048 p≤0.001).
Patients with newly diagnosed T2D were younger, with higher BMI, compared with 15 years earlier, a challenge for diabetes care. Prevalence of pre-existing myocardial infarction had decreased notably, in line with, but still less than in the general population; while pre-existing hypertension had increased, in both diabetes types. C-peptide was associated with several cardiovascular conditions in newly diagnosed T2D in the recent cohort, which warrants further investigation.
Despite an increasing amount of research related to gender-affirming treatment (GAT) outcomes among transgender and gender-diverse (TGD) people (ie, people who experience discomfort or distress in the misalignment between their gender and sex assigned at birth) in recent years, the evidence base for current recommendations is suboptimal. One contributing factor is the heterogeneity in the outcomes and outcome measures used. This study seeks to address this challenge by developing a foundational core outcome set (COS) to be used for TGD adults receiving GAT in Sweden.
Recommendations from the Core Outcome Measures in Effectiveness Trials initiative will be used to address this aim in four phases. Phase 1, an umbrella review of peer-reviewed literature and international guidelines in GAT will be conducted to identify relevant outcomes. In phase 2, we will solicit input from TGD individuals through the review of patient and interest organisations’ reports and an anonymous survey to identify outcomes of personal significance. In phase 3, using the Delphi method, 2–3 rounds of assessment will be conducted where researchers, healthcare professionals, policy-makers and TGD adults rate the identified outcomes by perceived importance. In phase 4, a consensus meeting will convene representatives from all stakeholder groups to finalise the COS.
The results of this study will consist of a COS for GAT regarding TGD adults in Sweden. Participant survey responses will be evaluated using interpretive analysis to identify core outcomes. During each of the Delphi rounds, Likert-type scale ratings will be aggregated for outcomes to advance or be eliminated in each round.
The study has received ethical approval by the Swedish Ethical Review Authority (Umeå medicine department, Registration number: 2024-04672-01). The results of this study will be published open-access and disseminated through TGD interest organisations and a Swedish research network for gender dysphoria.
COMET registration number 3223.
FreshRSS 