FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Estimating the velocity and direction of African Swine Fever spread in wild boar populations in South Korea using Trend-Surface Analysis

by Cecilia Aguilar-Vega, Jaime Bosch, Satoshi Ito, Benjamin Ivorra, Hyunkyu Jeong, José Manuel Sánchez-Vizcaíno

African swine fever (ASF) is a lethal disease of swine that has spread across Asia since its introduction in 2018. South Korea first reported the disease in September 2019 in domestic pigs, and since then, more than 4,000 cases have been reported in wild boars during its expansion up to August 2024. Due to the high number of ASF notifications in wild boars in South Korea, contrasted with their scarcity in most Asian countries, analyzing the spatiotemporal spread of the disease in a setting with active surveillance provides valuable insights. In this study, we performed a trend-surface analysis on temporally gridded case data to characterize the overall geographic spread and direction of ASF in wild boars across South Korea, from its emergence to August 2022. Additionally, we propose a novel approach distinct from previous studies, to estimate spread velocity by incorporating an upper threshold to avoid unrealistic values. The model described the spread of ASF in the study area. The disease showed greater expansion in the east of the country. Initially, a south and eastward direction was estimated. The estimated median velocity was 19.53 km/month, with cell-level velocities ranging from 2.45 to 69.99 km/month. Velocity increased notably from autumn 2021 onward and varied substantially across years. Our results show the dynamics of ASF in wild boars of South Korea, providing new evidence of their role in the epidemiology of the disease.

Enhanced Wound Healing Through Air‐Break Augmentation of Hyperbaric Oxygen Therapy Combined With Adipose‐Derived Stromal Cell Transplantation in a Murine Model

ABSTRACT

Hyperbaric oxygen therapy (HBOT) enhances wound healing by promoting angiogenesis and reducing hypoxia. However, the role of air-breaks—intermittent exposures to ambient air during HBOT—remains unclear. We investigated the effects of air-breaks on HBOT-mediated wound healing, particularly in combination with adipose-derived stromal cells (ASCs). Full-thickness wounds were created in C57BL/6 mice (n = 36) and assigned to control, HBOT (1 h/day, 2 ATA for 11 days), or HBOT with a 10-min air-break groups. In a second experiment, we evaluated ASC treatment combined with HBOT and air-breaks. Wound healing was assessed via gross examination, histology and gene expression analysis of collagen type 1 alpha 1 (Col1a1), hypoxia-inducible factor 1 alpha (Hif1a) and tumour necrosis factor (Tnf-α). Compared with HBOT alone, air-breaks significantly improved wound closure, epithelial regeneration and collagen deposition (p < 0.05). Gene analysis showed higher Col1a1 expression and lower Hif1a and Tnf-α levels in the air-break group. In ASC-treated wounds, air-breaks further accelerated healing, enhancing collagen synthesis and reducing hypoxia and inflammation. These findings suggest that incorporating air-breaks into HBOT protocols improves wound healing outcomes, both generally and in ASC-based therapies, by modulating collagen production, hypoxia and inflammation, and could optimise HBOT efficacy, particularly in cell-based regenerative therapies.

Sustaining Dignity at Life's End: A Meta‐Ethnographic Study of Nurses' Insights

ABSTRACT

Aim

To systematically synthesise nurses' perspectives on dignified death, providing a culturally informed and comprehensive understanding.

Design

Meta-ethnography.

Methods

This study was conducted using Noblit and Hare's approach, which included reciprocal translation, refutational synthesis, and line-of-argument synthesis. Methodological rigour and credibility were evaluated using the Critical Appraisal Skills Program (CASP) checklist. The review included peer-reviewed qualitative studies published in English or Korean that focused on nurses' or nursing students' views on dignified death in end-of-life care.

Data Sources

A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and the Web of Science in August 2023, with an updated search in August 2024. Seventeen qualitative studies published between 2010 and 2024 met the inclusion criteria.

Results

Four interconnected themes emerged: A death that embraces humanity, a death that preserves personal identity, a death that facilitates connection and reconciliation, and a death that affirms acceptance and spiritual serenity. These themes, including eight sub-themes, highlight cultural influences shaping nurses' approaches to dignified death.

Conclusion

The findings emphasise the influence of cultural context in shaping end-of-life care and support the development of culturally sensitive nursing education and guidelines to enhance care quality.

Implications for the Profession and Patient Care

This research provides culturally grounded strategies to improve end-of-life care and strengthen nurses' competencies in delivering holistic support.

Impact

This study highlights cultural variations in nurses' approaches to balancing autonomy, family expectations, and spiritual needs, offering practical insights for holistic, patient-centred, and culturally sensitive care.

Reporting Method

This review complies with the Equator and improving reporting of meta-ethnography (eMERGe) guidelines.

Patient or Public Contribution

No patient or public contribution.

What do patients value? A retrospective study of compliment letters from a single institution

Por: Kwon · Y. G. · Namgung · M. · Kim · M. K. · Choi · J. C. · Jeong · D. · Kim · C. W.
Objectives

This study aimed to analyse patient-initiated compliment letters from a single institution, identify the key elements that patients value and offer actionable insights to enhance patient-centred care.

Design

A retrospective, single-institution study using the Healthcare Complaints Analysis Tool (HCAT), text network analysis and latent Dirichlet allocation (LDA) topic modelling on patient compliment letters to pinpoint key valued care elements.

Setting

A newly established general hospital in Gwangmyeong, South Korea, opened on 22 March 2022.

Participants

A total of 1213 compliment letters were collected through the hospital’s feedback system, which accepted both online and on-site submissions between 25 March 2022 and 28 June 2024. Letters lacking substantive descriptive content and those containing purely administrative requests were excluded.

Primary and secondary outcome measures

The HCAT was adapted to categorise positive statements into clinical, management and relationship domains, along with six stages of care. Inter-rater reliability was evaluated using Gwet’s AC1 statistic. A text network analysis, applying a term frequency–inverse document frequency approach, was conducted to identify prominent keywords. Subsequently, LDA was performed to extract thematic topics.

Results

Most compliments concerned the ‘relationship’ domain (62%), particularly during the care in the ward stage (56%). Keyword analysis indicated that the most frequently mentioned terms were ‘gratitude’, ‘kindness’, ‘nurse’, ‘doctor’ and ‘heart/mind’, underscoring patients’ high valuation of positive interactions, professional competence and compassionate communication with medical staff. Topic modelling identified three primary topics, namely, ‘appreciation of nursing care’ (39%), ‘professionalism in surgery and treatment’ (35%) and ‘effective communication during consultations’ (26%).

Conclusions

Positive relationships with medical staff, particularly kindness, professionalism and effective communication, influence patient satisfaction. Patient compliment letters serve as important indicators of exceptional care and can inform quality improvement initiatives. Healthcare institutions should leverage these insights to enhance patient-centred services by strengthening patient–provider relationships and promoting a culture of excellence.

Association between lifestyle changes and metabolic syndrome: a prospective cohort study in middle-aged Koreans

Por: Jeong · K. · Kim · H. · Lee · S. · Baek · Y.
Objectives

This study aimed to determine whether certain lifestyle factors, specifically alcohol consumption, smoking, physical activity, sleep duration and sleep quality, are associated with an increased risk of metabolic syndrome (MetS) and to assess how changes in lifestyle behaviours over time influence MetS prevalence in the middle-aged Korean population.

Design

Community-based, prospective cohort study.

Setting

South Korea, baseline in 2017–2019 and follow-up in 2020–2022.

Participants

The study included 1436 adult individuals aged ≥30–59 years.

Outcome measures

The primary outcome of this study was the prevalence of MetS at follow-up, determined according to established diagnostic criteria. Secondary outcomes included the association between MetS and five key lifestyle factors: alcohol consumption, smoking, physical activity, sleep quality and sleep duration. Lifestyle changes were categorised into four groups based on stability between baseline and follow-up assessments. Outcome measures remained consistent with the study’s initial protocol, with no modifications to the planned variables or measured criteria.

Results

The prevalence of MetS increased from 15.3% at baseline to 19.6% at follow-up. At follow-up, insufficient physical activity (OR=1.42, 95% CI 1.06 to 1.92) and poor sleep quality (OR=1.37, 95% CI 1.02 to 1.84) were significantly associated with MetS. Among lifestyle change patterns, long-term unhealthy physical activity (OR=1.57, 95% CI 1.03 to 2.39) and sleep quality (OR=1.50, 95% CI 1.01 to 2.24) behaviours were associated with an increased risk of MetS. Poisson regression analyses of incident cases showed that only unfavourable changes in sleep duration were significantly associated with incident MetS (rate ratios=1.74, 95% CI 1.02 to 2.95). However, no significant associations were observed for other lifestyle change patterns, including behaviours that improved or worsened over time, and no meaningful associations were identified for non-significant lifestyle factors, such as smoking and alcohol consumption.

Conclusions

The prevalence of MetS was associated not only with individual lifestyle factors but also with long-term patterns of unhealthy behaviours, with persistent shortage of physical activity, poor sleep quality and inadequate sleep duration identified as significant contributors to increased MetS risk. Future research should explore a broader range of risk factors over longer follow-up periods to better understand the long-term impact of lifestyle modifications on MetS development.

Post-discharge healthcare utilization and costs in musculoskeletal surgery patients: A cohort study in Korea

by Boyoung Jeon, Boyoung Jung, Yun-Kyung Song

Background

Musculoskeletal surgery imposes extended recovery periods and significant financial burdens that can undermine individual and system-level health security. Patients undergoing musculoskeletal surgery often face prolonged recovery and substantial post-discharge costs, yet longitudinal evidence on their healthcare use remains limited.

Methods

This study quantified two-year post-discharge utilization and identified predictors of high expenditure among Korean musculoskeletal surgery patients. A retrospective cohort was constructed from the 2019–2021 Korea Health Panel. Adults (n = 182) hospitalized for spinal, knee, shoulder or other musculoskeletal disorders between July 2019 and June 2020 were followed for 24 months. Outcomes were total healthcare expenditure (log-transformed) and in the top 25% cost group (“high-expenditure”) in the second post-discharge year.

Results

Among 182 adults hospitalized for musculoskeletal surgery, first-year post-discharge spending averaged US $848 but fell to US $487 in the second year. Readmission fell from 19.2% to 7.1%, and Western-medicine outpatient visits declined from 18.3 ± 25.9 to 13.6 ± 22.9 per person. By contrast, Traditional Korean Medicine (TKM) visits rose from 2.3 ± 6.5 to 3.3 ± 10.0. In multivariable models, metropolitan residence, obesity, additional chronic conditions, and heavier first-year inpatient and outpatient use independently predicted higher second-year costs. Lower household income was associated with lower spending. Index diagnoses were pivotal: spinal disorders and shoulder disorders markedly increased the odds of falling into the top-cost quartile. Among the first-year TKM, frequent chuna/manual therapy sessions were marginally associated with higher costs, suggesting these rehabilitative modalities may serve as proxies for underlying health complexity during the stabilization phase.

Conclusions

Spinal and shoulder disorders, metropolitan residence, obesity, multimorbidity, heavy inpatient and outpatient use during the first post-discharge year, and frequent TKM sessions, albeit marginally, jointly predicted the highest second-year expenditures. These findings highlight the value of early risk stratification and tightly coordinated Western-and-traditional care pathways that facilitate the shift from structural repair to functional restoration. From a policy perspective, these results suggest the need for integrated post-discharge care models and targeted financial support strategies to reduce avoidable costs and enhance equity in musculoskeletal rehabilitation.

Registered Nurse‐Led Assessments in Australian Residential Aged Care Homes: A Scoping Review

ABSTRACT

Aim

To understand the current evidence base regarding holistic nursing assessments performed by registered nurses in residential aged care homes in Australia, and identify the gaps in knowledge and potential areas for future research.

Design

A scoping review informed by JBI guidelines and the PRISMA extension for Scoping Reviews.

Methods

The electronic databases Medline, EMBASE, CINAHL, Scopus and ProQuest Central were searched, alongside citation chaining and manual journal searches. Limits of English language and publication after the year 2000 were applied. Studies were screened against pre-defined eligibility criteria. Data were extracted and analysed using descriptive statistics and a narrative synthesis.

Results

A total of 3987 studies were identified, of which 28 were categorised as comprehensive or multimodal assessment programmes, standalone assessment tools or assessment infrastructure papers. Key outcomes described included staff factors and resident emergency department transfers or hospitalisations. The key feature of existing nursing assessments across studies was education, which was generally associated with improved staff knowledge, confidence and efficiency. Apart from this, there was large heterogeneity among assessment interventions with inconsistent effects. Few studies focused on residents with dementia or palliative care needs.

Conclusion

There is currently no standardised, systematic approach to the holistic assessment of residents by registered nurses in Australia. This gap in assessment is especially evident for residents with dementia or palliative care needs.

Impact

This research highlights the need to develop standardised holistic nursing assessments to bridge this gap in practice.

Patient or Public Contribution

No Patient or Public Contribution.

Prediction of early recovery in patients with acute peripheral facial paralysis using serial electroneuronography

by Yong Seok Jo, Seung Jae Lee, Hyun Jin Lee, Jeon Mi Lee

Objectives

This study aimed to determine the preferred timing and measurement sites for electroneuronography (ENoG) to predict early recovery from acute peripheral facial paralysis.

Methods

We retrospectively evaluated 42 patients with acute peripheral facial paralysis who received standard treatment with oral corticosteroids. The severity of facial paralysis was assessed at the initial visit and after 1 month using the House–Brackmann grading system. Patients were classified into recovery and non-recovery groups according to changes in the grade. ENoG was performed at the initial visit and after 2 weeks. ENoG amplitudes of four facial muscles (frontalis, nasalis, orbicularis oculi, and orbicularis oris) at the initial visit and after 2 weeks, as well as age, sex, affected side, and diagnosis, were compared between the two groups.

Results

No differences were observed in degeneration ratios across all subsites in the initial ENoG, which can be explained by the fact that Wallerian degeneration is not yet complete at this early stage. However, the second ENoG, performed after degeneration had progressed, showed significant differences across all subsites. Binary logistic regression analysis revealed that the degeneration ratio of the orbicularis oris muscle was the best predictor of early recovery (odds ratio, 0.961; p = 0.014). Receiver operating characteristic curve analysis also revealed that the degeneration ratios of all subsites measured in the second ENoG were useful in predicting early recovery, with the highest possibility at the orbicularis oris muscle (area under the curve = 0.789). When the degeneration ratio exceeded 60% in all subsites in the second ENoG, a favorable prognosis was not expected.

Conclusion

This study provides the preferred testing time and measurement sites for ENoG to predict early recovery from facial paralysis. Given the personal and social impact of facial paralysis, predicting early recovery is crucial for reassuring patients, providing better treatment, and encouraging early reintegration into society.

Pharmacokinetic profiles of Moutan Cortex after single and repeated administration in a dinitrobenzene sulfonic acid-induced colitis model

by Jin-Hwa Kim, Ji-Soo Jeong, Jeong-Won Kim, Eun-Hye Chung, Su-Ha Lee, Je-Won Ko, Youn-Hwan Hwang, Tae-Won Kim

Moutan Cortex (MC), the dried root bark of Paeonia suffruticosa, is used in traditional Chinese and Korean medicine to treat enteritis for its anti-inflammatory properties. This study compared the pharmacokinetic (PK) profiles of paeonol and paeoniflorin in normal and dinitrobenzene sulfonic acid (DNBS)-induced colitis rats, and to determine how repeated low-dose MC [MC(L), 0.5 g/kg] or high-dose MC [MC(H), 2.5 g/kg] alters PK and disease severity. Using ultra-performance liquid chromatography–tandem mass spectrometry, we found that DNBS modestly increased paeonol AUClast (NC: 247.8 ± 63.7 vs DNBS: 337.0 ± 120.8 hr*ng/mL) and decreased paeoniflorin (NC: 474.1 ± 11.7 vs DNBS: 463.7 ± 106.8 hr*ng/mL) compared to controls (ns). After repeated dosing, the maximum plasma concentration (Cmax) of paeonol was higher in the MC(H) than that in the MC(L) group (MC(L): 63.81 ± 29.74 vs MC(H): 4221.5 ± 1579.2 ng/mL, p max in the MC(H) group was also higher than MC(L) group (MC(L): 60.5 ± 15.3 vs MC(H): 164.7 ± 74.7 ng/mL, p 

Exploring influences of environmental information, beliefs and self‐efficacy on nurses' climate health behaviours and their relationships

Abstract

Background

To create a healthy nursing environment and protect human health in response to climate change, it is essential to encourage behaviour change among nurses. Although numerous studies have been conducted on nurses to address climate change, few studies have explored the relationships of factors that influence and promote nurses' climate health behavioural behavioural change, making it difficult to determine how nurses should act and prioritise regarding climate health behaviours.

Aims

To investigate influential environmental factors on climate health behaviours among nurses through the causal relationships between environmental information, environmental beliefs and environmental self-efficacy using the Information-Motivation-Behavioural Skills (IMB) model.

Design

A cross-sectional study.

Methods

This study recruited 186 nurses working in hospitals nationwide in July 2023. Self-reported questionnaires (Climate, Health, and Nursing Tool; National Environmental Consciousness Survey; New Ecological Paradigm Scale; Personal Efficacy Scale) were used to collect the data. Path analysis was performed.

Results

The factors influencing nurses' climate health behaviours were environmental information, environmental beliefs and environmental self-efficacy. Environmental self-efficacy was found to be more influenced by the exogenous variables of environmental information than environmental beliefs and to be the most significant factor affecting climate health behaviours.

Conclusions

It is more important for nurses to obtain environmental information than environmental beliefs to achieve the goal of climate health behaviours. This in turn, will lead to personal self-efficacy that nurses can mitigate the climate crisis. Their strong self-efficacy affects their climate health behaviours.

Implications for the Profession

Nurses should seek and draw on the appropriate environmental information related to climate health change and nurses with environmental self-efficacy become environmental nursing leaders, encouraging other health care workers to participate actively in climate health behaviours and continuously carry out the behaviours within daily life, hospital and community environments.

Impact

The study addressed the lack of relationship research on factors influencing nurses' climate health behaviours, emphasizing the importance of accessing environmental information to foster self-efficacy. Nurses with heightened self-efficacy can lead healthcare professionals in climate health actions.

Reporting Method

This research has adhered to relevant EQUATOR and STROBE.

Patient or Public Contribution

No Patient or Public Contribution.

Nurses' Perceptions and Behaviours Regarding Climate Change and Health: A Quantile Regression Analysis

ABSTRACT

Aims

The aim of this study is to identify the factors associated with nurses' perceptions and behaviours related to climate change and health (PBCH) according to their PBCH levels.

Design

A cross-sectional study was used.

Methods

This study included a sample of 499 Korean nurses and adhered to the STROBE checklist. Data were collected from March 23 to May 10, 2023. Quantile regression analysis was performed, and PBCH levels were measured using the Korean version of the Climate Health and Nursing Tool.

Results

Across all quantile groups, the experience of extreme weather events and awareness of climate change-coping facilitators were associated with PBCH. Differences were observed in factors associated with PBCH levels. Significant associations with PBCH were observed within the 75th percentile group, for having a religion, household income, and workplace climate friendliness. In the 25th percentile group, having a child, the number of sources for climate change–health-related information, and experience in setting climate change–health goals and strategies significantly influenced PBCH.

Conclusion

We propose a differentiated strategy by elucidating the factors associated with high and low quantiles of PBCH levels.

Implications

By verifying specific factors associated with PBCH levels, nurses can enhance their preparedness to respond to the health risks posed by climate change in their clients.

Impact

Identifying common factors associated with all quantiles of nurses is important for establishing universal PBCH characteristics. Recognising the distinctions between high and low PBCH levels can aid in developing tailored nursing strategies to enhance PBCH among nurses.

Reporting Method

This study adhered to the STROBE guidelines.

Patient or Public Contribution

No Patient or Public Contribution.

Safety and efficacy of quick-soluble gelatin microparticles for transarterial embolization of the lower urinary tract: Preclinical study in a rabbit urinary bladder embolization model

by Sunghoon Jeon, Keunho Kim, Cheolwon Choe, Juil Choi, Gun Lee, Chung-Do Lee, Hyeon-Jeong Moon, Jun-Gyu Park, Jin-kyung Kim, Namsoon Lee, Dongwoo Chang

Quick-soluble gelatin microparticles (QS-GMP) are emerging embolic agents under investigation for temporary vascular occlusion, offering reduced ischemic risk compared to permanent materials. The aim of this preclinical study was to evaluate the safety and efficacy of QS-GMP for transarterial embolization in a rabbit model of urinary bladder embolization. Twelve male New Zealand White rabbits underwent bilateral umbilical artery embolization using QS-GMP. Animals were assigned to four time-points (immediately, 3, 7, and 14 days post-embolization), with comprehensive assessments including clinical observations, hematologic and serum biochemical analysis, angiography, and histopathology. The procedure was technically feasible in all animals without intraoperative complications. Temporary hematuria and a transient decrease in body weight were observed post-procedure, both of which resolved spontaneously. Complete occlusion of the cranial vesical artery and absence of bladder wall perfusion were achieved immediately after embolization, followed by full recanalization at 3 days. Angiographic imaging at 7 and 14 days revealed transient hypervascularization of the bladder wall. Histopathological analysis showed marked edema, epithelial necrosis, and inflammatory infiltration at 3 and 7 days, with full urothelial regeneration observed at 14 days. No signs of ureteral or renal injury, or adverse systemic responses were detected. These findings suggest that QS-GMP may serve as a feasible option for temporary arterial occlusion in future veterinary lower urinary tract applications, although further long-term evaluation is warranted.

Association between voice-activated technology interventions and well-being in older adults living alone: a protocol for a systematic review and meta-analysis

Por: Kang · B. · Hong · D. · Park · M. K. · Park · S. · Jeong · S. · Park · Y. S.
Introduction

A growing number of community-dwelling older adults living alone face a range of physical, psychological and social challenges that negatively impact their well-being. Various technologies have been developed to support healthy ageing, with voice-activated technology (VAT) offering particularly promising opportunities to improve later life well-being. However, its effect on older adults living alone has not yet been systematically evaluated. Thus, this study aims to provide an evidence base for the effectiveness of VAT interventions in enhancing the physical, psychological and social well-being of older adults living alone.

Methods and analysis

We will conduct a systematic review and meta-analysis of studies examining the use of VAT interventions among older adults living alone. The eligible study designs include randomised controlled trials and quasi-experimental studies. Primary outcomes will focus on physical, psychological and social well-being. A comprehensive search will be conducted across international (PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, ProQuest and Web of Science) and Korean databases (RISS, DBpia and KISS). Two reviewers will independently conduct study selection, risk-of-bias assessment and data extraction. A meta-analysis will be conducted to synthesise the effects of VAT interventions on psychological, physical and social domains of well-being.

Ethics and dissemination

Synthesising existing evidence, this review aims to inform the development of targeted interventions and support strategies to improve the well-being of older adults living alone. As no new data will be collected, ethical approval is not required. Findings will be published in a peer-reviewed journal to guide targeted intervention strategies and engage both academic and policy audiences.

PROSPERO registration number

CRD420251084621.

Experiences of Nurses Speaking Up in Healthcare Settings: A Qualitative Metasynthesis

ABSTRACT

Aim

To systematically review and synthesise qualitative research on nurses' experiences of speaking up in various contexts and to identify factors facilitating or impeding such a behaviour.

Design

This review was conducted as a qualitative metasynthesis, utilising the qualitative meta-ethnography approach.

Methods

A total of 6250 articles were screened. Two reviewers screened titles, abstracts and full texts. A total of 15 studies were included in this review. Researchers conducted a quality appraisal using the JBI critical appraisal checklist for qualitative research. An a priori protocol was created and registered on the Open Science Framework.

Data Sources

Literature searches were conducted in five international bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global) and five Korean databases (RISS, KISS, DBpia, KCI and NDSL).

Results

Three main themes were identified from the 15 studies used in the metasynthesis: (1) decisional complexity of speaking up, (2) motivators for speaking up and (3) barriers to speaking up. Nurses experienced challenges in speaking up. They were, and continue to be, concerned about negative responses. Hierarchy structure and poor work environment were identified as barriers to speaking up; professional responsibility and a supportive atmosphere were identified as facilitators for speaking up.

Conclusions

This review synthesised nurses' experiences of speaking up and influencing factors. Speaking up is crucial for nurses to improve patient safety, as frontline nurses are ideally positioned to observe early indicators of unsafe conditions in healthcare delivery.

Impact

Identified motivators and barriers of nurses' speaking-up behaviour offer considerations and opportunities for healthcare leaders and managers. This could lead to improvement in patient safety through the establishment of a safety culture that facilitates nurses' speaking-up behaviour.

Reporting Method

The review adhered to the ENTREQ guideline.

Patient or Public Contribution

No patient or public contribution has been made in this review.

The Association Between Caregiving Context and the Health and Well‐Being of Carers and Their Care Recipients Living With Dementia: A Cross‐Sectional Study

ABSTRACT

Aim(s)

To examine the association between caregiving context and the health and well-being of community-dwelling people with dementia (functional ability, physical function, depression, quality of life and health-related quality of life) and their informal carers (health-related quality of life) at the pre-rehabilitation stage and the potential mediating role of caregiving context variables.

Design

Cross-sectional study.

Methods

Secondary analysis of baseline data from a randomised controlled trial of 130 dementia care dyads—the Interdisciplinary Home-based Reablement Programme (2018–2022). Bivariate analyses were applied to identify key caregiving context variables—co-residence, sole carer status, additional caring responsibilities, client-carer relationship and subjective carer burden (carer burden hereafter)—associated with health outcomes. Subsequently, multivariable linear regression models were developed. To examine carer burden, two models were run for each outcome: one with caregiving context variables and covariates, and the other adding carer burden. The mediating effects of the identified caregiving context variable were examined using post hoc mediation analysis.

Results

Spouse/partner carer relationship was significantly associated with better client well-being, including lower depressive symptoms and higher quality of life scores compared to adult child and other relationships. Higher carer burden was strongly associated with lower functional ability, more depressive symptoms, lower quality of life for clients and lower health-related quality of life for both clients and carers. Including carer burden in regression models explained the greatest variance across most models. Carer burden fully mediated the association between additional caring responsibilities and client functional ability, and partially mediated the association between other carers and client depression.

Conclusion

Carer burden needs to be carefully considered in supporting the health and well-being of dementia carer dyads.

Implications

Addressing carer burden and tailoring support to carers are essential for optimising health impacts for dementia carer dyads.

Reporting Method

STROBE checklist.

Patient or Public Contribution

None.

Trial Registration

ClinicalTrials.gov identifier: ACTRN12618000600246

Protocol for an observational cohort study integrating real-world data and microsimulation to assess imaging surveillance strategies in stage I-IIIA NSCLC patients in OneFlorida+

Por: Braithwaite · D. · Karanth · S. D. · Bian · J. · Meza · R. · Jeon · J. · Tammemagi · M. · Wheeler · M. · Cao · P. · Rackauskas · M. · Shrestha · P. · Yoon · H.-S. · Borondy Kitts · A. · Verma · H. · Blair · M. C. · Chen · A. · Das · D. · Lou · X. · Wu · Y. · Han · S. · Hochhegger · B. · Guo · Y
Introduction

Although lung cancer remains the leading cause of cancer deaths in the US, recent advances in early detection and treatment have led to improvements in survival. However, there is a considerable risk of recurrence or second primary lung cancer (SPLC) following curative-intent treatment in patients with early-stage non-small cell lung cancer (NSCLC). Professional societies recommend routine surveillance with CT to optimise the detection of potential recurrence and SPLC at a localised stage. However, no definitive evidence demonstrates the effect of imaging surveillance on survival in patients with NSCLC. To close these research gaps, the Advancing Precision Lung Cancer Surveillance and Outcomes in Diverse Populations (PLuS2) study will leverage real-world electronic health records (EHRs) data to evaluate surveillance outcomes among patients with and without guideline-adherent surveillance. The overarching goal of the PLuS2 study is to assess the long-term effectiveness of surveillance strategies in real-world settings.

Methods and analysis

PLuS2 is an observational study designed to assemble a cohort of patients with incident pathologically confirmed stage I/II/IIIA NSCLC who have completed curative-intent therapy. Patients undergoing imaging surveillance will be followed from 2012 to 2026 by linking EHRs with tumour registry data in the OneFlorida+ Clinical Research Consortium. Data will be consolidated into a unified repository to achieve three primary aims: (1) Examine the utilisation and determinants of CT imaging surveillance by race/ethnicity and socioeconomic status, (2) Compare clinical endpoints, including recurrence, SPLCs and survival of patients who undergo semiannual versus annual CT imaging and (3) Use the observational data in conjunction with validated microsimulation models to simulate imaging surveillance outcomes within the US population. To our knowledge, this study represents the first attempt to integrate real-world data and microsimulation models to assess the long-term impact and effectiveness of imaging surveillance strategies.

Ethics and dissemination

This study involves human participants and was approved by the University of Florida Institutional Review Board (IRB), University of Florida IRB 01, under approval number IRB202300782. The results will be disseminated through publications and presentations at national and international conferences. Safety considerations encompass ensuring the confidentiality of patient information. All disseminated data will be de-identified and summarised.

Barriers to and Facilitators of Shared Decision‐Making Implementation in Fertility Preservation for Patients With Cancer: A Qualitative Study

ABSTRACT

Introduction

To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.

Design

Qualitative descriptive study.

Methods

Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.

Results

We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.

Conclusion

Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.

Clinical Relevance

This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.

Nurse‐Led Innovations for Optimising the Quality and Safety of Care for the Older Person in Residential Aged Care: A Warrant for Action

ABSTRACT

Aim

To canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high-quality and person-centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person-centred care delivery.

Design

Position paper.

Methods

This paper promulgates the current dialogue among key stakeholders of quality residential aged care in Australia, including clinicians, regulatory agencies, researchers and consumers. A desktop review gathered relevant literature spanning research, standards and guidelines regarding current and future challenges in aged care in Australia.

Results

This position paper explores the issues of improving the quality and safety of residential aged care in Australia, including the lingering impact of COVID-19 and incoming reforms. It calls for nurse-led research and innovation to deliver tools to address these challenges.

Conclusion

The paper proposes an appropriate holistic, evidence-based nursing framework to optimise the quality and safety of residential aged care in Australia.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

Examining the Impact of Telehealth Stoma Care Interventions on the Ostomates: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To assess telehealth stoma care interventions' impact on stoma adjustment, self-efficacy, anxiety and ostomates' quality of life.

Design

Systematic review and meta-analysis of randomised controlled trials.

Methods

Studies published until April 2025 were searched across eight databases—MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Scopus, Web of Science, CINAHL, ClinicalTrials.gov and PQDT Global. Randomised controlled trials with individuals aged 18 and older who received telehealth stoma care interventions were included. A meta-analysis was performed using a random-effects model, with the GRADE approach employed to evaluate evidence certainty. This systematic review and meta-analysis complied with the PRISMA guideline and PRISMA 2020 checklist.

Results

Eight studies were included in the meta-analysis. Telehealth interventions significantly improved stoma adjustment (SMD: 1.44, 95% CI: 0.22–2.66) and self-efficacy (MD: 10.23, 95% CI: 3.01–17.44), but did not significantly affect anxiety, while results regarding the effect on quality of life were inconsistent. Three studies showed a high risk of bias, while five showed some concerns. Evidence certainty was moderate for stoma adjustment, self-efficacy and stoma quality of life, and low for anxiety.

Conclusion

Telehealth can enhance stoma adjustment and self-efficacy, thereby improving management. However, the limited and inconsistent findings on anxiety and quality of life outcomes underscore the need for further high-quality research.

Impact

This review demonstrates that telehealth stoma care can be vital in improving stoma adjustment and self-efficacy in ostomates.

Reporting Method

The PRISMA 2020 checklist.

Patient or Public Contribution

Not Applicable.

Visualized Pattern-Based Hypothesis Testing on Exhaustion, Resilience, Sleep Quality, and Sleep Hygiene in Middle-Aged Women Transitioning Into Menopause or Postmenopause

imageExploratory data analysis involves observing data in graphical formats before making any assumptions. If interesting relationships or patterns among variables are identified, hypotheses are developed for further testing. This study aimed to identify significant differences in the levels of exhaustion, resilience, sleep quality, and sleep hygiene according to the personal characteristics of middle-aged women transitioning into menopause or postmenopause through exploratory data analysis. A total of 200 women aged 44 to 55 years were recruited online in August 2023. Data were collected using valid instruments and analyzed through data visualization, pattern identification in the visualized data, and hypothesis establishment based on the visualized patterns. Hypotheses were tested through the independent-samples t test, analysis of variance, and the Kruskal-Wallis test. A total of 11 patterns and corresponding hypotheses were identified. According to the statistically supported pattern-based hypotheses, middle-aged women who were in their perimenopausal period perceived themselves as unhealthy, had professional occupations, and had the highest level of exhaustion and the lowest levels of resilience, sleep quality, and sleep hygiene. This study demonstrated that data visualization is an efficient way to explore relationships or patterns between data. Data visualization should be considered an informatics solution that can provide insight in the field of healthcare.
❌