FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
Ayer — Octubre 2nd 2025Tus fuentes RSS

The Symptoms and Impacts Experienced by Healthcare Professionals as Second Victims After a Safety Incident: A Scoping Review

ABSTRACT

Aim

This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.

Design

Scoping review.

Methods

JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.

Data Sources

The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.

Results

A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.

Conclusions

This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.

Implications for the Profession and/or Patient Care

By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.

Impact

The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.

Patient or Public Contribution

No patient or public contribution.

Protocol Registration

Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1

The Mediating Role of Death Coping Between Moral Resilience and Vicarious Posttraumatic Growth Among ICU Nurses

ABSTRACT

Aim

This study aimed to examine the level of vicarious posttraumatic growth among intensive care unit nurses in China and explore the mediating role of death coping ability in the relationship between moral resilience and vicarious posttraumatic growth.

Study Design

A multicentre, cross-sectional study was conducted in accordance with the STROBE guidelines.

Methods

Between January and March 2025, a questionnaire survey was conducted among 666 intensive care unit nurses from nine tertiary Grade A hospitals across five provinces in China. Participants completed three standardised instruments: the Rushton Moral Resilience Scale, the Coping with Death Scale–Short Version, and the Vicarious Posttraumatic Growth Inventory. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, and correlation analyses, and employed AMOS 27.0 to perform structural equation modelling for testing mediation effects.

Results

Intensive care unit nurses demonstrated a moderate level of vicarious posttraumatic growth. Moral resilience was positively associated with both death coping ability and vicarious posttraumatic growth. Death coping ability was found to play a partial mediating role in the relationship between moral resilience and vicarious posttraumatic growth.

Conclusion

Moral resilience and death coping ability are key factors associated with vicarious posttraumatic growth among intensive care unit nurses. Nurses with stronger moral resilience are more likely to cope constructively with death-related stress, which may support psychological growth in trauma-intensive environments.

Impact

This study highlights the need to enhance intensive care unit nurses' moral and emotional capacities through ethics education, emotional coping training, and institutional support strategies. Strengthening these competencies may foster professional development and mental wellbeing in critical care settings.

Environment and weight class linked to skin microbiome structure of juvenile Eastern hellbenders (<i>Cryptobranchus alleganiensis alleganiensis</i>) in human care

by Andrea C. Aplasca, Peter B. Johantgen, Christopher Madden, Kilmer Soares, Randall E. Junge, Vanessa L. Hale, Mark Flint

Amphibian skin is integral to promoting normal physiological processes in the body and promotes both innate and adaptive immunity against pathogens. The amphibian skin microbiota is comprised of a complex assemblage of microbes and is shaped by internal host characteristics and external influences. Skin disease is a significant source of morbidity and mortality in amphibians, and increasing research has shown that the amphibian skin microbiota is an important component in host health. The Eastern hellbender (Cryptobranchus alleganiensis alleganiensis) is a giant salamander declining in many parts of its range, and captive-rearing programs are important to hellbender recovery efforts. Survival rates of juvenile hellbenders in captive-rearing programs are highly variable, and mortality rates are overall poorly understood. Deceased juvenile hellbenders often present with low body condition and skin abnormalities. To investigate potential links between the skin microbiota and body condition, we collected skin swab samples from 116 juvenile hellbenders and water samples from two holding tanks in a captive-rearing program. We used 16s rRNA gene sequencing to characterize the skin and water microbiota and observed significant differences in the skin microbiota by weight class and tank. The skin microbiota of hellbenders that were housed in tanks in close proximity were generally more similar than those housed physically distant. A single taxa, Parcubacteria, was differentially abundant by weight class only and observed in higher abundance in low weight hellbenders. These results suggest a specific association between this taxa and Low weight hellbenders. Additional research is needed to investigate how husbandry factors and potential pathogenic organisms, such as Parcubacteria, impact the skin microbiota of hellbenders and ultimately morbidity and mortality in the species.

A blueprint of synergistic effect in Crataegus pinnatifida and obesity-related gut microbiota against obesity via systems biology concept

by Jinghui Xie, Haofang Guan, Maohui Liu, Weijun Ding

Background

Current obesity treatments include behavioral interventions, pharmacotherapy and surgery. Recently, the combination of ‘medicinal food’ products such as the plant Crataegus pinnatifida and its interaction with the gut microbiota has shown promise as an alternative therapeutic strategy to treat obesity.

Methods

We obtained secondary metabolites (SMs) of obesity-related gut microbiota and Crataegus pinnatifida from gutMGene database and NAPSS database. bioinformatics analysis was used to elucidate key target and signaling pathways, whereas molecular docking (MD), molecular dynamics simulation and quantum chemical calculations identified crucial SMs involved in these pathways. The toxicity and physicochemical properties of these SMs were also assessed.

Results

Phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), a key mediator in the phosphoinositide 3-kinase (PI3K)/ Protein Kinase B (Akt) pathway that is crucial for regulating insulin signaling and adipogenesis, emerged as the central hub within the PPI network. Strong binders to PIK3R1 were predicted to be quercetin, kaempferol and naringenin chalcone, suggesting their potential as therapeutic agents to treat obesity.

Conclusion

The synergistic combination of Crataegus pinnatifida and the obesity-related gut microbiota holds promise as a novel therapeutic strategy for obesity by targeting PIK3R1 and modulating the PI3K/Akt signaling pathway. Further experimental validation is necessary to confirm these findings.

Seeking validation in the digital age: The impact of validation seeking on self-image and internalized stigma among self- vs. clinically diagnosed individuals on r/ADHD

by Xinyu Zhang, Yoo Jung Oh, Yunhan Zhang, Jianfeng Zhu

The digital age has fueled a surge in ADHD self-diagnosis as people turn to online platforms for mental health information. However, the relationship between validation-seeking behaviors and self-perception in these online communities and users’ self-perception has received limited scholarly focus. Drawing on self-verification theory and utilizing natural language processing to analyze 452,026 posts from the r/ADHD subreddit, our study uncovers distinct patterns in validation-seeking behaviors. Results show that (a) self-diagnosed individuals with ADHD are more likely to seek social validation and media validation and to report higher levels of negative self-image and internalized stigma than clinically diagnosed individuals, (b) social validation was strongly associated with both positive and negative self-perceptions; and (c) diagnosis status significantly moderated these relationships, such that the effects of social validation on self-image and stigma were consistently weaker for the self-diagnosed group. Theoretically, this study extends self-verification theory by demonstrating that professional verification hierarchically moderates self-verification effectiveness. This implies a practical need for clinicians to acknowledge online validation seeking and for digital communities to affirm user experiences while mitigating stigma.
AnteayerTus fuentes RSS

Construction of an automated machine learning-based predictive model for postoperative pulmonary complications risk in non-small cell lung cancer patients undergoing thoracoscopic surgery

by Xie Qiu, Shuo Hu, Shumin Dong, Haijun Sun

Objective

To develop a predictive framework integrating machine learning and clinical parameters for postoperative pulmonary complications (PPCs) in non-small cell lung cancer (NSCLC) patients undergoing video-assisted thoracic surgery (VATS).

Methods

This retrospective study analyzed 286 NSCLC patients (2022–2024), incorporating 13 demographic, metabolic-inflammatory, and surgical variables. An Improved Blood-Sucking Leech Optimizer (IBSLO) enhanced via Cubic mapping and opposition-based learning was developed. Model performance was evaluated using AUC-ROC, F1-score, and decision curve analysis (DCA). SHAP interpretation identified key predictors.

Results

The IBSLO demonstrated significantly superior convergence performance versus original BSLO, ant lion optimizer (ALO), Harris hawks optimization (HHO), and whale optimization algorithm (WOA) across all 12 CEC2022 test functions. Subsequently, the IBSLO-optimized automated machine learning (AutoML) model achieved ROC-AUC/PR-AUC values of 0.9038/0.8091 (training set) and 0.8775/0.8175 (testing set), significantly outperforming four baseline models: logistic regression (LR), support vector machine (SVM), XGBoost, and LightGBM. SHAP interpretability identified six key predictors: preoperative leukocyte count, body mass index (BMI), surgical approach, age, intraoperative blood loss, and C-reactive protein (CRP). Decision curve analysis demonstrated significantly higher net clinical benefit of the AutoML model compared to conventional methods across expanded threshold probability ranges (training set: 8–99%; testing set: 3–80%).

Conclusion

This study establishes an interpretable machine learning framework that improves preoperative risk stratification for NSCLC patients, offering actionable guidance for thoracic oncology practice.

Associations between nutritional status and jumping performance in pre-school children

by Sanja Ljubičić, Vilko Petrić, Ljubomir Antekolović

Although it has been confirmed that overweight and obesity may have negative impact on jumping performance in school-aged children and adolescents, little evidence has been provided for pre-school children. The findings have provided inconclusive results, but mostly that overweight and obese pre-school children do not have an impaired jumping performance, in comparison to their normal weight peers. Therefore, the main purpose of the study was to examine the differences between normal weight and overweight/obese pre-school children in jumping performance outcomes and their correlations with anthropometric indices. Four-hundred and eleven pre-school children with the mean (SD) age = 4.9 (1.1) years, height = 111.2 (9.3) cm, weight = 20.0 (4.2) kg, 53.5% girls were recruited from 34 kindergartens in four major cities. Anthropometric indices included body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Normal weight, overweight and obesity were classified according to international norms. Jumping performance was evaluated by the countermovement jump (CMJ) without and with arm swing with Optojump system. In general, pre-school children with overweight and obesity exhibited poorer performance in vertical jumping; they had shorter flight time and flight height, lower power relative to body mass and lower relative strength index (RSI), compared to normal weight children. The strongest correlations were observed between WHtR and jumping outcomes, where higher WHtR values led to shorter flight time and flight height, and lower power relative to body mass in both boys and girls. This study adds new information related to nutritional status and jumping performance in pre-school children. Thus, overweight and obesity need to be considered, when monitoring vertical jumping performance.

Antipsychotics for Parkinsons disease: a protocol for a systematic review with network meta-analysis and trial sequential analysis

Por: Petersen · J. J. · Kamp · C. B. · Juul · S. · Bjerg · J. L. · Sillassen · C. D. B. · Faltermeier · P. · Salvesen · L. · Hejl · A.-M. · Bech · S. · Lokkegaard · A. · Jakobsen · J. C.
Introduction

Parkinson’s disease is a neurological disease with a rising incidence and prevalence. Patients with Parkinson’s disease may receive antipsychotics, for example, due to Parkinson’s disease psychosis. Parkinson’s disease psychosis is characterised by visual hallucinations and other psychotic symptoms. To date, no systematic review has evaluated the effects of antipsychotics in patients with Parkinson’s disease. Therefore, this review aims to assess the beneficial and harmful effects of antipsychotics for Parkinson’s disease.

Methods and analysis

This is a protocol for a systematic review. A search specialist will perform a search in major medical databases (eg, MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica database), CENTRAL (Cochrane Central Register of Controlled Trials)) and clinical trial registries. Published and unpublished randomised clinical trials comparing antipsychotics to any control (placebo, standard care or other antipsychotics) in patients with Parkinson’s disease will be included. Two review authors will independently extract data and conduct risk of bias assessments with the Cochrane Risk of Bias tool—V.2. Primary outcomes will be all-cause mortality, serious adverse events and significant falls. Secondary outcomes will be hospitalisations, non-serious adverse events, Unified Parkinson’s Disease Rating Scale total score and psychotic symptoms using any valid symptom scale. Data will be synthesised by aggregate meta-analysis, trial sequential analysis and network meta-analysis. Several subgroup analyses are planned. An eight-step procedure will be used to assess if the thresholds for clinical significance are crossed, and the certainty of the evidence will be assessed by GRADE (Grading of Recommendations Assessment, Development and Evaluations) and CiNeMA (Confidence in Network Meta-Analysis) approach.

Ethics and dissemination

This protocol does not include results, and ethics approval is not required for the project. The findings from the systematic review will be published in international peer-reviewed scientific journals.

PROSPERO registration number

PROSPERO ID: CRD42025633985. Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD42025633985.

The Perceptions of Male Accessibility to the Fields of Nursing Practice by Those Studying or Teaching Nursing in England: Cross‐Sectional Survey

ABSTRACT

Aims

Investigate the perception of male accessibility to the fields of nursing practice by those studying or teaching nursing in England.

Design

Cross-sectional survey.

Methods

Online questionnaire with three closed-scale questions and two open-text questions designed to elicit perceptions on the accessibility of men to the fields of nursing practice. The questionnaire was distributed to the staff and students at 61 nursing schools in England. Inferential and descriptive statistics were used to analyse the closed questions data and inductive content analysis was used to analyse open-text questions data.

Results

Students (n = 52) and staff (n = 51) responded to the survey. Adult (Mdn = 6, IQR = 2) and mental health (Mdn = 6, IQR = 2) were perceived as the most accessible fields of nursing practice to men, and child (Mdn = 4, IQR = 2) the least. Specialised practice areas in acute and emergency (Mdn = 6, IQR = 2), education (Mdn = 6, IQR = 2), leadership (Mdn = 7, IQR = 1), prison services (Mdn = 7, IQR = 1), and research (Mdn = 7, IQR = 2) were rated the most accessible to men and neonatal care (Mdn = 3, IQR = 3) the least. Societal stereotyping and stigma were seen as barriers to men entering the nursing profession. The perception that nursing is a feminised profession persists and a distrust of men is associated with child nursing. Men were viewed as progressing to leadership roles with greater ease than women.

Conclusion

Societal level stereotyping and stigma are perceived as prevalent in nursing practice areas considered less accessible to men entering the nursing profession.

Impact

This study adds insight into the gendered nature of nursing and highlights the barriers to men entering a profession with a workforce crisis.

Reporting Methods

STROBE cross-sectional studies guidelines. COREQ guidelines for content analysis.

Patient or Public Contribution

No patient or public contribution.

Exposure to Violence for Nurses Across Ethnic Groups: A Qualitative Study

ABSTRACT

Aim

To explore the social context of violence for hospital-based and community nurses from different ethnic groups, the types of violence experienced or witnessed both in and outside the workplace, and its impact on mental and physical health.

Design

Cross-sectional, qualitative study using semi-structured interviews.

Methods

Semi-structured interviews were conducted online with 12 hospital-based and community nurses recruited from London, England, between May and August 2021. Data were analysed using reflexive thematic analysis.

Results

The sample comprised seven hospital nurses and five community nurses. Four themes were identified: (i) the social context in which nurses from different ethnic groups are exposed to community violence; (ii) types of workplace violence experienced or witnessed by hospital-based and community nurses from different ethnic groups; (iii) perceptions of the factors contributing to workplace violence; (iv) impacts of violence on mental and physical health outcomes. Using the social ecological framework and sociological theory of stress, these findings informed a conceptual stress process model of violence exposure for nurses.

Conclusion

Nurses from different ethnic groups are exposed to violence both in and outside the workplace which negatively affects their mental and physical health. Effective violence prevention requires a multi-factorial approach that addresses the social and institutional factors contributing to violence, shifting the focus from individual measures to systemic organisational changes.

Impact

The NHS workforce is currently more diverse than ever, and healthcare leaders must improve access to mental health and well-being resources for staff affected by workplace violence, particularly for those who hold multiple social identities at the intersection of ethnicity, gender and age. Prioritising this support is essential not only to safeguard against negative health outcomes but also to improve the recruitment and retention of healthcare professionals.

Patient or Public Contribution

No patient or public contribution.

Bridging the Social Gap Through ‘Conscious Caring’: A Constructivist Grounded Theory of the Art of Caring for Older Adults With Dual Sensory Impairment

ABSTRACT

Aim

The aim of this study was to develop a conceptual understanding of the role of caring for older adults with combined vision and hearing impairment (DSI).

Background

Dual sensory impairment (DSI) impacts both listening and speechreading communication, function and social participation, meaning that older adults often require support and care to ‘age in place’ successfully. Family carers play a key role in supporting older adults with DSI to maintain social and physical health.

Design/Methods

This qualitative study uses Charmaz's constructivist grounded theory (GT) methodology. Data were collected between 2017 and 2019 and analysed using constructivist GT methods. Lengthy interviews with eight family carers of older adults living with DSI explored personal histories of DSI, relationships with families, social networks and health care professionals.

Results

This study demonstrates that caring in this context is predominantly social and ‘invisible’. To reduce the social effort of their family member with DSI and to maintain their own self-identity, family carers adopted a ‘conscious caring’ approach. This is conceptualised as an approach to caring that supports family carers to access resources embedded in their social networks by bridging the gap between the dyad and their broader, more diverse social networks.

Conclusion

This study identifies that a reduction in both close and broader social networks limits personal, social and psychosocial resources and impacts the capacity of the dyad to renegotiate their roles, create and maintain their individual and shared social networks and successfully transition to living with DSI.

Implications

There is a gap in the literature regarding the impact of sensory impairments on complex communication, health and social care needs of older adults and the role that family carers play. Registered nurses require complex communication skills to support older persons with DSI during health and social care interactions. A better understanding of DSI itself, as well as understanding the key role family carers play in integrating care for their family member, is crucial to delivering person-centred care.

Impact

This study addresses a growing social gerontological issue and identifies the role that family carers play in integrating health and social care for their family member with DSI. Better professional recognition of DSI and increased visibility of the challenges of living with DSI could help address barriers to effective communication between service providers, formal care support staff and those with DSI. Integrating family carers into care teams is critical to improving health and social care experiences for both caregiver and care receiver.

No Patient or Public Involvement

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

Stress and Health‐Related Quality of Life in Adults With Type 1 Diabetes: The Mediating Role of Perceived Support and Treatment Adherence

ABSTRACT

Aims

To examine the associations among diabetes-related stress, treatment adherence, perceived social support, and health-related quality of life (HRQoL) in adults with type 1 diabetes mellitus (DM1), and to explore the mediating roles of support and adherence in this relationship.

Design

A cross-sectional observational study using self-report standardised measures and mediation analysis.

Methods

A total of 772 Spanish adults with DM1 completed validated instruments measuring diabetes-related distress, perceived social support, treatment adherence, and HRQoL. Hierarchical multiple regression and serial mediation analysis (PROCESS Model 6, 10,000 bootstraps) were conducted, controlling for age, sex, and time since diagnosis.

Data Sources

Not applicable (primary data collection, not a review).

Results

Diabetes-related stress was the strongest predictor of lower HRQoL. Perceived social support and treatment adherence also contributed significantly. Mediation analyses indicated that the impact of stress on HRQoL was partially mediated by perceived social support and, in sequence, by treatment adherence. The indirect path through social support alone and the sequential path involving both mediators were significant.

Conclusion

Stress and social support are critical in understanding and improving HRQoL in adults with DM1. Treatment adherence appears to be influenced by perceived support, highlighting an indirect mechanism linking stress to quality of life.

Implications for the Profession and/or Patient Care

Healthcare professionals should integrate psychosocial assessments and interventions into routine diabetes care. Targeting stress reduction and enhancing social support may improve adherence and overall well-being in adults with DM1.

Impact

What problem did the study address? The study addressed the need to understand how psychosocial factors—specifically stress, perceived social support, and treatment adherence—contribute to HRQoL in adults with DM1. While prior research often focused on paediatric or clinical populations and rarely explored mediation models, this study sought to fill those gaps with data from a large community sample of adults.

What were the main findings? The main findings indicate that diabetes-related stress is the most significant predictor of reduced HRQoL. This relationship is partially mediated by perceived social support and, sequentially, by treatment adherence. While stress directly affects HRQoL, its negative impact is also channelled through diminished social support and decreased adherence. The indirect effect through treatment adherence alone was not significant.

Where and on whom will the research have an impact? The research has implications for adults living with DM1, particularly those in community settings outside of clinical supervision. It informs healthcare providers, diabetes educators, and policymakers on the importance of addressing emotional distress and strengthening support networks to improve both treatment adherence and overall quality of life.

Reporting Method

This study adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies. All methods and results are reported in alignment with EQUATOR Network recommendations for transparent and rigorous research reporting.

Patient or Public Contribution

The study was conducted in collaboration with the Spanish Diabetes Federation (FEDE), which supported participant recruitment and dissemination through its affiliated associations. Patient input was incorporated throughout the study. A person with lived experience of type 1 diabetes contributed to the conceptual development of the research questions and the interpretation of findings. Their perspective helped ensure that the study design, choice of measures, and implications were relevant and meaningful to people living with the condition. This involvement supported a patient-centred approach to both the research and the manuscript preparation. Patients' participation as voluntary contributors was essential to the data collection process.

Lived Experiences of Transgender Inmates in Barcelona Prisons: An Interpretative Phenomenological Study

ABSTRACT

Introduction

Incarceration significantly impacts inmates health, particularly marginalized groups like transgender persons, due to systemic oppression and inadequate healthcare. This study aims to understand transgender prisoners' health management experiences.

Methodology

An interpretative phenomenological approach was used. Data were collected through in-depth interviews with eight transgender inmates in Barcelona, Spain, and analyzed using the seven-step Colaizzi method.

Results

Three primary themes emerged: (1) Navigating Vulnerability in Healthcare Dynamics, which highlighted experiences of stigma and inadequate care; (2) The Quest for Wellbeing Amidst Uncertainty, underscoring concerns regarding treatment continuity; and (3) Negotiating a Landscape of Violence, revealing experiences of harassment and discrimination.

Discussion

This study highlights the need for culturally competent, person-centered healthcare policies in prisons, particularly for transgender individuals. Addressing the specific health needs of transgender inmates is crucial for enhancing their overall well-being. This emphasizes the importance of systemic reforms to improve care provision for transgender prisoners.

Clinical Relevance

Prison nurses must prioritize person-centered approaches, ensure continuity of gender-affirming treatments, and provide empathetic mental health support to enhance trust and improve the overall well-being of transgender inmates.

Measurement properties of instruments used to measure health-related quality of life in pediatric and adults patients with inherited epidermolysis bullosa: A systematic review and meta-analysis protocol

by Mario Gómez-Martínez, Greta Arias-Merino, Juan Benito-Lozano, Ana Villaverde-Hueso, Renata Linertová, Verónica Alonso-Ferreira

Inherited Epidermolysis Bullosa (EB) is a group of rare, genetic skin diseases characterized by extreme fragility of the skin and mucous membranes, leading to blistering and wounds in response to minimal trauma or friction. These clinical manifestations significantly reduce health-related quality of life (HRQoL). The objective of this protocol article is to provide information about the methods planned to be used to assess the measurement properties of HRQoL instruments specifically developed for EB patients of all age groups through a systematic review and meta-analysis. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) guideline. The literature search will be conducted in PubMed, Web of Science (WOS) and EMBASE, including terminology that aligns with the four key elements of the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) research question (construct, target population, measurement properties and type of PROM), as well as the terminology proposed by COSMIN for measurement properties. Studies that include information on measurement properties (specifically, validity and/or reliability) with a sample of patients with inherited EB will be selected. Both title and abstract screening and full text review, will be conducted by two independent reviewers using the Rayyan tool. In addition, the risk of bias will be assessed using the COSMIN-Risk of Bias checklist. The data from each study and each measurement property will be summarized in accordance with the COSMIN guidelines. The evidence gathered will strive to adjudicate data on measurements properties of HRQoL instruments used in EB patients, and the limitations of the future systematic review will be discussed. Ultimately, results of the future systematic review will help develop more personalized guidelines for the assessment of HRQoL in EB patients of all age groups. The protocol is registered in OSF with registration number vrm87: https://osf.io/vrm87/

Nurse and Other Healthcare Managers' Experiences and Recommendations for Patient Incident Reporting Processes and Real‐Time Software Development: A Qualitative Study

ABSTRACT

Aims

To (1) analyse managers' experiences with handling patient safety incident reports in an incident reporting software, identifying key challenges; (2) analyse the incident report processes from the managers' perspective; (3) examine managers' perceptions of ways to support and improve health professionals' experiences of report-handling processes; and (4) investigate how, from their point of view, incident reporting software should be developed in the future.

Design

A descriptive qualitative study.

Methods

Interviews and focus group discussions on Microsoft Teams from 11/2024 to 3/2025, including 16 participants, analysis with deductive and inductive content analysis.

Results

Of 16 participants, 15 were managers and one was a patient safety expert. Most were nurse managers (n = 9). Four discussion themes were divided into 30 categories. Participants highlighted the need to improve the reporting software's terminology, classification and analysis tools. The use of artificial intelligence was desired but not currently integrated into the software. Participants were unsure of their skills to use all the software features. Clear and transparent handling processes, feedback, managers' behaviour and communication methods were seen as key to improving staff's experience with report processes. A real-time warning system was considered beneficial for various incident types. Specific questions must be answered before further developing such systems.

Conclusion

This study deepened the understanding of reporting software's challenges regarding its handling features. The handling processes of incident reports had multiple shortcomings, which may negatively affect health professionals' experiences in report handling. Real-time warning systems could assist healthcare managers in processing reports.

Implications for the Profession and/or Patient Care

Organisational-level guidance for incident report processing is needed. Improvements to report processing and reporting software can improve shared learning and understanding of the status of patient safety.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

COnsolidated criteria for REporting Qualitative research Checklist.

Experiences of Visually Impaired Individuals in Self‐Administering Prescription Medications: A Cross‐Sectional Study

ABSTRACT

Aim

To explore the challenges that visually impaired individuals face in managing their prescribed therapy at home, and to identify the implications for all healthcare professionals involved in medication management and patient safety.

Design

A cross-sectional, descriptive, observational study.

Methods

Data were collected from 357 visually impaired adults recruited at the premises of the Union of the Blind and Visually Impaired during their visits for various reasons between October 2022 and June 2023, using an interviewer-administered questionnaire. Variables included demographics, medication practices, and self-reported challenges in medication administration and dosing. Data were analysed using multivariate analysis of variance (MANOVA), a series of Kruskal-Wallis tests, and post hoc Dunn's tests in R (v. 4.4.3).

Results

Respondents faced major problems in differentiating different types of tablets/capsules (56%) and differentiating different packages of drugs (47%); 5% of respondents sometimes take the wrong medicine, 4% sometimes take the wrong dose, and 11% sometimes take medicine at the wrong time. The most frequent problem was applying medications in liquid form. Older participants, those with chronic illness, multiple medications, lower education, or complete blindness reported significantly more difficulties. More than half of the respondents stated that they needed help in recognising drugs (60%), dosing (62%), and the expiration date of the drug (74%).

Conclusions

Visually impaired individuals, particularly those who are older and have complex medication regimens, face substantial barriers to safe and independent medication use. These findings highlight the need for individualised support and practical education strategies.

Implications for Profession and/or Patient Care

Through individualised approaches and practical training, with interprofessional collaboration, patient safety can be significantly improved and the risk of medication errors reduced. In a healthcare system with rapid technological advances and a growing shortage of healthcare workers, it is necessary to consider a broader range of support strategies, including efforts to understand the specific needs of people with visual impairments and the use of available assistive devices.

Impact

What problem did the study address?: Visually impaired individuals encounter substantial challenges in safely managing their prescribed medications, especially as they age and develop chronic health conditions. Despite the increasing global prevalence of vision impairment, this issue remains underexplored in nursing literature and practice.

What were the main findings?: This study presents evidence on the specific challenges that visually impaired adults face when self-administering medications. It identifies key risk factors—including advanced age, polypharmacy, chronic illness, and complete blindness—and highlights the dosage forms that pose the greatest difficulty. Importantly, it also reveals a widespread need for assistance with medication identification, dosing, and monitoring expiration dates.

Where and on whom will the research have an impact?: The findings highlight nurses' essential role in facilitating safe medication management for visually impaired patients. This involves assessing medication literacy, educating patients and caregivers, and promoting accessible medication labeling. The study highlights the need for nurse-led interventions and policy efforts to reduce disparities in medication safety, while recognising the valuable roles of both pharmacists and physicians in providing a comprehensive, interprofessional approach.

Reporting Method

The authors adhered to the STROBE guidelines.

Patient or Public Contribution

No patient or public involvement.

iHEART trial: study protocol for a German multicentre randomised controlled trial on the feasibility and acceptance of an internet-based preoperative intervention to optimise patient expectations and improve outcomes after heart surgery

Por: Compere · V. N. · Balci · S. · Heinz · C. · Schade-Brittinger · C. · Rastan · A. J. · Salzmann-Djufri · M. · Niemann · B. · Boening · A. · Choi · Y.-H. · Zarski · A.-C. · Laferton · J. · Euteneuer · F. · Rief · W. · Salzmann · S.
Introduction

Treatment expectations are a key mechanism of placebo effects in clinical trials. In a previous study (PSY-HEART-I), preoperative expectation optimisation improved quality of life 6 months postcardiac surgery. However, barriers such as travel distance, staffing shortages and COVID-19 limited participation. This study evaluates the feasibility and acceptability of iEXPECT, a brief internet-based intervention designed to optimise expectations before heart surgery.

Methods and analysis

In this three-arm, multicentre randomised controlled trial, 160 patients undergoing elective coronary artery bypass graft surgery are randomised to: (a) standard of care (SOC); (b) SOC plus iEXPECT with phone-based guidance (iEXPECT enhanced) or (c) SOC plus iEXPECT with email-based guidance (iEXPECT limited). The intervention includes four 20 min online modules addressing surgical benefits, side effects and coping strategies. Modules are accompanied by personalised guidance provided through feedback on each module via email or telephone (three before surgery, three booster sessions at 6, 12 and 18 weeks postsurgery). Assessments occur at baseline (5–21 days before surgery), preoperatively (day before surgery), 7 days postsurgery and 6 months later. Primary feasibility outcomes include recruitment (≥1 participant/week/centre), retention (≥49% completing 6-month follow-up including biomarkers) and engagement (≥75% completing ≥1 presurgery module). Acceptability is measured by self-reported enjoyment, usefulness and impact, with acceptance defined as mean scores >3.4 (5-point Likert scale) and CSQ-I ratings. Secondary outcomes include psychological measures, inflammatory markers and heart rate variability.

Ethics and dissemination

Ethical approval was granted by the Ethics Committees of Philipps University Marburg (AZ 229/23 BO) and the University of Giessen (AZ 186/23). All participants provide written informed consent. Results will be shared via publications, conferences and public outreach with relevant consumer advocacy groups.

Trial registration number

DRKS00033284.

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.

❌