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This study aimed to explore informal caregivers' (family members of patients) perspectives on their involvement in ongoing multidisciplinary treatment of diabetes-related foot ulcers in a highly specialised outpatient service with a multidisciplinary team structure that was still evolving. Using focus group interviews and template analysis, we identified patterns in caregivers' experiences, needs, and preferences. The findings suggest considerable potential to improve patient care through earlier caregiver involvement. While some caregivers reported positive experiences, many rarely or never attended consultations and struggled to define involvement in practical terms. However, caregivers consistently expressed a strong wish for earlier involvement—ideally at the time of diabetes diagnosis—to acquire the knowledge and skills needed to support patients between clinical visits. Caregivers play an important role in foot ulcer management, as complex regimens such as wound care, offloading, and lifestyle adjustments require ongoing support outside clinical settings. However, involvement may also create strain. Participants described emotional and practical burden, feelings of guilt, and uncertainty about their roles. The study highlights the need for structured caregiver education, clear communication, and systemic support to balance the benefits of caregiver involvement with the risk of caregiver burden.
This study investigates the potential of digital health technologies (DHTs), such as wearable devices and smartphones, to complement traditional submaximal functional capacity tests, such as the 6 min walk test (6MWT) and the timed up and go test (TUG). While these traditional tests are widely used due to their simplicity and relevance to daily living activities, they have limitations, including infrequent administration and the need for clinical observation. DHT offers continuous, real-world monitoring, which may accurately reflect patients’ health status and effectively inform clinical decisions. However, there is a need to establish the validity of the data and metrics computed through DHT and understand patient perspectives on using such technology.
This is an observational pilot study (Synergy Digital Health study) that aims at linking wearable data with traditional test outcomes and assessing participants’ acceptance and usage of such DHT. A cohort of 30 cardiovascular patients from Oxford University Hospitals, UK, and 30 community-dwelling elderly people from social centres in Helsingborg, Sweden, will use wearable devices for 2 months in free-living conditions, they will fill out technology acceptance questionnaires (AQs), have baseline assessments and perform physical tests such as the 6MWT and TUG using the Mobistudy smartphone app. Subgroups will participate in codesign workshops to identify experience-based design recommendations for the technology. Quantitative and qualitative methods will be adopted to analyse the collected data.
The study protocol received ethical approval in Sweden from the Etikprövningsmyndigheten (2024-04886-01) and in the UK from the National Health Service (NHS) Research Ethics Committees (Iras project ID: 340870), in accordance with local regulations. All participants are asked for written informed consent. The results of the study will be shared via scientific journals and conferences.
Although research and evidence-based practice are widely regarded as foundational to high quality patient care, little is known about the evidence-based practice and research competencies of ambulatory care nurses.
The aim of this study was to measure the self-perceived evidence-based practice and research competencies and learning needs of ambulatory care nurses.
In 2024, a national sample of 2790 ambulatory care nurses participated in an online cross-sectional structured survey measuring evidence-based practice and research competencies. Respondents rated their competency using the EBP Capability Beliefs Scale and the Application of Knowledge and Skills subscale from the Research Competencies Assessment Instrument for Nurses (RCAIN). Results were compared across practice settings, job roles, and subspecialties.
Higher education levels correlated with higher scores in both evidence-based practice and research competencies. After controlling for education level, nurses from specialty or procedural areas scored higher in evidence-based practice competencies than nurses from all other work environments. Direct care nurses scored lower than nurses in all other roles in research competencies. Statistically significant correlations were also found between evidence-based practice competencies and the type of organization where a nurse worked.
Findings indicate EBP and research competencies must be increased among ambulatory care nurses. Leadership support and resource allocation are critical for EBP development. Among ambulatory care nurses, those in direct care roles may have the greatest opportunities to develop EBP and research competencies. Nurses with limited exposure to EBP and research should be encouraged to engage in professional development activities on these topics. Education and EBP mentorship for ambulatory care nurses should be tailored to the ambulatory care environment where possible, to make it relatable to learners.
To evaluate the acceptability, mechanisms of impact, and contextual factors affecting a 9-month, nurse-led self-management intervention specifically designed for newly diagnosed patients with inflammatory arthritis, from both the patient and healthcare professional (HPs) perspectives.
A qualitative longitudinal study.
Individual baseline and follow-up interviews were conducted with 12 patients (baseline n = 12; follow-up n = 10) and four focus group interviews were conducted with 4 HPs at key intervention stages. Interview guides were drafted with open-ended questions and iteratively refined across interviews to match the evolving stages of the intervention. Data analysis was conducted using template analysis. This study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ): 32-item checklist.
Patients valued the tailored individual sessions, which provided emotional support and improved their understanding of IA. Group sessions received mixed feedback, with some patients suggesting a need for more organisation. The intervention fostered a sense of community, reducing isolation and empowering patients to navigate the healthcare system better. HPs praised the patient-centred approach and emphasised the importance of training and organisational support.
Both patients and HPs highly accepted our nurse-led self-management intervention, though group sessions received mixed feedback. Key impact mechanisms were the proactive management of symptoms and lifestyle, and the intervention's tailored support and emotional guidance. The HPs experienced professional growth but scheduling occasionally conflicted with regular work.
This study has provided valuable information in understanding intervention mechanisms. Findings from the evaluation will be used to refine the intervention.
Two patients contributed to the development of the intervention, and a patient research partner was actively engaged in all phases of this study.
To explore the lived experience of the trusting nurse–patient relationship among patients admitted to internal medicine wards.
A qualitative study guided by van Manen's hermeneutic phenomenological approach.
Semi-structured interviews were conducted with fourteen hospitalised patients in a Danish University hospital in 2024. Data were analysed through thematic reflection.
The analysis revealed one overarching theme—the journey towards trust: bridging the need to feel safe with the pathways to wellbeing—supported by five subthemes. Trust developed through a dynamic and interpersonal process shaped by the patient's vulnerability, the nurse's actions and their mutual understanding. When trust was present, care was experienced as coherent, meaningful and safe; when absent, it felt disconnected and inadequate.
Trust within the nurse–patient relationship is experienced as a dynamic process shaped by the nurse's presence, authenticity and responsiveness. Rather than a static state, trust unfolds gradually, influencing how patients feel safe, understood and cared for. Relational competence should be recognised as a clinical skill, requiring the same support as technical competencies. Education, leadership and policies must protect interpersonal care. Further research should examine nurses' experiences and interventions that sustain trust.
The findings emphasise the need to recognise relational care as a professional and clinical competence. Supportive environments, relational training and organisational awareness are essential to enable nurses to prioritise trust-based relationships.
This study addresses the challenge of sustaining relational care in time-constrained hospital settings. It offers insight into patients' experiences of trust and highlights key relational behaviours. The findings are relevant for nurses, educators and healthcare leaders aiming to strengthen relational competence and improve patient care quality.
The study adheres to the COREQ reporting guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
Fathers of preterm infants wish to be actively involved and attentive in caring for their children. The positive impacts of paternal caregiving on preterm infants’ cognitive and social development have been recognised. Awareness of the need to support fathers during early parenthood is increasing, but fathers may feel excluded when their infants are in the neonatal intensive care unit. Here, we present the protocol for a study involving the development and national implementation of a complex intervention supporting first-time fathers of preterm infants in early parenthood.
The study adheres to the Medical Research Council framework for complex interventions. A multicentre, prospective, non-blinded, quasi-experimental design will be applied to evaluate the effect of a clinical and technology-based intervention targeting both nurses and the fathers. Outcomes from participants enrolled during the control (2023–2024) and intervention (2025–2026) periods, comprising 295 fathers and their partners, will be compared. Effects on parental confidence, stress, depression and mood and family and reflective functioning as well as infants’ emotional and social development will be assessed. A comprehensive process evaluation will be applied using both qualitative and quantitative methods.
The study has been registered at Clinicaltrials.org [no. NCT0 6 116 747 (The SUPPORTED study – First-time Fathers of Preterm Infants), approved on 3 November 2023]. The Danish Data Protection Agency has approved the study (P-2022–792). The findings will be disseminated through peer-reviewed publications.
Continuous glucose monitoring (CGM) provides real-time glucose data for people with diabetes. However, detailed knowledge of its use in daily life remains limited. We aim to investigate the interaction between people with type 1 diabetes (T1D) and their CGM data and the impact of the interaction on glycaemia and diabetes distress.
This is a two-centre observational study of adults (n=500) with T1D using FreeStyle Libre 2. Over a period of 14 days, participants will continue their regular CGM use, record insulin doses and timing with smart insulin pens, track activity and sleep with an activity tracker, log all food intake in the LibreLink app and answer questions about quality of life and hypoglycaemia two times per day. Before the study period, the participants will complete a survey of 11 validated questionnaires assessing diabetes distress, hypoglycaemia awareness and other patient-reported outcomes (PROs). After the study period, the participants will complete two additional questionnaires assessing diabetes distress and health literacy.
The collected data will be used in two substudies with the overall aims of:
Substudy 1: to investigate how CGM is used in practice and the impact of the interaction on diabetes distress and glycaemia.
Substudy 2: to investigate whether and how CGM functions as a technological substitute for impaired awareness of hypoglycaemia, focusing on alarm data.
Endpoints will include CGM metrics, alarm data and PROs.
The Danish Data Protection Agency approved the study (P-2024–15985), and the regional committee on health research ethics has granted an ethical waiver (H-24014662). All participants have signed written informed consent forms before participating. The results will be published in an international peer-reviewed scientific journal by the study investigators and shared via www.clinicaltrials.gov. Participants who agreed to receive information about the study will be sent the results after publication.
ClinicalTrials.gov (NCT06453434).
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