Conectar
To explore key stakeholders' experiences and perceptions of end-of-life communication in acute care settings.
A qualitative descriptive study.
Data were collected from 4 May to 31 October 2023. Patients with terminal illness, family caregivers and healthcare providers were recruited from two Chinese hospitals via purposive sampling. Individual interviews were conducted with patients and family caregivers, whereas healthcare providers participated in focus group discussions. Thematic analysis was conducted.
Nineteen patients, 22 family caregivers and 25 healthcare providers participated. Five themes emerged: (1) protective end-of-life communication, characterised by dominant family involvement, truth concealment and restricted end-of-life topics; (2) open end-of-life communication, characterised by dominant patient involvement, truth disclosure and diverse end-of-life topics; (3) patient-related factors, including comfort level in talking about end-of-life, burden and treatment engagement; (4) family-related factors, including comfort, burden, expectations, values and trust in healthcare providers and (5) healthcare provider-related factors, including comfort, time availability and clinical priorities, end-of-life communication awareness and skills and end-of-life care knowledge.
End-of-life communication in Chinese acute care settings oscillates between protective and open approaches, influenced by several individual factors.
Healthcare providers must overcome stereotypes rooted in cultural values and adopt a proactive approach to end-of-life communication. Enhanced training and institutional procedures are needed to improve end-of-life communication in acute care settings.
The study provides nuanced insights into end-of-life communication dynamics in Chinese acute care settings, complementing global evidence. Coexisting protective and open communication approaches highlight the need for context-sensitive approaches to end-of-life communication. Multifocal interventions addressing patient-, family- and healthcare provider-related factors are warranted.
Standards for Reporting Qualitative Research.
No patient or public contribution was involved in the design or conduct of the study.
International migrants comprise 3.6% of the global population and face systemic barriers to accessing sexual and reproductive health (SRH) services, such as contraception, safe abortion care and sexual function support. In high-income countries, policy frameworks vary widely, with migration status significantly influencing entitlement and access to host countries. This protocol outlines a planned study to systematically analyse SRH policies in high-income countries with strong migrant integration frameworks, aiming to identify policy gaps, assess inclusivity and inform recommendations to strengthen Australia’s SRH policy landscape.
This study employs a systematic policy analysis using the Joanna Briggs Institute scoping review methodology. Countries with ≥10% migrant populations and a Migrant Integration Policy Index health score ≥70 will be included. 13 countries meet these criteria, including Australia, Canada and Sweden. A comprehensive search of academic databases (PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature and ProQuest Public Health) and grey literature from governmental and non-governmental sources will be conducted. Data extraction will follow Bacchi’s ‘What’s the Problem Represented to Be?’ approach. Thematic analysis will combine deductive and inductive methods to examine the extent to which SRH policies address migrant and refugee needs, including sexual function, safe abortion care and fertility care. A comparative policy matrix will identify strengths, limitations and best practices.
As this study analyses publicly available policy documents, ethics approval is not required. Findings will be disseminated through peer-reviewed publications and policy briefs targeting stakeholders involved in SRH policy and migrant health.
This protocol is registered with the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/AYZ6P
Although the WHO and the Centers for Disease Control and Prevention (CDC) classify preconception health risks (PCHRs) into biomedical, behavioural and social categories, this classification remains theoretical, mainly inconsistent and lacks a scientifically robust framework. Data-driven clustering techniques may help clarify this complexity for policymakers and healthcare providers. This study aimed to assess the status of PCHRs and identify latent classes of these risks among women preparing for pregnancy.
This community-based cross-sectional study was conducted from 31 July to 16 August 2024 in Tigray, Ethiopia, among 865 married women planning to conceive within the next 6 months. Data were gathered through face-to-face interviews using a structured questionnaire. Risk factor indicators covering lifestyle behaviours, substance use, nutritional risks and related factors were developed based on guidelines from the WHO, the CDC and national recommendations. Latent class analysis (LCA) was employed to identify distinct classes of PCHRs, with the optimal number of classes determined using statistical fit indices, adequacy criteria and interpretability. The study also evaluated the overall distribution of PCHRs among participants.
The study took place in Tigray, Ethiopia, among married women intending to become pregnant within 6 months.
Burden of PCHRs and identified distinct latent classes of these risks within the participants.
All participants were exposed to at least four PCHRs, with 84.2% experiencing between 6 and 12 risk factors. The optimal LCA model identified four distinct classes of PCHRs: lifestyle behavioural risks (n=458, 52.9%), reproductive health risks and chronic medical conditions (n=106, 12.25%), nutritional risks and environmental exposure (n=149, 17.23%) and social determinants of health (n=152, 17.57%).
Our study reveals a high baseline level of PCHRs, with all participants exhibiting multiple risk factors for adverse pregnancy outcomes. The identification of four distinct risk profiles underscores the need for tailored risk-specific interventions, particularly in conflict-affected settings. Our findings point out the need for targeted preconception care and risk stratification in national health strategies to improve maternal and child health outcomes.
by Hailemariam Gezie, Endalk Birrie Wondifraw, Muluken Amare Wudu, Habtam Gelaye, Fekadeselassie Belege Getaneh
BackgroundNeural tube defects (NTDs) are severe congenital anomalies resulting from the incomplete closure of the embryonic neural tube, affecting around 300,000 newborns globally each year and leading to significant mortality and disability. While high-income countries have seen a reduction in NTD prevalence, developing nations like Ethiopia continue to face high rates. Families impacted by NTDs often endure emotional challenges, including grief, anxiety, and social isolation. This study aims to investigate the birth prevalence of NTDs and the associated parental stress, emphasizing the wider effects on families.
MethodologyAn institution-based cross-sectional study was conducted in Dessie and Deber Berhan comprehensive specialized hospitals from July 24, 2023, to July 24, 2024, to evaluate the birth prevalence of NTDs and the associated parental stress among parents of children aged 1 month to 12 years diagnosed with NTDs. A total of 308 parent-child pairs participated in the study. Data were gathered using a pretested questionnaire and an 18-item Parenting Stress Scale. Statistical analysis was performed using Stata version 17, where linear regression was utilized to identify significant predictors after verifying the necessary assumptions. The findings were presented in multiple formats for clarity and comprehensibility.
ResultsThe overall birth prevalence of neural tube defects was found to be 0.0052 (95% CI: 0.0038, 0.0067), which translates to 52 cases per 10,000 deliveries. Key factors associated with increased parental stress included being a mother (β = 2.51), older parental age (β = 0.18), the child’s age (β = 0.81), a prior history of having children with NTDs (β = 7.88), and the presence of a ventriculoperitoneal shunt in the child (β = 4.66).
ConclusionThe findings of this study indicate that the birth prevalence of NTDs is becoming a significant public health concern. Additionally, several factors contributing to increased parental stress were identified, including older parental age, the child’s age, a previous history of NTDs in siblings, and the presence of a ventriculoperitoneal shunt. These results highlight the urgent need for targeted support and resources for affected families to help mitigate the psychological impact associated with these conditions.
FreshRSS 