To translate, cross-culturally adapt, validate and psychometrically test the MISSCARE Survey–Patient for assessing patients' perspectives on missed nursing care (MNC) in a Danish hospital setting.
A two-phase cross-cultural adaptation and psychometric validation study.
The study was conducted in two phases. First, the MISSCARE Survey–Patient was cross-culturally adapted to ensure its relevance in a Danish hospital context. This phase involved translation and back-translation, expert committee reviews and cognitive interviews with 18 inpatients to establish content validity. Second, a convenience sample of 284 patients from surgical and medical departments completed the adapted survey. Psychometric properties were evaluated using structural equation modelling to test a second-order formative model.
The cross-cultural adaptation phase led to minor and substantial revisions, including the addition of six new items to enhance content validity. These items addressed aspects of nursing care relevant to patients in the contemporary hospital setting that were not captured by the original survey. Structural equation modelling confirmed the second-order formative model and demonstrated robust psychometric properties.
The MISSCARE Survey–Patient was successfully adapted and validated for use in Danish hospitals, ensuring strong content validity and psychometric robustness.
The Danish version of the survey provides a valuable tool for assessing MNC from patients' perspectives in hospital settings. Its use can help identify specific areas where nursing care falls short, guiding targeted initiatives to enhance care quality and patient safety. By integrating patients' experiences into quality improvement initiatives, the survey supports the development of more person-centred care practices.
The study adhered to the COnsensus-based Standards for the selection of health Measurement INstruments reporting guideline for studies on measurement properties of patient-reported outcome measures.
Patients were not involved in the study's design, conduct, or reporting.
The Danish version of the survey facilitates data collection on patients' perspectives of MNC in contemporary hospital settings, providing valuable insights into care quality. By offering a validated tool to assess MNC from patients' perspectives, the survey helps hospitals identify care gaps, prioritise improvement efforts and enhance person-centred care.
The evidence for the optimal duration of psychotherapy for borderline personality disorder (BPD) is scarce. Two previous trials have compared different durations of psychotherapy. The first compared 6 months versus 12 months of dialectical behaviour therapy for BPD (the FASTER trial). The second compared 5 months versus 14 months of mentalisation-based therapy for BPD (the MBT-RCT trial). The primary objective of the present study will be to provide an individual patient data pooled analysis of two randomised clinical trials by combining the two short-term groups and the two long-term groups from the FASTER and MBT-RCT trials, thereby providing greater statistical power than the individual trials. Accordingly, we will evaluate the overall evidence on the effects of short-term versus long-term psychotherapy for BPD and investigate whether certain subgroups might benefit from short-term versus long-term psychotherapy.
An individual patient data pooled analysis of the FASTER trial and the MBT-RCT trial will be conducted. The primary outcome will be a composite of the proportion of participants with a suicide, a suicide attempt or a psychiatric hospitalisation. The secondary outcome will be the proportion of participants with self-harm. Exploratory outcomes will be BPD symptoms, symptom distress, level of functioning and quality of life. We will primarily assess outcomes at 15 months after randomisation for the FASTER trial and at 16 months after randomisation for the MBT-RCT trial. Predefined subgroups based on the design variables in the original trials will be tested for interaction with the intervention as follows: trial, sex (male compared with female), age (below or at 30 years compared with above 30 years) and baseline level of functioning (Global Assessment of Functioning baseline score at 0–49 compared with 50–100).
The statistical analyses will be performed on anonymised trial data that have already been approved by the respective ethical committees that originally assessed the included trials. The final analysis will be published in a peer-reviewed scientific journal and the results will be presented at national seminars and international conferences.
CRD42024612840.
by Brooke Allemang, Francine Buchanan, Pranshu Maini, Dalya Kablawi, Lin Li, Linda Nguyen, Kimberly Courtney, Jessie Cunningham, Carla P. Southward, Kristin Cleverley, Sarah Munce, Alene Toulany
BackgroundPediatric patient and family engagement is an active and collaborative process, that involves children, adolescents, and family members with lived experience contributing to the design, implementation, and evaluation of healthcare services. Prior studies have highlighted the patient engagement methods and impact in clinical care, education, and research. However, gaps remain in understanding the commonalities and distinctions of engagement approaches, patient/family partner roles, and outcomes in clinical care, education, and research contexts. Further, research examining the nuances of pediatric patient and family engagement within healthcare delivery, education, and research in pediatric institutions is needed to streamline efforts.
ObjectiveThis scoping review will identify the commonalities of and distinctions between pediatric patient and family engagement in clinical care, education, and research contexts in pediatric healthcare institutions.
MethodsA scoping review, conducted in collaboration with a team of adolescent, young adult, and family partners, will allow us to systematically map out key concepts, evidence, and knowledge gaps regarding pediatric patient and family engagement in clinical care, education, and research. We will follow the Joanna Briggs Institute framework in the design and conduct of the review and guidance on engaging knowledge users within scoping reviews. The protocol for this scoping review has been registered with the Open Science Framework database (https://osf.io/63qx5).
ResultsThis study will describe the engagement types, approaches, and outcomes of pediatric patient and family engagement employed within clinical care, education, and research settings, highlighting commonalities and distinctions across contexts. In doing so, it will identify potential opportunities for collaboration and resource-sharing based on the context of engagement and provide needed clarity on streamlining pediatric patient and family engagement approaches within pediatric institutional settings.
ConclusionsIt is anticipated that the results will produce preliminary evidence of relevance to pediatric institutions seeking to consolidate engagement practices across clinical care, education, and research domains.
by Tremaine B. Williams, Pearman Parker, Milan Bimali, Maryam Y. Garza, Alisha Crump, Taiquitha Robins, Emel Seker, Ava Storey, Allison Purvis, Mya Tolbert, Anthony Drake, Taren Massey Swindle, Kevin Wayne Sexton
African Americans experience approximately 2.5 times more heart failure hospitalizations than Caucasians and the complexity of heart failure requires registered nurses to work in collaboration with other types of healthcare professionals. The purpose of this study was to identify care team configurations associated with long lengths of hospital stay in African Americans with heart failure hospitalizations and the related effect of the presence of registered nurses on their length of hospital stay. This study analyzed electronic health record data on the heart failure hospitalizations of 2,274 African American patients. Binomial logistic regression identified the association between specific care team configurations and length of stay among subgroups of African American patients. Of the significant team configurations, a Kruskal-Wallis H test and linear regression further assessed the team composition and the specific change in days associated with a one-unit change in the number of registered nurses on a patient’s care team. Six team configurations were associated with a long length of stay among all African Americans regardless of age, sex, rurality, heart failure severity, and overall health severity. The configurations only differed significantly in the proportion of registered nurses with respect to other care team roles. An increase in one additional registered nurse on a care delivery team was associated with an increase in length of stay of 8.4 hours (i.e., 504 minutes). Identifying the full range of social and technical care delivery tasks performed by RNs, and controlling for their effect on length of stay, may be a key strategy for reducing length of stay and explaining why these six configurations and RNs are associated with long LOS. The identification of these models can be used to support decision-making that optimizes the availability of patient access to high-quality care (e.g., clinical staffing and supplies).The transition from paediatric to adult healthcare marks a pivotal period for chronically ill adolescents, as they transition from a highly supportive and family-oriented environment to an adult-oriented and a more individual-oriented healthcare system that places a greater emphasis on personal responsibility and independence. Parents, given their firsthand experience managing their child’s healthcare, play a central role in ensuring a smooth and successful transition, yet their perspectives on the barriers and facilitators of this complex process remain vastly underexplored. This scoping review aims to assess and provide comprehensive insights into parents’ perceptions of the successes and challenges during their adolescents’ transition from paediatric to adult healthcare.
This scoping review is led by patient partners and will be guided by the Peters et al and the Joanna Briggs Institute guidelines for scoping reviews. The preliminary search strategy will be developed and calibrated in Ovid MEDLINE and will be subsequently replicated in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychInfo, Embase, Web of Science and Sociological Abstracts from inception through 18 December 2024, including all types of studies. Grey literature sources recommended by patient partners and clinical and qualitative research experts will also be included. Two reviewers will independently perform the title and abstract review of all studies against the predefined inclusion and exclusion criteria, followed by the full-text review of included studies. The reference list of all included studies will also be screened to maximise the retrieval of relevant sources. Data will be extracted and analysed quantitatively and qualitatively, with the study procedural and reporting format following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.
This scoping review, through the broad and systematic mapping of existing literature, aims to provide a foundation for developing targeted support systems, strategies and interventions to address the unique needs and barriers faced by parents and caregivers of chronically ill adolescents during this critical transition to adult care.
Psychotic disorders are more prevalent among minority ethnic groups in the UK. However, there is no research on how the British Sikh community understands and seeks help for psychosis. The way in which a community understands the nature, causes and treatment of psychosis can impact their duration of untreated psychosis, treatment pathways, experience and engagement with mental health services, and outcomes.
To explore the lay understandings of psychosis and associated help-seeking within the Sikh community in England, and how family, religion and culture influence these perspectives
An exploratory qualitative design, consisting of online semistructured interviews across the UK.
30 participants, 11 men and 19 women, ages ranged from 19 to 69, who identified as Sikh.
Thematic analysis revealed several common themes, including a lack of awareness and knowledge of psychosis, variety of causal beliefs held about psychosis, professional help-seeking being encouraged, religious practices regarded as helpful coping mechanisms, supernatural beliefs influencing alternative help-seeking, strong negative perceptions towards psychosis and general mental illness, the significant role of family and community, and conflicting religious and cultural beliefs.
Participants showed limited understanding of psychosis and mental illnesses, accompanied by widespread negative perceptions, potentially delaying help-seeking. Increasing awareness may prompt earlier help-seeking, enhancing outcomes and diminishing stigma.
The nursing profession has undergone significant evolution over the past century, shifting from a role traditionally viewed as an auxiliary to physicians to one of autonomous healthcare professionals equipped with specialised skills and expertise. This shift is driven by the increasing recognition of the importance of evidence-based practice in enhancing patient outcomes and advancing the field of nursing. Consequently, nursing research has emerged as a critical priority in the profession. This study seeks to explore the nursing research landscape in Malaysia, where data remain limited, by examining trends before, during and after the COVID-19 pandemic.
This scoping review will be conducted following the Arksey and O'Malley framework, using four electronic databases: PubMed, Scopus and CINAHL for journal articles published between 2015 and 2024, and Web of Science for conference proceedings from the same period.
The findings from this scoping review will provide an overview of the nursing research landscape in the Malaysian context, offering insights that could guide the future advancement of nursing research in the country. The results will be disseminated through submission to a peer-reviewed scientific journal for publication. Ethical approval is not required for this scoping review, as it involves the synthesis of data from available published literature.
by Kiera Middel, Hailey Strydhorst, Hannah McKenzie, Chunu Mainali, Darcy R. Visscher
The increasing spread of wild pigs across Canada is concerning due to their potential role as reservoirs for zoonotic diseases, including trichinosis and toxoplasmosis. Trichinosis is caused by the parasitic nematode Trichinella spp. and can manifest clinically in humans. Likewise, the intracellular protozoan parasite Toxoplasma gondii is a significant global foodborne and waterborne parasite responsible for toxoplasmosis. Despite wild pigs being recognized globally as reservoirs for T. gondii and Trichinella spp., the status of wild pigs in Alberta remains undetermined. Wild pig diaphragms were collected as part of provincial control efforts between 2018–2024 from four Alberta counties. Meat juice was analyzed for antibodies against Trichinella spp. and T. gondii using commercial ELISA kits. We found that 27/252 pigs were positive for antibodies against T. gondii and 11/293 positive for antibodies against Trichinella spp., corresponding with the respective true prevalence of 15.3% (95% CrI: 9.6–22.7%) and 3.8% (95% CrI: 1.8–6.5%) based on Bayesian analysis using reported test sensitivity and specificity. We found a difference in true prevalence of antibodies against Trichinella spp. between counties, and the prevalence of antibodies against Trichinella spp. and T. gondii was significantly higher in solitary wild pigs, suggesting social context of the individual is an important determinant of infection risk. These findings suggest that Alberta wild pigs function as Trichinella spp. and T. gondii reservoirs, underscoring the need for a One Health approach for managing Alberta’s invasive wild pigs.Sleep disordered breathing is a chronic condition often requiring patient commitment to positive airway pressure (PAP) therapy. Understanding the lived experience of PAP therapy users is crucial for clinicians to support successful treatment and identify research priorities. There is a lack of evidence in this area, and published data predominantly explore the negative experiences of PAP. This study aims to explore the lived experiences of patients using PAP therapy.
This study employs a phenomenological approach, appropriate for researching human experiences where there is little existing research. Heideggerian theory underpins the research, recognising that the researcher’s beliefs influence meaning, allowing for rich analysis of the lived experience.
Participants will be recruited from a randomised controlled trial investigating the medium-term clinical impact of customised interfaces for patients requiring PAP therapy. Purposive sampling will be used to seek representation from various demographics, with a maximum of 30 participants.
Data collection will be via 1:1 semistructured interviews. Data will be analysed using Braun and Clarke’s six-phase reflexive thematic analysis. Data will be analysed inductively through an interpretivism lens. Data will be managed with computer-assisted qualitative data analysis software.
This protocol has been approved by the Hampshire B Research Ethics Committee (REC reference: 22/SC/0405). Results will be disseminated to healthcare professionals and patients through conferences, open-access journals, newsletters, the study webpage, infographics, animations, social media and healthcare awards. Tracy’s eight ‘big tent’ criteria for excellent qualitative research are comprehensive and encompassing, and this protocol has aimed to meet the criteria. The Consolidated Criteria for Reporting Qualitative Research has also been used. The findings of this study will contribute to a more holistic understanding of the lived experience of PAP therapy users, informing clinical practice and future research.
by Eugénie M. Kamabu, Justin L. Paluku, William P. Howlett, Abid M. Sadiq, Eliada B. Nziku, Doreen T. Eliah, Ibrahim Ali Ibrahim Muhina, Fuad H. Said, Tumaini E. Mirai, Elifuraha W. Mkwizu, Furaha S. Lyamuya, Elichilia R. Shao, Kajiru G. Kilonzo, Venance P. Maro, Sarah J. Urasa, Nyasatu G. Chamba
BackgroundAmong acute stroke patients (ASPs), diabetes mellitus (DM) is associated with a higher risk of death, functional dependency, and recurrence. This study aimed to determine the impact of DM on the 30-day mortality among admitted ASPs in northern Tanzania.
Materials and methodsThis was a hospital-based prospective cohort study performed among ASPs with and without DM who were admitted to Kilimanjaro Christian Medical Centre from November 2022 to May2023. ASPs were followed for 30 days after the onset of an acute stroke to identify the primary outcome, which was all-cause mortality. Descriptive statistics, logistic regression, and survival analysis were conducted,
ResultsOut of 213 ASP, 82 (38.5%) had DM. The overall crude mortality rate was 46.9%. ASPs with DM had a higher mortality rate of 53.7% compared with those without DM (42.7%). A higher proportion of acute stroke patients with DM (84.1%) had a poor outcome (mRS 3-6) (p = 0.038). DM was statistically non-significant for 30-day mortality (aHR 1.56; 95% CI: 0.73–3.32; p = 0.252). However, fever (p = 0.005), severe admission Glasgow coma scale (p = 0.005), severe stroke (p = 0.008), elevated serum creatinine (p = 0.008), and an abnormal respiratory pattern (p = 0.042), were predictors of 30-day mortality,
ConclusionThis study demonstrated a high mortality in ASPs. Although DM did not have a significant impact on 30-day mortality, other factors, such as altered mental state, stroke severity, fever, elevated creatinine, and abnormal respiration, need to be accounted for that may have a significant impact on the mortality in ASPs. These findings highlight the significant burden of DM in stroke patients and underscore the importance of early diagnosis and treatment of ASPs, in the hopes of improving clinical practice and guidelines and reducing morbidity and mortality in Tanzania.
To determine prognostic factors of disability in multiple sclerosis (MS), that is, (1) identify determinants of the dynamics of disability progression; (2) study the effectiveness of disease-modifying treatments (DMTs); (3) merge determinants and DMTs for creating patient-centred prognostic tools and (4) conduct an economic analysis.
Individuals registered in the French Observatoire Francais de la Sclérose en Plaques (OFSEP) database were included in this OFSEP-high definition cohort if they had a diagnosis of MS, were ≥15 years old and had an Expanded Disability Status Scale (EDSS) score
A cohort of 2842 individuals, 73.4% women, mean (SD) age of 42.7 (11.6) years, median disease duration of 8.8 years, has been recruited from July 2018 to September 2020. The course of MS was relapsing remitting in 67.7%, secondary progressive in 11.9%. The mean annual relapse rate was 0.98. The disease-modifying treatment received was highly effective therapy in 50.3% and moderately effective therapy in 30.7%.
The participants will be followed until December 2026. Disease course up to four landmarks will be examined as predictors of disease progression: (1) diagnosis of MS; (2) relapse activity worsening and independent progression; (3) any recent disease activity and (4) any visit with absence of disease activity in the past 5 years. The marginal effectiveness and tolerability of treatments will be assessed. Stratified algorithms will be proposed for medical decision-making. Economic evaluation of disease cost and cost-effectiveness of new DMTs will be conducted from a public payer perspective.
To synthesise the effects of psychosocial interventions compared with standard care in improving psychosocial outcomes of parents of children with cancer receiving active treatment.
This was a systematic review and meta-analysis that was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
All randomised controlled trials examining the effects of psychosocial interventions for parents of children with cancer were considered eligible. All identified articles were imported into Endnote X9. Two independent authors conducted study selection and data extraction. Risk-of-Bias version 2 and the Grading of Recommendations Assessment, Development and Evaluation approach were used to evaluate the methodological quality and overall quality of the evidence, respectively. Review Manager 5.4.1 software was used for data analysis, and sensitivity and subgroup analyses were conducted to examine heterogeneity, if applicable.
Seven databases, including PubMed, Embase, Scopus, PsycINFO, CENTRAL, CINAHL and ProQuest, were searched up to 6 December 2023.
Sixteen studies involving 1379 participants were included in the systematic review, with 12 studies pooled for meta-analysis. Psychosocial intervention was effective in anxiety symptoms and depressive symptoms among parents of children with cancer. No significant differences were observed in parental stress and quality of life between psychosocial intervention and control groups.
This study showed that psychosocial intervention was beneficial for decreasing anxiety symptoms and depressive symptoms of parents of children with cancer. Future trials with a more robust methodology are needed to augment current findings.
As our systematic review showed that psychosocial interventions were effective in decreasing anxiety symptoms and depressive symptoms among parents of children with cancer, healthcare professionals could consider integrating psychosocial support for these parents.
This systematic review had no patient or public contribution.
This review was registered at PROSPERO (CRD42022384452) on 29 December 2022. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=384452).
by Ana Paula Serafini Poeta Silva, Guilherme Arruda Cezar, Edison Sousa Magalhães, Kinath Rupasinghe, Srijita Chandra, Gustavo S. Silva, Marcelo Almeida, Bret Crim, Eric Burrough, Phillip Gauger, Christopher Siepker, Marta Mainenti, Michael Zeller, Rodger G. Main, Mary Thurn, Paulo Fioravante, Cesar Corzo, Albert Rovira, Hemant Naikare, Rob McGaughey, Franco Matias Ferreyra, Jamie Retallick, Jordan Gebhardt, Angela Pillatzki, Jon Greseth, Darren Kersey, Travis Clement, Jane Christopher-Hennings, Melanie Prarat, Ashley Johnson, Dennis Summers, Craig Bowen, Kenitra Hendrix, Joseph Boyle, Daniel Correia Lima Linhares, Giovani Trevisan
This study evaluated the use of endemic enteric coronaviruses polymerase chain reaction (PCR)-negative testing results as an alternative approach to detect the emergence of animal health threats with similar clinical diseases presentation. This retrospective study, conducted in the United States, used PCR-negative testing results from porcine samples tested at six veterinary diagnostic laboratories. As a proof of concept, the database was first searched for transmissible gastroenteritis virus (TGEV) negative submissions between January 1st, 2010, through April 29th, 2013, when the first porcine epidemic diarrhea virus (PEDV) case was diagnosed. Secondly, TGEV- and PEDV-negative submissions were used to detect the porcine delta coronavirus (PDCoV) emergence in 2014. Lastly, encountered best detection algorithms were implemented to prospectively monitor the 2023 enteric coronavirus-negative submissions. Time series (weekly TGEV-negative counts) and Seasonal Autoregressive-Integrated Moving-Average (SARIMA) were used to control for outliers, trends, and seasonality. The SARIMA’s fitted and residuals were then subjected to anomaly detection algorithms (EARS, EWMA, CUSUM, Farrington) to identify alarms, defined as weeks of higher TGEV-negativity than what was predicted by models preceding the PEDV emergence. The best-performing detection algorithms had the lowest false alarms (number of alarms detected during the baseline) and highest time to detect (number of weeks between the first alarm and PEDV emergence). The best-performing detection algorithms were CUSUM, EWMA, and Farrington flexible using SARIMA fitted values, having a lower false alarm rate and identified alarms 4 to 17 weeks before PEDV and PDCoV emergences. No alarms were identified in the 2023 enteric negative testing results. The negative-based monitoring system functioned in the case of PEDV propagating epidemic and in the presence of a concurrent propagating epidemic with the PDCoV emergence. It demonstrated its applicability as an additional tool for diagnostic data monitoring of emergent pathogens having similar clinical disease as the monitored endemic pathogens.