Conectar
The long-term success of metabolic and bariatric surgery (MBS) depends largely on adherence to health-promoting behaviour following MBS. Especially, adherence to healthy dietary behaviour in line with guidelines appears to be of the utmost importance. The primary objective of the present study is to evaluate the effect of adherence to dietary behaviour recommendations and the percentage of total weight loss (%TWL) after MBS. Adherence is hypothesised to have a positive influence on the %TWL, 24 months after MBS. Furthermore, we investigate the association of various sociodemographic, organisational, psychological and behavioural factors prior to and after MBS and their effect on %TWL.
The present study is a single-centre observational, prospective, longitudinal cohort study conducted in Germany. Data are collected at nine measurement points (T0: 4 weeks prior to MBS; T1: 2 weeks after MBS, T2: 5 weeks after MBS; T3: 3 months after MBS; T4: 6 months after MBS; T5: 12 months after MBS; T6: 18 months after MBS; T7: 24 months after MBS; and T8: 36 months after MBS). Adherence to dietary behaviour recommendations is assessed using the Dietary Behavior Inventory-Surgery (DBI-S). N=325 patients applying for MBS will be included in the study. A regression analysis approach is chosen to answer the primary research question. The primary outcome %TWL is regressed at T7 (24 months after MBS) in a causal analysis on dietary adherence (DBI-S score) at T3–T7, with the covariates age, gender, marital status, educational attainment, employment status, Patient Health Questionnaire-4 score and body mass index at T0 and MBS method at T1. Stepwise hierarchical regression analyses are performed and analysed for significant model differences using 2 difference tests. Effect sizes are estimated by R2. Group differences are analysed using t-tests and Analyses of variance (ANOVAs). Bivariate correlations of continuous variables are examined using regression/correlation analyses.
The Ethics Committee of the Medical Faculty of the University of Essen-Duisburg has approved the conduct of the study (24-11969-BO). Results will be disseminated through manuscripts in clinical/academic peer-reviewed journals, presentations at academic conferences and communications with partners, participants and other stakeholders. Key findings will also be published in lay language on a publicly accessible website and disseminated via various (social) media channels.
The study has been prospectively registered on 8 October 2024 in the German Clinical Trials Register (DRKS00034888).
To examine the extent of adherence to high-level principles in remote prescribing and investigate how medical and non-medical prescribers comply with these principles.
Scoping Review.
A systematic search of CINAHL, PubMed, Medline, the Cochrane Database of Systematic Reviews, the Web of Science, and the Ovid Emcare databases was performed. A grey literature search was conducted on relevant professional websites and Google Scholar. Literature was searched from January 2007 to March 2025.
Research results were uploaded to Raayan for management and selection of evidence. Two reviewers independently scored and appraised papers using a structured data extraction form. The ‘United Kingdom High-level Principles for Good Practice in Remote Consultations and Prescribing’ served as a coding framework for deductive manifest content analysis.
Searches identified 6870 studies. After screening the title and abstract, 54 full texts were reviewed, and 14 studies were identified for analysis. Adherence to high-level principles was limited and inconsistent. Data categories were developed into 5 themes: (1) Patient privacy and vulnerability, (2) Adequate assessment, (3) Guidelines and evidence-based prescribing, (4) Investigations and safety netting, and (5) Organisational safety and creating safe systems.
This review provided insight into the challenges that medical prescribers face when adhering to governance principles during remote prescribing practice. However, no research about how non-medical prescribers integrate remote prescribing governance into their practice was found.
Remote prescribing has become firmly embedded within the current healthcare system and robust governance is required to safeguard patient outcomes. Further research exploring how non-medical prescribers integrate the high-level principles into practice will inform prescribing governance for this group.
No patient or public contribution was sought as the scoping review focused solely on the existing literature.
To explore the experiences of nurses transitioning from a clinical ward to a newly established respiratory intermediate care unit (IMCU).
A qualitative descriptive approach was adopted to capture the lived experiences of redeployed nurses. This design was selected to address the research question: What are the initial experiences of nurses transitioning from general ward settings to a newly established IMCU for respiratory patients?
Two focus groups were conducted in June 2024, involving 14 purposefully selected registered nurses. Data were analysed using Braun and Clarke's thematic analysis framework, with the study reported in line with the Standards for Reporting Qualitative Research.
The analysis revealed two interconnected themes reflecting the complexity of the redeployment experience. The first theme, ‘The introspection of waiting amidst change and readiness’, captures the emotional ambivalence nurses felt, characterised by anticipation, uncertainty and a perceived lack of preparedness. This phase was marked by concerns over clinical competence, fear of errors and the weight of new legal and ethical responsibilities. The second theme, ‘The road to organizational change with both driving forces and obstacles’, highlights nurses' concerns about physician readiness, feeling undervalued and limited involvement in planning. At the same time, nurses emphasised the importance of teamwork, structured preparation, experiential training and having the right equipment.
The study underscores the complexity of role transitions for nurses moving into semi-critical care settings like IMCUs. It reveals the need for targeted support strategies to reduce uncertainty and enhance role readiness.
To improve the redeployment experience and patient outcomes, healthcare organisations should prioritise structured training, tailored preceptorship programmes and inclusive decision-making processes. These measures can strengthen nurses' resilience, support workforce sustainability and ensure the delivery of high-quality, patient-centred care in intermediate care environments.
This study highlights the significant impact of inadequate preparation and communication on redeployed nurses' experiences in respiratory IMCUs, emphasising the need for structured training and supportive team dynamics. These findings can guide healthcare leaders, nurse managers and policymakers in developing evidence-based redeployment strategies that reduce anxiety, strengthen team cohesion and ultimately improve nurse adaptation and patient care in semi-critical settings.
We used the SRQR guidelines for reporting qualitative studies.
No patient or public contribution.
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis associated with significant morbidity and mortality, with no consensus treatment to date. To review all clinical trials of treatments for PG to synthesise clinical evidence regarding the efficacy and safety of different treatments. After PROSPERO (CRD42023459180) registration, we systematically searched five databases (clinicaltrials.gov, CENTRAL, Embase, PubMed and Scopus) up until 18th May 2024 for PG treatments. Of 10 579 identified articles, 5853 deduplicated abstracts were screened. Twenty studies met the screening criteria after a full text review of 60 articles. We assessed the risk of bias using ROBIN-I for non-randomised and ROB-2 for randomised trials. Two reviewers independently performed article screening and quality assessments. Two reviewers independently extracted and recorded data on study characteristics, participants' demographics, disease characteristics, treatment regimens, and outcomes for the selected studies. A single-arm meta-analysis of available RCTs and non-randomised studies was conducted to analyse the outcomes of different systemic immunomodulators. The primary outcome was the complete healing of PG. Secondary outcomes included rates of recurrence, treatment failure, adverse events and time to complete healing. A total of twenty (20) interventional studies were included in the data synthesis: nine (9) prospective open-label studies, six (6) prospective cohort studies, three (3) open-label clinical trials, and two (2) randomised controlled trials evaluating multiple biological, systemic, and topical interventions. On random effects meta-analysis of systemic therapies including adalimumab, canakinumab, infliximab, chlorambucil, cyclosporine, cyclophosphamide and prednisolone, the pooled proportion of complete healing across 11 studies was 0.59 (95% confidence interval [CI]: 0.41–0.74; Χ 2 = 26.66, p < 0.01; I 2 = 66%); the pooled proportion of PG recurrence across 6 studies was 0.30 (95% CI: 0.20–0.41; Χ 2 = 1.14, p = 0.95; I 2 = 0%); the pooled proportion of serious adverse effects from 4 studies was 0.10 (95% CI: 0.05–0.19; Χ 2 = 5.01, p = 0.17; I 2 = 40%); and the pooled proportion of PG treatment failure across seven studies was 0.36 (95% CI: 0.24–0.49; Χ 2 = 12.78, p = 0.03; I 2 = 61%). The proportion of complete wound healing varies significantly across treatments and recurrence is common even in a limited follow-up period. Heterogeneity of study methods and low numbers hamper disease research. There remains a significant unmet need for better outcome measures than just complete healing as well as better treatment options to improve patient outcomes.
by Alix Boirot, Maria Claudia Addamiano, Clémence Casanova, Niamh M. Redmond, Géraldine Cazorla, Michel Rotily, Anne-Marie Schott-Petelaz, Christian Balamou, Zineb Doukhi, Myriam Kaou, Françoise Couranjou, Julien Mancini, Cyrille Delpierre, Marie-Anne Durand, Aurore Lamouroux
BackgroundColorectal cancer (CCR) is one of the leading causes of death worldwide. Early detection remains a highly effective strategy for curing this disease. In France, despite a free organised screening programme for people aged between 50 and 74, participation rates remain suboptimal. Socioeconomic position and health literacy levels exacerbate the situation, with the lowest screening rates observed in the most socially disadvantaged areas. This study assessed patients’ and General Practitioners’ (GP) views on the acceptability of an intervention to increase screening uptake using a simple brochure and video on the importance and process of CCR screening.
MethodWe conducted a cross-sectional qualitative study using semi-structured interviews with patients (n = 24) and GPs (n = 22) who used or participated in the DECODE project intervention. The interviews were conducted by telephone or videoconference and analysed thematically using Nvivo software and dual independent coding.
Results95% of GPs expressed a clear preference for the video over the brochure. Patients had varied results with 50% preferring the video, as it demonstrated how to do the test, versus the brochure. The humorous and de-dramatising aspects of the video were the two key factors highlighted by interviewees. However, support from healthcare staff (GPs, nurses, etc.) is still essential, in supporting patients in prevention. This presents a challenge for GPs, who are frequently constrained by time limitations during consultations.
ConclusionOur findings emphasize the need to tailor promotional materials for both patients and healthcare professionals to improve CCR screening uptake, balancing digital efficiency with maintaining core human relationships in healthcare. Such intervention can be integrated into different workflows. The addition of video into national CRC screening programs might also help. Targeting CRC screening interventions at provider-patient interactions, ensuring they are tailored, accessible, and engaging, is key to reducing disparities.
This paper examines network meta-analysis (NMA) as a methodological advancement in nursing research and discusses considerations for interpreting and applying NMA results in clinical practice.
Methodological discussion.
The NMA method simultaneously evaluates multiple interventions by combining direct and indirect evidence. The publication of NMA articles in nursing journals has been increasing. However, interpreting NMA results can be complex and challenging. In this paper, we outline the prerequisites and assumptions of NMA, provide a graphical representation, discuss effect estimation and quality of evidence and give an overview of applying NMA results in clinical practice.
NMA is a valuable analytical approach in nursing research that can provide high-level evidence to guide clinical decision-making. Accurate interpretation of NMA findings is necessary to inform clinical practice. This paper serves as an introduction to NMA for nurses unfamiliar with the approach.
NMA is a powerful statistical technique for assessing the relative effectiveness of different nursing interventions and informing evidence-based nursing guidelines. When interpreting the results, nurses should consider the certainty of evidence and the practical value of the results and be cautious of misleading conclusions.
NMA is a recent analytical method in nursing research. This practical introduction seeks to enhance comprehension of NMA and the interpretation and application of NMA findings in clinical practice. NMA is a robust statistical technique to assess the relative effectiveness of various nursing interventions.
In the methodological discussion guide, no new data was generated. A hypothetical dataset was used.
This methodological paper contributes to understanding NMA and interpreting its results, integrating it into clinical practice, and improving patient outcomes.
To provide a worked example informed by relevant literature and related studies that novice and early career researchers may use to reflect on, prepare and conduct a thoughtful and rigorous qualitative descriptive study.
Methodological discussion of qualitative descriptive design.
Seminal work and recent related literature were reviewed to situate the discussion and identify the concepts and steps to conduct a qualitative descriptive study.
Qualitative descriptive design is widely used in nursing and health science research. This design offers flexible use of qualitative methods, which presents a double-edged sword, posing challenges in preparing a well-developed study and achieving methodological rigour. The design often borrows methods from other qualitative traditions, which may need to be clarified for novice and early career researchers, wherein studies may be conducted using a mix and match of methods without giving justice to the heart of qualitative descriptive design. In this paper, we present a step-by-step guide, using a worked example, to demonstrate how to conduct a qualitative descriptive study.
Qualitative descriptive design may be confusing due to its flexibility, which may limit the scope of research and subsequently, the quality and impact of the findings. With the appropriate application of research methods producing high-quality and relevant findings, qualitative descriptive design is a valuable qualitative method in its own right.
Novice and early career researchers may increase the impact of their findings through rigorously conducting their studies. Clarifying steps for thoughtful execution may inform novice and early career researchers, allowing for a rigorous application of the method, which, in turn, may contribute to impactful findings.
A clear presentation of steps, supported by a worked example and related studies, may support novice and early career researchers in conducting a qualitative descriptive study with methodological rigour.
Not applicable.
No patient or public contribution.
To identify and compare the digital competence profiles of nurse educators, the background variables associated with profiles, and the self-assessed level of digital competence in four European countries.
A descriptive comparative cross-sectional study.
Data were collected from nurse educators (n = 263) in 36 nursing education organisations in Finland, Malta, Slovakia and Spain. Partitioning around medoids (PAM) clustering was used to identify competence groups, and descriptive and inferential statistics were used to examine the association of nurse educators' background variables.
The clustering analysis resulted in two nurse educator digital competence profile groups: high and moderate. The profiles differed based on completed pedagogical studies and teaching experience, with an emphasis on the high competence profile. Educators in the high competence profile group showed greater interest in using educational technology and self assessed their digital competence at a higher level compared to educators in the moderate competence profile group. Nurse educators' lowest digital competence was in the safe and responsible use of technology, such as knowing copyright laws.
Despite the heterogeneous background of nurse educators, international continuing professional development needs in digital competence are identified. Nurse educators' continuing education should support the utilisation of technology through pedagogical approaches, and educators' competence in the safe and responsible use of technology (e.g., how to protect digital materials) must be enhanced in nursing education organisations.
This study highlights the need to further develop nurse educators' digital competence. Continuing professional development should target preparation in safe and responsible technology use and include pedagogical studies and mentoring from experienced peers.
The STROBE checklist was adhered to in reporting the results.
Each participating educational organisation assigned a contact person to distribute the survey to the nurse educators.
Vaccinations are essential to ensure protection for healthcare professionals, patients and communities. However, vaccination hesitancy has been reported among healthcare professionals. Nurses are the main, first and direct point of contact for patients and citizens in most healthcare services, but only a minority of studies investigated vaccination hesitancy and uptake specifically in this population. Thus, this study aimed to explore the determinants and motivations of vaccination hesitancy and uptake among nurses.
Systematic review with a narrative synthesis approach.
We included primary research exploring determinants or motivations of vaccination hesitancy or uptake among nurses. No time or geographical limit was applied. Generalised random-effects linear models with a logit link were used to calculate the pooled estimated proportions for vaccine uptake among nurses.
We explored nine databases (2023).
The initial search identified 3452 records; 42 records were eventually included in this review. Older age, longer professional experience, lack of confidence in vaccine safety and effectiveness and cost associated with the vaccine were among the most common determinants of vaccine hesitancy. Safety concerns, complacency (e.g., beliefs of not needing the vaccine), and accessibility (e.g., logistics) were among the most common motivations for being vaccine hesitant. Having strong confidence in the vaccine, a high sense of collective responsibility, previous vaccination uptake/positive intentions towards future vaccination, weaker vaccine complacency, and older age were among the most common determinants of vaccine uptake. Willingness to protect themselves and/or others, contribute to the herd immunity, and comply with recommendations were among the most common motivations for vaccine uptake. The pooled prevalence of influenza vaccine uptake among nurses was 44% (95% CI: 35–73).
The findings of this systematic review with meta-analysis could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
This study contributes to further understanding nurses' beliefs, barriers, and facilitators towards vaccination. By doing so, these results could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
We have adhered to relevant EQUATOR guidelines, in particular to the PRISMA checklist.
No patient or public contribution.
PROSPERO number: CRD42020212252
Young people (YP) whose parents have depression are at elevated risk for developing depression themselves and could benefit from preventive interventions. However, when parents are in a depressive episode, this reduces the effects of psychological interventions for depression in YP. Moreover, parental depression is often managed suboptimally in usual care. There is, therefore, a case for identifying and optimising parental depression treatment to enhance the effectiveness of psychological preventive interventions for depression in YP.
This is a randomised controlled trial (Skills for adolescent WELLbeing) to determine the effectiveness of a cognitive behavioural therapy (CBT) intervention compared with usual care in increasing the time to a major depressive episode in YP by 9-month follow-up (primary outcome). The intervention offers a 12-week treatment-optimisation phase for parents depressed at study entry, followed by randomisation of the young person to a small group manualised online CBT programme facilitated by a therapist. YP allocated to the intervention will receive eight weekly sessions plus three monthly continuation sessions. Secondary outcomes include the number of depression-free weeks, mental health symptoms and functioning. Mechanisms of intervention action will be assessed with mediation analysis of quantitative data and thematic analysis of qualitative interviews. Participants (parents/carers with depression and their children aged 13–19 years) will be identified through existing cohorts of adults with depression, from primary care through health boards in Wales and England, UK, schools and advertising including via social media.
The trial has received ethical approval from Wales NHS Research Ethics Committee (REC) 5, the Health Research Authority and Health and Care Research Wales (IRAS 305331; REC 22/WA/0254). This manuscript is based on V.5.7 of the protocol (17 January 2025). Findings will be disseminated in peer-reviewed journals and conferences. Reports and social media messages will be used to disseminate findings to the wider public.
ISRCTN13924193 (date registered: 15 March 2023).
by Fiona Newlands, Tanvi Markan, Isabelle Pomfret, Emily Davey, Tom King, Anna Roach, Millie Wagstaff, Tom G. Osborn, Roz Shafran, Polly Livermore, Michelle de Haan, Jeanne Wolstencroft, Sophie Bennett
Doctoral (PhD) students experience high rates of mental health challenges, including high rates of anxiety, depression, loneliness, and isolation. While universities offer mental health services, these may not fully address the specific needs of doctoral students. Peer support has emerged as a promising adjunct to existing service provision, drawing on shared experiences to provide emotional and practical guidance. This study aimed to explore doctoral students’ perceptions of peer support, identifying their needs and preferences for a peer support programme tailored to the doctoral experience. Nineteen doctoral students were recruited from a university in the south of England and participated in focus groups or semi-structured interviews. Thematic analysis yielded four overarching themes: (1) Barriers to seeking support; (2) Value of peer support for doctoral students; (3) Tailored peer support needs; and (4) Diversity and accessibility. Findings indicate that doctoral students value peer support as a flexible, informal space to share experiences and gain advice from those with similar backgrounds. However, they also emphasised the need for diverse representation among peer supporters, adaptable training to meet neurodiverse needs, and formal recognition of peer supporters’ contributions. Study findings suggest that universities should consider implementing tailored peer support programmes to address the specific challenges faced by doctoral students, incorporating flexibility, cultural sensitivity, and accessibility to create a supportive academic environment. Future research should evaluate the effectiveness of such programs in improving doctoral students’ mental health and well-being.Surgery often causes anxiety in adults due to various factors, including fear of anaesthesia and loss of independence. This anxiety can lead to higher anaesthesia requirements and more postoperative complications. Virtual Reality (VR) is increasingly used as a non-pharmacological intervention to decrease perioperative anxiety. This systematic review and meta-analysis aim to evaluate the effectiveness of VR to decrease perioperative anxiety in adult patients undergoing elective surgery.
A systematic review was conducted according to the Joanna Briggs Institute (JBI) method for systematic reviews of effectiveness. This paper complies with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.
Four electronic databases were searched from inception to July 2024. Inclusion criteria were experimental and quasi-experimental studies using VR preoperatively to reduce perioperative anxiety as the primary outcome, with no language or date restrictions. Two independent reviewers screened and critically appraised the studies using the JBI appraisal tool. Randomised controlled trials (RCTs) were synthesised, and data were pooled in a statistical meta-analysis. A random effects meta-analysis was used due to heterogeneity. For studies that could not be meta-analysed, a narrative synthesis was performed.
11 studies met the inclusion criteria, including eight RCTs and three quasi-experimental studies. Overall, the majority of studies demonstrated that VR effectively reduced anxiety and increased patient satisfaction. The meta-analysis revealed a small, non-significant reduction in preoperative anxiety, favouring VR (Standardised Mean Difference − 0.29, 95% Confidence Interval − 0.83 to 0.24), with moderate heterogeneity (I 2 = 47%). However, findings regarding secondary outcomes including VR side effects, stress levels, preparedness levels, patients' satisfaction and length of hospital stay were inconsistent.
The evidence is limited to support the use of VR in reducing perioperative anxiety among adults. Larger sample sizes, high-quality RCTs and standardised anxiety measures are required to determine the effectiveness of VR on perioperative anxiety.
PROSPERO CRD42020158529 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=158529.
No patient or public contribution was required to design or undertake this review.
There is limited evidence on the economic implications of assessing patients’ access to personalised treatments through Comprehensive Genomic Profiling (CGP) and Molecular Tumour Board (MTB), prompting the need to analyse their impact on the cost of the cancer diagnostic journey (from hospital admission to MTB evaluation) and accessibility to personalised therapies.
Retrospective observational cohort.
Patients discussed from April 2020 to September 2021 by the institutional MTB operating at Fondazione IRCCS Istituto Nazionale Tumori of Milan, an Italian centre of excellence in oncology pertaining to the national health system.
676 patients focused on: non-small cell lung cancer (NSCLC), cholangiocarcinoma (CCA), pancreatic carcinoma (PC) and gastro-oesophageal carcinoma (GEC). We defined two different scenarios: (1) patients tested with small Next-Generation Sequencing (NGS) panels (≤60 biomarkers) vs (2) patients tested with comprehensive panels (>60 biomarkers).
We measured (1) patients’ eligibility to personalised therapies based on genomic data obtained using targeted somatic NGS panels, (2) MTB cost and the overall diagnostic journey cost and (3) the cost to find a patient eligible to access personalised treatments.
Tumour profiling with comprehensive NGS panels improved patients’ eligibility to personalised therapies compared with small panels (NSCLC: 39% comprehensive panel vs 37% small panel; CCA: 43% vs 17%; PC: 35% vs 3%; GEC: 40% vs 0%). The overall diagnostic journey cost per patient was between 3.2K and 7.4K (NSCLC: 7.4K comprehensive panel vs 6.4K small panel; CCA: 4.9K vs 3.7K; PC: 5.8K vs 4.5K; GEC: 4.2K vs 3.2K). MTB discussion accounted for only 2–3% of the diagnostic journey cost per patient (around 113/patient). The cost to find patient eligible for personalised treatments varied significantly according to panel size and tumour setting (NSCLC: 5K comprehensive panel vs 2.8K small panel; CCA: 4.4K vs 4.4K; PC: 5.5K vs 27K; GEC: 5.2K vs not measurable since none of the patients analysed with small NGS panels were eligible).
MTB discussion of genomic data obtained with NGS comprehensive panels significantly increases patient eligibility to targeted therapies and optimise the cost to find a patient eligible to personalised treatments, mainly for CCA, PC and GEC patients.
by Kristina Devi Singh-Verdeflor, Michelle M. Kelly, Gregory P. DeMuri, Gemma Warner, Sabrina M. Butteris, Mary L. Ehlenbach, Barbara Katz, Joseph A. McBride, Shawn Koval, Ryan J. Coller
BackgroundCOVID-19 testing safeguards the health of children with medical complexity (CMC) through several key mechanisms, such as the implementation of clinical action plans and COVID-19-directed therapies. However, testing utility is limited by barriers to access and perceptions surrounding use. This study investigated associations between rurality and COVID-19 testing access, intent, motivators, and concerns for caregivers of CMC.
MethodsWe conducted a cross-sectional survey (April – June 2022) of English- and Spanish-speaking caregivers of children with at least one complex chronic condition between ages 5–17 at an academic medical center in the Midwestern USA. Rurality was dichotomized using Rural-Urban Commuting Area codes. Outcomes represented COVID-19 testing access, intent, motivators, and concerns. Covariates included demographic and clinical characteristics. Unadjusted and adjusted logistic regression analyses examined associations between rurality and each outcome.
ResultsAmong 1,432 responses (response rate 49%), 359 (25%) were classified as rural. Respondents had varied education, income, and insurance levels. In the multivariable models, rural and urban caregivers reported similarly high testing access, but rural caregivers had significantly less testing intent (adjusted Odds Ratio [95% CI]: 0.53, [0.40, 0.71]). Notably, rural caregivers were significantly more likely to indicate “It will be difficult to get needed healthcare if my child has it” (2.49 [1.19, 5.18]).
ConclusionsWhile rural and urban CMC caregivers reported generally high access and ease of COVID-19 testing, potentially modifiable factors exist to improve testing intention and decrease barriers, including communication regarding testing utility and timing as well as access to effective treatment response upon testing positive.
To develop a concise Consensus Statement on the management of venous leg ulcers (VLUs) that incorporates existing standards and guidance on new technology, including improvement of calf muscle pump function and the utilisation of advanced wound therapies. A multidisciplinary panel of 19 wound healthcare providers from across Canada, who treat patients with VLUs, was formed. A draft document was created and four rounds of consultation and feedback were sought from the panel. The Consensus Statement was completed in June 2024 with 100% consensus on 20 sections and > 85% consensus on the remaining three sections. The key elements are—Clinical assessment and investigations; Treatment-compression to improve calf muscle pump function, and wound treatment with the principles of Wound Bed Preparation; When not healing or only suboptimal compression can be used - add treatment with muscle pump activator by continuous Neuromuscular Electrical Stimulation of the common peroneal nerve to improve calf muscle pump function; When VLUs are not healing with optimal therapy - an algorithm for the use of advanced wound therapies; and Prevention of VLU recurrence. The Consensus Statement is a concise guide for healthcare providers to use at the bedside and has been endorsed by leading nursing and homecare associations in Canada that also have physician representation.
To cross-culturally adapt and psychometrically test the Italian version of the EPICC Spiritual Care Competency Self-Assessment Tool for clinical nurses (EPICC Tool-It).
Multicentre, cross-sectional validation study.
The 28-item EPICC Tool was translated into Italian and culturally adapted following a rigorous methodology. A nationwide survey was conducted. Psychometric evaluation included content validity, structural validity (exploratory and confirmatory factor analyses), construct validity (known group analysis) and reliability using Cronbach's alpha, McDonald's omega and factor score determinacy.
The sample included 725 clinical nurses (76% female, 80% hospital-based), on average 38.7 years old (SD 11.33), with 14.6 years (SD 11.03) of experience. Confirmatory factor analysis supported a four-factor model (Knowledge of spirituality, Attitudes towards spirituality and spiritual care, Knowledge of spiritual care and Skills in spiritual care), with a second-order factor for the EPICC Tool-It. Construct validity was supported through known group analysis, showing score variation based on nurses' experience, education and religiosity. Internal consistency was excellent across all factors and the overall scale.
A valid, multidimensional instrument is provided to assess spiritual care competencies in Italian-speaking nurses. The EPICC Tool-It is suitable for research and practice, facilitating evaluation of self-perceived competencies and educational effectiveness.
The use of the EPICC Tool-It by nursing managers, educators and clinicians is recommended in both clinical and research settings to support education on spiritual care competencies.
The EPICC Tool-It sets reliable measurement standards for spiritual care competencies, enhancing holistic care and comprehensive understanding of competencies globally.
This study adheres to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines.
Patients, service users, caregivers, or the public were not involved in the study. However, nurses as target users of the tool participated in the cultural adaptation and validation process.
FreshRSS 