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Interfaces between communication, education and health: a scoping review protocol

Introduction

The interfaces between the fields of communication, education and health have been indicated by international institutions such as the WHO and the European Centre for Disease Prevention and Control. However, hegemonic scientific practices supersede dialogue between the three fields, isolating their practices. This fragmenting tendency is observed in scientific literature, which has created gaps in the dialogue and articulation between communication, education and health. Although health promotion requires both communicative and educational practices, the epistemological, historical, political, cultural and socioeconomic aspects have also engendered tensions between the fields. Communication is often seen as a mere instrument for other practices, rather than a phenomenon that (re)produces meanings and power dynamics. In opposing the reductionist and instrumentalising perspectives of knowledge fields, the primary objective of the scoping review is to map the scientific evidence on the interfaces between communication and education in health to indicate a conceptual framework that articulates communication and education practices within the context of health.

Methods and analysis

A transdisciplinary team developed this protocol based on the 2024 Joanna Briggs Institute Manual for Evidence Synthesis. The procedures required to conduct the review were guided by the frameworks proposed by Arksey and O'Malley, Levac et al and Peters et al. The study eligibility criteria were established based on the Problem, Concept and Context outlined in the research questions. Primary and secondary studies will be retrieved from nine sources, covering both conventional and grey literature. These sources include Embase, ERIC, LILACS, PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science, the Brazilian Digital Library of Theses and Dissertations, and the Networked Digital Library of Theses and Dissertations. A categorised form will be used for data collection and subsequent analysis. The reporting of the review findings will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Ethics and dissemination

The nature of the research and the use of secondary data sources do not require informed consent forms or approval from ethics committees in Brazil. The scientific findings from the review will be disseminated through peer-reviewed journals, academic conferences and other scientific communication channels.

Study registration

The protocol was registered on the Open Science Framework (OSF) and is available at https://doi.org/10.17605/OSF.IO/Z3CX7.

Feasibility of a phase 3 partially randomised clinical trial to assess the safety and efficacy of paediatric praziquantel for schistosomiasis treatment in children aged 3 months to 6 years in endemic regions of Brazil: a pilot study

Objective

This study assessed the feasibility of implementing a phase 3 field-based clinical trial protocol to evaluate paediatric praziquantel (PED-PZQ) for the treatment of Schistosoma mansoni infection in children aged 3 months to 6 years in endemic areas of Brazil, focusing on operational aspects such as recruitment logistics, documentation management, investigational product handling and protocol adherence.

Design

Pilot and feasibility study for a phase 3 clinical trial, comprising two components: a randomised, open-label, parallel-group, two-arm trial and a single-arm trial.

Setting

Conde, Bahia, Brazil, from December 2024 to January 2025.

Participants

Two trials aim to screen 5774 participants from three rural areas in Bahia and three in Sergipe, states in northeastern Brazil, and enrol 403 children eligible for either randomisation or allocation. Trial 1 will randomise (1:1 ratio) 240 children aged 4–6 years into the PED-PZQ treatment arm or the standard praziquantel (PZQ) 1. Trial 2 will enrol 163 children aged 3 months to 3 years, all receiving PED-PZQ. Both trials are open label. Eligible participants shall meet age criteria, test positive for S. mansoni and fulfil other inclusion criteria. In the first recruiting centre, Conde (Bahia), it was estimated that 650 participants would need to be screened for trial 1 and 552 for trial 2, assuming schistosomiasis prevalence of 5% and 4%, respectively. This pilot study reports on the first 60 participants enrolled.

Primary and secondary outcome measures

The primary outcome of this pilot study is the feasibility of implementing the research protocol in a real-world field setting, focusing on key aspects such as study documentation challenges, participant safety, investigational medicinal product custody chain and protocol adherence. In addition to providing preliminary data on the parasitological cure rate, secondary outcomes include the prevalence of S. mansoni infection and the reduction in S. mansoni egg count (Kato-Katz method). Furthermore, the occurrence and severity of drug-related adverse events are monitored from drug administration to day 21 post-treatment, alongside changes in renal, hepatic and cardiac functions assessed through biochemical markers.

Results

A total of 60 participants were recruited, and 55 provided stool samples for screening. The pilot phase demonstrated the feasibility of implementing the clinical protocol under field conditions, with successful completion of all planned procedures and minimal protocol deviations. Operational challenges were identified mainly in documentation processes, participant recruitment and investigational product management and were addressed through preventive and corrective quality assurance actions. The experience also highlighted logistical and infrastructural barriers typical of field-based trials in remote endemic areas, which informed adjustments for the subsequent phase 3 study. Preliminary parasitological results indicated an overall S. mansoni prevalence of 9.1% (5/55), with 21% in trial 1 and 2.8% in trial 2. All infected participants met the eligibility criteria, received treatment and completed follow-up. Four achieved a parasitological cure, and one case of treatment failure was observed (trial 1, PZQ group). Two mild adverse events (diarrhoea) were reported, with no serious complications or clinically significant changes in biochemical parameters.

Conclusions

This pilot study demonstrated the feasibility of implementing a field-based phase 3 clinical trial protocol for PED-PZQ in endemic areas of Brazil. The findings confirm that the protocol can be successfully applied in primary care settings, despite operational challenges related to recruitment, logistics and documentation. The study also provided preliminary evidence supporting the safety and effectiveness of the paediatric formulation and highlighted the need to revise prevalence assumptions to improve future screening strategies. Overall, the experience offers valuable insights to guide the large-scale phase 3 trial and supports the incorporation of PED-PZQ into national schistosomiasis control policies.

Trial registration number

Brazilian Clinical Trials Registry; RBR-86kcy37.

Efficacy of YOga in people with chronic non-specific low BACK pain and poor PROgnosis (YOBACK-PRO): protocol for a randomised clinical trial

Por: Nunes · S. M. · Rizzo · R. R. · Franco · M. R. · Ferreira · F. R. · Barros · L. J. G. · Maciel · I. T. · Santos · R. L. · Nascimento · R. R. · Couto · A. J. · Quaresma · L. S. · Fontes · R. M. · Ferreira · E. M. R. · Maher · C. G. · McAuley · J. H. · Pinto · R. Z.
Introduction

Yoga has been shown to improve pain and function compared with no exercise in people with chronic low back pain (LBP), but treatment effects are small. Given that yoga is a mind–body intervention that addresses physical as well as psychological factors, it may be more effective for patients with chronic LBP who are at high risk of poor prognosis. The study aims to investigate the efficacy of a 12-week yoga programme combined with education in reducing pain and disability for individuals with chronic LBP at high risk of poor prognosis at short (12 weeks) and intermediate (24 weeks) terms, compared with a control group receiving education only.

Methods and analysis

A randomised controlled trial will include 110 adults with chronic non-specific LBP reporting an average pain intensity of 3 points or more on a 0–10 scale over the past week and classified as high risk of poor prognosis (ie, scoring 50 points or above) on the Orebro Musculoskeletal Pain Questionnaire short-form. Participants in the control group will receive an educational booklet and attend three face-to-face lectures over a 3-month period. In the intervention group, in addition to the booklet and lectures, participants will attend group yoga sessions twice a week for 12 weeks, totalling 24 yoga sessions. The primary outcome is disability assessed at 12 weeks, measured using the Roland-Morris Disability Questionnaire.

Ethics and dissemination

The study was approved by the Human Research Ethics Committee of Universidade Federal de Minas Gerais (Protocol number CAAE: 57028022.0.0000.5149). Findings will be disseminated to trial participants, clinicians and the broader public and scientific community.

Trial registration number

NCT05953155.

Comfort Needs of Renal Transplant Recipients: A Qualitative Analysis Guided by Kolcaba's Theory of Comfort

ABSTRACT

Aim

To analyse the comfort needs of patients following renal transplantation, guided by Kolcaba's Theory of Comfort.

Design

A qualitative design was employed.

Methods

This study was conducted at a Brazilian university hospital's renal transplant outpatient clinic. Forty-six post-transplant patients were purposively sampled by age, transplant time and clinic attendance. Face-to-face interviews were audio-recorded, transcribed and conducted using a semi-structured script. Data were analysed through thematic content analysis, guided by Kolcaba's Comfort Theory and relevant literature.

Results

Participant narratives were categorised according to the contexts outlined by Kolcaba's Theory of Comfort: Physical, Environmental, Sociocultural and Psychospiritual. In the physical context, pain was identified as a major factor diminishing comfort after renal transplantation. In the environmental context, elements such as light, odour, sound, temperature and uncomfortable furnishings contributed to discomfort. In the sociocultural context, family support was highlighted as essential. In the psychospiritual context, religiosity played a key role in enhancing the comfort of transplant recipients.

Conclusion

Spirituality, strengthened social support networks and non-pharmacological comfort measures are essential for promoting comfort among patients following renal transplantation. These findings underscore the importance of integrated care approaches that address physical, emotional and social aspects to improve quality of life for this population.

Implications for the Profession and/or Patient Care

Conceptual models in nursing provide a critical perspective for care and support the delivery of effective, evidence-based interventions. By identifying the multidimensional comfort needs of post-renal transplant patients, this study informs the development of targeted, holistic strategies for nursing and multidisciplinary practice in outpatient settings.

Impact

This study examined the multidimensional comfort needs of post-renal transplant patients and found that comfort is shaped by physical, environmental, sociocultural and psychospiritual factors. The results may guide global nursing and multidisciplinary outpatient care by informing integrated approaches that enhance the quality of life of transplant recipients.

Reporting Method

This study was reported according to the COREQ framework.

Patient or Public Contribution

No patient or public contribution.

Frailty, quality of life and nutritional status for the prediction of morbidity and mortality in individuals with chronic heart failure in southern Brazil (FPROHEART): a cohort study protocol

Por: Nascimento · D. M. d. · Wolffenbüttel · P. I. · Goldraich · L. A. · Schaan · B. · Clausell · N.
Introduction

Heart failure (HF) is a debilitating condition associated with high morbidity, mortality and healthcare resource use. Frailty in HF patients is associated with poorer outcomes, including increased morbidity, mortality and reduced quality of life (QoL). Nutritional disorders, such as malnutrition, are common in patients with HF and contribute to functional decline and increased mortality. The Meta-Analysis Global Group in Chronic HF (MAGGIC) risk score was developed to predict 1-year and 3-year hospitalization and mortality in patients with HF. This study aims to assess the added value of frailty, QoL and nutritional status to the MAGGIC risk score.

Methods and analysis

This prospective cohort study, conducted at a tertiary public hospital in southern Brazil, will include 316 patients with chronic HF who are followed up at the HF Outpatient Clinic. Frailty will be assessed using the Fried scale, health-related QoL will be assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and nutritional status will be assessed using the Mini Nutritional Assessment. These variables will be incorporated into the MAGGIC risk score. Continuous variables with a normal distribution will be described as mean±SD, skewed variables as median±IQR and categorical variables as absolute and relative frequencies. Survival analysis will be performed using the Kaplan-Meier method with log-rank test comparisons. The prognostic value of frailty, its components, the MLHFQ score and nutritional status will be assessed by Cox regression, which will be adjusted for the MAGGIC risk score. Net Reclassification Improvement and Integrated Discrimination Improvement will assess the accuracy of the MAGGIC score when including frailty, MLHFQ and nutritional status. A p value

Ethics and dissemination

This study adheres to the Declaration of Helsinki and was approved by the Institutional Committee for Scientific Ethics and Research (No 20220558) and the Brazilian Government Registry (No 66474223200005327). The data will be available on reasonable request from the corresponding author. The results will be disseminated via peer-reviewed manuscripts and shown at national and international conferences.

Hope‐Promoting Communication With Pediatric Patients With Chronic Diseases and Their Families: A Scoping Review

ABSTRACT

Introduction

The way communication is conducted directly influences the professional–patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication.

Design

Scoping review.

Methods

This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004–2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample.

Results

The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented—considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening.

Conclusions

Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted.

Clinical Relevance

This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.

COVID-19 Nursing Staff Sizing Technology

imageThis study shows the development of a software for calculating the number of nursing team members required for providing care during the coronavirus disease 2019 pandemic. Study about the development of a technology based on the literature about data and indicators. The indicators were systematized in the following dimensions: institutional, professional, and occupational structure, all with a focus on coronavirus disease 2019. The software was created to be used on the Web, client-server, in browsers such as Internet Chrome, Explorer, and/or Mozilla Firefox, accessing via an Internet address and also allowing access by Windows, Android, and Linux operating systems, with MySQL database used for data storage. The data and indicators related to the institutional structure for coronavirus disease 2019 were systematized with 10 dimensions and indicators, and the professional and occupational structure, with 14 dimensions and indicators. The construction of computer requirements followed the precepts of software engineering, with theoretical support from the area. In the evaluation of the software, data simulation revealed points that had to be adjusted to ensure security, data confidentiality, and easy handling. The software provides to calculate the size and quality of the team, nursing sizing required due to the needs generated by the coronavirus disease 2019 pandemic.

Prototyping Process and Usability Testing of a Serious Game for Brazilian Children With Type 1 Diabetes

imageThis study aims to describe the prototype development and testing of a serious game designed for Brazilian children with diabetes. Following an approach of user-centered design, the researchers assessed game's preferences and diabetes learning needs to develop a Paper Prototype. The gameplay strategies included diabetes pathophysiology, self-care tasks, glycemic management, and food group learning. Diabetes and technology experts (n = 12) tested the prototype during audio-recorded sessions. Next, they answered a survey to evaluate the content, organization, presentation, and educational game aspects. The prototype showed a high content validity ratio (0.80), with three items not achieving the critical values (0.66). Experts recommended improving the game content and food illustrations. This evaluation contributed to the medium-fidelity prototype version, which after testing with diabetes experts (n = 12) achieved high content validity values (0.88). One item did not meet the critical values. Experts suggested increasing the options of outdoor activities and meals. Researchers also observed and video-recorded children with diabetes (n = 5) playing the game with satisfactory interaction. They considered the game enjoyable. The interdisciplinary team plays an important role guiding the designers in the use of theories and real needs of children. Prototypes are a low-cost usability and a successful method for evaluating games.

Development, Validation, and Usability of the Chatbot ESTOMABOT to Promote Self-care of People With Intestinal Ostomy

imageThis study aimed to describe the process of construction, validation, and usability of the chatbot ESTOMABOT to assist in the self-care of patients with intestinal ostomies. Methodological research was conducted in three phases: construction, validation, and usability. The first stage corresponded to the elaboration of a script through a literature review, and the second stage corresponded to face and content validation through a panel of enterostomal therapy nurses. In the third phase, the usability of ESTOMABOT was assessed with the participation of surgical clinic nurses, patients with intestinal elimination ostomies, and information technology professionals, using the System Usability Scale. The ESTOMABOT content reached excellent criteria of adequacy, with percentages of agreement equal to or greater than 90%, which were considered adequate, relevant, and representative. The evaluation of the content validity of the script using the scale content validity index/average proportion method reached a result above 0.90, and the Fleiss κ was excellent (P

Eficacia de un instrumento interdisciplinario para la reducción de la infección relacionada con la asistencia

Objetivo: Evaluar la efectividad de un instrumento interdisciplinario, desarrollado y aplicado en una unidad de cuidados intensivos de adultos para reducir las infecciones asociadas a la atención de la salud. Metodología: Estudio transversal, cuantitativo, realizado de enero de 2018 y junio de 2019, en una UCI de un Hospital de Paraná-Brasil. Resultados: Se evaluaron 759 pacientes. Antes de la aplicación del instrumento, las medias eran respectivamente: 1,00 para IRAS CVC; 6.78 ID IPCS; 3,22 VAP; 21,62 DIPAV y 0,88 para IRAS CVD, después con la aplicación del Fast Checklist:  0,11 para IRAS CVC (p = 0,11); 0,86 ID IPCS (p = 0,017); 0,33 VAP (p = 0,001); 2,83 DIPAV (p = 0,003) y 0,00 para IRAS ECV (p = 0,0002). Conclusión principal: El estudio demostró que la implementación y aplicación diaria de la Lista de Verificación Rápida fue efectiva para la reducción de las IRAS en la Unidad de Cuidados Intensivos.

Producción de cuidados para mujeres embarazadas con VIH: la historia de Vicky

Objetivo: conocer la producción diaria de atención para mujeres embarazadas que viven con infección por el síndrome de inmunodefi-ciencia humana en una ciudad del estado de Río de Janeiro. Método: esta es una investigación cualitativa, descriptiva. Empleados como herramientas de producción de datos: la guía del usuario y el diario desde la perspectiva del Análisis Institucional. El análisis del material se realizó en función de la identificación de núcleos de significado en el contenido recopilado. Resultados: se construyó un diagrama de flujo, que presenta el recorrido del usuario en la red y los núcleos de significado, caracterizados como: tensión entre la demanda y el tiempo en servicio, yendo y viniendo de la producción burocrática y el vínculo entre la usuaria y los profesionales. Conclusión: un estudio señala la necesidad de reuniones en la construcción de una red de apoyo para mujeres embarazadas con el síndrome de inmunodefi-ciencia humana, que es una posibilidad de reflexión sobre el proceso de atención, centrado en la usuaria.

Gestión de Residuos en Unidades Hospitalarias: Una Revisión Integradora

Objetivo principal: identificar las producciones científicas sobre manejo de residuos procedentes de los servicios de salud (RSS) por el equipo de salud en unidades hospitalarias, y analizarlas a la luz de las buenas prácticas. Metodología: revisión integrativa con búsqueda en las bases LILACS, WEB OF SCIENCE, BDENF, MEDLINE / PUBMED. Criterios de inclusión: estudios realizados en unidades hospitalarias y que aborden la gestión en ese contexto. Resultados principales: se seleccionaron 24 publicaciones para representar la muestra de la encuesta. Gran parte de los profesionales no realizan la práctica de segregación y manejo correctamente. La falta de conocimiento de los profesionales es un factor agravante. Conclusión principal: es de extrema importancia la capacitación de los profesionales acerca del manejo adecuado y mayor inversión del gobierno para mejoras en la implantación de regulaciones y fiscalización para la gestión de RSS.

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