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Acceptability and implementation of a comprehensive digital diabetes self-management platform (MyWay Diabetes): a qualitative protocol

Por: Hawkes · R. E. · Ashpole · D. · Baxter · M. S. · Bickerton · A. · Osei-Kwasi · H. · Rutter · M. K. · Taylor · D. · Wake · D. J. · Willis · T. · Brooks · J.
Introduction

Diabetes is one of the most common long-term health conditions worldwide, placing a huge economic burden on health services. Diabetes self-management education and support programmes can support people with diabetes to manage their condition; however, uptake of face-to-face services remains low. Digital self-management tools are becoming increasingly available. MyWay Diabetes is a digital platform that offers a comprehensive self-management and education programme accessible through a mobile app and website and allows patients to access their personal healthcare records. Following successful implementation in Scotland, MyWay Diabetes is now being rolled out in three geographical areas in England. We plan to undertake three qualitative studies, as part of a larger mixed-methods research programme, to assess whether MyWay Diabetes is acceptable across diverse patient groups and healthcare professionals and gather views of patients who do not currently use the digital service.

Methods and analysis

We will conduct three online focus group studies. (1) One focus group with healthcare professionals (n=6–10) to understand their perceptions of implementing MyWay Diabetes in their local regions. (2) Up to four focus groups with existing users of MyWay Diabetes (n=24–40) across the three geographical areas in England to explore their acceptability of the platform. (3) Up to three focus groups with people living with diabetes who do not currently use MyWay Diabetes (n=18–30). Data will be collected using online videoconferencing and analysed thematically using template analysis.

Ethics and dissemination

Ethical approval was granted by South Central – Berkshire Research Ethics Committee (ref: 25/SC/0125) and The University of Manchester Proportionate Research Ethics Committee (ref: 2025-23064-42006). Study results will be disseminated through peer-reviewed journals, conference presentations, MyWay Digital Health platforms and national bodies. The evidence from this broader mixed-methods evaluation will inform decisions for platform improvement and regional and national commissioning across the National Health Service in England.

Unlocking insights: exploring mammography beliefs among Teshie community mothers - a qualitative exploratory descriptive study

Por: Osei · E. A. · Watson-Quartey · L. · Kappiah · J. B. · Attafuah · P. Y. A. · Odonkor · R. · Toure · H. A. · Bressey · N. S. · Sarpong · C.
Background

Breast cancer is a global concern, especially for women of African descent, with rising cases in Ghana. While awareness and diagnostic screening have improved, studies in Ghana and many African countries have prioritised breast self-examinations, with limited focus on mammography.

Objective

Our study explores beliefs and attitudes towards mammography screening among mothers at Teshie Community in Ghana.

Methods

The study methodology was qualitative and an exploratory design was used. Convenience sampling was used to select 30 participants until saturation was reached. Indepth, one-on-one interviews were conducted with a semistructured interview guide with probes until saturation was reached. Then data were audiotaped audiotaped, transcribed and coded. Content analysis was done to generate themes and subthemes.

Findings

Most participants, 93%, had not undergone mammography screening. Only two individuals (7%) had experienced mammography screening. The study identified two major themes: beliefs and perceptions regarding mammography, and attitudes towards mammography screening. Participants generally displayed limited knowledge of mammography screening, along with mixed attitudes and varying degrees of motivation. Notably, many participants enjoyed strong spousal support for mammography screening.

Conclusion

It was recommended that nurses should create awareness of mammography to increase the knowledge of women and the general population about mammography, as this is believed to increase the uptake of mammography screening.

Effects of exercise therapy with blood flow restriction on shoulder strength: protocol for a systematic review and meta-analysis

Por: Gholipour · M. A. · Hamedi · H. · Seyedhoseinpoor · T.
Introduction

Blood flow restriction therapy (BFRT) has gained attention for its capacity to induce substantial muscle hypertrophy and strength gains even when employing relatively minimal loads. Strength training is of significant importance in the rehabilitation of patients experiencing shoulder pain, which may arise from a multitude of sources, including rotator cuff injuries, tendinopathies or postsurgical recovery. However, traditional resistance training can be challenging for these individuals due to the presence of pain and functional limitations. In this regard, BFRT in conjunction with low-load strength training may prove an efficacious alternative. The integration of BFRT into rehabilitation protocols for shoulder pain could provide a viable pathway to improving muscle strength and facilitating recovery while minimising the risk of exacerbating pain or injury. The primary objective of this study is to conduct a systematic review of the effects of training with BFRT of the upper limb on shoulder strength.

Methods and analysis

A comprehensive database search will be conducted across multiple platforms, including PubMed, Scopus, Ovid, Web of Science, EBSCO, Cochrane Central, PEDro and Google Scholar, using predefined key terms without any language restriction. The particular focus of the study will be clinical trials with a controlled group that assess the impact of BFRT on upper extremity, neck and trunk muscles in both healthy individuals and patients. The primary outcome measure will be shoulder strength and power in different directions. The Cochrane Collaboration’s Risk of Bias 2 tool will be employed for the purpose of evaluating the risk of bias inherent to the studies in question. A meta-analysis will be conducted using Stata software. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be employed to evaluate the quality of evidence for the primary outcomes.

Ethics and dissemination

The previously published papers will be used for all analyses in this study. Results will be disseminated through professional networks, presentations at conferences and publication in a peer-reviewed journal. No ethics approval is required.

PROSPERO registration number

CRD42024605189.

The Relationship Between Perceived Nursing Workload and Occupational Fatigue in Clinical Nurses: The Moderating Role of Nursing Teamwork

ABSTRACT

Aim

This study investigated the association between perceived nursing workload and occupational fatigue in clinical nurses. We specifically focused on how nursing teamwork moderates this relationship.

Background

Hospital nurses often face heavy workloads, leading to significant fatigue. Understanding the link between workload, fatigue and teamwork is crucial to addressing nurse burnout.

Methods

A cross-sectional study was conducted among 356 clinical nurses from five educational-therapeutic hospitals in Ardabil, Iran. Data were collected using validated instruments, including the Occupational Fatigue Exhaustion Recovery-15 (OFER) scale, the Quantitative Workload Inventory (QWI) and the Nursing Teamwork Survey (NTS). Hierarchical linear regression analysis assessed the relationships between perceived workload, occupational fatigue and nursing teamwork.

Results

The study's findings show that increased nursing workloads were significantly linked to higher levels of both acute (B = 5.70 to 6.76, p < 0.001) and chronic fatigue (B = 6.71 to 7.16, p < 0.001). Additionally, effective nursing teamwork, comprising trust, team orientation, support, shared mental models and team leadership was associated with reduced fatigue levels.

Conclusion

Our study shows high workloads are linked to increased fatigue among nursing professionals. Teamwork can help lessen the adverse effects of workload on fatigue. Healthcare organisations should focus on optimising workload distribution and strengthening teamwork. Further research is needed to understand these dynamics and develop targeted interventions to support nursing staff in high-demand environments.

Implications for Nursing and Health Policy

The study emphasises the need for healthcare organisations to prioritise workload management and enhance teamwork among nursing staff. Implementing structured workload assessments and fostering a collaborative work environment, along with policies promoting work–life balance, can improve patient care quality, benefit nursing professionals and contribute to a more resilient healthcare system.

Integrating Toe Brachial Index and longitudinal strain echocardiography for detecting coronary artery disease in patients with diabetic foot syndrome

Abstract

Coronary artery disease (CAD) is a common problem amongst diabetic foot syndrome (DFS) patients, associated with peripheral arterial disease. This analytic cross-sectional study investigates the diagnostic efficacy of the Toe Brachial Index (TBI) in the detection of CAD in 62 DFS patients. The presence of CAD was assessed by longitudinal strain echocardiography, a sensitive method that provides a more accurate measure of intrinsic left ventricular contractility than left ventricular ejection fraction, especially in diabetic patients. Univariate and multivariate logistic regression identified CAD-associated factors. Receiver operating characteristic curve evaluated TBI and toe pressure's diagnostic performance for CAD. p-Values < 0.05 were considered significant. There was a significant association between TBI and CAD, with each 0.01 increase in TBI associated with a 15% decrease in the odds of CAD development (odds ratio = 0.85, 95% CI: 0.72–0.99, p = 0.039). TBI demonstrated an area under the curve of 0.854, a sensitivity of 80.0% and a specificity of 66.7% at a cut-off of 0.69. Additionally, toe pressure exhibited an area under the curve of 0.845, sensitivity of 74.0% and specificity of 75.0% at a cut-off of 68.0 mmHg. Overall accuracy for TBI and toe pressure was 77.4% and 74.2%, respectively, indicating their potential for CAD risk stratification in the DFS population. This study highlights a significant association between low TBI and the presence of CAD in DFS patients. Consequently, TBI emerges as a valuable screening tool for identifying CAD within this population.

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