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Prevalence of sexually transmitted infections among military personnel: a systematic review protocol

Por: Shoemaker · E. S. · Sandstrom · E. · Dangerfield · C. D. · Linton · J. · Cholette · F. · McClarty · L. M. · Lazarus · L. · Herpai · N. · Pavlova · D. · Pickles · M. · Becker · M.
Introduction

Military personnel are a unique population with heightened vulnerability to sexually transmitted infections (STIs), often exhibiting higher prevalence rates than civilians due to demographic, environmental and occupational factors. These vulnerabilities underscore the need for global prevalence estimates to guide effective, evidence-based interventions. This study aims to quantify the global burden of STIs among military personnel, providing a comprehensive and up-to-date assessment.

Methods and analysis

This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Guidelines (2020). Using the CoCoPop (Condition, Context, and Population) framework, a comprehensive search strategy will be conducted in MEDLINE, Embase, Global Health and Scopus to retrieve peer-reviewed records published between January 2010 and June 2025. Eligible studies will report numerical STI prevalence data among military personnel. Studies with insufficient information to calculate prevalence or those relying on self-reported STI data will be excluded. Data extraction will include study details, military descriptors, STI prevalence and diagnostic methods. Risk of bias will be assessed using the Joanna Briggs Institute critical assessment tool for prevalence and incidence studies. Prevalence estimates with 95% CIs will be reported for each STI and, where appropriate, pooled for curable STIs. Subgroup analyses will stratify prevalence by geographic region, service status, deployment status and socioeconomic factors. Heterogeneity will be evaluated within predefined subgroups using the I² statistic. Data will be presented in comprehensive tables and visualised with graphical tools, including forest plots for subgroup analyses and pooled estimates.

Ethics and dissemination

Ethical approval is not required for this review. The results will be disseminated through a peer-reviewed publication and conference presentations.

PROSPERO registration number

CRD42023472113.

Challenges to Compassion for Patients Considered ‘Difficult’ to Care for: A Qualitative Content Analysis

ABSTRACT

Aim

To explore healthcare professionals' experiences of providing compassionate care and identify care situations considered challenging, with attention to the factors that contribute to these challenges.

Method

A cross-sectional qualitative study was conducted involving 878 healthcare professionals in New Zealand who completed an anonymous online survey between February and May 2022. Of these, 115 participants provided detailed narrative responses describing patient care situations that challenged the provision of compassionate care. These qualitative responses were analysed using content analysis, guided by the Transactional Model of Physician Compassion and reported following the COREQ qualitative reporting guidelines.

Results

Three major themes emerged: (1) fragmented services, resource constraints, and compartmentalisation of care; (2) clinician compassion needs and motivations; and (3) patient-related challenges impacting compassionate care. Over 90% of narratives described barriers to compassionate care that were linked to interconnected patient, clinician, clinical, and systemic factors—rather than being focused on individual patient influences alone.

Conclusion

Challenges to compassionate care are rarely attributable to individual patient characteristics alone. Instead, they reflect complex interactions among patient, provider, clinical, and systemic factors, underscoring the need for multilevel interventions to foster equitable, compassionate care.

Impact

This study highlights that barriers to compassionate care are embedded in complex systemic, clinician, and patient domains. Findings underscore the need for interprofessional collaboration, resilience-building strategies, and integrated approaches to enhance compassionate and equitable healthcare delivery.

Patient or Public Contribution

None.

Feel the Fear and Do It Anyway—Beliefs About Compassion Predict Care and Motivation to Help Among Healthcare Professionals

ABSTRACT

Aims

To develop and preliminarily validate a measure of beliefs about compassion in health care and assess whether and which beliefs may predict compassion.

Design

Pre-registered cross-sectional online survey study with a repeated-measures vignette component.

Method

Exploratory and Confirmatory Factor analyses were performed on a split sample of 890 healthcare professionals in Aotearoa New Zealand (NZ). Links with fears of compassion for others, burnout, trait compassion, compassion competency and ability and self-efficacy were used to assess convergent and divergent validity. Linear mixed model regression analyses were used to assess relationships between beliefs and compassion. In writing this report, we adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Results

Four-factor structure featuring three negative (compassion as harmful, not useful, draining) and one positive (compassion is important) type of beliefs was established. Confirmatory factor analysis indicated a good fit and subscales indicated good measures of validity. Internal consistency was achieved for the subset of beliefs (harmful, not useful). Regression analyses indicated negative effects of the belief that compassion is draining on caring, motivation to help and compassion overall; negative effects of the belief that compassion is not useful on the motivation to help and a positive effect of the belief that compassion is important on caring and compassion overall. There was no effect of beliefs that compassion is harmful on compassion measures.

Conclusion

This report extends prior qualitative studies of beliefs about compassion in a large healthcare sample, offering a way to measure these potentially malleable factors that might be targeted in education, interventions and future research.

Patient or Public Contribution

The study was designed in consultation with healthcare and compassion research professionals, including substantial input from Indigenous Māori healthcare professionals.

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