by Ana Caroline Bini de Lima, Vanessa Cristini Sebastião da Fé, Maria Simara Palermo Hernandes, Emily Caroline Pfeifer de Cristo, Ana Gabrieli dos Santos Fagundes Euzébio, Maria Vitória e Silva Sousa, Fabiana Ribeiro Caldara, Viviane Maria Oliveira dos Santos
This study aimed to evaluate the ability of social noncontact environmental enrichment to facilitate social buffering and to characterize the emotional experience of horses subjected to restraint in stock by assessing physiological parameters and facial expressions. Pantaneiro horses (n = 11) were evaluated in a crossover design with two treatments: social noncontact enrichment during stock restraint and social isolation during stock restraint. Physiological parameters (heart rate, heart rate variability, respiratory rate, ocular temperature by infrared thermography, and auricular temperature by infrared thermometer) and facial expressions (EquiFACS) were assessed throughout the 24-minute restraint period. When horses were accompanied by a conspecific, heart rate, respiratory rate, and eye temperature were lower (p nostril dilator (AD38), inner brow raiser (AU101), upper eyelid raiser (AU5), eye white increase (AD1), ears forward (EAD101), and ears back (EAD104), was also lower (pChronic wounds represent a major global health and economic burden. Smart wound dressings integrate biosensing and stimuli-responsive materials to monitor and modulate biological parameters within the wound microenvironment. This scoping review maps the biological parameters monitored by smart wound dressings, an area not previously synthesized across preclinical and clinical contexts. Following Joanna Briggs Institute (JBI) and PRISMA-ScR frameworks, five databases were searched in March 2025. Studies published between 2008 and 2025 reporting biosensing or responding technologies in wound dressings were included. A total of 179 studies met the inclusion criteria, most being preclinical (in vitro or in vivo rodent models), with few human investigations. The most frequently monitored parameters were pH, temperature, oxygenation, moisture, bacterial burden, and protease activity (particularly MMP-9). Preclinical data showed enhanced collagen deposition, angiogenesis, and infection control compared with conventional dressings, whereas human studies mainly assessed feasibility and biocompatibility. Smart dressings demonstrate strong technical and biological performance, but clinical validation and standardized outcome reporting remain limited. Future interdisciplinary research should prioritize well-designed clinical trials to confirm therapeutic and economic benefits and enable translation into personalized wound care.
To assess public support and predictors of favourable or unfavourable views towards expanding Advanced Practice Nurse (APN) roles in Germany.
A quantitative, cross-sectional survey using Germany as a national case study.
Data came from the Politikpanel Deutschland, an online survey conducted 15–28 July 2024. After exclusions, 6733 respondents were included. Data were weighted by age, gender, federal state, and voting intention. Descriptive statistics, subgroup comparisons, and multinomial logistic regression were applied to analyse attitudes towards APNs, with results reported as average marginal effects and predicted probabilities.
Overall, 52.8% of respondents supported expanding APN roles, 25% opposed, and the remainder were undecided. Support was stronger among younger, male, and highly educated respondents, and those open to digital health technologies. Support was lower in East Germany and the city-states Berlin and Bremen, while it was higher in the south-west and north. Political ideology strongly predicted attitudes: supporters of right-wing parties were more likely to oppose, whereas left-leaning voters were more supportive.
Public support for expanding APN roles in Germany is moderate but uneven across demographic, regional, and political cohorts. Younger individuals and those favouring digital health technologies may drive future acceptance, while political resistance and regional disparities remain barriers.
This first, large-scale survey of German public attitudes towards APNs suggests that policymakers should (i) link APN role expansion with digital health innovations, (ii) address regional differences through tailored communication, and (iii) ensure that patients, physicians, and healthcare professionals perceive APN integration as enhancing, not diminishing primary care quality. Strengthening legal and educational frameworks and fostering collaboration between physicians and nurses will not only be essential to integrate APNs into Germany's healthcare system and, thereby, mitigate physician shortages, but also to foster public acceptance of APNs.
None.
CROSS-checklist.
Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting up to 14% of the French children. Topical treatments are restrictive, leading patients to seek alternative options. Medical hypnosis may be a therapeutic approach, providing hypno-analgesia through comfort and soothing of the skin as well as anxiolysis by managing stress and boosting self-esteem. To date, only five studies have explored medical hypnosis in AD, showing promising results but limited by small sample sizes and lack of control arms. This study protocol describes the methodology for an initial evaluation of medical hypnosis within a therapeutic patient education (TPE) programme, called Hypno-DA.
The Hypno-Atopic Dermatitis (Hypno-AD) study is a prospective, monocentric, non-blinded, parallel, cluster-randomised controlled trial conducted at the University Hospital of La Reunion, France. The study commenced on 13 August 2024 and is scheduled to conclude on 13 August 2026. The primary objective is to assess the feasibility of recruiting for a medical hypnosis programme for children with mild-to-severe AD. 32 patients (aged 8–17 years) will be randomly allocated in a 1:1 ratio to receive TPE sessions combined with medical hypnosis (experimental arm) or the usual TPE sessions performed for AD without medical hypnosis (control arm). The experimental arm will employ a hypnosis-based intervention, referred to as the ‘superhero costume’ technique. Reinforcement will be provided through the practice of self-hypnosis at home, guided by listening to an audio recording provided on a Universal Serial Bus (USB) key. Secondary outcomes will be assessed at 1-month, 3-month and 6-month post-randomisation. These will include compliance with the required practice of self-hypnosis at home, rate of loss of follow-ups, patient satisfaction, effectiveness of the hypnosis programme on the control of AD (ADCT) and severity of AD (Patient-Oriented SCORing Atopic Dermatitis) and the global impression parents may have concerning the changes in their child’s AD.
Ethics approval was obtained from the Ile de France I Research and Institutional Ethics Committee (No. 2022-A01153-40). All methods were carried out in accordance with French law No. 2012-300 (5 March 2012) related to research involving humans as well as Good Clinical Practices (International Council for Harmonisation (ICH) version 4 of 9 November 2016, and the decision of 24 November 2006). Methods will conform to the Declaration of Helsinki. Informed oral consent from at least one legal guardian of each participant will be obtained in addition to oral consent from the child. Results will be published in an indexed peer-reviewed journal as well as presented and disseminated at scientific conferences.
This study examines the effect of nurses' holistic nursing competency levels and humanistic behaviour skills on their professional pride levels.
The study was designed as a cross-sectional study.
The sample consisted of 224 nurses working in a city hospital. The data were collected using the Personal Information Form, the Holistic Nursing Competence Scale, the Humanistic Behaviour Skill Scale in Nursing Practices and the Pride in Nursing Profession Scale. Independent groups t-test, ANOVA, and regression analyses were applied to analyse the data.
The mean ± standard deviation of the total score of the nurses participating in the study from the Holistic Nursing Competence Scale was 170.48 ± 42.41, the mean ± standard deviation of the total score from the Humanistic Behaviour in Nursing Practice Scale was 121.35 ± 20.81, and the mean ± standard deviation of the total score from the Pride in Nursing Profession Scale was 79.65 ± 22.80. A statistically significant positive relationship was found between the Holistic Nursing Competence Scale and the Humanistic Behaviour in Nursing Practice Scale. The results showed a statistically significant relationship between the Holistic Nursing Competence Scale, the Humanistic Behaviour in Nursing Practice Scale and the Pride in Nursing Profession Scale. In addition, it was determined that nurses' holistic and humanistic behaviour skills explained 12.2% of the change in professional pride. The holistic nursing competencies and professional pride levels of nurses who willingly chose the nursing profession and loved their profession were found to be statistically significantly higher (p < 0.05).
Nurses demonstrated above-average holistic and humanistic competencies, yet their professional pride remained below average. This indicates that professional pride may be shaped not only by individual skills but also by external factors such as working conditions and societal perceptions of the profession.
These findings suggest that to increase professional pride among nurses, not only is the development of individual competencies insufficient, but also the improvement of workplace environments and greater societal appreciation of the profession are necessary. Without addressing systemic and societal challenges, the development of holistic and humanistic nursing competences may have a limited impact on professional satisfaction. On the other hand, nurses' provision of care services in line with holistic and humanistic principles positively affects their professional satisfaction and the quality of patient care, patient satisfaction, safety and general health outcomes.
This study adhered to the STROBE criteria.
Adolescent tobacco use (ATU) is a global public health concern, causing significant morbidity and premature death. This study aimed to assess trends in the prevalence of ATU in Indonesia between 2009 and 2019 and to identify factors contributing to the observed changes.
This study performed secondary data analysis of three consecutive waves (2009, 2014, and 2019) of the Indonesian Global Youth Tobacco Survey (IGYTS). Weighted prevalence estimates and complex survey data analysed using multivariate logistic regression were established across the three-wave surveys. A pooled IGYTS data set was explored to determine the risk factors of the ATU. A multivariate decomposition analysis (MDA) was used to determine factors contributing to the prevalence change in male adolescents over the last two surveys.
The prevalence of ATUs was 21.1% (38.2% in males; 6.4% in females), 18.6% (32.7% in males; 3.9% in females) and 19.8% (36.8% in males; 3.5% in females) for the three consecutive surveys, respectively. Being older adolescents, male, exposed to SHS (secondhand smoke) at home, tobacco industry promotion, not knowledgeable of the dangers of tobacco smoke and SHS, and against banning smoking in public places were associated with ATU consistently across the surveys. In addition, inadequate anti-cigarette media and not being knowledgeable of the difficulty of quitting smoking were also identified as risk factors in the pooled data. MDA showed that 88.94% of the explained change was due to differences in the composition of explanatory variables between the last two surveys.
This study suggests that social influence and tobacco industry promotion significantly impact ATU in Indonesia. Governments should emphasise these factors in their tobacco control interventions.
Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.
by Carmen Villagrasa, Giorgio Baiocco, Zine-El-Abidine Chaoui, Michael Dingfelder, Sébastien Incerti, Pavel Kundrát, Ioanna Kyriakou, Yusuke Matsuya, Takeshi Kai, Alessio Parisi, Yann Perrot, Marcin Pietrzak, Jan Schuemann, Hans Rabus
Biological effects induced by diverse types of ionizing radiation are known to show important variations. Nanodosimetry is suitable for studying the link between these variations and the patterns of radiation interactions within nanometer-scale volumes, using experimental techniques complemented by Monte Carlo track structure (MCTS) simulations. However, predicted nanodosimetric quantities differ among MCTS codes, primarily because each code employs distinct molecular-scale particle interaction models. This multi-code study examines these variations for low-energy electrons (20–10,000 eV), which play a critical role in energy deposition and biological effects by virtually all types of ionizing radiation. Specifically, the hypothesis tested in this work is that inter-code variability in nanodosimetry results is mainly caused by differences in assumptions regarding total interaction cross sections. Ionization cluster size distributions and derived nanodosimetric parameters were simulated with seven MCTS codes (PARTRAC, PHITS-TS, MCwater, PTra, and three Geant4-DNA options) in liquid water as a surrogate for biological tissue. Significant inter-code differences were observed, especially at the lowest energies. They were substantially reduced upon replacing the original cross sections in each code with a common, averaged dataset, created ad-hoc for this study and not based on theoretical assumptions. For example, for 50 eV electrons in 8 nm spheres, the variability in the predicted mean ionization numbers decreased from 23% to 5%, and in the probability of inducing two or more ionizations from 34% to 7% (relative standard deviations). This quantification demonstrates that total interaction cross sections are the primary source of uncertainty at low electron energies. A sensitivity test using DNA damage simulations with the PARTRAC code revealed that cross section variations notably affect biological outcome predictions. Replacing the code’s original cross sections with the averaged ones increased the predicted double-strand break yield by up to 15%. These findings underscore the urgent need for improved characterization of low-energy electron interaction cross sections to reduce uncertainties in MCTS simulations and enhance mechanistic understanding of radiation-induced biological effects.Teaching nursing theories is essential to structure and guide clinical practice, yet their integration into initial training courses remains a challenge.
To map the educational practices used to teach nursing theories and conceptual models in initial nursing training programmes.
A scoping review.
Is review was conducted following the guidelines of the Joanna Briggs Institute and the PRISMA-ScR. A comprehensive search of five databases and in the grey literature was conducted to find studies from the inception of the databases to January 2024. A total of 32 articles meeting the inclusion criteria were selected for analysis.
The findings reveal a wide variety of educational techniques, ranging from traditional lectures to innovative Methods such as simulation and virtual games. The analysis also shows that these educational practices cover a broad Spectrum of theories, from well-established theories that have stood the test of time, such as watson's, to more recent Theories like the fundamentals of care.
While integrating nursing theories into initial training programmes is crucial, further research is needed to assess the effectiveness of the pedagogical strategies used to teach them. The mapping of educational practices carried out in this review serves as a valuable resource for educators, providing a structured basis to diversify and enrich the teaching of nursing theories.
This scoping review explores for the first time the range of pedagogical practices used in the teaching of nursing theories on an international scale. It provides a valuable resource for educators, allowing them to enrich their pedagogical approach. It offers a structured overview of the various possible methods, thus facilitating the adaptation of teaching strategies to different contexts. This methodological diversity can also serve as a source of inspiration for developing new concepts for teaching disciplinary fundamentals. The renewed interest in teaching disciplinary fundamentals underscores the relevance of this review in the current context.
Through this mapping of pedagogical strategies, this scoping review contributes to improving the quality of teaching nursing disciplinary fundamentals internationally. The results provide a foundation for developing specific courses on nursing conceptual models and theories, offering educators various possibilities to enrich their teaching methods while adapting to local contexts and student needs.
No patient or public contribution. This is a scoping review.
by Nikola Lübbering, Alexander Krogmann, Felix Jansen, Eicke Latz, Georg Nickenig, Sebastian Zimmer
BackgroundAtherosclerosis is a chronic inflammatory disease driven by endothelial dysfunction, cholesterol accumulation, and immune activation leading to thrombosis and vascular stenosis. While LDL-lowering therapies are firmly established, targeting the underlying inflammation is still an emerging strategy. Cholesterol crystals (CC) contribute to inflammation by activating the NLRP3 inflammasome in monocytes and promoting disease progression. Cyclodextrin (CD), an FDA-approved drug carrier, has shown atheroprotective effects by enhancing cholesterol metabolism and reducing inflammation in preclinical models. This study investigated whether CC-uptake in human monocytes, a prerequisite for inflammasome activation, is also influenced by CD pretreatment.
MethodsHuman peripheral mononuclear cells were isolated from whole blood samples provided by 76 patients undergoing coronary angiography at the University Hospital Bonn between November 2017 and February 2018. After separation, peripheral mononuclear cells were stimulated with 2-Hydroxypropyl-γ-Cyclodextrin and CC. CC-uptake by monocytes was analyzed using flow cytometry.
ResultsCC-uptake by monocytes varied greatly between patients (8–37%), with lower uptake observed in patients with elevated leukocytes (p = 0.0058) and diabetes mellitus (p = 0.0448). CD-pretreatment significantly reduced CC-uptake (20.1% ± 0.8% vs. 15.0% ± 0.6%, p p = 0.0316), requirement for percutaneous coronary intervention (PCI) (p = 0.0030), and elevated leucocyte levels (p = 0.0135) had lower CCΔCD, suggesting a link between systemic inflammation and attenuated CD efficacy.
ConclusionWe demonstrated that CD significantly reduced CC-uptake in patients undergoing coronary angiography, which supports its role in inhibiting CC-phagocytosis and promoting cholesterol efflux. Interestingly, patient response to CD varied, with those exhibiting greater systemic inflammation or CAD showing a less pronounced reduction in CC-uptake. Our findings provide insight into the atheroprotective mechanisms of CD and suggest its potential utility in evaluating individual cardiovascular risk and monitoring CD-based therapeutic interventions in humans.
Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, inflammatory bowel diseases (IBDs) of unknown origin, affecting the gastrointestinal tract and often causing extraintestinal symptoms. Conventional treatments (eg, glucocorticosteroids, immunomodulators) and targeted advanced treatments, including anti-TNFα, antibodies to p40 subunit of IL-12/23, antibodies to p19 subunit of IL-23, anti-α4β7 integrin, Janus kinase inhibitors (JAKis) and sphingosine-1-phosphate receptor (S1PR) modulators, do not achieve sustained responses for all patients, leaving significant unmet therapeutic needs.
This prospective, multi-centre observational study will follow a cohort of 240 patients across multiple study centres within NHS trusts in the UK who are initiating or switching biologics, specifically anti-TNFα and anti-α4β7 integrin for UC, and anti-TNFα, antibodies to p40 subunit of IL-12/2 and JAKi for CD. Through comprehensive profiling of immunological, transcriptional, microbiome, genetic and proteomic markers at baseline, week 12, and week 52, this study aims to uncover non-invasive biomarkers that predict response to these drug classes, ultimately advancing personalised medicine in IBD.
Ethical approval for the Nottingham/AstraZeneca study was granted by the West of Scotland Research Ethics Committee. Recruitment began in December 2022 and is currently ongoing at 10 NHS Trust sites across the UK. Study findings will be disseminated by publication in peer-reviewed journals and presentations at relevant national and international conferences.
by Claude Emmanuel Koutouan, Marie Louisa Ramaroson, Angelina El Ghaziri, Laurent Ogé, Abdelhamid Kebieche, Raymonde Baltenweck, Patricia Claudel, Philippe Hugueney, Anita Suel, Sébastien Huet, Linda Voisine, Mathilde Briard, Jean Jacques Helesbeux, Latifa Hamama, Valérie Le Clerc, Emmanuel Geoffriau
Resistance of carrot to Alternaria leaf blight (ALB) caused by Alternaria dauci is a complex and quantitative trait. Numerous QTL for resistance (rQTLs) to ALB have been identified but the underlying mechanisms remain largely unknown. Some rQTLs have been recently proposed to be linked to the flavonoid content of carrot leaves. In this study, we performed a metabolic QTL analysis and shed light on the potential mechanisms underlying the most significant rQTL, located on carrot chromosome 6 and accounting for a large proportion of the resistance variation. The flavonoids apigenin 7-O-rutinoside, chrysoeriol 7-O-rutinoside and luteolin 7-O-rutinoside were identified as strongly correlated with resistance. The combination of genetic, metabolomic and transcriptomic approaches led to the identification of a gene encoding a bHLH162-like transcription factor, which may be responsible for the accumulation of these rutinosylated flavonoids. Transgenic expression of this bHLH transcription factor led to an over-accumulation of flavonoids in carrot calli, together with significant increase in the antifungal properties of the corresponding calli extracts. Altogether, the bHLH162-like transcription factor identified in this work is a strong candidate for explaining the flavonoid-based resistance to ALB in carrot.by Jorman H. Tejada-Perdomo, Valentina Gutierrez-Perdomo, Juana V. Agudelo-Castro, Jorge A. Pérez-Gamboa, Alejandro Weinstein, Sebastián San Martín, Rodrigo Salas, Jorge A. Ramos-Castaneda
The use of devices that facilitate rapid airway isolation is essential when managing critical patients in emergencies. In recent years, additive manufacturing has emerged as an innovative, versatile, and accessible technology for developing medical devices. This study presents the design, development, and validation of an extraglottic medical device created using computer-aided design tools and stereolithographic 3D printing to facilitate blind intubation by first responders. The device was iteratively modeled and fabricated with biocompatible materials; validation in airway simulators and human cadaveric specimens assessed dimensions, friction, intubation technique, and learning curve, and ease of use was rated with a Likert scale. Ten iterations led to a final design with low friction and minimal cervical manipulation; ramp angle, cup geometry, and distal tip were optimized for tube passage, and BioMed Flex 80A showed high strength and anatomical compatibility. The final version is a safe, reusable, and functional alternative for airway management and blind orotracheal intubation, particularly in emergencies and resource-limited settings; clinical validation in live patients is still needed.The incidence of anal carcinoma is increasing, with the current gold standard treatment being chemoradiotherapy. There is currently a wide range in the radiotherapy dose used internationally which may lead to overtreatment of early-stage disease and potential undertreatment of locally advanced disease.
PLATO is an integrated umbrella trial protocol which consists of three trials focused on assessing risk-adapted use of adjuvant low-dose chemoradiotherapy in anal margin tumours (ACT3), reduced-dose chemoradiotherapy in early anal carcinoma (ACT4) and dose-escalated chemoradiotherapy in locally advanced anal carcinoma (ACT5), given with standard concurrent chemotherapy.
The primary endpoints of PLATO are locoregional failure (LRF)-free rate for ACT3 and ACT4 and LRF-free survival for ACT5. Secondary objectives include acute and late toxicities, colostomy-free survival and patient-reported outcome measures. ACT3 will recruit 90 participants: participants with removed anal tumours with margins ≤1 mm will receive lower dose chemoradiotherapy, while participants with anal tumours with margins >1 mm will be observed. ACT4 will recruit 162 participants, randomised on a 1:2 basis to receive either standard-dose intensity modulated radiotherapy (IMRT) in combination with chemotherapy or reduced-dose IMRT in combination with chemotherapy. ACT5 will recruit 459 participants, randomised on a 1:1:1 basis to receive either standard-dose IMRT in combination with chemotherapy, or one of two increased-dose experimental arms of IMRT with synchronous integrated boost in combination with chemotherapy.
This study has been approved by Yorkshire & The Humber – Bradford Leeds Research Ethics Committee (ref: 16/YH/0157, IRAS: 204585), July 2016. Results will be disseminated via national and international conferences, peer-reviewed journal articles and social media. A plain English report will be shared with the study participants, patients’ organisations and media.
Medical overuse is a well-documented increasing issue, primarily examined in the context of physicians. Previous research has also identified unnecessary services involving allied health professionals (AHPs). The objectives of our study were to explore: (1) To what extent are physiotherapists (PT), occupational therapists (OT) or speech and language therapists (SLT) familiar with the phenomenon of medical overuse?, (2) What drivers do PTs, OTs and SLTs suspect?, (3) What are the consequences of medical overuse? and (4) What measures can be taken to reduce medical overuse?
This study used a qualitative descriptive design and applied qualitative content analysis to explore the AHPs’ point of view. A qualitative content analysis using a deductive–inductive approach was conducted. After coding half of the interviews, no further categories were added, indicating data saturation.
Bavaria, Germany.
14 AHPs, mostly female.
AHPs struggled to define overuse. To them, underuse was perceived as a much more pressing issue. AHPs identified structural, economic, physician and patient-driven factors. They did not see themselves as part of the problem of medical overuse and assumed that their treatment, even without indication, has little to no disadvantage for patients. AHPs found it difficult to derive specific solutions; they named terminating unnecessary therapies and healthcare system reforms.
AHPs lacked initial awareness of medical overuse, highlighting the need for education and broader research.
The purpose of this manuscript is to offer an overview of knowledge regarding Evidence-Based Practice and implementation science. It addresses the question: What are the EBP implementation models used in nursing settings?
Discursive paper.
The databases were searched with the following keywords: ‘Nursing Faculty’, ‘Nurse educator’, ‘Academic’, ‘clinic’, ‘Evidence-based implementation’, ‘evidence-based practice’, ‘implementation’, ‘implementation science’, ‘undergraduate’, ‘nurse’. The search strategy aims to identify published studies. Eight databases were searched.
There are specific implementation models for implementing EBP: the IOWA Model, the Stetler Model, the Johns Hopkins Nursing Evidence-Based Practice Model, the Stevens Star Model, the Promoting Action on Research Implementation in Health Services (PARIHS), the Advancing Research and Clinical practice through close collaboration (ARCC) model. They were analysed according to the Nilsen classification. An evidence-based implementation project must be structured. First, it is necessary to choose an implementation model, then identify one or more implementation strategies, and finally, plan evaluation for implementation outcome. The use of implementation science ensures successful implementation or at least highlights barriers that need adjustment. Effective utilisation of implementation science facilitates the transfer of obtained results to similar contexts.
Implementation science complements the EBP process perfectly and ensures the proper implementation of evidence.
EBP mentors now have the entire structure of implementation science to succeed in implementing evidence-based data in both academic and clinical settings.
The discursive paper addresses the difficulties of implementing evidence in academic or clinical settings. Implementation science is the bridge between evidence and practice. Nurses now have everything they need to implement evidence-based practice successfully.
There was no patient or public involvement in the design or writing of this discursive article.
Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient-centred care gains importance, evaluating the effects of this approach on patient-reported outcomes may be more relevant than widely assumed.
In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient-reported outcomes, such as anxiety and satisfaction.
This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Scoping Review extension guidelines.
Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS-I V2.0, RoB2 and ROB-E tools.
Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025.
Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking.
Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients.
No patient or public involvement.