Conectar
To explore the perceptions and experiences of parents caring for children with paediatric feeding disorders requiring feeding tubes (PFD-T).
A descriptive qualitative approach was adopted in this study.
Using purposive sampling, 12 parents were recruited from paediatric inpatient wards and the outpatient paediatric feeding clinic at a tertiary public hospital in Singapore. Data collection was done from July to December 2024. Semi-structured one-on-one interviews were conducted with the parents (fathers or mothers) until data saturation. Thematic analysis was used to identify themes from the interview content.
A total of three themes and six subthemes were identified, encapsulating the challenges experienced by parents with caregiving and feeding tube management, as well as the sources of support they had. The themes are: (1) A sense of community, (2) Grieving over the loss of normalcy and (3) Facing the unknown.
Parents in this study felt supported being in a community of other parents with children who have PFD-T. It enabled them to gain valuable information and offered them a space where they felt understood. At the same time, they expressed feelings of guilt and isolation, as the caregiving demands led to limited capacity to cater to or interact with other loved ones. Additional challenges parents faced included transitioning between types of feeding tubes and insufficient support from healthcare professionals.
Ethical approval was obtained from the National Health Group Domain Specific Review Board (DSRB 2024/00064) on 8 May 2024.
This study followed the reporting guidelines outlined by the COnsolidated criteria for REporting Qualitative (COREQ) research checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
To critically reflect on the 50-year evolution of nursing in Singapore, identify pivotal milestones that have shaped the profession, and discuss strategies to address emerging challenges over the next five decades.
Nursing in Singapore has evolved from a vocational, subordinate role into a respected profession grounded in higher education, evidence-based practice and leadership in clinical and policy domains. Reforms in education, professional identity, workforce development and technology have paved the way for addressing future challenges, including ageing populations, workforce sustainability, technological disruption, leadership equity and global health threats.
Discursive commentary informed by historical analysis, policy developments and published literature, focusing on nursing education, workforce, leadership and digital integration in Singapore.
Strategic investments in education, research and leadership have elevated nursing's status and scope, with milestones such as tertiary education, advanced practice roles and doctoral pathways enabling nurses to serve as autonomous clinicians, researchers and policy leaders. Sustaining progress will require preparing nurses for multimorbidity and healthy ageing, embedding digital competencies while preserving human connection, ensuring inclusive leadership and enhancing global research translation.
Singapore's unique blend of innovation and tradition positions it to lead in shaping the future of nursing. By adopting a systems-level approach that integrates education reform, workforce wellbeing, ethical technology adoption and global collaboration, nursing can transform emerging challenges into opportunities for national progress and international impact.
This commentary offers insights for policymakers, educators and healthcare leaders on how a mid-sized nation can strategically position its nursing workforce for future readiness. Lessons from Singapore's trajectory, particularly in education reform, leadership cultivation and technology integration, apply to other countries seeking to enhance nursing's role in achieving health equity and system resilience.
None.
Ethnic minoritized women face cultural and systemic barriers in accessing antepartum and intrapartum care. Healthcare providers play a pivotal role in addressing these challenges, but their perspectives and experiences in delivering culturally competent care remain underexplored.
To synthesise healthcare providers' experiences and perspectives on providing culturally competent antepartum and intrapartum care for ethnic minoritised women.
A qualitative meta-synthesis study design was employed. Six electronic databases were searched from their inception date till January 2025. The included studies were assessed using the method of the Critical Appraisal Skills Programme tool, and findings were meta-synthesised using Sandelowski and Barroso's six-step approach. This review was registered via the International Prospective Register of Systematic Reviews.
Overall, 38 studies were included, and three themes emerged. The first theme revealed how providers' biases and professional training distorted their ability to understand and respect cultural practices. The second theme underscored the impact of systemic barriers such as time constraints, resource scarcity and lack of representation among providers. The final theme highlighted healthcare providers' aspirations for improved communication, targeted training and guidance on building trust to enhance care delivery.
Healthcare providers encounter notable challenges in delivering culturally competent antepartum and intrapartum care, but remain hopeful about bridging gaps in communication and understanding. Practical recommendations include implementing mandatory cultural competency training at all levels of healthcare professional education, increasing resources for interpreters and cultural liaisons and fostering diversity within the healthcare workforce. Future research should explore patient-centred interventions and systemic reforms to improve care for ethnic minoritised women. These findings highlight the need for policies and practices that empower providers to deliver equitable, culturally respectful antepartum and intrapartum care.
No patient or public contribution.
If clinical trials measure and report the outcomes included in core outcome sets (COS) for a given condition/disease as a minimum, this has the potential to improve comparability between trials and prevent research waste. Until now, the uptake of the Bronchiectasis and Hidradenitis Suppurativa (HS) COS has not been assessed.
This study assessed the uptake of Bronchiectasis and HS COS using a review of trial registries, with entries taken from ClinicalTrials.gov and the WHO International Clinical Trial Registry Platform. This uptake assessment provides valuable information to inform COS refinement and uncover areas lacking uptake to inform further dissemination requirements.
For each trial, the outcomes included in the trial registry entry were extracted and compared with those included in the corresponding Bronchiectasis or HS COS. The Bronchiectasis COS consists of 18 outcomes, and the HS COS, 6.
Of the trials registered after both COS were developed in 2018, 63% (12/19) of HS trials planned to measure the full COS, whereas for Bronchiectasis, 0% (0/24) of trials planned to measure the full COS. However, of the five priority outcomes to be measured for Bronchiectasis, 4% (1/24) of trials planned to measure all five outcomes.
Both COS publications’ focus was to reach consensus on what outcomes should be measured. Despite both publications referring to the Core outcome Measures for Effectiveness Trials (COMET) Handbook, which discusses the importance of COS dissemination, implementation plans were not included in either publication.
The results suggest that uptake of the HS COS is relatively good, despite yearly fluctuations, whereas for Bronchiectasis, COS uptake is limited. Further research into standardised measurement tools for HS is expected to increase uptake. The focus for Bronchiectasis, however, will be to refine the COS for feasible application in clinical trials. Future COS development publications should use all resources from the COMET initiative to ensure feasible dissemination of the COS.
To consolidate and synthesise the literature reporting perceptions of nurses and nursing students regarding evidence-based nursing.
Qualitative systematic review.
Seven electronic databases (Cumulative Index to Nursing and Allied Health Literature, Embase, ProQuest Dissertations & Theses Global, PsycInfo, PubMed, Scopus and Web of Science) were searched from their respective inception dates to January 2025.
The Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines guided this review. The quality of included studies was assessed using the Critical Appraisal Skills Programme tool, and data were synthesised thematically using Sandelowski and Barroso's two-step approach.
Thematic analysis of the 19 included studies, published from 2007 to 2025, identified three key themes: (1) Advancing nursing through evidence, (2) Personal, structural and systemic challenges and (3) Promoting a new evidence-based nursing culture.
Evidence-based nursing can elevate nursing care standards and enhance patient outcomes. Numerous factors that encourage and hinder the implementation of evidence-based nursing among nurses and nursing students were reported.
This review suggests the need to incentivise nurses to champion evidence-based nursing initiatives, provide nurses and nursing students with continuing education, and develop updated evidence-based nursing guidelines. These strategies could help in cultivating a supportive evidence-based nursing workplace culture and improving the implementation of evidence-based nursing.
Valuable insights into the facilitators and barriers associated with the implementation of evidence-based nursing were reported by nurses and nursing students—the key personnel responsible for practising evidence-based nursing. Future research could be undertaken to explore the perceptions of nurses and nursing students across varied cultural settings and in underrepresented regions.
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the experiences and perceptions of Singaporean parents in managing feeding difficulties among children with developmental disabilities.
A descriptive qualitative study design was used.
Twenty parents were recruited via convenience sampling from a paediatric feeding clinic in a public hospital in Singapore between July and October 2024. One-to-one interviews were conducted using a semi-structured interview guide. Thematic analysis was used to analyse the data.
Four themes were identified: (1) Feeding as a ‘guessing’ game; (2) mutual understanding within the family and community; (3) beliefs regarding developmental disabilities and feeding difficulties; and (4) challenges in accessing adequate support. There were a total of nine subthemes supporting these themes.
This study revealed that parents of children with developmental disabilities faced challenges in adjusting to their child's feeding preferences, dealing with conflicting views on feeding practices among caregivers, and accessing adequate support. Parents also valued instrumental support from grandparents and domestic helpers, as well as emotional support from online peers. Additional research and targeted interventions are needed to better support parents of children with developmental disabilities in managing feeding difficulties.
Policies should facilitate the provision of feeding-specific resources, treatment, and education for parents. Additionally, healthcare providers should proactively assess feeding-related concerns and address misconceptions to enhance parental awareness of feeding difficulties and how they can improve the feeding practices of their children with developmental disabilities. Future research should obtain a more in-depth understanding of how differing beliefs in feeding difficulties between parents can impact the child's developmental outcomes, as well as the support and resources that may address feeding needs in these children.
This study followed the reporting guidelines outlined by the Consolidated criteria for Reporting Qualitative (COREQ) research checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
To investigate the incidence and the factors associated with paternal postpartum depression amongst new fathers in Singapore.
A prospective repeated measures study was conducted from September 2023 to March 2024.
A total of 200 fathers aged 21 years and above who had a neonate born at full term and no serious health events for both mother and neonate were recruited from a local hospital via convenience sampling. Fathers completed questionnaires at the third trimester of pregnancy (baseline) and 1 month postpartum. Multiple regression analyses were used to identify significant factors associated with postpartum depression in fathers.
The incidence of paternal postpartum depression was 5.26% at 1 month post-childbirth, using the Edinburgh Postpartum Depression Scale (EPDS). Using the Gotland Male Depression Scale (GMDS), 7% of the fathers were identified with high risk of depression and 14.3% of the fathers had moderate depressive symptoms. Paternal postpartum depression at 1 month post-childbirth could be predicted by paternal postpartum depression scores at baseline measured by EPDS and GMDS, as well as by baseline perceived social support and parental self-efficacy at 1 month post-childbirth.
This study found that a considerable number of fathers in Singapore are at risk of postpartum depression. There is an urgent need for the development of more comprehensive tools to measure postpartum depression in fathers that are culturally adapted to the local context.
Early screening during antenatal visits enables timely intervention and access to support, benefiting the entire family. Nurses could help fathers to be more involved by extending patient education and teaching infant care skills to both parents. When counselling patients, the involvement of extended family members and navigating new roles as caregivers of a new baby and breadwinners are important considerations for new parents.
This study is the first of its kind to measure the incidence of postpartum depression amongst new fathers in an urban multicultural Asian setting, like Singapore. The study found that the incidence of postpartum depression in fathers were 5.26% when measured using EPDS and 14.3% when measured using GMDS at 1 month postpartum. These findings could inform future family-centred and father-specific interventions to improve the mental health outcomes of new parents.
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.
No patient or public contribution.
To consolidate and appraise available evidence on the experiences and perceptions of male nurses and male midwives facing discrimination.
Qualitative systematic review. This review was informed by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA).
The Critical Appraisal Skills Program checklist was used to appraise included articles, and extracted data were meta-summarised and meta-synthesised using Sandelowski and Barroso's two-step approach.
PubMed, EMBASE, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest (Dissertations and Theses Global) and ClinicalTrials.gov were sourced from the inception to December 2022.
A total of 21 studies were included, involving 283 male nurses and 11 male midwives. Four themes were identified during the meta-synthesis: (1) It's a ‘women's world’, (2) discrimination within and beyond the workplace, (3) stereotypes and labels and (4) the silver lining.
This review offered male nurses' and male midwives' perspectives on discrimination faced in nursing. There is a need to ensure gender equality in the nursing profession by reinforcing the importance and value of employing men in this profession.
Future research should focus on examining the experiences of male nursing students and other healthcare stakeholders to understand discrimination faced by men in nursing from varied geographical and cultural backgrounds. The findings may provide helpful insights for planning supportive interventions, institutional adjustments, legislative changes, educational initiatives and research that benefit male nurses and male midwives.
This qualitative systematic review consolidated and meta-synthesised the available evidence on male nurses' and male midwives' experiences of discrimination. These findings contribute to the understanding of male nurses and male midwives as a gender minority and the need for greater gender equality.
PRISMA.
No patient or public contribution.
Many mothers experience poor psychological outcomes during their perinatal period. The presence of depression and anxiety has a significant adverse impact on the mother's health and the infant's development.
This review aimed to examine the effectiveness of peer support interventions in improving depression, anxiety, and perceived social support among mothers during the perinatal period.
This study was a systematic review and meta-analysis of randomized controlled trials. The reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Cochrane's Risk of Bias Tool for randomized controlled trials was used to examine the methodological quality of the included studies. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A comprehensive search was conducted from inception till May 2024 across seven databases: Pubmed, Scopus, CINAHL, Web of Science, ProQuest, PsycINFO, and Embase.
The results of the meta-analysis of the 12 included studies showed that peer support interventions could reduce depression and anxiety levels but not perceived social support levels. Sub-group analyses based on the mode of intervention delivery showed significant reductions on depression levels in online and face-to-face groups but not telephone call groups. Follow-up data analyses showed that peer support interventions could improve depression, anxiety, and perceived social support across a duration of 1–6 months post-intervention.
This review provides a deeper understanding of the effect of peer support interventions on mothers in the perinatal period. This can have a positive impact on current knowledge aimed at improving the well-being of mothers and thus, their infants, partners, and entire family unit. Findings showed that peer support interventions can positively improve psychological well-being of mothers in the perinatal period in the short and long term. Peer support can ultimately be considered as a standardized part of perinatal care. Future recommendations include implementing a combination of face-to-face and online approaches to peer support interventions delivered with both individual and group components.
This study aimed to review studies exploring the experiences and perceptions of healthcare students and providers regarding their personal choices for elective female fertility preservation and their recommendations of the same to patients.
Employing Pluye and Hong's convergent qualitative synthesis approach, a mixed-studies review was conducted. The appraisal of studies was performed using the Mixed Methods Appraisal Tool and data analysis utilised Thomas and Harden's thematic synthesis approach.
Six electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus and Web of Science) were searched from their inception till November 2023.
About 24 studies were reviewed, uncovering four major themes: varied personal perspectives, knowledge gaps and role ambiguities, perceived temporal and financial constraints and apprehensions related to fear and stigma.
This review underscored the challenges faced by healthcare professionals and students in their personal pursuit of elective fertility preservation. Addressing these challenges demands the implementation of fertility navigators, culturally and religiously sensitive public health campaigns and staff training. Moreover, standardised guidelines, transparent cost and process reporting, evidence-based education, counselling on risks and success rates and governmental support in the form of subsidies can mitigate barriers, enhance cost-effectiveness and promote equitable access to care. Collaboration among stakeholders is imperative to ensure equitable access and maintain quality care in elective female fertility preservation.
This mixed studies review followed the reporting guidelines in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement.
No Patient or Public Contribution.
Trial Registration: This review has been registered on the Prospective Register of Systematic Reviews (PROSPERO) database (CRD42023395406)
To consolidate adolescents' perspectives regarding various aspects of sleep and offer insights to promote healthier sleep habits during their critical developmental years.
Six electronic databases (PubMed, CINAHL, Embase, Scopus, PsycINFO and Web of Science) were searched from their inception dates to June 2023. Data were extracted and meta-summarised using Sandelowski and Barroso's approach and synthesised using Thomas and Harden's thematic analysis framework.
Meta-synthesis from 11 peer-reviewed published studies identified four main themes: (1) Awareness and understanding of sleep's significance, (2) The shadows and radiance of slumber, (3) Traversing the sleepscape: trouble bubbles and (4) Illuminating the path: Guiding lights to enhanced sleep.
Our review findings suggest a lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents. Identified barriers to adequate sleep encompass various factors, including overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities. Strategies to improve adolescents' sleep health involve multiple sleep strategies, including sleep education, workshops/seminars, parental involvement, incorporating digital well-being practices, the promotion of relaxation techniques and the provision of essential resources. Prioritising sleep health and implementing targeted interventions are key steps to empower adolescents, create supportive environments and shape a healthier future generation. Future research endeavours should focus on evaluating the effectiveness of interventions and exploring the influence of cultural factors.
There exists a notable lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents. Barriers to achieving adequate sleep among adolescents include overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities. The collaboration between healthcare institutions, professionals and educational institutions is crucial to facilitate (1) the implementation of sleep education workshops/seminars targeting adolescents, (2) increased parental involvement and role-modelling to instil good sleep practices among adolescents and (3) enhanced integration of digital well-being practices, the promotion of relaxation techniques and accessibility to essential sleep hygiene resources.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No patient or public contribution.
This review was registered on the Prospective Register of Systematic Reviews (CRD42023403775).
Extensive literature has shown the effectiveness of cognitive behavioral therapy in treating perinatal depression, but little is known about the effectiveness of its technology-based version.
The aim of this review was to examine the effectiveness of technology-based cognitive behavioral therapy in reducing depressive and anxiety symptoms in women suffering from or at risk of experiencing perinatal depression.
Six electronic databases were searched until February 2023 for articles published in English. Random-effect meta-analyses were conducted. Heterogeneity was assessed using the I 2 statistics and Cochran's Q chi-squared test. Sensitivity analyses and subgroup analyses were also performed, and quality appraisals at the study and outcome levels were conducted.
A total of 16 randomized controlled trials were included in the review. Results from meta-analyses suggest that technology-based cognitive behavioral therapy has a medium effect in reducing perinatal depressive symptoms and a small effect in reducing perinatal anxiety symptoms. Overall, women suffering from or at risk of perinatal depression may benefit from technology-based cognitive behavioral therapy.
Future interventions can be improved by addressing both perinatal depression and anxiety, paying more attention to antenatal women to prevent postnatal mental health issues, and using self-guided mobile applications for accessibility.
FreshRSS 