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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.
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.
Ethical approval is not required for this review. The results will be disseminated through a peer-reviewed publication and conference presentations.
CRD42023472113.
The aim of this study is to map nursing publications on the United Nations Sustainable Development Goals (SDG) in Web of Science, highlighting trends, key contributors, and central research themes to identify potential areas for future research.
The globally-spanning 2030 Agenda promotes sustainable development using research technology and scientific innovation. However, research data availability is a challenge. By conducting big data analyses, using all available nursing research literature indexed in the Web of Science database (Core Collection) pertaining to this field, aid in understanding and advancing this area.
This study adopts a cross-sectional descriptive bibliometric study design.
The search yielded 131 publications, comprising 116 articles (89%) and 15 review articles (11%). This can be compared to adjacent disciplines such as Internal General Medicine (n = 360), Nutrition/Dietetics (n = 171), and Paediatrics (n = 152). The leading countries in publication output were the United States, Australia, and the United Kingdom. Among the included publications, only eight SDGs were addressed: SDG3 (Good Health and Well-Being), SDG13 (Climate Action), SDG4 (Quality Education), SDG5 (Gender Equality), SDG6 (Clean Water and Sanitation), SDG16 (Peace, Justice, and Strong Institutions), SDG1 (No Poverty), and SDG9 (Industry, Innovation, and Infrastructure).
The findings indicate a scarcity of articles in nursing publications focusing on the SDGs, suggesting insufficient evidence of nursing's contributions to these goals—particularly beyond SDG3.
This study provides a comprehensive bibliometric review and analysis of existing nursing publications on the SDGs. The results offer valuable insights for future research areas related to the SDGs, particularly for nursing scholars, clinicians, managers, and policymakers concerned with the underrepresentation of nursing publications. To address this gap and advance both the SDGs and quality patient care, action plans should be developed to integrate the SDGs into daily nursing practice.
No Patient or Public Contribution. This study was a bibliometric analysis.
To explore Registered Nurses' experiences of continuity of care for patients with chronic obstructive pulmonary disease in primary care.
An inductive, descriptive qualitative study.
Data were collected through semi-structured interviews with 11 purposively sampled Registered Nurses of varying levels of experience from eight regions in Sweden. The audiotaped interviews were conducted over a 5-month period (December 2023–April 2024), transcribed verbatim and analysed using interpretive description.
Registered Nurses' experiences of continuity of care for patients with chronic obstructive pulmonary disease are described by three themes (seven subthemes): Patient continuity (Building personal relationships: Being accessible and enabling trust and confirmation), Collaborator continuity (Having a colleague to lean on: Colleagues can lean on me: Feeling alone with my expertise) and Continuity with myself (Trusting my own competence: Carrying a burden alone).
Consolidated Criteria for Reporting Qualitative Research Guidelines.
This study provides an understanding of Registered Nurses' experiences of continuity of care in primary care. The results may help improve future care since nurses play an essential role in the care of chronic obstructive pulmonary disease within primary care.
To enhance continuity of care for patients with chronic obstructive pulmonary disease, the relationship between the nurse and the patient is important, as is collaboration with colleagues. This collaborative approach allows these nurses to maintain continuity with both the patients and themselves, fostering a more stable and effective care environment.
This study offers valuable insights into the experiences of Registered Nurses in maintaining continuity of care within primary care, particularly for patients with chronic obstructive pulmonary disease. By highlighting the critical role of Registered Nurses in managing these patients, the study underscores the importance of strong nurse–patient relationships and effective collaboration among healthcare professionals.
No Patient or Public Contribution.
To explore existing research regarding how nurses' unclear responsibilities influence their professional role development in hospital settings.
A scoping review was conducted according to Arksey and O'Malley.
The Population Exposure Outcome framework was used to identify eligible inclusion and exclusion criteria and search terms. The included articles have been thematically analysed in guidance by Braun and Clarke.
Twenty-six studies conducted between 2016 and 2024 were identified in CINAHL, PubMed and Scopus.
The roles of nurses were highly adaptable within hospital settings and healthcare teams, requiring nurses to assess both organisational shortcomings and colleagues' needs. These assessments depended on the nurses' competence and motivation for professional growth.
There was a clear need to strengthen organisational structures and frameworks to support the evolving role of nurses. Basic nursing education must be better at preparing nurses for their upcoming leadership role.
Increasing complexity and unclear responsibilities contribute to role ambiguity among nurses. The review highlights the importance of recognising nurses as visible and accountable leaders. There is also a need to support nurses' adaptability through improved basic education, which may have implications for both clinical practice and education.
The PRISMA Scoping Review checklist was used during the review process. The PRISMA flowchart was used to report the database searches.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore how chief nursing officers perceive and enact their leadership within bureaucratic healthcare systems, with a particular focus on patient safety, strategic responsibilities and the advancement of nursing care quality.
A qualitative study design was used. Semistructured interviews were conducted between October 2023 and May 2024 with nine female Chief Nursing Officers, representing diverse regional healthcare settings across Sweden. The interviews were analysed using reflexive thematic analysis, which was informed by the theory of bureaucratic caring to support interpretation.
Chief nursing officers described navigating hierarchical and bureaucratic systems while promoting person-centred care and professional governance. Their work involved balancing strategic mandates with ethical imperatives, advocating for workforce development and fostering a culture of proactive safety. The analysis generated four interrelated themes: (1) grappling with complexity and power structures; (2) guided by ethics, compassion and purpose; (3) empowering the nursing workforce to provide improved care; and (4) shaping quality care through innovation, evidence and technology.
Chief Nursing Officers can act as key agents of transformation at the intersection of structure and care. Their leadership extends beyond administrative functions to encompass strategic influence, ethical advocacy and system-level improvement. The findings underscore the need to further formalise and institutionalise the role, ensuring it is equipped with the mandate and structures required to lead across organisational levels. Strengthening such roles calls for leadership models that foster collaboration, support shared governance and enable flatter organisational hierarchies—structures designed to enhance participation, distribute decision-making and promote professional autonomy.
This study followed reporting standards for qualitative research by adhering to the EQUATOR Network guidelines and using the COREQ checklist.
Only health care staff participated in this study.
This study highlights the strategic, ethical and relational dimensions of chief nursing officers' leadership and its impact on patient safety, quality improvement and workforce development. The findings demonstrate that they can play a pivotal role in embedding ethical perspectives into healthcare leadership—bridging professional nursing values with structural and strategic priorities. This underscores the importance of enabling nurses to shape care systems in ways that promote safety, professional governance and person-centredness.
The aim of this study was to explore why patients with hard-to-heal ulcers are treated without an aetiological diagnosis, using a grounded theory approach.
The study employed a qualitative semistructured interview design to gain in-depth insights. Data were collected in 2024, and an explanatory model was formed in accordance with grounded theory analysis.
Interviews were conducted with healthcare staff across primary, community and specialist care units in Sweden, encompassing both public and private sectors and representing a wide geographical spread.
The study involved 23 healthcare professionals, including nurses (n=18), assistant nurses (n=2) and physicians (n=3), from 22 healthcare units that participated in a preceding national mapping study. Participants were selected purposively to represent various professional roles and healthcare levels.
The analysis resulted in a theoretical model based on two categories: Healthcare traditions and clinical practices and Clinical governance. The lack of an aetiological diagnosis can be attributed to a traditional division of tasks, where ulcer care falls within the nurses’ domain. As a result, patients often receive treatment without a physician’s involvement, especially in home healthcare. Barriers and enablers for a diagnosis are present on different levels; issues close to the patient as well as structural matters. The results illustrate how healthcare units can be positioned along a scale, from traditional work distribution to evidence-based guidelines.
This study can be used to get a deeper understanding of the challenges of current wound management, where clinical governance can support or undermine the movement from a traditional work distribution towards an evidence-based clinical practice. Furthermore, this study can provide a basis for discussing quality improvement, to obtain good and equal care for patients with hard-to-heal ulcers.
Studies suggest that extreme heat events can have negative effects on mental health. However, characterisation of these effects in urban communities remains limited, and few studies have investigated the potential modifying effects of demographic, clinical and environmental characteristics. The aim of this study is to address this knowledge gap and quantify the impacts of extreme heat on mental health, health service use and mental well-being in vulnerable urban populations.
In this multidisciplinary project, we will assess mental health outcomes in different populations by bringing together two distinct datasets: electronic health record (EHR) data on mental health service users and data from general public participants of Urban Mind, a citizen science project. We will use EHRs from the South London and Maudsley NHS Foundation Trust (SLaM) and the North London NHS Foundation Trust (NLFT), from six boroughs which collectively cover more than 1.8 million residents in Greater London, to capture mental health service use and mortality among people with existing diagnoses of mental illness across 2008–2023. We will use smartphone-based ecological momentary assessment data from Urban Mind to measure mental well-being in the general population (2018–2023). These datasets will be linked to high-resolution spatiotemporal data on temperature, fine and coarse particulate matter (PM2.5, PM10), nitrogen dioxide (NO2), Normalised Difference Vegetation Index (NDVI) and density of large mature tree canopy. We will employ novel quasi-experimental designs, including case time series and case-crossover analysis, to examine the impact of extreme heat on mental health and explore effect modification by sociodemographic, clinical and environmental factors, including air pollution and types of green space coverage. We will also develop a microsimulation model combined with the InVEST urban cooling model to assess and forecast the mental health and social care impacts of extreme heat events and the mitigation of these impacts by different green space coverage and pollution-reduction policies. With a core team composed of researchers, community organisations, industry partners and specialist policy experts, this project will consider lived experience, benefit from broad stakeholder engagement and address gaps in policy and practice.
Each component of this project has been approved by the relevant ethics committee (ref RESCM-22/23-6905 for Urban Mind, LRS/DP-23/24-41409 for the co-development of a screening tool, 23/SC/0257 for the SLaM EHRs, and 24/EE/0178 for the NLFT EHRs). Our dissemination plan includes peer-reviewed scientific articles, policy briefs, a practical guide on fostering ecological and human resilience at the neighbourhood level, and a technical guide for planting and improving the growing conditions of large canopy trees.
Patients with acute psychiatric symptoms are often referred to the emergency department (ED) for medical evaluation to exclude medical causes before psychiatric admission. The absence of a prospectively validated medical screening tool leads to wide practice variation. This study aims to develop a new, evidence-based and consensus-based medical screening tool through a collaborative, interdisciplinary, international Delphi approach.
This modified Delphi study will include representatives from emergency medicine and psychiatry societies across four continents, as well as patient representatives with prior experience of medical screening in the ED. A minimum sample size of 24 participants is planned to account for potential dropouts. The Delphi procedure consists of four rounds. Round 1 will present current evidence and identify key items for the new medical screening tool. Round 2 will evaluate and refine statements from Round 1. Round 3 will seek consensus on the variables to be included in a medical screening tool. In Round 4, hypothetical clinical vignettes will be used to assess the agreement on the recommendations of the newly developed medical screening tool in order to test for content and construct validity. Surveys will be conducted via Research Electronic Data Capture (REDCap), with participants rating statements on a 6-point Likert scale. Response stability will be evaluated using the intraclass correlation coefficient, and consensus defined as ≥80% agreement. Results will be reported according to the ACcurate COnsensus Reporting Document guidelines and the Guidance for Reporting Involvement of Patients and the Public 2 short form.
The Ethics Committee of Northwestern and Central Switzerland exempted the project from committee approval under the Human Research Act on 11 September 2024. Written consent will be obtained from all participants. Results of this study will be summarised as a medical screening tool which will be validated in a prospective, multicentre study in a second step.
To explore what healthcare staff and staff in pharmacies experiences, as challenges, and possibilities in handling and use medications by foreign-born persons or their relatives, and how necessary information is exchanged between different units in the healthcare chain to prevent medication errors.
A qualitative explorative single-unit case study in a primary healthcare centre, with connected home care and pharmacies in an immigrant-dense area.
Individual semi-structured interviews with 17 respondents, including pharmacists, physicians and registered nurses, were conducted between May and December 2022, in Sweden. Inductive qualitative content analysis was applied.
Six categories were identified: limited knowledge about medications, lack of knowledge about the Swedish system for medication prescriptions and pharmacy regulations, insufficient time to develop trusting relations, communication to support medication management, tools for facilitating safe use of medications and problems in exchange of information in the healthcare chain.
Good communication is both a challenge and a prerequisite for safe medication management by well-informed patients. To ensure patient safety, it is crucial to establish ways to communicate with patients about their medications, regardless of their language skills. Improving communication within the healthcare chain is essential to prevent medication errors.
Understanding the complexity of medication management and preventing medication errors requires staff to communicate effectively with patients at all steps in the healthcare chain to identify their informational and educational needs.
This study provides a comprehensive understanding of the importance of communication within the healthcare chain, including prescribing physicians, nurses, pharmacists and patients, to prevent medication errors.
COREQ checklist.
This study focused on staff at a healthcare centre and two pharmacies.
To explore the meaning of ‘safety’ as it applies to critical care nurses during daily care practice in the intensive care setting.
A qualitative study design was employed.
The study enlisted 18 critical care nurses and nurse leaders from three hospitals in Sweden. Interview data were collected in 2017 and in 2024. The data were examined using reflexive thematic content analysis.
The meaning of safety within critical care settings was illustrated by the themes ‘Sustaining a safety mindset’, ‘Fostering commitment to patient safety’, ‘Showing individual accountability and continuous learning’ and ‘Managing complexity while prioritising safety standards’. Safe care practice in daily practice also involved adaptability and resilience in response to changing circumstances or unexpected events, ensuring thoroughness and allowing for a return to regular routines when conditions permitted, thereby preventing incomplete care. Core competencies in safety encompassed both technical and non-technical skills, such as the ability to assess and use technology, remain vigilant and thorough, plan ahead, prioritise and identify, and follow through on nursing interventions, all while working in a team and allocating sufficient time for patients.
Sustaining a safe mindset over time is both challenging and essential. Further research should focus on how to foster a sustained safety mindset. A more proactive approach to learning may be achieved by reflecting on and discussing things that have worked well even in challenging circumstances.
This study enriches our understanding of practising safe care in intensive care. It furnishes the nursing profession with a deeper theoretical grasp of proactive safety efforts, encompassing various factors that can mitigate risks in a technologically advanced environment.
Total diet replacements (TDRs) and weight loss medications (WLMs) have proven effective in producing substantial weight loss for individuals with obesity. Evidence is lacking on whether combining these treatments is effective and cost-effective in primary care for adults with obesity class I (body mass index (BMI) 30–34.9) or uncomplicated obesity class II or higher (BMI≥35 without obesity-related disease).
LightCARE is a 2-year 1:1 randomised, parallel-group, clinical superiority trial with blinded outcome assessment evaluating the benefits and harms of an intensive weight loss (IWL) intervention compared with usual care for adults with obesity in Denmark and the UK. The trial will include 400 participants aged 18–60 years with obesity class I or uncomplicated obesity class II or higher. The IWL programme aims to achieve and maintain a weight loss of ≥20% through a flexible and individualised combination of TDR, behavioural support, including physical activity and sleep guidance, and WLM if needed and will continue for 2 years. The control group will receive usual care offered in each country, typically consisting of brief behavioural support for weight loss. The primary outcome is body weight 2 years after randomisation. Secondary outcomes will include the proportion of participants achieving ≥20% weight loss, Short-Form-36 Mental Component Score, 4-m gait speed and Metabolic Syndrome Severity-Z score. Serious adverse events, the incidence of eating disorders and bone mineral density will be evaluated as safety outcomes. We will also examine the cost-effectiveness of the intervention, within the trial and in the longer term through modelling. We will conduct a process evaluation to inform any future implementation.
Ethical approval was granted in Denmark (December 2023, H-23051332) and the UK (August 2024, 24/SC/0210). Findings from the trial will be disseminated through peer-reviewed journals and scientific conferences.
To explore implementation patterns and perceived value of the SEXIT (SEXual health Identification Tool) method in the school health care (SHC) setting in Sweden.
Mixed method survey using an online questionnaire with closed and free-text response options.
115 SHC professionals who had completed SEXIT training responded to an online questionnaire (response rate 26%), between March and May 2024. Closed questions were answered on a five-point Likert scale, and responses trichotomised. Quantitative data were analysed using descriptive statistics, qualitative data with a deductive qualitative content analysis. CROSS guideline was used.
70 of 115 SHC professionals used SEXIT in their work. Findings suggest that SEXIT is appropriate and useful, supporting communication about topics such as sexual health and violence that both pupils and professionals may avoid addressing. Implementation patterns showed that 61% of those who had completed training also used SEXIT. 63% of those used SEXIT during regular health dialogues, but some did not use it with all pupils. The perceived value was that most SHC professionals felt that SEXIT helped them get a better understanding of the pupil's situation, an objection that it was too time-consuming.
Most SHC professionals who had completed SEXIT training used the method regularly and perceived the method as valuable and facilitating discussions about sexual ill health and experiences of violence with pupils. There are indications that SHC services fail to identify particularly at-risk young people. Sexual health inequity persists, as some structurally marginalised and vulnerable youths are excluded from the SEXIT dialogues. A follow-up study will focus on pupils' experiences.
This study validates SEXIT in a new setting, SHC, and is relevant for the promotion of sexual and reproductive health for all, and for preventing violence and sexual ill health among young people.
Social drivers of health (SDOH), such as housing stability, food security and access to transportation, profoundly influence both healthcare access and health outcomes. In pregnancy, screening positively for SDOH domains correlates with poorer perinatal outcomes. While the American college of Obstetricians and Gynaecologists recommends screening for SDOH at every routine prenatal visit, many prenatal practices struggle to systematically screen patients for SDOH. This study evaluates the implementation of a universal SDOH screening and management protocol in prenatal care and aims to bridge the gap between the recommendation for universal SDOH screening in prenatal care and its actual integration by evaluating implementation strategies that can serve as a guide for other prenatal care clinics.
This multi-site, prospective formative implementation evaluation will assess the integration of standardised SDOH screening and management into prenatal care workflows at four prenatal clinic sites within an academic Obstetrics and Gynaecology department. The study employs a concurrent triangulation mixed-methods approach integrating chart-abstracted patient data, staff surveys, and staff and patient semi-structured interviews, guided by established implementation science frameworks (exploration, preparation, implementation and sustainment, consolidated framework for implementation research and implementation outcomes framework). Key implementation strategies include workflow integration, electronic medical record optimisation, role clarification and comprehensive training. Implementation outcomes to be evaluated include feasibility, acceptability, appropriateness, adoption, fidelity and sustainability.
This study was approved by the University of North Carolina at Chapel Hill’s Institutional Review Board (IRB #24-3104). Verbal informed consent will be obtained from all interview participants, and consent will be embedded in staff surveys. Results will be disseminated through peer-reviewed publications, conference presentations, stakeholder meetings and directly to participating clinical sites.
Cardiac rehabilitation has traditionally been administered through face-to-face consultations with a specialised team of nurses, medical doctors and physiotherapists. However, the healthcare system is undergoing a significant digital transformation, which may lead to telemedicine (TM) becoming a cornerstone of healthcare. However, successful TM requires digital competencies among both patients and health professionals. This trial will examine the best methods of onboarding patients to TM by way of a co-designed cardiac telerehabilitation model with a family-focused approach.
The aim is to investigate how patients and family members could benefit from using TM, including video consultations and home monitoring, for cardiac rehabilitation. We ask how patients’ health literacy, digital health literacy, health-related quality of life and family support would be affected by a shift to TM.
The primary outcome is the Health Literacy Questionnaire, and secondary outcomes are the eHealth Literacy Questionnaire, European Quality of Life—Five Dimensions Scale, and the Iceland—Family Perceived Support Questionnaire. The sample size is 73 patients in each group. Data will be analysed with 2 or Fisher’s exact tests, a t-test or a Wilcoxon signed-rank test, depending on the distribution.
Approval for this trial was obtained from the Danish Data Protection Agency (P-2023-65) and the National Committee on Health Research Ethics (F-23075094). The trial will be conducted in compliance with the Declaration of Helsinki. The trial results—whether positive, neutral or negative—will be submitted for publication. The trial has been registered at ClinicalTrials.gov (NCT06320652).
(NCT06320652).
Despite the important role of healthcare services in trauma recovery, many survivors of violence do not seek help. This study aims to examine rates of healthcare utilisation, including differences for physical violence versus rape, gender and physical injury (vs no injury) and obstacles to seeking care within 6 months following incidents of physical violence and rape.
The participants were randomly chosen from the National Population Registry in Norway and invited to participate in a telephone survey on violence exposure and health between June 2021 and June 2022 (N=4299, 49% women).
The sample included 1768 violence-exposed individuals. Of the women (n=749), 82.1% had experienced physical violence and 40.3% had experienced forcible rape. Of the men, most had experienced physical violence (98.6%) and a small percentage had experienced rape (3.5%).
Logistic regression models were used to investigate whether healthcare seeking differed by gender, type of violence (rape vs physical violence) and severity (physical injury). Barriers to accessing healthcare were also investigated using descriptive statistics and content analysis.
Healthcare seeking rates were low after rape (16.9%) and physical violence (24.2%), with somewhat higher rates among individuals experiencing both types of violence (39.9%). There were no statistically significant differences in the odds of healthcare utilisation between the three types of violence exposures when we controlled for gender, physical injury, violence characteristics and sociodemographic factors. Men were more likely than women to have sought healthcare (adjusted OR (aOR): 1.37, 95% CI: 1.02 to 1.85, p=0.042). Physical injury was strongly associated with greater healthcare utilisation (aOR: 6.39, 95% CI: 4.85 to 8.41, p
Few victims seek healthcare shortly after experiencing rape or physical violence. Quantitative and qualitative findings indicate that many seek healthcare exclusively for severe physical injury. These results emphasise the need to improve health services’ outreach to victims of violence, who are at heightened risk of mental health issues and chronic illnesses.
Ages of attainment for early gross motor milestones have been widely studied, but definitions and measurement methods have varied greatly. Since delays in motor milestones have been used extensively as one of the earliest indicators of atypical development, it is imperative to establish a universal understanding of the methods and results reported on motor milestones in typically developing children. Therefore, the primary aim of this scoping review is to provide an overview of recent studies reporting ages of onset for independent sitting and walking in typically developing children worldwide; this will be achieved by summarising how these milestones have been operationalised and evaluated, the samples from whom these data have been drawn, and the reported ages of acquisition.
To meet inclusion criteria, articles must: be original research papers published in any language since 2003, contain a sample of typically developing children and report actual ages of onset for independent sitting and/or walking. To conduct this scoping review, the Joanna Briggs Institute methodological framework will be used. Search terms will include variations of the following concepts: acquisition of motor milestone (independent sitting and/or walking), age of onset, infancy. Six databases (CINAHL Plus, Embase, PsycNet: PsycINFO & PsycArticles, PubMed, Scopus, Web of Science: Core Collection) will be searched. Records from these databases will be screened for eligibility. Two people will independently review each record during title and abstract screening, and three people will independently screen full texts and extract data. Results will be displayed in tables, graphs and narrative summaries in the scoping review.
As the review will only include previously published data, ethics approval is not required. Findings will be shared at scientific conferences and in a peer-reviewed journal.
People with a learning disability face significant health and mortality inequalities as well as wider systemic inequities. Challenges in palliative and end of life care (PEOLC) include communication difficulties, lack of involvement in decision-making and multimorbidity. Early identification of PEOLC needs is challenging, impacting timely care planning. The study aims to (1) understand barriers and enablers to providing high-quality, accessible PEOLC for people with a learning disability, and identify effective service delivery models and interventions and (2) improve PEOLC quality and accessibility by developing robust guidance for health and social care services.
This is a mixed-methods study guided by the NHS England 2021 Ambitions Framework and adopting the Social Model of Disability. There are four workstreams: (1) a retrospective cohort analysis of the Clinical Practice Research Datalink; (2) a rapid scoping review; (3) field work in four study sites across England, involving (a) interviews with senior leaders and commissioners (n=up to 16) and informal stakeholder engagement conversations; (b) ethnographic case studies with people with a learning disability at the end of life (n=up to 20) and retrospective case reviews of people with a learning disability who have died (n=up to 40), using family and staff interviews and (c) development and piloting of methods for enabling systematic identification of PEOLC need, using experience-based co-design and (4) patient and public involvement (PPI) activities and a co-production group of 10 people with a learning disability to support data analysis and outputs. Data will be analysed using adapted framework analysis methodology. This is an inclusive, co-produced study with significant involvement of advisors and researchers with a learning disability as part of the study team.
Ethical approval has been obtained for workstreams 1, 3a and 3b. Significant attention has been paid to ensuring informed consent, making adjustments for capacity. Accessible information and consent forms will be used, involving consultees and adhering to the Mental Capacity Act for participants who lack capacity. Data security will follow General Data Protection Regulation rules. Dissemination will include patient exemplars, guidance and various resources, engaging stakeholders through multiple formats.
researchregistry10500.
To explore the meaning of adaptation after visceral transplantation in terms of patient experiences, symptoms, self-efficacy, transplant-specific and mental well-being.
A convergent parallel mixed-methods study, consisting of interviews and generic as well as transplant-specific questionnaires. Results were integrated using meta-inference.
The study comprises a population of 17 visceral transplant recipients in Scandinavia, 12 women and 5 men with a mean age of 40.6 years (range 19–63 years) and an average follow-up of 9.4 years (range 0–25 years). Data were collected between May 2023 and January 2024 through open-ended in-depth interviews with 12 participants and analysed in accordance with phenomenological hermeneutics. Questionnaires from all 17 participants were analysed to measure transplant-specific well-being, symptoms, self-efficacy as well as anxiety and depressive symptoms.
Being a visceral transplant recipient is a dynamic and life-long adaptation process that comprises two distinct yet interconnected trajectories: coherence and endurance. Coherence involves the person's ability to make sense of their situation and find meaning despite the challenges and adversity of the chronic condition. In contrast, endurance involves a person's capacity to withstand hardship and endure unpleasant or difficult experiences. Both trajectories interact dynamically, influencing and reinforcing each other. Resilience based on coherence enabled acceptance and adjustment. Conversely, uncertainty, resignation and feeling unsupported resulted in a lack of acceptance, manifested as resistance. The challenge involved in adaptation was demonstrated by 47% showing borderline elevated or elevated levels of anxiety and 18% reporting symptoms of depression. Self-efficacy varied considerably.
The meaning of adaptation after visceral transplantation in terms of experiences, symptoms, transplant-specific and mental well-being is balancing between coherence and endurance facilitated by acceptance and hampered by resistance. The uncertainty inherent in being a visceral transplant recipient may lead to heightened self-rated anxiety symptoms and diminished self-efficacy.
What problem did the study adress?
This study adresses the challenges involved in being a visceral transplant recipient and adapting to life after a visceral transplantation.
What were the main findings?
COREQ checklist (consolidated criteria for reporting qualitative research).
No Patient or Public Contribution was organised.
To cross-culturally adapt a framework for person-centred leadership in residential care for older people in Sweden.
This study has an exploratory and descriptive design.
The translation procedure followed a cyclic process of translation into Swedish and back-translation into English by two independent bilingual linguists. An evaluation of conceptual and semantic equivalence and comprehensiveness between the original English version and the translated Swedish version was performed by an expert committee. The translated version of the framework was validated by leaders (n = 34) in residential care, who assessed its relevance through a web form. The adaptation of the framework followed recommended guidelines for cross-cultural adaptation.
The translation procedure resulted in two minor changes related to the wording in two descriptors. The results of the validation procedure showed that the framework is relevant for leaders in Swedish residential care for older people.
The cross-culturally adapted framework is useful and suitable for leaders in Swedish residential care for older people. The framework clarifies the leader's role and identifies leadership attributes and requirements for person-centred leadership in residential care, thereby providing support to leaders by framing person-centred leadership.
The framework can be used as a guide for leadership training and/or development initiatives in residential care. It can be further extended to nursing curriculums, leadership development programs, and organisational performance and development processes. It may also provide a foundation for policy and guidelines by establishing the activities required for leaders to promote person-centredness in the care of older people.
This study followed the STROBE checklist for cross-sectional studies.
There was no patient or public contribution.
The study aimed to examine factors associated with the perceived feeling of safety and postoperative recovery in patients who have undergone orthopaedic day surgery under regional anaesthesia.
The design was quantitative, descriptive, and cross-sectional. The study participants comprised a consecutive sample (n = 209) of patients who underwent orthopaedic day surgery under regional anaesthesia.
A questionnaire was sent to the home addresses of the study population approximately 3 weeks postoperatively. The questionnaire included the Feeling Safe During Surgery Scale (FSS), the Swedish version of the post-discharge surgical recovery scale (S-PSR), and questions concerning background variables. Multivariate regression models were used to examine the association of different variables with both feeling safe and postoperative recovery.
The only factor associated with the feeling of safety was preoperative anxiety; higher levels of preoperative anxiety were associated with lower levels of perceived safety during surgery. The factors associated with postoperative recovery were the recovery process itself and the patient's feeling of safety. Higher levels of postoperative anxiety were associated with a lower level of postoperative recovery. Higher levels of perceived safety during surgery were associated with higher postoperative recovery.
The perceived feeling of safety in the perioperative period could not be explained by factors such as age, gender, or level of education. Based on the results of this study, postoperative recovery was associated with the perceived feeling of safety in the perioperative period. Anxiety in the perioperative period was associated with patients' perceived feeling of safety and their postoperative recovery. Thus, this study's results emphasise the importance of ensuring that people undergoing surgery feel safe to promote their recovery. Based on previous research, the nurse–patient relationship seems to be an important part of making patients feel safe, which ultimately affects their recovery.
This study examines the association between perceived feeling of safety in the perioperative period and patients' postoperative recovery after undergoing orthopaedic day surgery under regional anaesthesia. Previous research has shown that the nurse–patient relationship and patients' possibilities to participate in their care are important for them to feel safe. This study further emphasises the importance of fostering relationships in the perioperative period and making patients an active part in decision-making, as it may positively impact their recovery. Creating a feeling of safety for the patient should be prioritised, as it benefits their perioperative experience and postoperative recovery.
This research is reported in accordance with the STROBE guidelines.
No patient or public contribution.
FreshRSS 