Conectar
Commentary on: Lines. L.E., Bell. A., Hunter. S., Matwiejczyk. L., Williams. J., Kakyo. T. A., Baldwin. C. (2024) Interprofessional education within a nurse practitioner led paediatric service: A multi-methods study
Implications for practice and research Using formal and informal interprofessional education (IPE) offers novel approaches to IPE. More high-quality research is required.
Interprofessional education (IPE) is defined as ‘occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care’ (Barr, p6)
This initiative involved pre-registration nursing and allied-health...
Commentary on: Platz K, Metzger M, Cavanagh C, et al. Initiating and continuing long-term exercise in heart failure: A qualitative analysis from the GEtting iNTo Light Exercise-Heart Failure Study. J Cardiovasc Nurs; 2024 Feb 26. doi: 10.1097/JCN.0000000000001086. Epub ahead of print. PMID: 38411493
Implications for practice and research When clinicians have a better understanding of patient decisions regarding exercise, they are better equipped to redesign traditional cardiac exercise programmes. Themes from this study provide frameworks to design future quantitative and mixed-method studies that will inform clinicians about the patient experience with cardiac exercise programmes.
Management of heart failure (HF) is a challenge, with less than one-third of patients meeting physical activity recommendations.
Oncology nurses are frequently subjected to significant psychological stress due to the demanding nature of cancer care, which negatively impacts their mental and physical health as well as the quality of patient care. Although Mindfulness-Based Stress Reduction has been demonstrated to be effective in alleviating stress, practitioners often encounter barriers such as limited engagement and difficulty maintaining regular practice.
To enhance engagement and adherence, we integrated art elements into the Mindfulness-Based Stress Reduction framework, creating the Mindfulness-Based art therapy program, and evaluated its effectiveness among oncology nurses.
A three-arm randomized controlled trial.
90 oncology nurses participated (Mindfulness-Based Art Therapy group = 30, Mindfulness-Based Stress Reduction group = 30, waitlist controls group = 30) in an 8-week program. Stress, anxiety, depression, fatigue, and mindfulness levels were assessed at baseline, immediately after the fourth week of intervention, and immediately after the intervention concluded. Compliance and satisfaction were evaluated using attendance rates and satisfaction questionnaires. Descriptive statistics were used to analyze general data; intervention effects were compared using one-way ANOVA and generalized estimating equations, and compliance and satisfaction were compared using independent samples t-test.
Both Mindfulness-Based Art Therapy and Mindfulness-Based Stress Reduction significantly improved stress, physiological markers, and mindfulness vs. controls. Mindfulness-Based Stress Reduction better reduced depression (β = −2.980, 95% CI: −5.427, −0.533, p = 0.017), while Mindfulness-Based Art Therapy was superior for fatigue (β = −11.582, 95% CI: −20.615, −2.550, p = 0.012). Mindfulness-Based Art Therapy had higher adherence (93.3% vs. 73.3%, p < 0.05) and satisfaction (3.27 ± 0.45 vs. 2.40 ± 0.52, p = 0.01).
For oncology nurses, Mindfulness-Based Art Therapy is as effective as Mindfulness-Based Stress Reduction for improving stress and mindfulness, while providing greater adherence, satisfaction, and more consistent fatigue reduction.
Chinese Clinical Trial Registry, ChiCTR2300078124 (http://www.chictr.org.cn), 30/11/2023
by Xiuxin Liu, Yuhui Han, Ruixue Kuang, Wenjiong Sheng, Yan Zhang, Xinyu Jia, Xiaoxiao Gao, Yanchao Ma
DNA damage-induced by radiotherapy is a critical factor in promoting the death of colorectal cancer cells (CRC). Although high mobility group box 1 (HMGB1) reportedly plays a vital role in tumor radioresistance by modulating DNA damage repair, the precise mechanisms remain unclear. In this study, HMGB1 knockdown markedly enhanced cell apoptosis after radiation. HMGB1 downregulation significantly inhibited DNA damage repair and reactive oxygen species (ROS)-mediated redox homeostasis after irradiation in CRC cells. Mechanistically, HMGB1 interacts with KU70 via its region spanning residues 95–163. This interaction subsequently activates the non-homologous end joining (NHEJ) pathway to facilitate DNA damage repair, ultimately leading to reduced radiation-induced cell apoptosis. KU70 silencing showed the same effect as HMGB1 depletion mediated cell apoptosis and DNA damage response both in vitro and in vivo. Additionally, HMGB1 and KU70 were overexpressed in CRC tissues. Analysis of the GEPIA database indicated that elevated levels of both genes showed a trend toward association with poor patient prognosis, although this did not reach statistical significance. The current study revealed that HMGB1 may promote DNA damage repair through KU70 and its mediated NHEJ pathway to affect apoptosis in CRC cells after irradiation. Thus, targeting the HMGB1/KU70/NHEJ axis may be a potential therapeutic target to promote the response of CRC to radiotherapy and in-depth study of the specific mechanism of this axis in CRC radioresistance will help to the develop more effective treatment strategies.Outcomes for degenerative cervical myelopathy (DCM) patients are limited by delayed and missed diagnoses, driven in part by poor professional awareness. Despite DCM being the most common cause of adult spinal cord injury, it remains under-recognised and undertaught in clinical education. Lessons from other common pathology like stroke and acute myocardial infarction highlight the potential of education to improve early diagnosis. This study will develop a professional education strategy to improve early DCM diagnosis. It will define key audiences and identify an effective delivery method, laying the groundwork for a sustained, targeted intervention.
The study aims to define who needs to know about DCM, what they need to know and how they can learn it. This will be carried out in three phases: phase 1—who and what: to establish the target population and to define core competencies for the educational intervention; phase 2—how: to create and review the educational intervention; phase 3—evaluation: to test whether the framework is an improvement to existing strategies.
Ethical approval is in place from the University of Cambridge (HBREC.2024.24). Results from the study will be disseminated through scientific publication, conference presentation, blog posts and podcasts.
CRD42023461838
In May 2023, the US Food and Drug Administration (FDA) initially approved an AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine (adjuvanted RSVPreF3) for adults aged ≥60 years. The approval was expanded in June 2024 to include adults 50–59 years of age at increased risk for RSV-associated lower respiratory tract disease. In this paper, we describe the protocol of a postmarketing safety study evaluating the association between adjuvanted RSVPreF3 and new-onset Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM) and atrial fibrillation (AF) among adults ≥50 years of age in the USA and provide our rationale for key methodological decisions.
The potential associations between adjuvanted RSVPreF3 and GBS, ADEM and AF will be evaluated using secondary healthcare data and the self-controlled risk interval (SCRI) design. Data from five research partners in the USA spanning August 2023 through June 2030 will be used for the conduct of yearly monitoring queries and, sample size permitting, SCRI analyses. Claims-based definitions for new-onset outcomes (first diagnosis in 365 days) are: ≥1 inpatient diagnosis for GBS and ADEM; ≥1 inpatient or ≥2 ambulatory/emergency diagnoses for AF. The primary risk and control windows are 1–42 and 43–84 days, respectively, for GBS and ADEM; and 1–8 and 9–16 days for AF. SCRI analyses for GBS and ADEM will include chart-confirmed cases. SCRI analyses for AF will adjust for the positive predictive value obtained from validation against charts. Conditional Poisson regression will be used to calculate incidence rate ratios.
This study was approved by the Institutional Review Boards (IRB) of Harvard Pilgrim Health Care Institute; WIRB-Copernicus Group, Inc and its affiliates (collectively, ‘WCG’); WCG IRB, Inc; and Sterling IRB, with Federal Wide Assurance (FWA) numbers FWA00000100, FWA00033319 and FWA00025632, respectively, for all participating research partners. Study results will be shared with the US FDA and publicly disseminated through national or international clinical or scientific conferences and peer-reviewed publications.
This protocol has been registered in the Heads of Medicines Agencies–European Medicines Agency Real World Data Catalogues (EUPAS1000000486).
This prospective community-based cohort study (Acute Respiratory Infection Epidemiological Characteristics Assessment Study (ARI-ECAS)) aims to systematically monitor acute respiratory infection (ARI) incidence, characterise multiple pathogen coinfection patterns and explore microbial landscape dynamics in Shanghai’s general population. By integrating syndromic surveillance, molecular diagnostics and metagenomic sequencing, the study seeks to enhance understanding of ARI epidemiology, seasonal variation and host–pathogen interactions to inform predictive modelling and optimise public health interventions in high-density urban environments.
The study enrolled 15 199 permanent residents from all 16 districts of Shanghai, with baseline oropharyngeal swab samples across five representative districts (Xuhui, Jing’an, Jiading, Songjiang and Fengxian). Inclusion criteria required residency ≥6 months and consent for weekly follow-ups. Exclusion criteria addressed mobility limitations (planned relocation >6 months) and recent ARI history. Participants provided demographic, behavioural and clinical data via the Shanghai Health Cloud platform, with baseline and symptomatic-phase biological samples collected for analysis.
During the initial 8-month surveillance period (May 2024–January 2025), the ARI-ECAS cohort demonstrated critical insights into the epidemiology of acute respiratory infections in Shanghai’s urban communities. Among 15 199 participants, 10.96% reported symptomatic episodes, of whom 21.43% experienced recurrent infections. Pathogen detection using targeted next-generation sequencing (tNGS) identified microbial aetiologies in 53.52% of symptomatic cases, revealing a high prevalence of coinfections: 27.96% involved dual pathogens, while 33.01% showed polymicrobial interactions (≥3 pathogens). Notably, 85.09% of symptomatic episodes were self-managed, underscoring a low healthcare-seeking rate (14.91%) consistent with patterns observed in urban China during postpandemic transitions.
The current phase of data collection will conclude in June 2025; however, syndromic surveillance and tNGS protocols will be sustained to capture multiyear seasonal transmission patterns. To enhance comparative rigour, future protocols will aim to collect samples from participants during asymptomatic periods in the subsequent year to serve as seasonal baseline controls. Building on this foundation, the study will integrate contact behaviour and mobility surveys to quantify parameters critical for understanding pathogen transmission dynamics (eg, household contacts and public transportation usage). Furthermore, pathogen detection and metagenomic data will be combined with transcriptomic and metabolomic profiling in selected cases to model multipathogen interaction networks and delineate host immune response pathways, thereby advancing mechanistic insights into polymicrobial cocirculation.
Cancer in adolescents and young adults (AYAs; ages 15–39 years) is a rising global epidemic. Yet, AYAs remain an understudied population, and little is known about what research topics should be prioritised according to those with lived experience. The AYA Cancer Priority Setting Partnership (PSP) was established to identify the top 10 research priorities for AYA cancer in Canada according to patients, caregivers, and clinicians.
This project followed the James Lind Alliance (JLA) Priority Setting Partnership (PSP) methodology that included two national cross-sectional surveys and a final priority setting workshop following an adapted nominal group technique.
A national sample was recruited to participate from across Canada.
Participants were patients, caregivers, and clinicians with lived personal and/or professional experience of AYA cancer in Canada.
In the first survey, open-ended responses were collected from participants about questions they would like answered by research. Responses were collated into overarching summary questions and a literature search was undertaken to verify if questions were true uncertainties and not fully answered by existing evidence. Unanswered questions were ranked by participants in a second survey. The top-ranked questions were prioritised through consensus at the final priority setting workshop. The final outcome was the top 10 priorities for AYA cancer research in Canada.
In the initial survey, 1916 potential research questions were submitted by 275 patients, caregivers, and clinicians. Following data processing, summary question formation, and the evidence check, 58 questions were put forward for interim prioritisation in a second survey (n=285 patients, caregivers, and clinicians). The top 20 questions from the interim prioritisation were ranked at the final priority setting workshop attended by a diverse group of 23 patients, caregivers and clinicians from across Canada. The resulting top 10 priorities reflect topics across the cancer continuum including: diagnostic delays, screening and early detection, novel therapies, psychosocial impacts, end-of-life concerns, and survivorship issues.
This patient-directed research agenda will guide researchers, funding agencies, and policymakers to ensure that future research is aligned with what matters most to the AYA cancer community.
To determine the predictors of pressure injuries among residents living in Sri Lankan nursing homes.
A prospective multi-site longitudinal cohort study design.
Semi-structured observations and chart audits were used to gather data on 17 predictors of pressure injury from a consecutive sample of 210 residents (aged ≥ 60 years old) from nine nursing homes in Sri Lanka. Data were collected at baseline and followed up every week until the study endpoint: a new pressure injury or reaching the maximum 12 weeks of data collection, from July to October 2023. Validated semi-structured data collection forms and chart audits were utilised. Binary logistic regression was used to identify the predictors of pressure injuries. Generalised linear mixed models were used to assess the association between predictors and the development of new pressure injuries.
The cumulative incidence of pressure injuries was 17.1% (36/210) during the 12 weeks. The number of medical devices and baseline pressure injuries predicted the development of new pressure injuries. Each additional medical device increased the likelihood of developing a pressure injury by 2.3-fold, and individuals with a baseline pressure injury were 2.1 times more likely to develop a new pressure injury.
Multiple medical devices and baseline pressure injuries are predictors of pressure injury in older residents living in nursing homes.
This study provides evidence of pressure injury predictors among older residents living in nursing homes. Early identification of high-risk residents with an existing pressure injury and those with multiple medical devices is important for nurses and managers at nursing homes. Accurately assessing residents' risk of a pressure injury may result in implementing various preventive strategies that may ultimately help prevent future pressure injuries.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cohort studies guidelines.
No patient or public contribution.
To identify implementation strategies that effectively facilitate the adoption of social needs care coordination activities using enabling technologies among care management teams serving patients in community-based health centres.
Modified Delphi process.
Discrete, feasible implementation strategies were identified through literature review and semi-structured interviews with care management staff and subject matter experts in clinical informatics, workflow redesign, and product engineering. A modified Delphi was conducted with eight subject matter experts and nine health centre care management staff. Iterative rounds of online surveys were used to achieve consensus on the most relevant implementation strategies and their delivery methods.
The modified Delphi process achieved consensus on nine discrete implementation strategies needed to advance care management teams' ability to screen, refer and track social needs. Prioritised strategies included developing champions, enhancing quality improvement capacity, training staff on using enabling technologies and providing tailored technical assistance for workflow refinement. Consensus was also reached on a monthly cadence for most of the implementation strategies.
Consensus was reached on strategies to enhance care management teams' implementation of social needs screening, referrals and tracking using enabling technologies. These strategies will comprise an intervention to be pilot tested, refined and assessed in a cluster randomised clinical trial.
Findings from this study will inform the development of strategies to further the adoption of enabling technologies to support social needs care coordination.
This work is key to the design of a type 2 hybrid implementation-effectiveness trial that will assess whether user-informed, evidence-based implementation strategies can improve care management teams' adoption of enabling technologies to facilitate social needs care coordination for patients.
The research team includes a patient advisor with community-based nursing expertise and a nurse practitioner-clinical informaticist leader who was involved in data collection and interpretation of findings.
Trial registration: Clinicaltrials.gov registration # NCT06489002. Registered July 5, 2024, https://clinicaltrials.gov/study/NCT06489002?term=NCT06489002&rank=1.
To analyse the current status of psychological resilience in Parkinson's disease (PD) patients and its correlation with social support and coping style.
A cross-sectional study.
PD patients hospitalized in a tertiary-level hospital in Shijiazhuang, Hebei Province, from March 2022 to March 2023 were selected for the study using the convenience sampling method. A general information questionnaire, psychological resilience scale, Medical Coping Modes Questionnaire and Perceived Social Support Scale were used to investigate 111 cases of PD. SPSS 25.0 software was used for statistical analysis. The data were analysed using independent samples t-test, one-way ANOVA, multiple linear regression analysis and the Pearson correlation coefficient.
Parkinson's disease patients have a moderate level of psychological resilience. The results of the Pearson correlation analyses showed that the level of psychological resilience was positively correlated with social support and confrontation and was negatively correlated with avoidance and acceptance-resignation. The results of multiple linear regression analysis showed that social support and acceptance-resignation were the influencing factors of psychological resilience in PD patients.
The psychological resilience of PD patients is at a moderate level. Social support and acceptance-resignation are the factors influencing the psychological resilience of PD patients.
This study analysed the level of psychological resilience in PD patients and its correlation with social support and coping style from the perspective of positive psychology to provide some reference for targeted clinical interventions. Our study found that social support and acceptance-resignation are influential factors in psychological resilience in PD patients. Medical staff should encourage patients to face the disease positively and their social support should be increased in order to improve their level of psychological resilience.
No patient or public contribution.
To explore the practical experiences and perceived needs of healthcare professionals in fostering resilience among bereaved parents.
A qualitative descriptive study was conducted.
Twenty-seven healthcare professionals were recruited from the Paediatric Palliative Care Special Group of the Paediatrics Society of the Chinese Medical Association. The participants included 9 physicians, 7 nurses and 11 social workers from 22 hospitals and 5 community-based services. In-depth interviews were conducted between July and December 2022. Data were analysed using content analysis.
Guided by the Society-to-Cells Resilience Theory, this study identified 10 categories of practical experiences and seven of perceived needs, encompassing multiple levels: society (integrating multidisciplinary resource; preserving relevant cultural tradition; advocating for system enhancements; raising public awareness), community (establishing an accessible support network; fostering an inclusive community; offering proactive community support), family (providing anticipatory guidance; enhancing family cohesion; navigating bereavement resources; providing ongoing follow-up and support), individual (evaluating grief-related experiences; offering tailored personal support; sustaining connections; addressing spiritual needs) and physiological (managing body reactions; maintaining physical well-being).
This study provides insights from healthcare professionals, highlighting practices and identifying significant gaps in current approaches to building resilience in bereaved parents. The findings suggest that resilience is a socially constructed, multidimensional process that can be nurtured through a holistic approach to better support this vulnerable group.
The study's findings lay the foundation for developing targeted interventions to foster resilience among bereaved parents. A holistic, empowering approach is essential to strengthen their coping mechanisms and facilitate healing at multiple levels, ultimately contributing to the creation of a robust, effective support system for this resilient yet vulnerable population.
This study was about the experiences and perceptions of healthcare providers. It was designed and conducted by researchers who were both researchers and healthcare providers.
To explore the prescribing practices and behaviours of Advanced Practice Nurses (APN) and pharmacist prescribers in Singapore, assess their confidence in key prescribing competencies, examine their use of information sources, and understand their views on the consequences of prescribing errors.
Cross-sectional national survey.
A census survey of all registered APN and pharmacist prescribers in Singapore was conducted from February to May 2024 using a validated 96-item instrument. The survey assessed prescribing practices, confidence in prescribing competencies, use of information sources, and prescribing safety. Descriptive statistics were used for analysis.
Ninety-one prescribers (54 APNs, 37 pharmacists) responded (32% response rate), most of whom worked in public medical/surgical settings. Prescribing comprised a median of 75% of their practice. Most time was spent prescribing continued medications, with less on initiating new medicines. Participants reported high confidence in communication, therapeutic partnerships, and working within professional standards. Greatest confidence was seen in educating patients, legal prescribing, and monitoring treatment response. Lower confidence was noted in complementary medicine-related tasks. Professional literature and colleagues were the most valued information sources. Most participants acknowledged the serious consequences of prescribing errors, though many believed such errors would likely be intercepted.
APNs and pharmacists demonstrate strong competencies in safe, holistic prescribing. However, cultural factors may limit patient engagement, highlighting the need to strengthen shared decision-making and collaborative practice.
Refining governance structures, adopting tiered prescriber autonomy, and enhancing training in complex prescribing are essential. Standardising deprescribing, improving access to decision-support tools, and promoting interprofessional collaboration and patient involvement can strengthen care quality and team-based delivery.
This study offers the first national insight into Singapore's Collaborative Prescribing Framework and informs training, policy, and workforce development for non-physician prescribers locally and in similar international contexts.
STROBE checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
Death preparedness is an important prerequisite for improving the quality of life and the quality of death in advanced cancer patients. However, research on the level of death preparedness in patients is insufficient, and there is little understanding of the current status and influencing factors of death preparedness in advanced cancer patients.
This study aims to assess the current status of death preparedness and its influencing factors in advanced cancer patients.
Based on the PRECEDE-PROCEED model, a structured survey questionnaire was designed to collect data on personal factors (such as gender, age and residence area), interpersonal factors (such as social support, caregiver readiness and healthcare worker readiness) and social factors (such as care resources, policy support and information supply). Through multiple linear regression and BP neural network analysis, the study explores the impact and significance of these influencing factors on death preparedness in advanced cancer patients.
A total of 930 valid questionnaires were collected in this study. The death preparedness score in advanced cancer patients was 72.18 ± 22.82, indicating a moderate level, with the highest score being the ‘reflexive care’ dimension and the lowest score being the ‘hospice programme’ dimension. Multivariate analysis revealed that meaning in life and social support were the most significant predictors of death preparedness in advanced cancer patients. In addition, personal factors such as dignity, household income and coping style, also played an important role. Interpersonal factors like social support, as well as social factors such as care resources and policy support, also had an impact on patients' death preparedness to some extent.
Death preparedness in advanced cancer patients is generally at a moderate level, and death preparedness is influenced by a combination of personal factors, interpersonal factors and social factors.
This study is based on the PRECEDE-PROCEED model to comprehensively explore the influencing factors of death preparedness in advanced cancer patients. It provides theoretical support for improving life services for advanced cancer patients. It offers valuable practical experience and insights for societal attention and reform in end-of-life care.
No Patient or Public Contributions were included in this paper.
To consolidate the best evidence on digital therapeutic interventions for self-management in patients with hip fragility fractures, providing a foundational guide for clinicians in developing digital therapy-based self-management plans.
Integrative review.
A comprehensive electronic search was conducted across multiple databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Chinese databases like China National Knowledge Infrastructure and SinoMed. This study retrieved papers published from the establishment of the database to September 2023.
Studies were selected based on inclusion criteria, such as relevance to hip fragility fractures and self-management through digital therapies. Quality assessments were conducted independently by two reviewers using established tools for each type of study, ensuring the inclusion of high-quality evidence.
Fifteen studies were included: 4 guidelines, 5 expert consensus documents, 5 systematic reviews and 1 evidence summary. From these, 26 best practices were identified across 4 domains: digital design, self-management influencing factors, intervention plans and intervention content.
This integrative review provides a comprehensive, evidence-based summary of digital therapeutic interventions for self-management in patients with hip fragility fractures. The findings offer healthcare professionals a scientific basis for integrating digital therapy into clinical practice, highlighting its potential to enhance patient self-management.
This review underscores the value of digital therapies in empowering patients to take an active role in their rehabilitation, potentially improving adherence to self-management strategies and long-term outcomes.
No patient or public contribution was used for this study.
To identify and evaluate the magnitude of the association between caregiver psychosocial factors and depressive symptoms among people with dementia.
Systematic review and meta-analysis.
A systematic review with meta-analysis used a random-effects model to estimate the effect size.
Medline, PsycINFO, CINAHL, Scopus and Embase databases were searched for peer-reviewed studies from inception to 25 November 2023.
The review included 88 articles, with 61 selected for meta-analysis. Seven caregiver psychosocial factors were determined for the meta-analysis: caregiver quality of life, distress, positive aspects of caregiving, depression, burden, quality of the relationship and anxiety.
This study suggested that depressive symptoms in people with dementia were associated with caregiver quality of life, distress, burden, depression and positive aspects of caregiving.
Recognising the association between caregiver psychosocial factors and depressive symptoms in people with dementia has essential nursing implications. Adopting family-centred care models and integrating respite care and psychological support for caregivers can help improve patient outcomes and overall dementia care.
This study highlights the association between caregiver psychosocial factors and depressive symptoms in people with dementia. Caregiver distress, burden and depression were linked to increased depressive symptoms in people with dementia, while caregiver quality of life and positive aspects of caregiving were associated with depressive symptoms in people with dementia. These findings underscore the need for tailored interventions to enhance dyadic health.
This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
There was no patient or public contribution.
This review was registered in PROSPERO (2024 CRD42024511383).
In China, government-funded free treatment programmes have substantially expanded access to mental healthcare for patients with severe mental illnesses (SMIs). However, the effectiveness and patient satisfaction associated with these programmes can vary significantly. Understanding the factors underlying these variations is crucial for optimising patient adherence and rehabilitation outcomes.
To identify factors influencing SMI patients' satisfaction with a government-funded free treatment programme in District S, Nanjing, China, and propose targeted measures to enhance the programme's effectiveness and improve patient outcomes.
A cross-sectional study.
This study was conducted in 23 community healthcare centres in District S, Nanjing, China, from January to July 2022. A total of 924 SMI patients enrolled in the programme were selected using a two-stage random sampling method. Data on patients' individual characteristics, health behaviours and satisfaction with the programme were collected by a self-developed structured questionnaire. Guided by Andersen's Behavioural Model, hierarchical logistic regression analysis was employed to determine factors associated with patient satisfaction.
Among the 924 valid responses, 51.3% of patients with SMIs reported low satisfaction with the programme. Factors associated with patient satisfaction included individual predisposing, enabling, need and health behaviour variables. Specifically, patients who were employed, had schizophrenia, experienced adverse drug reactions, feared program exposure of their condition and received treatment in hospital were more likely to report lower satisfaction.
This study revealed that satisfaction among SMI patients with the programme remains low, with patient satisfaction primarily determined by individual need and health behaviour factors. Policymakers and stakeholders should implement targeted measures to address these factors and improve patient satisfaction.
The findings offer new insights and scientific bases for policymakers seeking to improve the programme and practical recommendations for stakeholders to develop effective solutions.
STROBE guidelines.
No patient or public contribution.
To evaluate the effects of the organisational environment on hospital discharge readiness during public health emergencies.
An observational study.
A regression-discontinuity design approach was employed to assess the impact of the organisational environment on hospital discharge readiness. Adult patients diagnosed with acute myocardial infarction and discharged from the Cardiac Critical Care Unit of a tertiary hospital in Shanghai, China, were recruited. Spearman correlation analysis was conducted to examine the associations between multiple factors at individual and organisational levels and hospital discharge readiness across three stages of pandemic policy changes.
A total of 411 patients were included in the analysis. The regression-discontinuity analysis revealed a significant discontinuity at the cut-off, indicating that policy-driven changes in the organisational environment during public health emergencies were associated with a 21.61% reduction in hospital discharge readiness. Additionally, family functioning and the quality of nursing discharge education were significantly associated with discharge readiness across all three pandemic stages.
These findings demonstrate that patient-perceived hospital discharge readiness is significantly influenced by changes in the organisational environment during public health emergencies. Future research should focus on developing targeted discharge preparation programmes that allow for organisational adaptation in response to emergencies, such as pandemics or natural disasters.
Organisational responses to public health emergencies need to prioritise enhancing discharge preparedness. This includes bolstering family involvement and ensuring that nurses are adequately trained to provide effective discharge education, especially when healthcare resources are strained.
The findings underscore the importance of adaptable and resilient discharge planning and transitional care, particularly in public health emergencies. Fostering an organisational environment that supports seamless discharge processes can significantly improve patient readiness for post-hospital care.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
No patient or Public Contributions.
This study aims to explore the mediating role of resilience and perceived social support in the relationship between gratitude and the work reintegration adaptability of cancer patients in China.
A cross-sectional and correlational study.
A total of 402 participants were collected from July to December 2023 from a tertiary hospital in Jiangsu Province, China, using a convenience sampling method. The survey utilised the General Information Questionnaire, the Gratitude Questionnaire-6 (C-GQ-6), the Cancer Patient Return-to-Work Adaptation Scale, the resilience Scale (CD-RISD), and the Perceived Social Support Scale (PSSS) to collect data. The theoretical hypothesis was tested using structural equation modelling (SEM) analysis, with model fit corrections performed to examine the internal relationships and pathways among gratitude, resilience, perceived social support and return-to-work adaptability.
Gratitude, resilience, and perceived social support were significantly correlated with work reintegration adaptability. Resilience and perceived social support independently mediate the relationship between gratitude and work reintegration adaptability, with mediation effects of 56.63% and 7.77%, respectively. Additionally, resilience and perceived social support fully mediate the relationship between gratitude and work reintegration adaptability, with a chain mediation effect of 35.60%.
Gratitude can affect cancer patients' return to work adaptation through resilience and perceived social support.
Healthcare professionals should focus on the impact of gratitude on cancer patients' adaptability to work reintegration. Interventions targeting resilience and perceived social support should be developed to enhance patients' work reintegration and promote their overall recovery and social reintegration.
STROBE checklist.
No patient or public contribution.
FreshRSS 