Conectar
Tobacco use accounts for approximately 1.35 million deaths annually in India, disproportionately affecting low-income individuals, men, rural residents, those without formal education and groups of low socioeconomic status (SES). Despite progress in tobacco control, scalable, low-cost solutions, such as brief advice interventions, are needed. This study explored priority implementation determinants for adapting an evidence-based brief advice/counselling intervention for high-reach, low-resource settings in Mumbai, India. The focal settings (health-focused and tuberculosis-focused non-governmental organisations (Health NGOs and TB NGOs) and dental clinics) served low-SES populations.
Mumbai-based and US-based team members conducted a qualitative study employing semistructured interviews to gather data from four groups connected to Health and TB NGOs and dental clinics: (1) 15 patients, (2) 33 practitioners, (3) nine practice leaders and (4) three policymakers. We used a team-based, critical, reflexive thematic analysis approach to analysis, grounded in the Exploration, Preparation, Implementation and Sustainment framework. We managed data with Nvivo software.
Participants were supportive but highlighted diverse challenges and supports required for implementing the intervention in these diverse settings. First, many noted that societal constraints such as economic insecurity and cultural factors were expected to limit tobacco control efforts for low-SES populations. Second, setting-specific intervention adaptations were identified as necessary to support integration and ensure access to support for all patients. Various participant groups highlighted different adaptation areas. For example, patients noted that tobacco was part of their routines and social lives, practitioners emphasised the need to design implementation plans that support integration alongside existing needs, and policymakers highlighted the need for uniform implementation strategies.
Adapting brief advice/counselling interventions for Health NGOs, TB NGOs and dental clinics in Mumbai will require strategic communication to support buy-in, thoughtful workflow integration and changes to funding and support mechanisms for organisations so meaningful reductions in tobacco use can be achieved among low-SES groups. In other words, there is a need to adapt both the intervention and the implementing system to allow for brief advice/counselling to contribute to broader tobacco control efforts.
R01 CA230355.
This study aimed to examine the level of vicarious posttraumatic growth among intensive care unit nurses in China and explore the mediating role of death coping ability in the relationship between moral resilience and vicarious posttraumatic growth.
A multicentre, cross-sectional study was conducted in accordance with the STROBE guidelines.
Between January and March 2025, a questionnaire survey was conducted among 666 intensive care unit nurses from nine tertiary Grade A hospitals across five provinces in China. Participants completed three standardised instruments: the Rushton Moral Resilience Scale, the Coping with Death Scale–Short Version, and the Vicarious Posttraumatic Growth Inventory. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, and correlation analyses, and employed AMOS 27.0 to perform structural equation modelling for testing mediation effects.
Intensive care unit nurses demonstrated a moderate level of vicarious posttraumatic growth. Moral resilience was positively associated with both death coping ability and vicarious posttraumatic growth. Death coping ability was found to play a partial mediating role in the relationship between moral resilience and vicarious posttraumatic growth.
Moral resilience and death coping ability are key factors associated with vicarious posttraumatic growth among intensive care unit nurses. Nurses with stronger moral resilience are more likely to cope constructively with death-related stress, which may support psychological growth in trauma-intensive environments.
This study highlights the need to enhance intensive care unit nurses' moral and emotional capacities through ethics education, emotional coping training, and institutional support strategies. Strengthening these competencies may foster professional development and mental wellbeing in critical care settings.
In the era of ‘Undetectable = Untransmittable’ (U=U), reductions in condom use and increases in casual partnerships may contribute to elevated risks of coinfection with other sexually transmitted infections (STIs) and HIV super-infections among men living with HIV. These trends may reflect a shift in personal attitudes towards sexual behaviour and HIV risk, yet their influence on actual behaviours remains unclear.
To investigate how changes in personal attitudes and safe sex self-efficacy influence sexual decision-making.
Two-wave longitudinal study design.
We conducted a 3-month longitudinal study from March to December 2023 among HIV-positive men (≥ 18 years) initiating ART in Changsha, China. Cross-lagged panel analysis and half-longitudinal mediation analysis were used to examine how changes in personal attitudes influenced sexual behaviours.
427 men living with HIV were included at baseline, and 301 completed the follow-up survey. Sexual behaviours were associated with personal attitudes, namely safe sex fatigue, viral load/transmission beliefs, and sexual sensation seeking. More positive personal attitudes in these domains at baseline predicted lower safe sex self-efficacy over 3 months, while reduced baseline self-efficacy increased the likelihood of engaging in condomless sex and/or multiple sexual partners. All three personal attitude domains had significant indirect effects on sexual behaviours via safe sex self-efficacy.
In the era of U=U, the changed personal attitudes among men living with HIV may lead to the increased likelihood of engaging in condomless sex and/or having multiple sexual partners, and safe sex self-efficacy serves as a mediator in this relationship.
This study highlights the potential influence of attitudinal changes on sexual behaviours among men living with HIV in the ‘U=U’ era. Findings provide valuable evidence for developing more targeted interventions that address not only behavioural outcomes but also underlying personal attitudes.
No patient or public contribution.
by Yanxuan Wu, Fu Li, Hao Chen, Liang Shi, Meng Yin, Fan Hu, Gongchang Yu
BackgroundMetabolic syndrome (MetS) and sarcopenia are major global public health problems, and their coexistence significantly increases the risk of death. In recent years, this trend has become increasingly prominent in younger populations, posing a major public health challenge. Numerous studies have regarded reduced muscle mass as a reliable indicator for identifying pre-sarcopenia. Nevertheless, there are currently no well-developed methods for identifying low muscle mass in individuals with MetS.
MethodsA total of 2,467 MetS patients (aged 18–59 years) with low muscle mass assessed by dual-energy X-ray absorptiometry (DXA) were included using data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES). Least Absolute Shrinkage and Selection Operator (LASSO) regression was then used to screen for important features. A total of nine Machine learning (ML) models were constructed in this study. Area under the curve (AUC), F1 Score, Recall, Precision, Accuracy, Specificity, PPV, and NPV were used to evaluate the model’s performance and explain important predictors using the Shapley Additive Explain (SHAP) values.
ResultsThe Logistic Regression (LR) model performed the best overall, with an AUC of 0.925 (95% CI: 0.9043, 0.9443), alongside strong F1-score (0.87) and specificity (0.89). Five important predictors are displayed in the summary plot of SHAP values: height, gender, waist circumference, thigh length, and alkaline phosphatase (ALP).
ConclusionThis study developed an interpretable ML model based on SHAP methodology to identify risk factors for low muscle mass in a young population of MetS patients. Additionally, a web-based tool was implemented to facilitate sarcopenia screening.
Although multicomponent exercise is a popular nonpharmacological treatment, its effects on cognition vary across studies because of the diversities in exercise combinations. Identifying the most effective combination is of great importance to the prevention and treatment of cognitive impairment.
To compare and rank the efficacy of various multicomponent exercise interventions on cognition in people with cognitive impairment.
We searched PubMed, Web of Science, Embase, Cochrane, SPORTDiscus and PsycInfo databases up to April 2025 for eligible randomised controlled trials about multicomponent exercise interventions in people with cognitive impairment. Primary outcome was global cognition, with secondary outcomes being executive function and memory. Pairwise and network meta-analyses were performed using random-effects models.
Twenty-five trials involving 2298 participants were included. Pairwise meta-analyses showed multicomponent exercise interventions were effective on global cognition (standardised mean difference (SMD) = 0.59; 95% confidence interval (CI): 0.30, 0.89; p < 0.001) and executive function (SMD = 0.28; 95% CI: 0.12, 0.45; p < 0.001). Network meta-analyses revealed that aerobic exercise (AE) + balance & flexibility (BF) training had the highest probability (70.8%) of being the optimal exercise combination for global cognition (SMD = 1.07; 95% CI: 0.23, 1.90; p = 0.016), and AE + resistance exercise (RE) had the highest probability (43.1%) of being the optimal exercise combination for executive function (SMD = 0.56; 95% CI: 0.03, 0.10; p = 0.042). We did not observe significant effects of multicomponent exercise on memory.
AE + BF training is likely the most effective multicomponent exercise combination for global cognition, while AE + RE showed the optimal effect on executive function in people with cognitive impairment.
Our study contributes to guiding clinical professionals to design and conduct targeted multicomponent exercise interventions as per individual cognitive impairment characteristics to protect individual cognition.
No patient or public contribution applies to this work.
The study protocol was registered with PROSPERO (CRD42023489517).
In recent years, the critical role of health literacy in diabetes management has become increasingly prominent. The aim of this study was to investigate the impact of social support on health literacy among patients with diabetes, to test the mediating role of self-efficacy and empowerment between social support and health literacy, and the moderating role of eHealth literacy.
A cross-sectional study conducted between August 2023 and June 2024.
This study adopted the cluster sampling method and conducted a questionnaire survey among 251 patients with diabetes in a tertiary hospital in Wuhu City, Anhui Province. The questionnaires included the Social Support Rating Scale, the Self-Efficacy for Diabetes scale, the Health Empowerment Scale, the eHealth Literacy Scale and the Diabetes Health Literacy Scale.
Social support was positively associated with health literacy in patients with diabetes. Self-efficacy and empowerment mediated the relationship and formed chained mediation pathways respectively. eHealth literacy has a moderating role between self-efficacy and empowerment.
The results revealed that social support influences health literacy among patients with diabetes through the mediating pathways of self-efficacy and empowerment, and that this process is moderated by eHealth literacy. These findings provide a theoretical basis and practical insights for improving health literacy among patients with diabetes.
Enhancing health literacy among people with diabetes by strengthening social support, self-efficacy and empowerment levels, while focusing on the technology-enabling role of eHealth literacy in this context.
This study adheres to the relevant EQUATOR guidelines based on the STROBE cross-sectional reporting method.
We thank all patients who participated in the study for their understanding and support.
This study aims to examine the chain-mediating effects of affective reactions and burnout on the relationship between workplace violence and work performance among nurses while distinguishing between physical and psychological violence.
A longitudinal study was conducted between October 2020 and October 2022. The study took place in four tertiary hospitals of Shandong Province, China. A total of 1086 nurses were recruited.
Workplace psychological violence, workplace physical violence, work performance, affective reactions (including anxiety and depressive symptoms) and burnout were assessed using self-report questionnaires. Data were analysed using multiple linear regressions and structural equation modelling on SPSS and AMOS.
The STROBE checklist was used for this study.
Workplace psychological violence, but not physical violence, was associated with nurses' work performance. Burnout mediates the relationship between workplace psychological violence and work performance. Affective reactions and burnout play serial intermediary roles in the relationship between workplace psychological violence and work performance.
Interventions aimed at reducing anxiety, depressive symptoms, and burnout among nurses who have experienced psychological violence may enhance their work performance.
Hospital administrators should prioritise the development of strategies to prevent psychological violence (e.g., anti-bullying training and counselling support) and enhance nurse performance through burnout screening and targeted interventions.
This study was conducted in Shandong Province, China, and relied on self-reported data, which may be subject to social desirability bias.
No patient or public contribution.
Labour companionship is a recommendation by WHO that health authorities enable women to choose a companion during labour to ensure a safe and dignified labour experience for the birthing woman. However, most healthcare facilities in low- and middle-income countries do not necessarily consider this maternal need, which hampers a positive maternal experience during labour.
This study aims to examine midwives' perception towards the involvement of male partners in labour companionship.
An exploratory phenomenological approach was chosen and semi-structured interviews were used for this study.
The four main themes identified in this study include ‘Understanding of male partners' involvement in labour companionship’, ‘Involvement of midwives in decision-making’, ‘Barriers to male partners' involvement in labour companionship’ and ‘Facilitators of male partners' involvement in labour companionship’.
This study found a lack of understanding among midwives of the significance of male partners' involvement in labour companionship; and the identification of hierarchical and authoritarian leadership as a barrier to midwives' participation in decision-making highlights the need for transformational leadership styles to empower midwives. Overall, the findings of this study can inform maternity care policy as well as resource development, education and professional training in the field of midwifery.
by Zhixuan Huang, Jian Liu, Hui Li, Hengjun Huang, Yangwen Ai, Dongyue Zhou
BackgroundEvodia rutaecarpa is a traditional Chinese herbal medicine known for its potential benefits in the treatment of cardiovascular and cerebrovascular diseases. Despite its recognized effects, the effects of Evodia rutaecarpa on ischemic stroke (IS), along with the primary active compounds and precise mechanisms of action, require elucidation.
MethodsNetwork pharmacology analyses and molecular docking were performed to integrate information related to Evodia rutaecarpa and IS. Cell oxygen–glucose deprivation (OGD) and rat middle cerebral artery occlusion (MCAO) models were established to simulate cerebral ischemic injury. The effects of rutaecarpine on these models were evaluated to assess its effect on IS.
ResultsNetwork pharmacological analysis indicated that rutaecarpine from Evodia rutaecarpa showed therapeutic effects against IS. The mechanism underlying these effects mainly involved the mitogen-activated protein kinase (MAPK), and targets such as matrix metalloproteinase (MMP)-9, caspase 3 and MMP-2 may be activated to exert these effects. In vitro studies showed that rutaecarpine significantly improved the mitochondrial membrane potential of HT22 cells, reduced the production of reactive oxygen species, and reversed OGD-induced cytotoxicity. In the MCAO rat model, pretreatment with rutaecarpine significantly reduced neuronal death, decreased infarct volume, and improved neurological functional deficits. In addition, rutaecarpine alleviated damage to the blood–brain barrier in the brain tissue. These effects may be related to the regulation of the MAPK-mediated MMPs pathway.
ConclusionThis study revealed the neuroprotective effects and molecular mechanisms of rutaecarpine on IS, providing a new theoretical basis for the clinical application of Evodia rutaecarpa.
Identifying the core information needs of breast cancer radiotherapy patients serves as the foundation for delivering targeted information services. The Kano model, a qualitative tool for classifying service needs, is increasingly being employed to prioritise patient needs and enhance healthcare quality.
This study aims to examine the informational needs of breast cancer patients undergoing radiotherapy using the Kano model as the analytical framework.
Between October 2024 and February 2025, 260 patients with breast cancer undergoing radiotherapy were recruited as study participants. A cross-sectional survey was conducted using the Information Needs Questionnaire. Kano analysis was applied to identify and assess the information needs of these patients. This study adhered to the STROBE guidelines.
Among the 36 items analysed, 15 items (41.7%) were classified as one-dimensional attributes, primarily related to adverse reaction identification and self-management information. 11 items (30.5%) were identified as attractive attributes, mainly concerning the impact of radiation therapy and social–emotional needs five items (13.9%) were must-be attributes, focusing on basic radiotherapy information. Five items (13.9%) were indifference attributes, including the impact of radiotherapy on breast reconstruction, and guidance on image-related concerns during radiotherapy. The quadrant chart findings revealed that 15 needs were predominant in Area I, five in Improving Area II, five in Secondary Improving Area III and 11 in Reserving Area IV.
The information needs of breast cancer radiotherapy patients are diverse. Kano model analysis aids medical staff in developing health guidance and meeting patients' informational needs.
Understanding the differentiated informational needs of patients with breast cancer undergoing radiotherapy provides valuable insights for developing targeted educational interventions, ultimately improving patient engagement and outcomes.
The contributions of patients/members of the public were limited solely to data collection.
by Xuanqi Pan, Katerina Togka, Hilde ten Berge, Lisa de Jong, Harry Groen, Maarten J. Postma, Eleftherios Zervas, Ioannis Gkiozos, Christoforos Foroulis, Kyriaki Tavernaraki, Sofia Lampaki, Georgia Kourlaba, Antonios Moraris, Sofia Agelaki, Konstantinos Syrigos
ObjectiveThis study aimed to assess the cost-effectiveness of lung cancer screening (LCS) employing volume-based low-dose computed tomography (LDCT) in contrast to the absence of screening, targeting an asymptomatic high-risk population in Greece, leveraging the outcomes derived from the NELSON study, the largest European randomized control trial dedicated to LCS.
MethodsA validated model incorporating a decision tree and an integrated state-transition Markov model was used to simulate the identification, diagnosis, and treatments for a population at high risk of developing lung cancer, from a healthcare payer perspective. Screen-detected lung cancers, costs, life years (LYs), quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were predicted. Sensitivity and scenario analyses were conducted to assess the robustness and reliability of the model’s outcomes under varying parameters and hypothetical situations.
ResultsAnnual LCS with volume-based LDCT detected 17,104 more lung cancer patients at early-stage among 207,885 screening population, leading to 8,761 premature lung cancer deaths averted. In addition, in contrast to no screening, LCS yielded 86,207 LYs gained and 50,207 incremental QALYs at an additional cost of €278,971,940, resulting in an ICER of €3,236 per LY and €5,505 per QALY, over a lifetime horizon. These estimates were robust in sensitivity analyses.
ConclusionsLCS with volume-based LDCT, targeting an asymptomatic high-risk population, is highly cost-effective in Greece. Implementing LCS ensures efficient allocation of public healthcare resources while delivering substantial clinical benefits to lung cancer patients.
To explore the association between body image, fear of childbirth and maternal-fetal attachment and the mediating effects of fear of childbirth among different body image profiles.
A cross-sectional study.
Pregnant women were recruited from obstetric outpatient clinics between February 2022 and October 2023. Face-to-face data were collected using validated questionnaires. First, the mediating role of fear of birth was examined between body image and maternal-fetal attachment by calculating the total scores. Then, latent analysis was performed to identify body image profiles, and the relative mediation effects were examined for fear of childbirth in the association between body image profiles and maternal-fetal attachment.
This study included 676 pregnant women, most of whom were in their third trimester. Using the total score, fear of childbirth was found to partially mediate the relationship between body image and maternal-fetal attachment. Latent profile analysis revealed three body image profiles in pregnant women: positive, moderate and negative. Using positive body image as the reference, pregnant women with moderate body image experienced a higher fear of childbirth, resulting in lower maternal-fetal attachment. Notably, the relative mediating effect of fear of childbirth was more pronounced in women with more negative body image profiles.
Body image affected maternal-fetal attachment directly and indirectly through fear of childbirth, with stronger mediating effects among women with more negative body image profiles.
The findings provide evidence on the underlying pathways between body image and maternal-fetal attachment and suggest body image and fear of childbirth as potential intervention targets to improve maternal-fetal attachment. Pregnant women with more negative body image may benefit more from such interventions.
Little is known about the pathway between body image and maternal-fetal attachment in pregnant women. Body image affects maternal-fetal attachment directly and indirectly through fear of childbirth. The mediating effects of fear of childbirth were more pronounced among women with more negative body image profiles. These findings highlight fear of childbirth in the association between body image and maternal-fetal attachment and identify women with a more negative body image as high-risk populations, which provides insights for developing personalised interventions to improve perinatal psychological health.
The study has followed the STROBE checklist for reporting method.
No patient or public contribution.
The efficacy of radiotherapy and the satisfaction of patients can be significantly improved by adequately addressing their information needs. This process is impeded by the current lack of a comprehensive tool for assessing these needs.
To develop an Information Needs Questionnaire for patients with breast cancer undergoing radiotherapy and to assess its reliability and validity.
The initial item pool for the questionnaire was developed through a literature analysis and semi-structured interviews with 12 patients with breast cancer receiving radiotherapy. The Delphi method was employed to consult 16 experts and the questionnaire content was refined based on expert feedback and item ratings to form the first draft. A pre-investigation was conducted on 30 patients with breast cancer treated with radiotherapy to refine the item expression. From March–October 2024, item analysis, factor analyses, and reliability tests were conducted on 220 patients. This study adhered to STROBE guidelines.
The final questionnaire comprised 36 items. Exploratory factor analysis revealed 5 dimensions, with all item factor loading within their respective dimensions being ≥ 0.4 and no items exhibiting multiple loadings. These five factors accounted for 72.805% of the total variance. The overall content validity index was 0.980, with item-level content validity index ranging from 0.900 to 1.000. The Cronbach's α coefficient for the entire questionnaire was 0.959, and the coefficients for each dimension ranged from 0.786 to 0.958.
The Information Needs Questionnaire demonstrated excellent reliability and validity in patients with breast cancer undergoing radiotherapy. It can effectively guide medical staff to accurately assess the information needs of patients with breast cancer who are undergoing radiotherapy.
Identifying the authentic informational needs of breast cancer patients throughout the entire radiotherapy process is instrumental in enabling medical staff to devise personalised and targeted information support interventions.
A total of 220 participants provided perspectives on their information needs.
by Ji Sun, Xuanyu Deng, Juanjuan Huang, Gefei He, Shiqiong Huang
Nirmatrelvir/Ritonavir, acting as an effective agent against COVID-19, has achieved considerable results in clinical studies in terms of drug efficacy. However, there is little research about its medication safety. Based on the FDA adverse event reporting system (FAERS) database, this study aims to mine the adverse reaction signals of the latest major recommended drug Nirmatrelvir/Ritonavir for the antiviral treatment of COVID-19, so as to provide a basis for safe and rational drug use. The reporting odds ratio (ROR) was used to explore the adverse event report data of all COVID-19 emergency use authorization (EUA) products in the FAERS database with the deadline of third quarter of 2023. In the analysis, 135427 adverse drug event (ADE) reports were found, and 35250 ADEs were reported with Nirmatrelvir/Ritonavir as the primary suspected drug, which was involved in multiple system. There was a high signal intensity of dysgeusia (ROR = 72.98), diarrhea (ROR = 3.03) and headache (ROR = 1.25), which was compatible with the adverse reactions recorded in the manual for Nirmatrelvir/Ritonavir. In addition, it was suggested that Nirmatrelvir/Ritonavir might cause pale-colored stools (ROR = 45.53), chromaturia (ROR = 3.07), yellow skin (ROR = 3.62), tongue coating (ROR = 35.55) and other new adverse reactions (not included in the instructions manual for Nirmatrelvir/Ritonavir). The ADEs of Nirmatrelvir/Ritonavir that are not in the instructions and are highly relevant in the real world are supplemented, prompting clinical attention to the ADEs of the drug, and providing a theoretical basis for the safe and effective application of the drug.To systematically search, evaluate and synthesise the most robust evidence regarding pressure injury prevention in orthopaedic patients admitted to general wards.
The present study provides an evidence-based summary of the most robust findings, adhering to the evidence guidelines established by the Center for Evidence-Based Nursing of Fudan University.
According to the “6S” model, a systematic search was conducted for literature on pressure injury prevention among orthopaedic patients in general wards. The types of literature included guidelines, clinical decisions, expert Consensus, evidence summaries, etc. The search period covered the time from the beginning of the database up to December 2023.
The following databases and resources were systematically searched: Up To Date, JBI, NICE, WOCN, NZWCS, etc.
Fifteen literature sources were included, comprising one clinical decision, eight guidelines, one systematic review, and one expert Consensus. In these sources, a comprehensive collection of 34 pieces of best evidence was formed across six key topics: risk assessment, position management, skin care, device used for device-related pressure injury, nutritional assessment, and support, as well as health education and training. Among the evidence gathered, a strong recommendation was made for 18 pieces, while the remaining 16 received a weak recommendation.
This study provides a comprehensive synthesis of the most robust evidence on pressure injury prevention in orthopaedic patients, encompassing 34 pieces of evidence that can serve as valuable references for clinical practice. Before implementing this evidence, it is crucial to evaluate the specific contextual factors within different countries and medical institutions, as well as the facilitators and barriers influencing its application by healthcare professionals and patient's preferences. Furthermore, targeted evidence selection should be conducted through careful screening and subsequent adjustments in implementation, thereby offering a more scientifically grounded basis for clinical nursing practice. Future research endeavours should prioritise investigating strategies for effective evidence utilisation.
The prevention of pressure injuries poses a significant challenge for orthopaedic patients. This study presents a synthesis of 34 pieces of best evidence to provide guidance on preventive measures for pressure injuries in orthopaedic patients. Adhering to and implementing these 34 pieces of evidence can effectively aid in preventing pressure injuries in clinical practice. This evidence encompasses risk assessment, position management, skin care, device usage for device-related pressure injuries, nutritional support and evaluation, and health education and training, establishing a comprehensive and systematic implementation process. Assessing the risk of pressure injuries during interventions serves as an essential prerequisite for developing effective strategies to prevent such injuries among orthopaedic patients. Ultimately, this study will offer valuable guidance to healthcare professionals worldwide regarding preventing pressure injuries in orthopaedic patients.
Upon admission to the hospital, it is essential to conduct a risk assessment and implement evidence-based, individualised prevention measures for pressure ulcers in patients to prevent their occurrence. This study will provide valuable insights into preventing pressure injuries in orthopaedic patients admitted to orthopaedic wards for healthcare workers worldwide.
The PRIMA manifest is utilised during the text preparation process.
Trail Registration: ES20245365
Managing medication interruptions is considered one of the biggest dilemmas for nurses in clinical settings. To improve medication safety, it was imperative to conduct a systematic review to get a deeper understanding of nurses' experiences with medication interruptions.
A systematic review and qualitative meta-synthesis aimed to explore clinical nurses' experiences of interruption during medication in hospitals.
Systematic searches were conducted in PubMed, CINAHL, Ovid Medline, Embase, Web of Science, and The Cochrane Library from inception to January 2024. The search strategy included four groups of keywords: (1) qualitative research, (2) nurses, (3) medication interruption, and (4) experience. Critical Appraisal Skills Programme was used to assess the quality of the studies. Meta-ethnography was utilized to synthesize the findings of the included studies.
Nine articles published between 2012 and 2023 were included; the number of participants varied from 5 to 40, aged 20–68 years, and the majority were female. Four synthesized findings were identified as follows: (1) an inevitable part of the routine, (2) a decision-making process, (3) working in a minefield, and (4) coping with interruption.
Nurses embraced interruptions as an inherent component of clinical care. Previous experience and nursing culture, encompassing personal and professional aspects, significantly influence nurses' attitudes toward medication interruptions. It is crucial to incorporate the distinctive work experiences of nurses into techniques aimed at efficiently handling interruptions in future research. The registration number in PROSPERO is CRD42023470276.
To provide a viable tool for the early clinical identification of high-risk populations in patients with sepsis.
Sepsis-associated delirium (SAD) has the potential to significantly impact the short- and long-term prognosis of patients. However, accurately predicting and effectively managing SAD remains a significant challenge.
This study employed a retrospective analysis of adult sepsis patients admitted to the intensive care unit (ICU) for the first time. Patients were divided into two groups based on their initial Braden score upon admission to the ICU: a high-risk group (≤ 15 points) and a low-risk group (> 15 points). The relationship between Braden score and delirium was assessed using logistic regression and restricted cubic splines, while restricted mean survival time was employed to analyse the relationship between Braden scores and patients' 90- and 180-day mortality.
Of the 28,312 patients included in the study, those in the high-risk group exhibited a significantly elevated risk of delirium (44.8% vs. 29.7%) and higher 90-day (28.7% vs. 19.4%) and 180-day (33.2% vs. 24.1%) mortality rates (all p < 0.001). After adjusting for confounding variables, logistic regression demonstrated that the risk of delirium was 1.54 times higher in the high-risk group (95% CI = 1.45–1.64, p < 0.001). Following propensity score matching, the difference in survival was statistically significant at both time points, with the high-risk group having a reduced survival rate of 7.50 days (95% CI = −8.24, −6.75; p < 0.001) and 15.74 days (95% CI = −17.40, −14.08; p < 0.001) at 90 days and 180 days, respectively.
The Braden score is a simple and effective tool for the early identification of patients at increased risk of adverse outcomes in sepsis.
Retrospective study.
The Braden score can be employed by clinical nurses for the purpose of early identification of poor prognostic risk in patients with sepsis.
This study was conducted according to the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.
Patients were involved in the sample of the study.
FreshRSS 