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Short- and long-term complications after slowly resorbable biosynthetic P4HB mesh (Phasix) implantation in European centres: a protocol paper for a multiregistry study

Background

Phasix mesh is a fully resorbable synthetic mesh for use in clean and contaminated ventral incisional hernia repairs. Long-term absorbable Phasix mesh appears to be a safe and promising device in incisional hernia repair, with low recurrence rates; however, data on long-term complications after surgery, particularly after the resorption period of the mesh, are scarce.

Methods and analysis

This protocol describes a study of several European registries on the use of a Phasix mesh in incisional hernia repair. The primary endpoint of the study is long-term complications at 2–5 year follow-up after mesh implantation, with secondary endpoints including hernia recurrence and complications during short-term follow-up.

Ethics and dissemination

Ethical approval was not required for this protocol as the study is based on anonymised registry data collected with prior patient consent in each registry. Each participating registry has its own ethical approval process, and this study will adhere to those regulations. The results will be disseminated through peer-reviewed publications and conference presentations.

Quality and efficiency of integrating customised large language model-generated summaries versus physician-written summaries: a validation study

Objectives

To compare the quality and time efficiency of physician-written summaries with customised large language model (LLM)-generated medical summaries integrated into the electronic health record (EHR) in a non-English clinical environment.

Design

Cross-sectional non-inferiority validation study.

Setting

Tertiary academic hospital.

Participants

52 physicians from 8 specialties at a large Dutch academic hospital participated, either in writing summaries (n=42) or evaluating them (n=10).

Interventions

Physician writers wrote summaries of 50 patient records. LLM-generated summaries were created for the same records using an EHR-integrated LLM. An independent, blinded panel of physician evaluators compared physician-written summaries to LLM-generated summaries.

Primary and secondary outcome measures

Primary outcome measures were completeness, correctness and conciseness (on a 5-point Likert scale). Secondary outcomes were preference and trust, and time to generate either the physician-written or LLM-generated summary.

Results

The completeness and correctness of LLM-generated summaries did not differ significantly from physician-written summaries. However, LLM summaries were less concise (3.0 vs 3.5, p=0.001). Overall evaluation scores were similar (3.4 vs 3.3, p=0.373), with 57% of evaluators preferring LLM-generated summaries. Trust in both summary types was comparable, and interobserver variability showed excellent reliability (intraclass correlation coefficient 0.975). Physicians took an average of 7 min per summary, while LLMs completed the same task in just 15.7 s.

Conclusions

LLM-generated summaries are comparable to physician-written summaries in completeness and correctness, although slightly less concise. With a clear time-saving benefit, LLMs could help reduce clinicians’ administrative burden without compromising summary quality.

Does a participatory live music practice support nurses to deliver compassionate care to hospitalised patients? A qualitative study

Abstract

Aim

To gain more insight into how nurses experience a participatory live music practice in relation to their ability to deliver compassionate care to medically hospitalised patients.

Design

Qualitative interpretive design.

Methods

Sixteen nurses participating in a live music practice with patients were interviewed using in-depth interviews with open-ended questions. Audio recordings were transcribed verbatim and subsequently coded. Theory-driven inductive and deductive approaches were applied in thematic data analysis.

Results

We identified four themes: (1) Nurses' empathy and compassion; (2) The caring nurse–patient relationship; (3) Person-centred approaches to care and (4) Nurses' subjective wellbeing. By observing patients' reactions to the music, nurses described that they obtained a deeper insight and understanding of patients' emotional wellbeing. These observations led to increased feelings of compassion in patient contact and stimulated informal communication between nurses and patients through a sense of shared humanity. According to nurses, these aspects positively affected collaboration with patients in delivering care and stimulated them to pursue person-centred approaches to care. Participating in the live music practice also positively affected nurses' wellbeing, enhanced relaxation and created an ambiance in which compassion could be expressed.

Conclusion

A live music practice can positively contribute to the delivery of compassionate care by providing meaningful shared moments that increase feelings of empathy and compassion and strengthen the caring relationship.

Implications for the profession

Offering a live music practice at the ward and bedside offers a unique possibility to enhance engagement in person-centred, compassionate care.

Impact

While compassion and compassionate care are essential component of nursing, nurses often experience multiple barriers to its provision in daily practice. An innovative way to stimulate compassionate care is through the participation of nurses and patients in a live music practice, providing a meaningful moment shared between them. This stimulates feelings of shared humanity and bonding in the caring relationship.

Reporting Method

The COnsolidated criteria for REporting Qualitative research (COREQ). No Patient or Public Contribution.

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