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Development, Validation, and Usability of the Chatbot ESTOMABOT to Promote Self-care of People With Intestinal Ostomy

imageThis study aimed to describe the process of construction, validation, and usability of the chatbot ESTOMABOT to assist in the self-care of patients with intestinal ostomies. Methodological research was conducted in three phases: construction, validation, and usability. The first stage corresponded to the elaboration of a script through a literature review, and the second stage corresponded to face and content validation through a panel of enterostomal therapy nurses. In the third phase, the usability of ESTOMABOT was assessed with the participation of surgical clinic nurses, patients with intestinal elimination ostomies, and information technology professionals, using the System Usability Scale. The ESTOMABOT content reached excellent criteria of adequacy, with percentages of agreement equal to or greater than 90%, which were considered adequate, relevant, and representative. The evaluation of the content validity of the script using the scale content validity index/average proportion method reached a result above 0.90, and the Fleiss κ was excellent (P

Content Validation of a Questionnaire to Measure Digital Competence of Nurses in Clinical Practice

imageClinical practice nurses need adequate digital competence to use technologies appropriately at work. Questionnaires measuring clinical practice nurses' digital competence lack content validity because attitude is not included as a measure of digital competence. The aim of the current study was to identify items for an item pool of a questionnaire to measure clinical practice nurses' digital competence and to evaluate the content validity. A normative Delphi study was conducted, and the content validity index on item and scale levels was calculated. In each round, 21 to 24 panelists (medical informatics specialists, nurse informatics specialists, digital managers, and researchers) were asked to rate the items on a 4-point Likert scale ranging from “not relevant” to “very relevant.” Within three rounds, the panelists reached high consensus and rated 26 items of the initial 37 items as relevant. The average content validity index of 0.95 (SD, 0.07) demonstrates that the item pool showed high content validity. The final item pool included items to measure knowledge, skills, and attitude. The items included represent the international recommendations of core competences for clinical nursing. Future research should conduct psychometric testing for construct validity and internal consistency of the generated item pool.

A meta‐synthesis exploring nurses' experiences of assisted dying and participation decision‐making

Abstract

Aims and Objectives

To explore nurses' experiences of assisted dying and understand how their perspectives inform their participation decision-making.

Background

Assisted dying is a complex and contentious issue with the potential to create moral unrest for nurses. The nursing role in assisted dying varies between jurisdictions.

Design

Systematic review. A meta-synthesis using thematic analysis.

Methods

Three electronic databases were searched for primary qualitative studies published in English, from New Zealand, Australia or Canada, up to October 2022. Seven articles were included; themes were analysed and key themes were established. Reporting adhered to PRISMA.

Results

The findings highlight the complexity of nurses' decision-making about participation or non-participation in assisted dying and the moral, philosophical and social influences that impact on their decision-making. This is presented as a spectrum of influence which persuades or dissuades nurses to participate in assisted dying. The 12 themes have been categorised into four key themes: personal persuaders, personal dissuaders, professional persuaders and professional dissuaders.

Conclusions

The findings suggest that nurses should be involved in policy and procedure guideline development and be offered education and training programmes to ensure safe, confident and informed practice. The need for mentorship programmes was also prevalent in the research.

Relevance to Clinical Practice

It is crucial that nurses be offered education and training in assisted dying. Clear policy and procedure guidelines are essential, and nurses should be involved in the development of these.

Make My Day: primary prevention of stroke using engaging everyday activities as a mediator of sustainable health - a randomised controlled trial and process evaluation protocol

Por: Patomella · A.-H. · Guidetti · S. · Hagströmer · M. · Olsson · C. B. · Jakobsson · E. · Nilsson · G. H. · Akesson · E. · Asaba · E.
Introduction

The individual, societal and economic benefits of stroke prevention are high. Even though most risk factors can be reduced by changes to lifestyle habits, maintaining new and healthy activity patterns has been shown to be challenging.

The aim of the study is to evaluate the impact of an interdisciplinary team-based, mHealth-supported prevention intervention on persons at risk for stroke. The intervention is mediated by engaging everyday activities that promote health. An additional aim is to describe a process evaluation that serves to increase knowledge about how the programme leads to potential change by studying the implementation process and mechanisms of impact.

Methods and analysis

The study will be a randomised controlled trial including 104 persons at risk for stroke. Persons at risk of stroke (n=52) will be randomised to an mHealth-supported stroke prevention programme. Controls will have ordinary primary healthcare (PHC) services. The 10-week programme will be conducted at PHC clinics, combining group meetings and online resources to support self-management of lifestyle change using engaging everyday activities as a mediator. Primary outcomes are stroke risk, lifestyle habits and participation in health-promoting activities. Assessments will be performed at baseline and at follow-up (11 weeks and 12 months). The effects of the programme will be analysed using inferential statistics. Implementation will be analysed using qualitative and quantitative methods.

Ethics and dissemination

The study has been approved by the Swedish Ethical Review Authority. Study results will be disseminated in peer-reviewed journals and at regional and international conferences targeting mixed audiences.

Trial registration number

NCT05279508.

Cumulative violence exposures among men who have sex with men living with HIV in India: Psychosocial correlates of HIV care continuum outcomes

by Bushra Sabri, Chakra Budhathoki, Allison M. McFall, Shruti H. Mehta, David D. Celentano, Sunil S. Solomon, Aylur K. Srikrishnan, Santhanam Anand, Canjeevaram K. Vasudevan, Gregory M. Lucas

Lifetime exposures to violence among men who have sex with men (MSM) are associated with multiple psychosocial health risks and can affect engagement and outcomes of HIV treatment. This study a) explored relationships between levels of exposures to violence and HIV care continuum outcomes among MSM living with HIV in India, and b) identified psychosocial correlates of HIV care continuum outcomes among MSM living with HIV and those with lifetime cumulative exposures to violence (CVE). CVE referred to exposures to violence in both childhood and adulthood. This cross-sectional analysis used survey data collected between August 2016 and May 2017 from 1763 men who have sex with men living with HIV across 10 cities in India, using respondent-driven sampling. We found that higher levels of violence exposure were significantly associated with lower awareness of HIV positive status, and lower likelihood of initiating antiretroviral therapy. Compared with MSM living with HIV that had no CVE, those with CVE were more likely to report perpetration of interpersonal violence, alcohol misuse, depressive symptoms, and HIV transmission risk behaviors and to have two to four co-occurring psychosocial problems. In multivariable analysis with the subset of MSM with CVE, psychosocial correlates significantly associated with at least one HIV care continuum outcome were HIV transmission risk behaviors, perpetration of interpersonal violence, depression, and alcohol misuse. The findings highlight the need for integrating care for lifetime violence exposures and associated behavioral problems in HIV care settings for men who have sex with men living with HIV in India.

Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients

by Nora Tabea Sibert, Tobias Kurth, Clara Breidenbach, Simone Wesselmann, Günther Feick, Ernst-Günter Carl, Sebastian Dieng, Mohamad Hatem Albarghouth, Atiqullah Aziz, Stefan Baltes, Elisabeth Bartolf, Jens Bedke, Andreas Blana, Marko Brock, Stefan Conrad, Christopher Darr, Florian Distler, Konstantinos Drosos, Gregor Duwe, Amr Gaber, Markus Giessing, Nina Natascha Harke, Axel Heidenreich, Sameh Hijazi, Andreas Hinkel, Björn Theodor Kaftan, Shatlyk Kheiderov, Thomas Knoll, Gerd Lümmen, Inga Peters, Bülent Polat, Valentin Schrodi, Jens-Uwe Stolzenburg, Zoltan Varga, Julius von Süßkind-Schwendi, Vahudin Zugor, Christoph Kowalski

Background

Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool.

Methods

Observational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80–20 splitting of the data set and 10-fold cross validation. To assess performance, R2, RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models.

Results

For model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R2 = 0.12, RMSE = 25.40, sexual function: R2 = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/.

Conclusion

The final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients.

Llamada a la Acción enfermera: por el presente y futuro del planeta, sus habitantes y la profesión.

El 27 de septiembre de 2023 seis jóvenes portugueses llevaron ante el Tribunal Europeo de Derechos Humanos a 32 gobiernos por su inacción ante la crisis climática global.

A pesar de que las enfermeras somos titulares de obligaciones del derecho a la salud, sus protectoras y defensoras, este suceso, como muchas otras iniciativas que luchan por la salud global, ha pasado desapercibido para la mayoría de las compañeras de profesión. ¿Dónde estamos como colectivo sanitario mayoritario en estas causas? ¿Dónde está nuestro apoyo manifiesto a la lucha por la salud planetaria?

Como enfermeras debemos movernos con la realidad del planeta y responder a los retos de salud globales. Si queremos mirar al futuro de la profesión, la profesión del presente debe actuar.

Determinants of anemia level among reproductive-age women in 29 Sub-Saharan African countries: A multilevel mixed-effects modelling with ordered logistic regression analysis

by Kusse Urmale Mare, Setognal Birara Aychiluhm, Kebede Gemeda Sabo, Abay Woday Tadesse, Bizunesh Fentahun Kase, Oumer Abdulkadir Ebrahim, Tsion Mulat Tebeje, Getahun Fentaw Mulaw, Beminate Lemma Seifu

Background

Despite the implementation of different nutritional and non-nutritional interventions, 43% of reproductive-age women in Africa suffer from anemia. Recent evidence also shows that none of the Sub-Saharan African (SSA) countries are on the track to achieve the nutrition target of 50% anemia reduction by 2030. To date, information on the level of anemia and its determinants among reproductive-age women at the SSA level is limited. Thus, this study aimed to estimate the pooled prevalence of anemia level and its determinants in SSA countries.

Methods

We used a pooled data of 205,627 reproductive-age women from the recent demographic and health surveys of 29 SSA countries that were conducted between 2010–2021. A multilevel mixed-effects analysis with an ordered logistic regression model was fitted to identify determinants of anemia level and the deviance value was used to select the best-fitted model. First, bivariable ordinal logistic regression analysis was done and the proportional odds assumption was checked for each explanatory variable using a Brant test. Finally, in a multivariable multilevel ordinal logistic regression model, a p-value Results

The pooled prevalence of anemia among women of reproductive age in SSA was 40.5% [95% CI = 40.2%-40.7%], where 24.8% [95% CI: 24.6%-25.0%], 11.1% [95% CI = 10.9%-11.2%], and 0.8% [95% CI = 0.7%-0.8%] had mild, moderate, and severe anemia, respectively. The prevalence significantly varied from the lowest of 13% in Rwanda to the highest of 62% in Mali, and anemia was found as a severe public health problem (prevalence of ≥ 40%) in 18 countries. The regression result revealed that polygamous marriage, women and husband illiteracy, poor household wealth, shorter birth interval, non-attendance of antenatal care, underweight, unimproved toilet and water facilities, and low community-level women literacy were positively linked with high anemia level. Additionally, the likelihood of anemia was lower in women who were overweight and used modern contraception.

Conclusions

Overall results showed that anemia among women of reproductive age is a severe public health problem in SSA countries, affecting more than four in ten women. Thus, enhancing access to maternal health services (antenatal care and contraception) and improved sanitation facilities would supplement the existing interventions targeted to reduce anemia. Moreover, strengthening women’s education and policies regulating the prohibition of polygamous marriage are important to address the operational constraints.

The burden of non-disabled frailty and its associated factors among older adults in Bangladesh

by Sabuj Kanti Mistry, A. R. M. Mehrab Ali, Uday Narayan Yadav, Saruna Ghimire, Afsana Anwar, Md. Nazmul Huda, Fouzia Khanam, Rashidul Alam Mahumud, Ateeb Ahmad Parray, Shovon Bhattacharjee, David Lim, Mark Fort Harris

Objective

The present study aims to measure the prevalence of non-disabled frailty and its associated factors among Bangladeshi older adults.

Methods

This cross-sectional study was conducted during September and October 2021 among 1,045 Bangladeshi older adults (≥60 years). Telephone interviews, using a semi-structured questionnaire, were undertaken to collect data on participants’ characteristics and level of frailty. The non-disabled frailty was measured using the ‘Frail Non-Disabled (FiND)’ questionnaire. A multinomial logistic regression model assessed the factors associated with frailty among the participants.

Results

Around a quarter of the participants (24.8%) were frail. The multinomial regression analysis showed that older participants aged ≥80 years (RRR = 3.23, 95% CI: 1.41–7.37) were more likely to be frail compared to participants aged 60–69 years. Likewise, the participants living in a large family with ≥4 members (RRR = 1.39, 95% CI: 1.01–1.92) were more likely to be frail compared to those living in smaller families. Also, participants having memory or concentration problems (RRR = 1.56, 95% CI: 1.12–2.17) were more likely to be frail compared to those who were not suffering from these problems. Moreover, participants whose family members were non-responsive to their day-to-day assistance (RRR = 1.47, 95% CI: 1.06–2.03) were more likely to be frail compared to those whose family members were responsive. Furthermore, participants who were feeling lonely (RRR = 1.45, 95% CI: 1.07–1.98) were more likely to be frail than their counterparts who were not feeling lonely.

Conclusions

The findings of the present study suggest developing tailored interventions to address the burden of frailty among the older populations in Bangladesh. In particular, providing long-term care and health promotion activities can be of value in preventing frailty and reducing adverse health outcomes among this vulnerable population group.

Comparison of national and international sedentary behaviour and physical activity guidelines for older adults: A systematic review and quality appraisal with AGREE II

by Amy Huang, Ellen Wang, Stephanie Sanger, Alexandra Papaioannou, Isabel B. Rodrigues

Most older adults 65 years and older accumulate over 8.5 hours/day of sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults has prompted development of sedentary behaviour guidelines. The purpose of our review was to compare national and international sedentary behaviour and physical activity guidelines for older adults and appraise the quality of guidelines using AGREE II. We conducted our search in Medline, Embase, Global Health, Web of Science, CINAHL, and relevant grey literature. We included the most recent guidelines for older adults written in English. We identified 18 national and international guidelines; ten of the 18 guidelines included sedentary behaviour recommendations while all 18 included physical activity recommendations for older adults. The ten sedentary behaviour guidelines were developed using cohort studies, knowledge users’ opinions, systematic reviews, or other guidelines while the physical activity guidelines were developed using randomized controlled trials, systematic reviews, meta-analysis, and overview of reviews. The definition of sedentary behaviour and the recommendations were inconsistent between the guidelines and were based on very low to low quality and certainty of evidence. All guidelines provided consistent recommendations for aerobic and resistance training; the recommendations were developed using moderate to high quality and certainty of evidence. Only eight physical activity guidelines provided recommendations for balance training and six on flexibility training; the balance training recommendations were consistent between guidelines and based on moderate quality evidence. Further work is needed to develop evidenced-based sedentary behaviour recommendations and flexibility training recommendations for older adults.

Feasibility interventional study investigating PAIN in neurorehabilitation through wearabLE SensorS (PAINLESS): a study protocol

Por: Moscato · S. · Orlandi · S. · Di Gregorio · F. · Lullini · G. · Pozzi · S. · Sabattini · L. · Chiari · L. · La Porta · F.
Introduction

Millions of people survive injuries to the central or peripheral nervous system for which neurorehabilitation is required. In addition to the physical and cognitive impairments, many neurorehabilitation patients experience pain, often not widely recognised and inadequately treated. This is particularly true for multiple sclerosis (MS) patients, for whom pain is one of the most common symptoms. In clinical practice, pain assessment is usually conducted based on a subjective estimate. This approach can lead to inaccurate evaluations due to the influence of numerous factors, including emotional or cognitive aspects. To date, no objective and simple to use clinical methods allow objective quantification of pain and the diagnostic differentiation between the two main types of pain (nociceptive vs neuropathic). Wearable technologies and artificial intelligence (AI) have the potential to bridge this gap by continuously monitoring patients’ health parameters and extracting meaningful information from them. Therefore, we propose to develop a new automatic AI-powered tool to assess pain and its characteristics during neurorehabilitation treatments using physiological signals collected by wearable sensors.

Methods and analysis

We aim to recruit 15 participants suffering from MS undergoing physiotherapy treatment. During the study, participants will wear a wristband for three consecutive days and be monitored before and after their physiotherapy sessions. Measurement of traditionally used pain assessment questionnaires and scales (ie, painDETECT, Doleur Neuropathique 4 Questions, EuroQoL-5-dimension-3-level) and physiological signals (photoplethysmography, electrodermal activity, skin temperature, accelerometer data) will be collected. Relevant parameters from physiological signals will be identified, and AI algorithms will be used to develop automatic classification methods.

Ethics and dissemination

The study has been approved by the local Ethical Committee (285-2022-SPER-AUSLBO). Participants are required to provide written informed consent. The results will be disseminated through contributions to international conferences and scientific journals, and they will also be included in a doctoral dissertation.

Trial registration number

NCT05747040.

Dietary replacement of soybean meal with black soldier fly larvae meal in juvenile <i>Labeo rohita</i> and <i>Catla catla</i>: Effects on growth, nutritional quality, oxidative stress biomarkers and disease resistance

by Shafaq Fatima, Ayesha Afzal, Hamna Rashid, Saba Iqbal, Rosheen Zafar, Komal Khalid, Ayman Rauf, Maryam Majeed, Aqsa Malik, Chris G. Carter

This experiment aimed to investigate the effects of partial substitution of crude protein from soybean meal (SBM) with black soldier fly (Hermetia illucens) larvae meal (BSFLM) in juvenile rohu (Labeo rohita) and catla (Catla catla). Four isonitrogenous diets (23% crude protein) were formulated to replace 0% (T0), 40% (T40), 80% (T80) and 100% (T100) crude protein from SBM with BSFLM. Triplicate groups of each species (10 fish per replicate) were fed in an eight week growth experiment. After final sampling (n = 20 fish per dietary group), the remaining fish were exposed to bacterial (Staphylococcus aureus) challenge (0.80 CFU/ml) for 15 days. Rohu fed with BSFLM substituted diets showed significantly higher growth and feed conversion ratio as compared to those in T0. Catla fed with BSFLM substituted diets showed slightly higher growth indices. The growth response of rohu to BSFLM substitution was better than that noted in catla in all groups. The chemical composition, amino acids and fatty acids profile, haematological and biochemical parameters, levels of liver function enzymes measured in T0, T40, T80 and T100 were similar between four dietary groups in both species. However, the maximum value of cholesterol and triglycerides were noted in T100 both in catla and rohu. The values of lauric acid, α-linolenic acid, decosahexanoic acid, n3:n6 fatty acids ratio progressively increased with dietary increase of BSFLM in both species. At end of the growth experiment, the levels of catalase, superoxide dismutase and lysozyme increased linearly with the inclusion of BSFLM in both species while malondialdehyde showed similar values between different groups. However, catalase, and superoxide dismutase increased (T0

The perspectives of internationally qualified nurses regarding their specialty skill transition to Australia: A cross‐sectional survey

Abstract

Aim

To identify barriers and facilitators of speciality skill transfer for internationally qualified nurses in Australia from the nurses' perspective.

Design

A cross-sectional study.

Methods

A cross-sectional online survey was distributed through social media, snowballing and nursing professional organization. Data analysed using Statistical Package for the Social Sciences.

Data Sources

Online survey data from participants matching the inclusion criteria were collected from July to September 2022.

Results

Survey results reveal facilitators (competence, scope of practice, linguistic sufficiency, understanding of decision-making) and barriers (lack of opportunity, transition pathways, confidence in overseas education, financial instability) for internationally qualified nurses' speciality skill utilization in Australia.

Conclusion

Identifying and addressing barriers and facilitators, along with developing tailored transition pathways, are crucial for maximizing speciality skill utilization among internationally qualified nurses. These findings have implications for policymakers, healthcare organizations and nurses. They highlight the need to address barriers, facilitate smooth transitions and implement proactive measures for internationally qualified nurses to effectively utilize their specialty skills.

Impact

The study addresses maximizing skill usage for internationally qualified nurses, identifies barriers and facilitators for specialty skill transfer in Australia and will impact policymakers, healthcare organizations and nurses by guiding strategies for safe nursing service delivery and optimizing patient care.

Reporting Method

STROBE checklist.

Patient or Public Contribution

A total of 71 internationally qualified nurses contributed their experiences and opinions.

What Does this Paper Contribute to the Wider Global Clinical Community?

Lack of opportunity and the lack of transition pathways inhibit the use of specialty nursing skills by internationally qualified nurses. This study's findings contradict the result of other studies that suggest language is a significant obstacle to the utilization of specialty skills of internationally qualified nurses.

Trial and Protocol Registration

The protocol is registered on OSF. The data for this study are available for sharing with the reviewers upon request. However, it is worth noting that ethical approval has not been obtained specifically for web sharing, and therefore, the data has not been posted in any repositories or public platforms.

Preliminary validity of the BNSSS-20 in Arabic: Exploratory study on basic needs satisfaction in sport for a sample of Tunisian athletes

by Mohamed Baaziz, Ali Aloui, Saber Abdellaoui, Matthew Stults-Kolehmainen, Daniel Boullosa, Abderraouf Ben Abderrahman

Background

Satisfaction of fundamental needs is an important concept in sport, but currently there is no tool in Arabic to measure this construct. Basic needs are often linked to high rates of motivation and performance. It is necessary to develop tools to assess psychological needs in the sport context.

Aim

This study aimed to validate the Basic Needs Satisfaction in Sport Scale (BNSSS) in Arabic language across Tunisian athletes, and to test its psychometric properties (factorial structure, internal reliability, construct validity, and sensitivity).

Methods

Athletes in various sports participated in this study (370 men, 146 women; mean age 18.35) and voluntarily completed the Arabic version of the BNSSS-20. Both exploratory (EFA, N = 294; males: 68%; females: 32%; [14–18] = 182; [19–28] = 112) and confirmatory (CFA; N = 222; males: 76.6%; females: 23.4%; [14–18] = 103; [19–28] = 119) factor analyses were examined.

Results

Results from the EFA suggest that the BNSSS scale reflects the theoretical model well, with good internal consistency for all factors. All 20 items of BNSSS revealed excellent reliability (McDonald’s omega = 0.773, Cronbach’s α = 0.886, Gutmann’s λ6 = 0.970) and good temporal stability (ICC = 0.84, 95% CI = 0.55–0.93) over a 4-week period. Likewise, the CFA fit indices were excellent.

Conclusion

The BNSSS presented excellent fit to the theoretical model for all indices, confirming the factorial structure and providing validity of the instrument for Tunisian athletes.

Gender and racialisation of pharmaceutical sector leaders in Canada: a cross-sectional study

Por: Satgunanathan · K. · Workentin · A. · Woods · H. · Sabir · A. · Persaud · N.
Objective/design

Lacking diversity in pharmaceutical leadership positions could contribute to inequities in medicine access. The objective of this cross-sectional study was to determine the gender and racial identities of individuals who hold leadership positions in the Canadian pharmaceutical sector.

Participants

We compiled a list of all Canadian governmental bodies, pharmaceutical companies and insurance providers. We identified individuals who were part of the leadership team, including executives and members of the board of directors.

Primary outcome measures

The main outcomes of the study were the racialisation and gender of the individuals in leadership positions. The gender and racialisation of an individual were determined by reviewing their name, pronouns and institutional profile through internet searches. Two members of the research team performed the assessment and a third reviewer resolved disagreements.

Results

We identified 957 individuals holding leadership positions within the pharmaceutical sector, including 280 drug evaluation committee members, 12 governmental executive officers, 273 insurance company executive and board members and 392 executive and board members. Reviewers identified a total of 375 (39.2% of 957) women holding leadership roles, with most of these positions being held by governmental leaders (52.4% of 292) and a minority by insurance (37.0% of 273) and pharmaceutical (30.9% of 392) leaders. There were a total of 157 (16.4% of 957) racialised leaders, with most of these positions being held by governmental (18.5% of 292) and pharmaceutical (18.1% of 392) leaders, and a minority in insurance companies (11.7% of 273). Across the pharmaceutical sector, there were a total of 48 (5.0% of 957) racialised women and 327 (34.2% of 957) white women.

Conclusions

Leaders within the Canadian pharmaceutical sector are mostly white men, and racialised women hold few leadership roles. Public policy should recognise that these institutions are mostly led by white men and reasons for this disparity could be explored.

Analysis and prevention of falls among community‐dwelling older adults in southern Thailand

Abstract

Aim

To analyse fall prevalence, risk factors and perceptions among Thai older adults to design a prevention model.

Design

Quantitative and qualitative data were collected using a convergent parallel mixed-methods design.

Methods

A cross-sectional analysis was conducted using secondary data from health screenings of older adults in 20 subdistrict hospitals in southern Thailand from January 2018 to September 2019 (n = 12,130). In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with purposively sampled participants who were representatives of older adults and stakeholders (n = 50).

Results

The quantitative analysis showed that the prevalence of falls was 12.1%. The independent risk factors were female gender, employment status, cognitive impairment, semi-dependent functional ability, balance problems, vision impairment, hearing difficulties, use of medications, reliance on assistive devices and access to outdoor toilets. The qualitative analysis revealed misconceptions on falls and fall prevention measures among older adults and community stakeholders. In Thailand, healthcare providers and community nurses play a crucial role in providing primary advice and conducting interventions, yet they encounter obstacles due to lack of personnel, time constraints, limited resources, inadequate support and unclear policies. Stakeholders stress the urgency of improving practice guidelines, developing evidence-based strategies and aligning with government policies.

Conclusions

Fall risk factors and prevention challenges among older adults were identified. Effective fall prevention programmes are needed.

Impact

The identified fall events may guide public health agencies and local administrations in planning fall prevention programmes. For implementation in Thai communities, teamwork among leaders and stakeholders is key.

Patient or Public Contribution

IDIs and FGDs were conducted with older adults, village health volunteers, nurses, healthcare providers, local organization administrators and village headmen.

Care call requests and inpatient beds modernization: Is there any link? A prospective observational study in the oncological setting

Abstract

Aim

The study aims to analyse the principal causes of patients' care calls and compare differences before and after inpatient beds' technological modernization in a surgical breast oncological ward.

Design

A prospective observational study was conducted under the STROBE guidelines. Data were collected from June to September 2022.

Methods

Statistical analyses were performed to compare each reason for care calls, by shifts and pre and post-inpatient bed modernization.

Results

Two thousand five hundred and fifty-nine care request calls were analysed during the 202 observed shifts. The most frequent reason was related to the requests for positions.

Conclusion

Technological modernization of the beds has not led to effective—positive—changes; on the contrary, it seems at first glance to show an upward trend in calls above all in the short period after the changes.

Implications for the profession and/or patient care

What problem did the study address? By analysing the principal causes of care calls and comparing the differences before and after inpatient beds' technological modernization, this study evaluates if inpatient gear or device modernization can impact care call requests. What were the main findings? The results show that the most frequent reasons for care calls were position, possession and other. These findings seem not superimposable; the hypothesis supported by the international literature in which the causes relating to potty and pain were found among the main reasons. Where and on whom will the research have an impact? These results could impact the care organizational area in nursing care and could improve care quality, patient satisfaction and safety.

Reporting Method

This prospective observational study was conducted following STROBE guidelines.

Patient or Public Contribution

After adequate information (presentation, design methods and objectives), all unit healthcare staff agreed to collaborate in the study.

Roles of nurse‐surgeons in global surgical care: A scoping review

Abstract

Aim

To identify the roles of nurse-surgeons in the provision of surgical care.

Design

Scoping review.

Methods

This scoping review adhered to the JBI guideline for scoping reviews and EQUATOR Network's PRISMA-ScR checklist. Searches were performed from May 2022 to July 2022 using a combination of MeSH headings, keywords and filters via database and hand searching based on the eligibility criteria. Keywords included nurse-surgeon, nurse endoscopist, nurse hysteroscopist and nurse cystoscopist. Data sources were CINAHL, Cochrane, Google Scholar, PubMed and Scopus. Descriptive analysis was used to report the findings.

Results

Ninety-six included records indicated nurse-surgeon practice in 26 countries. Forty-one nurse-surgeon titles were found, the majority of which were types of nurse practitioner. A total of 5,684,198 surgeries were performed by nurse-surgeons varying from laparotomies to biopsies. Nine records reported that nurse-surgeons perform surgeries safely and on par with physicians with zero to minimal complications. Nineteen records reported improved surgical care efficiency by nurse-surgeons in terms of patient access to surgery, waiting times, surgery times, patient show rates, patient education, physician workload and junior physicians' training. Seven records reported high patient satisfaction. Nurse-surgeons were cost-effective according to five records. Thirteen records recommended the standardization of nurse-surgeon practice.

Conclusion

Nurse-surgeons performed millions of surgeries worldwide assisting in easing the global surgical burden. This review identified the roles and benefits nurse-surgeons play in global surgical care. Research gaps on nurse-surgeon roles were discovered including the ambiguity in nurse-surgeon titles and the need to regulate nurse-surgeon practice.

Impact

This research addressed the clinical safety, quality, contribution to timely surgical access and cost efficiency of nurse-surgeon performed surgeries, as well as the need to standardize nurse-surgeon practice and use a more consistent nurse-surgeon title to ensure role identification and monitoring.

Vignettes as a novel research tool in spiritual care: A methods paper

Abstract

Aims

To discuss the construction and use of vignettes as a novel approach in spiritual care research and education.

Design

Methods paper.

Methods

In this methods paper, the authors introduce the use of vignettes in spiritual care research and provide insight into the construction of vignettes. The vignette presented was part of a study of neurosurgical nurses' attitudes and responses to the spiritual needs of neuro-oncology patients. The development process, consisting of four steps, is explained in this paper.

Results

Using a vignette to explore nurses' attitudes towards spiritual care is an innovative way to understand what behaviours nurses consider appropriate in situations where the patient is seeking meaning and connection. Transparent description of the development process is crucial to ensure reproducibility.

Conclusion

The use of theoretically constructed and validated vignettes in spiritual care research is new. Vignettes used in surveys have the potential to elicit nurses' responses to patients' search for meaning and connectedness.

Implications

In order to investigate nurses' attitudes and behaviours towards patients' spiritual needs, carefully constructed and validated vignettes are valuable research tools.

Impact

Vignettes have proven to be a valuable research tool in the social and health sciences. So far, their use as a survey instrument in spiritual care research has not been investigated. Therefore, this method paper introduces vignettes as a novel approach to spiritual care research. Our findings contribute to the further development of vignettes in nursing science, as there are similarities with case development and simulation training in nursing education.

Reporting Method

Reporting guideline is not applicable.

Patient or Public Contribution

No patient or public contribution.

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