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Strengthening research capacity in Africa is vital for tackling pressing health, educational and socioeconomic challenges facing the continent. At the core of this effort is the cultivation of innovative research leaders through postgraduate training programmes that incorporate mentorship-infused supervision. Such models have demonstrated potential in improving research skills, boosting academic productivity and fostering leadership development among emerging scholars. This systematic review and meta-synthesis protocol aims to examine existing mentorship-infused supervision practices across African higher education institutions. The review seeks to identify effective models, uncover common challenges and barriers, and generate evidence-based recommendations to develop sustainable, contextually relevant strategies. Insights from this work will inform policies and practices to enhance postgraduate research training, advance research leadership and contribute to the broader goal of strengthening research ecosystems across Africa.
A systematic review and thematic meta-synthesis will be undertaken, focusing on qualitative research studies as well as the qualitative components of mixed-methods studies. Relevant studies published in English will be identified through a comprehensive search strategy. The electronic databases, including Medline/PubMed, Scopus, Web of Science, African Journals Online, EMBASE and CINAHL, will be searched to capture a wide range of peer-reviewed articles and grey literature. Databases will be searched from March 2026. Two reviewers will independently perform study selection, data extraction, quality assessment and evaluation of risk of bias, using the Critical Appraisal Skills Programme checklist.
This systematic review and meta-synthesis will analyse publicly available literature and does not require ethical approval, as it involves no primary data collection. It will adhere to established ethical and methodological standards, including proper citation and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The findings will be widely disseminated through open-access journal publication, conference presentations and targeted reports for universities, research institutions and policymakers to inform and support mentorship-based postgraduate research supervision across Africa.
CDR420251049878. Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD420251049878.
by Nasib Babaei, Vahid Zamanzadeh, Leila Valizadeh, Mojgan Lotfi, Marziyeh Avazeh
IntroductionChronic and complex wounds are serious public health problems worldwide. Given the time-consuming nature of chronic wound healing and the need for long-term follow-up, a virtual care approach can effectively manage these patients. Identifying the care needs of patients with chronic wounds is key to successfully managing their care remotely. This study aimed to identify the care needs of patients with chronic wounds for implementing a virtual care program to manage this group of patients remotely.
MethodsThis descriptive qualitative study was conducted using a conventional content analysis approach in wound care clinics of East Azerbaijan Province (northwestern Iran). Data were collected through six focus group discussions with wound therapists and six semi-structured individual interviews with patients with chronic wounds. Participants were recruited using purposive sampling. The data were analyzed by MAXQDA 10 software.
ResultsAfter analyzing the data, the most important care needs of patients with chronic wounds for implementing a virtual care program were identified into three main categories, including the need for awareness-raising, needs related to health dimensions, and the need for specialized financial support (insurance).
ConclusionThe findings of this study indicated that the successful implementation of a virtual care program for patients with chronic wounds requires addressing three core needs: enhancing patients’ awareness regarding wound management, attending to their physical, emotional, and social health dimensions, and providing financial support through insurance coverage for wound care services. Addressing these needs can significantly improve the quality of care and therapeutic outcomes for patients in a virtual care setting.
Health cadres, who assist midwives in supporting pregnant women in community settings, need to enhance their competencies in identifying risk factors and referring high-risk pregnant women to midwives for further care. Since the capabilities of these health cadres are influenced by maternal complications, an educational programme was implemented to strengthen their skills. Therefore, this study aimed to evaluate the competency of health cadres by providing a researcher-developed educational programme.
An open-label, cluster non-randomised controlled trial.
Health cadres with at least 1 year of work experience were recruited at six public health centres (PHCs) in Banjarnegara Regency, Indonesia.
Six PHCs were selected and allocated into intervention group (IG=3 PHCs) and control group (CG=3 PHCs) groups. A total of 133 female health cadres were enrolled across the selected PHCs. At each PHC, a systematic random sampling method was used to select the participants. The researchers and health professionals provided a 3-week period of theoretical and scenario-based simulations to the IG, while the CG received no education.
Researcher-developed questionnaires and checklists were used to assess the knowledge, skills (health assessment, communication, attitude) and confidence. The primary endpoint was competency, a total score of knowledge and skills. The outcome domains were compared between the two groups, and a linear mixed-effect model was used to account for cluster-level variation.
A total of 130 (97.7%) completed the study (IG:64, CG:66). The competency score showed significant improvement at endline (CG=49.5 and IG=52.5; p=0.002). The median scores for health assessment skills (CG=12 vs IG=14; p
Education effectively increased the competency of health cadres. A well-structured education programme is necessary for health cadres to improve and maintain their competencies in monitoring high-risk pregnant women.
To identify and explain the challenges of effective pain management in patients with cancer in Iran.
A convergent mixed-methods study.
Oncology departments and palliative care units across multiple healthcare institutions in Iran.
Quantitative phase: 320 healthcare providers, including anaesthesiologists, general practitioners, oncologists, nurses and pharmacists, selected via convenience sampling. Qualitative phase: 10 stakeholders, including patients, caregivers, policy makers and clinicians.
Quantitative data were collected using a psychometrically validated 23-item questionnaire assessing knowledge, attitudes and perceived barriers to cancer pain management. Qualitative data were obtained through semistructured interviews and analysed using Graneheim and Lundman’s content analysis method with MaxQDA software. Integration was performed using a side-by-side approach.
Quantitative data showed that over 65% of providers did not routinely assess pain, and only 29.1% believed pharmacological treatments were effective. Qualitative analysis identified 13 barriers across three domains—professional, patient and organisational—spanning physical, psychological, social and spiritual dimensions. Integrated findings revealed consistent patterns of underassessment, legal and cultural resistance and lack of interdisciplinary collaboration. These converging challenges highlight the need for holistic, system-level reform.
The convergence of quantitative and qualitative data reveals a multilayered system of barriers, professional, patient-related and organisational—rooted in physical, psychological, social and spiritual dimensions. These interlinked challenges contribute to fragmented pain management and limited interdisciplinary coordination. Addressing them requires a holistic reform strategy that integrates structural, cultural and clinical solutions.
by Mohamadreza Hatefi, Seyedeh Feriyal Mahdavi, Amirreza Abbasi, Farideh Babakhani
BackgroundUpper extremity (UE) dominance is often defined by self-reported hand preference; however, this may not accurately reflect true functional or strength-based dominance. This study examined the relationship between writing hand, throwing hand, and maximal grip strength to assess how these measures align.
MethodsThirty-four healthy, recreationally active college-aged individuals reported their preferred writing and throwing hands and completed standardized grip strength testing. Associations among the variables were analyzed using Phi coefficients and chi-square tests.
ResultsA moderate, significant relationship was found between writing and throwing hand preference (φ = 0.456; p = 0.008), indicating general consistency across these subjective measures. However, no significant association emerged between grip strength dominance and either writing (φ = 0.027; p = 0.876) or throwing hand (φ = 0.096; p = 0.574).
ConclusionThese results suggest that grip strength dominance may not correlate with commonly used indicators of hand preference, highlighting the need for task-specific definitions of dominance in clinical and athletic contexts. Consequently, employing such task-specific definitions allows for more accurate assessments and enhances the translational relevance of research findings in practical settings.
The expenses associated with cancer treatment are increasing at a rapid pace. The financial strain of providing care is experienced worldwide, but is particularly pronounced in low and middle-income countries (LMICs). This has resulted in a growing acknowledgement of the importance of value-based cancer care. Choosing Wisely Africa (CWA) is an initiative aimed at reducing the excessive use and expenses associated with cancer treatment. In this study, we assessed adherence to CWA recommendations for the treatment of breast cancer in three high-volume cancer centres in Sub-Saharan Africa (SSA).
A cross-sectional study across Rwanda, Ghana and Tanzania was conducted, involving a review of medical records to assess adherence to five measurable CWA practices in breast cancer care. The study used inferential statistics, such as 2 tests, to compare adherence among these countries.
This study was conducted in three cancer centres (Ocean Road Cancer Institute, Rwanda Military Hospital and Korle Bu Teaching Hospital) in three countries (Tanzania, Rwanda and Ghana, respectively).
A total of 542 patients were recruited. Eligible patients were those with a breast cancer diagnosis and complete data as pertaining to five CWA recommendations.
A total of 542 participants with a mean age of 51 years were included. Participants were well distributed across Ghana (37%), Rwanda (34%) and Tanzania (29%). Female patients represented 97% of the study cohort. Half (51%) of the participants had some form of insurance. The study observed high adherence to cancer staging (94%) before treatment and histological confirmation (91%) before breast lump removal across all sites. Hypofractionation was used in 0% of cases in Rwanda, 42% in Ghana and 70% in Tanzania.
This study provides critical insights into the implementation of CWA recommendations in breast cancer care in SSA. It highlights the disparities in adherence to CWA recommendations across different centres, showing the need for policy-driven changes and healthcare infrastructure improvement to standardise cancer care practices in LMICs.
This article challenges the tendency to frame diminished confidence and ethical uncertainty among nurses as individual shortcomings. While the need for up-to-date knowledge and moral clarity is undeniable, this piece argues that systemic factors—such as inadequate institutional support, unsafe staffing, and lack of access to continuing education—play a significant role in undermining nurses' ability to act ethically and confidently. Drawing from global case examples, including the Ebola crisis and the COVID-19 pandemic, this article highlights how moral distress often stems not from ignorance or weakness, but from structural barriers and ethical overload.
To explore the process of how nurses experience and deal with workplace violence based on nurses' perceptions and experiences in Iran.
An exploratory qualitative study was conducted using grounded theory approach. Participants included 17 nurses working in 4 hospitals in 2 urban areas in Iran with at least 1 year of clinical experience in emergency departments and intensive care units. Data were collected through in-depth, semi-structured individual interviews conducted between August 2024 and March 2025. The constant comparative analysis approach was used for data analysis. This research method was carried out in five stages: open coding to identify concepts; development of concepts in terms of their characteristics and dimensions; contextual analysis; integration of the process to data analysis; and final category integration.
The main concern of participants in dealing with workplace violence was a ‘multidimensional security threat’. ‘Perpetrator response to nursing care’ (at the individual level) and ‘organisational inefficiency’ (at the organisational level) provided the context for this threat. A general theme entitled ‘tensive adaptation’ was the core category in this research and included four main categories: ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ were the outcomes.
The theoretical model of ‘tensive adaptation’ provides a new perspective on ‘what’ and ‘how’ nurses experience and manage workplace violence. Effective strategies for managing violence such as effective communication, empathy, providing appropriate care, anger management, self-care, effective teamwork and requesting support can be considered by nursing administrators and incorporated into training programmes for nurses and nursing students. The adverse consequences of nurses' exposure to workplace violence should receive greater attention, as the entire healthcare system is affected by this exposure.
Workplace violence leads to physical and psychological problems, reduced job satisfaction, diminished performance, negative effects on personal and family life and decreased quality of patient care. The main concern of participants in dealing with workplace violence was ‘multidimensional security threat’. This concept includes three characteristics: ‘psychological health threats’, ‘physical health threats’ and ‘professional position threat’. ‘Perpetrator response to nursing care’ (individual level) and ‘organisational inefficiency’ (organisational level) served as contextual conditions that expose nurses to workplace violence. In ‘tensive adaptation’, nurses attempt to respond to workplace violence through strategies such as ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ are the consequences of nurses' exposure to workplace violence.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this study.
This study did not include patient or public involvement in its design, conduct, or reporting.
Worldwide, maternal mortality is mostly caused by avoidable or treatable health complications, despite the progress made in maternal health. High-quality care focuses on a standardised and patient-centred approach. In this light, care bundles, which are sets of evidence-based practices, were introduced to improve the quality of care and maternal outcomes. The existing reviews on care bundles focus on specific conditions, and there is, to our knowledge, no comprehensive systematic review on the effectiveness and evidence-based character of care bundles on multiple maternal outcomes. This systematic review aims to describe maternal care bundles on labour and birth, to assess their effectiveness on maternal outcomes and to evaluate the evidence-based character of their interventions.
This systematic review will include randomised controlled trials, quasi-randomised studies, cohort studies, case-control studies, controlled before-and-after studies and interrupted-time-series studies, starting from 2001, focused on labour and childbirth stages, addressing care bundles that include multiple conditions. The search strategy will include six electronic databases (PubMed, Cochrane Library, CINAHL, Embase, Scopus and Web of Science) used to retrieve relevant titles and abstracts based on a database-specific search strategy. Titles and abstracts will be independently screened by two reviewers, followed by a full-text eligibility assessment. Reviewers will also extract data based on this review’s objectives and outcomes. Analysis will be performed in three phases: descriptive analysis, evaluation of the evidence-based character of interventions and quantitative synthesis analysis.
Ethics approval is not needed. Dissemination will be performed through publication in peer-reviewed journals, conference presentations and informing policies and stakeholders by offering a structured overview of maternal care bundles on labour and childbirth.
PROSPERO 2025 CRD420251081127.
This paper responds to the recently published article on nurses' turnover intentions and their lived experiences of disempowerment, moral distress and organisational neglect. While the study illuminates important workplace realities, it overlooks the perspectives of nurses who have left not only their institutions but also their countries of origin. From the vantage point of Filipino nurses in the diaspora, the decision to migrate mirrors the dynamic, cumulative processes described in the article. Migration is seldom the result of one critical incident; rather, it arises from entrenched systemic issues—understaffing, lack of respect and persistent undervaluing of nursing contributions—that transcend borders. Diaspora nurses bring with them narratives of resilience, yet their departure reflects health system fragility in their home countries and exposes new challenges in host nations. This commentary highlights the urgent need for global cooperation, stronger leadership and policy innovations that recognise migration as part of the retention equation, not apart from it.
Pre-eclampsia causes significant maternal and perinatal morbidity and mortality. It also causes changes in the cardiovascular, endothelial and metabolic systems, from which women may not fully recover after delivery. This study examined the association between the time of onset of pre-eclampsia and the risk for cardiovascular disease (using glucose tolerance, lipid profile and blood pressure) and renal function at 6 weeks post partum.
A prospective cohort study.
Lagos University Teaching Hospital, Idi-Araba, Mother and Child Centre, Gbaja, Surulere and Lagos Island Maternity Hospital, Lagos, Nigeria.
44 women with pre-eclampsia were studied and data on their sociodemographic characteristics, gestational age at diagnosis and blood pressure were collected on admission. They were followed up through delivery till 6 weeks post partum, when blood pressure check, 75 g oral glucose tolerance test, fasting lipid profile and serum creatinine were done.
The exposure was pre-eclampsia. The outcomes were cardiovascular disease risk markers, viz persistent hypertension, glucose intolerance and dyslipidaemia, and renal function at 6 weeks post partum in women who had pre-eclampsia.
Data were analysed using Stata V.16.1. Mann Whitney-U test was used to compare medians and Fisher's exact test was used to compare the categorical variables.
Of the women studied, 13 (29.5%) had early onset pre-eclampsia and 31 (70.5%) had late onset pre-eclampsia. Mean gestational age at diagnosis was 30.8±1.57 weeks in women with early-onset pre-eclampsia and 35.6±1.26 weeks in women with late-onset pre-eclampsia (p
The prevalence of persistent hypertension at 6 weeks post partum is high in women with pre-eclampsia. Serum triglyceride concentration was significantly higher in early onset compared with late onset pre-eclampsia; subsequent studies powered to determine the full cardiovascular risk and how long to follow postnatal women up will be beneficial.
To examine the relationship between health literacy with the quality of discharge planning and readiness for hospital discharge in acute myocardial infarction patients in Jordan.
Acute myocardial infarction is a major heart disease caused by plaque formation in coronary arteries. Complications after acute myocardial infarction include readmission and physical complications such as chest pain, and limited health literacy increases the risk of complications. Improving the health literacy of patients can improve postdischarge outcomes and decrease complications.
This study was conducted using a cross-sectional design. Data were collected from 123 patients who were recruited from three hospitals in Jordan. A demographics questionnaire and three valid and reliable instruments (Health Literacy Questionnaire, Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale) were used to collect the data. The authors adhered to the STROBE checklist during the preparation of this study.
The results demonstrated that the Readiness for Hospital Discharge had weak to moderate positive correlations with health literacy scales (r = 0.24–0.36, p < 0.05). The content subscale of the Quality of Discharge Teaching Scale showed weak positive correlations with navigating the healthcare system, finding good health information and understanding health information scales of the Health Literacy Questionnaire.
The results reported here indicate that health literacy positively correlates with readiness for hospital discharge and quality of discharge teaching.
Improving the health literacy of acute myocardial infarction patients can enhance their discharge planning outcomes. The findings of this study are beneficial for healthcare providers in designing targeted interventions that correspond to health literacy among acute myocardial infarction patients.
No patient or public contribution.
A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic.
Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety.
A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist.
The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life.
The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout.
These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.
FreshRSS 