Conectar
To describe the challenges related to the flow of medication information in home care, their contributing factors, and home care registered nurses' and nurse leaders' views on preventing them.
A descriptive qualitative study.
Six group and one individual semi-structured interview were conducted remotely with 15 home care registered nurses and nurse leaders between 12 February 2023 and 9 November 2023 in Finland. The data were analysed using reflexive thematic analysis.
We identified four main themes related to the challenges of medication information flow: the complexity of home care work in cooperation and the medication process, technology-related challenges, the healthcare professionals' individual factors and client-related challenges. These factors contributed to the challenges: the lack of healthcare professionals' resources, the healthcare professionals' attitudes to work and individual characteristics, the lack of healthcare professionals' uniform practices and client-related factors. Preventing challenges and incidents: strengthening standard healthcare practices, increasing healthcare resources, improving the individual factors of healthcare professionals, and guiding the client in the management of medication.
The medication information flow can be improved by discussing standard practices for the flow of medication information in home care and between home care and hospital teams.
It is crucial to identify challenges, contributing factors and prevention in the medication information flow from the home care registered nurses' and nurse leaders' perspective. These elements play an important role in developing medication information flow by collaborating extensively with other healthcare providers, clients, and relatives.
Healthcare professionals, nurse leaders, and educators can utilise this study's findings to develop the flow of medication information within and between organisations.
The Standards for Reporting Qualitative Research checklist was used.
No patient or public contribution.
To explore how parents perceive health care encounters related to their child's higher weight and to interpret these experiences within the broader societal context shaped by cultural norms and representations.
A qualitative design was employed using semi-structured interviews to capture parents' experiences. The study was informed by a conceptual framework that views weight as both a personal and socially constructed phenomenon.
Eighteen parents from Finland were interviewed between May 2022 and June 2023. The data were analysed using reflexive thematic analysis to identify key themes in parents' experiences and perceptions.
Three main themes were identified. The relational dimension highlighted the importance of individualised care, where health care professionals take time to get to know the family and recognise each member as an individual. The emotional dimension emphasised the need to protect the child, strengthen parental self-efficacy and provide sensitive, skilled support that fosters a sense of safety. The practical dimension focused on the need for active and targeted care, including structured weight-related routines, multidisciplinary collaboration and services that respond to the everyday realities of families.
The study highlights the need for health care encounters that are individualised, emotionally safe and sensitive to the diverse realities of families. Moving beyond weight-centric approaches, care should offer a range of supportive options that reflect parents' varied expectations, concerns and needs.
This study responds to the need for a deeper understanding of how parents experience health care encounters related to their children's higher weight. The findings highlight the importance of designing care interactions that provide professionals with adequate time, expertise and training to deliver individualised, stigma-sensitive care.
COREQ.
No patient or public contribution.
by Ryosuke Segawa, Makiko Yagisawa, Chihiro Miyata, Noriyasu Hirasawa
Thymic stromal lymphopoietin (TSLP) is an epithelial-derived cytokine that induces type 2 immune responses through dendritic cell activation, and its aberrant regulation is implicated in TSLP-associated inflammatory disorders including atopic dermatitis. We previously demonstrated that hypoxia-inducible factor (HIF) suppresses TSLP expression in human keratinocyte cells; however, the underlying mechanism remained unclear. In this study, we aimed to explore the suppressive mechanism of enarodustat, an HIF-prolyl hydroxylase inhibitor. Enarodustat selectively suppressed TSLP expression induced by the fibroblast-stimulating lipopeptide (FSL-1), a toll like receptor 2/6 agonist in HaCaT, a human keratinocyte cell line. Although both the nuclear factor-κB (NF-κB) and activator protein (AP)-1 contributed to FSL-1-induced TSLP induction, enarodustat preferentially attenuated AP-1 signaling by reducing c-Jun N-terminal kinase (JNK) phosphorylation. This JNK dephosphorylation required both HIF1α and HIF2α and was accompanied by increased expression of dual-specificity phosphatases (DUSPs), which target JNK for dephosphorylation. Collectively, our findings identify a previously uncharacterized HIF–DUSP–JNK axis that negatively regulates TSLP expression. This study provides mechanistic insight into how HIF activation shapes epithelial cytokine responses, offering a basis for understanding the pathogenesis of TSLP-associated diseases such as atopic dermatitis.
Binge drinking in the previous month was reported in 23.5% of US adults, and 28.1 million adults met criteria for Alcohol Use Disorder (AUD) in 2023. Individuals with AUD face increased risks of oral health problems, including caries, periodontal disease and mucosal lesions. Poor oral hygiene, nutrition and dental care all contribute to these conditions, but individuals with AUD are often under-represented in oral health surveys. Understanding relationships between oral health behaviours, attitudes and general health is crucial for designing future interventions. This pilot aims to explore the relationship between oral and systemic health in subjects with AUD, focusing on oral health behaviours, salivary biomarkers and clinical phenotype, including systemic biomarkers of inflammation, to inform future research on oral–systemic interactions in AUD.
This protocol has two parts. Part 1 involves cognitive interviews to assess the content validity and interpretability of the Oral Health Behaviours Assessment (OHBA) questionnaire. Part 2 will collect biological and behavioural data from treatment-seeking patients with AUD and matched controls (age, sex and smoking status), including saliva, blood, dental exams, and health behaviour and symptom measures. Inpatients with AUD will provide biospecimens and answer symptom severity questionnaires at admission and again at the dental exam visit (7–12 days later), while controls will provide a single set of measures at their dental exam visit. Oral health will be assessed through structured dental and periodontal examinations, radiographs and validated questionnaires (including the OHBA). Additional data will include alcohol use history, psychiatric and medical history assessments, dietary recall, and measures of stress, sleep and mood to capture potential moderators of oral–systemic relationships. Biomarkers of inflammation and stress will be quantified from saliva and blood using immunoassays. Primary outcomes will compare oral health, salivary biomarkers and clinical measures between AUD and controls, while secondary outcomes will evaluate within-subject changes in patients with AUD during inpatient treatment and early abstinence.
This clinical protocol was approved by the National Institutes of Health Institutional Review Board (IRB #002005). Prior to enrolling, participants will be informed of the study purpose, risks and benefits, and study procedures, and evaluated for understanding prior to signing consent. Part 1 of the protocol is currently active and recruiting participants for cognitive interviews. The study findings will be disseminated through journals and conferences related to addiction medicine, psychology, immunology, neuroscience and dentistry. We expect the results of the pilot study will inform future research on oral health and salivary bioscience while also providing treatment-seeking patients with AUD targeted information on the importance of oral health behaviours for maintaining oral and systemic health.
NCT06684483; preresults.
Nurses are pivotal in EBHC implementation; however, its adoption remains limited, highlighting the need to investigate nurses' experiences and perceptions of their EBHC competence.
To critically appraise and synthesise qualitative evidence of nurses' experiences and perceptions of EBHC competence.
A qualitative systematic review.
The review followed the JBI methodology for qualitative systematic reviews. Inclusion criteria were qualitative studies published in Finnish, Swedish or English that explored nurses' experiences and perceptions of EBHC competence. Data were synthesised using JBI's meta-aggregation method and the findings were graded with the ConQual approach.
CINAHL, Medic, PubMed, Scopus and grey literature from EBSCO Open Dissertations and MedNar, searched in December 2023.
Seventeen qualitative studies were included. The study findings were generated from four synthesised findings with low confidence scores. The synthesised findings were: (1) Nurses' competence in Global Health, (2) Nurses' competence in enhancing Evidence generation, (3) Nurses' competence in optimising Evidence Transfer and (4) Nurses' competence in effective implementation of evidence. A new finding of this systematic review was that nurses did not express their experiences or perceptions on evidence synthesis.
Nurses' experiences of EBHC competence focus mainly on evidence implementation and global health. The lack of findings to evidence synthesis suggests that core principles of the EBHC model are not yet fully embedded in nursing practice. Nurses emphasised the need for greater support for developing EBHC competence.
Integration of EBHC into education, mentoring and adequate resources enhances nurses' competence, motivation and commitment to EBHC sub-dimensions, while also strengthening their professional confidence and development.
Strengthening nurses' EBHC competencies contributes to supporting the delivery of high-quality, effective and sustainable healthcare services.
PRISMA guidelines followed.
None.
PROSPERO-registered: CRD42021285179
To investigate the perceptions of family members (FMs) of patients with traumatic brain injury (TBI) and nurses on empowering support and its implementation during the acute phase within Finnish neurosurgical and neurological care in hospital settings, focusing on identifying similarities and differences in their viewpoints.
Participatory qualitative descriptive study.
Data were collected from seven FMs and 11 nurses using the World Café method in November 2019. An abductive approach was employed for data analysis, combining deductive interpretation within the conceptual framework of empowering support and inductive content analysis.
Four main themes were identified: (1) FMs' diverse information and guidance needs of TBI, treatment and its impact on family life, (2) support based on empowering FMs in participation, competence and decision-making, (3) empowering FMs through collaborative nursing practices and interprofessional support, and (4) internal and external hospital support enhancing and promoting the empowerment of FMs.
The perceptions of FMs and nurses regarding empowering support were largely consistent, yet diverged in its implementation in nursing practice. Nurses play a crucial role in fostering the empowerment of FMs; however, further research is needed to explore the impact of organisational and community factors on the implementation of empowering support.
Our study contributes to advancing nursing practices by underscoring the necessity for a paradigm shift towards a family-centred approach. Furthermore, it emphasises the urgency for standardising nursing practices to ensure equitable access to empowering support for FMs, applicable across various care settings for patients with TBI.
This review is part of a larger research project in which FMs of patients with TBI and nurses were involved in designing the project.
This study was reported using the Consolidated Criteria for Reporting Qualitative Checklist for qualitative studies.
Background
Chronic pain is a major cause of distress and disability, and biomarkers may aid in the assessment and treatment of it. Urine metabolites may be valuable bioindicators that can provide biological insight regarding chronic pain.
Objectives
To investigate the relationship between a multimarker composite measure of metabolites and patient-reported outcomes scores in adults with chronic pain, using data from a pragmatic clinical trial with a sequential, multiple-assignment randomized trial design.
Methods
Self-reported measures and urine samples from 169 active-duty service members with chronic pain were collected. Urine was analyzed using a preestablished panel of metabolites, including four previously identified biomarkers of pain: kynurenic acid, pyroglutamic acid, ethylmalonic acid, and methylmalonate. Multivariable linear regression models—adjusted for participant characteristics such as age and sex—were used to cross-sectionally examine the relationship between 11 patient-reported outcomes (fatigue, sleep-related impairment, anxiety, depression, anger, pain catastrophizing, physical function, pain interference, satisfaction with participation with social roles, pain intensity, and pain impact score) and the four urine metabolites both individually and as a composite (urine metabolite pain indicator, or UMPI). Given the study’s small sample size and exploratory nature, a significance threshold of p ≤ .10 was used for all analyses.
Results
The UMPI showed statistically significant associations with five self-reported measures (fatigue, anxiety, depression, physical functioning, and pain impact score); adjusted Pearson correlations ranged from .18 to .25. Individual metabolite analyses supported these findings, with all relationships between individual metabolites and self-reported measures showing positive associations. Kynurenic acid and ethylmalonic acid showed the strongest associations, each having statistically significant relationships with four individual self-reported measures, while pyroglutamic acid had statistically significant relationships with three self-reported measures and methylmalonate with none. The UMPI demonstrated feasible reliability.
Discussion
Our finding of associations between the UMPI and components of the self-reported measures supports the development of the UMPI and these four urine metabolites as biomarkers for chronic pain outcomes. Further research is planned and will be essential for establishing mechanistic insight and guiding biomarker development within the context of pain management.
Objetivo: Identificar os efeitos da pandemia da COVID 19 nos profissionais atuantes no atendimento pré-hospitalar. Método: revisão integrativa, conduzida de acordo com o protocolo prisma, por meio das bases de dados: Medline/PubMed, Lilacs, SciElo, BDENF, CUIDEN, CINAHAL. Adotaram-se os Descritores em Ciências da Saúde (DeCS): “Saúde do trabalhador” “Pandemia” “COVID 19” “Atendimento pré-hospitalar” “Segurança” “Profissionais de saúde” “Trabalho”. Após a aplicação dos critérios de inclusão, foram selecionados treze artigos que compuseram a amostra do estudo. Resultados: dezoito artigos foram analisados e duas categorias foram construídas: risco de contaminação e exposição ocupacional dos profissionais da saúde que cuidam de pacientes acometidos pela COVID-19 e risco de adoecimento psicoemocional dos profissionais da saúde que cuidam pacientes acometidos pela COVID-19. Conclusão: A revisão mostrou os potenciais efeitos sobre a saúde dos profissionais durante o atendimento de pacientes acometidos pela COVID-19. E a importância da implementação de estratégias de intervenção focadas nos riscos ocupacionais.
FreshRSS