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☐ ☆ ✇ Journal of Advanced Nursing

The Reported Evidence of Nursing and Midwifery Mentorship Programmes Internationally: A Scoping Meta‐Review Providing a Comprehensive Overview of Mentorship Programmes

Por: Giltenane Martina · Murphy Louise · McNamara Claire · Chatzi Anna · Nowell Lorelli · Kilduff Marie · Lane Aoife · Doody Owen — Enero 16th 2026 at 16:16

ABSTRACT

Aim

To synthesise and critically analyse existing reviews of evidence on mentorship in nursing and midwifery, providing a comprehensive overview of current knowledge.

Design

A scoping meta-review.

Methods

The review was conducted using the scoping meta-review framework outlined by Sarrami-Foroushani et al. (2015), alongside the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to ensure rigour and transparency. The following steps were included: (i) defining the problem, (ii) literature search and criteria, (iii) study selection and data extraction, (iv) data synthesis, (v) presentation of results and (vi) interpretation and recommendations.

Data Sources

A comprehensive search strategy was designed, utilising Boolean operators, truncation and predefined keywords across seven databases including MEDLINE, CINAHL, Embase, PsycINFO, Epistemonikos, ERIC and Google Scholar.

Results

Following double-blind screening of 269 papers, 14 literature reviews were included. The findings provided a detailed overview of mentorship programme types (formal and informal), outcome measures used to evaluate mentorship effectiveness and recommendations for future programmes. Identified themes included skill development, job satisfaction, career progression and retention outcomes, together with challenges including time constraints and balancing clinical responsibilities with mentorship roles. Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Informal mentorship continues to offer valuable, flexible support, particularly when used alongside formal structures. Implementation challenges exist, such as time constraints, limited organisational support, and mismatched mentor-mentee pairings.

Conclusion

This review highlights the critical role of mentorship in nursing and midwifery, offering insights into effective practices, challenges and potential areas for further research. The findings suggest that formal, structured mentorship programmes produce consistent benefits, including enhanced clinical skills, confidence and satisfaction among mentees, as well as leadership development and professional fulfilment for mentors, while positively impacting organisational efficiency and patient outcomes. Successful mentorship programmes require organisational commitment, with protected time, resources, and ongoing mentor training.

Implications for the Profession and/or Patient Care

Mentorship programmes in nursing and midwifery enhance professional development, job satisfaction, and retention, enabling a stable healthcare workforce. Mentorship for mentors and mentees is linked to increased confidence, competency and readiness for advanced roles among nurses and midwives. Fostering mentorship in healthcare can lead to improved quality and continuity of care as mentees grow into more competent and confident practitioners.

Impact

Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Policymakers responsible for healthcare workforce development can use these findings to advocate for mentorship as a strategic investment, potentially influencing policies related to nurse retention, professional development and funding allocations for mentorship initiatives. Structured mentorship improves job satisfaction, reduces turnover and fosters professional growth, thus reducing costs associated with recruitment and training.

Reporting Method

The findings are reported in line with the PRISMA guidelines (Page et al., 2021) and through a narrative synthesis, summarising and analysing the results of various reviews to present a cohesive understanding of mentorship practices in nursing and midwifery. This method allowed for the integration of qualitative and quantitative findings and the identification of common themes and patterns across studies.

Patient or Public Contribution

Patients or members of the public did not directly contribute to this review. However, by focusing on mentorship practices that support nurses and midwives, the study indirectly addresses public interests, as improved mentoring contributes to the quality of patient care. Future studies could benefit from patient or public feedback on desired qualities in care providers, further informing the development of mentorship programmes aligned with patient-centred care outcomes.

☐ ☆ ✇ BMJ Open

Trajectory, healthcare utilisation and recovery in 3590 individuals with long covid: a 4-year prospective cohort analysis

Por: Prashar · J. · Hillman · T. · Wall · E. C. · Sarna · A. · Mi · E. · Bell · R. · Sahota · J. · Zandi · M. · McNamara · P. · Livingston · R. · Gore · R. · Lunken · C. · Bax · E. · Nyam · R. · Rafie Manzelat · A. M. · Hishmeh · L. · Attree · E. · Cone · S. · Banerjee · A. · Heightman · M. — Enero 14th 2026 at 15:37
Objective

To characterise long-term trajectory of recovery in individuals with long covid.

Design

Prospective cohort.

Setting

Single-centre, specialist post-COVID service (London, UK).

Participants

Individuals aged ≥18 years with long covid (hospitalised and non-hospitalised) from April 2020 to March 2024.

Main outcome measures

Routine, prospectively collected data on symptoms, quality of life (including Fatigue Assessment Scale (FAS) and EuroQol 5 Dimensions (EQ-5D), return to work status and healthcare utilisation (investigations, outpatient and emergency attendances). The primary outcome was recovery by self-reported >75% of ‘best health’ (EQ-5D Visual Analogue Scale) and was assessed using Cox proportional hazards regression models over 4 years. Linked National Health Service England registry data provided secondary care healthcare utilisation and expenditure.

Results

We included 3590 individuals (63.3% female, 73.5% non-hospitalised, median age 50.0 years, 71.9% with ≥2 doses of COVID-19 vaccination), who were followed up for a median of 136 (0–346) days since first assessment and 502 (251–825) days since symptom onset. At first assessment, 33.2% of employed individuals were unable to work. Dominant symptoms were fatigue (78.7%), breathlessness (68.1%) and brain fog (53.5%). 33.4% of individuals recovered to >75% of best health prior to clinic discharge (recovery occurred median 202 (94–468) days from symptom onset). Vaccinated individuals were more likely to recover faster (pre: HR 2.93 (2.00–4.28) and post: HR 1.34 (1.05–1.71) COVID-19 infection), whereas recovery hazard was inversely associated with FAS (HR 0.37 (0.33–0.42)), myalgia (HR 0.59 (0.45–0.76)) and dysautonomic symptoms (HR 0.46 (0.34–0.62)). There was high secondary care healthcare utilisation (both emergency and outpatient care). Annual inpatient and outpatient expenditure was significantly lower in hospitalised individuals while under the service. When compared with the prereferral period, emergency department attendances were reduced in non-hospitalised patients with long covid, but outpatient costs increased.

Conclusions

In the largest long covid cohort from a single specialist post-COVID service to date, only one-third of individuals under follow-up achieved satisfactory recovery. Fatigue severity and COVID-19 vaccination at presentation, even after initial COVID-19 infection, was associated with long covid recovery. Ongoing service provision for this and other post-viral conditions is necessary to support care, progress treatment options and provide capacity for future pandemic preparedness. Research and clinical services should emphasise these factors as the strongest predictors of non-recovery.

☐ ☆ ✇ International Wound Journal

Cultural Adaptation and Psychometric Assessment of the Catalan Version of the Wound‐QoL‐17

ABSTRACT

Complex chronic wounds are an increasing health concern, affecting individuals both physically and psychologically. To measure the quality of life of this population properly translated and validated questionnaires in their native language are needed. The aim of this work is to provide a validated instrument for measuring the quality of life in the Catalan speaking population with complex wounds. A cultural adaptation of the Wound-QoL-17 questionnaire into Catalan was carried out by independent official translators and the back translation was approved by the original author. Validity, reliability, responsiveness, and feasibility were assessed. Face and content validity were determined by a group of experts: the 17 items of the Wound-QoL-17 Catalan version were appropriate for their purpose. Reliability was demonstrated by an interclass correlation coefficient of 0.884 for the scores obtained by two different observers and of 0.928 for the same observer on two time points. Chronbach's alpha coefficient was 0.926. Responsiveness was proved by a Pearson's correlation coefficient of 0.661. Feasibility was shown by the time, 3.46 min, taken to complete the questionnaire.

☐ ☆ ✇ Journal of Advanced Nursing

Interventions Addressing Compassion Fatigue Among Nurses: A Scoping Review

Por: Kasi Mayan Pavithrakshmi · Surekha Chukkali · Vardhini Krishnamurthy — Enero 8th 2026 at 16:39

ABSTRACT

Aim

To identify and synthesise intervention programs designed to address compassion fatigue among nurses, with a focus on their types and core characteristics.

Design

A scoping review.

Methods

This review was conducted according to the scoping review guidelines proposed by Arksey and O'Malley and met the requirements of PRISMA-ScR guidelines.

Data Sources

Literature published between January 2015 and March 2025 was thoroughly searched in Scopus, PubMed, Cochrane Library, APA PsycNet, Science Direct, and ProQuest. Major search terms included ‘compassion fatigue’, ‘secondary traumatic stress’, ‘burnout’, ‘nurses’ and ‘intervention’.

Results

Fourteen studies met the inclusion criteria. Interventions were categorised as: (1) Enhancement of Organisation and Social Support, (2) Development of Individual Psychological Capacities, (3) Systemic-level Interventions, these results align with the framework of the job demands resources theory.

Conclusion

This review highlights diversity in the focus. While some emphasised on strengthening the job resources and building the personal individual-based resources, few others focused on system level interventions to address compassion fatigue in nurses. The findings also emphasise the importance and need for customised and accessible support strategies at both individual and organisational levels. Nurse well-being and resilience interventions promote balanced job settings and quality health care support.

Implications for the Profession and/or Patient Care

This review provides a foundation for designing comprehensive, empirically supported strategies to address compassion fatigue in nursing. Future research should focus on integrating individual and systemic support to build a healthy work environment.

Impact

This review helps to understand the core characteristics and types of existing interventions addressing compassion fatigue among nurses, and highlights the need to focus on both individual as well as organisational needs and outcomes, thereby enhancing the well-being of nurses and creating healthy work environments.

Reporting Method

PRISMA-ScR was used in this scoping review.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ BMJ Open

Optimal timing of induction of labour to improve maternal and perinatal outcomes: protocol for an individual participant data and network meta-analysis

Por: Meacham · H. · Ona-Igbru · A. · McNeill · R. · Ajayi · R. · Pickering · E. · Grobman · W. A. · Black · M. · Khalil · A. · Mccourt · C. · Miranda · A. · Mol · B. W. · Walker · K. · Wilson · A. · Zamora · J. · Thangaratinam · S. · Allotey · J. — Enero 8th 2026 at 13:18
Introduction

Despite advances in maternity care, stillbirth remains a major burden. It disproportionately affects black and Asian mothers, those with obesity and women over the age of 35 years. Induction of labour may benefit these women, but there is no clear evidence to guide recommendations on optimal timing of induction because of variations in the intervention and insufficient power in primary trials for rare outcomes such as stillbirth and perinatal mortality, or to assess whether effects differ by maternal characteristics. We will conduct an individual participant data (IPD) meta-analysis of randomised trials to assess the overall and differential effect of induction of labour, according to timing of induction and maternal characteristics, on adverse perinatal and maternal outcomes. We will also rank induction of labour timing strategies by their effectiveness to inform clinical and policy decision-making.

Methods and analysis

We will identify randomised trials on induction of labour by searching MEDLINE, CINAHL, EMBASE, BIOSIS, LILACS, Pascal, SCI, CDSR, ClinicalTrials.gov, ICTRP, ISRCTN registry, CENTRAL, DARE and Health Technology Assessment Database, without language restrictions, from inception to June 2025. Primary researchers of identified trials will be invited to join the OPTIMAL Collaboration and share the original trial data. Data integrity and trustworthiness assessment will be performed on all eligible trials. We will check each study’s IPD for consistency with the original authors before standardising and harmonising the data. Study quality of included trials will be assessed by the Cochrane Risk of Bias tool. We will perform a series of one-and-two-stage random-effects meta-analyses to obtain the summary intervention effect on composite adverse perinatal outcome (stillbirth, neonatal death or severe morbidity requiring admission to neonatal unit) with 95% CIs and summary treatment–covariate interactions (maternal age, ethnicity, parity, socioeconomic status, body mass index and method of conception). Heterogeneity will be summarised using tau2, I2 and 95% prediction intervals for effect in a new study. Sensitivity analysis to explore robustness of statistical and clinical assumptions will be carried out. Small study effects (potential publication bias) will be investigated using funnel plots.

Ethics and dissemination

The study is registered on PROSPERO (CRD420251066346) and ethics approval is not required. We will disseminate findings widely to women, healthcare professionals and policymakers through academic, professional bodies and social media channels, and in peer-reviewed journals to achieve impact.

PROSPERO registration number

CRD420251066346.

☐ ☆ ✇ BMJ Open

Clinical characteristics, treatments and outcomes of hospitalised COVID-19 patients across pandemic waves at a tertiary acute care hospital in Narita, Japan: a single-centre retrospective observational study

Por: Hase · R. · Kurata · R. · Niiyama · Y. · Matsuda · N. · Ueda · H. · Kikuchi · K. · Ishida · K. · Kubota · Y. · Fujii · M. · Kurita · T. · Muranaka · E. · Sasazawa · H. · Mito · H. · Yano · Y. · Oku · R. · Tateishi · Y. · Toishi · S. · Obata · S. · Noguchi · Y. · Nakanishi · K. · Sunami · S. — Enero 8th 2026 at 13:18
Objective

This study aims to describe the characteristics of hospitalised COVID-19 patients in a tertiary care hospital close to an international airport in Japan and to compare these characteristics among different waves during the pandemic.

Design

Retrospective observational study.

Setting

Tertiary care centre in Japan.

Participants

All patients diagnosed with COVID-19 who were hospitalised between January 2020 and April 2022 were included.

Measurements

Clinical characteristics, characteristics of admission, treatments and outcomes were investigated and compared among six pandemic waves.

Results

A total of 827 patients were included. The median age was 58.0 years. More than half of the patients (58.3%) had at least one comorbidity. The majority of patients (89.0%) were domestically infected patients admitted under the Infectious Diseases Law, while the remaining patients (11.0%) were those diagnosed during airport quarantine and admitted under the Quarantine Act. Hospital-acquired COVID-19 infection occurred in 7.0% of cases, and mainly during the sixth wave. Overall, some form of oxygen therapy, high-flow oxygen devices, invasive mechanical ventilation (IMV) and extracorporeal membrane oxygenation was provided in 46.3%, 10.4%, 4.5% and 1.5% of cases, respectively. Only 1.8% of patients were treated in the intensive care unit (ICU), and 59.5% of patients on IMV were managed in the non-ICU ward. The in-hospital mortality rate was 5.8%. Median age, percentages of some comorbidities, vaccination coverage, medications for COVID-19, types of supportive care and ICU admissions differed significantly among waves.

Conclusions

This study suggests that patient characteristics, vaccination coverage, standard of treatment and severity of illness changed across waves during the COVID-19 pandemic. Intensive care delivery in non-ICU wards was unavoidable due to limited ICU capacity, which may be a key consideration when preparing for future pandemics.

☐ ☆ ✇ BMJ Open

Temporal trends in the causes of in-hospital cardiac arrest: a retrospective observational cohort study on the limitations of the current alert system at a tertiary hospital in Korea

Por: Lee · J. M. · Cho · M. S. · Cha · M.-J. · Kim · J. · Choi · K.-J. · Kim · A.-R. · Kim · M.-S. · Lee · J. · Shin · Y. · Go · U. J. · Oh · H. Y. · Hong · S.-B. · Nam · G.-B. — Diciembre 23rd 2025 at 10:35
Objectives

In-hospital cardiac arrest (IHCA) is associated with high mortality and serious neurological sequelae. Although medical alert systems have evolved, the ability of these systems to influence changes in IHCA incidence and aetiology remains limited.

Designs

Retrospective observational cohort study.

Settings

A single tertiary hospital in South Korea, covering tertiary care levels.

Participants

A total of 1994 adult patients (≥18 years) who experienced 2121 episodes of IHCA between January 2011 and December 2019. Patients with out-of-hospital cardiac arrest, those aged ≤18 years and those with do-not-resuscitate orders were excluded. The mean age of patients was 63.0 years (SD, 14.6); 64.1% were male.

Interventions

Not applicable.

Main outcome measures

The incidence and temporal trends of IHCA were stratified by aetiology (cardiac vs non-cardiac). Additional analyses examined changes in arrhythmic versus non-arrhythmic causes over time using Poisson regression.

Results

Cardiac arrhythmia was the most common cause of IHCA (314 of 2121, 14.8%; incidence: 0.42/1000 admissions), including ventricular tachycardia (n=86), ventricular fibrillation (n=87) and Torsades de Pointes (n=79). Respiratory failure was the second most common cause (266 of 2121, 12.5%; incidence: 0.36/1000 admissions). The incidence of IHCA due to respiratory failure in 2011 was 0.63/1000 admissions, which decreased to 0.20/1000 admissions by 2019 (β=0.883, 95% CI 0.842 to 0.926, p for trend 0.007; Poisson p

Conclusion

IHCA causes have shown significant temporal shifts. Arrhythmia has become the leading cause of IHCA, with incidences remaining stable, whereas a marked decrease has been observed in respiratory-related IHCA. Therefore, enhanced in-hospital cardiac monitoring systems are required for early detection.

☐ ☆ ✇ BMJ Open

Effectiveness of fresh frozen plasma in the resolution of coagulopathy in human patients following hemotoxic snakebites: a systematic review and meta-analysis

Por: Ganessane · E. · Mohammed Muthanikkatt · A. · Manu Ayyan · S. · Abraham · S. V. · Krishnamoorthy · Y. — Diciembre 18th 2025 at 10:31
Objective

To assess the effectiveness of fresh frozen plasma (FFP) as an adjunctive treatment to anti-snake venom (ASV) for resolving venom-induced consumption coagulopathy (VICC) in patients with hemotoxic snakebites.

Design

Systematic review and meta-analysis, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Data sources

MEDLINE, ScienceDirect, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Europe PubMed Central, Directory of Open Access Journals, Google Scholar, ClinicalTrials.gov and WHO ICTRP were searched from inception to 30 July 2025 using multiple terms, including ‘fresh frozen plasma’, ‘plasma transfusion’, ‘hemotoxic snakebite’, ‘vasculotoxic snakebite’, ‘coagulopathy in snake bite’ and ‘venom-induced consumption coagulopathy’.

Eligibility criteria

We included randomised controlled trials and observational studies in the English language comparing antivenom alone with antivenom with FFP in patients with hemotoxic snakebite-induced coagulopathy. Studies must have reported coagulopathy resolution as measured by international normalised ratio (INR) normalisation or 20 min whole blood clotting test (WBCT) correction. Non-English publications, case reports, case series, reviews, conference abstracts, preclinical studies and studies lacking full-text availability or without quantitative INR or WBCT outcome data were excluded.

Data extraction and synthesis

Two independent reviewers extracted data using standardised extraction forms and assessed risk of bias using the Cochrane Risk of Bias 2 tool for randomised controlled trials and the Newcastle–Ottawa scale for observational studies. Data were pooled using random-effects meta-analysis and expressed as ORs with 95% CIs. Statistical heterogeneity was assessed using I² statistics, and the certainty of evidence was evaluated using the Grades of Recommendation, Assessment, Development and Evaluation approach.

Results

Four studies involving 370 patients were included (two randomised controlled trials and two prospective observational studies). The pooled analysis demonstrated that adjunctive FFP significantly increased the likelihood of coagulopathy resolution compared with antivenom alone (OR=7.71, 95% CI 2.20 to 27.04, p=0.001). No evidence of a significant difference in mortality was observed between groups (OR=4.96, 95% CI 0.55 to 44.60, p=0.15). High heterogeneity was noted among the four studies (I² = 67%), but a subgroup analysis of three studies, which used INR as the outcome assessment method, showed lower heterogeneity (I² = 25%). Adverse events were inconsistently reported across studies.

Conclusions

FFP as an adjunct to antivenom significantly improves coagulopathy resolution in patients with hemotoxic snakebite-induced coagulopathy. However, the certainty of evidence is very low because of methodological limitations, small sample sizes and significant heterogeneity. Although FFP shows promise for rapid coagulopathy correction, mortality benefits are not established, and it should not replace timely antivenom administration or comprehensive supportive care.

Study registration

PROSPERO, CRD42023483336.

☐ ☆ ✇ Journal of Advanced Nursing

Teaching and Learning Activities That Promote Critical Thinking in Student Nurse Practitioners: A Rapid Review

Por: Shannon McNamara · Lisa Cranley · Kelley Kilpatrick · Monica Parry — Diciembre 18th 2025 at 08:04

ABSTRACT

Background

Critical thinking has been identified as a key requirement for safe and competent practice for Nurse Practitioners. It has been suggested that it is the foundation for the development of clinical reasoning, diagnostic reasoning, and clinical judgement. Poorly developed critical thinking is linked to negative patient outcomes, diagnostic error, cognitive bias, and poor information processing. There is little literature that studies the teaching and learning activities that can be used in the development of critical thinking in Nurse Practitioners. The aim of this rapid review was to identify teaching and learning activities that promote critical thinking in Nurse Practitioners.

Design and Method

A rapid review was conducted to identify studies that examined different teaching and learning activities that promoted the development of critical thinking or any of its subthemes such as clinical reasoning, diagnostic reasoning or clinical judgement. Four databases were systematically searched: CINAHL, Medline, Embase and ERIC. The methodology used was guided by the Cochrane Rapid Review Methods Group. Eligible papers included peer-reviewed publications that evaluated the efficacy or effectiveness of teaching or learning strategies used for the development or promotion of critical thinking or its components. The included populations were faculty teaching in a Nurse Practitioner programme, Nurse Practitioners, Nurse Practitioner students or graduate level nursing students.

Results

The search yielded 6421 article titles and abstracts. Of these, 12 were included in the final rapid review. Teaching and learning activities were divided into three themes: classroom, simulation, and written. Classroom activities included problem-based learning, unfolding case scenarios, self-explanation, and Socratic inquiry. Simulation was in the form of high fidelity using standardised patients, computer-based programmes, escape rooms and virtual reality. Written activities included concept mapping, evolving case studies and illness scripts. Study participants noted that using a combination of teaching and learning activities had the greatest impact on their development of critical thinking.

Conclusion

There is limited knowledge on the effects of teaching and learning strategies on the development of critical thinking in nurse practitioners. This review offers a perspective on strategies that were most impactful for student nurse practitioners in their development of the different aspects of critical thinking. Simulation activities were the most researched and using it in combination with other activities was preferred by study participants.

Patient or Public Contribution

No patient or public contribution as this is a literature review.

☐ ☆ ✇ BMJ Open

Intersections of menstruation, gender-based violence and contraceptive use: qualitative insights from girls and young womens experiences in western Kenyan family planning clinics

Por: Hartman · E. A. · Marston · C. · Namwebya · J. · Asala · E. · Ombidi · W. · Thungu · F. · Odwe · G. · Colombini · M. · Singh · N. S. · Buller · A. M. — Diciembre 8th 2025 at 06:09
Objective

To examine how menstruation, contraceptive use and gender-based violence intersect to shape the sexual and reproductive health and autonomy of girls and young women in Kenya.

Design

Qualitative study exploring girls and young women’s experiences with contraceptive use and menstrual management, using in-depth interviews and focus group discussions analysed through a reflexive thematic approach.

Setting

Four county-run family planning clinics in Uasin Gishu County, Kenya.

Participants

77 girls and young women aged 15–19 years (via 35 in-depth interviews and 7 focus group discussions) and 27 family planning clinic providers (via 5 focus group discussions).

Results

Interviewees’ contributions suggest that covert contraceptive use, when discovered through menstrual monitoring, provoked intimate partner violence. Heavy menstrual bleeding, whether related to contraceptive use or not, was viewed as a sexual restriction and also fuelled intimate partner violence. Furthermore, the inability to afford sanitary pads, combined with the stigma surrounding menstruation, drove some girls and young women into exploitative sexual relationships, often resulting in unwanted or unintended pregnancies.

Conclusions

Menstrual bleeding and contraceptive use, both independently and in combination, affect girls and young women’s reproductive autonomy and overall health and well-being, particularly in relation to gender-based violence. Improving menstrual hygiene management, challenging the stigma and harmful norms tied to menstruation and contraception and ensuring safe contraceptive use are integral to improving sexual and reproductive health and autonomy and are requisite for preventing and eradicating gender-based violence.

☐ ☆ ✇ BMJ Open

Changes in attitudes towards prenatal diagnosis for haemoglobinopathies: a 40-year retrospective observational study in Northern Italy

Por: Voi · V. · Giordano · N. · Sciannameo · V. · Sciarrone · A. · Sbaiz · L. · Barberis · M. · Curcio · C. · Irrera · M. A. · Roetto · A. · Piga · A. · Giachino · D. F. · Mandrile · G. — Diciembre 8th 2025 at 06:09
Objectives

To analyse demographic trends and decision-making patterns regarding prenatal diagnosis (PND) in couples at risk for hereditary haemoglobinopathies at the Thalassemia and Rare Haematological Disease Centre in Turin over a 40-year period.

Design

Retrospective observational study analysing demographic and clinical data from 1983 to 2023.

Setting

Tertiary care genetic service Centre in Orbassano (TO), Northern Italy.

Participants

Couples seeking genetic counselling and PND for hereditary haemoglobinopathies. Selection criteria included couples at risk of having children affected by β-thalassaemia major or Sickle Cell Disease (SCD).

Main outcome measures

Primary outcomes included acceptance rates of PND and pregnancy termination (TOP). Variables analysed included couples’ age at first consultation, age at first PND, birthplace, employment status, specific haemoglobinopathy risk and number of pregnancies.

Results

The analysis identified three main factors influencing PND and TOP decisions: nationality, type of haemoglobinopathy risk and number of previous pregnancies. Age showed no significant correlation with decision-making patterns. The impact of education level and employment status could not be definitively determined due to unavailable or unfit data.

Conclusions

The 40-year analysis of prenatal diagnosis for haemoglobinopathies in Turin shows evolving trends influenced by immigration patterns, improved medical treatments and cultural factors, leading to increased acceptance of affected pregnancies in recent years, particularly after 2015, due to better disease management and comprehensive healthcare support. This comprehensive analysis of our centre’s experience provides valuable insights that can serve as a model for similar institutions worldwide in supporting couples through carrier screening and PND processes.

☐ ☆ ✇ Journal of Advanced Nursing

Exploring Individual and Organisational Factors Related to Inclusive Leadership Among Healthcare Professionals: A Systematic Review and Meta‐Analysis

Por: Vanamo Vilokkinen · Suvi Kuha · Eeva Vuorivirta‐Vuoti · Jouko Miettunen · Outi Kanste — Diciembre 9th 2025 at 08:07

ABSTRACT

Aim

To offer a comprehensive overview of the individual and organisational factors related to inclusive leadership among healthcare professionals.

Design

Systematic review and meta-analysis.

Methods

The review was conducted following the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Findings were synthesised using meta-analysis, a random effects model and narrative synthesis.

Data Sources

In January 2025, a systematic search was conducted with no time or geographical limits in the CINAHL, MEDLINE (PubMed), Mednar, ProQuest and Scopus databases. Studies in English, Swedish and Finnish were included.

Results

A total of 34 studies were included. The meta-analysis revealed a statistically significant positive relationship between inclusive leadership and psychological safety among healthcare professionals (n = 10). The narrative synthesis further identified individual and organisational factors related to inclusive leadership. Individual factors consisted of well-being at work, performance and productivity, social behaviour, innovativeness and creativity and psychological capacity. Organisational factors revealed work community cohesion and citizenship, as well as organisational fairness and appreciation.

Conclusions

Inclusive leadership is a promising leadership behaviour, with positive outcomes for healthcare professionals and organisations. By enhancing psychological safety, inclusive leadership offers broader benefits for individuals and organisations. As such, it could improve the retention of professionals and the attractiveness of organisations in the healthcare sector.

Implications for Healthcare Management

To strengthen the functioning of healthcare organisations, leaders should be educated in inclusive leadership and its practical benefits. Training should focus on developing inclusive leadership behaviours that foster belonging, value individual uniqueness and encourage participation across all professional groups, creating an environment where both individuals and organisations can thrive.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used to report the results.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

The protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (ID: CRD42024503861)

☐ ☆ ✇ PLOS ONE Medicine&Health

Precarious employment and gender-based violence against migrant women: A scoping review mapping the intersections

by Cyndirela Chadambuka, Prossy Kiddu Namyalo, Rhea Raghunauth, Navya Arora, Fiona Kouyoumdjian, Beverley M. Essue

The risk of gender-based violence (GBV) against migrant women is largely exacerbated by precarious employment opportunities available to them as they go through the resettlement process. Despite the risk that the connection of precarious employment and GBV pose to migrant women’s health and wellbeing, critical gaps exist in literature. Our scoping review sought to identify and synthesize evidence on the interconnectedness of GBV and precarious employment among migrant women. Six electronic databases were searched for empirical literature and two reviewers independently conducted title/abstract and full text screening of studies that met the inclusion criteria. Data synthesis was guided by the intersectionality theory and the Feminist Political Economy framework. 50 articles met the criteria for inclusion in this review. Our findings reveal that precarious employment plays both a catalytic and consequential role in GBV. Findings highlighted how post-migration shifts in gender roles, schedule unpredictability leading to work-life imbalance, and debt bondage trap migrant women in cycles of exploitation and abuse. Few studies highlighted how human trafficking is intertwined with precarious labor markets, where the exploitation and abuse of migrant women mirror the characteristics of human trafficking. This review underscores the urgent need for integrated policy responses that are not only focused on individual supports but also address the structural drivers or labor precarity and protect migrant women from GBV and human trafficking. By applying an intersectional lens, policies and intervention programs can tackle systemic oppression across economic, and social systems essential in reducing exploitation and abuse to advance migrant women’s wellbeing.
☐ ☆ ✇ BMJ Open

K-LARS trial: protocol for a multicentre randomised controlled trial evaluating a knowledge-enhanced digital intervention to prevent low anterior resection syndrome in Korea

Por: Ryoo · S.-B. · Ahn · H.-M. · Nam · B.-H. · Song · Y. M. · Sohn · D. K. — Noviembre 30th 2025 at 04:37
Introduction

Low anterior resection syndrome (LARS) is a common functional complication after sphincter-preserving surgery for rectal cancer that significantly impairs the quality of life. Current postoperative management strategies are suboptimal, and effective preventive approaches are lacking. This study aims to evaluate the impact of a mobile-based, knowledge-enhanced digital intervention for reducing the incidence of major LARS.

Setting

This is a multicentre, open-label, parallel-group, randomised controlled trial to be conducted across three academic medical centres in Korea.

Methods and analysis

A total of 300 adult patients who underwent low anterior resection or stoma reversal after rectal cancer surgery will be randomly assigned in a 1:1 ratio to the intervention group (mobile digital programme) or the control group (standard educational materials). The digital programme includes daily symptom monitoring, exercise suggestions, dietary recommendations and structured feedback from healthcare providers during clinical visits based on outcomes. The primary outcome is the incidence of major LARS (score ≥30) at 12 months postoperatively. Secondary outcomes include longitudinal changes in LARS score, quality of life (European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-Core 30 (C30), EORTC QLQ-Colorectal Cancer 29 (CR29)), European Quality of Life 5 Dimensions Level Version (EQ-5D-5L), patient satisfaction and programme adherence. Statistical analyses will include stratified chi-squared tests and mixed-effects models based on the intention-to-treat principle.

Ethics and dissemination

The trial received ethical approval from the Institutional Review Board of the National Cancer Centre, Korea. Written informed consent will be obtained from all participants. The findings will be disseminated through peer-reviewed publications and conference presentations.

Trial registration number

NCT07041515.

☐ ☆ ✇ PLOS ONE Medicine&Health

Global HIV prevention, treatment, and care interventions and strategies for key populations: Protocol for a scoping review

by Emmanuel Kumah, Dorothy Serwaa Boakye, Eunice Agyei, Richard Boateng, Veronica Penaman Asamoah, Emmanuel Osei Tutu

Introduction

Since its emergence, HIV/AIDS has remained one of the most significant global health challenges, with key populations—such as sex workers, men who have sex with men (MSM), transgender people, people who inject drugs (PWID), and individuals in prisons or other closed settings—disproportionately bearing the burden of the epidemic. These groups, often at heightened risk due to social, legal, and structural vulnerabilities, face persistent barriers to accessing prevention, treatment, and care services. Despite progress in reducing new infections and improving treatment outcomes, these disparities, exacerbated by stigma, structural inequalities, and insufficient political commitment, continue to limit the effectiveness of global HIV responses.

Aim

This scoping review protocol aims to systematically map the range of HIV prevention, treatment, and care interventions and strategies targeting key populations worldwide. Rather than formally evaluating effectiveness, the review will describe the nature, extent, and types of interventions implemented, identify barriers to implementation, and highlight gaps in research and practice.

Methods

Following the Joanna Briggs Institute (JBI) guidelines for scoping reviews, the study will systematically identify and analyze evidence from multiple databases, including PubMed, Embase, CINAHL, Scopus, and PsycINFO, alongside regional and grey literature sources. The review will include studies focusing on key populations and evidence-based interventions, such as prevention tools, treatment strategies, and policy or structural interventions. Data will be extracted and synthesized using quantitative and qualitative approaches, with results presented through descriptive statistics and thematic analysis. Findings will inform the development of a comprehensive, evidence-based framework tailored to the unique needs of key populations.

Conclusion

By mapping available interventions and strategies for HIV prevention, treatment, and care among key populations, this review will provide a comprehensive overview of existing approaches, barriers, and gaps. The findings will inform future research, policy, and practice, supporting more targeted, inclusive, and sustainable HIV responses that contribute to global efforts to end AIDS as a public health threat by 2030.

☐ ☆ ✇ PLOS ONE Medicine&Health

Effect of fascial closure using barbed sutures on incisional hernias in midline laparotomy for gynecological diseases: A multicenter randomized controlled trial (KGOG 4001)

by Yong Jae Lee, Nam Kyeong Kim, Kidong Kim, Chel Hun Choi, Keun Ho Lee, Jong-Min Lee, Kwang Beom Lee, Dong Hoon Suh, Sunghoon Kim, Min Kyu Kim, Seok Ju Seong, Myong Cheol Lim

Objective

To identify the effect of fascial closure using barbed sutures on the incidence of incisional hernia in patients undergoing elective midline laparotomy for gynecological diseases.

Methods

In this multicenter, non-blind randomized controlled trial conducted from February to December 2021, patients with a BMI 2 and aged >18 years, scheduled for midline laparotomy, were randomly assigned to receive either barbed (experimental) or non-barbed sutures (control) for fascial closure. The primary outcome was the cumulative incidence rate of incisional hernia up to 1-year post-surgery. Secondary outcomes included incisional hernia up to 2-years post-surgery, wound complications, and postoperative pain assessed by Brief Pain Inventory-Korean scores, and Numeric Rating Scale.

Results

Out of 174 patients (experimental, 86; control, 88), 36 were excluded due to dropout or loss to follow-up, leaving 138 patients (experimental, 67; control, 71) included in the analysis. The groups were balanced in terms of cancer surgeries, mean wound length, and mean surgery time. The cumulative incidence rates of incisional hernia up to 1-year (0.0% vs. 1.4%; p > 0.999) and 2-years (0.0% vs. 3.4%, p = 0.496) post-surgery did not differ significantly between the experimental and control groups. Additionally, no significant differences were observed in the incidence of wound dehiscence 4 weeks post-surgery, cumulative incidences of wound dehiscence and wound infection up to 4 weeks post-surgery, or postoperative pain scores between the groups.

Conclusions

Fascial closure using barbed sutures resulted in no cases of incisional hernia up to 2-years post-surgery, but did not demonstrate a significant reduction in incisional hernia rates compared with the non-barbed suture.

Trial registration

ClinicalTrials.gov NCT04643197

☐ ☆ ✇ Journal of Advanced Nursing

Australian and New Zealand nursing and midwifery educators' planetary health knowledge, views, confidence and teaching practices: A descriptive survey study

Abstract

Aim

To explore Australian and New Zealand nursing and midwifery educators' planetary health knowledge, views, confidence and teaching practices.

Design

A cross-sectional survey design.

Methods

An online survey was sent to Australian and New Zealand nursing and midwifery educators across the 45 Schools of Nursing and Midwifery between July and September 2023. The online survey consisted of 29 open- and closed-ended questions about nursing and midwifery educators' planetary health knowledge, views, confidence and teaching practices.

Results

There was a total of 127 responses to the first open-ended question. A total of 97 nursing and midwifery educators then completed the remaining questions. While educators had mostly positive views about integrating planetary health into their teaching, they lacked the knowledge and/or confidence to do so effectively.

Conclusion

Australian and New Zealand nursing and midwifery educators acknowledge that planetary health should be included in nursing and midwifery curricula, but most reported a deficit in knowledge and/or confidence to integrate these complex concepts into their teaching. When considering planetary health, most educators focussed on climate change, which demonstrates their limited understanding of the concept of planetary health.

Implications for the Profession

All nurses and midwives need to understand how the health of the planet and human civilization are interconnected and be prepared to address complex global health challenges now and in the future. Across the world, key healthcare organizations have called upon nursing and midwifery educators to prepare the healthcare workforce to practice in a more sustainable way, including supporting decarbonization of healthcare. However, our study has demonstrated that nursing and midwifery educators do not feel ready to respond due to a lack of required knowledge and/or confidence.

Reporting Method

We used the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Secondary Traumatic Stress and Post‐Traumatic Stress Symptoms in Nurses: Mediating Role of Psychological Distress and Moderating Role of Emotional Support

Por: Soo‐Hyun Nam · Jungmin Lee — Noviembre 14th 2025 at 12:57

ABSTRACT

Aim

This study aimed to investigate whether psychological distress mediates the relationship between secondary traumatic stress (STS) and post-traumatic stress symptoms (PTSS) among clinical nurses, and whether perceived emotional support moderates this mediating effect.

Design

A cross-sectional study.

Methods

A total of 205 clinical nurses who had direct patient contact and trauma-related experience were included. Data were collected using validated instruments: the Secondary Traumatic Stress Scale (STSS), Depression Anxiety Stress Scale-12 (DASS-12), Impact of Event Scale-Revised (IES-R), and the Multidimensional Scale of Perceived Social Support (MSPSS). All scales demonstrated high internal consistency (Cronbach's α = 0.88–0.97).

Results

Psychological distress significantly mediated the relationship between STS and PTSS. Perceived emotional support moderated the path from STS to psychological distress, such that higher emotional support amplified the association. However, emotional support did not significantly moderate the relationship between psychological distress and PTSS.

Conclusion

Psychological distress plays a central role in translating STS into PTSS among clinical nurses. Although emotional support may buffer early psychological distress, it does not attenuate PTSS development once distress is established.

Implications for the Profession and/or Patient Care

Early detection and management of psychological distress can prevent STS from progressing to PTSS. Nurses frequently exposed to trauma require timely psychological support. We recommend implementing routine screening and early interventions focused on distress, along with peer-support programmes and supervisory encouragement to enhance resilience. Trauma-informed care training and organisational awareness should also be strengthened to foster a supportive environment.

Impact

This study shows that managing early emotional symptoms is critical in preventing PTSS among nurses exposed to secondary trauma. Findings can inform global policies, peer-support initiatives, and early screening systems to enhance resilience and safeguard patient care.

Reporting Method

The study adhered to the STROBE checklist for cross-sectional studies.

Patient or Public Contribution

No patient or public contribution.

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