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☐ ☆ ✇ PLOS ONE Medicine&Health

Quality of life in hypertensive patients using the WHOQOL-BREF instrument in the post-pandemic Bangladesh: A cross-sectional study

by Nasrin Akter, Farhana Faruque Zerin, Bilkis Banu, Fatema Afrin Kanta, Shahnaz Begam, Sarder Mahmud Hossain

Background

To combat growing prevalence of hypertension in Bangladesh, it is critical to have an in-depth understanding about quality of life (QOL) among people living with hypertension and related factors. In the recent COVID-19 pandemic the QOL of hypertensive people got downsized. This study aimed to measure QOL among hypertensive people in a selected tertiary hospital in Dhaka city, and its association with the basic characteristics of the patients.

Methods

This study was conducted among randomly selected 300 hypertensive patients from two departments of Square Hospitals Limited, using the patient register record. Data were collected through face-to-face interview methods. The WHOQOL-BREF questionnaire was used to assess the QOL of the subjects. Descriptive statistics were used to examine mean scores of quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analysis was used to measure the association between QOL domains and independent variables.

Results

Both overall WHOQOL-BREF and each domain had a good internal consistency, (r = 0.13–0.77, p  Conclusion

The results revealed low QOL in psychological and social domain, including significant factors associated with the poor QOL in all domains. Planning and implementation of effective interventions are needed to improve QOL among hypertensive patients targeted towards aged, diabetic, lower income group who had positive COVID-19 infection and poor lifestyle through health system strengthening.

☐ ☆ ✇ BMJ Open

Is metformin therapy in conjunction with lifestyle modifications more effective than lifestyle modifications alone in lowering the risk of gestational diabetes mellitus in pregnant women with metabolic dysfunction-associated steatotic liver disease (MASLD

Por: Jayaseelan · V. · Subbaiah · M. · Arikrishnan · K. · Govindarajalu · R. · Pulavarthi · S. · Nanda · N. · Nasreen Vadakkepeediyakkal · K. · Mohan · P. · Murugesan Sivagurunathan · G. · Musthafa · M. K. · Duraiswamy · M. · Pulikkot Suragi · S. — Diciembre 30th 2025 at 15:31
Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) and gestational diabetes mellitus (GDM) are prevalent metabolic disorders in pregnancy, posing significant risks to maternal and fetal health. This study evaluates the effectiveness of metformin, in combination with lifestyle modifications, compared with lifestyle modifications alone, in reducing the incidence of diabetes, pro-inflammatory liver markers, adverse maternal and neonatal outcomes and total gestational weight gain in pregnant women diagnosed with MASLD in the first trimester.

Methods

This parallel-arm, randomised controlled trial will recruit pregnant women (≤14 weeks of gestation) with confirmed MASLD from antenatal clinics of tertiary care public hospitals in Puducherry, India. Participants will be consecutively enrolled until a sample size of 296 is reached. Block randomisation will ensure balanced group allocation, with allocation concealment maintained using sequentially numbered opaque sealed envelopes. The intervention group will receive oral metformin (500 mg two times per day) alongside structured lifestyle modification counselling, while the control group will receive lifestyle modification counselling alone. Primary outcomes include GDM incidence, changes in pro-inflammatory markers, MASLD grading (assessed via liver function tests and ultrasound) and adverse maternal outcomes such as hypertensive disorders, polyhydramnios, genitourinary infections, caesarean delivery and postpartum haemorrhage. Neonatal outcomes assessed include macrosomia, stillbirth, intrauterine death, birth injury, shoulder dystocia, respiratory distress and neonatal hypoglycaemia. The secondary outcome is total gestational weight gain. Participants will be followed at 24–28 weeks, 34–36 weeks and post partum (within 6 weeks of delivery). Data collection will be conducted using a pretested structured questionnaire, with data entry and management performed using REDCap software. Statistical analysis will be conducted using STATA V.4, applying both intention-to-treat and per-protocol analyses. Effect sizes will be reported as proportions and relative risks with 95% CIs, ensuring robust statistical inference.

Conclusions

This study provides a rigorous framework to assess metformin’s role in managing MASLD and preventing GDM, thereby promoting favourable maternal and neonatal outcomes. Findings will contribute to improved clinical management, public health strategies and policy recommendations.

Ethics and dissemination

The study was approved by the JIPMER Institutional Ethics Committee (JIP/AEC/2023/01/011), and the findings will be disseminated through peer-reviewed journals and academic conferences.

Trial registration number

CTRI/2023/12/060930.

☐ ☆ ✇ Journal of Clinical Nursing

Immersed in Fear and Doubt: Mothers' Experiences of Caring Transition for Children With Cancer—A Qualitative Study

Por: Nasrin Ghanbari · Eesa Mohammadi · Mitra Khoobi — Diciembre 9th 2025 at 12:52

ABSTRACT

Aim

This study aimed to explore and describe the experiences and perceptions of mothers of children with leukaemia regarding the transition of care from hospital to home.

Design

A qualitative content analysis with a conventional approach was employed, and this report follows the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Methods

Thirteen mothers of children with leukaemia were recruited using purposive sampling from two Iranian paediatric hospitals. Data were collected through in-depth, semi-structured interviews conducted between 2023 and 2024 and analysed using conventional qualitative content analysis.

Results

Drowning in the Vortex of Fear and Doubt emerged as the central theme, encapsulating the shared experiences of mothers of children with leukaemia. This overarching theme comprised five categories: (1) Fear of Unpredictable and Life-Threatening Complications, (2) Paradoxical Concerns About Discharge, (3) Doubts and Hopelessness About Treatment Effectiveness, (4) Stress Regarding the Child's Future Life Trajectory and (5) Sense of Helplessness in Alleviating the Child's Suffering.

Conclusion

The findings underscore the need to provide comprehensive supportive services for parents of children with leukaemia. Policymakers and healthcare teams should prioritise initiatives that enhance parental awareness, deliver psychosocial support and empower families to navigate the arduous path of care and treatment with greater trust and confidence.

Implications for the Profession and Patient Care

Ensuring the well-being and comfort of both the child with cancer and the parents throughout the treatment process is essential for improving care outcomes.

Reporting Method

The study is reported according to the COREQ.

Public Contribution

Mothers of children with leukaemia participated as interviewees and contributed to ensuring the rigour of the study through data validation.

☐ ☆ ✇ Journal of Advanced Nursing

Understanding the Long‐Term Relationship in Dyads of Parental Live Liver Donors and Adolescent Young Adults

Por: Annette S. Nasr · David Perez · Roberta S. Rehm — Noviembre 18th 2025 at 05:14

ABSTRACT

Aim

This qualitative study aimed to understand how dyads of parental donors and adolescent young adult recipients make sense of living donor liver transplantation from donation to adolescence.

Design

This qualitative study used a focused ethnographic design.

Methods

Twelve dyads of parental liver donors and their adolescent young adults were interviewed together using a semi-structured interview guide. Data was collected from April 16 to July 30, 2019. All of the interviews were audiotaped and transcribed. The theoretical framework of sensemaking was implemented. Thematic analysis was used, concepts were categorised, connections were made and references to the coding were conducted.

Results

Thematic analysis contributed to the emergence of three categories: connections, reflections and life transitions, and the overarching theme of gratitude for being given or giving the gift of life.

Conclusion

The dyads' gratitude increased over time through the social process of sensemaking.

Implications for the Profession and Patients

As living donor liver transplantation in the paediatric population enters its third decade, understanding how it shapes relationships in dyads of parental donors and adolescent young recipients over time can provide new insights for nurses who work in paediatric transplantation.

Impact

This study's findings address the current gap in the literature on the long-term impact of living donor liver transplant dyads and highlight the role of nurses who provide care and guidance at the time of evaluation and surgery to the ongoing support during the years that follow.

Reporting Method

This qualitative study followed EQUATOR guidelines and adhered to the COREQ checklist for qualitative studies.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Evaluating Nurse Practitioners' Peri‐Operative Roles and Their Outcomes: A Prospective Observational Study in Surgical Care

Por: Limor Chen · Ziv Gil · Nasra Idilbi · Dafna Zontag · Efrat Shadmi — Septiembre 27th 2025 at 06:54

ABSTRACT

Aims

To evaluate nurse practitioner (NP) roles during the peri-operative period and their association with healthcare outcomes, including length of stay (LOS), post-operative emergency department (ED) visits and 30-day readmissions.

Design

A prospective observational study.

Methods

This study, conducted at an Israeli tertiary care centre between 2022 and 2023, included 188 patients from Paediatric Orthopaedics, General Surgery and Breast and Stoma Services. Data on patient demographics, clinical details and outcomes, including LOS, post-operative ED visits and 30-day readmissions, were extracted from medical records. NPs documented interventions they performed across the pre-operative, in-hospital and post-hospital phases. Associations between NP interventions and patient outcomes were analysed using multivariate regression models.

Results

NPs performed an average of 6.7 interventions per patient across the peri-operative phases. A moderate-to-high number of interventions performed during the pre-operative phase was significantly associated with a shorter LOS. Performing a moderate-to-high number of interventions during the post-hospital phase was correlated with fewer ED visits and lower rates of 30-day readmission.

Conclusions

Interventions performed by NPs during the pre-operative and post-hospital phases were significantly linked to better patient outcomes, notably shorter hospitalizations and fewer post-discharge complications.

Implications

Recognising the role of NPs in peri-operative care may guide healthcare systems in optimising post-surgical care pathways, ultimately minimising preventable emergency visits, reducing hospital LOS and lowering readmission rates.

Impact

This study underscores the value of NPs as integral providers in peri-operative surgical care. Their involvement in pre-operative preparation and post-discharge coordination contributes meaningfully to patient recovery trajectories. The findings support expanding their role within surgical teams to enhance care continuity and promote better recovery outcomes.

Reporting Method

The EQUATOR guidelines were used with the STROBE checklist for reporting this study.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ BMJ Open

Imaging analysis using Artificial Intelligence to predict outcomes after endovascular aortic aneurysm repair: protocol for a retrospective cohort study

Por: Lareyre · F. · Raffort · J. · Kakkos · S. K. · DOria · M. · Nasr · B. · Saratzis · A. · Antoniou · G. A. · Hinchliffe · R. J. · on behalf of the European Research Hub Working Group · Venermo · Boyle · Pherwani · Trenner — Julio 16th 2025 at 09:42
Introduction

Endovascular aortic aneurysm repair (EVAR) requires long-term surveillance to detect and treat postoperative complications. However, prediction models to optimise follow-up strategies are still lacking. The primary objective of this study is to develop predictive models of post-operative outcomes following elective EVAR using Artificial Intelligence (AI)-driven analysis. The secondary objective is to investigate morphological aortic changes following EVAR.

Methods and analysis

This international, multicentre, observational study will retrospectively include 500 patients who underwent elective EVAR. Primary outcomes are EVAR postoperative complications including deaths, re-interventions, endoleaks, limb occlusion and stent-graft migration occurring within 1 year and at mid-term follow-up (1 to 3 years). Secondary outcomes are aortic anatomical changes. Morphological changes following EVAR will be analysed and compared based on preoperative and postoperative CT angiography (CTA) images (within 1 to 12 months, and at the last follow-up) using the AI-based software PRAEVAorta 2 (Nurea). Deep learning algorithms will be applied to stratify the risk of postoperative outcomes into low or high-risk categories. The training and testing dataset will be respectively composed of 70% and 30% of the cohort.

Ethics and dissemination

The study protocol is designed to ensure that the sponsor and the investigators comply with the principles of the Declaration of Helsinki and the ICH E6 good clinical practice guideline. The study has been approved by the ethics committee of the University Hospital of Patras (Patras, Greece) under the number 492/05.12.2024. The results of the study will be presented at relevant national and international conferences and submitted for publication to peer-review journals.

☐ ☆ ✇ BMJ Open

Mental health interventions for humanitarian volunteers: a scoping review

Por: Nasrullah · S. M. · Refat · T. · Gustavsson · M. E. — Julio 7th 2025 at 06:01
Objectives

The aim of this scoping review was to map the nature and extent of the existing literature on mental health interventions for humanitarian volunteers in disaster contexts. The study also explored how the interventions were evaluated.

Design

The methodology of this scoping review followed the extended guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews.

Data sources

Five academic bibliographic databases (PubMed, Embase, Web of Science, EBSCOhost and Google Scholar), grey literature websites (Google Scholar, ProQuest, Policy Commons, etc.) and relevant organisational archives were systematically searched for eligible documents.

Eligibility criteria

Both peer-reviewed and grey literature studies on mental health interventions for humanitarian volunteers in the context of any type of disaster were eligible for inclusion. Research papers that evaluated any such intervention were also included. Documents that targeted professional humanitarian workers or explored physical health conditions or diseases in disaster contexts, letters to the editor, comments, correspondence and research protocols were excluded. There were no restrictions in terms of the date and language of the documents.

Data extraction and synthesis

A systematic search of the targeted databases was conducted from 12 May 2025 to 20 May 2025. Deduplication, screening and full-text evaluation for the selection of documents were done using the online version of Rayyan. Data were collected and recorded into a structured Microsoft Excel sheet. Two researchers individually conducted the selection of the articles and the extraction of data. A third researcher helped to resolve any discrepancies if required.

Results

A total of 2627 documents were retrieved by searching the targeted databases and websites. After matching them with the eligibility criteria, 20 documents were included in the final list. 14 of them were research papers; the rest was organisational literature. All the papers were from 2006 and later, except one that was from 1998. No documents were found from the Middle East, North Africa and Sub-Saharan regions. 10 broad categories of interventions were identified, which were either implemented in the field or suggested in the form of guidelines. Most of the interventions were postexposure and preventive in nature. Psychological first aid was the most widely used intervention in this context, being used by the national societies of the International Federation of Red Cross and Red Crescent Societies. Nine of the documents were research papers evaluating the effectiveness of the interventions using different scales and customised questionnaires. Four of them did not observe any notable effect on the mental health of the participants.

Conclusions

Over the past two decades, the evidence on mental health interventions for humanitarian volunteers has grown. The reviewed literature documented various interventions and guidelines that need further study and testing to both prove and improve their effectiveness. Organisational policies could incorporate and further evaluate these to ensure the psychosocial well-being of volunteers. A review of research papers on intervention effectiveness found heterogeneity in settings, designs, interventions and methods, precluding a systematic review. More research is needed on individual interventions, volunteer perceptions and comparing interventions to identify the most effective ones. Additionally, comparing pre-exposure and postexposure interventions with multimodal systems that support volunteers throughout deployment is recommended.

☐ ☆ ✇ Worldviews on Evidence-Based Nursing

Perceived Work Environment and Work‐Related Well‐Being in Nursing Homes: Comparison of Different Care Worker Groups

ABSTRACT

Background

A skilled and diverse healthcare workforce is essential in nursing homes, yet recruitment and retention remain a major challenge. Gaining insight into the well-being of different care worker groups and how they perceive their work environment can highlight areas of concern and opportunities for improvement.

Aims

To compare the perceived work environment and well-being among different care worker groups in nursing homes.

Methods

This descriptive study used cross-sectional survey data from the Flanders Nursing Home (FLANH) project, collected from February–July 2023. A total of 1521 care workers from 25 Flemish nursing homes participated (64.4% response rate), including care assistants (43.7%), registered nurses (20.5%), support staff (15.4%), allied health professionals (14.8%), and team leaders (5.7%). Chi-squared tests were used to compare the percentages of the care worker groups reporting the work environment items and well-being outcomes (job satisfaction, intention to leave, burnout). Post hoc analyses were conducted to identify which groups contributed to the significant differences observed.

Results

Significant differences among care worker groups were found for almost all work environment items and well-being outcomes. Staffing adequacy was perceived least among care assistants and registered nurses. More registered nurses and team leaders perceived high workload and emotional burden compared to the other groups. Work–life interference and involvement were perceived most among team leaders. A person-centered vision, work autonomy, and salary satisfaction were reported most among allied health professionals and team leaders. Skill use and training opportunities were reported least among support staff. Work-related well-being appeared to be experienced most among allied health professionals and least among care assistants.

Linking Evidence to Action

These findings highlight key differences in work environment perceptions and well-being among care worker groups, offering valuable insights for tailored initiatives to foster a supportive workplace that benefits the well-being of all types of care workers in nursing homes.

☐ ☆ ✇ Journal of Clinical Nursing

Stakeholders' Actions, Responsibility and Limitations in Support of Nursing Students Experiencing Workplace Violence During Clinical Placement: The Clinical Facilitators View

Por: Hila Ariela Dafny · Nicole Snaith · Paul Cooper · Nasreena Waheed · Stephanie Champion · Christine Mccloud — Febrero 20th 2025 at 05:23

ABSTRACT

Background

Workplace violence toward nurses is a significant global issue affecting their mental and physical health, job satisfaction and performance, and can ultimately lead to decisions to leave the profession. As the least experienced caregivers in the health workforce, nursing students are particularly vulnerable to experiencing workplace violence and are often powerless to deal with WPV incidents.

Aim

To examine clinical facilitators' insights into how to support nursing students following experiences of workplace violence during their clinical placement.

Design

An exploratory, descriptive qualitative design.

Methods

Data were collected between September and November 2022 using semi-structured interviews with 11 clinical facilitators working in South Australia, each lasting about 1 h. The interviews were transcribed verbatim and analysed using thematic analysis.

Results

Clinical facilitators identified that many students found support and solace from avenues outside of the CFs and university staff, including ward staff, family, friends and other students. However, students are limitedly prepared for the realities of clinical work, particularly concerning workplace violence, and that the university supports available were reactive to events in the clinical environment.

Conclusion

Addressing workplace violence requires systemic changes, better support for clinical facilitators and a steadfast commitment by all stakeholders to student safety.

Implications for the Profession

Solid collaborations between universities and clinical facilities with clear guidelines and direct lines to address potential violence issues are essential. Zero-tolerance policies regarding workplace violence could provide a safer environment that promotes nursing student learning outcomes, safer placements, better student experiences and optimal healthcare provision.

Reporting Method

COREQ guidelines were adhered to for reporting qualitative research.

No Patient or Public Contribution

This paper specifically explores the perspective of the clinical facilitator's experience of WPV in their role of supporting student learning during clinical placement.

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