Conectar
To explore how nurses across international settings support the sexual wellbeing of people living with inflammatory bowel disease through their clinical practice.
Qualitative descriptive study.
Online semi-structured interviews and one focus group were conducted with nurses from Australia, Canada, Japan, the Republic of Ireland and the United Kingdom. The interviews were conducted in Japanese (for Japanese participants) and English (for the rest). A total of 28 nurses with extensive experience caring for people living with inflammatory bowel disease were recruited between May 2023 and December 2024 through snowball sampling. Data were analysed using thematic analysis.
The overarching theme identified was ‘careful exploration in real life practice’ with the following primary themes: (1) building the foundation for sexual wellbeing care, (2) addressing sexual wellbeing issues as a team, (3) identifying sexual wellbeing needs and (4) providing personalised nursing support. These themes highlighted the lack of sexual wellbeing care education in nursing, leading to unpreparedness and low confidence among nurses who nonetheless strived to support people living with inflammatory bowel disease despite limited training and communication barriers.
Nurses supported the sexual wellbeing of people living with inflammatory bowel disease by building trust and working collaboratively. They offered individualised care based on each patient's life context, fostering open communication. Despite cultural taboos surrounding sex, similar challenges and training needs were reported across target regions.
This study highlights the importance of addressing sexual wellbeing as a key component of holistic care for people living with inflammatory bowel disease. To achieve this, sexual wellbeing should be treated as a routine and important aspect of everyday nursing practice. Furthermore, nurses need to be empowered to play an active role in supporting sexual wellbeing and work in environments that facilitate open and respectful discussions.
This study addresses the long-neglected issue of sexual wellbeing in inflammatory bowel disease care, which has rarely been explored in nursing research. Drawing on qualitative data from multiple countries, primarily Japan, it offers a new international perspective by illustrating how nurses engage with and support sexual wellbeing. The findings have implications for clinical practice, nurse education and global research on holistic chronic illness care.
The Consolidated Criteria for Reporting Qualitative Research checklist was followed.
This study did not include patient or public involvement in its design, conduct or reporting.
To explore concerns and coping experiences regarding sexual well-being in inflammatory bowel disease and examine the relationship between these concerns and affected individuals' background factors.
Explanatory sequential mixed methods study.
Recruitment flyers (n = 1347) were distributed to individuals attending inflammatory bowel disease outpatient clinics in seven facilities. Participants completed a questionnaire assessing demographics, concerns and coping experiences related to their sexual well-being. Those who provided consent participated in semi-structured online interviews. Quantitative data were analysed descriptively, and qualitative data were analysed using content analysis.
A total of 551 participants completed the questionnaire, and 21 participated in the interviews. Among them, 251 (45.6%) reported experiences of concerns related to romantic relationships and marriage, sexual life, pregnancy, childbirth and childcare. The nature of these concerns varied by background factors: unmarried individuals more often reported relationship concerns; those with surgical or perianal history more often reported sexual concerns; and women, married individuals and individuals with Crohn's disease more often reported pregnancy-related concerns. Coping experiences were categorized as (1) active barrier management, (2) partner and professional support, (3) passive or resignation coping and (4) cognitive reframing.
Sexual well-being is significantly affected among individuals with inflammatory bowel disease. Many participants reported understanding and support from significant others or relied on personal coping strategies; however, others reported an absence of coping experiences. Sharing these findings with individuals with inflammatory bowel disease and healthcare professionals may enhance awareness and promote support strategies to improve these individuals' sexual well-being.
Concerns about sexual well-being are influenced by both clinical and psychosocial factors, including treatment history, life stage and partner relationships. Healthcare professionals should provide individualised and comprehensive care that incorporates the partners and families of individuals with inflammatory bowel disease to better address sexual well-being.
This study presents the first large-scale mixed methods evidence on how individuals with inflammatory bowel disease experience sexual well-being, providing direct implications for improving quality of life. By illustrating both adaptive and absent coping strategies, the findings contribute essential insight to inform patient-centred clinical practice and psychosocial care.
The Good Reporting of a Mixed-Methods Study (GRAMMS) guidelines were followed.
No patient or public contribution.
by Tanaporn Anosri, Soraya Kaewngam, Ram Prajit, Kornrawee Suwannakot, Nataya Sritawan, Anusara Aranarochana, Wanassanan Pannangrong, Jariya Umka Welbat, Peter Wigmore, Apiwat Sirichoat
Methotrexate (MTX) is used in treating several malignancies. However, MTX neurotoxicity remains a significant clinical side effect, leading to cell division malformation, and neurogenesis impairment. Chrysin, a flavonoid compound found in natural products, demonstrates various biological characteristics, including neuroprotective and antioxidant properties. The purpose of this study was to investigate the ameliorative effect of chrysin on oxidative damage and neurogenesis impairment caused by MTX. Male Sprague-Dawley rats were randomly divided into four groups, including the vehicle, MTX (75 mg/kg), chrysin (10 mg/kg), and chrysin+MTX groups. Chrysin was orally administered for 15 days. MTX was administered intravenously on days 8 and 15. The hippocampal neural stem cells were evaluated using sex determining region Y-box 2 (sox2) and nestin immunofluorescence staining. Antioxidant enzyme expression and the levels of oxidative stress marker were assessed. Additionally, the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2), brain-derived neurotrophic factor (BDNF), cAMP-response element binding (CREB), and phosphorylated CREB (pCREB) were evaluated using Western blotting. Results showed that MTX significantly decreased the activity of antioxidant enzymes and produced oxidative stress. MTX also impaired neurogenesis, evidenced by decreased sox2 and nestin-positive cells and decreased expression of Nrf2, BDNF, CREB, and pCREB in the hippocampus and prefrontal cortex. However, chrysin significantly reversed the effects of MTX on these parameters. In conclusion, chrysin exhibits neuroprotective effects against MTX-induced neurogenesis impairment by upregulating antioxidant enzyme activity, reducing oxidative stress, and improving protein expression related to neurogenesis.To examine clinical nurses' attitudes towards and self-reported experiences of family nursing in Japan following the relaxation of COVID-19 visitation restrictions. Particular attention is paid to early career nurses whose formative training occurred during visitation bans. The study focused on nurses' negative perceptions and emotional burdens associated with family involvement.
A quantitative-dominant mixed-methods cross-sectional study reported in accordance with the STROBE guideline.
Using a convenience sampling approach, a self-administered, paper-based questionnaire was distributed to clinical nurses in four general hospitals in Japan between January and May 2024. The questionnaire consisted of four parts: demographic and professional background, learning methods related to family nursing, 17 items including negatively valenced statements adapted from the Families' Importance in Nursing Care–Nurses' Attitudes (FINC-NA) scale, and one open-ended question. Quantitative data were analysed using descriptive statistics and t-tests, and qualitative responses were thematically analysed.
Of 1921 nurses invited, 957 responded (response rate: 49.8%), and data from 892 valid responses were analysed. Overall, the nurses demonstrated positive recognition of family nursing as a professional value but also reported lingering emotional burdens and practical challenges when interacting with families. Early-career nurses who began practice during the pandemic showed greater uncertainty and lower affective engagement. Thematic analysis revealed five key themes: relational disruption, emotional stress, moral conflict, reappraisal of family engagement and ongoing barriers.
The findings underscore the need to structurally and educationally reintegrate families into nursing care. Simulation-based training, clear institutional policies and hybrid communication models are essential to rebuild relational continuity and support nurses' emotional and ethical capacity for family nursing.
The findings highlight the need to structurally and educationally reintegrate families into clinical care to address the emotional burden and ambivalence reported by nurses. Organisational support—such as clear visitation policies, simulation-based education and reflective opportunities—can help rebuild nurses' relational competence and confidence in engaging with families. Creating supportive learning environments, including on-the-job mentoring and team-based reflection, may further facilitate the restoration of family nursing.
This study addressed how prolonged COVID-19 visitation restrictions disrupted family nursing practice in Japan, created generational differences in nurses' competencies, and shaped nurses' perceptions of family involvement. Nurses reported emotional strain, feelings of being monitored and lack of time when families were present. Early career nurses showed lower relational engagement, while experienced nurses expressed moral distress. ‘Latent indifference’ was also noted. The findings provide valuable insights for healthcare organisations, nurse educators and policymakers by informing strategies to reintegrate families into patient care, improve discharge planning and strengthen training models.
The STROBE checklist.
No patient or public contribution.
To examine how cultural health brokers, as trusted intermediaries between formal systems and diverse ethnocultural communities, help navigate decisional conflict and misinformation regarding COVID-19 vaccination and to identify how their work contributes to system resilience in crisis contexts.
A community-based participatory action sensemaking research project to capture the real-time work of cultural health brokers in helping people navigate decisional conflict for vaccination.
Multicultural Health Broker Cooperative in Edmonton, Alberta where brokers speak 54 languages and serve more than 10 000 people from diverse ethnolinguistic communities. 28 cultural health brokers (9 male; experience 4–25 years) contributed to data collection and analysis between 16 September 2021 and 16 December 2021.
The brokers captured real-time reflections and self-interpretations in the SenseMaker platform through a theoretically informed, codesigned, mixed-method data collection tool. The team engaged in 13 weekly, 90 minute, audio-recorded and transcribed sessions: seven focused on understanding and action planning and five reflecting on the SenseMaker data, the focus of the thematic analysis. Data were managed in NVivo (QSR International, Version 12, 2018).
Brokers collected 277 narratives and conducted 13 sensemaking sessions. Understanding and purpose were identified in 68% of narratives as key to achieving coherence; 81% of narratives highlighted trust as crucial to what was needed for action; 62% of narratives reflected on a potential risk, with loss of trust a concern in 70% of them. A rich understanding of the sources of decisional conflict and misinformation was achieved and managed through outreach. There were four entwined components to navigation of the evolving complexity of COVID-19 vaccination: (1) building and sustaining trust; (2) strengthening relationships; (3) creating safe spaces for collective sensemaking and solution finding; and (4) leveraging cultural and social capital to address barriers. Through these mechanisms, brokers reduced decisional conflict and misinformation, supporting informed, values-congruent decisions.
Cultural health brokers, embedded within communities and linked to formal systems, play a critical role in crisis response by fostering trust, mobilising resources and enabling collective sensemaking. This study demonstrates how these intermediaries’ contextually and culturally attuned work provides a model for building system resilience for future crisis response.
Chronic inflammatory skin diseases, despite low mortality, significantly impair quality of life (QoL). Up to 80% of patients with dermatological conditions experience severe itch and poor sleep, as well as related mental health challenges such as anxiety and depression. The relationship between skin diseases and mental health highlights the challenges that doctors face in treating these conditions. Existing psychotherapeutics, such as mindfulness training, cognitive behavioural therapy and acceptance and commitment therapy, are widely used and effective in the treatment of mental health illnesses. However, there is limited evidence on the application of such interventions in dermatology, and most mental health apps lack robust clinical evaluation. We report the design of a randomised controlled trial to evaluate the efficacy and implementation of a mobile app containing dermatology-specified psychotherapeutic strategies in reducing QoL burden.
English-speaking patients aged 16 years and older with psoriasis, eczema or chronic urticaria will be recruited and randomised into the intervention arm (psychotherapeutic application) or active control group (Healthy365 app, a general wellness application managed by the Singapore Health Promotion Board). This allows a comparative assessment of app-usage-specific outcomes while preserving the blinding of all participants. The primary outcome is the change in the Dermatology Life Quality Index (DLQI) score from baseline to week 8. Secondary outcomes include physician-assessed disease severity at weeks 8 and 16 relative to baseline, differences in other patient-reported measures at weeks 8, 16 and 32, self-reported treatment adherence and initiation/escalation of systemic medications. To understand how patients engage with the app, we will evaluate the implementation process, focusing on key measures such as engagement, satisfaction and willingness to pay. Statistical analysis will be carried out on an intention-to-treat basis, and missing data will be analysed using last observation carried forward.
All participants will receive both verbal and written study information that aligns with Good Clinical Practice guidelines. Ethical approval has been obtained from the National Healthcare Group’s Domain Specific Review Board (reference number: 2022/00751). Results will be disseminated via publication in a relevant journal. Data will be available from the corresponding author on reasonable request.
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