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There is a significant need for trials that evaluate the treatment of University of Texas (UT) grade 2 and 3 diabetic foot ulcers (bone, joint, or tendon exposed wounds). We undertook a trial looking at the effect of intact fish skin graft (IFSG) on these deep and difficult-to-heal ulcers. 262 patients Intent to Treat (ITT) patients with UT grade 2 and 3 DFUs were randomised to receive intact fish skin graft (IFSG) or a standardised treatment (SOC) that adhered to the International Working Group on the Diabetic Foot (IWGDF) guidelines. The secondary endpoints that were measured included wound area reduction (WAR), healing rates at 20 and 24 weeks; closure rates by UT grade, perfusion, quality of life, pain reduction and IFSG safety. We report ITT (all randomised) (mITT previosly reported) The (WAR) at 12 weeks was 65.53% for IFSG versus 30.82% for SOC (p = 0.007). UT 2 wounds (60% of total) exhibited a closure rate of 47% versus 23% at 16 weeks for IFSG versus SOC (p = 0.0033). Target wound infections were comparable (39 vs. 37) and major outcomes were comparable during the 24 week period (target-limb amputations 8% vs. 7%). Time-to-heal favoured IFSG (restricted mean to 24 weeks 17.31 vs. 19.37 weeks; KM/log-rank significant; Cox HR 1.59). The in the treatment of deep complex diabetic foot wounds the addition of IFSG significantly improved the number of patients with total wound closure as well as the time to wound closure without increased risk of complications. This improvement in total wound closure and time to wound closure was noted across prior amputation status, quality of perfusion, and UT grade.
by Clarisse Kagoyire, Albert Ndagijimana, Gilbert Nduwayezu, Jean Nepo Utumatwishima, Jean Pierre Mpatswenumugabo, Marie Anne Mukasafari, Diane Rinda, Vedaste Ndahindwa, Kristina Elfving, Gunilla Krantz, Torbjörn Lind, Ali Mansourian, Renée Båge, Ewa Wredle, Elias Nyandwi, Aline Umubyeyi, Jean Baptiste Ndahetuye, Petter Pilesjö
Despite national progress, stunting remains prevalent in specific regions of Rwanda, highlighting the limitations of coarse-resolution data for effective mapping and intervention planning. This study explored optimal spatial resolution and analytical approach to capture localised dynamics and the multifactorial nature of stunting. A cross-sectional, population-based study was conducted in the Northern Province of Rwanda, focusing on children aged 1–36 months. Data were collected using structured questionnaires covering socio-demographic, economic, health, childcare, livestock factors and anthropometric measurements. Environmental characteristics were obtained from national datasets, while household geographic coordinates were captured using a customized mobile geodata platform (emGeo). After data cleaning, predictors were analysed using univariable and multivariable logistic regression as well as geographically weighted logistic regression (GWLR) to account for spatial heterogeneity. Among 601 children, stunting prevalence was 27% (boys 33.8%; girls 20.9%). GWLR improved model fit, increasing adjusted deviance explained from 34% to 39%. Significant predictors included child age (adjusted OR = 2.46; 95% CI: 1.78–3.39), male sex (OR = 2.83; 95% CI: 1.65–4.86), birthweight (OR = 0.71; 95% CI: 0.54–0.94), maternal autonomy (ability to refuse sexual intercourse; OR = 0.48; 95% CI: 0.27–0.86), inconsistent maternal social support (OR = 2.30; 95% CI: 1.20–4.42), household electricity access (OR = 0.48; 95% CI: 0.27–0.84) and handwashing facilities (OR = 0.21; 95% CI: 0.07–0.67). GWLR revealed substantial spatial heterogeneity in these factors, delineating areas where each factor matters most. This household-level, spatially explicit analysis reveals localised risk patterns often masked by aggregated national data. Prioritising context-specific interventions (such as electrification, hygiene promotion, and enhanced maternal social support), can enhance effectiveness. The proposed analytical workflow provides a model for addressing persistent stunting in other resource-limited settings.To determine how patients use the internet to get health information and to identify their needs and preferences for a journal transparency tool which would highlight journal transparency practices.
A mixed-methods study comprising a cross-sectional online survey followed by virtual focus groups to further explore the survey responses.
Canada.
A total of 183 adult patients and caregivers completed our online survey. 29 survey respondents participated in the subsequent focus groups.
We report descriptive statistics (counts and percentages) for all quantitative survey items. We used thematic content analysis for text-based survey responses. The focus groups asked patients about four key topics: (1) the content they would like to see in a journal transparency tool, (2) how they would like the content visually displayed, (3) how to best share the tool with patients and (4) how to determine whether the tool was successful over time. We conducted a thematic content analysis to identify core themes discussed. Focus group participants then rank-ordered the themes identified by their perceived importance.
Of the 183 survey respondents, 146 (82%) indicated they use the internet most often when looking for health information, 66 (37%) indicated they sometimes read original research articles when searching for health information and 92 (52%) indicated they sometimes have difficulty knowing if the information they read online is reliable. Approximately half (86; 49%) of the survey respondents had never heard of predatory journals. We identified 32 themes across the four key topic areas that were discussed in the focus groups.
Patients have expressed a need for a journal transparency tool. This study will inform the tool’s development to ensure that it meets the needs and preferences of patients.
by Ralph Kwakye, Grace Boakye, Bright Yaw Vigbedor, Albert Aniagyei, Bernard Owusu Asimeng, Boniface Yeboah Antwi, David Neglo, Salifu Nanga
Zeolite X was synthesized from kaolin and then modified using (Azadirachta indica) neem together with silver nitrate solution by ion exchange. X-ray diffraction confirmed a highly crystalline FAU framework characterised by a low angle reflection, which showed that silver incorporation did not alter the zeolite structure. Scanning Electron Microscopy (SEM) revealed a well-defined polyhedral crystal for zeolite X, whiles the Ag-zeolite X exhibited increased surface heterogeneity and agglomeration. Fourier Transform Infrared (FT-IR) and Raman Spectroscopy further confirmed framework retention, with band broadening attributed to the partial substitution of Na⁺ by Ag+ within the zeolite lattice. The antimicrobial activity of zeolite X, Ag-zeolite X, were evaluated against Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecalis, Candida albicans, Aspergillus niger strains by Minimum Inhibition Concentration (MIC) and Minimum Bacterial/fungal Concentration (MBC/MFC) Assays. The antioxidant properties were evaluated using 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and 2,2’-Azino-bis (3-ethylbenzothialine-6-sulfonic acid (ABTS) radical scavenging assays. The unmodified zeolite X showed weak activity (MIC, MBC, MFC > 1 mg/mL, R > 4) whilst the Ag-zeolite X showed strong antimicrobial activity (MIC = 0.5–1.0 mg/mL, MBC, MFC = 0.5–2 mg/mL, R ≤ 4) across all tested strains. Antioxidant activity assessed using DPPH and ABTS radical scavenging assays showed significantly enhanced antioxidant performance for Ag-zeolite X compared to unmodified zeolite X, particularly in the ABTS assay. These findings demonstrate that neem-assisted silver modification enhances the bioactivity of kaolin-derived zeolite X while preserving its crystalline framework, supporting its potential application in biomedical, food packaging, and water treatment systems.To evaluate the effect of mutuality on self-care in people with CHD and the contribution of their caregivers, and whether such relationships can be mediated by self-efficacy.
Secondary analysis of baseline data from a multi-centre longitudinal study.
Patients at the onset of coronary artery disease who underwent angioplasty, along with their caregivers, were included in the sample. Data from 136 patients and 136 caregivers were used for the analysis. Mutuality between patients and caregivers was measured using the Mutuality Scale. Self-care was measured using the Self-Care of Coronary Heart Disease Index and the Caregiver Contribution to Self-Care of Coronary Heart Disease Index. The actor–partner interdependence mediation models were used to assess the mediating role of self-efficacy for self-care between perceived mutuality and self-care behaviours.
An actor indirect effect was found between patient mutuality and their self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on their contribution to self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on patient self-care maintenance and on patient self-care monitoring, through the mediation of patient self-efficacy. All models demonstrated satisfactory fit to the data.
Mutuality between patients and caregivers enhances self-care behaviours in patients with coronary heart disease, and self-efficacy is a crucial mediator in this relationship. Interventions targeting both mutuality and self-efficacy within patient–caregiver dyads may improve self-care outcomes.
We adhered to STROBE guidelines.
Patients and members of the public were not involved in the design, conduct, reporting, or dissemination plans of this research.
Medication administration errors are high-risk patient safety issues that could potentially cause harm to patients, thereby delaying recovery and increasing length of hospital stay with additional healthcare costs. Nurses are pivotal to the medication administration process and are considered to be in the position to recognize and prevent these errors. However, the effectiveness of interventions implemented by nurses to reduce medication administration errors in acute hospital settings is less reported.
To identify and quantify the effectiveness of interventions by nurses in reducing medication administration errors in adults' inpatient acute hospital.
A systematic review and meta-analysis was conducted up to 03/24. Six databases were searched. Study methodology quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal tools, and data extraction was conducted. Meta-analysis was performed to combine effect sizes from the studies, and synthesis without meta-analysis was adopted for studies that were not included in the meta-analysis to aggregate and re-examine results from studies.
Searches identified 878 articles with 26 studies meeting the inclusion criteria. Five types of interventions were identified: (1) educational program, (2) workflow smart technologies, (3) protocolised improvement strategy, (4) low resource ward-based interventions, and (5) electronic medication management. The overall results from 14 studies included in meta-analysis showed interventions implemented by nurses are effective in reducing medication administration errors (Z = 2.15 (p = 0.03); odds ratio = 95% CI 0.70 [0.51, 0.97], I 2 = 94%). Sub-group analysis showed workflow smart technologies to be the most effective intervention compared to usual care. Findings demonstrate that nurse-led interventions can significantly reduce medication administration errors compared to usual care. The effectiveness of individual interventions varied, suggesting a bundle approach may be more beneficial. This provides valuable insights for clinical practice, emphasizing the importance of tailored, evidence-based approaches to improving medication safety.
PRISMA guided the review and JBI critical appraisal tools were used for quality appraisal of included studies.
Retroperitoneal sarcomas (RPS) are rare and often large malignancies that frequently require extensive surgery for complete tumour removal. Resections of the colorectum are part of the standard resection, this way contributing to complication rates, including anastomotic leakage or obstruction. Surgical strategies for stoma formation and colorectal reconstruction remain poorly defined. The Colorectal Resections and Postoperative Quality of Life in Retroperitoneal Sarcoma Patients Across German-Speaking Sarcoma Centres (COLOSARC-Q) study aims to explore surgical procedures and health-related quality of life (HRQoL) in patients undergoing colorectal procedures during RPS surgery.
COLOSARC-Q is a prospective, multicentre, non-interventional study and will recruit 120 patients with primary RPS who undergo colorectal resection as part of sarcoma surgery in a sarcoma referral centre in Germany or Switzerland. HRQoL is assessed using standardised questionnaires (EORTC QLQ-C30, QLQ-CR29) as well as semi-structured interviews by psycho-oncology services and patient advocates. Data will be collected via an electronic Case Report Form, encompassing demographic, clinical, surgical and outcome-related information. All data will be centrally analysed. For the assessment of quality of life, a qualitative analysis with content and context analysis, as well as evaluation of the questionnaires according to a standardised scoring system, is planned. The primary aim is to evaluate surgical techniques for bowel resection and reconstruction and their influence on the further course of disease. Secondary endpoints assess postoperative complications as well as tumour-, patient- and treatment-related factors.
Ethical approval was granted by the Ethics Committee II of the University of Heidelberg (approval number 2024-562; 13 June 2024). The data protection review was approved by the data protection officer of the University of Heidelberg. Participation of other centres in the study requires local ethical approval. All patients will be required to sign an informed consent form. Results of primary and secondary endpoints will be published.
NCT06943612; German Clinical Trials Registry (DRKS00034135).
Atrial fibrillation (AF) is a growing public health concern associated with significant morbidity, mortality and impaired quality of life. Despite evidence supporting cardiac rehabilitation (CR) as part of secondary prevention in AF care, referral rates remain low, and the extent of CR needs in this population is unknown. This protocol outlines a nationwide survey-based and registry-based study aiming to: i) describe CR needs among individuals with AF and ii) assess eligibility and acceptance of referral to specific CR components based on individual patient preferences and their overlap with identified needs.
This cross-sectional study includes three phases: 1) identification of the study population using Danish national registries; 2) electronic survey distribution to individuals with a first-time AF diagnosis in 2023–2024 and 3) registry data enrichment of the entire population. The survey includes validated patient-reported outcome measures aligned with a newly developed Needs Assessment Model, supplemented by items on patient preferences for CR components. Data are analysed descriptively and using correlation analysis.
Participants are informed of the study purpose, data protection and their rights before providing informed consent through survey participation. The study follows the Declaration of Helsinki and Danish ethical standards. Findings are disseminated via scientific journals, conferences, a cross-sectoral stakeholder workshop and public outreach activities.
To explore nurse managers' perceptions at first-line, middle and executive levels regarding their transition to first-line management in two divisions of a highly specialised university hospital in Spain.
A qualitative descriptive study.
A purposive sampling technique was employed to conduct four focus groups and two semi-structured interviews with 31 nurse managers across three hierarchical levels in two divisions of a highly specialised university hospital in Spain. Participants included two Chief Nursing Officers, four Nursing Directors and 25 first-line nurse managers. Data were analysed thematically.
Three themes emerged: ‘Bridging the Readiness Gap: Training, Role Clarity, and Institutional Alignment’, revealing the lack of structured transition plans, role ambiguity and gaps in managerial skills, such as human resources, financial management and leadership; ‘Fighting Loneliness: A Common Challenge in Care Management’, highlighting the isolation of first-line nurse managers due to the absence of structured mentorship and peer support; ‘Clinical Expertise as a Cornerstone: The Role of Prior Experience in Nurse Management’, examining how clinical expertise facilitates leadership transitions but also presents challenges, particularly for managers promoted within their teams, where authority negotiation and role redefinition become critical.
Findings underscore the need for structured training and mentorship to address role ambiguity, enhance managerial competencies and support nurse managers' transitions through targeted education.
Structured transition programmes focusing on role clarity, training and institutional alignment can ease transitions, boost leadership confidence and enhance peer collaboration. Providing mentoring and training tailored to first-line nurse managers can improve team dynamics, support professional integration and strengthen organisational cohesion.
Tailored educational interventions are essential in supporting nurse managers' transitions. Structured mentorship and targeted training enhance leadership readiness, adaptability and institutional alignment, strengthening healthcare leadership, efficiency and patient care quality.
No patient or public contribution.
by Andrea Salinas, Christa Burgos, Aaron Rodríguez-Ramos, Alberto Burgos-Edwards, Nelson Alvarenga, Pablo H. Sotelo, Patricia Langjahr
Inflammation plays a crucial role in homeostasis and defense responses; however, exaggerated and chronic inflammation contribute to the development and worsening of various diseases. Acanthospermum australe (Loefl.) Kuntze (A. australe) is a medicinal plant traditionally used to alleviate inflammation. However, the anti-inflammatory activity of this plant has not yet been explored. This study aimed to evaluate the immunomodulatory activity of this species using network pharmacology, UPLC-ESI-MS/MS analysis, and in vitro assays. Network pharmacology analysis revealed the involvement of immune system processes, and among the main targets of A. australe related to inflammation were innate immune responses, toll-like receptors (TLRs), and T cell receptor signaling pathways. A methanolic extract was prepared and analyzed using UPLC-ESI-MS/MS, and 15 compounds were detected. Additionally, the potential targets of A. australe predicted by network pharmacology analysis were validated in vitro using monocytic THP-1 cells and splenocytes. The RT-qPCR analysis indicated that A. australe significantly inhibited the production of pro-inflammatory cytokines IL-1β, IL-6, and TNF-α, as well as chemokine CCL-2, in lipopolysaccharide (LPS)-stimulated cells. Finally, the extract significantly decreased concanavalin A (ConA)-induced T cell proliferation. Overall, our study provides evidence for the anti-inflammatory effects of this species and highlights its mechanisms of action.Evidence-based practice (EBP) is essential for improving the quality of care and health outcomes in healthcare organizations. This study aimed to analyze the association between the nursing work environment and EBP elements, including attitude, training, implementation and quality of care.
A multicenter, cross-sectional study was conducted with 1022 registered nurses from 57 primary care centers and four public hospitals in northern Spain. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess the nursing work environment. Data collection also included the Health Sciences Evidence-Based Practice (HS-EBP) questionnaire to evaluate attitudes toward EBP, and self-reported measures of EBP training, EBP implementation, and overall quality of care. Odds ratios (OR) and 95% confidence intervals for the association between the nursing work environment and EBP elements were calculated using logistic regression adjusted for sociodemographic and occupational characteristics.
Compared to nurses who reported working in unfavorable environments (n = 220; 21.5%), those working in favorable environments (n = 437; 42.8%) exhibited a positive attitude toward EBP (OR = 2.89; 95% CI [2.00, 4.18]), EBP implementation (OR = 2.30; 95% CI [1.52, 3.39]) and higher quality of care (OR = 2.35; 95% CI [1.61, 3.44]). Using a composite measure that considered all EBP elements, favorable environments were associated with overall EBP engagement (OR = 3.47; 95% CI [2.38, 5.07]). The most influential environmental dimensions were adequate staffing and strong nursing foundations.
A favorable nursing work environment was strongly associated with a positive attitude toward EBP, the implementation of EBP, and a commitment to providing high-quality care. Key strategies to promote EBP should involve healthcare and academic institutions working together to establish a healthy work environment with appropriate staffing and care foundations rooted in nursing theory.
This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.
Scoping review.
JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.
The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.
A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.
This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.
By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.
The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.
No patient or public contribution.
Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1
Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.
To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.
Meta-research study.
A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.
A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16–22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having “some concerns”, largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were “Delivery of care” and “Physical functioning”.
Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
Introducción. La punción arterial para el análisis gasométrico provoca dolor de intensidad variable. Este dolor podría alterar la dinámica ventilatoria y, por tanto, los parámetros respiratorios de la muestra sanguínea. Objetivos. Determinar la posible relación entre el dolor inducido por la punción arterial y los parámetros obtenidos del análisis gasométrico de estas muestras de sangre. Como objetivos secundarios, obtener la prevalencia del dolor provocado en la muestra estudiada y la posible asociación con el número de intentos. Metodología. Estudio transversal que incluyó 100 muestras arteriales de 61 pacientes durante el primer semestre de 2024. La intensidad del dolor, reportada mediante la escala NRS-11, fue la variable principal de estudio. Se analizó la asociación de esta variable con variables gasométricas (por ejemplo, pH, pO2, pCO2 y lactato) y con otras variables sociodemográficas y relacionadas con punción arterial. Resultados. La edad fue de 69,43 ± 13,07 y el 68% eran hombres. Respecto a la variable principal de resultado, la puntuación media del dolor fue de 4,03 ± 2,61. La intensidad del dolor no mostró asociación con ninguna variable gasométrica. Sin embargo, el número de intentos de obtener con éxito una muestra arterial mostró significación. Tras ajustar por otras variables, cada intento adicional aumentaba el dolor en 1,14 puntos. Discusión. No se encontró asociación entre el dolor de la punción arterial y los parámetros del análisis gasométrico, por lo que los resultados pueden interpretarse de forma robusta en situaciones en las que no es posible un manejo adecuado del dolor.
ABSTRACT
Introduction. Arterial puncture for gasometrical analysis causes pain of varying intensity. This pain could alter the ventilatory dynamics and therefore the respiratory parameters of the blood sample. Objectives. To determine the possible relationship between the pain induced by arterial puncture and the parameters obtained from the gasometrical analysis of these blood samples. As secondary objectives, to obtain the prevalence of pain caused in the sample studied and the possible association with the number of attempts. Methodology. Cross-sectional study involving 100 arterial samples from 61 patients during the first half of 2024. Pain intensity reported by the NRS-11 was the main study variable. The association of this variable with gasometrical variables (for example: pH, pO2, pCO2, lactate) and with other variables of different nature (sociodemographic and related to the arterial puncture itself) was analyzed. Results. The age was 69,43 ± 13,07 and 68% were men. Regarding the main outcome variable, the mean pain score was 4.03 ± 2.61. Pain intensity showed no association with any of the gasometric variables. However, the number of attempts to successfully obtain an arterial sample showed significance. After adjustment for other variables, each additional attempt increased pain by 1.14 points. Discussion. No association was found between arterial puncture pain and gasometric analysis parameters, so the results can be robustly interpreted in situations where adequate pain management is not possible.
Introducción: Algunas prácticas ambientales arraigadas culturalmente ocasionan enfermedades infantiles como: diarreas, neumonías, dermatitis, lesiones domésticas no intencionales, etc. Objetivos: Describir las prácticas culturales y ambientales del ámbito rural de Perú que influyen en la salud infantil. Metodología: Investigación cualitativa, descriptiva, el escenario fueron los hogares de 15 madres de familia, residentes rurales de la costa norte de Perú; la muestra fue delimitada por saturación y redundancia, el muestreo no probabilístico por conveniencia. Los datos se recolectaron mediante entrevista semiestructurada y procesados según el análisis de contenido. Resultados: A) Riesgo en la salud infantil por práctica cultural y ambiental de cocina a fuego abierto, B) Práctica cultural y ambiental en la eliminación de excretas, C) Costumbre de quema de residuos sólidos. Conclusiones: La mayoría de las madres de la zona rural cocinan a fuego abierto, usan leña, esto es un riesgo para los niños que permanecen con ellas. Eliminan las excretas en pozos ciegos, debido a la falta de saneamiento. Además, manifiestan un inadecuado manejo de residuos sólidos, eliminados en espacios abiertos que favorecen la proliferación de vectores, para posteriormente ser quemados.
Older adults may experience a wish to die in the context of deteriorating health, a loss of autonomy, loneliness, or depression. Home care workers may likewise experience burden or symptoms of depression as a result of prolonged contact with this physical and emotional suffering. Training initiatives that can support the well-being of home care workers are therefore important.
To describe the typical profile of older adults who express a wish to die to their home care worker, and to examine whether a psycho-educational intervention for care workers exploring the end-of-life process and self-care strategies had an impact on the older adult's wish to die and on the care worker's perceived burden and depressive symptoms.
Quasi-experimental, longitudinal study involving non-randomized experimental and control groups and follow-up at 3–6 months post-intervention.
At the start of the study, all care workers (n = 126) provided sociodemographic information (age, gender) for themselves and the care recipient, and completed the Karnofsky Performance Status scale and the Assessment of the Frequency and Extent of the Desire to Die (AFEDD) interview to provide a baseline measure of the care recipient's functional status and wish to die. They also completed the Beck Depression Inventory (BDI) and Zarit Burden Interview (ZBI) as a measure of their own perceived burden and depressive symptoms. The AFEDD, BDI, and ZBI were completed again by care workers at 3 and 6 months post-intervention.
The typical profile of care recipients was a woman aged 85.5 years who required considerable support and assistance and who had at least occasionally experienced a wish to die, although these thoughts were not always verbalized. Scores on the AFEDD remained relatively stable over the follow-up period in both the control and experimental groups. There was no significant association between the older adult's wish to die and depressive symptoms in the care worker across the study period. However, a positive and significant correlation between a wish to die in the older adult and perceived burden in the care worker was observed at 6 months post-intervention in both the total sample (p = 0.032) and among controls (p = 0.028). By contrast, this significant association was not found for care workers in the experimental group (p = 0.376), suggesting that the psycho-educational intervention may have had a protective effect.
Although further studies are needed to corroborate and extend these findings, the results suggest that psycho-educational interventions aimed at increasing home care workers' understanding of the end-of-life process and which introduce them to self-care strategies may help to reduce their perceived burden when the older person for whom they are caring expresses a wish to die.
Home care workers may find it challenging to care for an older adult who expresses a wish to die. Psycho-educational interventions that enhance care workers' understanding of the end-of-life process and teach them self-care strategies could help to support their well-being and their ability to provide adequate care.
Global organizations have pronounced about the importance of involving people in health care, however, this process is challenging. Given the availability of evidence that addresses people's experiences of involvement in nursing care, it is important to produce recommendations at this point by synthesizing the evidence. So, this review aims to synthesize the available qualitative evidence about people's experiences of their involvement in nursing care in a hospital setting.
Systematic review of qualitative evidence.
This systematic review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A comprehensive search strategy was conducted in nine databases/resources. The selection process, methodological quality assessment, and data extraction were conducted independently by two reviewers. The data were synthesized using the meta-aggregation approach, and the results were graded according to ConQual.
A total of 75 findings and 141 illustrations were extracted from the 15 included studies. These findings were aggregated into 12 categories and generated into three synthesized findings: (1) People who are hospitalized conceptualize and attribute importance to involvement in nursing care as an active process of participation and monitoring of care, decision-making, opinion, and partnership; (2) The establishment of a relationship between hospitalized people and nurses, trust, communication, and information are essential for participation in care; (3) People's participation in care is affected by the person's own constraints and preference for assuming a passive role, by barriers associated with a lack of information, the organization of care, the relationship established between nurses, and paternalistic attitudes.
People who were admitted to hospital conceptualized and attached importance to this phenomenon, perceived the conditions necessary to promote it, and the barriers they experienced.
This systematic review provides recommendations for nurses' clinical practice (with grade B). It recommends that nurses should establish a partnership relationship with hospitalized people, through trust, communication and information; give people the opportunity to monitor care, participate in decision-making and give their opinion; assess the person's preferences for involvement and other factors; and that the barriers to this process identified here should be assessed and addressed in each context. As such, this review provides very valuable information for nurses' clinical practice and should also be incorporated into health policy.
Protocol Registration: PROSPERO CRD42024506501.
Objetivos: Conocer el efecto de la autotrascendencia sobre el bienestar, por lo cual se planteó la hipótesis que indica que a mayor autotrascendencia (intrapersonal, interpersonal y transpersonal [espiritualidad]) mayor bienestar (físico, psicológico y social) en los adultos mayores. Metodología: estudio descriptivo correlacional. La población fueron adultos mayores de ambos sexos. El muestreo fue probabilístico aleatorio estratificado, la muestra total fueron 251 adultos mayores. Resultados: El efecto de la autotrascendencia y la espiritualidad fue significativo (F(1,249) = 4.24, p=.015) sobre el bienestar físico (consumo de alcohol sensato) explicando el 25% de la varianza total. Respecto al efecto de estas mismas variables sobre el bienestar psicológico se puede observar que el modelo fue significativo (F(1,249) = 51.52,p=.001) explicando el 28.8% de la varianza total. Por último se identificó que el efecto de la autotrascendencia y la espiritualidad sobre el bienestar social fue significativo (F(1,249) = 31.00, p=.001), este modelo explicó el 20.0% de la varianza total. Conclusiones: La autotrascendencia (intra e interpersonal y transpersonal [espiritualidad]) tiene efecto sobre el bienestar físico (consumo de alcohol sensato), bienestar psicológico y social. Debido a los resultados se considera que la enfermería debe de abordar estas problemáticas de estudio bajo marcos teóricos que promuevan el desarrollo integrar en el adulto mayor y facilitar el bienestar de la persona en todas las etapas de la vida.
ABSTRACT
Objectives: To know the effect of self-transcendence on well-being, for which the hypothesis was raised that indicates that the greater the self-transcendence (intrapersonal, interpersonal and transpersonal [spirituality]), the greater the well-being (physical, psychological and social) in elderly. Methodology: predictive descriptive study. The population was older adults of both sexes. The sampling was stratified random probabilistic, the total sample was 251 older adults. Results: The effect of self-transcendence and spirituality was significant (F(1,249) = 4.24, p=.015) on physical well-being (sensible alcohol consumption) explaining 25% of the total variance. Regarding the effect of these same variables on psychological well-being, it can be seen that the model was significant (F(1,249) = 51.52, p=.001) explaining 28.8% of the total variance. Finally, it was identified that the effect of self-transcendence and spirituality on social well-being was significant (F(1,249) = 31.00, p=.001), this model explained 20.0% of the total variance. Conclusions: Self-transcendence (intra- and interpersonal and transpersonal [spirituality]) has an effect on physical well-being (sensible alcohol consumption), psychological and social well-being. Therefore, it is considered that nursing should address these study problems under theoretical frameworks that promote the comprehensive development of the elderly and facilitate the well-being of the person at all stages of life.
This study shows the development of a software for calculating the number of nursing team members required for providing care during the coronavirus disease 2019 pandemic. Study about the development of a technology based on the literature about data and indicators. The indicators were systematized in the following dimensions: institutional, professional, and occupational structure, all with a focus on coronavirus disease 2019. The software was created to be used on the Web, client-server, in browsers such as Internet Chrome, Explorer, and/or Mozilla Firefox, accessing via an Internet address and also allowing access by Windows, Android, and Linux operating systems, with MySQL database used for data storage. The data and indicators related to the institutional structure for coronavirus disease 2019 were systematized with 10 dimensions and indicators, and the professional and occupational structure, with 14 dimensions and indicators. The construction of computer requirements followed the precepts of software engineering, with theoretical support from the area. In the evaluation of the software, data simulation revealed points that had to be adjusted to ensure security, data confidentiality, and easy handling. The software provides to calculate the size and quality of the team, nursing sizing required due to the needs generated by the coronavirus disease 2019 pandemic. 
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