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To analyse the comfort needs of patients following renal transplantation, guided by Kolcaba's Theory of Comfort.
A qualitative design was employed.
This study was conducted at a Brazilian university hospital's renal transplant outpatient clinic. Forty-six post-transplant patients were purposively sampled by age, transplant time and clinic attendance. Face-to-face interviews were audio-recorded, transcribed and conducted using a semi-structured script. Data were analysed through thematic content analysis, guided by Kolcaba's Comfort Theory and relevant literature.
Participant narratives were categorised according to the contexts outlined by Kolcaba's Theory of Comfort: Physical, Environmental, Sociocultural and Psychospiritual. In the physical context, pain was identified as a major factor diminishing comfort after renal transplantation. In the environmental context, elements such as light, odour, sound, temperature and uncomfortable furnishings contributed to discomfort. In the sociocultural context, family support was highlighted as essential. In the psychospiritual context, religiosity played a key role in enhancing the comfort of transplant recipients.
Spirituality, strengthened social support networks and non-pharmacological comfort measures are essential for promoting comfort among patients following renal transplantation. These findings underscore the importance of integrated care approaches that address physical, emotional and social aspects to improve quality of life for this population.
Conceptual models in nursing provide a critical perspective for care and support the delivery of effective, evidence-based interventions. By identifying the multidimensional comfort needs of post-renal transplant patients, this study informs the development of targeted, holistic strategies for nursing and multidisciplinary practice in outpatient settings.
This study examined the multidimensional comfort needs of post-renal transplant patients and found that comfort is shaped by physical, environmental, sociocultural and psychospiritual factors. The results may guide global nursing and multidisciplinary outpatient care by informing integrated approaches that enhance the quality of life of transplant recipients.
This study was reported according to the COREQ framework.
No patient or public contribution.
by Maria Cecilia Rasuk, Alfonsina Palladini, Andrea Moyano, Viviana Díaz, Antonella Giudice, Gisela Castillo, Solana Abraham, Juan Rull, Anja Poehlein, Rolf Daniel, Julian Rafael Dib
The Mediterranean fruit fly (Ceratitis capitata Wied.) is an agricultural pest of significant economic importance. This species has been globally managed using the Sterile Insect Technique (SIT). Insects, including tephritid flies, harbor a diverse gut microbiota that plays critical roles in their physiology, behavior, and overall fitness, suggesting that microbial communities may profoundly influence the biology of this pest. The aim of this study was to characterize the fungal and bacterial gut microbial communities of C. capitata from Tucumán, Argentina, and to assess their response to antimicrobial treatment using amplicon-based 16S rRNA gene and ITS region sequencing. Both control and treated flies were dominated by Proteobacteria (bacteria) and Zygosaccharomyces (fungi). Antimicrobial treatment induced significant shifts in bacterial and fungal composition, reducing diversity and altering gut community structure. Untreated flies exhibited a diverse and structured bacterial gut community dominated by the family Enterobacteriaceae, while antibiotic-treated communities were dominated by Rhizobiaceae. Despite these shifts, fungal communities in both treated and untreated groups were consistently dominated by the genus Zygosaccharomyces. Functional predictions revealed notable changes in metabolic pathways following antibiotic treatment, including increased gene abundance for ABC transporters and the phosphotransferase system, and decreased representation of genes involved in antibiotic biosynthesis and two-component systems. These results indicate significant alterations in bacterial metabolism and stress response mechanisms induced by the treatment. Such changes may help explain the underperformance of irradiated, mass-reared males within the context of SIT. This study provides new insights into the structural and functional dynamics of the C. capitata gut microbiome under disturbance. These findings have implications for understanding the ecological roles of microbial communities in this pest and their potential impact on fly health and fitness. Identification of dominant gut bacterial and fungal groups may support the development of probiotic diets, enhancing the efficiency of SIT application.The aim of this study was to document the process of the implementation and the perceived impact and sustainability of the Expansive Learning in Practice Model and its associated costs to inform future rollout.
A mixed-method rapid evaluation was conducted, comprising both qualitative and economic workstreams to document the implementation of the Expansive Learning in Practice Model and its associated costs. Semi-structured interviews (n = 44) were carried out with student nurses, student assessors, and staff involved in the delivery of the Model. The qualitative workstream utilised a rapid cycle evaluation approach, where data were collected and analysed in parallel, and preliminary findings were shared with stakeholders as the study was ongoing. The quantitative workstream relied on routinely collected data about non-staff-related costs, staff-related costs, and data on students' participation.
The main themes developed from the qualitative data included the organisation of the Expansive Learning Experiences, the supportive environment, the enhanced learning experience, and capacity building. Participants perceived that the model had a positive impact on student practice (including preparation and confidence) and on student nurse satisfaction. At the end of the programme, it is estimated that the programme will have cost about £523,572.
This model can be used as a framework for hospitals aiming to improve the learning experiences for student nurses. Improvements could be made by increasing staff buy-in and the streamlining of spoke opportunities. Future studies should focus on evaluating the long-term impact of the model, particularly the impact on generating student placement capacity. The evaluation also highlights the need for solutions for potential educational staff shortages, which could pose a risk to maintaining sufficient practice placement capacity for student nurses in healthcare settings.
Study participants perceived an improvement in student nurses' learning experiences and student nurse placement capacity as a result of the implementation of this model.
The relevant EQUATOR guidelines followed for reporting were the GRAMM guidelines (Good Reporting of a Mixed Methods Study).
The study centred around student nurse and staff experiences.
To explore and compare patients' and healthcare professionals' experiences of communication during hospitalisation for neurological diseases.
Effective communication is essential for establishing strong relationships between patients and healthcare professionals, thereby ensuring patient-centred care that respects individual values and preferences. Neurological patients face additional communication challenges due to cognitive and motor deficits, such as speech difficulties and delayed cognitive processing. Limited research has investigated how both patients and healthcare professionals experience communication in this context.
An explorative, qualitative design was applied within a hermeneutic framework inspired by photo-voice methods.
Data were obtained through interviews with patients (n = 12), one focus group discussion with healthcare professionals (n = 10) and six additional interviews with healthcare professionals (n = 6). Interviews were combined with photographs taken during the interviews. Data were analysed using reflexive thematic analysis, and the COREQ guideline was applied.
The analysis revealed a main theme: The core of connected care, encompassing three subthemes: Guided alignment, A changing environment and Human before patient. These themes created the foundation for effective, compassionate and humanised care. Participants metaphorically compared this to an aquarium, emphasising that, like an ecosystem, effective communication requires balance between alignment, environment and humanity. This main theme represents the quality of communication between patients with cognitive challenges and their healthcare providers.
This study provides insight into the experiences of communication from both patients and healthcare professionals. Effective communication is important to manage treatment and engage patients in care.
Improving communication, promoting shared decision-making and enhancing the implementation of person-centred care are key strategies for increasing patient outcomes and satisfaction.
None.
Cardiac rehabilitation has traditionally been administered through face-to-face consultations with a specialised team of nurses, medical doctors and physiotherapists. However, the healthcare system is undergoing a significant digital transformation, which may lead to telemedicine (TM) becoming a cornerstone of healthcare. However, successful TM requires digital competencies among both patients and health professionals. This trial will examine the best methods of onboarding patients to TM by way of a co-designed cardiac telerehabilitation model with a family-focused approach.
The aim is to investigate how patients and family members could benefit from using TM, including video consultations and home monitoring, for cardiac rehabilitation. We ask how patients’ health literacy, digital health literacy, health-related quality of life and family support would be affected by a shift to TM.
The primary outcome is the Health Literacy Questionnaire, and secondary outcomes are the eHealth Literacy Questionnaire, European Quality of Life—Five Dimensions Scale, and the Iceland—Family Perceived Support Questionnaire. The sample size is 73 patients in each group. Data will be analysed with 2 or Fisher’s exact tests, a t-test or a Wilcoxon signed-rank test, depending on the distribution.
Approval for this trial was obtained from the Danish Data Protection Agency (P-2023-65) and the National Committee on Health Research Ethics (F-23075094). The trial will be conducted in compliance with the Declaration of Helsinki. The trial results—whether positive, neutral or negative—will be submitted for publication. The trial has been registered at ClinicalTrials.gov (NCT06320652).
(NCT06320652).
To investigate discrepancies in perceptions regarding the accessibility and availability of rest and relaxation (R&R) spaces between hospital doctors in Scotland and NHS Scotland regional health boards (HBs), with the intention of informing best practices for organisational policy on the provision of R&R spaces both now and in the future.
A qualitative study, through an inhabited institutionalism (II) lens, of semi-structured interviews of hospital doctors across the career continuum in Scotland and all NHS regional HBs in Scotland providing written information relating to R&R space provision.
NHS Scotland during the COVID-19 pandemic and beyond.
Hospital doctors (n=30) who had participated in a larger qualitative study and provided specific insights on R&R spaces. All NHS Scotland regional HBs (n=14).
Although HBs reported the provision of R&R spaces, numerous doctors reported R&R spaces had been removed, relocated or were inaccessible. Furthermore, limited awareness of their availability attributed to inadequate communication, compounded the issue. This divergence between institutional reporting and front-line experience can be interpreted through the lens of II, which posits that institutional polices are often interpreted and implemented differently.
This study emphasises how crucial R&R spaces are to promoting doctors’ well-being especially during the time of high stress. HBs must not only guarantee the accessibility and physical availability of R&R spaces but also enhance their communication regarding the provision.
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.
Health advocacy (HA) is acknowledged as a core competence in medical education. However, varying and sometimes conflicting conceptualisations of HA exist, making it challenging to integrate the competence consistently. While this diversity highlights the need for a deeper understanding of HA conceptualisations, a comprehensive analysis across the continuum of medical education is absent in the literature. This protocol has been developed to clarify the conceptual dimensions of the HA competence in literature as applied to medical education.
The review will be conducted in line with the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. A comprehensive literature search was developed and already carried out in eight academic databases and Google Scholar, without restrictions on publication date, geography or language. Articles that describe the HA role among students and physicians who receive or provide medical education will be eligible for inclusion. Two independent reviewers will independently complete title and abstract screening prior to full-text review of selected articles and data extraction on the final set. A descriptive-analytical approach will be applied for summarising the data.
This scoping review does not involve human participants, as all evidence is sourced from publicly available databases. Therefore, ethical approval is not required for this study. The findings from this scoping review will be disseminated through submission to a high-quality peer-reviewed journal and presented at academic conferences. By clarifying the conceptualisations of HA, this review aims to contribute to a shared narrative that will strengthen the foundation for integrating the HA role into medical education.
A preliminary version of this protocol was registered on the Open Science Framework on 9 December 2024, and can be accessed at the following link: https://osf.io/ed2br. We have also registered our scoping review protocol as a preprint at medRxiv:
Objetivo: diseño de una intervención psicoeducativa de enfermería para el control del peso gestacional en mujeres embarazadas mexicanas basado en Modelo de Promoción de la Salud. Método: Uso de teorías en el diseño de intervenciones. Resultados: Los determinantes que se utilizaron para el diseño de la intervención, fue la autoeficacia, barreras percibidas e intenciones de implementación. Se diseñaron dos manuales, uno para el facilitador y otro para el participante. Conclusiones: El modelo de promoción de la salud es útil para guiar intervenciones psicoeducativas.
Objetivo principal: Describir la prevalencia de sarcopenia y analizar la influencia de las conductas asociadas del estilo de vida en la sarcopenia en personas mayores residentes de Mexicali, México. Metodología: Se consideró un diseño descriptivo inferencial. Participaron 105 personas mayores de 60 años o más. El muestreo fue no probabilístico. Se evaluaron los criterios diagnósticos para sarcopenia y las conductas asociadas al estilo de vida. La investigación se realizó acorde a la reglamentación ética. Resultados principales: El 24,8% y el 59% presentaron uno de los tres estadios de la sarcopenia acorde a los puntos de corte para la población mexicana y EWGSOP respectivamente. Se encontró asociación con el IMC (p <,01) y sexo (p <,05). Conclusión principal: Se identificó que la prevalencia es menor cuando se consideran los puntos de corte regionales para México. El IMC y el sexo se asociaron con la sarcopenia.
Objetivo principal: Diseñar y validar el instrumento SEG-MED para identificar el cumplimiento de los principios correctos y riesgos en la administración de medicamentos. Metodología: Estudio metodológico. Fase inicial de revisión de literatura para establecer bases conceptuales y propuesta de ítems. Se continua con validez de contenido y validez facial por expertos y finalmente se realiza confiabilidad con la participación de 210 profesionales de enfermería. Resultados principales: instrumento Inicial de 46 ítems, que luego del proceso se reduce a 43. Se compone de dos dimensiones: cumplimiento de principios correctos (22 ítems) y riesgos en la administración de medicamentos (21 ítems). Con un promedio de aceptabilidad de los ítems en un 87%, concordancia global de 0.72 y alfa de Cron Bach 0,9. Conclusión principal: se obtiene una herramienta para medir la percepción del cumplimiento de los principios correctos e identificar condiciones de riesgo para para la ocurrencia de eventos adversos en la administración de medicamentos por enfermería válida y fiable para el constructo.
Objetivo principal: Conocer la satisfacción de los usuarios del circuito de diagnóstico rápido de cáncer de pulmón. Metodología: Estudio prospectivo de cohortes que incluye todos los pacientes estudiados en consulta de cáncer de pulmón entre 1 de noviembre del 2016 hasta 31 de octubre del 2017, diagnosticados de neoplasia. Para conocer la satisfacción, la recogida de datos se realizó mediante cues-tionario en la última visita a la consulta de cáncer de pulmón. Resultados principales: Se estudiaron 566 pacientes con sospecha de malignidad, con diagnóstico final de neoplasia en 127 (84,7%) y con enfermedad metastásica en 29 (15,3%). Participaron 158 pacientes. La satisfacción fue alta (“excelente” y “muy bien”) en 85,4% pacientes. Conclusiones: Los resultados obtenidos muestran alto índice de satisfacción de los pacientes con la atención recibida y esto es un indicador de calidad del proceso.
Rev Enferm;41(3): 198-209, mar. 2018. tab, ilus. [Artículo]
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