Generative artificial intelligence (GAI), including large language models and multimodal generative systems, is rapidly emerging in healthcare with growing interest in its potential applications for dementia care. These technologies offer new possibilities for communication support, cognitive engagement and personalised interaction, yet they also introduce complex ethical, relational and practical challenges. Nurses—who hold central, sustained roles across dementia care settings—are key mediators of technology adoption and are positioned to assess the appropriateness, safety and ethical implications of GAI use. However, existing literature remains fragmented and largely focused on technological development or patient-facing outcomes, with limited synthesis of nurses’ roles, experiences and ethical perspectives. This scoping review aims to map the current evidence regarding how nurses engage with GAI in dementia care and to identify gaps that may inform practice, policy and future research.

This review will follow the methodological framework of Arksey and O’Malley, refined by Levac et al and guided by the Joanna Briggs Institute Manual for Evidence Synthesis. Reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The review will be conducted between March 2026 and October 2026, encompassing database searching, screening, data charting, synthesis and reporting. A comprehensive search will be conducted across MEDLINE (Ovid), CINAHL, PsycINFO, Scopus and Web of Science using controlled vocabulary and keywords related to nursing, generative artificial intelligence and dementia. Eligible sources will include empirical studies, reviews, conceptual papers and policy analyses that report nursing roles, experiences or ethical considerations related to GAI in dementia care. Two reviewers will independently screen titles/abstracts and full texts and extract data using a structured charting form. Findings will be synthesised through descriptive statistics and inductive thematic analysis, supported by conceptual mapping to illustrate relationships among GAI types, nursing roles, ethical concerns and care settings. Critical appraisal will not be undertaken, as it is optional in scoping reviews and is not aligned with the primary mapping objectives of this review.

Ethical approval is not required as the review synthesises publicly available literature. Should the optional interest-holders consultation be undertaken, ethical clearance will be obtained from an appropriate institutional review board prior to participant engagement. Findings will be disseminated through peer-reviewed publication, conference presentations and knowledge-translation outputs targeted at clinicians, educators, policymakers and AI developers. The review will support informed, ethically grounded integration of GAI in dementia care.

Parenting a preterm infant in the neonatal intensive care units (NICUs) is a profoundly stressful experience, shaped by clinical uncertainty, physical separation and emotional vulnerability. Although stress management strategies—such as counselling, peer support and psychoeducation—are commonly available in NICU settings, little is known about how parents experience these forms of support when they are intended to be culturally sensitive or delivered within diverse cultural contexts. Cultural values, beliefs and practices shape how parents interpret stress and engage with support, highlighting the need to synthesise qualitative evidence on parents’ lived experiences of culturally sensitive stress management strategies during NICU hospitalisation.

This systematic review of qualitative evidence will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. A comprehensive search will be undertaken across six databases: MEDLINE, CINAHL, Scopus, Web of Science, PsycINFO and Airiti Library. This review will include qualitative studies that examine parents’ experiences, perceptions and meaning-making in relation to stress management strategies that are explicitly culturally sensitive or situated within identifiable cultural contexts in NICU settings. Studies published in English or Chinese between 2014 and 2024 will be eligible. Two reviewers will independently screen studies, assess methodological quality using the JBI critical appraisal checklist and extract data using the standardised JBI data extraction tool. Meta-aggregation will be used to synthesise findings, and the ConQual approach will be applied to assess confidence in the synthesised outputs.

This systematic review of qualitative evidence will synthesise data from previously published studies and does not require formal ethical approval. The review will be conducted and reported in accordance with the JBI methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systematic reviews. Findings will be disseminated through publication in a peer-reviewed journal and presentations at national and international conferences on neonatal care, nursing and family-centred healthcare. Target audiences include NICU clinicians, hospital administrators, educators and policymakers interested in integrating culturally responsive approaches into stress management and family support practices.

CRD42022357472.

People with serious mental illness (SMI) can experience significant physical health challenges. The Health Champions intervention was developed to support their physical health through using trained volunteers. However, volunteer and patient perspectives on the impact and implementation of this intervention have yet to be understood.

To compare the views of patients and volunteers on the Health Champions intervention.

A qualitative thematic analysis was conducted on interviews with 29 study participants. Interviews were carried out either face-to-face, via Microsoft Teams, or by telephone and included 12 patients (6 men and 6 women) and 17 volunteers (the Health Champions) (5 men and 12 women).

Four overarching themes were identified, highlighting both similarities and differences between stakeholders’ perspectives: (1) supporting goal setting; (2) impact on positive lifestyle; (3) experiences and perception of the programme and (4) navigating challenges during the programme. Both groups found the programme to be largely successful, by motivating patients to work towards their physical health goals and facilitating successful matching of patients with volunteers. Volunteers and patients valued good communication with the research team. Though both groups shared some views on the challenges with scheduling and a lack of face-to-face contact during the COVID-19 pandemic, their perceptions on how patients incorporated their health changes during and after the programme, as well as other administrative concerns such as views on the efficacy of journaling and breakdown of roles, differed.

The Health Champions intervention was perceived as useful to improve the physical health of patients with SMI. Differences in the views between the two stakeholders may result from their distinct experiences and expectations. Future volunteering programmes should further support the diverse physical health needs of patients with SMI.

Studies have demonstrated the positive impact of falls prevention interventions for high-risk older adults who have experienced a severe fall. However, uptake and adherence rates remain low. The purpose of this study is to assess the capabilities, opportunities and motivations of older adults following a fall with subsequent presentation to the emergency department and direct discharge home in relation to falls prevention measures.

This study, conducted as part of the ‘Sentinel fall presenting to the emergency department’ project at the Carl von Ossietzky University Oldenburg in Germany, involved a participatory research team (PRT). It was a qualitative study based on focus group interviews undertaken between June and October 2022, analysed in accordance with qualitative content analysis following Kuckartz. The Theoretical Domains Framework forms the basis of the deductive category system. PRT members collaborated as co-researchers in conducting and analysing the focus groups.

12 focus groups were conducted (N=52). The participants were older adults (≥60 years) who had received outpatient care in an emergency department following a fall (N=41) and their relatives (N=11).

Interviewees indicated that both knowledge of available support options and the ability to self-evaluate are important following a fall. Additionally, health circumstances, such as limitations resulting from fall-related consequences, influence the adoption of falls prevention measures. Social influences, as well as environmental context and resources, were also discussed, reflecting participants’ preferences for intervention design, such as having a central point of contact and specific courses on fall training. Moreover, the fall event itself may strengthen the perceived need for preventive measures, whereas a fear of falling can lead to reduced or modified activity levels.

To improve the engagement of older adults in falls prevention interventions following a fall, the establishment of a central point of contact could be considered. Individual tailored interventions, including psychological support as well as specific fall training, are needed.

DRKS00025949.

Both varicose veins (VV) and iliac vein compression syndrome (IVCS) can cause skin damage and functional impairment in the lower extremities, and these issues often coexist. However, the question of whether IVCS exacerbates VV progression and leads to differences in the surgical outcomes of therapy for VV remains unanswered. Therefore, no high-level evidence-based medical data is available to support the concomitant use of iliac vein stenting in patients with VV and severe IVCS, and treatment protocols vary significantly among different centres. This study will investigate the effects of concomitant iliac vein stenting on post-procedure varices recurrence and quality of life (QoL) on the basis of a prospective, multicentre, randomised controlled trial with the goal of providing a foundation for the standardised treatment of patients with VV and IVCS.

This prospective, multicentre, randomised controlled trial will enrol 160 patients with VV and severe IVCS. All patients will be randomly divided into either the VV endovenous thermal ablation (ETA) alone group or the VV ETA combined with iliac vein stenting (ETAS) group. Baseline data will be collected and follow-up will be conducted at 1, 6, 12 and 36 months after the procedure. The primary outcome is post-procedure VV recurrence (as assessed by clinical and ultrasound examination). Secondary outcomes include QoL scores (according to the Aberdeen Varicose Vein Questionnaire, the Chronic Lower Limb Venous Insufficiency Questionnaire, the European Quality of Life Five-Dimensions, and the Venous Clinical Severity Score) and the incidence of post-procedure complications. Bleeding complications resulting from anticoagulation therapy and stent-related complications (such as restenosis and deep vein thrombosis) will also be recorded for patients in the ETAS group.

This study has been approved by the Ethics Committee of the First Affiliated Hospital of Xi'an Jiaotong University (approval number: XJTU1AF2024LSYY-075). Written informed consent has been obtained from all participants. The final results of this study will be published in a peer-reviewed journal and presented at national or international conferences.

This protocol was registered on chictr.org.cn prior to enrolment, which began on 19 June 2024 (Registration ID: ChiCTR2400085815).

Severe pectus excavatum (PE) may impair cardiopulmonary and physical function. The effectiveness of surgical treatment to correct PE and restore physical function is widely debated due to a lack of high-quality comparative evidence. The RESTORE trial aims to determine the clinical and cost-effectiveness of corrective surgery for severe PE compared with conservative management for the first time in a randomised controlled trial (RCT).

RESTORE is a pragmatic, multicentre, RCT with an embedded observational cohort. 200 participants aged ≥12 years with severe PE will be recruited at around 12 National Health Service cardiothoracic surgical centres in England. Participants will be randomised 1:1 to receive either surgery within 3 months of randomisation (intervention arm) or no surgery until after the primary outcome measurement at 1 year (comparator arm). The primary outcome is change in physical functioning from baseline to 1 year as measured by the Short Form Health Survey (SF-36v2) physical function score. The primary economic outcome is cost-effectiveness. The key secondary outcome is change in % predicted VO_2peak at 1 year measured by cardiopulmonary exercise test (CPET). Outcomes will be assessed at 1 year post-randomisation in the comparator arm and 1 year post-surgery in the intervention arm. The primary analyses will be undertaken on an intention-to-treat population using a linear mixed-effects model, adjusted for stratification variables via a binary covariate. Other secondary outcomes will include change from baseline of cardiopulmonary function (CPET and spirometry), health-related quality of life using the EuroQol 5 Dimension 5 Level (EQ-5D-5L) and SF-36v2 questionnaires, Hospital Anxiety and Depression Scale and disease specific symptoms (Phoenix Comprehensive Assessment for Pectus Excavatum Symptoms and Pectus Excavatum Evaluation Questionnaire). Adverse events, complications from surgery and operative technical success (Haller and Compression Indices from preoperative and postoperative CT scans) will also be assessed. Health economic analysis will estimate the incremental cost per quality adjusted life year at 1 year.

The trial was approved by East of Scotland Research and Ethics Service (24/ES/0034). Participants who are ≥16 years of age will be required to provide written informed consent. For participants

ISRCTN11359779.

Although individuals with dementia who reside in nursing homes are particularly susceptible to developing delirium, this condition is rarely recognised in these settings. Detection of delirium requires validated and reliable tools for this setting that can be applied by nursing staff. The primary objective of the study is to assess the comprehensibility, practicality and inter-rater reliability of two delirium detection tools (4 A’s test (4AT) and 4-item delirium superimposed on dementia (4-DSD)) and one tool for assessing both the diagnosis and severity of delirium (Delirium Rating Scale-Revised-98 (DRS-R-98)) in people with dementia who reside in nursing homes when used by nurses.

The comprehensibility and practicality of the German versions of the 4AT, 4-DSD and DRS-R-98 will be evaluated using cognitive interviews in accordance with the consensus-based standards for the selection of health measurement instruments framework. On the basis of the results of the cognitive interviews, a manual for each of the three tools will be developed and finalised by an expert panel. Finally, the inter-rater reliability and measurement error of the three tools will be determined using the manuals. For this purpose, a total of 70 residents from six nursing homes will be assessed by at least two nurses. The data analysis will include descriptive statistics and inter-rater reliability assessment for individual items (kappa value) and total scores (Intraclass correlation coefficients).

This study will assess the comprehensibility, practicality and inter-rater reliability of the 4AT, 4-DSD and DRS-R-98 for use in residents with dementia in nursing homes. The project was approved by the medical ethics committee of the University of Oldenburg (reference number: 2025-093).

The inter-rater reliability study was registered in the German Clinical Trials Register. Registration number: DRKS00037458 (https://www.drks.de/search/de/trial/DRKS00037458/details).

This study aimed to examine adverse event occurrences in outpatient care settings and healthcare utilisation after discharge and to identify the characteristics of patients at high risk of safety issues during the care transition from the hospital to their homes. In addition, the performance of outpatient triggers for the detection of adverse events was explored.

A retrospective cohort study using hospital medical record reviews over 6 months postdischarge.

A tertiary teaching hospital in South Korea.

A total of 746 adult patient medical records mainly including patients potentially at high risk of adverse events were analysed, comprising 5439 outpatient visits.

Occurrence of adverse events.

Approximately 14.2% of patients experienced at least one adverse event within 6 months postdischarge. Medication-related (84.2%) and surgical/procedural (13.2%) events were common. Most events were mild in severity and assessed as unpreventable. Patients who experienced adverse events had significantly more all-cause re-hospitalisations, emergency room visits and outpatient clinic visits. No difference was found in mortality. Controlling for other variables, multiple logistic regression analysis showed that patients who are overweight (OR=0.48, 95% CI 0.25 to 0.90), with circulatory system diseases (OR=0.38, 95% CI 0.15 to 0.96) and with a National Early Warning Score 2 (NEWS2) ≥2 at discharge (OR=0.26, 95% CI 0.12 to 0.54) were less likely to experience adverse events. Those with admissions via emergency rooms or day-surgery centres (OR=1.98, 95% CI 1.18 to 3.32), in medical departments (OR=1.93, 95% CI 1.15 to 3.23), with a diagnosis of cancer (OR=2.03, 95% CI 1.14 to 3.62) and longer hospital stays (OR=1.07, 95% CI 1.02 to 1.11) were more likely to experience adverse events postdischarge. Outpatient triggers with relatively high performance included ‘constipation with narcotics/calcium channel blockers’, ‘abrupt medication discontinuation’, ‘rash’ and ‘white blood cell count 3’.

Approximately 14% of patients, mainly comprising high-risk patients, experienced adverse events postdischarge, with more emergency room visits and all-cause re-hospitalisations. Patients experiencing adverse events were characterised by body mass index, type of admission route, clinical department, medical diagnosis, length of hospital stay and NEWS2. Patient and caregiver participation in the monitoring and reporting of adverse events should be encouraged to improve postdischarge patient safety. The use of triggers to detect potential patient safety problems is recommended.

Sarcopenia has emerged as a significant public health issue that threatens the health of older adults. The association between sleep duration and sarcopenia is receiving increasing attention. Based on data from the China Health and Retirement Longitudinal Study (CHARLS), this study investigates the dynamic characteristics of sleep duration trajectories and their relationship with the onset of sarcopenia.

A retrospective cohort study.

The study used data from the CHARLS across various regions of China.

Data were drawn from the 2011, 2013 and 2015 waves of CHARLS, including 2521 participants aged 45 years or older at baseline who had complete 3-year records of sarcopenia diagnosis. Sarcopenia was defined according to the 2019 criteria established by the Asian Working Group for Sarcopenia and was assessed across three dimensions: grip strength, estimated appendicular skeletal muscle mass and physical function.

Participants were categorised by changes in sleep duration, and linear mixed-effects models were used to identify three trajectories of sleep duration change (decrease–increase, decrease–no recovery and continuous increase). Multivariate logistic regression was conducted to examine the association between these trajectories and the risk of sarcopenia, adjusting for confounders, such as education level, body mass index (BMI) and lifestyle factors.

The median age of the cohort was 57.00 years, 61.40% of participants were female and the median BMI was 23.44. During the 5-year follow-up, the prevalence of sarcopenia was 14.09%. Compared with the non-sarcopenia group, individuals with sarcopenia had a higher median age (60.00 vs 56.00 years, p

This study developed a novel sleep trajectory model using longitudinal data, revealing the non-linear, multidimensional nature of the relationship between sleep duration and sarcopenia risk. Although no independent association was identified between 5-year sleep duration trajectories and sarcopenia in Chinese middle-aged and older adults, the study provides a valuable methodological framework for exploring multifactorial interactions in the ageing process and establishes a foundation for future research.