Conectar
by Mohajit Arneja, Swetharajan Gunasekar, Dharaneswari Hari Narayanan, Joshma Joseph, Harilalith Kovvuri, Sharath Shanmugam, Pavitraa Saravana Kumar, Asuwin Anandaram, Vinod Kumar Balakrishnan, Jayanty Venkata Balasubramaniyan, Sadhanandham Shanmugasundaram, Sankaran Ramesh, Nagendra Boopathy Senguttuvan
BackgroundFaster time to reperfusion can be achieved by minimizing various patient and system-level delays that contribute to total ischemic time. Procedural delays within the catheterization laboratory represent a non-negligible and modifiable component in the chain of reperfusion, but remain unquantified by conventional metrics such as door-to-ballon (D2B) time. Universal catheter approaches have rapidly gained traction as an alternative to the traditional two catheter approach for transradial coronary interventions. However, their utility for both diagnostic angiography and subsequent angioplasty is limited, and the impact of this strategy on reperfusion outcomes has remained unexplored. We utilized a procedural metric termed fluoroscopy-to-device (FluTD) time to quantify the efficiency of a single catheter strategy, and assessed its impact on epicardial and myocardial perfusion.
Methods and resultsIn this retrospective study, consecutive STEMI patients undergoing transradial primary PCI (pPCI) at a tertiary care center in India between May 2022 to October 2024 were analyzed. Patients were divided into two groups: 51 underwent PCI using a single universal guiding catheter (UGC), and 51 underwent the conventional two-catheter (CTC) approach. The primary outcome of the study was a comparison of the FluTD time between the two procedural strategies. Secondary outcomes included myocardial blush grade (MBG), Thrombolysis in Myocardial Infarction (TIMI) flow grade, total fluoroscopy time, radiation dose, device safety and efficacy, and procedural success.The median FluTD time was significantly shorter in the UGC compared to the CTC group (3 minutes [IQR 3–4] vs. 10 minutes [IQR 8–17], p Conclusion
A single catheter strategy for both angiography and pPCI in STEMI patients was associated with a significant reduction in FluTD time and improved microvascular perfusion, without compromising device safety or efficacy. In low- and middle-income countries (LMICs), where intra- and extra-procedural delays are often more pronounced, inclusion of the single catheter strategy can optimize catheterization workflows and yield substantial cost-savings.
Spiritual well-being (SpWB) is a critical yet often underexplored component of holistic care for patients with advanced cancer. This study aimed to assess the SpWB and quality of life (QOL) levels and examine their correlation among patients receiving palliative care at a tertiary cancer centre in Kerala, India.
Institution-based cross-sectional observational study among patients with advanced cancer conducted between August 2023 and December 2024.
The outpatient department of a major tertiary-level, autonomous cancer centre under the Government of Kerala, India.
398 patients with advanced cancer aged 18 and above.
SpWB and QOL were measured using validated Malayalam versions of the Functional Assessment of Chronic Illness Therapy–Spiritual well-being Expanded Version and European Organisation for Research and Treatment of Cancer, Quality of Life Core 30 questionnaires, respectively. Data collection included patient self-reports or assistance by a medical social worker.
The median (IQR) age of participants was 59 (51–65) years; most were married (94.5%) and from an upper-lower socioeconomic background (55%). Hinduism was the predominant religion (67.1%). Almost all patients (99%) were aware of their diagnosis, but only 62.3% knew their prognosis. The median (IQR) SpWB score was 67.5 (57–76), significantly higher in females (p=0.02). The median (IQR) QOL score was 50 (41.7–66.7). SpWB was positively correlated with QOL (r=0.766, p
SpWB showed a strong positive correlation with QOL among patients with advanced cancer. Enhancing SpWB may play a pivotal role in improving overall QOL in palliative care settings.
by Bwambale Jonani, Emmanuel Charles Kasule, Bwire Roman Herman, Joel Fredrick Arturo, Mwesigwa Calvin Mugambwa, Ssebulime Stephen, John Bosco Mundaka, Richard Kwizera, Gerald Mboowa, Felix Bongomin
IntroductionSickle Cell Anemia (SCA) is a significant genetic disorder in Africa; however, comprehensive data on its prevalence and geographic distribution remain limited. We aimed to estimate the pooled prevalence of SCA (HbSS) in African populations and examine regional, demographic, and temporal variations from 1994–2024.
MethodsWe systematically searched PubMed, Scopus, Google Scholar, and BASE databases for studies reporting SCA prevalence in African populations. Screening and quality assessments were performed using JBI tools. A random-effects meta-analysis with logit transformation was performed, with subgroup analyses by region, age, sex, and study design. Meta-regression explored heterogeneity sources, including geographic region, age category, diagnostic method, study design, and publication year.
ResultsFrom 115 studies with 1,203,839 participants and 17,458 confirmed HbSS cases, the pooled prevalence was 1.43% (95% CI: 1.08%–1.88%), with substantial heterogeneity (I2 = 99.1%) and a prediction interval of 0.21%–8.91%. Central Africa showed the highest prevalence (1.99%), and Southern Africa showed the lowest (0.59%). Children exhibited a higher prevalence (1.65%) than adults (0.45%), while sex differences were non-significant (males 2.71%, females 1.74%; p = 0.694). The prevalence has remained stable over three decades despite a six-fold increase in research output, although wide prediction intervals indicated substantial between-study variability. Electrophoretic techniques predominated (86.4% of cases). Diagnostic method (χ² = 16.73, p = 0.033) and age category (χ² = 33.66, p 2 = 98.6%). Leave-one-out sensitivity analysis showed that no single study significantly impacted the pooled estimates.
ConclusionSCA represents a substantial and geographically variable public health challenge across Africa. These findings highlight the need for region-specific interventions, expanded newborn screening programs, improved diagnostic accessibility with quality assurance for point-of-care technologies, and continued surveillance to address geographic gaps.
by Patrick Kaggwa, Juliet Nabbuye Sekandi, Mcdonald Kerone Adenike, Peter Nabende, Sarah Nabukeera, Kenneth Kidonge Katende, Esther Buregyeya, Nazarius Mbona Tumwesigye
BackgroundUnique patient identification is often challenging in healthcare systems, especially in low- and middle-income countries. Digital facial recognition is a promising alternative to traditional identification methods. This pilot study explores the perceptions and attitudes of healthcare workers towards using facial recognition technology in a healthcare setting in Uganda.
MethodsWe conducted an explorative qualitative study using key informant interviews with healthcare workers in Kampala, Uganda, to assess perceptions and attitudes towards digital facial recognition. We interviewed a total of 10 healthcare workers, including five doctors and five nurses, aged 20–39 years, with at least one year of professional experience. A trained interviewer provided a brief overview and demonstration of the facial recognition application and then used an open-ended interview guide to elicit responses about perceptions and attitudes. The interviews were audio recorded and transcribed verbatim. Data obtained from Key Informant Interviews were manually analyzed using thematic content analysis.
ResultsOverall, the healthcare workers perceived digital facial recognition as a more effective and acceptable way to identify patients who receive service at outpatient clinics. Four themes emerged, including: i) Challenges affecting current patient identification standards, ii) Healthcare workers’ views on facial recognition, iii) Perceived digital facial recognition implementation challenges, and iv) Solutions to challenges of digital facial recognition. The healthcare workers recommended ensuring the protection patients’ images privacy, providing adequate technological infrastructure in clinics, and securing stable internet access for the successful implementation of digital facial recognition.
ConclusionOur exploratory study indicates that overall, healthcare workers have a positive perception of the digital facial recognition application. However, it is crucial to acknowledge and address concerns regarding confidentiality and privacy to pave the way for the future implementation of the system.
by Evelyn Aboagye Addae, Moses Adjei, Uchechi Shirley Anaduaka, David Kyetuo Wuollah-Dire, Regobert Bondong
Though the impact of COVID-19 pandemic’s effects on individuals’ life domains and quality of life has been widely researched, there remains unanswered questions on the mechanisms that explain the impact of fear of COVID-19 on different measurements of adolescents’ subjective well-being (SWB) particularly in the sub-Saharan African context. In a mediation model, we employed data collected during the pandemic to examine the mediating mechanisms that links fear of COVID-19 and COVID-19-induced changes in multiple life domains (subjective feelings of unsafety, positive affect and peer relationships) to different measurements of adolescents’ SWB (overall life satisfaction, overall happiness, subjective happiness, and composite SWB). Findings revealed significant negative correlations between fear of COVID-19 and all employed measurements of SWB as well as between the proposed mediating variables – changes in peer relationship, positive affect, subjective feelings of unsafety and the different measurements of SWB. Adolescents who reported negative changes in peer relationship, positive affect and subjective feelings of unsafety were more likely to report poorer SWB including lower life satisfaction and happiness. For instance, adolescents who experienced increase in peer relationship were more likely to experience higher overall life satisfaction (B = .169, p B = .172, p B = .056, p B = .416, p B = .381, p B = −1.350, pby Claude Emmanuel Koutouan, Marie Louisa Ramaroson, Angelina El Ghaziri, Laurent Ogé, Abdelhamid Kebieche, Raymonde Baltenweck, Patricia Claudel, Philippe Hugueney, Anita Suel, Sébastien Huet, Linda Voisine, Mathilde Briard, Jean Jacques Helesbeux, Latifa Hamama, Valérie Le Clerc, Emmanuel Geoffriau
Resistance of carrot to Alternaria leaf blight (ALB) caused by Alternaria dauci is a complex and quantitative trait. Numerous QTL for resistance (rQTLs) to ALB have been identified but the underlying mechanisms remain largely unknown. Some rQTLs have been recently proposed to be linked to the flavonoid content of carrot leaves. In this study, we performed a metabolic QTL analysis and shed light on the potential mechanisms underlying the most significant rQTL, located on carrot chromosome 6 and accounting for a large proportion of the resistance variation. The flavonoids apigenin 7-O-rutinoside, chrysoeriol 7-O-rutinoside and luteolin 7-O-rutinoside were identified as strongly correlated with resistance. The combination of genetic, metabolomic and transcriptomic approaches led to the identification of a gene encoding a bHLH162-like transcription factor, which may be responsible for the accumulation of these rutinosylated flavonoids. Transgenic expression of this bHLH transcription factor led to an over-accumulation of flavonoids in carrot calli, together with significant increase in the antifungal properties of the corresponding calli extracts. Altogether, the bHLH162-like transcription factor identified in this work is a strong candidate for explaining the flavonoid-based resistance to ALB in carrot.by Maja Stiawa, Paul Nickel, Gironimo Krieg, Katharina Senk, Reinhold Kilian, Natalie Lamp, Maria Panzirsch, Silvia Krumm
PurposePartners of people with mental illness can play an important role in helping them cope with the illness. Previous studies have highlighted the potential burden of depression on partners, but there has been little research into the perspective of female partners of men with depression in terms of their role and support needs. The aim of this study is to investigate the subjective view of female partners on the opportunities and challenges of dealing with a male partner’s depression.
Materials and methodsQualitative semi-structured interviews were conducted online with 13 female partners of men with depression using a semi-structured interview guide. The transcripts were analyzed using qualitative content analysis.
ResultsFour central categories were derived from the analysis: 1) perceived changes in depressed partners; 2) positive impacts on their relationship; 3) burdens and challenges in coping with the partner’s depression; and 4) experiences with and expectations of support. Female partners often take on an active and demanding role during the depression treatment period and exhibit a high level of caring behavior towards and responsibility for their partner with depression. Compensating for the impact of the partner’s depression on family life, women have to bear additional hardship that may lead to overload. The women’s needs are primarily met by close contacts from within their personal networks. Joint therapy sessions during the male partner’s treatment are valuable in helping cope with the illness together.
ConclusionsFor partners of men with depression, the impact of the illness is ambivalent: On the one hand, the partner’s depression is associated with a number of difficulties and challenges. On the other hand, dealing with the illness together can also strengthen their relationship. Female partners of men treated for depression should be provided with low-threshold services, including therapeutic interventions that focus on successful joint coping.
To investigate whether internal and external violence are associated with turnover intentions among nurses during demanding periods of work.
Workplace violence can negatively impact upon mental and physical health and turnover intentions. Research focusing on how dimensions of workplace violence, internal versus external, influence turnover intentions and the factors that mitigate these effect is lacking.
An online cross-sectional survey of multi-item measures was used to collect data from 462 Iranian nurses. We employed path modelling and analysed the data using SPSS and PROCESS macro. A STROBE checklist was used to report findings.
Both dimensions, internal and external, of violence were positively associated with turnover intentions. Moreover, perceived invulnerability and organisational support moderates this association. When individuals perceived invulnerability and perceived organisational support are high, internal violence is no longer indirectly related to turnover intentions via job satisfaction. In a similar vein, when perceived invulnerability and perceived organisational support are low, external violence is not related to intentions to quit. When perceived invulnerability and perceived organisational support are high, however, external violence is indirectly and negatively related to intentions to quit.
Nurses who regard themselves as invulnerable might be motivated to quit when they experience workplace violence. However, they are motivated to stay on the job when they both perceive themselves as invulnerable and the organisation as supporting.
Organisations should reconsider their policies and approach towards workplace violence especially during periods of intensive work.
by Mohammad K. Siddiqui, Shagufta Khan, Rinchenla Bhutia, Vivek Nair, Ashok Rai, Nirmal Gurung, Tseten Yamphel, Peggy K. Dadul, Debya S. Kerongi, Karma Doma Bhutia, Jagat Pradhan, Kabita Khati, Sreenivas A. Nair, Shamim Mannan, Kiran K. Rade, Dinesh Gupta, Pawan Malhotra, L. Masae Kawamura, Shikha Dhawan, Asif Mohmmed
BackgroundMonasteries in India house individuals from childhood to advanced age. These congregate settings amplify tuberculosis (TB) transmission and exposure when the disease is present, especially in the high burden areas like Sikkim, India. However, the prevalence of active-TB disease (ATB), tuberculosis infection (TBI), and their associated risk factors have not been studied. The diagnosis and treatment of TBI remain a major bottleneck in eradicating TB. ATB and TBI risk among residents living in the congregate setting of monasteries in Sikkim, India, a high-TB burden area, may be high due to high-density living quarters, public interaction and their frequent travel history but has never been illustrated.
MethodA cross-sectional screening of the monks and residents of Rumtek Monastery (Sikkim, India) was carried out to assess extent of ATB and TBI in a congregate setting. TrueNat MTB and GeneXpert MTB/Rif systems were utilized for ATB diagnosis, whereas QuantiFERON-TB Gold Plus (QFT-plus) Interferon-gamma release assay (IGRA) analysis was used for TBI detection. Follow-up sputum testing by TrueNat MTB was performed on IGRA-positive individuals to exclude ATB.
ResultsAmong the 350 inhabitants of the monastery, 7% (25/350) were found to be symptomatic for TB, whereas 93% (325/350) were asymptomatic. Out of them, 189 participants, including symptomatic cases, agreed to participate in the study and were screened for TBI; however, 15 participants were excluded from the study due to result discrepancies. None of the participant were diagnosed with active tuberculosis (ATB), although, 44.2% (77/174) were found to be positive for TBI; however, none of those with TBI progressed to ATB during one year follow-up. Risk factors for TBI included: advancing age, frequent travel history, family history of TB or having contacts with TB patients and abnormal Body Mass Index (BMI) ≤18.5- ≥ 25.
ConclusionThis study confirms the high prevalence of TBI among residents in the congregate setting of monasteries, and justify TB prevention strategies by targeted screening, TBI testing and preventive treatment in congregate settings of high TB burden areas.
Mentalising, the capacity to understand behaviour via underlying mental states, is a key construct in psychopathology. While self-report instruments are widely used to assess mentalising, significant questions about their psychometric properties persist and no systematic review has comprehensively evaluated them using standardised criteria. This systematic review, guided by the COnsensus-based Standards for the selection of health Measurement Instruments () methodology, aims to: (1) identify all available self-report mentalising measures for adults; (2) evaluate the methodological quality of their validation studies; (3) synthesise and grade the quality of evidence on their measurement properties and (4) provide evidence-based recommendations for their use in research and clinical practice.
Five electronic databases (SCOPUS, Web of Science, PsycINFO, PubMed, ProQuest) will be searched from their inception, supplemented by a search of grey literature and reference lists. We will include studies of any design that report on at least one measurement property of a self-report measure of mentalising in adults. Two reviewers will independently screen all records, extract relevant data and assess the methodological quality of included studies using the COSMIN Risk of Bias checklist. For each instrument, the evidence for each measurement property will be synthesised, and the overall quality of the evidence will be graded using a modified Grading of Recommendations Assessment, Development and Evaluation approach.
As this systematic review will synthesise data from previously published studies, it does not require formal ethical approval. The findings will be disseminated through a peer-reviewed, open-access publication and presentations at scientific conferences. The results will provide a comprehensive inventory of available measures and a rigorous evaluation of their psychometric quality, creating an evidence base to guide clinicians and researchers in selecting the most appropriate instruments for mentalising assessment.
CRD420251031469.
by Chean Tat Chong, Lalitha Palaniveloo, Sulhariza Husni Zain, Muhamad Khairul Nazrin Khalil, Kishwen Kanna Yoga Ratnam
Gestational diabetes mellitus (GDM) is a growing public health concern, particularly among women with advanced maternal age. Understanding the prevalence and associated sociodemographic factors is crucial for targeted interventions. This study aimed to determine the prevalence of GDM and its association with sociodemographic factors among Malaysian women with advanced maternal age. This study utilized data from the National Health and Morbidity Survey 2022: Maternal and Child Health, a nationwide cross-sectional survey employing a two-stage stratified cluster sampling design. GDM was identified based on the result of a modified oral glucose tolerance test (MOGTT) recorded in the mother’s antenatal book. The 75-g MOGTT was performed according to the Clinical Practice Guidelines for the Management of Diabetes in Pregnancy in Malaysia. Sociodemographic variables, including ethnicity, locality, education, employment, and household income, were analysed. Multiple logistic regression was performed to identify factors associated with GDM. The prevalence of GDM among women with advanced maternal age in Malaysia was 33.7% (95% CI: 30.9%−36.5%). Ethnicity was significantly associated with GDM, with Indian women showing the highest prevalence (48.8%) and odds (AOR: 7.31, 95% CI: 2.58–20.72; Pby Denis Sereno, Tahar Kernif, Renato Leon, Kholoud Kahime, Souad Guernaoui, Chaymaa Harkat, Mario J. Grijalva, Omar Hamarsheh, Anita G. Villacis, Bachir Medrouh, Thiago Vasconcelos Dos Santos, Razika Beniklef, Naouel Eddaikra, Phlippe Holzmuller
IntroductionLeishmaniases are a vector-borne parasitic diseases with diverse clinical manifestations involving multiple Leishmania species and animal hosts. While most leishmaniasis cases are caused by a few well characterized Leishmania species, reports describe infections by unconventional or emerging Leishmania taxa, atypical clinical presentations from classical species, and occurrences of atypical Leishmania in animal hosts. These underrecognized infections present diagnostic and therapeutic challenges and are rarely reflected in surveillance systems or clinical guidelines. A systematic mapping of this evolving landscape is needed to guide future diagnostics, policy, and research priorities.
Methods and analysisFollowing the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, we will search PubMed, Embase, Cochrane Library (CENTRAL), PROSPERO, Web of Science, and Global Index Medicus, as well as relevant grey literature. Eligible studies will include human cases with clinical presentations that diverge from those typically associated with well-characterized Leishmania species, reports involving unconventional or emerging Leishmania species, and animal cases of veterinary relevance caused by non-classical species, regardless of study design. Dual independent screening of records and data extraction using a standardized charting form will be conducted. Discrepancies between reviewers will be resolved by consensus. Data will be summarized descriptively through tables, figures, and thematic synthesis. Research gaps will be identified to inform future studies and public health strategies.
DisseminationThis review will use data from published sources and findings will be disseminated through publication in a peer-reviewed journal, presentations at scientific conferences, and sharing with relevant stakeholders. The results are intended to inform clinicians, researchers, and policymakers about the evolving landscape of leishmaniasis and to highlight priorities for future research and surveillance.
by Connie Nait, Simple Ouma, Saadick Mugerwa Ssentongo, Boniface Oryokot, Abraham Ignatius Oluka, Raymond Kusiima, Victoria Nankabirwa, John Bosco Isunju
BackgroundDespite advances in HIV care, viral load suppression (VLS) among adolescents living with HIV (ALHIV) in Uganda continue to lag behind that of adults, even with the introduction of dolutegravir (DTG)-based regimens, the Youth and Adolescent Peer Supporter (YAPS) model, and community-based approaches. Understanding factors associated with HIV viral load non-suppression in this population is critical to inform HIV treatment policy. This study assessed the prevalence and predictors of viral load non-suppression among ALHIV aged 10–19 years on DTG-based ART in Soroti City, Uganda.
MethodsWe conducted a cross-sectional study among 447 ALHIV attending three urban HIV clinics in Soroti City. Data were abstracted using a structured questionnaire and analyzed in STATA 15.0. Modified Poisson regression with robust error variance was used to identify predictors of viral load non-suppression. Adjusted relative risks (aRR) and 95% confidence intervals (CIs) were reported, with statistical significance set at p ≤ 0.05.
ResultsOf the 447 participants, 53.5% were female, with a median age of 16 years (IQR: 14.0–17.6). The majority (72.9%) were from Soroti district and had been on DTG-based ART for a median of 42.5 months (IQR: 37.0–48.0). Most were receiving multi-month dispensing (MMD) (75.2%) and were active in care (98%). The prevalence of viral load non-suppression was 19.2% (86/447). Independent predictors of non-suppression included older age (15–19 vs. 10–14 years) (aRR: 1.69; 95% CI: 1.08–2.67), male sex (aRR: 1.48; 95% CI: 1.05–2.11), prior non-suppression before switching to DTG (aRR: 1.76; 95% CI: 1.19–2.59), use of non-fixed dose DTG regimens (aRR: 2.03; 95% CI: 1.23–3.33), history of poor adherence (aRR: 4.36; 95% CI: 2.05–9.26), and not receiving MMD (aRR: 2.83; 95% CI: 1.93–4.15).
ConclusionNearly one in five adolescents on DTG-based ART in Soroti City had viral non-suppression, despite optimized treatment regimens. Targeted interventions−particularly enhanced adherence counseling for older and male adolescents, expanding MMD coverage, and provision of fixed-dose regimens−are urgently needed to improve VLS among ALHIV. These findings underscore the need for adolescent-centered HIV care strategies to close the viral suppression gap and advance progress towards epidemic control.
To explore how public health nurses at child and family health clinics work to prevent maltreatment and the experiences of public health nurses in the maltreatment prevention efforts.
Child maltreatment is a serious societal issue with major consequences. Preventive efforts are increasing and have broad political support. A key objective of the child and family health clinic services is to prevent, identify, and stop maltreatment, abuse, and neglect. National clinical guidelines outline, in general terms, how such work should be conducted. However, limited research exists on how public health nurses prevent maltreatment and the effectiveness of their methods.
A qualitative and explorative design was used, based on semi-structured interviews with 14 public health nurses conducted as part of the project ‘Public Health Nurses in Child and Family Clinics' Role in Preventing and Detecting Child Maltreatment’ at Oslo Metropolitan University. The interviews were carried out between August and November 2021. We used qualitative content analysis with an inductive approach to analyse the data.
Three main categories were developed: 1. Structure and system: weaving prevention into daily practice; 2. To dare and endure: a negotiation of courage and understanding, and 3. To empower and uphold: the goal of strengthening and supporting parents. The results show the importance of early intervention, barriers to discussing maltreatment with parents, and the importance of building trust and empowering parents.
Preventing maltreatment is a key part of public health nurses' clinical work, focusing on early risk identification and parental guidance. While building trust with families is prioritised, structural, resource, and guideline-related challenges persist.
This study provides knowledge about Norwegian public health nurses clinical work with child maltreatment at the child and family health clinics, which can serve as a valuable foundation for further research as well as for collaborating services.
EQUATOR guidelines were followed, using the COREQ checklist.
No patient or public contribution.
Introducción: La motivación cumple un rol fundamental sobre todo en el desempeño laboral del profesional de Enfermería. Esta motivación representa un factor protector tanto para el profesional de Enfermería como también al paciente que se encuentra a su cuidado. Se objetivó analizar la relación existente entre factores motivacionales y desempeño laboral del profesional de Enfermería quienes ejercen funciones en dos hospitales del departamento Central 2023. Metodología. Estudio observacional descriptivo transversal realizado en dos centros asistenciales de referencia nacional, de alta complejidad de la República del Paraguay, muestreo no probabilístico por conveniencia. El instrumento, un cuestionario pre-elaborado y validado. Resultados. Respeto al desempeño laboral, predominó el nivel alto. En referencia a las dimensiones del desempeño laboral, ha predominado mayoritariamente el nivel alto, no registrándose ningún participante en el nivel bajo. Al relacionar los factores motivacionales con el desempeño laboral, se encontró asociación estadísticamente significativa, con lo que se acepta la hipótesis de investigación que indica que existe asociación entre factores motivacionales y el desempeño laboral de profesionales de enfermería. Discusión. Al relacionar los factores motivacionales con el desempeño laboral, se observó una asociación estadísticamente significativa. Esto se respalda en un estudio realizado en Perú, cuyos resultados sugieren que el desempeño laboral de los profesionales de enfermería estaría influenciado por la dependencia de factores motivacionales extrínsecos. Conclusión: Se recomienda fortalecer programas de reconocimiento y mejora de condiciones laborales para estimular la motivación extrínseca, como implementar oportunidades de desarrollo profesional y participación en la toma de decisiones.
ABSTRACT
Introduction: Motivation plays a fundamental role, especially in the work performance of nursing professionals. This motivation represents a protective factor for both the nursing professional and the patient under their care. The objective was to analyze the existing relationship between motivational factors and work performance of nursing professionals who work in two hospitals in the Central department 2023. Methodology. A cross-sectional, descriptive, observational study carried out in two national reference, highly complex healthcare centers in the Republic of Paraguay, using a non-probabilistic convenience sampling. The instrument was a pre-prepared and validated questionnaire. Results. Regarding work performance, a high level predominated. Regarding the dimensions of work performance, the high level predominated, with no participants registered at the low level. When relating motivational factors with work performance, a statistically significant association was found, thereby accepting the research hypothesis that indicates an association between motivational factors and the work performance of nursing professionals. Discussion. When relating motivational factors to job performance, a statistically significant association was observed. This is supported by a study conducted in Peru, whose results suggest that nursing professionals' job performance may be influenced by their dependence on extrinsic motivational factors. Conclusion. Strengthen recognition programs and improve working conditions is recommended to stimulate extrinsic motivation, such as implementing opportunities for professional development and participation in decision-making.
To describe newly graduated nurses' experiences of reflection as a support for professional development during the initial months of their transition while caring for patients in a hospital setting.
A qualitative descriptive design.
Four focus groups with 20 newly graduated nurses participating in a professional development programme at aregion in Sweden were conducted in 2023. The data were analysed using qualitative content analysis.
The analysis identified one main category: Reflection supports newly graduated nurses' professional development during their transition. This main category includes three generic categories: (1) Reflection with peers in a regularly structured dialogue group strengthens the professional role; (2) reflection with experienced healthcare instructors in learning activities enhances the mastery of care tasks; and (3) reflection with experienced colleagues in the workplace enhances task performance. Structured reflection in dialogue groups and interactive learning activities within the Professional Development Programme facilitated deeper reflections on caring experiences.
Newly graduated nurses reported that regularly structured reflection, adequate space, and established trust were essential to their professional development. While the professional development programme provided opportunities, variations in the workplace environment led to unequal conditions for reflective practice.
Addressing the need for reflection among newly graduated nurses is crucial for organisations to facilitate their transition. Establishing structures for reflection on caring experiences within introduction programmes can support their professional development.
Reflective practice in complex and challenging hospital settings can support the professional development of newly graduated nurses.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) was adhered to.
No patient or public contributions.
(1) To codesign a health literacy intervention within a specialist healthcare setting to help the parents of children with epilepsy access, comprehend, use and communicate information and (2) to assess the intervention's feasibility by exploring stakeholders' perspectives on its usefulness, ease of use of trial methods and contextual factors impacting its execution.
A codesign participatory approach followed by a feasibility approach inspired by the OPtimising HEalth LIteracy and Access to Health Services (Ophelia) process for health literacy intervention development.
(1) The codesign approach included workshops with (a) multidisciplinary personnel (n = 9) and (b) parents (n = 12), along with (c) an interview with one regional epilepsy specialist nurse (n = 1). The participants discussed parents' health literacy needs on the basis of vignettes and brainstormed service improvements. A three-step intervention was subsequently designed. (2) The intervention's feasibility was assessed via interviews with six parents (n = 6), a focus group interview with study nurses, a short doctors survey and a log of time spent testing the intervention.
(1) The parents of first-time admitted children to a specialist epilepsy hospital were targeted for the intervention. Nurse–parent consultations were central to the intervention, activating parents in codeveloping and executing a tailored education plan. (2) Feasibility: parents (n = 6) experienced consultations and education plans that were beneficial for enhancing their self-efficacy in managing the child's condition. The study nurses (n = 3) acknowledged positive outcomes in streamlining patient education but felt that their training on the intervention methods was insufficient. Both parents and nurses identified limited personnel resources as a significant barrier to executing the intervention.
The codesigned intervention engaged nurses and parents in HL development despite system barriers. The parents experience enhanced self-efficacy in managing their child's condition. However, needs refinements and further feasibility tests are needed before future implementation.
The Consort Statement 2010 extension for reporting non-randomised pilot and feasibility studies was used to ensure the methodological quality of the study. A Consort Statement 2010 checklist is provided as an additional file.
The collaboration of parents within the target group, the providers involved and the project's steering committee was crucial in codesigning and evaluating this three-step intervention. Parents and multidisciplinary providers actively contributed through workshops, interviews and in discussion meetings. The study nurses testing the intervention played a key role in defining the documentation process for the codeveloped education plan.
This three-step health literacy intervention can positively impact parents' self-efficacy in managing their child's condition. Enhancing nurses' communication skills is essential for improving parents' health literacy, making it crucial to allocate resources for such training. The intervention content and strategies to meet parents' health literacy needs require refinement, with more provider involvement to better adapt it to the context. Future studies should focus on further feasibility testing by considering a more flexible time frame.
Open Science Framework: https://osf.io/fg9c7/
To evaluate the impact of spatial separation on patient flow in the emergency department.
This was a retrospective, time-and-motion analysis conducted from 15 to 22 August, 2022 at the emergency department of a tertiary hospital in Kuala Lumpur, Malaysia. During this duration, spatial separation was implemented in critical and semi-critical zones to separate patients with symptoms of respiratory infections into respiratory area, and patients without into non-respiratory area. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Patients triaged to critical and semi-critical zones were included in this study. Timestamps of patient processes in emergency department until patient departure were documented.
The emergency department length-of-stay was longer in respiratory area compared to non-respiratory area; 527 min (381–698) versus 390 min (285–595) in critical zone and 477 min (312–739) versus 393 min (264–595) in semi-critical zone. In critical zone, time intervals of critical flow processes and compliance to hospital benchmarks were similar in both areas. More patients in respiratory area were managed within the arrival-to-contact ≤30 min benchmark and more patients in non-respiratory area had emergency department length-of-stay ≤8 h.
The implementation of spatial separation in infection control should address decision-to-departure delays to minimise emergency department length of stay.
The study evaluated the impact of spatial separation on patient flow in the emergency department. Emergency department length-of-stay was significantly prolonged in the respiratory area. Hospital administrators and policymakers can optimise infection control protocols measures in emergency departments, balancing infection control measures with efficient patient care delivery.
STROBE guidelines.
None.
The study obtained ethics approval from the institution's Medical Ethics Committee (MREC ID NO: 20221113–11727).
The author has checked and make sure our submission has conformed to the Journal's statistical guideline. There is a statistician on the author team (Noor Azhar).
To describe the development of a shared decision making intervention for planning end-of-life care for patients with kidney failure, their relatives and health professionals in kidney services.
End-of-life care conversations within standard disease management consultations are challenging for patients with kidney failure, their relatives and health professionals. End-of-life care planning is about making difficult decisions in advance, which is why health professionals need shared decision making skills to be able to initiate end-of-life conversations. Health professionals report needing more skills to raise the issue of end-of-life care options within consultations and patients want to be able to discuss issues important to them about future care plans.
The development design was guided by the UK Medical Research Council's framework and a user-centred approach was applied. Four workshops were conducted with end users. The Template for Intervention Description and Replication for Population Health and Policy interventions was used to shape which questions needed to be answered through the workshops and to present the intervention. The International Patient Decision Aid Standards (IPDAS) criteria set the standards to be achieved.
Areas considered significant to a shared decision making intervention were training of health professionals, conversations about end-of-life care, planning and evaluation of the decisions, reporting decisions in health records and repetition of consultation. The development process went through 14 iterations.
An intervention named DESIRE was developed that comprises: (1) a training programme for health professionals; (2) shared decision making conversations; and (3) a patient decision aid. The intervention met 30 out of 33 IPDAS criteria.
DESIRE is intended to support shared decision making about planning end-of-life care among patients with kidney failure, their relatives and health professionals. The study provides important tools for the stakeholders engaged that can be used within different models of care.
International guidelines recommend health professionals involve patients with kidney failure in making decisions about end-of-life care, but there is variation in how this is implemented within and across kidney services. Furthermore, patients, relatives and health professionals find it challenging to initiate conversations about end-of-life care.
The study resulted in the development of a complex intervention, called DESIRE, about shared decision making and planning end-of-life care for patients with kidney failure, their relatives and health professionals in kidney services, including a training programme for health professionals, shared decision making conversations and a patient decision aid.
The research contributes a shared decision making intervention to patients in the later stage of kidney failure, their relatives and health professionals. We believe that the DESIRE intervention could be introduced during consultations with health professionals at an earlier stage of the patient's illness trajectory, as well as being applied to other chronic diseases.
This intervention development research is reported according to the GUIDance for the rEporting of intervention Development (GUIDED) checklist and the DEVELOPTOOLS Reporting Checklist.
Patients, relatives and health professionals have been involved throughout the research process as part of the research team and advisory board. For this study, the advisory board has particularly contributed to the development process of the DESIRE intervention by actively participating in the four workshops, in the iterations between the workshops and in the preparation of the manuscript.
To summarise, interpret and synthesize research findings on patients' and nurses' experiences of caring in nursing across clinical practices.
Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients' and nurses' experiences of caring.
This integrative literature review covers papers published between 2000 and 2022. Four databases—PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)—were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA-S checklists were used. An Integrative review methodology guided the process.
In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient–nurse relationship.
The experience of caring in nursing depended on nurses' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing.
By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts.
No patient or public contribution was made due to the study design.
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