Conectar
In 2024, 30.4% of the German population had a migration background. People with migration-related language barriers face numerous challenges within the healthcare system, which can negatively impact their health outcomes. While language barriers affect healthcare in general, oncology represents a complex field in which effective communication is crucial. For people with cancer in particular, difficulties in understanding information, treatment options, and the healthcare system itself may hinder access to services. This increases the risk of complications, prolonged hospitalisations and readmissions. At the same time, there is little information about this group, and evaluations of structured services are lacking. This study assesses a nurse-led complex intervention focusing on structured information and ongoing support for people with cancer and migration-related language barriers.
The intervention is designed for people with cancer and migration-related language barriers and comprises three key elements: (a) continuous guidance provided by already existing roles of oncology nurse specialists, (b) a telephone interpreting service and (c) multilingual informational materials. We will assess the intervention’s effectiveness with a controlled before-and-after study. Assuming an effect size of d=0.5 and using a 2:1 allocation ratio with 80% power, we aim to recruit 126 people with cancer and migration-related language barriers (84 intervention; 42 control) for participation. We will assess the primary outcome psychosocial support needs assessed with the Psychosocial Risk Questionnaire (PSR) at admission, discharge, and 3-month post-discharge using paper-based or digital questionnaires. The secondary outcomes, such as knowledge, quality of life, anxiety and satisfaction, are measured alongside the primary outcomes and compare the distribution of items and scores using Student’s t-test (total scores) or the Wilcoxon rank sum test (individual items) at a one-sided significance level of 5%. We will use an embedded process and economic evaluation to examine the feasibility, acceptability and implementation of the intervention in line with the Medical Research Council guidance for process evaluations of complex interventions.
The Ethics Committee of the Faculty of Medicine, University of Cologne (No. 23–1303 and 24–1266), approved the protocol, and the study was registered in the German Clinical Trials Register. We will disseminate the results of the study through peer-reviewed publications and at academic conferences.
German Clinical Trials Register (DRKS00034749).
To evaluate resilience, burnout, intent to leave and use of resiliency skills among new graduate nurses following the introduction of resiliency skills during a nurse residency programme.
This programme evaluation used a quasi-experimental, repeated-measures design, with assessments conducted at baseline, 2 weeks and 3 months following the intervention.
Nurse residents participated in a 1-h, in-person introduction to the evidence-based Community Resiliency Model (CRM) as part of a didactic day away from bedside care. The CRM is a sensory-focused self-care approach to regulating the nervous system and is associated with improved healthcare worker well-being and work team engagement. Changes in resilience and burnout were evaluated over time, and relationships among resiliency skill use, resilience, burnout and intent to leave were examined.
The training was well received based on post-intervention surveys. A total of 135 nurse residents were trained, and 68 provided evaluation data at baseline and 3 months. No significant changes in resilience, burnout or intent to leave scores were observed. However, 73% of new graduate nurse participants reported using the resiliency skills at least once during the 3 months following training.
This evaluation suggests that the CRM training is feasible and acceptable as an addition to new graduate nurse professional development strategies. Although no significant changes in resilience, burnout or intent to leave were observed, the majority of participants reported using resiliency skills following training. Introducing sensory-based resiliency skills during the residency period may provide nurses with practical strategies for managing role transition and work-related stress that can be reinforced and further developed throughout their careers.
Retention in HIV care is associated with higher rates of antiretroviral treatment adherence and viral suppression, as well as lower risk of AIDS-related morbidity and mortality. However, the multidimensional nature of retention complicates measurement standardisation, limiting comparability and global evaluation.
This study explored how HIV stakeholders define and assess retention, aiming to develop a patient-centred and conceptually robust understanding to inform research and practice.
We conducted a qualitative study using interpretive description methodology, an applied qualitative approach designed to generate practice-relevant knowledge in health research. We purposively sampled 20 stakeholders representing diverse areas of expertise and geographic regions across World Bank country income classifications. We conducted and video-recorded in-depth semistructured interviews and subsequently transcribed them. Using constant comparative analysis, we identified recurring, convergent and contradictory patterns.
The analysis identified five overarching themes. The first two, exploratory themes, included Patient-Centred Understanding of Retention in HIV Care, which captured how stakeholders conceptualised retention in their respective contexts and Operationalisation of Retention Measures, which explored the key components used to measure retention. The next two explanatory themes, included Purpose-Driven Definitions of Retention, which described how retention measures were selected based on their intended use, and Building Capacity through Shared Understanding and Integrated Action, which emphasised retention as a cyclical, interconnected process dependent on collaboration between patients and health systems. The final, prescriptive theme, Advancements Shaping Retention, reflected stakeholders’ shared vision of improving retention through innovations in HIV treatment and technology.
The findings suggest that stakeholders operationalise retention measures in line with specific objectives and individual health goals, while remaining attentive to contextual realities. Retention measures should remain flexible and patient-centred, rather than relying on a single rigid standard.
Lesbian, gay, bisexual, transgender or non-binary and intersex (LGBTI) populations experience persistent health inequities, including poorer mental and physical health outcomes and higher unmet healthcare needs compared with non-LGBTI populations. These inequities are partly attributable to insufficient training of primary care physicians (PCPs) in LGBTI health. However, evidence on effective and scalable training interventions for PCPs remains limited, particularly outside North America. This study evaluates the effectiveness of a self-directed e-learning programme—Improving Care and Access for Rainbow Equity (I-CARE)—designed to improve PCPs’ knowledge, attitudes, skills and behaviours related to LGBTI health.
We will conduct a type I effectiveness-implementation hybrid, two-arm, parallel-group, superiority randomised controlled trial among PCPs practising in French-speaking Switzerland. Eligible physicians will be randomly assigned (1:1) to either the I-CARE programme (intervention) or an e-learning programme on motivational interviewing (control) matched for format and duration. Outcomes will be measured at baseline, immediately postintervention and at the 3-month follow-up. The primary outcomes are knowledge and attitudes towards LGBTI patients assessed at the postintervention time point using validated scales. Superiority will be declared if the intervention group is statistically significantly superior to the control group on at least one primary outcome and statistically significantly inferior on neither primary outcome. Secondary outcomes include skills, self-reported behaviours and the presence of LGBTI-inclusive environmental cues. Effectiveness will be analysed using generalised estimating equations. Implementation outcomes will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.
Participants will provide electronic informed consent. All study data will be managed and stored on secure servers hosted by the Lausanne University Hospital (CHUV). All information will be handled in strict accordance with the Swiss Federal Act on Data Protection. The project was approved by the Central Ethics Commission of the University of Lausanne on 7 July 2025 (C_Services centraux_052025_00018). Study findings will be disseminated through peer-reviewed scientific publications and lay summaries intended for the public, Swiss PCPs and LGBTI communities.
ISRCTN93781961 (11 March 2026, updated 14 July 2026)
by Yordanos Getachew, Tamirat Tamiru, Mekdelawit Fisseha, Sami Sebri, Tadesse Shume, Regasa Diriba, Kassu Desta
BackgroundMultidrug-resistant Enterobacteriaceae (MDRE) is among the leading causes of hospital-acquired infections, resulting in prolonged hospitalization, increased healthcare costs, and mortality. Carbapenem are often used as last-resort antibiotics; however, the emergence of carbapenemase-producing Enterobacteriaceae (CPE) has severely limited treatment options. In Ethiopia, data on their burden from routine diagnostic laboratory settings remain limited. This study assessed the prevalence of multidrug-resistant and carbapenemase-producing Enterobacteriaceae among clinical isolates in Addis Ababa.
MethodsA laboratory-based cross-sectional study was conducted from January 2, 2025, to April 2, 2025 on clinical specimens referred to Wudassie Advanced Medical Laboratory in Addis Ababa, Ethiopia. A total of 1105 clinical specimens collected through convenience sampling method were processed. Bacterial identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (EXS 3000, Zybio Inc., China). Antimicrobial susceptibility testing was conducted using the Kirby–Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI 2024) guidelines. Carbapenemase production was confirmed using the modified Carbapenem Inactivation Method (mCIM). Data were analyzed using SPSS version 26.
ResultsOf the 1105 clinical specimens, 288/1105 (26.1%) showed bacterial growth. Enterobacteriaceae accounted for 156/288 (54.2%) of the isolates. The most common isolates were Escherichia coli 89/156 (57.1%) and Klebsiella pneumoniae 47/156 (30.1%). Overall, 123/156 (78.8%) of Enterobacteriaceae were multidrug resistant. Carbapenem resistance was detected in 35/154 (22.7%) of isolates, and 30/154 (19.5%) were confirmed as carbapenemase producers. Klebsiella pneumoniae 24/30 (80%) was the predominant carbapenemase-producing organism. Most CPE isolates were recovered from urine specimens, followed by wound and sputum samples.
ConclusionThis study demonstrates a high prevalence of multidrug-resistant and carbapenemase-producing Enterobacteriaceae in Addis Ababa. The findings highlight the urgent need for strengthened antimicrobial stewardship programs, early detection strategies, and enhanced infection prevention and control measures in the private health facilities.
To identify a correlation between unmet needs and HL levels in people with Multiple Sclerosis (pwMS) and to evaluate how sociodemographic characteristics influence HL levels and unmet needs.
A cross-sectional study.
The study was conducted using a questionnaire including the HLS19-Q12 to assess HL and the Long-term Unmet Needs in Multiple Sclerosis tool, which evaluates five domains (neuropsychological, ambulation, physical, interpersonal relationship, and informational) and identifies whether needs are met or unmet and the desire for support.
Among the 116 participants included in the study, the overall HL level was sufficient. Mean scores across unmet needs domains were comparable. A significant difference in HL emerged in the informational domain, where participants reporting informational needs and a desire for support showed higher mean ranks. Although not significant, participants who acknowledged a need and expressed a desire for help showed higher mean ranks in HLS19-Q12 scores across several domains. No significant correlations were found between HL and unmet needs domains.
HL levels may enhance patients' ability to recognize and express needs without necessarily ensuring that these needs are met.
Routine assessment of both HL and unmet needs may help healthcare professionals identify patients who recognize problems but lack the structural support to address them.
The impact of HL on need recognition and communication, together with the complexity and interconnectedness of unmet needs, highlights the need for healthcare systems to implement organizational, systemic, and multidimensional interventions aimed at promoting HL and effectively addressing patients' needs. Such strategies may support better disease management and improve quality of life in pwMS.
This study was reported according to STROBE checklist.
None.
This review analyses and synthesises the available evidence on the barriers limiting women's career advancement in nursing. It aims to identify effective interventions to promote gender equity in healthcare leadership through an integrated framework informed by Social Role Theory, Ambivalent Sexism Theory and Theory of Planned Behaviour.
Rapid Evidence Assessment.
The search was conducted on the databases: PubMed, CINAHL Complete, MEDLINE, ApaPsycArticles, ApaPsycInfo between March and May 2025.
The Population–Exposure–Outcome framework guided the formulation of the research question. Two reviewers independently conducted screening, quality appraisal and data extraction.
Eight studies with heterogeneous research designs were included: four literature reviews, three quantitative studies and one qualitative study. The analysis identified four themes: (1) gender pay gap; (2) gender stereotypes and cultural expectations; (3) systemic barriers: organisational structures and institutional culture; (4) organisational strategies for gender equity and female leadership.
Career advancement for female nurses is limited by systemic and internalised constraints that reinforce vertical segregation. Multilevel interventions are needed to dismantle structural inequalities and reshape gender norms within nursing leadership.
Targeted reforms, including transparent promotion criteria, structured mentoring, bias awareness training and inclusive organisational policies, are essential to promote leadership equity, improve workplace justice and foster a sustainable health system.
This study addresses the persistent gender gap in nursing leadership, identifying systemic, cultural and individual barriers to women's career progression. Through a Rapid Evidence Assessment, it proposes a new multilevel theoretical framework. The results support policies and interventions to promote gender equity in nursing leadership.
This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting.
None.
Burnout, a form of moral suffering, has become more commonplace among health care workers in recent years. Measures of general resilience have been widely used to capture improvement in burnout but lack the ability to capture the anguish that comes with burnout from a moral standpoint. The purpose of this analysis was to understand whether moral resilience is uniquely related to burnout beyond a measure of general resilience in a sample of interprofessional health care workers.
Secondary analysis of cross-sectional survey data.
In total, 702 interprofessional health care workers participated in a cross-sectional survey. Key measures included the Rushton Moral Resilience Scale (RMRS), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Hierarchical multiple regression modeling was used to examine the effect of moral resilience (RMRS) in predicting the three dimensions of burnout (MBI-HSS) over and above general resilience (CD-RISC-10).
Moral resilience explained five, six, and 4% of variance for personal accomplishment, depersonalization, and emotional exhaustion, respectively, after accounting for general resilience (CD-RISC-10) and all covariates.
Findings highlight the clear conceptual differences between general and moral resilience and their unique relationship to burnout. Accounting for moral resilience will facilitate an improved multi-level response to moral suffering among health care workers.
Measuring and understanding the differences between general resilience and moral resilience is vital for us to better facilitate the necessary support(s) for health care workers experiencing moral suffering. This will contribute to more sustainable clinical environments, reduced burnout and suffering, and improved patient outcomes.
by Mesfin Abebe, Yordanos Sisay Asgedom, Amanuel Yosef Gebrekidan, Tsion Mulat Tebeje
BackgroundBreast cancer is the leading cause of cancer-related deaths in women globally and a significant public health burden in sub-Saharan Africa, which accounts for approximately 15% of all cancer-related mortality. In sub-Saharan Africa, breast cancer incidences increased by 247% from 1990 to 2019. In Lesotho, breast cancer is the second most common cancer affecting women, a situation worsened by a fragile healthcare system and low screening rates. Despite its high morbidity and mortality, there is limited understanding of the factors influencing breast cancer screening among women of reproductive age. This study aims to identify these factors by utilizing the newly released Lesotho DHS dataset and the Anderson Behavioral Model.
MethodsThis study utilized a cross-sectional design with data from the recent Lesotho Demographic and Health Survey (LDHS), which employed a stratified two-stage sampling method across 400 Enumeration Areas and 9,976 households. This analysis included a weighted sample of 6,413 reproductive-age women (15–49 years) to determine factors of breast cancer screening. The predisposing, enabling, and need factors were examined using the Andersen Behavioral Model. Stata version 16 was used for a multilevel mixed-effects logistic regression model. Results were presented as adjusted odds ratios (AOR) with 95% confidence intervals, and a P-value less than 0.05 was considered statistically significant.
ResultsThe prevalence of breast cancer screening among women of reproductive age in Lesotho was 22.20% (95% CI 21.19–23.23). Significant factors included age 25–34 (AOR = 1.54; 95% CI 1.26–1.88), age 35–49 (AOR = 2.10; 95% CI 1.71–2.58), healthcare facility visits in the past 12 months (AOR = 1.47; 95% CI 1.26–1.71), health insurance coverage (AOR = 1.86; 95% CI 1.36–2.53), high media exposure (AOR = 1.23; 95% CI 1.01–2.52), contraceptive use (AOR = 1.18; 95% CI 1.03–1.37), and parity: multiparous (AOR = 2.29; 95% CI 1.84–2.85) and grand multiparous (AOR = 1.67; 95% CI 1.16–2.40).
ConclusionThis finding that 22.2% of reproductive age women in Lesotho underwent breast cancer screening highlights a pressing gap in preventive health efforts. The Andersen Behavioral Model underscores key determinants that significantly influence breast cancer screening uptake in our study. Significant factors included age, healthcare facility visits, health insurance coverage, media exposure, contraceptive usage, and parity. These findings underscore the need for targeted interventions that address model-based determinants to improve breast cancer screening uptake.
Background
There is a dearth of research inclusive of African American adults living with obstructive sleep apnea (OSA) despite differences in symptom presentations compared to non-Hispanic White patient populations. Less is known regarding the potential effect of comorbidities, including hypertension, on commonly reported symptoms, such as fatigue, and their association with inflammatory biomarkers.
Objective
This longitudinal pilot study aimed to characterize fatigue symptom presentations among African American adults newly diagnosed with OSA and discern peripheral blood analytes linked to symptoms while accounting for co-occurring hypertension.
Methods
African American adults newly diagnosed with OSA with and without co-occurring hypertension were approached by study staff and recruited following their diagnostic visit with sleep medicine clinicians at two health systems and followed over 6 months after commencing continuous positive airway pressure treatment. Patient-Reported Outcomes Measurement Information System Fatigue surveys and plasma were collected every 3 months from 29 participants. Mixed-effects models examined changes in fatigue symptom presentations over time while accounting for plasma-based analytes and hypertension status.
Results
Despite higher fatigue symptom severity upon diagnosis, participants with co-occurring hypertension reported greater improvements in fatigue scores after commencing continuous positive airway pressure treatment for up to 6 months than those without hypertension. Inverse correlations were observed between fatigue scores, C-reactive protein, matrix metalloproteinase-8, and osteoprotegerin analyte levels among participants with/without hypertension. Across all participants, changes in interleukin-6 were associated with changes in fatigue scores in the first 3 months after diagnosis.
Discussion
Findings indicate that hypertension is linked to increased fatigue upon diagnosis of OSA in this sample of African American adults. Fatigue in persons with hypertension improved after treatment in this sample. These hypothesis-generating findings can inform future interventional studies aimed at improving fatigue among persons with OSA while leveraging markers linked to fatigue symptom severity as potential objective markers of improvements. Further research on the role of inflammatory markers, such as IL-6, on fatigue symptom presentations is warranted in persons with OSA. Background
A healthy nursing workforce is vital to ensuring that patients are provided quality care. Assessing nurses' well-being and related factors requires routine evaluations from health system leaders that leverage brief psychometrically sound measures. To date, measures used to assess nurses' well-being have primarily been psychometrically tested among other clinicians or nurses working in specific clinical practice settings rather than in large, representative, heterogeneous samples of nurses.
Objectives
This study aimed to psychometrically test measures frequently used to evaluate factors linked to nurse well-being in a heterogeneous sample of nurses within a large academic health system.
Methods
This cross-sectional, survey-based study used a convenience sample of nurses working across acute care practice settings. A total of 177 nurses completed measures, which included the Professional Quality of Life, the short form of the Professional Quality of Life measure, the two-item Connor–Davidson Resilience Scale, the five-item World Health Organization Well-Being Index, the Secondary Traumatic Stress Scale, and the single-item Mini-Z. Internal reliability and convergent validity were assessed for each measure.
Results
All the measures were found to be reliable. Brief measures used to assess domains of well-being demonstrated validity with longer measures, as evident by significant correlation coefficients.
Discussion
This study provides support for the reliability and validity of measures commonly used to assess well-being in a diverse sample of nurses working across acute care settings. Data from routine assessments of the nursing workforce hold the potential to guide the implementation and evaluation of interventions capable of promoting workplace well-being. Assessments should include psychometrically sound, low-burden measures, such as those evaluated in this study. La vivencia de un proceso quirúrgico supone un alto grado de ansiedad para la persona que lo padece y para su entorno familiar. Duran-te el tiempo de estancia del paciente en quirófano, los familiares se encuentran angustiados, hasta que éste sale por la puerta de quiró-fano, debido en parte por la escasez de información y su desconocimiento del ámbito sanitario. Fruto de esas reflexiones surge la idea de realizar este trabajo, un relato bibliográfico a través de una entrevista en profundidad, cuyo objetivo es dar a conocer las v vivencias y los sentimientos de las personas que se operan con nosotros. El relato que a continuación se expone me lo facilitó una paciente que fue intervenido de un cáncer de colon en el quirófano de cirugía. Se describen las categorías extraídas del relato observando como una vida de una persona normal sufre un cambio tras la enfermedad que la lleva a un primer periodo de sufrimiento y temor, un segundo periodo en el que hay una búsqueda de solución no dando por perdidas las esperanzas y cargadas de un gran optimismo. Como enfermera de quirófano me planteé la realización de este trabajo, para tratar el tema de la espera de los familiares mientras los pacientes se están operando, dentro del esfuerzo constante por humanizar la asistencia en los hospitales y por mejorar la calidad de los cuidados que reci-ben nuestros pacientes.
FreshRSS 