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Polyp prophylactic properties of polyacetylenes from carrots in patients with previous polypectomy--Px7 The study protocol of a multicentre binational randomised controlled trial

Por: Agache · A. · Deding · U. · Kaalby · L. · Kobaek-Larsen · M. · Al-Najami · I. · Ostergaard Hansen · L. · Stryhn · C. · Wilde · D. · Forsberg · A. · Backman · A.-S. · Bates · T. · de Lange · T. · Martling · A. · Baatrup · G.
Introduction

A large bowel cancer chemoprevention potential has been demonstrated by the consumption of carrots, which represent the major dietary source of polyacetylenes. Their interaction with cancer cells and enzyme systems of animals and humans has been systematically investigated over the last 15 years and has now been characterised as anti-inflammatory compounds with antineoplastic effect. Our objective is to investigate whether selected carrot species with a high content of the polyacetylenes falcarinol (FaOH) and falcarindiol (FaDOH) prevent neoplastic transformation and growth in humans, without side effects.

Methods and analysis

We will conduct a multicentre prospective binational (Denmark and Sweden) randomised controlled trial, with the aim to test the clinical effects of adjuvant treatment with carrot juice in patients who had an excision of high-risk colon adenomas. Patients from six centres will be randomised to receive either anti-inflammatory juice made of carrots high in FaOH and FaDOH or placebo. We will compare the proportion of participants with recurrent adenoma and mean size of them, found in the 1-year follow-up colonoscopy between the two randomised groups.

Ethics and dissemination

Informed written consent will be obtained from all participants before randomisation. The study was approved by the regional ethics committee in Denmark (ref. S-20230072) and Sweden (ref. 2024-04732-01). After completion of the trial, we plan to publish two articles in high-impact journals: one article on primary and secondary outcomes, respectively.

Trial registration number

NCT06335420.

Perceived Capability, Opportunity and Motivation to Deliver Fundamental Nursing Care: A Cross‐Sectional Survey in Neurological Settings

ABSTRACT

Background

Delivering nursing care to patients' fundamental needs in neurological settings is challenging due to complex needs such as long-term care, physical disability and cognitive or communicative impairment.

Aim

To examine how registered nurses and nurse assistants perceive their capability, opportunity and motivation to deliver fundamental nursing care and use this insight to inform implementation strategies based on the Fundamentals of Care framework.

Design

Cross-sectional survey.

Methods

The questionnaire, grounded in the Capability–Opportunity–Motivation (COM-B) model and the Fundamentals of Care framework, was distributed to all nursing staff (n = 404) in four neurological departments at a university hospital in Denmark. Level of agreement was calculated as the proportion of responses in the top two Likert categories (‘to some extent agree’ and ‘completely agree’) and categorised as low (< 60%), medium (60%–85%) or high (> 85%). Quantitative results were analysed descriptively and inferentially; open-text answers were examined using deductive content analysis.

Results

The response rate was 63%. Agreement was high for capability (90.6%), motivation (89.2%) and addressing physical needs (85.2%), while opportunity (75.3%) and relational care (69.1%) were lower. The relational domain scored notably high for taking time to listen (95.8%) and low for evaluating the nurse–patient relationship (43.5%). Nurse assistants showed significantly higher agreement in the physical care domain than registered nurses. Variation across departments highlighted higher agreement in spinal cord injury and neurology compared to anaesthesia, pain, respiratory and traumatic brain injury units.

Conclusion

Nursing staff show strong internal drive and perceived competence—particularly in physical care—but face structural barriers in relational nursing and continuity. Implementation strategies should leverage high motivation, strengthen leadership engagement, ensure resource allocation and systematically integrate relational care into practice.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

Danish Data Protection Agency (P20231246)

Beyond Survival: Unveiling Psychological and Social Adaptation After Visceral Transplantation

ABSTRACT

Aim

To explore the meaning of adaptation after visceral transplantation in terms of patient experiences, symptoms, self-efficacy, transplant-specific and mental well-being.

Design

A convergent parallel mixed-methods study, consisting of interviews and generic as well as transplant-specific questionnaires. Results were integrated using meta-inference.

Methods

The study comprises a population of 17 visceral transplant recipients in Scandinavia, 12 women and 5 men with a mean age of 40.6 years (range 19–63 years) and an average follow-up of 9.4 years (range 0–25 years). Data were collected between May 2023 and January 2024 through open-ended in-depth interviews with 12 participants and analysed in accordance with phenomenological hermeneutics. Questionnaires from all 17 participants were analysed to measure transplant-specific well-being, symptoms, self-efficacy as well as anxiety and depressive symptoms.

Results

Being a visceral transplant recipient is a dynamic and life-long adaptation process that comprises two distinct yet interconnected trajectories: coherence and endurance. Coherence involves the person's ability to make sense of their situation and find meaning despite the challenges and adversity of the chronic condition. In contrast, endurance involves a person's capacity to withstand hardship and endure unpleasant or difficult experiences. Both trajectories interact dynamically, influencing and reinforcing each other. Resilience based on coherence enabled acceptance and adjustment. Conversely, uncertainty, resignation and feeling unsupported resulted in a lack of acceptance, manifested as resistance. The challenge involved in adaptation was demonstrated by 47% showing borderline elevated or elevated levels of anxiety and 18% reporting symptoms of depression. Self-efficacy varied considerably.

Conclusion

The meaning of adaptation after visceral transplantation in terms of experiences, symptoms, transplant-specific and mental well-being is balancing between coherence and endurance facilitated by acceptance and hampered by resistance. The uncertainty inherent in being a visceral transplant recipient may lead to heightened self-rated anxiety symptoms and diminished self-efficacy.

Implications for the Profession and/or Patient Care

What problem did the study adress?

This study adresses the challenges involved in being a visceral transplant recipient and adapting to life after a visceral transplantation.

What were the main findings?

Reporting Method

COREQ checklist (consolidated criteria for reporting qualitative research).

Patient or Public Contribution

No Patient or Public Contribution was organised.

Family members' experiences of COVID‐19 visiting restrictions in the intensive care unit—A qualitative study

Abstract

Objective

To describe how family members of critically ill patients experienced the COVID-19 visiting restrictions in Sweden.

Background

In Sweden, the response to COVID-19 was less invasive than in many other countries. However, some visiting restrictions were introduced for intensive care units, with local variations. Although there is a growing body of literature regarding healthcare professionals' and family caregivers' perspectives on visiting restriction policies, there may be inter-country differences, which remain to be elucidated.

Design

This study has a qualitative descriptive design. Focus group interviews with 14 family members of patients treated for severe COVID-19 infection were conducted. The interviews took place via digital meetings during the months after the patients' hospital discharge. Qualitative content analysis was used to interpret the interview transcripts. Reporting of the study followed the COREQ checklist.

Results

Two categories—dealing with uncertainty and being involved at a distance—described family members' experiences of coping with visiting restrictions during the COVID-19 pandemic. These restrictions were found to reduce family members' ability to cope with the situation. Communication via telephone or video calls to maintain contact was appreciated but could not replace the importance of personal contact.

Conclusions

Family members perceived that the visiting restriction routines in place during the COVID-19 pandemic negatively influenced their ability to cope with the situation and to achieve realistic expectations of the patients' needs when they returned home.

Relevance to Clinical Practice

This study suggests that, during the COVID-19 pandemic, the visiting restrictions were experienced negatively by family members and specific family-centred care guidelines need to be developed for use during crises, including the possibility of regular family visits to the ICU.

Patient and Public Contribution

None in the conceptualisation or design of the study.

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