Conectar
To examine how household members, community health research workers (CHRWs) and broader social networks influenced pregnant women’s capabilities, opportunities and motivations to consume a daily balanced-energy protein (BEP) supplement or a multiple micronutrient supplement (MMS) in the context of an effectiveness trial in rural Bangladesh.
In-depth interviews, group interviews, focus group discussions, thematic analysis using the Capability, Opportunity, Motivation-Behaviour (COM-B) framework.
Gaibandha, Bangladesh.
Women (n=32) who had completed participation in the TARGET-BEP randomised trial, their husbands (n=13) and mothers-in-law (n=13), who participated in 13 group interviews, and CHRWs (n=39) who participated in six focus group discussions.
Capability to adhere to BEP and MMS was strengthened when family members understood the value of supplements and actively supported supplementation. Children emerged as unexpected facilitators, reminding mothers to consume supplements and tracking intake. Opportunity to use supplements consistently was enhanced by women’s educational attainment and the availability of household resources. Finally, motivation to take the supplements was influenced by many actors including neighbours, who could offer support but also often transmitted rumours and taboos, and CHRWs, who adeptly adapted adherence messages to the local context and to women’s specific concerns.
To improve antenatal supplement adherence and maternal–infant health in Bangladesh and similar contexts, pregnancy nutrition programmes should move beyond the woman-as-sole-agent paradigm by: (1) co-designing messages for husbands, mothers-in-law, children and neighbours in conversation with effective community health workers, such as those working in the TARGET-BEP trial; (2) equipping community health workers with flexible, family-engaging counselling strategies; and (3) complementing women’s education gains with gender-transformative and family-inclusive interventions.
ClinicalTrials.gov NCT05576207
Pressure ulcers (PUs) (also termed pressure injuries [PIs]) remain a major patient safety issue, particularly in critical care and other high-risk healthcare settings. Nurses are central to PUs/PIs prevention; however, deficiencies in knowledge, attitudes, and preventive practices among nursing staff may negatively affect patient outcomes. To systematically synthesise global evidence on nurses' knowledge, attitudes, and practices related to PUs/PIs prevention, and to identify factors influencing preventive performance. A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, CINAHL, EBSCO, MEDLINE, PsycINFO, and Springer were searched for studies published between 2011 and 2025. Eligible studies were primary research articles examining registered nurses' knowledge, attitudes, and/or practices regarding PUs/PIs prevention, using cross-sectional, observational, or non-experimental designs. Data extraction focused on study characteristics, settings, samples, assessment instruments, and key outcomes related to knowledge, attitudes, and preventive practices. Due to methodological heterogeneity, a narrative synthesis was performed. Twenty-nine studies from diverse geographical regions were included, with sample sizes ranging from 28 to 950 nurses. Overall, nurses' knowledge of PUs/PIs prevention was frequently inadequate, particularly in prevention-specific domains. In contrast, attitudes toward prevention were generally positive across studies. Preventive practices, however, were often suboptimal. Commonly reported barriers included staff shortages, high workload, limited resources, and insufficient institutional support. Higher educational attainment, specialised clinical experience, recent training, and professional seniority were consistently associated with better knowledge, more positive attitudes, and improved preventive practices. Although nurses generally demonstrate positive attitudes toward PUs/PIs prevention, persistent gaps in knowledge and practice remain. These findings underscore the need for structured education programmes, simulation-based training, and strengthened organisational support to enhance adherence to evidence-based prevention strategies. Future research should employ experimental and longitudinal designs, standardised measurement tools, and broader international representation to support sustainable improvements in PUs/PIs prevention and patient safety.
Older adults face growing risks of depression and anxiety, yet stigma, comorbidities, cost, and limited access impede receipt of conventional care. Digital mental health interventions (DMHIs), including immersive virtual reality (VR), exergaming, and mobile apps, may reduce these barriers.
To evaluate the efficacy of DMHIs in reducing depressive and anxiety symptoms among adults aged ≥ 50 years.
We conducted a PRISMA adherent systematic review and meta-analysis of randomized controlled trials. Interventions included immersive VR, exergaming/physical digital platforms, mobile applications, and digital cognitive training. Standardized mean differences (SMDs) were pooled with random effects models; heterogeneity was assessed with I 2.
Nineteen RCTs (n = 718; mean ages 50.9–84.7 years) met inclusion criteria. Across studies, DMHIs significantly reduced depressive symptoms (SMD = −0.656, 95% CI = −0.932 to −0.380; p < 0.001) and anxiety symptoms (SMD = −0.559, 95% CI = −0.740 to −0.380; p < 0.0001). Immersive and physically engaging modalities (e.g., VR, exergaming) outperformed app-based approaches. Heterogeneity ranged from moderate to high (I 2 ≈ 69.6%–97%).
Offer DMHIs: especially VR or exergaming when access to in-person therapy is limited or as an adjunct to usual care. Provide brief onboarding and, when feasible, caregiver support to boost adherence and confidence with technology. Select or configure age-friendly interfaces (e.g., large fonts, simple navigation) to address common usability barriers. Integrate DMHIs into stepped-care or rehabilitation pathways and monitor outcomes with validated tools (e.g., GDS, STAI). Address equity by supplying devices/connectivity solutions and consider cost-effectiveness and long-term engagement in implementation plans.
Trial Registration: PROSPERO ID: CRD420250655153
by Qian Yue Tan, Kinda Ibrahim, Helen C. Roberts, Khaled Amar, Simon D.S. Fraser
BackgroundPeople with Parkinson’s (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes.
ObjectiveTo assess the extent of treatment burden in Parkinson’s disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden.
MethodsA mixed-methods study was conducted consisting of: 1) a UK-wide cross-sectional survey for PwP and caregivers using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden levels and associated factors and 2) focus groups with key stakeholders to discuss survey findings and develop recommendations.
Results160 PwP (mean age = 68 years) and 30 caregivers (mean age = 69 years) completed the surveys. High treatment burden was reported by 21% (N = 34) of PwP and 50% (N = 15) of caregivers using the MTBQ. Amongst PwP, higher treatment burden was significantly associated with advancing PD severity, frailty, a higher number of non-motor symptoms, and more frequent medication timings (>3 times/day). Caregivers reporting higher treatment burden were more likely to care for someone with memory issues, had lower mental well-being scores and higher caregiver burden. Three online focus groups involved 11 participants (3 PwP, 1 caregiver and 7 healthcare professionals) recruited from the South of England. Recommendations to reduce treatment burden that were discussed in the focus groups include improving communication. clear expectation setting, and better signposting from healthcare professionals, increasing education and awareness of PD complexity, flexibility of appointment structures, increasing access to healthcare professionals, and embracing the supportive role of technology.
ConclusionsTreatment burden is common amongst PwP and caregivers and could be identified in clinical practice using the MTBQ. There is a need for change at individual provider and system levels to recognise and minimise treatment burden to improve health outcomes in PD.
FreshRSS 