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Ayer — Marzo 4th 2026Tus fuentes RSS

Home Care Organisational Models in Italy: A Cross‐Sectional Study of Cluster Analysis and Stakeholder Perceptions

ABSTRACT

Aim

To classify Italian home care models based on structural characteristics, process factors and stakeholder perceptions.

Design

This is a secondary analysis of the AIDOMUS-IT multicentre cross-sectional study, conducted in Italy between July 2022 and December 2023.

Methods

Data were collected via online surveys completed by 33 Local Health Authority Nursing Directors, home care nurses and patients. Hierarchical cluster analysis was used to classify different organisational models based on structural and process-related factors. Nurses' and patients' perceptions of care were described for each identified cluster.

Results

The analysis identified three distinct organisational home care models: The ‘multidisciplinary model’, in which nurses reported high dissatisfaction due to organisational complexity and excessive workloads. In the ‘nurse-centred model’, characterised by publicly employed nurses, strong leadership, and a supportive work environment, patients reported high levels of satisfaction. The ‘performance-based model’, which operated with a lower nurse-to-patient ratio, reduced service hours, and greater reliance on external professionals. Nurses in this model reported high job satisfaction but also a greater intention to leave, while patient satisfaction was lower.

Conclusions

This study underscores the importance of leadership, resource management, and a supportive work environment in influencing both job satisfaction and patient outcomes in home care settings.

Implications for the Profession and/or Patients Care

Policymakers could use these findings to refine care models and improve service delivery.

Impact

Limited research has examined the organisational structures of home care services, which are important for professionals' organisational well-being, patient safety, and quality of care. This study identified three distinct organisational home care models that could be used to refine care approaches and improve service delivery.

Reporting Method

This study respects the EQUATOR guideline for observational studies (STROBE).

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

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Evaluation of usability and acceptability of a Peruvian telemental health service for early assessment among vulnerable occupational workers: Mixed-method study with a user-centered design approach

by Jimmy Andreyvan Cainamarks-Alejandro, Liliana Cruz-Ausejo, Miguel Angel Burgos-Flores, Jaime Rosales-Rimache, Jonh Astete-Cornejo, David Villarreal-Zegarra

Background

The COVID-19 pandemic marked an increase in depressive, anxiety, and post-traumatic stress disorder symptoms, more specifically among healthcare workers, teachers, and police officers. These workers face external and occupational factors which had a significant impact on mental health, significant increase in workload and direct exposure to the virus, shortage of personnel protective equipment, and instances of abuse, including discrimination. Mental health care in primary care requires a process of early identification and timely referral of complex cases. Telehealth emerges as an effective alternative for addressing challenges in mental health care, although its implementation encounters obstacles.

Objective

To design a telehealth service that facilitates screening, initial management, and timely referral for mental health diagnoses in workers with prior SARS-CoV-2 infection, and to evaluate usability, acceptability, and user satisfaction.

Methods

Mixed-method study with a user-centered design approach involving key external and internal service users in three sequential stages (pre-design, co-design, and post-design). The study phases lasted 6 months, involving a total of 23 participants in the pre-design phase (contextual inquiry and preparation and training), 12 participants in the co-design phase (framing the issue, generative design, and sharing design), and in the post-design phase, 4 participants were involved in service implementation, and 81 participants—drawn from the subgroup of 134 users who received psychoeducation—were included in the efficacy assessment.

Results

The proposal included the development and evaluation of a service model guide and a telehealth software platform. First, the participants took part in a series of workshops (Pre-design, Co-design) where they provided ideas for meeting the product requirements, based on the Design Thinking methodology framework. The telehealth service model was named TelePsico CENSOPAS. It comprised four processes: a) Service promotion; b) User pre-identification; c) Appointment management; d) Psychoeducation counseling and referral. The Telehealth platform was designed through three cycles of an iterative process and integrated a proprietary development platform with third-party service technologies for communication support and information exchange. During post-design, the pilot test involved 698 screened patients; 193 were identified with mental health risks, and 134 of them received psychoeducation sessions. In addition to user acceptance, the usability score of the platform was 86.1 ± 16.9 SD, satisfaction dimensions of the service was 45.1 ± 7.2 SD for satisfaction with care processes, and 36.7 ± 5.2 SD satisfaction with psychological care.

Conclusion

The proposal for mental health telehealth services and its supporting platform was successfully developed and accepted by both internal and external users, particularly within well-structured occupational health services in workplaces serving vulnerable occupational groups. In addition, it achieved higher satisfaction and usability scores than Peru’s outpatient care services. These findings support the replicability of user-centered design frameworks—such as design thinking—within the occupational health sphere.

Protocol for the development and testing of a web-based patient decision aid for early-stage breast cancer patients within a cancer centre care: a mixed-method approach

Por: Sdinami · S. · Sebri · V. · Monzani · D. · Zagami · P. · Criscitiello · C. · Grasso · R. · Bagnardi · V. · Curigliano · G. · Pravettoni · G.
Introduction

Early breast cancer (BC) detection enhances survival, with treatment options influenced by cancer stage, pathological characteristics and patient preferences. Patient decision aids (PDAs) promote shared decision-making (SDM), enhancing patients’ engagement, adherence to treatment and satisfaction. However, few PDAs for early-stage BC patients exist in the Italian context.

Methods and analysis

A first developmental phase will include a systematic review on current PDAs and semistructured interviews with patients and healthcare professionals. Outcomes will be used to develop a first draft of PDA. Following international guidelines, the PDA will be sent to patients to gather first qualitative feedback and subsequently quantitative feedback regarding the attractiveness, usability and comprehensibility of the tool and patients’ health literacy. Once having reached a final version of PDA, a pilot randomised controlled trial study will be implemented: a control group will receive standard care (n=75) and an experimental group (n=75) will receive standard care and the PDA. Depression, anxiety, SDM, quality of life (QoL) and distress levels will be assessed through validated questionnaires in both groups at three different time points. Measures will include attractiveness, usability and comprehensibility of the PDA as well as efficacy measures assessed through evaluation of patients’ levels of anxiety, depression, distress and QoL.

Ethics and dissemination

This protocol was approved by the ethical committee Comitato Etico Territoriale Lombardia 2 of the Istituto di Ricovero e Cura a Carattere Scientifico European Institute of Oncology (L2-253; approved in November 2024). All participants will be given written and verbal information, and informed consent will be obtained from all participants across all phases of our project. Participation in the study will be fully voluntary. All the methodologies mentioned in this protocol will be carried out according to both national and international declarations, guidelines and regulations compliant with proper ethical research involving human subjects. Results will be published in peer-reviewed journals, through traditional academic pathways. This protocol study has been registered on clinicaltrials.gov in January 2025 (Identifier: NCT06762496).

Trial registration number

NCT06762496.

Cohort profile: Sub-cohort study on the second phase of the Chiba Study of Mother and Child Health (C-MACH), Japan

Purpose

The second phase of the Chiba Study of Mother and Child Health (C-MACH) was initiated to investigate how environmental exposures from the fetal period to early childhood influence maternal and child health outcomes. The sub-cohort focuses specifically on detailed assessments of indoor environmental factors and neighbourhood-built and social environments. By integrating environmental metrics with biological, behavioural and sociodemographic data, the study aims to elucidate their role in the development of allergies, neurodevelopmental disorders and other non-communicable diseases in early life.

Participants

Between June 2021 and April 2023, 505 pregnant women were enrolled in the second phase of the C-MACH main study. Of these, 298 participants consented to join the sub-cohort study, including 258 in the sleep and physical activity monitoring option (Option 1) and 148 in the indoor allergen exposure sub-study (Option 2). The study includes biological sampling, environmental monitoring and repeated questionnaire surveys. At baseline, 253 live births were recorded from 251 pregnancies.

Findings to date

Of the 298 women, 272 completed early pregnancy questionnaires. The mean maternal age was 33.1 years (SD 4.6); 97.8% were married. University-level education was reported by 51.0% of mothers and 53.7% of fathers. Most households had an annual income of 6 to

Future plans

Longitudinal follow-up will continue until the children reach age 15. Future analyses will examine associations between environmental exposures and allergic, developmental, endocrine/metabolic and obesity-related outcomes.

Feasibility and results of joint ambulatory monitoring of exposure to particulate matter pollution and lung function in children in Abidjan, Cote dIvoire: a cross-sectional observational study

Por: Pajot · A. · Yapo · M. · Liousse · C. · Doumbia · M. · Gnamien · S. · Ahoua · S. · Dje · S. · Dick · F. · Fayon · M. · Yoboue · V. · Marcy · O.
Background

Children are largely exposed to air pollution in low- and middle-income countries, yet data on exposure and respiratory effects of air pollution remain limited. This study aimed to assess the feasibility and outcomes of joint ambulatory monitoring of exposure to fine particulate matter (particles with a diameter of less than 2.5 µm (PM2.5)) and spirometry in children living in Abidjan, Côte d’Ivoire.

Methods

We did a cross-sectional observational study among children aged 7–17 years. After a baseline spirometry, children were asked to wear portable PM2.5 sensors and to perform 2x3 daily flow–volume curves using a portable spirometer for 7 days. We described the proportion of acceptable measurements, per cent predicted forced expiratory volume (ppFEV1), and hourly geometric mean PM2.5 concentrations, and analysed the cumulative delayed effects of PM2.5 on ppFEV1 using distributed lag non-linear models.

Results

Of 29 children enrolled, 18 (62.1%) were female, median age 12 years, all performed spirometry with 1101 (90.4%) of 1218 expected flow-volume curves obtained. Of these, 625 (51.3%) acceptable curves were received and 313 valid, non-duplicate curves were analysed. The median ppFEV1 was 79.6% (71.5–87.4), with lower values in the morning than in the evening (p2.5 measurements, 93 689 (64.1%) were obtained; 6328 aberrant data were excluded. The median hourly PM2.5 concentrations were 164.2 (107.0–272.2) µg/m3. PM2.5 levels varied throughout the day, with pollution peaks observed in the morning. A significant decrease in ppFEV1 was observed between 0 and 2 hours post-exposure, after an IQR increase of 120.9 µg/m3 in PM2.5 exposure (β=–2.21; CI –3.74 to –0.69).

Conclusion

Ambulatory spirometry and PM2.5 measurements are feasible with portable devices in African children. High PM2.5 exposure and individual variability in lung function highlight the need for further research on the respiratory effects of air pollution in children.

Comparison of the revised Shock Index multiplied by the Glasgow Coma Scale and the Trauma and Injury Severity Score for predicting survival in paediatric patients with trauma: a nationwide retrospective cohort study in Japan

Por: Minami · S. · Toida · C.
Objectives

The Trauma and Injury Severity Score (TRISS) is widely used to predict survival in patients with trauma; however, its predictive accuracy in paediatric populations remains suboptimal. In contrast, the revised Shock Index multiplied by the Glasgow Coma Scale (rSIG), a simple physiological marker, has shown potential utility in adults and children. Therefore, we aimed to compare the predictive performance of rSIG and TRISS in paediatric patients with trauma.

Design

Retrospective cohort study.

Setting

Japan Trauma Data Bank.

Participants

Paediatric patients with trauma aged ≤17 years who were registered in the Japan Trauma Data Bank between 2009 and 2021.

Primary and secondary outcome measures

The optimal cut-off value for rSIG was determined using the derivation cohort (2009–2018). In the validation cohort (2019–2021), the predictive accuracy of rSIG and TRISS for in-hospital survival was compared using the area under the receiver operating characteristic curve (AUC).

Results

In the derivation cohort, the optimal cut-off value for rSIG was 10.13. In the validation cohort, the overall AUC for rSIG was 0.857 (95% CI 0.796 to 0.918) compared with 0.740 (95% CI 0.661 to 0.820) for TRISS, demonstrating the significantly superior predictive accuracy of rSIG (p=0.006). Age-stratified analyses revealed that rSIG significantly outperformed TRISS in the 7–12 and 13–17 age groups.

Conclusions

The rSIG demonstrated higher predictive accuracy for in-hospital survival among paediatric patients with trauma than TRISS. These findings suggest that rSIG is a more effective prognostic tool for paediatric trauma care. Validation and the establishment of age-specific cut-off values are warranted to enhance its clinical applicability.

Protocol for a biomarker discovery study to identify correlates of risk for future tuberculosis disease progression in South African children (INTREPID)

Por: Hamilton · M. S. · Derks · I. P. · Kaforou · M. · Dunbar · R. · McNamara · R. P. · Fortune · S. M. · Basu-Roy · R. · van Deventer · A. · Bosch · C. · Dunican · C. · van der Zalm · M. M. · Levin · M. · Schaaf · H. S. · Altin · J. A. · Hesseling · A. C. · Seddon · J. A.
Introduction

Young children and children living with HIV are at high risk of progressing to tuberculosis (TB) disease following Mycobacterium tuberculosis (Mtb) exposure and infection, and also of developing severe forms of disease and TB-related mortality. Identifying children who have very early (sub-clinical) TB disease, prior to progression to clinically apparent TB, would mean that TB preventive treatment (TPT) could be more efficiently targeted to this group. Identifying biomarker changes on drug therapy in children with Mtb infection or very early disease could pave the way for the development of tests that can identify which children have viable bacilli and are therefore at increased risk of disease progression.

Methods and analysis

The INTREPID study will use already collected samples taken from well-phenotyped paediatric cohorts in three clinical studies conducted in South Africa in children Mtb exposure to disease and from children treated for Mtb infection and early TB disease, as well as targeted Mtb antibody analysis. Data on viral co-infections and relevant clinical and epidemiological parameters will be integrated and evaluated to identify the optimal biosignatures that can predict future progression to clinically overt disease in children below 5 years of age, including those living with HIV.

Ethics and dissemination

The study protocol received ethical approval from the Stellenbosch University Health Research Ethics Committee (N23/03/025). The study findings will be disseminated through peer-reviewed publications, scientific conferences and formal presentations to healthcare professionals and to local communities, in collaboration with the Desmond Tutu TB Centre Community Advisory Board.

Protocol for Personalised Prediction of Persistent Postsurgical Pain

Por: Holzer · K. J. · Alaverdyan · H. · Xu · Z. · Frumkin · M. R. · Frey · K. A. · Gregory · S. H. · Rodebaugh · T. L. · Lu · C. · King · C. R. · Head · D. · Kannampallil · T. · Haroutounian · S.
Introduction

Persistent postsurgical pain (PPSP) affects up to 15% of patients after major surgery, impairing physical function, quality of life and increasing risk for long-term opioid use. Current PPSP prediction models rely on static or retrospective data and fail to incorporate dynamic perioperative factors. The Personalised Prediction of Persistent Postsurgical Pain (P5) study aims to develop individualised, multimodal prediction models by integrating preoperative behavioural, psychophysical and neurocognitive assessments and high-frequency symptom monitoring.

Methods and analysis

P5 is a prospective, single-centre cohort study enrolling 2500 adults aged 18–75 undergoing major surgery at a tertiary academic hospital. Participants complete baseline surveys, cognitive testing and quantitative sensory testing preoperatively. Ecological momentary assessments (EMAs) are collected via smartphone three times per day through 30 days postoperatively, capturing pain, mood, catastrophising and medication use. Participants are assessed on postoperative day 1 and complete online surveys at 3 and 6 months, evaluating pain persistence, interference, neuropathic symptoms and related outcomes. Clinical and perioperative data are extracted from the electronic health record. The primary outcome is PPSP at 3 months. Predictive models will be developed using supervised machine learning and dynamic structural equation modelling to extract latent features from EMA data. Model performance will be assessed using area under the receiver operating characteristic curve, area under the precision-recall curve and SHapley Additive exPlanations for interpretability.

Ethics and dissemination

This study has received ethics approval from the Washington University School of Medicine Institutional Review Board #202101123. Informed consent is required. Results will be submitted for publication in peer-reviewed journals and presented at research conferences.

Trial registration number

NCT04864275.

Implementation Outcomes and Their Determinants for Hospital‐Led Care Coordination Interventions Targeting Patients With Complex Care Needs: A Qualitative Systematic Review

ABSTRACT

Aim

To describe the implementation determinants for care coordination interventions in a hospital context.

Design

Systematic review.

Methods

This review was guided by the Consolidated Framework of Implementation Research (CFIR), assessed for quality using the Mixed Methods Appraisal Tool and reported with the PRISMA guidelines.

Data Sources

CINHAL Complete, EMBASE, MEDLINE Complete, PsychINFO (between January 1, 2013, and December 31, 2022, and updated May 09, 2024) and a manual reference list search of all included studies.

Results

The search returned 5614 articles after duplicates were removed. After title and abstract screening, 264 articles underwent full-text review. Sixteen studies (15 care coordination models) met the inclusion criteria. The CFIR inner setting domain and the implementation process domain were the most prominent domains and ‘Partnerships & Connections’, ‘Work Infrastructure’, ‘Capability’ and ‘Reflecting and Evaluating’ subdomains emerged as important determinants across the included studies.

Conclusion

Inconsistent findings relating to care coordination outcomes are likely to be substantially influenced by the complexity and heterogeneity of the interventions and variations in implementation and contextual factors. Intra- and inter-organisational relationships were important to connect previously disconnected parts of the health system and were facilitated by experienced care coordinators. Continual improvement was also important to increase fit with contextual factors. More high-quality studies are needed to identify commonalities and provide generalisable principles and characteristics associated with high-performance implementation.

Implications for the Profession and/or Patient Care

Review findings will provide practitioners, policymakers, and researchers with a comprehensive synthesis of evidence underpinning implementation of effective community care coordination from hospital settings.

Impact

These review findings will inform the effective implementation of care coordination interventions in a hospital context for patients with complex multimorbidity.

Reporting Methods

Preferred Reporting Items for Systematic reviews and Meta-Analysis.

Trial and Registration

PROSPERO Registration: CRD42022376642.

Patient or Public Contribution

No patient or public Contribution.

Nursing Literature Mapping in Neurodegenerative Diseases: A Scoping Review

ABSTRACT

Aim

To explore the topics and themes covered in published research studies in nursing about neurodegenerative disease, synthesise the available evidence, and discuss future directions.

Design

Scoping review following the Joanna Briggs Institute guidelines.

Methods

A multi-step search strategy was applied across different databases to identify studies published in English or Italian up to September 2023. Data were analysed using a Nursing Data Matrix based on the nursing meta-paradigm and the Child Health and Nutrition Research Initiative (CHNRI) 4D-framework. Screening and data extraction were performed independently by pairs of reviewers; data were extracted and thematically analysed to identify existing research questions and potential priorities.

Data Sources

Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Embase databases were searched for studies published from 2013 to 2023.

Results

A total of 351 studies met inclusion criteria. The majority of studies originated from the United States (35%). Parkinson's disease and Alzheimer's disease were the most studied conditions, while rare diseases were scarcely represented. Most studies focused on nursing care (39%), with limited attention to rehabilitation (0.8%) and cost-effectiveness (1%). Although 70% of articles included at least one nurse author, 22% lacked any nursing authorship despite addressing nursing-related topics. Thematic and matrix analyses revealed an uneven distribution of research, with a predominance of descriptive studies and limited work in discovery-oriented research.

Conclusion

This review provides a comprehensive overview of nursing research in neurodegenerative diseases, highlighting key themes and gaps. The findings informed the preliminary identification of new nursing research priorities in neurodegenerative diseases to guide future studies and enhance evidence-based nursing care.

Implications for the Profession and/or Patient Care

The study highlights key trends and gaps in nursing research on neurodegenerative diseases, calling for a more inclusive, equitable, and comprehensive research agenda.

Reporting Method

PRISMA-ScR guidelines.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Trial and Protocol Registration

Review registration was done on Open Science Framework, and can be viewed at https://osf.io/tn5v9 (https://doi.org/10.17605/OSF.IO/TN5V9)

Frailty and disability among older adults residing in Rohingya refugee camp in Bangladesh

by Afsana Anwar, Mahmood Parvez, Farhan Azim, Uday Narayan Yadav, Saruna Ghimire, Ateeb Ahmad Parray, Shovon Bhattacharjee, ARM Mehrab Ali, Rashidul Alam Mahumud, Md Irteja Islam, Md Nazmul Huda, Mohammad Enamul Hoque, Probal Kumar Mondal, Abu Ansar Md Rizwan, Suvasish Das Shuvo, Sabuj Kanti Mistry

Background

Frailty and disability often emerge with ageing and affect quality of life. Older adults residing in Rohingya refugee camp in Bangladesh are particularly susceptible to frailty and disability due to adverse physical and social environment along with limited health and social care services available in the camp. This study aimed to investigate the prevalence and factors associated with frailty and disability among Rohingya older adults living in Bangladesh.

Methods

This cross-sectional study was conducted among older adults aged ≥60 years residing in the Rohingya refugee settlement in Bangladesh. The primary outcomes were frailty and disability, explored using the ‘Frail Non-Disabled (FiND) questionnaire. Data were collected face-to-face during November-December 2021, using a semi-structured questionnaire. A multinomial logistic regression model was used to identify the factors associated with frailty and disability.

Results

The majority of participants (n = 864) were aged 60–69 years (72.34%), male (56.25%), married (79.05%), and without formal education (89.0%). The study revealed a high prevalence of frailty (36.92%) and disability (55.21%) among the participants. The multinomial regression analysis showed that the likelihood of experiencing disability was significantly higher among participants who were aged 70–79 years (RRR = 2.65, 95% CI: 1.25, 5.66) and ≥80 years (RRR = 8.06, 95% CI: 1.05, 61.80), were female (RRR = 3.93, 95% CI: 1.88, 8.1.9), had no formal education (RRR = 4.34, 95% CI: 2.19, 8.63), were living in a large family (RRR = 1.82, 95% CI: 1.05, 3.18) and were suffering from non-communicable diseases (RRR = 2.36, 95% CI: 1.32, 4.22) compared to their respective counterparts. The regression analysis also revealed that frailty was significantly higher among participants who were female (RRR = 2.82, 95% CI: 1.34, 5.94), were suffering from non-communicable diseases (RRR = 2.28, 95% CI: 1.27, 4.09), and had feeling of loneliness (RRR = 2.16, 95% CI: 1.11, 4.22).

Conclusions

The findings underscore the need for long-term care and health promotion activities to alleviate the burden of frailty and disability among older adults in humanitarian settings. Efforts should particularly target the most vulnerable groups- older individuals (≥80 years), women, those without formal education, those living in large families, and those with non-communicable diseases.

The Reported Evidence of Nursing and Midwifery Mentorship Programmes Internationally: A Scoping Meta‐Review Providing a Comprehensive Overview of Mentorship Programmes

ABSTRACT

Aim

To synthesise and critically analyse existing reviews of evidence on mentorship in nursing and midwifery, providing a comprehensive overview of current knowledge.

Design

A scoping meta-review.

Methods

The review was conducted using the scoping meta-review framework outlined by Sarrami-Foroushani et al. (2015), alongside the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to ensure rigour and transparency. The following steps were included: (i) defining the problem, (ii) literature search and criteria, (iii) study selection and data extraction, (iv) data synthesis, (v) presentation of results and (vi) interpretation and recommendations.

Data Sources

A comprehensive search strategy was designed, utilising Boolean operators, truncation and predefined keywords across seven databases including MEDLINE, CINAHL, Embase, PsycINFO, Epistemonikos, ERIC and Google Scholar.

Results

Following double-blind screening of 269 papers, 14 literature reviews were included. The findings provided a detailed overview of mentorship programme types (formal and informal), outcome measures used to evaluate mentorship effectiveness and recommendations for future programmes. Identified themes included skill development, job satisfaction, career progression and retention outcomes, together with challenges including time constraints and balancing clinical responsibilities with mentorship roles. Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Informal mentorship continues to offer valuable, flexible support, particularly when used alongside formal structures. Implementation challenges exist, such as time constraints, limited organisational support, and mismatched mentor-mentee pairings.

Conclusion

This review highlights the critical role of mentorship in nursing and midwifery, offering insights into effective practices, challenges and potential areas for further research. The findings suggest that formal, structured mentorship programmes produce consistent benefits, including enhanced clinical skills, confidence and satisfaction among mentees, as well as leadership development and professional fulfilment for mentors, while positively impacting organisational efficiency and patient outcomes. Successful mentorship programmes require organisational commitment, with protected time, resources, and ongoing mentor training.

Implications for the Profession and/or Patient Care

Mentorship programmes in nursing and midwifery enhance professional development, job satisfaction, and retention, enabling a stable healthcare workforce. Mentorship for mentors and mentees is linked to increased confidence, competency and readiness for advanced roles among nurses and midwives. Fostering mentorship in healthcare can lead to improved quality and continuity of care as mentees grow into more competent and confident practitioners.

Impact

Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Policymakers responsible for healthcare workforce development can use these findings to advocate for mentorship as a strategic investment, potentially influencing policies related to nurse retention, professional development and funding allocations for mentorship initiatives. Structured mentorship improves job satisfaction, reduces turnover and fosters professional growth, thus reducing costs associated with recruitment and training.

Reporting Method

The findings are reported in line with the PRISMA guidelines (Page et al., 2021) and through a narrative synthesis, summarising and analysing the results of various reviews to present a cohesive understanding of mentorship practices in nursing and midwifery. This method allowed for the integration of qualitative and quantitative findings and the identification of common themes and patterns across studies.

Patient or Public Contribution

Patients or members of the public did not directly contribute to this review. However, by focusing on mentorship practices that support nurses and midwives, the study indirectly addresses public interests, as improved mentoring contributes to the quality of patient care. Future studies could benefit from patient or public feedback on desired qualities in care providers, further informing the development of mentorship programmes aligned with patient-centred care outcomes.

Trajectory, healthcare utilisation and recovery in 3590 individuals with long covid: a 4-year prospective cohort analysis

Por: Prashar · J. · Hillman · T. · Wall · E. C. · Sarna · A. · Mi · E. · Bell · R. · Sahota · J. · Zandi · M. · McNamara · P. · Livingston · R. · Gore · R. · Lunken · C. · Bax · E. · Nyam · R. · Rafie Manzelat · A. M. · Hishmeh · L. · Attree · E. · Cone · S. · Banerjee · A. · Heightman · M.
Objective

To characterise long-term trajectory of recovery in individuals with long covid.

Design

Prospective cohort.

Setting

Single-centre, specialist post-COVID service (London, UK).

Participants

Individuals aged ≥18 years with long covid (hospitalised and non-hospitalised) from April 2020 to March 2024.

Main outcome measures

Routine, prospectively collected data on symptoms, quality of life (including Fatigue Assessment Scale (FAS) and EuroQol 5 Dimensions (EQ-5D), return to work status and healthcare utilisation (investigations, outpatient and emergency attendances). The primary outcome was recovery by self-reported >75% of ‘best health’ (EQ-5D Visual Analogue Scale) and was assessed using Cox proportional hazards regression models over 4 years. Linked National Health Service England registry data provided secondary care healthcare utilisation and expenditure.

Results

We included 3590 individuals (63.3% female, 73.5% non-hospitalised, median age 50.0 years, 71.9% with ≥2 doses of COVID-19 vaccination), who were followed up for a median of 136 (0–346) days since first assessment and 502 (251–825) days since symptom onset. At first assessment, 33.2% of employed individuals were unable to work. Dominant symptoms were fatigue (78.7%), breathlessness (68.1%) and brain fog (53.5%). 33.4% of individuals recovered to >75% of best health prior to clinic discharge (recovery occurred median 202 (94–468) days from symptom onset). Vaccinated individuals were more likely to recover faster (pre: HR 2.93 (2.00–4.28) and post: HR 1.34 (1.05–1.71) COVID-19 infection), whereas recovery hazard was inversely associated with FAS (HR 0.37 (0.33–0.42)), myalgia (HR 0.59 (0.45–0.76)) and dysautonomic symptoms (HR 0.46 (0.34–0.62)). There was high secondary care healthcare utilisation (both emergency and outpatient care). Annual inpatient and outpatient expenditure was significantly lower in hospitalised individuals while under the service. When compared with the prereferral period, emergency department attendances were reduced in non-hospitalised patients with long covid, but outpatient costs increased.

Conclusions

In the largest long covid cohort from a single specialist post-COVID service to date, only one-third of individuals under follow-up achieved satisfactory recovery. Fatigue severity and COVID-19 vaccination at presentation, even after initial COVID-19 infection, was associated with long covid recovery. Ongoing service provision for this and other post-viral conditions is necessary to support care, progress treatment options and provide capacity for future pandemic preparedness. Research and clinical services should emphasise these factors as the strongest predictors of non-recovery.

Cultural Adaptation and Psychometric Assessment of the Catalan Version of the Wound‐QoL‐17

ABSTRACT

Complex chronic wounds are an increasing health concern, affecting individuals both physically and psychologically. To measure the quality of life of this population properly translated and validated questionnaires in their native language are needed. The aim of this work is to provide a validated instrument for measuring the quality of life in the Catalan speaking population with complex wounds. A cultural adaptation of the Wound-QoL-17 questionnaire into Catalan was carried out by independent official translators and the back translation was approved by the original author. Validity, reliability, responsiveness, and feasibility were assessed. Face and content validity were determined by a group of experts: the 17 items of the Wound-QoL-17 Catalan version were appropriate for their purpose. Reliability was demonstrated by an interclass correlation coefficient of 0.884 for the scores obtained by two different observers and of 0.928 for the same observer on two time points. Chronbach's alpha coefficient was 0.926. Responsiveness was proved by a Pearson's correlation coefficient of 0.661. Feasibility was shown by the time, 3.46 min, taken to complete the questionnaire.

Interventions Addressing Compassion Fatigue Among Nurses: A Scoping Review

ABSTRACT

Aim

To identify and synthesise intervention programs designed to address compassion fatigue among nurses, with a focus on their types and core characteristics.

Design

A scoping review.

Methods

This review was conducted according to the scoping review guidelines proposed by Arksey and O'Malley and met the requirements of PRISMA-ScR guidelines.

Data Sources

Literature published between January 2015 and March 2025 was thoroughly searched in Scopus, PubMed, Cochrane Library, APA PsycNet, Science Direct, and ProQuest. Major search terms included ‘compassion fatigue’, ‘secondary traumatic stress’, ‘burnout’, ‘nurses’ and ‘intervention’.

Results

Fourteen studies met the inclusion criteria. Interventions were categorised as: (1) Enhancement of Organisation and Social Support, (2) Development of Individual Psychological Capacities, (3) Systemic-level Interventions, these results align with the framework of the job demands resources theory.

Conclusion

This review highlights diversity in the focus. While some emphasised on strengthening the job resources and building the personal individual-based resources, few others focused on system level interventions to address compassion fatigue in nurses. The findings also emphasise the importance and need for customised and accessible support strategies at both individual and organisational levels. Nurse well-being and resilience interventions promote balanced job settings and quality health care support.

Implications for the Profession and/or Patient Care

This review provides a foundation for designing comprehensive, empirically supported strategies to address compassion fatigue in nursing. Future research should focus on integrating individual and systemic support to build a healthy work environment.

Impact

This review helps to understand the core characteristics and types of existing interventions addressing compassion fatigue among nurses, and highlights the need to focus on both individual as well as organisational needs and outcomes, thereby enhancing the well-being of nurses and creating healthy work environments.

Reporting Method

PRISMA-ScR was used in this scoping review.

Patient or Public Contribution

No patient or public contribution.

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