Mapping Person‐Centred Care in Wound Management: A Scoping Review of Frameworks, Concepts and Outcome Measures

ABSTRACT

Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.

Cyclodextrin reduces cholesterol crystal uptake by circulating monocytes in patients undergoing coronary angiography

by Nikola Lübbering, Alexander Krogmann, Felix Jansen, Eicke Latz, Georg Nickenig, Sebastian Zimmer

Background

Atherosclerosis is a chronic inflammatory disease driven by endothelial dysfunction, cholesterol accumulation, and immune activation leading to thrombosis and vascular stenosis. While LDL-lowering therapies are firmly established, targeting the underlying inflammation is still an emerging strategy. Cholesterol crystals (CC) contribute to inflammation by activating the NLRP3 inflammasome in monocytes and promoting disease progression. Cyclodextrin (CD), an FDA-approved drug carrier, has shown atheroprotective effects by enhancing cholesterol metabolism and reducing inflammation in preclinical models. This study investigated whether CC-uptake in human monocytes, a prerequisite for inflammasome activation, is also influenced by CD pretreatment.

Methods

Human peripheral mononuclear cells were isolated from whole blood samples provided by 76 patients undergoing coronary angiography at the University Hospital Bonn between November 2017 and February 2018. After separation, peripheral mononuclear cells were stimulated with 2-Hydroxypropyl-γ-Cyclodextrin and CC. CC-uptake by monocytes was analyzed using flow cytometry.

Results

CC-uptake by monocytes varied greatly between patients (8–37%), with lower uptake observed in patients with elevated leukocytes (p = 0.0058) and diabetes mellitus (p = 0.0448). CD-pretreatment significantly reduced CC-uptake (20.1% ± 0.8% vs. 15.0% ± 0.6%, p p = 0.0316), requirement for percutaneous coronary intervention (PCI) (p = 0.0030), and elevated leucocyte levels (p = 0.0135) had lower CCΔCD, suggesting a link between systemic inflammation and attenuated CD efficacy.

Conclusion

We demonstrated that CD significantly reduced CC-uptake in patients undergoing coronary angiography, which supports its role in inhibiting CC-phagocytosis and promoting cholesterol efflux. Interestingly, patient response to CD varied, with those exhibiting greater systemic inflammation or CAD showing a less pronounced reduction in CC-uptake. Our findings provide insight into the atheroprotective mechanisms of CD and suggest its potential utility in evaluating individual cardiovascular risk and monitoring CD-based therapeutic interventions in humans.

Identification of novel molecular drivers, prognostic and diagnostic biomarkers for Inflammatory Bowel Disease (IBD): protocol for the Nottingham/AstraZeneca prospective IBD observational cohort study

Introduction

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, inflammatory bowel diseases (IBDs) of unknown origin, affecting the gastrointestinal tract and often causing extraintestinal symptoms. Conventional treatments (eg, glucocorticosteroids, immunomodulators) and targeted advanced treatments, including anti-TNFα, antibodies to p40 subunit of IL-12/23, antibodies to p19 subunit of IL-23, anti-α4β7 integrin, Janus kinase inhibitors (JAKis) and sphingosine-1-phosphate receptor (S1PR) modulators, do not achieve sustained responses for all patients, leaving significant unmet therapeutic needs.

Methods and analysis

This prospective, multi-centre observational study will follow a cohort of 240 patients across multiple study centres within NHS trusts in the UK who are initiating or switching biologics, specifically anti-TNFα and anti-α4β7 integrin for UC, and anti-TNFα, antibodies to p40 subunit of IL-12/2 and JAKi for CD. Through comprehensive profiling of immunological, transcriptional, microbiome, genetic and proteomic markers at baseline, week 12, and week 52, this study aims to uncover non-invasive biomarkers that predict response to these drug classes, ultimately advancing personalised medicine in IBD.

Ethics and dissemination

Ethical approval for the Nottingham/AstraZeneca study was granted by the West of Scotland Research Ethics Committee. Recruitment began in December 2022 and is currently ongoing at 10 NHS Trust sites across the UK. Study findings will be disseminated by publication in peer-reviewed journals and presentations at relevant national and international conferences.

Design, 3D printing, and preclinical validation of an extraglottic ramp to facilitate blind orotracheal intubation in emergency airway management

by Jorman H. Tejada-Perdomo, Valentina Gutierrez-Perdomo, Juana V. Agudelo-Castro, Jorge A. Pérez-Gamboa, Alejandro Weinstein, Sebastián San Martín, Rodrigo Salas, Jorge A. Ramos-Castaneda

The use of devices that facilitate rapid airway isolation is essential when managing critical patients in emergencies. In recent years, additive manufacturing has emerged as an innovative, versatile, and accessible technology for developing medical devices. This study presents the design, development, and validation of an extraglottic medical device created using computer-aided design tools and stereolithographic 3D printing to facilitate blind intubation by first responders. The device was iteratively modeled and fabricated with biocompatible materials; validation in airway simulators and human cadaveric specimens assessed dimensions, friction, intubation technique, and learning curve, and ease of use was rated with a Likert scale. Ten iterations led to a final design with low friction and minimal cervical manipulation; ramp angle, cup geometry, and distal tip were optimized for tube passage, and BioMed Flex 80A showed high strength and anatomical compatibility. The final version is a safe, reusable, and functional alternative for airway management and blind orotracheal intubation, particularly in emergencies and resource-limited settings; clinical validation in live patients is still needed.

On the Move to Surgery: A Scoping Review of Patient‐Reported Outcomes for Preoperative Walking Into the Operating Theatre

ABSTRACT

Introduction

Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient-centred care gains importance, evaluating the effects of this approach on patient-reported outcomes may be more relevant than widely assumed.

Aim

In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient-reported outcomes, such as anxiety and satisfaction.

Design

This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Scoping Review extension guidelines.

Methods

Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS-I V2.0, RoB2 and ROB-E tools.

Data Sources

Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025.

Results

Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking.

Conclusion

Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients.

Patient or Public Contribution

No patient or public involvement.

Did health reform improve financial protection for disadvantaged groups in Ecuador? A socio-economic inequality assessment of catastrophic health expenditures 2006-2014

Objectives

Latin American countries have long struggled with socioeconomic inequalities and health equity. In 2007, Ecuador implemented a health reform to address these issues by making public health services free, coordinating finances between subsystems and increasing the state’s health budget. This study evaluates whether Ecuador’s health system reform (2007–2017) reduced out-of-pocket (OOP) health spending, catastrophic health spending (CHS) and socioeconomic inequalities in CHS.

Design

Cross-sectional study.

Setting

Secondary data available of households from the 2006 and 2014 National Living Standards Measurement surveys.

Methods

Descriptive statistics (means and medians) and log-binomial regression were applied to assess prevalence of OOP and socioeconomic inequalities (residence, region, health insurance status and wealth) in catastrophic health expenditure (CHE) for each period and over time.

Results

Overall, there was a significant reduction of 14% points in the proportion of households with OOP healthcare expenditure. The prevalence of CHE decreased from 17% to 10% and within each socioeconomic group over time. Significant reductions in relative risk were observed in all socioeconomic variables. The inequality in CHE decreased significantly in households placed in rural areas (relative difference (RD): 0.88; 95% CI: 0.79 to 0.97) and poorest (RD: 0.82; 95% CI: 0.69 to 0.97); however, it increased within regions (RD: 0.58; 95% CI: 0.44 to 0.76) and for uninsured households (RD: 1.39; 95% CI: 0.95 to 2.04).

Conclusions

This study suggests that recent health reform effectively reduced OOP healthcare expenditure, CHE and some socioeconomic inequalities. Future reforms should further invest in key areas, expand health insurance for the most disadvantaged and monitor progress towards universal health coverage to address persistent inequalities.

Responsabilidades civiles, éticas y legales del profesional de enfermería en Caaguazú, Paraguay

Introducción: La enfermería, como disciplina, demanda un alto nivel de compromiso y responsabilidad, debe abordar conocimientos esenciales para la labor diaria como las responsabilidades tanto éticas, civiles y penales. Objetivo. Este estudio tiene como finalidad evaluar el nivel de conocimientos sobre las responsabilidades civiles, éticas y legales que poseen los profesionales de Enfermería de un hospital público del interior del país, el Hospital Distrital Inmaculada Concepción de la Ciudad de Caaguazú de Paraguay, en el año 2023. Metodología. Se llevó a cabo un estudio cuantitativo, descriptivo de corte transversal con componente analítico. La población estuvo compuesta por 130 profesionales de Enfermería que realizan funciones en las áreas asistenciales y de salud pública. La técnica utilizada fue la encuesta por medio de un instrumento con 25 preguntas, el cuestionario fue validado mediante prueba piloto y la revisión por parte de un panel de expertos. Resultados. De los 130 profesionales de Enfermería encuestados el 77,69% eran del sexo femenino, con promedio de edad entre 30 a 36 años y el 63,85% eran casados, el 49,23% (64) tienen nivel de conocimiento deficiente sobre las responsabilidades penales y el 77.69% (101) poseen el nivel de conocimiento excelente en cuanto a responsabilidad civil, el 44.62% (58) de los profesionales tiene nivel de conocimiento regular sobre responsabilidad ética. Discusión. Más de la mitad de los profesionales de enfermería menores de 32 años tienen nivel de conocimiento malo sobre las responsabilidades penales, lo que resalta la necesidad de implementar programas de formación continua en estas áreas críticas, además de ser un respaldo legal en el actual diario de su profesión.

ABSTRACT

Introduction. Nursing, as a discipline, demands a high level of commitment and responsibility, it must address essential knowledge for daily work such as ethical, civil and criminal responsibilities. Objective. This study aims to evaluate the level of knowledge about civil, ethical and legal responsibilities that nursing professionals have in a public hospital in the interior of the country, the Inmaculada Concepción District Hospital of the City of Caaguazú in Paraguay, in the year 2023. Methodology. A quantitative, descriptive cross-sectional study with an analytical component was carried out. The population was made up of 130 nursing professionals who perform functions in the healthcare and public health areas. The technique used was the survey using an instrument with 25 questions, the questionnaire was validated through pilot testing and review by a panel of experts. Results. Of the 130 nursing professionals surveyed, 77.69% were female, with an average age between 30 to 36 years and 63.85% were married, 49.23% (64) have a poor level of knowledge about the criminal responsibilities and 77.69% (101) have an excellent level of knowledge regarding civil liability, 44.62% (58) of professionals have an excellent level of knowledge. of regular knowledge about ethical responsibility. Discussion. More than half of nursing professionals under 32 years of age have a poor level of knowledge about criminal responsibilities, which highlights the need to implement continuous training programs in these critical areas, in addition to being legal support in the current journal of his profession.

Percepción de los profesionales sanitarios sobre cómo afecta la luz y ruido al sueño/descanso de los pacientes en el Servicio de Urgencias

Objetivo principal: Mejorar la calidad del sueño y descanso de los pacientes en el servicio de urgencias mediante la participación y cono-cimiento de las percepciones de los profesionales sanitarios. Metodología: Un total de 173 profesionales sanitarios (79 enfermeras/os, 33 TCAE, 29 médicos/as y 32 celadores/as) cumplimentaron el cuestionario ad hoc de percepción de los profesionales sobre cómo afecta la luz y ruido al sueño y descanso de los pacientes. Resultados principales: Aspectos relacionados con la organización y dinámicas de trabajo, las competencias, habilidades y cuidados llevados a cabo por los profesionales daban lugar a distinciones en la participación de responder al cuestionario y en las percepciones de los profesionales sobre cómo la luz y ruido afecta al sueño y descanso de los pacien-tes, lo cual remarcaba la necesidad de evaluar factores perturbadores ambientales y establecer estrategias, medidas, intervenciones y cuidados para mejorar la calidad de sueño de los pacientes. Por tanto, los resultados de este trabajo aportaban nuevos datos en compa-ración con los datos de escasos estudios sobre la necesidad de conocer la percepción de los profesionales sanitarios sobre factores perturbadores ambientales que afectan al sueño/descanso de los pacientes, particularmente en el servicio de urgencias. Conclusión principal: Existe una variabilidad de las diferentes categorías de profesionales sanitarios en relación a la participación en contestar al cuestionario ad hoc, así como diferencias significativas entre las percepciones sobre cómo afecta la luz y ruido sobre el sueño/descanso de los pacientes. Por tanto, se plantean perspectivas de futuro y se alude a estrategias dirigidas a los pacientes, profesionales y organi-zación/entorno de trabajo para mejorar la calidad de sueño de los pacientes en el servicio de urgencias.

Repercusión de la luz y ruido sobre el sueño/descanso en los pacientes hospitalizados

Introducción: los pacientes que se encuentran hospitalizados sufren un conjunto de reacciones y sentimientos que conlleva generalmente proble-mas de sueño en el hospital, donde el trabajo es continuo en relación a los cuidados que requieren los pacientes y donde es necesario considerar la tecnología que caracteriza a las diferentes unidades, por el ruido que se produce y la luz que requieren los profesionales para llevar a cabo el trabajo. El ruido y la luz son los factores ambientales que afectan en mayor medida a los pacientes hospitalizados. El objetivo es comprobar, identifi-car y discutir cuales son los factores perturbadores ambientales que afectan al sueño/descanso de los pacientes ingresados en el hospital. Material y métodos: se llevó a cabo una búsqueda bibliográfica en las principales bases de datos primarias y secundarias como Pubmed®, CINAHL®, Coch-rane® y Google Acádemico® de los últimos 10 años. Resultados: se obtuvo un gran número de artículos, de los cuales se seleccionaron los que fueron más relevantes según el objetivo de esta revisión narrativa crítica. Discusión y conclusiones: existe una gran complejidad y variabilidad en las metodologías de los diferentes estudios relacionados con factores perturbadores ambientales, pero también en los últimos años se está prestando mayor atención a la investigación sobre los factores que afectan a sueño y descanso de los pacientes ingresados en el hospital. Se puede concluir que el ruido y la luz son los factores perturbadores ambientales principales que afectan al sueño/descanso de los pacientes hospitalizados y que se necesita más investigación de alta calidad para superar las limitaciones y dificultades de estudios previos y fortalecer los cuidados de enfermería basados en la evidencia.