Conectar
To critically appraise and synthesise the evidence about the effects and experiences of care models and interventions to improve person-centred care for older people in long-term care facilities.
A mixed methods systematic review, following the Joanna Briggs Institute guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
MEDLINE, PubMed, CINAHL, PsycINFO, Embase, Web of Science, Cochrane Library, and Thaijo were searched to identify relevant primary research published in English and Thai from January 2000 to February 2024.
All relevant primary research with quantitative, qualitative, and mixed methods design was included. A convergent synthesis approach was used to synthesise and integrate findings.
4070 records were identified, of which 30 studies were retained: 12 quantitative, nine qualitative, and nine mixed methods studies. The evidence revealed five themes: (1) personalised preference, social engagement, and well-being; (2) autonomy and dignity; (3) a home-like environment; (4) family involvement and satisfaction; and (5) organisational and staff support.
This review indicated that person-centred care models and interventions could improve residents' quality of life, autonomy, and promote individual care provision, create an environment based on individual needs, and involve families in care, although challenges such as staff shortages and lack of managerial support may hinder successful implementation. Future work is required to evaluate and identify effective strategies to strengthen organisational support, including leadership development, staff retention, and resource allocation, and evaluate how organisational culture influences the adoption and success of person-centred care practices.
The review provides valuable insights and a comprehensive understanding of the care models and interventions specifically designed to improve person-centred care and enhance the quality of life for older people in long-term care facilities.
Not applicable.
The protocol was registered with the PROSPERO (CRD42024509504)
Although obstetrics and gynaecology (O&G) is a predominantly female specialty, previous studies have suggested that women remain under-represented in academic authorship. This study evaluates trends in female and male first and last authorship in six leading O&G journals (Human Reproduction Update, American Journal of Obstetrics and Gynecology, British Journal of Obstetrics and Gynaecology, Obstetrics and Gynecology, Gynecologic Oncology and Best Practice & Research Clinical Obstetrics & Gynaecology) between January 2013 and December 2023.
A bibliometric analysis was conducted using the Web of Science database. The gender of the first and last authors was determined using Genderize.io, with a probability threshold of ≥75% for classification. Binary logistic regression was performed to model the probability of authorship by gender across journals.
Among 57 310 publications, 38 455 first (43.8% male and 56.2% female) and 38 950 last authors (58.6% male and 41.4% female) were identified and analysed. Over the past decade, female authorship has shown a clear upward trend, with first authorship increasing from 43% (1141/2636) in 2013 to 69% (2769/4036) in 2023, and last authorship increasing from 29% (770/2700) to 54% (2180/4047). First authorship was statistically more likely to be held by women in Human Reproduction Update (1.23, 95% CI 1.02 to 1.48), American Journal of Obstetrics & Gynecology (1.63, 95% CI 1.58 to 1.70) and Obstetrics & Gynecology (2.33, 95% CI 2.22 to 2.45). However, female last authorship was significantly more likely only in Obstetrics & Gynecology (1.21, 95% CI 1.16 to 1.27).
Despite an increasing trend in female representation in first and last authorships over the past decade, a significant gender disparity persists. While women now constitute the majority of first authors, last authorship remains disproportionately male, reflecting ongoing barriers to female leadership in O&G research. These findings highlight the need for targeted institutional efforts to promote gender equity in academic medicine.
To explore intensive care unit (ICU) clinicians’ experiences of withdrawing mechanical ventilation during end-of-life care.
An exploratory qualitative design was used, with data collected via semistructured, face-to-face online interviews and analysed using reflexive thematic analysis.
We recruited ICU clinicians from two hospitals within the West Midlands region of the UK.
Semistructured, face-to-face online interviews were used to explore experiences with limitation of life-sustaining treatments in ICU, decision-making and practices for withdrawing mechanical ventilation.
22 ICU clinicians were interviewed (Physiotherapist=1, Advanced Critical Care Practitioners=4, Physicians=9 and Nurses=8), of which 13 were women (59%). Four themes were developed. (1) Multilayered communication: effective communication was key in planning withdrawal and informing family members, with conflicts arising from cultural differences. (2) Considerations regarding the mode of withdrawing invasive mechanical ventilation: clinicians expressed differing preferences for the method of mechanical ventilation withdrawal. (3) Multiprofessional teamwork: collaborative teamwork was vital, with palliative care practitioners consulted during conflicts or challenging symptoms. (4) Clinicians’ feelings and impact: clinicians empathised with families and experienced psychological burden.
Physician preferences influence the withdrawal process, which is communicated within the multidisciplinary team. Clear protocols can help reduce ambiguity and support less experienced clinicians. Reflection on these practices may help mitigate burnout and compassion fatigue. Further research should examine the effects of physician demographics and patient cultural diversity on the withdrawal process.
FreshRSS 