Conectar
Whiplash-associated disorders (WADs) are the most common and costly consequence of road traffic injury (RTI). Providing early and effective treatment is a healthcare priority; however, current guideline-based care which focuses on education and physiotherapy-led exercise does not routinely address the psychosocial effects of trauma, and access to early integrated treatment is limited. This study aims to evaluate the feasibility of delivering and evaluating recovery, information, support and empowerment (RISE), a co-designed short message service-based intervention integrating psychosocial and exercise/activity support for individuals with acute whiplash injury who are at risk of poor recovery in a randomised feasibility trial. Secondary aims are to explore preliminary changes in candidate clinical outcomes and opportunities for intervention personalisation and future implementation.
This mixed-methods randomised controlled feasibility trial with a nested process evaluation will recruit 50 participants (
This trial is approved by the Townsville Hospital Human Research Ethics Committee (HREC/QTHS/121395) and ratified by the Human Research Ethics Committee at The University of Queensland, which is the study sponsor (2025/HE002491). Results will be published in peer-reviewed journals and presented at conferences and professional meetings.
ACTRN12626000506392; date registered: 23 April 2026; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=390706&isReview=true
To identify and describe the barriers and enablers to nurses routinely screening for dysphagia in hospital and map these to domains in the Theoretical Domains Framework.
Systematic review with meta-ethnography.
CINAHL, Embase, PubMed, Scopus, Clinical Trials and World Health Organisation trials registry (database inception to November 2024).
The review protocol was registered on PROSPERO (CRD42024608080). Studies set in stroke and older adult wards were included. Data were coded as barriers or enablers, mapped to the original authors' themes and then synthesised into higher-level themes. Barrier and enabler codes were also mapped to domains in the Theoretical Domains Framework.
From 6750 studies identified, six were included. None of the included papers were conducted in an older adult ward setting. Four high-level themes were developed: (i) The surrounding environment, (ii) Variation in practice, (iii) Influence of knowledge and skills, and (iv) The value of dysphagia screening. Identified barriers and enablers were predominantly mapped to ‘Environmental context and resources,’ ‘Knowledge,’ ‘Beliefs about capabilities’ and ‘Beliefs about consequences’ Theoretical Domains Framework domains.
For successful dysphagia screening, nurses require adequate training, a standardised screening tool and sufficient environmental support. Further work is required to contextualise these findings specifically to older adult ward settings.
To introduce routine nurse screening for dysphagia into different contexts, this paper provides guidance on how to set up and create a theory informed service. Mapping of barriers and enablers to the Theoretical Domains Framework can facilitate the development of a behaviour change intervention through the framework's linkage to a taxonomy of behaviour changes strategies.
ENhancing Transparency in REporting the synthesis of Qualitative research.
Patient and public involvement focused on interpretation of findings, ensuring the review identified patient-relevant priorities.
PROSPERO registration number: CRD42024608080
Compression therapy is the evidence-based treatment for healing venous leg ulcers. However, it is not routinely applied in many UK hospitals. This paper explores hospital staff's' perspectives of venous leg ulcer care provision where compression therapy is not routinely applied. A semi-structured interview study was conducted with 11 participants, drawn from a larger study, who confirmed that their respective hospitals did not apply compression therapy to inpatients with venous leg ulcers. The interviews were analysed using reflexive thematic analysis. Findings indicate that venous leg ulcer care in hospitals was de-prioritised, which, along with structural and organisational constraints, affected clinicians' engagement and focus on it in their hospitals. This de-prioritisation also led to a lack of formal leg ulcer training in hospitals. However, some clinicians showed remarkable empathy for patients derived from their clinical professionalism and deep understanding of their suffering. To help hospital clinicians and senior managers prioritise venous leg ulcer care, it is crucial to first understand their clinical practise priorities. Secondly, understanding how some hospitals implement compression therapy could be beneficial for those where it is not routine practise. Further research should focus on better understanding clinicians and senior managers' clinical priorities and the structural and organisational constraints in real-world settings, ideally in hospitals where compression therapy is a routine practise. Most importantly, the study highlighted key questions for hospital leaders and policymakers: consider fostering the established clinicians' empathy before it is too late.
The dynamic physiological and hormonal changes through the menopause transition predispose women to an increased risk of chronic diseases including cardiovascular disease, metabolic disease, depression and dementia. The underlying mechanisms remain unclear, yet it is thought that chronic systemic inflammation and changes to lifestyle behaviours play important roles. The LIfestyle risk Factors for chronic disease across the stagEs of reproductive ageing (LIFE study) is a cross-sectional study aimed to characterise how hormonal and lifestyle (physical activity, diet and sleep) differences across pre, peri and postmenopause influence chronic systemic inflammation, visceral adiposity, cognitive function and sleep health.
Women aged between 40 and 65 years were recruited and classified into pre, peri or postmenopausal groups. Body composition measures and blood samples were collected. Sleep and physical activity were objectively measured using activPAL4 and ActiGraph GT9X link accelerometer over 7 days. Participants were also provided with a sleep diary. Physical function was assessed using the Short Physical Performance Battery. Cognitive function was evaluated using Addenbrooke’s Cognitive Examination-III and Cambridge Neuropsychological Test Automated Battery. Participants completed a series of questionnaires: Depression, Anxiety and Stress Scale-21, RuSATED, Berlin Questionnaire, Insomnia Severity Index, Activities-specific Balance Confidence Scale and the Australian Eating Survey.
Ethical approval was received from the relevant University Human Research Ethics Committee (ethics approval number #S221718) prior to the commencement of the research project. Data collection is ongoing and expected to be completed by April 2026. Results are expected to be available from July 2026. Findings will be disseminated in national and international conferences and in peer-reviewed journals and expected to inform how differences in lifestyle behaviours across menopause influence chronic systemic inflammation, visceral adiposity and cognitive function. Understanding and characterising the links between lifestyle behaviours and menopausal symptoms will inform targeted strategies to improve long-term well-being, heart, brain and metabolic health.
by Kethmany Ratsavong, Dirk Essink, E. Pamela Wright, Somphou Sayasone, Sengchanh Kounnavong, Jacqueline E. W. Broerse
Child undernutrition remains a significant public health challenge in many low and middle-income countries (LMICs), including Lao PDR, where high levels persist even in urban areas with generally available and accessible food. This study aimed to explore factors underlying the persistently high rates of undernutrition among young children in urban (Saysetha) and peri-urban (Pakgneum) districts of the Vientiane Capital in Lao PDR. A cross-sectional survey employed a sequential explanatory mixed-methods approach, combining a structured questionnaire of 333 mother–child pairs for quantitative analysis with semi-structured interviews of 47 caregivers for qualitative insights. The prevalence of malnutrition among children under 24 months in Vientiane Capital was 27.3% for stunting, 4.2% for wasting, 14.4% for underweight, and 5.11% for overweight. Multiple logistic regression was applied to identify factors associated with malnutrition, while qualitative data were thematically analyzed. The principal findings revealed that, beyond food access, the quality of caregiving and, critically, caregivers’ capacity to translate nutrition knowledge into effective practices distinguished well-nourished from undernourished children. Caregivers of better-nourished children obtained health and nutrition information from diverse sources, whereas those of undernourished children relied mainly on health services. In conclusion, strengthening practical nutrition communication in various methods and channels, such as through videos and demonstrations, and enhancing caregivers’ ability to apply nutritional knowledge, are central to improving child nutritional outcomes in urban and peri-urban settings in Lao PDR.Thirty-day hospital readmissions remain a persistent challenge, undermining patient safety, disrupting care continuity, and straining healthcare system performance. Ineffective discharge education and weak care transitions leave patients vulnerable after hospitalization. Evidence suggests that structured follow-up calls within 24–72 h can reduce preventable readmissions and strengthen care transitions.
This study aimed to evaluate the effectiveness of structured, nurse-led follow-up telephone calls, guided by the AHRQ RED Toolkit, in reducing 30-day hospital readmissions.
This study was conducted in a 200-bed urban medical center. It was reviewed and classified as a quality improvement initiative with minimal ethical risk and did not require informed consent. Over a 12-week implementation period, registered nurses used a standardized script to conduct follow-up calls within 24–72 h of discharge. Calls addressed health status, medication use, follow-up appointments, and home support. Pre- and post-intervention readmission data were collected from the electronic health record. Analysis included descriptive statistics and Chi-square testing.
Among 287 patients who received standard care, 17% were readmitted within 30 days of discharge. In contrast, only 3.5% of 112 patients who received structured follow-up calls were readmitted, representing an absolute reduction of 13% (χ 2 = 12.05, p = 0.0005). Patients also reported improved satisfaction and confidence in managing their care.
Structured, nurse-led post-discharge follow-up telephone calls within 24–72 h should be integrated into standard discharge workflows to reduce preventable hospital readmissions. Nursing leadership can leverage this low-cost, scalable intervention to strengthen transitional care, improve patient safety, and support value-based care outcomes across diverse healthcare settings.
Nurse-led post-discharge follow-up calls significantly reduced 30-day readmissions while enhancing patient safety and care transitions. Findings support incorporating structured follow-up calls into standard discharge planning as a cost-effective, evidence-based intervention for broad implementation.
Proactive deprescribing is the process of stopping a medicine and comprises four steps: (1) identify a patient for potential stop of a medicine, (2) evaluate a patient for potential stop of a medicine, (3) stop a medicine and (4) monitor after stopping.
The CHARMER (CompreHensive geriAtRician-led MEdication Review) trial is a stepped-wedge design to evaluate the effectiveness and cost-effectiveness of a behaviour change intervention to increase proactive deprescribing in hospitals. The CHARMER intervention comprises a deprescribing action plan, deprescribing briefings, videos of successful deprescribing consultations, deprescribing case studies workshop and a deprescribing performance dashboard. The process evaluation will explore trial processes, CHARMER intervention implementation, CHARMER behavioural mechanisms of action and contextual factors influencing these aspects.
The convergent parallel design process evaluation will follow the UK Medical Research Council guidance. We will interview: staff involved in CHARMER implementation, geriatricians and pharmacists who receive the intervention and research delivery staff involved in patient/carer recruitment and data collection. We will also interview patients/carers and primary care practitioners. Interviews will be supplemented with recordings of implementation activities and completed implementation manuals. Questionnaires will capture the extent to which the four proactive deprescribing steps are enacted by intervention recipients, measure the behavioural mechanisms by which the CHARMER intervention operates and capture the patient experience of proactive deprescribing. Qualitative data will be analysed thematically and then mapped to Normalisation Process Theory to explore implementation and the Theoretical Domains Framework to explore behaviour change. Most quantitative data will be analysed descriptively; however, changes in staff questionnaire responses preintervention and postintervention will be analysed using a Mann-Whitney test. We will triangulate qualitative and quantitative findings to explain intervention effects.
Ethical and governance approvals have been obtained by the Wales 2 Research Ethics Committee and the Health Research Authority, respectively. The dissemination strategy will be underpinned by the evidence-based Guide to Disseminating Research (GuiDiR) targeting healthcare practitioners, policy makers and patient-facing organisations.
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a significant procedural adverse event (AE), occurring in 5–15% of cases and leading to substantial morbidity and mortality. Aggressive prolonged intravenous (IV) fluid regimens have demonstrated efficacy in reducing PEP in clinical trials. However, these regimens typically involve continuous infusion of IV fluids over 8–24 hours following ERCP, making them impractical for outpatient settings. Data on shorter hydration protocols are lacking. The STRIPE study aims to address this gap by evaluating short-term peri-procedural IV fluid regimens as a practical alternative for mitigating PEP.
This proof-of-concept, parallel-arm, randomised controlled trial will evaluate the impact of various short-term IV fluid regimens on post-ERCP serum amylase levels, a surrogate marker for PEP. Participants undergoing ERCP will be randomised into five groups, receiving 500 mL, 1000 mL, 1500 mL, 2000 mL or 2500 mL of IV Ringer’s lactate during the peri-procedural period. Patients, endoscopists and outcome assessors will be blinded to treatment allocation during the peri-procedural period. The primary outcome is the serum amylase level 24 hours post-ERCP. Secondary outcomes include PEP, 30-day AEs and unplanned healthcare encounters including those related to volume overload or cardiovascular AEs, duration of hospitalisation (for inpatients), death within 30 days and other relevant laboratory markers at 24 hours. A total of 505 participants (101 in each arm) will be enrolled to ensure adequate power after accounting for attrition and/or sample loss.
This trial was registered on clinicaltrials.gov on 7 February 2024. The study was approved by the University of Calgary Conjoint Health Research Ethics Board (REB23-0625). On study completion, data will be made available on reasonable request to the corresponding author after completion of the study. Study dissemination and knowledge translation is planned via presentations at scholarly meetings, publications in peer-reviewed journals and, ideally, via adoption of results into clinical practice guidelines.
Managing mood, cognition and fatigue are top unmet needs reported by stroke survivors, which impact quality of life. There is currently no standardised UK care pathway to support post-stroke psychological outcomes. The ENhanced Reviews of PsychologIcal Changes (ENRICH) programme, an intervention co-designed with stroke survivors, carers and healthcare professionals, aims to fill this gap. Here, we describe the protocol for evaluating the feasibility and acceptability of ENRICH.
ENRICH reviews comprise cognition, mood and fatigue assessment, personalised psychoeducation and tools to communicate results and discuss self-management strategies, delivered at 1, 3 and 6 months post-stroke. N=140 participants (N=80 patients who had a stroke, N=45 carers, N=15 healthcare professionals) will be recruited to a single-arm multicentre feasibility study.
Patients who had a stroke and carers will complete demographics at baseline (T1) questionnaires of quality of life, mood and healthcare resource use at 6 months post-stroke (T2) and an optional interview on experiences of ENRICH. Process evaluation will include fidelity assessment via audio recordings. Descriptive statistics will be calculated for study outcomes.
Key qualitative acceptability outcomes are sought on intervention delivery by clinicians, patients and carers.
Key intervention delivery feasibility outcomes relate to training clinicians (including competency and fidelity delivering ENRICH), and review completion rates. Study feasibility outcomes will include site and participant recruitment and retention rates and completion of candidate primary outcome measures on quality of life.
The ENRICH study was approved by a UK Research Ethics Committee (reference: 24/LO/0341). Consent procedures include a waiver of consent to the intervention itself due ENRICH’s service-level design and written informed consent/consultee advice for participants providing research data. Results will be disseminated through peer-reviewed publications, conferences and lay summaries for study participants and healthcare professionals. Results will inform whether ENRICH is acceptable to delivering clinicians and receiving patients who had a stroke and carers, and provide key insights to inform a future randomised trial to determine effectiveness.
Falls among community-dwelling older adults are prevalent and have serious individual, societal and economic consequences. Allied health professionals provide key falls prevention interventions yet their representation in current clinical practice guidelines is inconsistent. Increased recognition of allied health roles and delivering context-specific guidelines for falls care could help to address workforce gaps and optimise care approaches. This scoping review explored the roles of the allied health professions in falls prevention screening, assessment and intervention for community-dwelling older adults.
Scoping review, using the Joanna Briggs Institute methodology for scoping reviews.
PubMed, CINAHL, Scopus, Cochrane, Web of Science and Allied and Complementary Medicine Database databases. The initial search was completed in November 2023, with a secondary search performed in July 2025.
Sources were eligible if they identified or described a specific role of at least one allied health professional in falls prevention care for older adults. No restrictions were placed on publication type or date. Study protocols and conference abstracts were excluded, and only English-language sources were included.
ChatGPT-4o was used for initial data extraction. Authors then cross-checked and updated inaccuracies as required. A numerical descriptive analysis, and a qualitative content analysis were performed to answer the research questions.
The search identified 442 relevant sources from 34 countries. The roles of 17 allied health professions in falls prevention for community-dwelling older adults were discussed. Screening, assessment and intervention roles were identified spanning medical, physical capacity, environmental, education and behavioural–psychological domains. Profession-specific interventions closely aligned with their primary scope of practice, and notable areas of overlap between professions were highlighted.
This review highlights the diverse and overlapping contributions of allied health professionals to falls prevention in community-dwelling older adults. Varying levels of evidence are available across the professions and evidence gaps were highlighted for smaller allied health professions, indicating a need for foundational research to substantiate their roles and facilitate their inclusion in future practice guidelines.
Research and mental health services agree that more youth co-production in service design and delivery is needed, but there is little consensus on how to do it well. This study is trying to find agreement about the best ways to do this.
A realist eDelphi study will be conducted. People with experience of co-production and engagement in youth mental health services will be invited to participate. This will include young people with relevant lived experience, family members/carers of young people with mental ill health, youth mental health researchers and other professionals with experience of youth engagement work (eg, mental healthcare staff, mental health service managers and participation/engagement professionals in the sector). The target is to recruit 10–20 participants from each of these four groups (40–80 participants total).
The following steps will be taken: (1) an advisory group of young people will use results from a realist literature review completed prior to this study, to generate the first list of items for the survey; (2) using the online survey tool Qualtrics, participants will be invited to rate these items in an online survey. A prompt question formatted using a realist framework will allow participants to comment on their rating and how this survey item works (or does not work) in this context, for young people or other stakeholders. Participants will be able to add further suggestions at this stage; (3) using Qualtrics, a second survey round will be completed which will include the new suggestions from participants, and original items with their average participant ratings and comments displayed. Participants will be asked to rerate items in this round; (4) a list of items will be generated that comprises survey items believed to be ‘essential’ or ‘important’ by 80% or more of the participants; (5) this list will be discussed with the Youth Advisory Group to generate a final recommendations document and consider creative outputs and dissemination methods. Data analysis will include raw numbers, means and frequencies.
Ethical approval has been granted by the University of Birmingham Research Ethics Committee (Ref: ERN_1550-Apr2024). Both traditional and non-traditional outputs will be created (eg, conference presentations, publications, a plain English summary and social media infographics).
This study aimed to evaluate the impact of a social prescribing intervention (the Central Locality Integrated Care Service (CLICS)) on unplanned hospital usage in the city of Bradford.
A quasi-experimental study applying a dynamic staggered difference-in-differences (DID) analysis on a propensity matched cohort between 2019 and 2023, using data from the Connected Bradford dataset, a pseudonymised linked health dataset on the whole Bradford population.
CLICS was delivered within general practices in deprived and ethnically diverse inner-city areas of Bradford, Yorkshire, UK.
In total, 1304 CLICS patients were matched to 5216 control patients on key characteristics including ethnicity, deprivation, age, gender and health conditions.
A proactive social prescribing intervention that integrates clinical and non-clinical services, including an individualised approach to tailor support based on the patient’s needs, both within primary care services and by linking them to appropriate community-based assets/services.
The primary outcome was the rate of unplanned hospital admissions and the secondary outcome was unplanned accident and emergency (A&E) attendances.
CLICS patients were 2.1% (95% CI –3.8% to –0.4%, p=0.013) less likely to have an unplanned hospital admission and 2.4% (95% CI –4.6% to –0.2%, p=0.03) less likely to have an unplanned A&E attendance compared with the matched control. The DID analysis demonstrated a gradual increase in the association over time. Subanalyses revealed heterogeneity by ethnicity, the reduction in unplanned hospital admissions was observed only in patients of the Pakistani group, whereas the reduction in A&E attendances was statistically significant only in the white British group.
The CLICS intervention was associated with a reduction in unplanned hospital usage. Social prescribing may be a valuable component of strategies to reduce health inequalities in unplanned hospital usage.
To explore mental health help-seeking behaviours among East Asian American dementia caregivers and construct a theory grounded in their behaviour patterns.
Qualitative using constructivist grounded theory design.
We recruited 20 East Asian American dementia caregivers between August 2023 and March 2024 using purposive sampling. We conducted one-on-one interviews and analysed the data using constructivist grounded theory coding.
We constructed a theory including six concepts and 22 categories. While ‘providing care’, caregivers manage caregiving tasks and personal life, experiencing caregiving challenges. ‘Individual capacity’ is a key to perceiving caregiving situations and ‘considering seeking support’. Various factors can affect ‘using support’. Different types of support can be used separately or in combination. When receiving adequate support, caregivers can ‘gain benefits from support’. These benefits, alongside individual capacities, can shape caregivers' ‘outlook on the present and the future’.
This study explains the mental health help-seeking process within East Asian culture, broadening perspectives on diverse populations and highlighting insights into culturally tailored services.
This study offers clinicians and communities insights into the mental health help-seeking process among East Asian American dementia caregivers and highlights strategies to encourage their use of mental health services.
This theory incorporates aspects of East Asian culture, addressing a research gap in studies of Asian Americans. It may enhance understanding of culturally tailored approaches and facilitate future funding for research and services, considering cultural diversity.
The Standards for Reporting Qualitative Research.
No Patient or Public Contribution.
To explore the feasibility and acceptability of acoustic monitoring and real-time recommendations for stress detection and management (i.e., smarthealth intervention).
This qualitative study used a framework of acceptability for healthcare interventions.
From January 2021 to December 2023 in the U.S.A., we interviewed 10 family caregivers who had completed the 4-month smarthealth intervention. The caregivers shared their user experiences and feedback on the system's feasibility and acceptability. Data were analysed using abductive thematic analysis, incorporating the framework of acceptability for healthcare interventions and the collected data.
Seven themes and 19 categories emerged: attitudes, burden, ethicality, intervention adherence, intervention coherence, perceived effectiveness and suggestions. Feedback on the smarthealth intervention was mixed. Some found it beneficial, citing accuracy, ease of use and increased awareness. However, others felt burdened during its use, primarily due to time constraints.
The smarthealth intervention can potentially improve caregivers' awareness of themselves and caregiving situations.
Future directions should involve adapting the smarthealth intervention to consider diverse caregiving scenarios and incorporating a larger sample of caregivers.
This is the first study to offer a voice detection system and real-time stress management recommendations to caregivers of people living with dementia. An individualised approach should be considered to improve the system's effectiveness. This includes providing personalised intervention components, considering caregivers' time and establishing a user-friendly system with high accessibility. The findings can be a cornerstone for smarthealth interventions influencing dementia caregivers' self-care and emotional regulation.
Standards for Reporting Qualitative Research.
Members of the public and service users from a memory clinic and social media platforms contributed to the study by reviewing recruitment materials.
Trial Registration: This trial's study protocol was registered with ClinicalTrials.gov (ID No. NCT04536701) on 3 September 2020 (https://classic.clinicaltrials.gov/ct2/show/NCT04536701)
Compression therapy is the cornerstone, first-line effective evidence-based treatment for healing and managing venous leg ulcers. However, compression therapy is inconsistently applied in hospitals. This paper explores the experiences of a diverse group of clinicians and senior managers applying compression therapy in hospitals across the United Kingdom. A semi-structured qualitative interview study was conducted with 19 participants, drawn from a larger study, who confirmed that their respective hospitals apply compression therapy to inpatients with venous leg ulcers. The interviews were analysed using reflexive thematic analysis. Analysis generated four key themes: Patients ‘slip through the net’, Prioritisation in Hospital Care, A ‘blind Spot’ within Healthcare System and Motivation to Deliver Care. Patients ‘slip through the net’ refers to inpatients with venous leg ulcers face unequal access to compression therapy both within and between hospitals. Prioritisation in Hospital Care indicates how certain diseases are given greater emphasis within healthcare systems. A ‘blind Spot’ in Healthcare System described failing to implement compression therapy has created a critical underlying ‘blind spot’ within the NHS healthcare systems. Motivation to Deliver Care refers to a deep commitment to providing compression therapy, driven by clinicians' inherent dedication and ethical obligation towards improving patient quality of care. The study identified key challenges influencing the application of compression therapy in acute hospitals despite its routine use. These include the lottery of care, systemic inequities, unclear ownership, interprofessional disputes and organisational priorities. It also demonstrated the significant role of passion, motivation and moral responsibility encouraging clinicians to implement compression therapy despite these systemic barriers.
by Elizabeth Baguley, Madelyn Knaub, Jessica VanDyke, Gideon Hirschfield, Mark G. Swain, Gail Wright, Deirdre McCaughey, Abdel Aziz Shaheen
Pandemic restrictions impacted healthcare, particularly during the first year. We evaluated the impact of the pandemic on quality of life and clinical care among patients with primary biliary cholangitis (PBC). This mixed-methods study administered quality of life surveys (Fear of COVID-19 Scale [FCV-19S], EuroQol 5-dimension 3-level [EQ-5D-3L], 29-item Patient-Reported Outcomes Measurement Instrument Survey [PROMIS-29]) and a PBC Care Delivery questionnaire to 348 Canadian PBC patients, followed by two focus groups with patients (n = 14) and stakeholders (n = 3). Quality of life scores were compared among sub-groups (i.e., care delays and pandemic appointment type) and with various reference populations. Most participants were female (94.0%) and Caucasian (88.2%), with a median age of 63.0 years (IQR: 55.9–71.2). During the pandemic, 75.8% had the majority (≥ 50%) of their hepatologist appointments virtually, but only 22.4% preferred to continue with virtual care post-pandemic. Participants with care delays had worse scores on the FCV-19S (p = 0.014), EQ-5D-3L (p = 0.009), and PROMIS-29 (i.e., fatigue, anxiety, sleep disturbance, ability to participate in social roles and activities, p pTo report how person-centred care principles are applied to care planning and to explore the contextual factors affecting their implementation in older adult care homes in England.
A combined framework analysis and quantitative content analysis study.
Using a semi-structured questionnaire, we interviewed 22 care home managers in England, exploring topics around care planning processes. Audio recordings were transcribed verbatim. Transcripts were analysed through a combined framework approach and content analysis.
Most care home managers discussed person-centred care planning in terms of understanding residents' values and preferences and their engagement in decision-making. Factors facilitating person-centred planning implementation included accessible planning tools, supportive care home leadership, effective communication and collaborative partnerships. Inhibiting factors included regulatory and care practice misalignment, time constraints and adverse staffing conditions.
Differences between care home practitioners' understanding and practice of person-centred care planning require further examination to improve understanding of the sector's complexity and to develop suitable care planning instruments.
Findings demonstrate a need for improved staff access to specialised person-centred care training and an opportunity for care home nursing practitioners to lead the co-development of digital person-centred care planning tools that reflect the reality of long-term care settings.
Identifying factors influencing the implementation of holistic approaches to care planning makes clear the need for modernising long-term care policy and practice to adapt to the contemporary challenges of the care home sector.
Study reporting was guided by the Standards for Reporting Qualitative Research.
Two public involvement advisors with lived experience of caring for a relative living in a care home contributed to the development of the interview guide, advised on care home engagement, guided the interpretation of the findings and commented on the drafted manuscript.
To identify whether nurse practitioners (NPs) in New Zealand (NZ) have the organisational opportunities to make decisions related to performing their role.
A cross-sectional study of self-reported decision-making, social support, psychosocial demands and identification with role in a representative population of NPs employed in a range of practice settings in NZ.
This study utilised the internationally validated Job Content Questionnaire. Reliability and construct validity were assessed using co-efficient α and confirmatory factor analysis. Linear regression analyses were conducted to understand the strength and direction of the relationships between the constructs.
All scales demonstrated acceptable levels of internal reliability. Factor analysis supported a five-factor model, with decision latitude, psychological job demands, co-worker support, supervisor support and job insecurity as the main factors fitting the theoretical model. Regression models suggested that NPs (n = 169) have more control over their decision-making when supported by their colleagues rather than supervisors. NPs perceive improved relationships with healthcare consumers if they feel an increase in support from their colleagues; this relationship is mediated by the freedom to make decisions. NPs in rural settings had more job security when they felt valued and appreciated at work.
The presence of collegial support significantly influences the freedom and autonomy of NPs in making decisions. Workforce policy, the organisation of practice and vocational training may be effective ways of helping NPs expand access to healthcare services.
Collegial and supervisory support are critical for NPs to work to their full scope. A funded, first-year-in-practice vocational training program designed to support role transition, foster collegial support and build a community of practice for newly qualified NPs.
For the first time, nurse practitioner decision-making and autonomy determinants have been described in NZ. These findings should be considered within the context of international evidence and in global nursing workforce policies that seek to create opportunities for NPs to work to the limit of their scope.
The authors have adhered to relevant EQUATOR guidelines—STROBE checklist.
No patient or public contribution.
The Nurse Practitioner Onsite Peer Review is an integral part of the British Columbia College of Nurses and Midwives Quality Assurance program. Traditionally an in-person assessment, Nurse Practitioner Onsite Peer Review involves a critical review of documentation by an experienced nurse practitioner assessor against regulatory standards and entry-level competencies. The onset of the COVID-19 pandemic and resulting environmental limitations required the college to rethink its approach to onsite reviews, resulting in the quality assurance program embarking on a pilot project to explore the feasibility of conducting reviews virtually. As there are many factors that can affect the transition of an onsite assessment to one that is virtual, it was important to consider the technical, workflow, and usability aspects in developing this new method of performance assessment. Therefore, including usability testing and a human factors approach to exploring this emerging method was vital to ensuring its success. In this article, we discuss our experience, including benefits, technical and administrative considerations, barriers, challenges, and lessons learned. Background
The prevalence of hypertension is 55% among African American/Black women, who have a higher risk for poor health outcomes compared to women from other racial and ethnic groups, in part because of uncontrolled blood pressure. Previous research results suggest that peers may positively influence self-management of chronic conditions like hypertension. However, few studies have described the personal characteristics of peers in the health social networks of Black women.
Objective
This substudy aimed to examine health social networks and describe the peers’ characteristics, as reported by a convenience sample of Black women with hypertension.
Methods
In this analysis of data from a larger study, 94 Black women with hypertension attending a church conference participated in a cross-sectional, descriptive study. Their mean age was 59 years, and their mean systolic blood pressure was 143 mm Hg. All participants completed a survey to gather data about (a) the characteristics of individuals they discussed health matters with (their peers or health social network) and (b) their perceptions about hypertension status and knowledge of hypertension among the peers in their health social network.
Results
Collectively, participants from the larger study named a total of 658 peers who were part of their health social networks; the mean health social network size was six peers. The peers were mostly women, Black, family members, and, on average, 54 years old. The participants discussed hypertension with 71% of the peers, reported that 36% had hypertension, and felt that 67% were somewhat or very knowledgeable about the condition. A small, positive correlation existed between the participants’ health social network size (number of peers named) and their systolic blood pressure levels.
Discussion
The health social network peers were similar to those in the larger study, with most of the same gender, race, and age. The findings of this analysis may be used to help practitioners and scientists guide patients in building health social networks for support in self-managing hypertension and conducting future studies to examine the best strategies for developing and using health social networks to improve health outcomes and reduce health disparities. 
FreshRSS 