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The aim of this scoping review was to identify hard-to-reach and hidden groups in health-related research and to understand the recruitment methods used with these groups.
The presented scoping review has an exploratory perspectiveand was conducted in accordance with Arksey and O'Malley's framework and the PRISMA-ScR guidelines.
A comprehensive search of CINAHL and MEDLINE databases was performed for studies published up to November 2022. The searches were updated in December 2024.
Relevant papers were identified via specific search terms and inclusion and exclusion criteria. Two authors independently assessed eligible literature and extracted relevant data, which was analysed and synthesised to answer the research questions. The analysis method used was descriptive analysis with quantification.
Overall, 1024 studies were screened. The included studies were published between 2001 and 2022. A total of 41 studies were included in the review. In this data, groups were defined mostly as hard-to-reach and hidden. The groups were divided into eight categories: LGBTQ+ community, intoxicant users, sex workers and their clients, marginalised groups, mental health care seekers and users, impaired persons, people living outside their original home country and victims of abuse or neglect. Recruitment methods were varied, with snowball sampling, respondent-based sampling and websites being the most used.
This review provides insight into the current knowledge on hard-to-reach and hidden study groups. In studies targeting hard-to-reach and hidden groups, the use of concepts is variable and inconsistent.
In clinical nursing practice, it is important to identify hidden and hard-to-reach groups, as the goal of equality is to improve the health and well-being of all individuals, including marginalised groups.
Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis ex-tension for Scoping Reviews (PRISMA-ScR).
No patient or public contribution.
To examine the impact of climate anxiety on the quality of life (QoL) of patients with COPD. It also explores how climate anxiety interacts with clinical factors, such as disease severity and comorbidities, to influence QoL.
Cross-sectional.
A total of 270 COPD patients were recruited using a convenience sampling method. Data were collected through structured interviews and clinical assessments, incorporating the Climate Anxiety Scale, the St. George's Respiratory Questionnaire and the BODE Index. Hierarchical multiple regression analysis was performed to determine the predictors of QoL.
The study found a statistically significant association between climate anxiety and both QoL (r = 0.81, p < 0.01) and COPD severity (r = 0.76, p < 0.01). COPD severity (B = 4.68, p < 0.01) and climate anxiety (B = 0.28, p < 0.01) were predictors of QoL. Among the covariates, former smokers, older patients and multiple comorbidities reported significantly worse QoL (B = 4.80, p = 0.03; B = 0.43, p < 0.01; B = 0.85, p = 0.02, respectively). Collectively all predictors explained 86% of the variance in QoL.
Climate anxiety significantly contributes to reduced QoL in COPD patients, beyond disease severity and demographic factors. Addressing psychological distress in COPD management is essential to improving patient outcomes.
Nurses should recognise climate anxiety as a key variable influencing COPD management. Incorporating climate anxiety screening into nursing assessments and providing targeted interventions can enhance patient support and improve overall COPD care.
Climate anxiety is an emerging concern in COPD. While previous research has focused on physical and clinical determinants of COPD-related QoL, climate anxiety remains underexplored. This study provides new evidence that climate anxiety is a predictor of poorer QoL, highlighting the need for holistic nursing interventions that address both physical and psychological health.
This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).
Patients with COPD were involved in this study.
Caregivers make an essential contribution to the self-care of patients with multiple chronic conditions (MCCs), but no studies have described caregiver contribution (CC) and caregiver self-efficacy in contributing to patient self-care in low-/middle-income countries (LMICs). This study aimed to describe the CC to patient self-care and caregiver self-efficacy of patients affected by MCCs living in a low-middle-income country such as Albania.
A Multicenter cross-sectional study design was used.
A sample of 376 Albanian caregivers was enrolled if identified by the patient with MCCs as the primary unpaid informal caregiver in outpatient settings in Albania. The Caregiver Contribution to Self-Care of Chronic Illness Inventory (CC-SCCII) and the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale (CSE-CSC) were used to measure the CC to patient self-care maintenance, monitoring, and management and the caregiver's confidence in their ability to contribute to patient self-care, respectively.
Participants' mean age was 48.10 (15.14) years. Most of the caregivers were women (67.9%), adult children (53.2%) or spouses (46.8%) of the patient. Regarding the CC to self-care maintenance, inadequate behaviors were observed in caregiver recommendations for physical activity (41%) and stress management (33%). In the CC to patient self-care monitoring, inadequate behaviors in recognition of symptoms were reported (20%) by caregivers. In the CC to patient self-care management, inadequate behaviors were found in caregiver ability to recognize reflecting on the effectiveness of the remedy used to manage signs and symptoms of the patient's illness (60%) and in alerting the healthcare provider (25%). Caregiver self-efficacy was lower in the ability to persist in finding a remedy for symptoms of the person for whom they care (27%) and to evaluate the effectiveness of a remedy they used (27%).
We found, on average, adequate CC to patient self-care maintenance, monitoring, management behaviors, and caregiver self-efficacy in contributing to patient self-care of MCCs, but specific CC behaviors were found to be insufficient.
This study described CC and caregiver self-efficacy in contributing to patient self-care in a low-middle-income country. This knowledge will enable healthcare professionals to identify inadequate caregiver contributions to self-care and strengthen them through targeted educational interventions, thus optimizing the scarce resources available in these contexts.
To discuss inter-organisational collaboration in the context of the successful COVID-19 vaccination programme in North Central London (NCL).
An action research study in 2023–2024.
Six action research cycles used mixed qualitative methods.
Four findings are presented which illustrate inter-organisational collaboration across professional and organisational boundaries: working in the action research group, learning to work as an action research group, working collaboratively in new ways, working outside professional, occupational and organisational silos. These themes are discussed in relation to the literature on interprofessional and inter-organisational collaboration.
The COVID-19 vaccination programme offered a way out of the pandemic. Between December 2020 and February 2022, 2.8 M people were vaccinated by the NCL Vaccination team in an example of inter-organisational collaboration between science, health and community. Staff on the vaccination programme worked inter-organisationally in new ways to achieve this. In NCL several thousand local residents joined the NHS to work with healthcare professionals including nurses, nursing associates and students to deliver the programme in new ways which are illustrative of inter-organisational collaboration.
No PPI within this study.
The implications for the profession and for healthcare organisations of the findings are that, in contrast to traditional ways of working which have been entrenched in silos of professional knowledge and expertise, health professionals are able to work in new ways and find inter-organisational work satisfying. This has implications for patients as it has the potential to improve communication between very different organisations and as the vaccination programme shows, results in successful public health vaccination rates.
This study set out to create a public resource for learning (for future pandemics or other works of national effort) to commemorate the collaborative efforts of the diverse vaccination workforce and volunteers involved in the programme. Participation in the COVID-19 vaccination programme had a profound effect on NHS clinical and professional staff, on partners across business and volunteer organisation in North Central London and on volunteers from the public in North Central London. Inter-organisation collaboration has been sustained after the delivery of the vaccination programme in North Central London; innovative ways of working have been introduced in the local community to deliver ongoing vaccinations and wider prevention activities and the partnership between academia and clinical practice. The research findings have had an impact on the research participants and the wider public through the website created as a public resource to commemorate the COVID-19 vaccination programme in North Central London.
The consolidated criteria for reporting qualitative studies (COREQ) was used as a guide throughout data collection and analysis.
The public were involved as participants in this study. They did not participate in the study design.
Building nursing process competency among beginner nurses is a pivotal need in contemporary, complex, fast-paced nursing practice. However, transitioning from the educational phase to practicing as a nurse can be a significant adjustment. New practitioners often experience a period of shock, which may present challenges in developing nurse competency. Fostering system thinking among those nurses could buffer the negative signs of transition shock and cultivate nursing process competencies at earlier times.
This study explores the relationship between transition shock and nursing process competency among early career nurses and investigates the moderating effect of system thinking on this relationship.
This cross-sectional correlational exploratory study was conducted at four large hospitals in Egypt. Data were collected from 393 nurses from the first of February 2024 to the end of April 2024 using the transition shock scale, the competency of nursing process questionnaire, and the system thinking scale. Correlational and hierarchical regression analyses were used to test the study variables.
A statistically significant negative correlation exists between transition shock, nursing process competency, and system thinking among early-career nurses. System thinking is positively associated with nursing process competency. System thinking positively moderates the relationship between transition shock and nursing process competency among early-career nurses. Transition shock and system thinking account for 23.9% of the variance in nursing process competency among early-career nurses.
Transition shock is an inevitable phenomenon among early-career nurses, negatively affecting their competency in the nursing process. System thinking buffers this adverse effect and significantly augments nursing process competency among this set of nurses. Predicting and mitigating transition shock among early-career nurses is pivotal in building nursing process competency. Nurse educators must develop curricula that cultivate system thinking skills among nursing students, which enables them to buffer transition shock after graduation.
The utility and uptake of pain management interventions across intensive care settings is inconsistent. A rapid realist review was conducted to synthesise the evidence for the purpose of theory building and refinement.
A five-step iterative process was employed to develop project scope/ research questions, collate evidence, appraise literature, synthesise evidence and interpret information from data sources.
Realist synthesis method was employed to systematically review literature for developing a programme theory.
Initial searches were undertaken in three electronic databases: MEDLINE, CINHAL and OVID. The review was supplemented with key articles from bibliographic search of identified articles. The first 200 hits from Google Scholar were screened.
Three action-oriented themes emerged as integral to successful implementation of pain management interventions. These included health facility actions, unit/team leader actions and individual nurses' actions.
Pain assessment interventions are influenced by a constellation of factors which trigger mechanisms yielding effective implementation outcomes.
The results have implications on policy makers, health organisations, nursing teams and nurses concerned with optimising the successful implementation of pain management interventions.
The review enabled formation of a programme theory concerned with explaining how to effectively implement pain management interventions in intensive care.
This review was informed by RAMESES publication standards for realist synthesis.
No patient or public contribution.
The study protocol was registered in Open Science Framework.
Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.
This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years).
Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.
Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake.
CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities.
At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.
Existing literature suggests that transgender women (TW) may be at high risk for adverse mental health due to stress attributed to combined experiences of stigma and complex social and structural vulnerabilities. Little research has examined how these co-occurring experiences relate to mental health. We aimed to test a theoretically driven conceptual model of relationships between stigma, social and structural vulnerabilities, and mental health to inform future intervention tailoring.
Partial least square path modeling followed by response-based unit segmentation was used to identify homogenous clusters in a diverse community sample of United States (US)-based TW (N = 1418; 46.2% White non-Hispanic). This approach examined associations between latent constructs of stigma (polyvictimization and discrimination), social and structural vulnerabilities (housing and food insecurity, unemployment, sex work, social support, and substance use), and mental health (post-traumatic stress and psychological distress).
The final conceptual model defined the structural relationship between the variables of interest within stigma, vulnerability, and mental health. Six clusters were identified within this structural framework which suggests that racism, ethnicism, and geography may be related to mental health inequities among TW.
Our findings around the impact of racism, ethnicism, and geography reflect the existing literature, which unfortunately shows us that little change has occurred in the last decade for TW of color in the Southern US; however, the strength of our evidence (related to sampling structure and sample size) and type of analyses (accounting for co-occurring predictors of health, i.e., stigma and complex vulnerabilities, reflecting that of real-world patients) is a novel and necessary addition to the literature. Findings suggest that health interventions designed to offset the negative effects of stigma must include anti-racist approaches with components to reduce or eliminate barriers to resources that contribute to social and structural vulnerabilities among TW. Herein we provide detailed recommendations to guide primary, secondary, and tertiary prevention efforts.
This study demonstrated the importance of considering stigma and complex social and structural vulnerabilities during clinical care and design of mental health interventions for transgender women who are experiencing post-traumatic stress disorder and psychological distress. Specifically, interventions should take an anti-racist approach and would benefit from incorporating social support-building activities.
FreshRSS 