Conectar
To generate an in-depth understanding of the perceptions and experiences of individuals with youth-onset type 2 diabetes (T2D) to inform knowledge translation initiatives and clinical care.
Interpretive descriptive qualitative study.
Individuals were eligible to participate if they received a T2D diagnosis on or before 18 years of age, resided in Manitoba, and were between 10 and 25 years of age at the time of data collection. Twenty-two individuals (13 females, 7 males, 2 prefer not to indicate gender; mean age = 19.3 years) participated in 22 semi-structured interviews (mean length: 29:01 min) remotely using Zoom video conferencing software or by telephone. Data were analysed using inductive thematic analysis.
Four themes were generated: (1) Low public knowledge, misconceptions, and stigma impact youth experiences including those of diagnosis, disclosure, treatment, and supports; (2) shared familial experiences impacts perception of the future; (3) mental and emotional wellness is critically important but requires more attention; and (4) T2D carries unanticipated positive and negative impacts for youth.
Findings illustrate the complex interrelationships between public and personal conceptions of T2D, stigma, and T2D navigation, emphasising the centrality of emotional and mental well-being to participants' T2D experiences and management. This representation of experiences and perceptions of youth onset T2D offers direction for holistic and youth-centred research and care and highlights areas where further mental health and educational resources would be beneficial.
The knowledge translation resource being developed from this study involves input from patient and public partners.
To better develop and understand the practice of rooming-in in adult care, this study aims to explore the perceptions of the three most important stakeholders: nurses, patients, and family members.
A cross sectional survey study in a university medical centre in the Netherlands.
A convenience sample was drawn from nurses, adult patients, and family members across ten general wards. Data of patients and family members were collected through online questionnaires, developed and validated prior to the study. Their responses were summarised using descriptive statistics. For the nurses, data were obtained by analysing responses to an open-ended question from an existing questionnaire, using thematic analysis.
The sample consisted of 364 nurses, 26 patients, and 35 family members. Thematic analysis of the nursing data revealed four themes: (1) reducing the workload of nurses, (2) optimising patient recovery, (3) unclear policy and inadequate facilities, and (4) complexities for nurses. Regarding the perceptions of patients and family members, more than 75% perceived that rooming-in enhanced patients' sense of safety. Additionally, 54.1% of family members indicated that rooming-in improved their understanding of medical information. For most patients (57.7%) and family members (62.9%), the rules and conditions for rooming-in were not clear. Moreover, 65.7% of family members reported experiencing physical burden. Both patients and family members rated rooming-in with a median of 8 out of 10.
According to nurses, patients, and family members, rooming-in may be beneficial in reducing nurses' workload, enhancing patient safety, and improving family understanding of medical information.
Given the ambiguity surrounding rooming-in policies in adult care, clear guidelines and their implementation are essential for ensuring their success.
Rooming-in can positively contribute to adult care by facilitating family involvement.
STROBE statement.
No patient or public contribution.
Although the positive correlation between self-efficacy and quality of life and the negative correlation between symptom occurrence and self-efficacy are well established in the cancer literature, the underlying mechanism, whether self-efficacy mediates the effect of symptoms on quality of life, remains unclear due to the cross-sectional design of prior studies. Longitudinal investigation is crucial for establishing the causal mechanism of self-efficacy in mitigating the adverse impact of cancer-related symptoms on quality of life.
To examine the longitudinal mediating effect of self-efficacy on the relationship between symptom occurrence and quality of life among 534 cancer patients on treatment with moderate to high symptoms.
This is a secondary data analysis of the longitudinal mediating effect. A sample of patients with moderate to high symptoms on cancer treatments (N = 534) from a randomised controlled trial was used. We adopted a cross-lagged panel model (CLPM) approach to test the longitudinal mediating effect with three waves. The longitudinal invariance of the measurement was previously tested.
The results showed that cancer-coping self-efficacy predicted the following assessment of symptom occurrence, but not vice versa. Also, cancer-coping self-efficacy had an immediate direct impact on quality of life and the influence sustained to the following assessment. Our mediating analysis showed that cancer-coping self-efficacy totally mediated the relationship between symptom occurrence and quality of life (unstandardized β = −0.008, standardised B = −0.036, p = 0.036, CI95 = [−0.001, −0.016]).
Our findings provide initial evidence supporting the causal mechanism of cancer-coping self-efficacy in interventions that aim for symptom management and quality of life improvement.
This study is the first to test the longitudinal mediating mechanism of cancer-coping self-efficacy in the relationship between symptom occurrence and quality of life among the cancer population. Further testing using a randomised controlled trial of a specifically designed self-efficacy-enhancing intervention is needed.
No patient or public contribution.
To identify implementation strategies that effectively facilitate the adoption of social needs care coordination activities using enabling technologies among care management teams serving patients in community-based health centres.
Modified Delphi process.
Discrete, feasible implementation strategies were identified through literature review and semi-structured interviews with care management staff and subject matter experts in clinical informatics, workflow redesign, and product engineering. A modified Delphi was conducted with eight subject matter experts and nine health centre care management staff. Iterative rounds of online surveys were used to achieve consensus on the most relevant implementation strategies and their delivery methods.
The modified Delphi process achieved consensus on nine discrete implementation strategies needed to advance care management teams' ability to screen, refer and track social needs. Prioritised strategies included developing champions, enhancing quality improvement capacity, training staff on using enabling technologies and providing tailored technical assistance for workflow refinement. Consensus was also reached on a monthly cadence for most of the implementation strategies.
Consensus was reached on strategies to enhance care management teams' implementation of social needs screening, referrals and tracking using enabling technologies. These strategies will comprise an intervention to be pilot tested, refined and assessed in a cluster randomised clinical trial.
Findings from this study will inform the development of strategies to further the adoption of enabling technologies to support social needs care coordination.
This work is key to the design of a type 2 hybrid implementation-effectiveness trial that will assess whether user-informed, evidence-based implementation strategies can improve care management teams' adoption of enabling technologies to facilitate social needs care coordination for patients.
The research team includes a patient advisor with community-based nursing expertise and a nurse practitioner-clinical informaticist leader who was involved in data collection and interpretation of findings.
Trial registration: Clinicaltrials.gov registration # NCT06489002. Registered July 5, 2024, https://clinicaltrials.gov/study/NCT06489002?term=NCT06489002&rank=1.
To explore how nursing teams (co)organise their work environment by going beyond caregiving.
A descriptive qualitative study with a phenomenological approach.
Semi-structured group interviews were conducted in 2022 with nurses and managers from 18 nursing teams in a general hospital located in the Netherlands. In each group interview, 2–3 participants per team took part. The interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis.
The analysis identified four main themes contributing to a more supportive work environment: (1) embracing diversity, (2) stretching nursing roles, (3) raising voices, and (4) aligning nurses and managers. These themes show how nursing teams go beyond caregiving and actively shape and co–organise their work environment.
Teams that extend their roles create more supportive work environments, enhancing patient care and professional development. These findings contribute to the understanding of organising professionalism in nursing and provide insights for nursing teams striving to improve their work environments.
Nursing teams can use the four themes—as team features—to reflect upon their organising roles and engagement with their work environment. Our findings offer practical insights for nurses with responsibilities in areas such as team development and leadership. They can focus on team diversity, voicing, stretching roles, and organisational alignment, and facilitate their teams to become more assertive.
The Consolidated criteria for Reporting Qualitative research guideline was followed.
No patient or public involvement.
To synthesise the evidence on implementation strategies used to implement transitional care interventions for adult surgical patients.
Scoping review.
Medline, CINAHL and EMBASE were searched in August 2023 and updated June 2025, followed by citation searches. Studies were screened independently by two researchers, and one extracted data, another verified its accuracy. Studies about transitional care interventions for adult surgical patients were coded according to the ‘Five classes of implementation strategies’ and the ‘Patterns, Advances, Gaps, Evidence for practice and Research recommendations’ framework, to illuminate the review findings.
Based on 27 studies included in the scoping review, staff education, changes to staffing and electronic systems, and change management techniques were frequently used implementation strategies. Implementation strategies were mostly used with patients undergoing colorectal and cardiac surgery in Asia and the United States. Scale-up strategies and capacity-building initiatives for people in charge of spearheading the change initiatives were less common.
To further the field, future research could focus on capacity-building and scale-up strategies, fidelity reporting, and financial implications of implementation in a wider range of surgical populations and settings. Work is needed to effectively implement surgical transitional care interventions in real-world settings.
Our findings provide strategies for hospital leaders to adopt when implementing transitional care interventions for surgical patients.
Scoping Reviews (PRISMA-ScR) checklist.
Determined review focus, interpreted findings, and contributed to manuscript.
The Open Science Framework.
To review the evidence on the experiences and perceptions of culturally and linguistically diverse informal carers supporting older adults during transitions from hospital to home, including their interactions with transitional care interventions.
Scoping review guided by Arksey and O'Malley's framework.
We searched CINAHL, MEDLINE, Embase, Emcare, AMED, PsycINFO, Global Health, Social Work Abstracts, JBI EBP, Scopus, Web of Science Core Collection, ProQuest and Informit for studies published between January 2010 and November 2024.
Two reviewers independently screened studies and extracted data. Analysis followed the Patterns, Advances, Gaps, Evidence for Practice and Research recommendations framework.
Seventeen studies involving 1275 carers were included. Carer experiences were summarised into four themes: (1) cultural and communication barriers; (2) role ambiguity and practical challenges; (3) limited involvement in discharge planning and (4) barriers to accessing support and services. Perceptions of transitional care interventions were mixed. While some interventions improved carer preparedness and reduced stress, most lacked cultural tailoring and did not address carers' psychosocial and communication needs.
Culturally and linguistically diverse informal carers face challenges navigating transitional care. While involving them in care planning improves outcomes, implementation remains inconsistent. Emotional support and culturally tailored services are insufficient.
There is a need for culturally and linguistically tailored transitional care programmes that prioritise carer education and communication support. Key areas for improvement include: (1) health literacy and system navigation; (2) involvement in care planning; (3) communication with providers; (4) psychosocial and emotional support and (5) culturally appropriate services. Future research should explore the unique emotional and psychosocial needs of these carers to inform targeted support strategies.
This review follows the PRISMA guideline for reporting.
No patient or public contribution.
This study sought to understand the experience of women veterans transitioning from military to civilian life.
A community-based research design and Ricoeur's hermeneutic phenomenology guided the philosophical framework.
Seventeen women veterans were recruited from a non-profit organisation. Data was collected in six virtual focus groups using Zoom in the fall of 2022 using dialogical engagement. Analysis of the data was done using hermeneutic phenomenology. Five participants in the research validated the data and recommended changes to their peer-to-peer support group.
The veterans described their environment as service to confusion and from pride to embodied shame. The phenomenology of this experience was screaming in silence, harsh reality, creating a village, and taking the high road. Lists of deployment and military sexual trauma triggers were created.
There are many obstacles for women transitioning from military to civilian life. Some veterans suffer more than others. For those who are challenged by living in civilian life, this study strongly emphasised that veterans are often their own best source of support. Peer-to-peer support groups for women veterans were highly encouraged as a vital part of their well-being.
The data obtained in this study provided us with rich information for nursing practice, including an understanding of the way of being of women veterans, suicide, military sexual trauma, and homelessness assessment, significant community resources, the significance of having peer-to-peer support groups, and the policies and research needed.
Consolidated criteria for reporting qualitative research.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the direct relationship between financial stress and mental health and wellbeing of nursing students and characterise the effectiveness of available support mechanisms.
Systematic integrative review.
Academic Search Complete, CINAHL, Education Research Complete, MEDLINE, ProQuest Central, PsycNET, Scopus and Web of Science were searched in January and October 2024.
Studies reporting a direct relationship between financial stress and mental health and wellbeing in nursing students were included. Data related to sources of financial stress, mental health impacts, and support mechanisms were extracted, synthesised narratively, and reported thematically.
Findings from nine studies reveal that financial stress significantly affects nursing students' mental health and wellbeing, contributing to emotional distress and reduced quality of life. Financial stress arises from personal, academic and clinical sources, with the intensity varying based on individual demographic profiles and fluctuating throughout their educational journeys. Marginalised and underserved groups experience greater impacts due to pre-existing disadvantages. Current support mechanisms are largely reactive, providing only short-term relief and failing to address root causes. Additionally, students' efforts to alleviate financial stress in one domain often exacerbated it in another.
This review highlights the multifaceted and compounding effects of financial stress on nursing students' mental health and wellbeing. Proactive strategies, including structured employment programs, embedded financial literacy education, and transparent pre-enrolment information offer promising solutions.
While financial stress cannot be fully eradicated, targeted support for at-risk students can mitigate its impacts, improving their mental health and educational outcomes.
This review addresses the critical issue of financial stress among nursing students, highlighting its disproportionate impact on marginalised and underserved groups. It underscores the need for proactive interventions and systemic reform to improve educational experiences globally.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement.
No patient or public contribution.
Trial Registration: PROSPERO: CRD42024514262
To explore reasons why patients with inflammatory bowel disease (IBD) do (not) engage in fatigue-related care and their care needs.
A qualitative interview study, using a phenomenological methodological approach.
We included 16 fatigued patients with IBD in remission. Data were collected between December 2021 and March 2022, using semi-structured interviews. Template analysis was performed.
We identified six themes regarding reasons why (not) to seek care for fatigue: (1) Cognitions about fatigue and coping with fatigue, (2) perceptions of fatigue-related care and previous care experiences, (3) perceived knowledge and behaviour of healthcare professionals, (4) physical and emotional well-being, (5) social relationships and support, and (6) practical factors. Regarding their care needs, patients reported a need for a holistic and person-centred care approach, with healthcare professionals actively addressing fatigue and offering care. They suggested a range of options for what care to offer, including eliminating physical causes of fatigue, discussing medication options, providing information on fatigue management, lifestyle support, psychological support, peer support and practical support.
Both patient- and healthcare-related factors play a role in why IBD patients do (not) seek fatigue-related care. Our findings emphasise the importance of active screening and discussion of fatigue, using a holistic and person-centred approach to treat fatigue.
This study contributes to the understanding of IBD patients' facilitators and barriers for seeking care for fatigue and their care needs. Moreover, results can inform nurses and physicians about ways to optimise the offer and uptake of fatigue-related care, and the development of interventions that fit patients' needs. Results also provide implications for the treatment of fatigue in other chronic (inflammatory) conditions.
The current results can inform nurses and physicians about ways to optimise the offer and uptake of fatigue-related care, and the development of interventions that fit the needs of patients with IBD. An increase in the uptake of effective and acceptable interventions can improve patients' health and well-being.
Findings were reported following the consolidated criteria for reporting qualitative research (COREQ).
No patients, service users or members of the public were involved in this study. The study focused on patients' experiences with fatigue-related care and their needs.
To explore how nurse practitioners experienced and understood development of their capability providing medication for opioid use disorder and safe supply in North American primary care settings.
A phenomenographic approach was applied to the study design, recruitment, and analysis.
Semi-structured interviews were conducted with 21 nurse practitioners via Zoom between July and September 2022 to elicit participant experiences and understanding of capability development when treating opioid use disorder. Participants worked in primary care settings in New England, United States and Ontario, Canada. Data was analysed using a phenomenographic approach.
Five categories of description representing conceptions of capability development in treating opioid use disorder were identified through iterative data analysis. Capability development was experienced as a process of developing foundational practice knowledge; integrating knowledge with existing practices; evolving practice perspectives; adaptation of practice and becoming expert.
Capability attributes included creative thinking, risk taking and adapting existing practice in the service of person-centered care and harm reduction.
Nurse practitioners have potential to increase access to treatment for opioid use disorder and demonstrated ability and willingness to engage in this work.
Nurse practitioners' participation as experts and leaders may be further leveraged in practice and policy development to enhance access to opioid use disorder treatment in primary care settings, including mentoring newer prescribers.
Consolidated Criteria for Reporting Qualitative Studies (COREQ) EQUATOR guideline.
There were no patient or public contributions to this research study.
The aim of this study was to provide insights into how, through exploring goal-setting interventions, a nursing team in geriatric rehabilitation might refine their patient-centred strategies.
The study design was participatory action research (PAR).
Team members and nursing students, under the guidance of a facilitator, performed two PAR cycles. In the first cycle, the action phase consisted of preparing a multidisciplinary team meeting (MTM) with a patient. In the second cycle, based on the evaluation of the first, the participants worked with goals on a whiteboard in the patient's room. The data were collected in The Netherlands between February 2020 and June 2022. The data collection methods included the facilitator's logbook, observations, (group) interviews, charting activities and short surveys. Data analysis was conducted in weekly team sessions. The Guidelines for Best Practices in the Reporting of Participatory Action Research were followed.
In the first PAR cycle, the team learned that preparing an MTM with a patient did not enhance the patient's engagement in achieving their rehabilitation goals, but it was beneficial for the nurses' intermediate role between the patient and the multidisciplinary team. Clarity about responsibilities in the multidisciplinary team was a prerequisite for nurses to take on this role adequately. In the second PAR cycle, it became clear that working with a whiteboard in the patient's room had a positive effect on the patient's engagement in the rehabilitation process, and the nurses gained knowledge about a broader variety of professional rehabilitation domains.
Through PAR, the nursing team learned two lessons: cooperating with patients through MTM preparation and working with whiteboards enhanced their patient-centredness, but patients needed tangible goals to become engaged in their rehabilitation planning.
Prepare the multidisciplinary team meeting with the patient, as discussing rehabilitation goals can indirectly boost motivation by making older patients feel seen and heard, even if they seem unable to fully participate in the conversation. Clarify responsibilities in the multidisciplinary geriatric rehabilitation team. This is a prerequisite for nurses to take on an advocacy role for patients in multidisciplinary team meetings. To enhance patient-centred care, consider working with tangible goals on a whiteboard in the patient's room.
No public and patient involvement.
FreshRSS 