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To explore the perceptions and experiences of parents caring for children with paediatric feeding disorders requiring feeding tubes (PFD-T).
A descriptive qualitative approach was adopted in this study.
Using purposive sampling, 12 parents were recruited from paediatric inpatient wards and the outpatient paediatric feeding clinic at a tertiary public hospital in Singapore. Data collection was done from July to December 2024. Semi-structured one-on-one interviews were conducted with the parents (fathers or mothers) until data saturation. Thematic analysis was used to identify themes from the interview content.
A total of three themes and six subthemes were identified, encapsulating the challenges experienced by parents with caregiving and feeding tube management, as well as the sources of support they had. The themes are: (1) A sense of community, (2) Grieving over the loss of normalcy and (3) Facing the unknown.
Parents in this study felt supported being in a community of other parents with children who have PFD-T. It enabled them to gain valuable information and offered them a space where they felt understood. At the same time, they expressed feelings of guilt and isolation, as the caregiving demands led to limited capacity to cater to or interact with other loved ones. Additional challenges parents faced included transitioning between types of feeding tubes and insufficient support from healthcare professionals.
Ethical approval was obtained from the National Health Group Domain Specific Review Board (DSRB 2024/00064) on 8 May 2024.
This study followed the reporting guidelines outlined by the COnsolidated criteria for REporting Qualitative (COREQ) research checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
Providing an overview of the organisation, tasks, and responsibilities of acute and transitional pain services in the Netherlands.
Cross-sectional questionnaire study.
An online questionnaire was sent to representatives of Dutch hospital pain services performing inpatient surgery. It included items on organisation, staffing, education, roles, tasks and responsibilities. Data were analysed descriptively.
Of the surveyed hospitals, 92.2% reported having an acute pain service, while only 6.5% had a transitional pain service. Most pain services (acute pain services 76.3%, transitional pain services 80.0%) are part of the anaesthesiology department. Staffing includes anaesthesiologists, nurses, and/or nurse anaesthetists, with or without pain specialisation. Acute pain service teams monitor complex pain management techniques. Nearly all acute pain services (89.8%) provide pain management training, and 60% monitor hospital-wide pain management quality. All transitional pain services monitored opioid use post-discharge and conducted follow-up calls with patients.
Acute pain services are well established in Dutch hospitals, whereas transitional pain services remain limited. Organisational structures, tasks, and responsibilities vary, with key challenges in staffing, service organisation, and education. Future research should focus on optimising staffing, expanding transitional pain services, the role of the pain nurse, and establishing a national pain management education framework.
This study highlights the significant impact of pain nurses as a central professional within the interdisciplinary team, contributing to quality care and education, ultimately benefiting patients.
This study provides a current overview of pain services in the Netherlands, supporting pain nurses in innovating pain services, highlighting key challenges and opportunities for improvement.
STROBE checklist.
None.
To explore the experiences and perceptions of Singaporean parents in managing feeding difficulties among children with developmental disabilities.
A descriptive qualitative study design was used.
Twenty parents were recruited via convenience sampling from a paediatric feeding clinic in a public hospital in Singapore between July and October 2024. One-to-one interviews were conducted using a semi-structured interview guide. Thematic analysis was used to analyse the data.
Four themes were identified: (1) Feeding as a ‘guessing’ game; (2) mutual understanding within the family and community; (3) beliefs regarding developmental disabilities and feeding difficulties; and (4) challenges in accessing adequate support. There were a total of nine subthemes supporting these themes.
This study revealed that parents of children with developmental disabilities faced challenges in adjusting to their child's feeding preferences, dealing with conflicting views on feeding practices among caregivers, and accessing adequate support. Parents also valued instrumental support from grandparents and domestic helpers, as well as emotional support from online peers. Additional research and targeted interventions are needed to better support parents of children with developmental disabilities in managing feeding difficulties.
Policies should facilitate the provision of feeding-specific resources, treatment, and education for parents. Additionally, healthcare providers should proactively assess feeding-related concerns and address misconceptions to enhance parental awareness of feeding difficulties and how they can improve the feeding practices of their children with developmental disabilities. Future research should obtain a more in-depth understanding of how differing beliefs in feeding difficulties between parents can impact the child's developmental outcomes, as well as the support and resources that may address feeding needs in these children.
This study followed the reporting guidelines outlined by the Consolidated criteria for Reporting Qualitative (COREQ) research checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the impact of systems thinking in nursing leadership on healthcare quality, decision-making and resource management.
A systematic review.
A comprehensive literature search was conducted in PubMed, CINAHL, Scopus and Web of Science for studies published in English and Italian up to 2024.
Studies were selected based on predefined eligibility criteria, focusing on nursing leadership integrating systems thinking. The Joanna Briggs Institute (JBI) checklist was used to assess methodological quality. A narrative synthesis was conducted to identify key themes and patterns.
Fifteen studies met the inclusion criteria. Findings suggest that systems thinking enhances resource management, decision-making and patient safety, while also reducing errors and improving staff collaboration. Adopting a systems approach allows nursing leaders to navigate complex healthcare environments effectively. However, variability in study designs and implementation strategies limits the generalizability of findings.
Integrating systems thinking into nursing leadership promotes a proactive, holistic approach to problem-solving, optimising healthcare outcomes. While evidence supports its benefits, further empirical studies are needed to confirm its effectiveness across diverse healthcare settings.
What problem did the study address? The need for structured systems thinking in nursing leadership. What were the main findings? Improved decision-making, resource optimisation and patient safety through systems-oriented leadership. Where and on whom will the research have an impact? Nurse leaders, healthcare administrators and policymakers in diverse healthcare settings.
Although patients and the public were not directly involved, this study has implications for enhancing patient safety and healthcare efficiency.
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