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Opioid use disorder (OUD) is a chronic and severe psychiatric condition defined by a level of opioid use which significantly impairs interpersonal and social functioning. In the biopsychosocial model of addiction, research has shown that psychiatric, sociological and neurobiological factors individually affect OUD severity. However, how these factors interact in the determination of OUD severity remains poorly understood.
The Epigenetic Bonds of Opioid Use Profiles are a multidisciplinary project whose primary objective is to characterise psychiatric and social factors of OUD in a large cohort of patients. The secondary objectives are, first, to correlate psychosocial severity with blood-derived epigenetic biomarkers to provide a deeper understanding of determinants of OUD and, second, to examine over a 2 year follow-up the correlation between the evolution of OUD and psychosocial severity with epigenetic biomarkers at inclusion. An additional objective is to analyse the impact of drug consumption rooms on access to care for most severely affected patients with OUD. In total, 300 opioid users will be recruited at supervised injection sites in Strasbourg and Paris and at addiction care centres in Strasbourg and Lyon to explore four psychiatric (substance use disorders beyond opioids, depression, anxiety, post-traumatic stress disorder) and five social (social support and status, traumatic experiences, housing, imprisonment, access to care) factors. Opioid users will be followed for 24 months and reassessed for psychosocial factors at 3, 6, 12, 18 and 24 months. Opioid consumption will be measured in all subjects using questionnaires, complemented by toxicological screenings (mass spectrometry). Finally, DNA methylation and gene expression will be characterised in capillary blood using next-generation sequencing. Mixed models will be used to model the primary and secondary outcomes.
This ongoing study was approved by the French Ethics Committee ‘Sud Méditerranée III’ of University Hospital of Nîmes (approval 2023–2024, protocol IDRCB number 2022-A02477-36) and authorised by the French Data Protection Authority (authorisation decision DR-2023–277 in December 2023). Results will be presented in international and national conferences and published in peer-reviewed international journals.
This study aimed to examine how older adults form beliefs about their memory and how these beliefs are influenced by their level of concern about dementia. Inaccurate beliefs and excessive worrying, indicative of erroneous metacognition, are associated with negative health outcomes. This research can help identify mitigation for these harmful effects.
Qualitative focus groups; thematic analysis.
Focus group discussion with healthy older adults hosted at a university in central London.
35 healthy older individuals (women=29) without any psychiatric or neurological diagnoses, over the age of 65 years (mean 75.31, SD: 6.15). 13 participants were identified as having a high level of worry about dementia and 22 as having low worry. Groups were matched for cognitive performance on the Telephone Mini Addenbrooke’s cognitive assessment (Tele-MACE).
Participants were assigned to a focus group depending on their level of worry about dementia. During focus groups, a vignette prompted discussion around lifespan changes in memory and how this affected concerns around memory. This allowed investigation of the differences in beliefs about memory.
Thematic analysis revealed two key themes. First, older adults appear to base their definition of ‘normality’ of their own memory on comparisons. These comparisons were between themselves and others and between themselves now and their own past self. Despite similar strategies to define ‘normality’, those with high dementia worry had stricter definitions of what they determined as normal. The second theme described narratives around the ‘self’ and the ‘other’. There was a difference between those with high versus low worry; those with high worry had a strong focus on the ‘self’, while those with low dementia worry focused on ‘others’.
Comparison is a common metacognitive strategy used in forming beliefs about memory. Targeting the use of comparison is potentially valuable in interventions aiming to alleviate older adults’ memory concerns. Addressing self-focused thinking, for example, with cognitive behavioural therapy, could improve harmful levels of high worry.
Digital inclusion (which includes skills, accessibility and connectivity to the internet and digital devices) is a ‘super social determinant of health’ because it affects many aspects of life that influence health. Older people are especially vulnerable to digital exclusion. Existing digital inclusion interventions are commonly offered opportunistically to people who come into contact with services, or in specific locations. The lack of systematic identification of need unintentionally excludes older people who may be most in need of support, and that support is not addressing their needs.
This multi-method project includes six workstreams: (1) A survey of people aged 65+ to ask about digital use and engagement. Survey data will be used to develop a model that predicts digital exclusion from data available in primary care records. (2) Testing, via a further survey, the external validity of the model to identify those who are digitally excluded. (3) Interviews with community service providers to identify, understand and define the components of existing digital inclusion services for older people. Concurrently, a rapid review of the literature will identify evidence for interventions aimed at supporting digitally excluded adults aged 65+. (4) Interviews with people aged 65+ representing a range of digital use will explore factors from the COM-B model that influence digital behaviours—their capability (C), opportunity (O) and motivation (M) relating to digital engagement. Analysis outputs will identify the intersectional nature of barriers or facilitators to digital inclusion. (5) Co-production workshops with older people and community service providers will identify key components of interventions that are required to address digital exclusion. Components will be mapped against existing interventions, and the ‘best fit’ intervention(s) refined. An implementation plan will be developed in parallel. (6) Feasibility testing of the refined intervention(s) to assess acceptability and obtain feedback on content and delivery mechanisms.
This study was approved by the Yorkshire & The Humber - Bradford Leeds Research Ethics Committee on 23 October 2023 (ref. 23/YH/0234). Findings will be disseminated in academic journals and shared at webinars, seminars, conferences and events arranged by organisations operating across the digital inclusion and older people fields.
To explore parents' experience when their children underwent emergence delirium during anaesthesia recovery.
A descriptive phenomenological qualitative study.
This descriptive phenomenological study was conducted at a medical center in Taiwan. Purposive sampling was employed, and a semi-structured interview guide was used to conduct in-depth interviews. Twelve parents whose children experienced emergence delirium were recruited after data saturation was reached. Data were collected between January and July 2024 and analysed using Colaizzi's seven-step method.
Parents underwent an unexpected journey characterised by emotional ups and downs when witnessing their child's emergence delirium. Four major themes were generated, including ‘unexpected chaos’, describing the disorienting situation parents experienced when confronted with their child's unfamiliar behaviours; ‘help beyond reach’, reflecting their inability to provide comfort despite being physically present; ‘a day of suffering’, highlighting the emotional overwhelm during the emergence delirium episode; and ‘appreciation after recovery’, illustrating their relief and gratitude once their child returned to baseline. These themes reveal the intense emotional fluctuations parents experience during this critical phase.
This study highlights the complex emotional fluctuations parents experience when facing their child's emergence delirium. The findings emphasise the need for anticipatory guidance and support strategies to better prepare parents and inform family-centred nursing practices.
This study addresses a gap regarding the emotional challenges experienced by East Asian parents when their child undergoes emergence delirium. The findings reveal complex parental distress shaped by internal worry and external social pressure in shared recovery spaces. These insights inform culturally sensitive care models, emphasising the importance of private environments and communication strategies that reduce parental stress and improve clinical support.
Two parents reviewed and provided feedback on the interview content and results, improving cultural relevance and clarity.
The study followed COREQ guidelines.
Despite a growing multidisciplinary interest in the Child and Family Centred Care approach, its meaning remains unclear in extant literature. It is, therefore, crucial to explore, analyse, describe, and clarify the concept of the Child and Family Centred Care approach and its associated terms.
A three-phased principle-based concept analysis approach was used to analyse the concept of Child and Family Centred Care. A systematic search of literature was completed using the CINAHL, PsycINFO, Medline, Scopus, and Web of Science databases. Peer-reviewed articles on Child and Family Centred Care, published from inception to 2023 were included if they were available in English and discussed children aged zero to 17 years, healthcare providers, and/or caregivers. A systematic screening of articles was undertaken to remove duplicates and articles that did not meet the inclusion criteria. A concept quality criteria assessment was performed independently based on a recommended appraisal tool.
Full texts of the retained 23 titles were included in the deductive thematic analysis. Guided by the three-phased principle-based concept analysis approach, data were grouped into epistemological, pragmatic, linguistic, and logical principles. The study revealed various characteristics of the concept of interest to highlight the common terms associated with the concept, primarily being collaboration, participation, communication, and respect/dignity.
This concept analysis provides a theoretical definition of the Child and Family Centred Care approach. The definition emphasises the child as an individual and an active collaborator with healthcare providers and their family. Standardised language improving health outcomes, patient satisfaction, and healthcare systems.
No Patient or Public Contribution.
This study explored the knowledge and awareness of Dutch patients, healthcare professionals (HCPs) and healthcare insurers on the climate impact of inhalers as well as (factors influencing) their attitude towards climate-friendly inhaler prescription.
We recruited participants for this qualitative study with purposive sampling. We conducted four online focus groups with patients, six with HCPs and two interviews with healthcare insurer representatives. Determinants were analysed with the Framework Approach.
21 patients, 27 HCPs and two healthcare insurer representatives.
Knowledge and awareness on the climate impact of inhalers varied and was generally lower among patients and healthcare insurers than among HCPs. The attitude towards climate-friendly inhaler prescription was variable among patients and mainly positive among HCPs. Both patients and HCPs assigned a greater role to HCPs than to patients in considering climate impact and agreed that patients’ interest must remain paramount. Factors influencing implementation were mainly related to outcome expectancies, such as expected effect on freedom of choice, expected response of patients and expected effect on patients’ health. The latter is partly influenced by beliefs about different types of inhalers. HCPs expressed a need for information and training on the topic and for collaboration with other stakeholders in the field of pulmonary care. Healthcare insurers assign themselves a role in a more climate-friendly healthcare but are reluctant to direct the preference policy on climate impact.
Both patients and HCPs feel climate-friendly inhaler prescription is important. Implementation can be promoted by enhancing awareness and providing HCPs with information on inhaler climate impact, how to safely practice climate-friendly prescription and how to inform patients about its benefits. Both patients and HCPs emphasise the significance of preserving freedom of choice in prescription and highlight the need for a consensus approach on climate-friendly prescribing endorsed by all pulmonary care stakeholders.
To (1) clarify the key components of resilience of adults with cancer; (2) summarise and analyse the resilience measures used in this population; and (3) discuss future evaluation directions.
An umbrella review.
MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Cochrane library and Epistemonikos were searched in December 2023.
The Joanna Briggs Institute (JBI) guidelines were followed for undertaking this umbrella review. Systematic and narrative reviews that defined resilience of adults with cancer and reported resilience measures, published in English, were included. The methodological quality was assessed using the JBI appraisal tool.
Fourteen eligible reviews were included. Four key resilience components from various resilience conceptualisations were identified. Twenty resilience measures were used among cancer patients, with the 25-item Connor-Davidson Resilience Scale providing a relatively comprehensive assessment of individual resilience. Recommended future research with cancer patients includes assessing these resilience components: (1) available individual resources—key psychological factors that enhance individual resilience; (2) access to social resources—close interpersonal relationships, family cohesion and social support; (3) adaptive coping ability—problem-solving skills, emotional management strategies and experiences in managing adversity; (4) ability to regain mental health and well-being—the capacity to recover a relatively stable psychological state and promote positive psychological functioning.
The findings provide evidence for refining future resilience measurement in the adult cancer population. Examining the four key components of resilience with this population across cultures is warranted.
Understanding the key components of resilience of cancer patients can help healthcare professionals identify individuals who may need further support and facilitate early intervention or referral to psychosocial support services. The 25-item Connor-Davidson Resilience Scale is recommended over other tools for use in the cancer population.
Patient or public involvement is not applicable in this study.
by Dominic Michael Rasp, Florian Kurt Paternoster, Michael Zauser, Jan Kern, Ansgar Schwirtz
Hamstring strain injuries are a prevalent burden in soccer. Low strength, muscle fatigue, and inter-limb differences in hamstring strength are associated with hamstring injury risk. Previous research shows increased hamstring injury incidence in soccer at the end of each half or the end of the match, respectively. This study aims at evaluating the aforementioned risk factors of hamstring injury over the course of a simulated soccer match. Ten active soccer players carried out the Loughborough Intermittent Shuttle Test, during which hamstring strength of both legs was assessed on seven occasions via the optimized 90:20 Isometric Posterior Chain Test. Hamstring strength of each limb and inter-limb differences in hamstring strength over the course of the Loughborough Intermittent Shuttle Test were parameters of interest. Repeated measures ANOVA were used to analyze the development of hamstring strength and limb-asymmetries in hamstring strength during the simulated soccer match. Compared to pre-match values, hamstring strength was significantly decreased after 15 and 30 minutes of simulated soccer match for the non-dominant and dominant leg, respectively. There were no further variations in hamstring strength within the simulated soccer match for either leg. We did neither measure significant recovery of hamstring strength to pre-match values at the beginning of the second half, as suspected by previous research, nor inter-limb differences, or a deterioration of limb asymmetries in hamstring strength during the simulated soccer match. Players who only participate for a short period in a soccer match may be exposed to the same risk of suffering hamstring injury like players who compete for a longer duration. Decreasing hamstring strength partly depicts the pattern of hamstring injury incidences during soccer matches. Additional factors may influence the increasing hamstring injury rate at the end of each half or the later stages of a match, respectively.by Nils Berginström, Sofia Wåhlin, Linn Österlund, Anna Holmqvist, Monika Löfgren, Britt-Marie Stålnacke, Marika C. Möller
Dysfunction in executive functions is common among patients with chronic pain. However, the relationships between executive functioning and pain management have not been extensively studied. In this study, 189 outpatients (160 women, 29 men; mean age 33.15) with chronic pain underwent an extensive neuropsychological assessment, including several tests of executive functions. In addition, all participants completed self-assessment questionnaires regarding pain and interference of pain in everyday life. After adjusting for effects of age, education, and depression, several aspects of executive functioning were significantly associated with self-assessed everyday interference of pain (rs = 0.13–0.22, all ps 0.05). This indicates that lower performance on tests of executive functioning was significantly associated with a higher degree of pain interference and a lower degree of life control. Pain characteristics such as pain intensity, pain duration, and pain spreading were not associated with executive functioning. These results suggest that preserved executive functions are related to better coping with pain, but not directly to the pain itself, in patients with chronic pain. Depression was also associated with self-management of pain, indicating that patients with lower executive functioning in combination with depression may need special attention during rehabilitation.New Zealand is one of the last high-income countries in the world experiencing significant rates of rheumatic fever. Nurses play a crucial role in rheumatic fever prevention; however, little is understood as to how nurses can best achieve this.
To explore nursing practices that optimise rheumatic fever prevention.
An integrative review.
Four electronic databases (CINAHL, SCOPUS, Medline via, and Ovid) were searched for peer-reviewed empirical articles published from 2013 to 2023. Grey literature (guidelines/reports) was also sourced. Critical appraisal was applied using the Mixed-Methods Appraisal Tools and the Joanna Briggs Critical Appraisal checklist. Qualitative Research in Psychology, 3(2), 77–101, thematic analysis method was used to generate themes.
Seven research articles and three national reports were included. Four themes—in-depth nursing knowledge and improving prophylaxis adherence, cultural competency, and therapeutic nurse–patient relationships—were found.
While nursing knowledge and ways to improve injection adherence are essential, being culturally receptive and developing therapeutic relationships are equally important. Without strong and trusting relationships, it is difficult to deliver care required for prevention success.
When working with vulnerable populations it is important to be culturally receptive in all interactions with patients and their families.
New Zealand has high rates of rheumatic fever, especially among vulnerable populations such as Pacific Islanders and Māori. Nurses are often frontline primary care providers who, when skilled with the right tools, can help reduce the prevalence of this disease.
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow chart.
No Patient or Public Contribution was required for this research.
To provide a comprehensive overview of how stroke nurses manage solid medication (SM) delivery to patients with post-stroke dysphagia.
Cross-sectional study.
A self-administered online survey was carried out among nurses in German-speaking countries between September and December 2021.
Out of a total of 754 responses, analysis was conducted on 195 nurses who reported working on a stroke unit. To identify swallowing difficulties in acute stroke care, 99 nurses indicated routinely administering standardised screenings, while 10 use unvalidated screenings, and 82 are waiting for a specialist evaluation. Regardless of whether screening methods are used or not, most preferred a non-oral route of medication administration for patients with suspected dysphagia. None of the respondents reported administering whole SMs orally to patients. If screening methods indicate dysphagia, approximately half of the respondents would modify SMs. Participants who stated to use the Gugging Swallowing Screen managed the SM intake guided by its severity levels. One-third of the group who awaited assessment by the dysphagia specialist provided modified medication before the consultation.
Most of the nurses on stroke units use swallowing screens and avoid the administration of whole SMs in post-stroke dysphagia. In addition to the non-oral administration, SMs are modified if dysphagia is suspected. Precise guidance on the administration of SM is needed, based on screening tests and prior to expert consultation.
ClinicalTrials.gov: Registration ID: NCT05173051/ Protocol ID: 11TS003721.
The present paper serves to alert nurses to the issue of patient safety when administering medication for acute stroke-induced dysphagia.
SM delivery after acute stroke-induced dysphagia is often neglected. While nurses are aware of the risk associated with dysphagia and would not give whole SMs to patients, the modification of tablets and their administration with semisolids are common.
This study was reported according to the Checklist for Reporting of Survey Studies (CROSS).
To identify, synthesise and map systematic reviews of the effectiveness of nursing interventions undertaken in a neonatal intensive care unit or special care nursery.
This scoping review was conducted according to the JBI scoping review framework.
Review included systematic reviews that evaluated any nurse-initiated interventions that were undertaken in an NICU or SCN setting. Studies that reported one or more positive outcomes related to the nursing interventions were only considered for this review. Each outcome for nursing interventions was rated a ‘certainty (quality) of evidence’ according to the Grading of Recommendations, Assessment, Development and Evaluations criteria.
Systematic reviews were sourced from the Cochrane Database of Systematic Reviews and Joanna Briggs Institute Evidence Synthesis for reviews published until February 2023.
A total of 428 articles were identified; following screening, 81 reviews underwent full-text screening, and 34 articles met the inclusion criteria and were included in this review. Multiple nursing interventions reporting positive outcomes were identified and were grouped into seven categories. Respiratory 7/34 (20%) and Nutrition 8/34 (23%) outcomes were the most reported categories. Developmental care was the next most reported category 5/34 (15%) followed by Thermoregulation, 5/34 (15%) Jaundice 4/34 (12%), Pain 4/34 (12%) and Infection 1/34 (3%).
This review has identified nursing interventions that have a direct positive impact on neonatal outcomes. However, further applied research is needed to transfer this empirical knowledge into clinical practice.
Implementing up-to-date evidence on effective nursing interventions has the potential to significantly improving neonatal outcomes.
No patient or public involvement in this scoping review.
To explore the International Network for Child and Family Centred Care (INCFCC) members' experiences and views on the long-term impact of COVID-19 on the nursing workforce.
On the 11 March 2020, the World Health Organization declared COVID-19 a global pandemic. While some countries adopted a herd immunity approach, others imposed stricter measures to reduce the transmission of the virus. Hospitals in some countries faced an avalanche of extremely sick admissions, whereas others experienced an early surge in cases or were able to control the spread.
Discursive paper.
A web-based survey was e-mailed to 63 INCFCC members from 28 March to 30 April 2022, as an invitation to share their experience concerning the long-term impact of COVID-19 on their role as a nurse educator, clinician or researcher.
Sixteen members responded, and the responses were grouped under the themes stress and anxiety, safe staffing and pay, doing things differently, impact on research, impact on teaching and learning, impact on clinical practice, nursing made visible and lessons for the future.
The INCFCC members provided their views and highlighted the impact on their role in nursing education, administration, research and/or practice. This discussion of international perspectives on the similarities and differences imposed by COVID-19 found that the impact was wide-ranging and prolonged. The overarching theme revealed the resilience of the participating members in the face of COVID-19.
This study highlights the importance of all areas of nursing, be it in academia or in clinical practice, to work together to learn from the present and to plan for the future. Future work should focus on supporting organizational and personal resiliency and effective interventions to support the nursing workforce both during a disaster and in the recovery phase. Nursing workforce resilience in the face of COVID-19.
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