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To explore the key factors influencing nurses' capability, opportunity and motivation to offer the choice for self-collection for cervical screening within rural primary care services, following a national policy change in Australia.
A qualitative study informed by implementation and behavioural change frameworks.
Primary health nurses working in Victoria were invited to participate in semi-structured interviews via video or telephone between December 2022 and March 2023. Eighteen nurses from 18 clinics participated. Interview data were analysed following a Framework analysis approach, and themes were mapped to the COM-B model.
Nurses were highly motivated to offer the choice for self-collection due to perceived advantages for their patients and potential opportunities for reaching people hesitant to screen. There was variation in how nurses offered this choice, and to whom. Some nurses were concerned about lost opportunities to visualise the vulval area or cervix, or to have broader health and wellbeing conversations with patients. Views were mixed about how self-collection would impact nurse roles, and several external factors were impacting their opportunities as cervical screening providers.
Appropriately trained nurses have the capability and motivation to incorporate the choice for self-collection within their screening practice; however, their opportunity to maximise equity and increase participation is impacted by funding models and structures that limit their autonomy.
People living outside major cities experience greater healthcare inequities. Australia introduced access to the choice for self-collection for all eligible individuals in 2022, in part to achieve greater equity in the national screening program. Nurses can play a key role in program delivery. Understanding how they incorporate self-collection into their practice, and the key factors influencing implementation in rural primary care settings, can inform future program implementation and improve outcomes for patients.
We have adhered to COREQ reporting guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Palliative cancer care is comprehensive, specialised medical care of patients that aims to alleviate physical, mental and emotional distress based on patients’ needs rather than on prognosis. In Ethiopia, the federal ministry of health started palliative care (PC) in 2016. Since then, services have been developed and integrated as important components of the Health Sector Transformation Plan II. However, there is a scarcity of nationally summarised data regarding PC service utilisation in Ethiopia. Therefore, this protocol describes a planned systematic review and meta-analysis that will evaluate utilisation of PC services and its predictors among adult cancer patients in Ethiopia.
The online databases of PubMed, Hinari, EMBASE, CINHAL, Science Direct, Scopus and Google Scholar will be comprehensively searched from inception to 31 February 2025. To assess the quality of included studies, the Joanna Briggs Institute critical appraisal tools will be used. The statistical software STATA V.17 will be used for data analyses. To examine the heterogeneity between studies, inverse variance (I2) will be used. To calculate the pooled prevalence of PC service utilisation, a fixed or random effects meta-analyses model will be used with a 95% CI, depending on the presence or absence of heterogeneity between included studies. To look for publication bias, a visual inspection of the funnel plot and Egger and Begg’s regression test and a 5% level of significance will be used.
Ethical approval is not applicable. The results will be disseminated to academic beneficiaries and the public.
This study aimed to assess eye check-up practice and associated factors among patients with diabetes attending primary hospitals in the Central Gondar Zone, Northwest Ethiopia.
A multicentre hospital-based cross-sectional study.
This study was conducted at primary hospitals in Central Gondar Zone, Northwest Ethiopia, from 10 June 2024 to 10 July 2024.
The study included 689 consecutive adult patients with diabetes who met the inclusion criteria.
Participants were diagnosed with diabetes mellitus by a general practitioner. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire. Binary logistic regression was performed to identify associated factors, with significance considered at a p
A total of 689 participants were involved in this study, with a response rate of 98.4%. The proportion of good eye check-up practice was 20.6% (95% CI: 17.6% to 23.8%). Factors associated with good eye check-up practice included urban residence (adjusted OR, AOR=4.10, 95% CI: 1.72 to 9.82), diabetes duration of 12+ years (AOR=4.98, 95% CI: 1.43 to 17.38), previous eye disease (AOR=3.78, 95% CI: 1.79 to 7.95), good knowledge of diabetic retinopathy (AOR=3.22, 95% CI: 1.42 to 7.29), higher family income (AOR=3.80, 95% CI: 1.27 to 11.36), referral from a diabetic clinic (AOR=3.48, 95% CI: 1.58 to 7.67) and a favourable attitude (AOR=3.75, 95% CI: 1.46 to 9.65).
This study revealed a low proportion of good eye check-up practices among patients with diabetes. Urban residency, longer duration of diabetes, higher income, clinic referrals, history of eye disease, knowledge of diabetic retinopathy and a favourable attitude were significantly associated with good eye check-up practices. Therefore, targeted health education and strengthened referral systems are recommended to improve regular eye check-up practices among individuals with diabetes.
A spinal cord injury (SCI) disrupts synaptic connections between the corticospinal tract and motor neurons, impairing muscle control below the injury site. Many individuals with an SCI have impaired trunk control, affecting the performance of activities of daily living and quality of life. Work has shown improvements in trunk control after home-based, unsupervised arm-crank exercise training (ACET) in people with chronic motor-incomplete SCI. However, no studies have examined ACET’s impact on trunk control in individuals with subacute SCI. This study aims to investigate ACET’s effects on trunk control in adults with subacute incomplete SCI, and its mechanisms, and its long-term benefits on neuropathic pain, psychological well-being, physical activity levels and health-related quality of life.
This multicentre, parallel-group, randomised controlled trial will evaluate self-directed ACET in 60 individuals with subacute SCI (
This study was approved by The Health Research Authority and Health and Care Research Wales (22/NS/0054). Results will be published in peer-reviewed journals. Findings will be presented at National and International conferences for researchers and clinicians. Finally, results will be disseminated to the SCI community.
People identified as higher risk by a machine learning algorithm (Future Innovations in Novel Detection of Atrial Fibrillation [FIND-AF]) are at increased risk of cardio-renal-metabolic-pulmonary disease and cardiovascular death. The OPTIMISE-1 randomised controlled trial aims to test the effect of community-based specialist-led identification and management of cardio-renal-metabolic-pulmonary (CRMP) disease and risk factors compared with usual care on the use of therapeutic interventions over a follow-up of 6 months among high FIND-AF risk community-dwelling individuals.
OPTIMISE-1 is a multicentre, pragmatic, prospective, randomised, open-label, blinded-endpoint strategy trial that will recruit 138 participants aged 30 years or older, with a high FIND-AF risk score and previously enrolled in the FIND-AF pilot study (NCT05898165), to be randomised 1:1 to a specialist-led care intervention or usual care. The primary endpoint is a composite of initiation or increase of guideline-directed CRMP therapies. The secondary endpoints are the components of the primary endpoint, time to primary endpoint, diagnosis of new CRMP diseases or risk factors, time to diagnosis of new CRMP diseases or risk factors, initiation or increase of guideline-directed CRMP therapies for participants with recorded CRMP disease, initiation or increase of guideline-directed CRMP therapies for participants with newly diagnosed CRMP disease and change in participant-reported quality of life.
The study has ethical approval (the North East & North Tyneside 2 Research Ethics Committee reference 24/NE/0188). Findings will be announced at relevant conferences and published in peer-reviewed journals in line with the Funder’s open access policy.
Clinicaltrials.gov NCT06444711.
Introducción: La enfermería, como disciplina, demanda un alto nivel de compromiso y responsabilidad, debe abordar conocimientos esenciales para la labor diaria como las responsabilidades tanto éticas, civiles y penales. Objetivo. Este estudio tiene como finalidad evaluar el nivel de conocimientos sobre las responsabilidades civiles, éticas y legales que poseen los profesionales de Enfermería de un hospital público del interior del país, el Hospital Distrital Inmaculada Concepción de la Ciudad de Caaguazú de Paraguay, en el año 2023. Metodología. Se llevó a cabo un estudio cuantitativo, descriptivo de corte transversal con componente analítico. La población estuvo compuesta por 130 profesionales de Enfermería que realizan funciones en las áreas asistenciales y de salud pública. La técnica utilizada fue la encuesta por medio de un instrumento con 25 preguntas, el cuestionario fue validado mediante prueba piloto y la revisión por parte de un panel de expertos. Resultados. De los 130 profesionales de Enfermería encuestados el 77,69% eran del sexo femenino, con promedio de edad entre 30 a 36 años y el 63,85% eran casados, el 49,23% (64) tienen nivel de conocimiento deficiente sobre las responsabilidades penales y el 77.69% (101) poseen el nivel de conocimiento excelente en cuanto a responsabilidad civil, el 44.62% (58) de los profesionales tiene nivel de conocimiento regular sobre responsabilidad ética. Discusión. Más de la mitad de los profesionales de enfermería menores de 32 años tienen nivel de conocimiento malo sobre las responsabilidades penales, lo que resalta la necesidad de implementar programas de formación continua en estas áreas críticas, además de ser un respaldo legal en el actual diario de su profesión.
ABSTRACT
Introduction. Nursing, as a discipline, demands a high level of commitment and responsibility, it must address essential knowledge for daily work such as ethical, civil and criminal responsibilities. Objective. This study aims to evaluate the level of knowledge about civil, ethical and legal responsibilities that nursing professionals have in a public hospital in the interior of the country, the Inmaculada Concepción District Hospital of the City of Caaguazú in Paraguay, in the year 2023. Methodology. A quantitative, descriptive cross-sectional study with an analytical component was carried out. The population was made up of 130 nursing professionals who perform functions in the healthcare and public health areas. The technique used was the survey using an instrument with 25 questions, the questionnaire was validated through pilot testing and review by a panel of experts. Results. Of the 130 nursing professionals surveyed, 77.69% were female, with an average age between 30 to 36 years and 63.85% were married, 49.23% (64) have a poor level of knowledge about the criminal responsibilities and 77.69% (101) have an excellent level of knowledge regarding civil liability, 44.62% (58) of professionals have an excellent level of knowledge. of regular knowledge about ethical responsibility. Discussion. More than half of nursing professionals under 32 years of age have a poor level of knowledge about criminal responsibilities, which highlights the need to implement continuous training programs in these critical areas, in addition to being legal support in the current journal of his profession.
To codesign a cancer personalised activity and lifestyle tool (CAN-PAL) based on an existing tool. To help cancer care workers support people affected by cancer to plan and integrate physical activity into lifestyles.
Mixed-methods codesign study.
Phase 1: Focus groups with people affected by cancer (n = 10) or interviews (n = 2) to discuss suitable physical activities and adaptation of the existing tool. Data were recorded, transcribed and analysed thematically. Themes informed the design of the prototype CAN-PAL and user guide. Phase 2: Healthcare professionals considered the potential use of the CAN-PAL prototype and completed an online survey including the system usability scale and free text responses.
Phase 1: Identified suitable physical activities and four themes were identified including: Capability, benefits, barriers and resources which informed the prototype CAN-PAL and user guide. Phase 2: The user survey was completed by 12 healthcare professionals. Median (range) system usability scale was 80 (50–95) (best score 100), scores >68 indicate good or better usability. Themes from the free text comments included strengths, amendments, considerations and limitations. Results were used to finalise CAN-PAL and the user guide.
The codesigned CAN-PAL tool had good usability. Further work is needed to evaluate the impact of CAN-PAL on activity levels and behaviour in people affected by cancer.
People affected by cancer need support to undertake physical activity. The purpose of CAN-PAL is to assist cancer care workers to support people affected by cancer to plan and integrate physical activity into lifestyles.
Public partners considered the findings from Phase 1 and 2 and informed the design of the prototype, final CAN-PAL and user guide and coauthored the paper.
The study adhered to relevant EQUATOR guidelines; the study was reported according to the COREQ checklist.
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