Conectar
There is limited research exploring the age-related difference in communication when describing pain experiences. This project aimed to identify key differences between adolescents’, young adults’ and adults’ (i) preferred communication method, (ii) language content and (iii) lexical amount and variety when discussing their persistent pain experience using chatbot technology.
An exploratory concurrent nested mixed-methods design using a comparative analysis.
Participants were recruited through a convenience sampling strategy from two tertiary multidisciplinary pain centres in Australia.
20 adolescents, 20 young adults and 20 adults completed a pain history assessment using the Dolores application. The inclusion criteria for this study were (i) persistent non-cancer pain for at least 3 months, (ii) 10 years of age and over and (iii) adequate expressive and receptive language skills to complete the required tasks in English, as determined by clinicians in the treating team.
Drawn, voice and typed responses provided by participants during the chatbot interaction were analysed using content analysis. Fisher’s exact tests and 2 tests were used to examine differences between age groups. Strong effect size estimates generated from comparative analyses suggested that adolescents were the most likely age group to utilise drawing (p=0.153, Cramer’s V=0.268), preferred typing over speaking (p==0.007, Cramer’s V=0.433). Young adults used the greatest number and variety of words in response to chatbot questions including evaluative language (p=0.097, Cramer’s V=0.296). Adults tended to use more metaphors (p=0.085, Cramer’s V=0.305) and had a strong preference for speaking over typing (p=
The results of this study provide insights into age-related differences in communication and preferences when using technology to communicate about persistent pain. Future research exploring individualised age-related approaches to pain assessment, supported by the findings of this study, in comparison to current standardised assessments administered by clinicians are warranted.
Metacognitive strategy training is a crucial approach for addressing metacognitive deficits and enhancing metacognitive abilities, which can help mitigate age-related cognitive decline and optimise cognitive functioning. The present scoping review aims to systematically examine and synthesise the existing evidence on metacognitive strategy training programmes designed for both neurotypical adults and individuals with cognitive-communication disorders (CCDs).
A scoping review following the JBI methodology.
A literature search was conducted systematically across PubMed, Embase and Web of Science between June and August 2024.
Studies involving metacognitive strategy training for neurotypical adults or individuals with CCDs, measuring cognition, communication or metacognitive skills.
Two reviewers independently screened studies in a two-step process, that is, title and abstract screening followed by full-text screening. Data extraction included study characteristics, participant demographics, intervention details and outcome measures.
A total of 32 studies met the selection criteria, revealing diverse metacognitive training approaches that varied in component and dosage. The most frequently used approaches are the Cognitive Orientation to Occupational Performance approach and the Multicontext approach. The reported outcome measures included cognitive outcomes, metacognitive outcomes, well-being measures and feasibility measures. The majority of interventions targeted occupational goals, followed by cognitive skills, with fewer studies addressing cognitive-communicative skills. Studies have focused primarily on individuals with CCDs, with only a few targeting neurotypical adults.
Studies examining the efficacy of metacognitive strategy training are heterogeneous in terms of population, intervention approaches, and outcome measures. There is significant potential to expand the focus of these interventions to include neurotypical adults, aiming to counteract age-related cognitive-communicative disorders. The limited research within the field of speech-language pathology presents a valuable opportunity for speech-language pathologists to broaden the application of metacognitive strategy training, particularly in enhancing cognitive-communicative abilities.
This study sought to explore decision making among caregivers of children with cancer in Pakistan, one of the largest lower middle-income countries in the world.
Cross-sectional survey study
This study was conducted in Pakistan at Indus Hospital and Health Network in Karachi and Children’s Hospital of Lahore. Children’s Hospital of Lahore is a public sector hospital, and Indus Hospital has a foundation-based funding structure. Both are larger tertiary care centers. Over 2,500 new patients are seen at these centers annually, this accounts for almost 50% of all children with cancer in Pakistan
Eligible participants included bedside caregivers, defined as a parent or family member involved in communication with the medical team, of children with cancer (
Primary outcome measures included caregiver priorities and experiences related to communication including decision-making role, involvement of the paediatric patient and decisional regret.
Participants included 200 caregivers of children
Findings from this study highlight the importance of exploring preferences for decision making and empowering bedside caregivers while respecting cultural norms. In the Pakistani context, it may be specifically important to consider gender roles and the inclusion of extended family members. Future work should investigate paediatric patient involvement in diverse settings.
Being able to talk about the anticipated course of living with an illness is essential to delivering and receiving person-centred care. Despite clinical heart failure guidance encouraging these prognostic conversations at all stages of disease, they occur infrequently or very late in the disease course. This qualitative synthesis will use the Joanna Briggs Institute (JBI) meta-aggregation approach to explore how prognostic conversations are currently taking place, what people think about prognostic conversations, and how people experience them.
This systematically conducted qualitative synthesis, using JBI meta-aggregation, considers qualitative evidence that explores the prognostic communication experiences, attitudes or practices of people with heart failure and their healthcare professionals. Prognostic communication is defined as a verbal interaction about anticipated changes to symptoms or function, possibility of unpredictable events, potential future treatments or care, expression of wishes about the future, or estimates of life expectancy. It will include interactions occurring in any setting (inpatient, outpatient, community). Exclusion criteria include studies of carer perspectives, discussion about implantable cardiac defibrillator deactivation, assisted dying and/or euthanasia, and those not published in the English language. Medical Literature Analysis and Retrieval System Online (MEDLINE) (Ovid), Excerpta Medica Database (EMBASE) (Ovid), PsycInfo (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus (EBSCOhost), Web of Science Core, Overton, ProQuest Dissertations and Theses Global, and Google Scholar databases will be searched for eligible studies. Reference screening of relevant systematic reviews will also be conducted. Two independent reviewers will screen, quality assess included studies and perform data extraction. JBI tools will be used for quality appraisal, data extraction, synthesis and assessing confidence of summarised findings.
Ethical approval is not required for the study since it is based on available published literature. Findings from the review will be disseminated through publication in a peer-reviewed journal.
International Prospective Register of Systematic Reviews (PROSPERO) CRD42024605240.
Antimicrobial resistance is one of the biggest threats posed to healthcare systems, accounting for hundreds of thousands of deaths worldwide and correlated with poorer health status and increased healthcare costs. The practice of delayed prescription seems to be an effective solution to diminish the unnecessary overprescription of antibiotics, as study results demonstrated that it does not negatively affect health status while engaging patients and addressing their desire for a prescription when visiting the doctor’s office. This study investigates the point of view of family doctors practising in Switzerland, a country where delayed prescription has not yet been introduced. The main scope was to describe the perceived barriers and facilitators towards delayed prescription of antibiotics.
A total of five online focus group discussions.
Family medicine.
21 family doctors practising in the Italian-speaking region of Switzerland (M=51.24; SD=9.73 years of age; 62% males).
Focus group discussions revealed a generally negative attitude towards delayed antibiotic prescription among participants. Thematic analysis identified three key themes reflecting perceived barriers to its implementation: (1) Maintenance of authority through a gatekeeping role, highlighting concerns about preserving professional control over treatment decisions; (2) Importance of maintaining communication, addressing fears that delayed prescription could undermine clarity and trust in doctor–patient interactions and (3) Healthcare system and guidelines for good practice, which encompasses structural and normative expectations around follow-up visits, pre-existing practices and clinical routines. These themes illustrate the multifaceted nature of physicians’ resistance to adopting delayed prescription in their daily practice.
An additional information that emerged from the discussions is the extensive use in the region of a practice similar to delayed prescription, called ‘the stock antibiotic’. However, it is perceived very differently by physicians because it does not enforce a predetermined waiting time on patients.
Past research has demonstrated that delayed prescription is an effective practice for reducing antibiotic consumption and promoting patients’ empowerment while maintaining their satisfaction. Nevertheless, the results of this study show that doctors’ perceptions of this practice are not always positive. Any attempt to introduce the practice should start with a careful evaluation of the cultural context and doctors’ opinions, as their willingness to embrace the practice is crucial for its successful adoption. A more practical implication of our results stems from the discovery of the practice of the stock antibiotic, which could be described as a new version of delayed prescription, tailored to the customs and practices of the region. This aspect highlights the importance of exploring local contexts to ensure that prescribing practices can be implemented in alignment with local preferences.
Audiovisual arts interventions show promise for youth mental health promotion, but evidence remains limited. This scoping review aims to systematically map evidence on audiovisual arts interventions for mental health promotion among youth aged 15–24 years.
The review will be conducted according to the Joanna Briggs Institute guide on evidence synthesis, and the results will be reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews. A comprehensive search will be conducted in seven electronic databases: Web of Science Core Collection (including MEDLINE and ProQuest), PubMed, Embase, Scopus, APA PsycInfo, Communication & Mass Media Complete and China National Knowledge Infrastructure. Grey literature sources, including WHO Institutional Repository for Information Sharing, will also be searched. The search will include publications from 1 January 2000 to 31 December 2025, with no language restrictions. Two reviewers will independently screen titles, abstracts and full texts, and chart data from included studies. The data will be synthesised using a narrative approach.
No ethical approval required as only published data will be analysed. Results will be disseminated through peer-reviewed publications, conferences and stakeholder engagement.
Open Science Framework registration DOI: https://doi.org/10.17605/OSF.IO/DEGPJ.
Physicians frame medical information for patients in different ways, impacting patient outcomes. What underlies their framing choices has not been investigated.
To explore the use and function of information framing practices in medical interactions.
Explorative, quantitative observational study with a mixed-methods design.
28 videorecorded hospital interactions, ranging from short-term/acute (orthopaedic surgery, gynaecology) to long-term/chronic care (oncology, gastroenterology) and involving 14 physicians and 28 patients.
Using a previously developed coding system, we analysed physicians’ framing practices. We extracted information sharing functions qualitatively, checking 10% of the analysis with an independent assessment from the physicians. To explore whether variation in physicians’ use of information frames stemmed from individual or clinical specialty differences, we estimated intraclass correlations. To assess how their use of information frames varied at the macro level (across clinical specialties) and micro (the immediate function in the interaction), we estimated linear mixed models adjusted for the number of words.
Variation in framing practices was mainly observed at the level of physicians nested within the same clinical unit (9.5% of the overall variance explained vs 1.3% for the unit level and 0.7% for the individual level). Physicians from different clinical units differed significantly in how they framed information, with the main differences between the gastroenterology and oncology units (mean difference=1.88; 95% CI 0.97; 2.79; p2 tests). Physicians from more short-term care units were oriented towards shared understanding, from gastroenterology towards inviting and convincing efforts and from oncology towards personal communication.
Results revealed signature marks of clinical units in terms of information sharing practices. Physicians’ information framing choices were driven both by the macro level (the clinical unit) and micro (the specific function for sharing information at that moment), thus highlighting potential areas for future interventions.
Individuals are diagnosed with terminal/chronic conditions on a daily basis globally. Unfortunately, a substantial proportion of the global disease burden of chronic illnesses is recorded within sub-Saharan Africa. Providing or receiving such news can be devastating and may be influenced by cultural preferences and contextual differences. Identifying existing trends and how such news is broken in sub-Saharan Africa will be relevant to identify and inform practice and future research.
This systematic review protocol was developed by following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P), and findings will be reported by following the guidelines and recommendations of PRISMA-2020. CINAHL, Global Health, MEDLINE, PubMed, Scopus, AJOL and APA PsycINFO will be searched for articles. Additional records will be gathered through reference harvesting in Google Scholar search. QualSyst will be used to assess the methodological quality of studies included. Thematic synthesis will be used to analyse and synthesise the findings from the eligible studies.
Due to the fact that systematic reviews focus on accessible and available literature without the direct involvement of human participants, ethical approval will not be sought. The completed review will be submitted to a peer-reviewed journal and may be presented at health conferences. The important findings would be shared with stakeholders and those involved in developing and conducting training for health practitioners, all of whom are involved in breaking bad news.
CRD42025642707.
The Surrey Communication and Language in Education Study (SCALES) cohort was established to estimate prevalence, persistence and impact of developmental language disorders on cognition and mental health, using newly established international consensus diagnostic criteria.
A population sample of 7267 children aged 4–5 years (59% of eligible children), who started state-maintained school in Surrey, England in 2011–2012 for whom teacher-rated screening data on language, behaviour and early learning goals were available. A subsample of monolingual children enriched for language difficulties completed intensive assessments in year 1 (age 5–6, n=529), year 3 (age 7–8, n=499), year 6 (age 10–11, n=384) and year 8 (age 12–13, n=246). Screening data for 7013 children has been linked to the UK Department of Education National Pupil Database data on special educational needs provision and academic progress.
Language disorders are more prevalent than other neurodevelopmental conditions (such as autism) and more common in areas of socioeconomic disadvantage. Language is a highly stable trait. Language status at school entry is therefore strongly predictive of long-term education progress, the need for specialist support, general cognitive abilities and increased risk for poor mental health, through its effects on social and emotional development.
The SCALES cohort will leave compulsory education in 2025 and we are planning to track academic qualifications and post-18 destinations. SCALES data are publicly available via the UK Data Service: DOI: 10.5255/UKDA-SN-8967-1 and DOI:
FreshRSS 