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Pain is a prevalent symptom in people living with dementia. Evidence shows that pain frequently remains unrecognised and untreated in this vulnerable population, leading to avoidable suffering. Effective pain management is hindered by multifactorial barriers at the individual, organisational and policy level. This study aims to achieve expert consensus on the key barriers to pain management in non-verbal people living with dementia and strategies to address these barriers within Portuguese residential care facilities.
An e-Delphi study will be conducted using two rounds of online questionnaires. The Behaviour Change Wheel (BCW) framework guided the development of e-Delphi statements by linking identified determinants (i.e., barriers and facilitators) to intervention functions. Barriers were extracted from the literature reviews and mapped into the capability, opportunity and motivation–behaviour model. Intervention functions were then selected using the BCW linkage matrices and operationalised into practical strategies. A purposive and snowball sampling approach will be used to recruit a heterogeneous panel of experts across national residential care facilities, including nurses, physicians, managers and policymakers with relevant experience in dementia. During the e-Delphi rounds, participants will be invited to rate the relevance of each barrier and associated strategy(ies) on a five-point Likert scale and provide comments or suggestions. Consensus will be defined as ≥75% agreement on each statement.
Ethical approval for this study was obtained from the Egas Moniz Ethics Committee (Ref. 1586), and all procedures will comply with the Declaration of Helsinki. Informed consent will be obtained from all participants. The findings will be disseminated through a peer-reviewed publication, scientific events and stakeholder networks, including residential care facilities, to inform future practice and policy in dementia care.
To observe and compare the environmental impacts of different types of infant feeding, considering the use of formula, infant feeding accessories, potentially increased maternal dietary intake during breastfeeding (BF) and food consumption habits.
An observational cross-sectional multicentre study conducted in the Barcelona Metropolitan Area of the Catalan Institute of Health.
Data were collected from 419 postpartum women on infant feeding type (formula milk and accessories), maternal dietary intake (24-h register) and food consumption habits from November 2022 to April 2023. The environmental impacts (climate change (CC), water consumption and water scarcity) of the infant feeding types and maternal diet were calculated using the IPCC, ReCiPE and AWARE indicators, respectively. The differences in impacts were calculated by Kruskal–Wallis test.
Significant differences for the three environmental impacts were observed. The CC impact of formula milk and feeding accessories was 0.01 kg CO2eq for exclusive BF, 1.55 kg CO2eq for mixed feeding and 4.98 kg CO2eq for formula feeding. While BF mothers consumed an extra 238 kcal, no significant differences were found related to maternal diet across feeding types.
Exclusive BF was the most sustainable type of infant feeding, considering formula and infant feeding accessories. In our study, the difference between the impacts of BF and non-BF mothers' diet was insignificant.
Offer informative and educational support for midwives and other healthcare professionals on BF and a healthy, sustainable diet to transfer this knowledge to the general public.
Raise the general public's awareness about BF and a healthy, sustainable diet. To reduce environmental impacts through behavioural changes.
STROBE.
Patients of the Catalan Health Service reviewed the content of the data collection tools.
Trial Registration: (for the whole GREEN MOTHER project): NCT05729581 (https://clinicaltrials.gov)
Diabetes mellitus is a significant global health challenge, requiring innovative strategies to improve management and mitigate complications. Digital health technologies offer promising solutions to enhance diabetes self-care by providing real-time feedback, improving communication and supporting data-driven decision-making. Despite the increasing adoption of digital self-care interventions, there is a lack of comprehensive synthesis of evidence on their impact, accessibility and integration into healthcare systems. This scoping review aims to map existing research on digital self-care solutions for diabetes management, identify knowledge gaps and highlight best practices and key factors influencing adoption.
The review will follow Arksey and O’Malley’s framework and adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic search will be conducted in Medline, Scopus, Embase, CINAHL and Google Scholar, focusing on studies published from January 2004 to December 2024 in English, French, Arabic, Portuguese, Spanish, Italian, Czech, Slovak and Chinese. Studies reporting on digital self-care solutions for diabetes management will be included, covering experimental and quasi-experimental study designs. Data extraction will cover study and participant characteristics, digital solution features, and barriers and facilitators to adoption. Ethical and equity considerations will also be analysed using established frameworks. Two reviewers will independently screen studies, with discrepancies resolved by a third reviewer.
This scoping review will provide a comprehensive understanding of digital self-care solutions for diabetes management, offering insights to inform future research and enhance self-care practices globally. Findings will be disseminated through peer-reviewed publications, conferences and interest holder engagements to inform clinical practice and policy development. As this study involves the review of existing literature, ethical approval is not required.
To examine the role of nurses in providing post-treatment follow-up care to breast cancer survivors, and to assess the impact of this care on survivors' satisfaction.
Scoping review.
An electronic literature search from PubMed and CINAHL databases was conducted, covering the period from 2013 to November 2023.
Twenty-seven articles were included in this review, highlighting key areas in which nurses play essential roles in the provision of post-treatment care for breast cancer survivors. The identified nursing roles include the surveillance and early detection of relapses, the assessment and support of self-management for late physical and psychosocial effects of cancer, health promotion and care coordination. Regarding satisfaction, survivors reported high overall satisfaction with nursing care. However, satisfaction levels varied with regard to specific needs, particularly in managing the fear of recurrence.
Nurses play a fundamental role in delivering post-treatment care to breast cancer survivors. However, evidence regarding their specific contributions and survivors' satisfaction with long-term care remains limited, underscoring the need for further research to enhance care during the long-term survivorship phase.
Consolidating the diverse roles of nurses in post-treatment care into a unified framework could support comprehensive and personalised care, addressing unmet needs. Evaluating patient satisfaction with nursing follow-up helps identify effective interventions and areas for improvement in future research.
This review analyses the diverse roles of nurses in the follow-up care of breast cancer survivors and highlights the impact of nursing care on patient satisfaction.
This study adhered to the PRISMA-ScR reporting guidelines.
No patient or public contribution.
La experiencia de un procedimiento quirúrgico puede ser angustiante tanto para los pacientes como
para sus familiares, lo que requiere la atención integral del equipo quirúrgico para minimizar las
inseguridades. Así, el objetivo de esta comunicación breve es reflexionar sobre la importancia de la
acogida humanizada en el Centro Quirúrgico y la Sala de Recuperación Postanestésica, presentando
aspectos prácticos para mejorar este enfoque. La humanización del cuidado implica una comunicación
efectiva, una atención personalizada y la creación de un ambiente acogedor. Este manuscrito destaca
estrategias para optimizar la acogida en el bloque quirúrgico. La humanización en la asistencia quirúrgica refuerza la esencia del cuidado en salud, yendo más allá de la mera aplicación de protocolos
técnicos
The way communication is conducted directly influences the professional–patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication.
Scoping review.
This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004–2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample.
The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented—considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening.
Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted.
This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.
To assess the proportions and associated factors of different post-discharge referrals among adolescents treated in the emergency department after a suicide attempt.
Observational, cross-sectional retrospective study.
We conducted a study using the medical records of 140 adolescents treated for a suicide attempt between January 2015 and May 2023 in a Brazilian emergency department, focusing on post-discharge referrals, defined as discharge without referral, unaddressed referral and referral addressed to the network. Associations between the outcomes and other variables were analysed using a Poisson regression model.
Discharges without referrals prevailed, followed by addressed and unaddressed referrals. Regression models showed associations between post-discharge and age, prior continuous use of psychotropic medications, location of care, continued suicidal ideation at discharge and evaluation by a multi-professional team.
A high number of adolescents were discharged from emergency departments without co-ordination with the mental health network, and the involvement of the multi-professional team was positively associated with addressed referrals.
This study informs healthcare professionals by raising awareness of their practices in discharging adolescents after suicide attempts in emergency departments, with the possibility of improving care quality and reducing the likelihood of readmission.
STrengthening the Reporting of OBservational studies in Epidemiology (STROBE).
No patient or public contribution.
Objetivo principal: Identificar las intervenciones adecuadas, desde el preoperatorio, para recuperar progresivamente la actividad previa a la formación del estoma, de forma segura. Metodología: Búsqueda de evidencias, siguiendo el modelo PRAXIS. Recomendaciones de Buena Práctica: a) motivar el autocuidado en el preoperatorio, b) instruir, el personal de hospitalización, en la movilización temprana adecuada c) promover la actividad física progresiva de forma individual d) instruir en habilidades y estrategias para una práctica deportiva segura Prácticas de autocuidado: saber manejarse y adaptarse a los cambios físicos, conocer tu cuerpo y desmitificar miedos, disfrutar de la actividad deportiva en grupo, compartir experiencias con otras personas ostomizadas.
Objetivo principal: Presentar, en forma de diario de campo, reflexiones sobre la experiencia docente en la docencia para la salud en Brasil, con enfoque en la pedagogía de Paulo Freire. Metodología: Presentar, en forma de diario de campo, reflexiones sobre la expe-riencia en la docencia para la salud en Brasil, con enfoque en la pedagogía de Paulo Freire. Resultados principales: La relación entre el docente y los alumnos proporcionó aprendizajes que implican descubrimientos para la necesidad de cambios y / o perfeccionamiento teórico, desde el punto de vista de la descolonialidad. Conclusión principal: A través del acto educativo, docentes y alumnos pueden desarrollar conocimientos para una práctica docente reflexiva.
Objetivo principal: Comparar la eficacia del uso del Expediente Clínico Electrónico (ECE) Vs Expediente Clínico Físico (ECF) en la mejora la calidad en atención de pacientes hospitalizados. Metodología: Se consideraron estudios relacionados con uso del ECE, utilizando los descriptores DeCS y MeSH, operadores booleanos AND, NOT y OR. Criterios inclusión: artículos de revisión con cinco años de publicación; criterios exclusión: pacientes ambulatorios o de consulta externa. Resultados principales: La evidencia establece ventajas del uso ECE como la facilidad de uso, accesibilidad, lectura, calidad en la documentación, control de información sobre los cuidados de los pacientes, cumplimiento normativo y toma de decisiones, lo cual reduce el riesgo de errores médicos; sin embargo, algunas desventajas es el empleo de hardware, software, redes; requiere soporte técnico las 24 horas al día. Conclusión principal: el empleo del ECE establece eficacia en la atención al paciente hospitalizado mediante la minimización de tiempos en registros y el aumento en la seguridad de la información.
Objetivo: Describir variables clínicas, sociodemográficas, Calidad de Vida Relacionada con la Salud (CVRS) en Hemodiálisis (HD) y Peritoneodiálisis (PD), en Hospital Puerto Montt, Chile. Metodología: cuantitativo descriptivo, transversal. n=75 (47 HD, 28 PD). Aprobado por Comité de Ética, revisión fichas clínicas, cuestionario sociodemográfico y KDQOL-36. Resultados: 51% mujeres, 49% hombres, 56% sector urbano, 20% 51-60 años. HD: 49% casados, 36% tratamiento sobre 84 meses. PD; 43% casados, 25% tratamiento 12-48 meses. KDQOL-36: 43% HD y 54% PD perciben “Buena” su salud. Esfera física; 25%, ambas terapias, refiere limitación en actividades de la vida diaria; 38% de PD refiere dolor “moderado”. Esfera psicológica; HD 28% refiere tranquilidad y sosiego “casi siempre”; PD 35% desánimo y tristeza “algunas veces”. Conclusiones: existe impacto negativo en dimensiones de CVRS; pero, globalmente considerada “Buena”; permitiendo formular mejoras para pacientes.
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