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This study aims to assess the feasibility of respondent-driven sampling (RDS) to recruit participants with recent abortion experiences in humanitarian contexts, and describe the composition of the study sample generated with this sampling method.
This was a three-phase mixed-methods community-engaged research study employing an exploratory and explanatory sequential approach. We conducted in-depth interviews, focus group discussions, an interviewer-administered questionnaire on abortion experiences and a health facility assessment.
Bidibidi Refugee Settlement, Uganda and Kakuma Refugee Camp, Kenya from November 2021 to December 2022.
Using RDS, we recruited 600 participants in Kakuma and 601 participants in Bidibidi with recent abortion experiences. In Kakuma, participants were primarily from Burundi, the Democratic Republic of the Congo and South Sudan; participants in Bidibidi were primarily from South Sudan. Most participants in both sites had completed at least some primary school and were not employed.
RDS recruitment dynamics: convergence and bottlenecks on key sociodemographic variables, recruitment and population homophily, reciprocity of social ties, success and experiences recruiting.
There were minor violations of RDS assumptions, particularly regarding assumptions of reciprocity of ties and seed composition independent of sample. In addition, there was a strong tendency of participants to recruit those from the same home country and living within the same camp zone. However, sample proportions for age, home country, marital status, zone of residence and student status reached equilibrium (stabilised) by around 500 participants at each site, and we were able to quickly attain the study sample size.
While the true representativeness of our sample remains unknown, RDS is a practical and effective recruitment method in humanitarian contexts for sensitive topics, particularly for research questions in which no data or sampling frames exist. However, attention to representativeness and community engagement is essential to optimising its application and ensuring success.
To provide bottom-up guidance on improving post-COVID care using patients’ experiences with received care and their perceived health
Qualitative study design using focus group interviews
30 patients with post-COVID condition recruited through purposive sampling based on patient complexity and diversity
Three dimensions for potential improvements of post-COVID care were identified: (1) building, supporting and maintaining patient resilience, (2) redesigning healthcare pathways to meet patient needs and (3) embedding post-COVID care in health systems and organisations. A conceptual framework that could guide improvements in post-COVID care was developed.
This study revealed several opportunities for improving and implementing post-COVID care following a person-centred approach in multidisciplinary integrated care pathways with an integrative vision of health.
Little research has been done on post-COVID symptoms at 24 months postinfection and on the association these may have on health-related quality of life (HRQOL).
We assessed the prevalence and severity of post-COVID symptoms and quantified EuroQol 5 Dimension 5 Level (EQ-5D-5L), self-perceived health question (EuroQol Visual Analogue Scale (EQ-VAS)) and health utility scores (HUS) up to 24 months follow-up.
The longitudinal multiple cohort CORona Follow-Up (CORFU) study combines seven COVID-19 patient cohorts and a survey among the general public. The participants received questionnaires on several time points. Participants were stratified by: without a known SARS-CoV-2 infection (control group), proven SARS-CoV-2 infection but non-hospitalised, proven SARS-CoV-2 infection hospitalised to the ward, and proven SARS-CoV-2 infection hospitalised to the intensive care unit (ICU).
In this study, data of seven COVID-19 patient cohorts and a survey among the general public are included.
Former COVID-19 patients and controls participated in this cohort study.
Former COVID-19 patients and non-COVID-19 controls were sent questionnaires on symptoms associated with post-COVID condition. The CORFU questionnaire included 14 symptom questions on post-COVID condition using a five-level Likert-scale format. Furthermore, HRQOL was quantified using the EuroQol EQ-5D-5L questionnaire: EQ-VAS and the EQ-5D-5L utility score. The EQ-5D-5L questionnaire includes five domains that are scored on a five-point Likert scale: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
A total of 901 participants (and 434 controls) responded at 24 months follow-up. In all former COVID-19 patients, the presence of post-COVID condition at 24 months was observed in 62 (42.5%, 95% CI 34.3% to 50.9%) of the non-hospitalised patients, 333 (65.0%, 95% CI 60.7% to 69.2%) of the hospitalised ward patients and 156 (63.2%, 95% CI 56.8% to 69.2%) of the ICU patients, respectively (p
Many former COVID-19 patients experience post-COVID symptoms at 24 months follow-up, with the highest prevalence in hospitalised participants. Also, former patients reported a lower HRQOL.
The CORFU study was registered at clinicaltrials.gov (registration number NCT05240742).
Virtual reality (VR) technology is increasingly being explored as a medium for delivering mindfulness-based interventions. While studies have investigated the feasibility and efficacy of VR-based mindfulness interventions, there has been limited synthesis of user experiences and perceptions across diverse applications, hindering the iterative refinement of these technologies and limiting evidence-based guidance for effective deployment in real-world settings. This systematic review aims to comprehensively identify, appraise and synthesise qualitative research on end-user experiences and perceptions of VR-based mindfulness interventions. Understanding user experiences is critical for translating research findings into practical design improvements and implementation strategies that enhance intervention effectiveness and user adoption.
A systematic search will be conducted in PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO and Scopus from inception to present. Studies reporting qualitative data on adult participants’ experiences, perceptions, attitudes or opinions related to VR-based mindfulness interventions will be included. Two independent reviewers will screen studies, extract data and assess methodological quality using the Critical Appraisal Skills Programme checklist. Thematic synthesis will be used to analyse the qualitative data. The Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach will be applied to assess confidence in the review findings.
Ethical approval is not required as this review will be based on published studies. The findings will be disseminated through peer-reviewed publication and conference presentations.
CRD42024594330.
by Ramesh Malashi, Sunita Sharma, Srijana Adhikari, Chitra Raj Sharma, Arun Kumar Joshi, Buna Bhandari
IntroductionHypertension is a significant risk factor for cardiovascular diseases (CVDs), which remains the leading causes of morbidity and mortality globally, with a disproportionate impact on low and middle income countries. While hypertension is prevalent across various populations, government employees are particularly susceptible due to high stress levels, sedentary lifestyles, and work-related pressures. Therefore, this study was undertaken to assess the prevalence of hypertension and its associated risk factors among government employees in the Doti district of Nepal.
MethodsA cross-sectional study was carried out among 195 government employees in Dipayal Silgadhi Municipality of Doti district of Sudurpashchim province of Nepal. The data was collected through face-to-face interviews using Simple Random Sampling (SRS) technique and analysed using SPSS v25. The structured questionnaire adopted from the WHO STEPS survey tool was used for data collection. Bivariate and multivariate logistic regression model was used to assess the factors associated with hypertension.
ResultsThe prevalence of hypertension among government employee was 36.4%% ± 5.6%. Participants with age group 30–40 years [Adjusted Odd’s Ratio (AOR) 14.4, 95% Confidence Interval (CI) (1.6, 127.7)], 40–50 years [AOR 13.7, 95% CI (1.04, 180.3)] and work experience (20–30 years) [AOR 6.67, 95% CI(1.23, 35.9), and drinking alcohol [AOR 0.35, 95% CI (0.17, 0.72)] were found to be statistically significant with hypertension.
ConclusionThe study revealed the high prevalence of hypertension among government employees; significantly associated with risk factors like age group 30–50 years, work experience and alcohol consumption, indicating an alarming public health concern. These results highlight the pressing need for focused interventions to reduce the risk of hypertension and its related problems among government employees, such as lifestyle changes, workplace health programs, and routine health screenings.
This study aimed to investigate the relationship between coping strategies and compassion fatigue among healthcare professionals in Central Uganda.
A facility-based cross-sectional study conducted between June and July 2023. Three tools were used for data collection: a socio-demographic survey, the Professional Quality of Life Scale (ProQOL-5) and the Brief-Coping, Orientation to Problem Experienced tool. Participants were asked to recall experiences from the previous 30 days.
The study was conducted in five prominent hospitals in Central Uganda.
A total of 548 healthcare providers, including 191 physicians, 256 nurses and 103 technicians.
Compassion fatigue scores.
Most participants were under 29 years old (50.9%) and women (62.0%). High levels of compassion fatigue were reported by 37.8% of participants. Active coping, self-distraction and denial were associated with higher compassion fatigue, while informational support, positive reframing and venting were linked to lower fatigue levels. Seeking social support effectively reduced compassion fatigue.
The findings highlight significant compassion fatigue among healthcare providers in Central Uganda, impacting their well-being and patient care. Coping strategies like active problem-solving and social support are promising in mitigating compassion fatigue. Interventions should focus on reducing self-distraction, enhancing problem-solving skills and fostering supportive work environments to improve healthcare workers’ well-being and patient care quality.
Over one billion adults attend emergency departments (EDs) internationally every year, including 6.6 million in Australia. Up to half of these patients have a peripheral intravenous catheter (PIVC) inserted. Although healthcare workers believe that placing a cannula is helpful (‘just in case’), PIVCs often remain idle. PIVC insertion is painful for patients, takes clinicians’ attention away from other care, has adverse outcomes and causes major economic and environmental burden. Our aim is to codesign an implementation toolkit to reduce unnecessary PIVC insertions and improve other national quality indicators using an implementation science framework.
A stepped-wedge cluster-controlled trial will be conducted in nine ED sites (clusters) across Australia. The interventions will be codesigned with and adapted to sites based on local context. The interventions are evidence-based multimodal intervention (MMI) and aligned to the 2021 Australian Commission for Safety and Quality in Health Care National PIVC Clinical Care Standard. The Consolidated Framework for Implementation Research and Learning Health System will be used to guide implementation. Interventions will be phased across three steps (three sites per step), and each site will collect control and postintervention data using mainly routinely collected clinical data. Each site will be allocated to receive the intervention at one of three study steps. Implementation strategies will tailor broad clinician and consumer engagement, policy changes, education, audit and feedback and clinical champions, along with environment and equipment changes, to each site. The primary objective is to reduce the proportion of adult patients who have a PIVC inserted by 10%. We will evaluate the clinical, implementation and cost-effectiveness of the intervention.
Study findings will be used to conduct a health economic analysis, develop an implementation toolkit and inform a sustainable roadmap for national roll-out. This will meet the needs of a diverse range of EDs nationally and internationally.
The protocol was approved by the Monash Health Human Research Ethics Committee (HREC Reference Number: HREC/100808/MonH-2023-390692(v3)). The outcomes of this trial will be disseminated through peer-reviewed publications, conference presentations and communication with study partners and stakeholders including professional colleges and the Australian Commission for Safety and Quality in Health Care.
Australian New Zealand Clinical Trials Registry registration number: ACTRN12623001248651. Date of registration: 1 December 2023. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386256&showOriginal=true&isReview=true
The Dutch Head and Neck Audit–Oral Cavity (DHNA-OC) cohort was collected to study the quality of care, current treatment and survival for oral cavity cancer (OCC) across all hospitals treating head and neck cancer (HNC) in the Netherlands.
The DHNA-OC is a registry-based national cohort of 2545 first primary OCC patients treated with curative intent between 2018 and 2021. All 14 HNC hospitals in the Netherlands contributed, guaranteeing national coverage. The DHNA-OC cohort is an elaborate dataset including variables on patient and tumour characteristics, treatment, complications, recurrence rates and survival.
The median age at diagnosis was 67 years and most tumours were early stage (cT1 in 32% and cT2 in 31%). Tongue tumours were most common, and surgery was performed in 91.3% of the patients. The number of included patients per hospital varied from 82 to 367. The proportion of advanced tumour stage varied significantly between hospitals. Substantial data completeness was acquired with only two variables exceeding 10% missing (comorbidities and performance score).
The DHNA-OC cohort will be used to study benchmarking of and current knowledge gaps in OCC care. Collaboration with other institutions or national/regional databases is highly encouraged. Some examples of planned studies are the assessment of hospital variation in outcome indicators for surgery and population-based treatment effects. The results of these studies will be used to identify best practices and continue improving the quality of care. Longitudinal cohort follow-up and enrolment will continue prospectively.
The purpose of this integrative review was to identify effective diabetes self-management education and support for increasing adult primary care referrals, participation rates and improving health outcomes for persons with diabetes.
Integrative review.
A systematic literature search of PubMed/MEDLINE, Embase and CINAHL was performed by applying the PRISMA guidelines. Following Whittemore and Knafl's method, 11 papers were included for review.
Integration of diabetes self-management education and support in primary care clinics and a multifaceted approach resulted in improved referral and participation rates, ameliorated glycated haemoglobin A1C and boosted patient, provider and staff satisfaction.
Patient-centred multifaceted interventions can boost current diabetes self-management education referrals and participation rates and enhance health outcomes for persons with diabetes. Nurses in their role as primary care providers, diabetes educators and clinic staff are well-positioned to undertake this intervention. Further investigation is needed to explore the impact of these interventions among individuals with type 1 diabetes, gestational diabetes and those living across various global regions.
Along with other healthcare providers, nurses are qualified to advocate for, and lead programmes that increase referrals for persons with diabetes to improve health outcomes. Additionally, as primary care providers, nurse practitioners are well placed to positively impact the outcomes of individuals with diabetes by referring them to diabetes self-management education. Nurses, as diabetes educators, are well positioned to implement diabetes self-management education which can improve patient outcomes.
Improved referral of persons with diabetes to diabetes self-management education and increased participation have the propensity to contribute to the achievement of positive health outcomes for individuals living with Type 2 Diabetes.
There is no patient or public contribution for this review.
by Iheanyi Oby Nwaoha, Albain Ayime Balibuno, Nuha Ibrahim
IntroductionDiabetic Retinopathy (DR) is a microvascular complication of chronic Diabetes that can lead to visual impairment if left untreated. While concerted efforts have been made to develop screening modalities to facilitate the early detection of Diabetic Retinopathy in sub-Saharan Africa, little is known about the factors impacting the optimal use of these screening services. This paper aims to identify and highlight factors associated with the access of Diabetic Retinopathy screening services from patient and service provider perspectives.
MethodologyThis scoping review was conducted using the Arksey and O’Malley (2005) framework. A comprehensive search of peer-reviewed articles and grey literature was conducted from May 2023 to June 2023. Electronic databases searched include Medline, Embase, PubMed, CINAHL Complete, APA PsycINFO, Web of Science, and African Journal Online (AJOL). Two reviewers independently screened the retrieved records for eligibility, and relevant data was extracted from the included studies. A descriptive overview of key findings was provided, and the 5As conceptual framework of access to healthcare was used to map the identified factors.
ResultsThe search strategy yielded 873 records. Of those, 19 studies met the criteria for inclusion. Health literacy and duration of Diabetes were reported in 12 and 9 studies as the most common factors associated with DR screening services access. Similarly, age at onset and inadequate referral by healthcare providers were cited as significant determinants of DR screening access in 7 studies, respectively.
ConclusionThe 5As framework of access to healthcare aids our understanding of factors associated with the access of DR screening from patient and service provider standpoints. To address these issues, there is a need for more research on this topic to design effective DR screening services in the region.
To investigate the real-world experiences of nurses' using smart glasses to triage patients in an urgent care centre.
A parallel convergent mixed-method design.
We collected data through twelve in-depth interviews with nurses using the device and a survey. Recruitment continued until no new themes emerged. We coded the data using a deductive-thematic approach. Qualitative and survey data were coded and then mapped to the most dominant dimension of the sociotechnical framework. Both the qualitative and quantitative findings were triangulated within each dimension of the framework to gain a comprehensive understanding of user experiences.
Overall, nurses were satisfied with using smart glasses in urgent care and would recommend them to others. Nurses rated the device highly on ease of use, facilitation of training and development, nursing empowerment and communication. Qualitatively, nurses generally felt the device improved workflows and saved staff time. Conversely, technological challenges limited its use, and users questioned its sustainability if inadequate staffing could not be resolved.
Smart glasses enhanced urgent care practices by improving workflows, fostering staff communication, and empowering healthcare professionals, notably providing development opportunities for nurses. While smart glasses offered transformative benefits in the urgent care setting, challenges, including technological constraints and insufficient organisational support, were barriers to sustained integration.
These real-world insights encompass both the benefits and challenges of smart glass utilisation in the context of urgent care. The findings will help inform greater workflow optimisation and future technological developments. Moreover, by sharing these experiences, other healthcare institutions looking to implement smart glass technology can learn from the successes and barriers encountered, facilitating smoother adoption, and maximising the potential benefits for patient care.
COREQ checklist (consolidated criteria for reporting qualitative research).
No patient or public contribution.
Nurses play an essential role in responding to severe viral disease which bring considerable challenges to their personal and professional well-being. This subsequently can affect the delivery of care and healthcare systems' organisational capacity to respond. Understanding nurses' experiences of these challenges will help inform healthcare policies.
To explore the experiences and coping strategies of nurses caring for patients during severe viral disease pandemics.
A mixed-methods systematic review informed by the Joanna Briggs Institute (JBI) methodology.
A mixed-methods systematic review. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA and Scopus were searched on 4th April 2021. Results were reported in accordance with PRISMA. The findings were analysed and reported in the context of the Self-Regulatory Common-Sense Model.
In total, 71 peer-review primary research articles describing nurses' experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza or SARS-CoV-2 / COVID-19 published in English from 2003 to 2021 were included. We found links between nurses' perception of the health threats, their emotional reactions, and coping strategies. Perceived health threats were influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, onerous workloads and working hours, unavailability of PPE, and lack of knowledge and training in pandemic management. These impacted nurses' physical, psychological and social well-being. Nurses also reported helpful and unhelpful coping strategies to manage the health threats.
It is vital for stakeholders, policymakers, government and healthcare institutions to recognise and monitor the wider impact on healthcare workers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to offset the anticipated impact pre and post pandemics/epidemics is needed. Our findings can inform those strategies for similar future health emergencies.
Nurses are often the first point of contact in providing direct care to patients, hence they are at high risk of being infected. The findings from this review can help managers and policymakers in developing programmes to enhance resilience in the nursing workforce.
This was a literature review study.
To synthesise and describe the combined evidence from systematic reviews of interventions using elements from the Transitional Care Model, on the content and timeframe of the interventions and the related improvement of outcomes for older patients with multiple chronic conditions.
The population of older patients with multiple chronic conditions is increasing worldwide and trajectories are often complicated by risk factors. The Transitional Care Model may contain elements to support transitions between hospital and home.
An umbrella review.
A comprehensive search in five electronic databases was performed in April 2021 based on the search terms: ‘Patients ≥60 years,’ ‘multi-morbidity,’ ‘Transitional care model,’ ‘Transitional care,’ and ‘Systematic review.’ PRISMA guidelines was used.
Five systematic reviews published from 2011 to 2020 comprising 62 intervention studies (59 randomised controlled trials and three quasi-experimental trials) were included in the review. The synthesis predominantly revealed significant improvements in decreasing re-admissions and financial costs and increasing patients' quality of life and satisfaction during discharge.
The results of the review indicate that multiple elements from the Transitional Care Model have achieved significant improvements in older patients' transitions from hospital to home. Especially a combination of coordination, communication, collaboration and continuity of care in transitions, organised information and education for patients and pre-arranged structured post-discharge follow-ups.
The transition from hospital to home is a complex process for older patients with multiple chronic conditions. A specific focus on coordination, continuity, and patient education should be implemented in the discharge process. Nurses with specialised knowledge in transitional care are needed to ensure safe transitions.
The umbrella review is part of a larger research program which involved a patient expert advisory board, which participated in discussing the relevance of the elements within the umbrella review.
FreshRSS 