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To compare recovery after laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH).
A parallel, open, non-inferiority, multicentre, randomised controlled, expertise-based surgery trial.
10 NHS (National Health Service) hospitals within the UK.
Women undergoing hysterectomy for a benign gynaecological condition.
Consenting women of 18–55 years were randomised to LH or AH using a secure internet facility by a surgeon with self-declared expertise. Major complications were recorded by clinicians, and recovery was assessed by regular text messaging and postal questionnaires.
Major surgical complications (Clavien-Dindo≥level 3) up to six completed weeks postsurgery, time to resumption of normal activities measured by the Patient-Reported Outcomes Measurement Information System Physical Function tool and quality of recovery at 24 hours (Quality of Recovery 15 score; 0–150).
75 women were randomised before early curtailment of the trial; 32/39 (82%) and 30/36 (83%) women underwent LH and AH, respectively. Major complications occurred in 2/32 (6%) LH versus 4/30 (13%) AH groups. No difference in time to resumption of usual activities was found (median [IQR, n] 7.5 weeks (3.6–8.2, 25) LH vs 7.5 weeks (5.5–10.6, 26) AH groups or quality of recovery (mean [SD, n] 81.1 (13.4, 27) vs 72.3 (17.6, 22), respectively; adjusted mean difference 7.2, 95% CI –3.2 to 17.6).
No differences were found in complications or recovery between LH and AH. However, early cessation of the trial due to recruitment challenges limits clinical inferences. It is important that larger comparative trials are conducted now that LH, including robotics, is becoming adopted as standard practice.
ISRCTN14566195, IRAS ID 287988.
The majority of patients with cancer tend to seek health-related information via the Internet. This descriptive and cross-sectional study aims to determine e-health literacy, cyberchondria levels, and affecting factors in patients with cancer. The population of the study consisted of 113 patients who were older than 18 years, with no sensory loss that could hinder their communication, literate in Turkish language, who were conscious, actively used the Internet, and visited a university hospital's oncology and hematology polyclinic. In the multiple regression analysis examining the E-Health Literacy Scale total score according to sociodemographic and other characteristics, it was found that solitary complementary and alternative medicine explained 40.8% of the variance in the E-Health Literacy Scale score (adjusted R2 = 0.408, P Antimicrobial resistance is a significant global health challenge, exacerbated by unnecessary antibiotic prescribing. Respiratory tract infections (RTIs) are common reasons for antibiotic prescribing in primary care, despite most being viral or bacterial infections that are self-limiting. C-reactive protein (CRP) point-of-care tests (POCTs) are promising tools to support antibiotic stewardship by guiding the management of lower RTIs (LRTIs). The aim of this study was to develop best practice guidance for using CRP POCT in the management of LRTIs in primary care.
Scoping review findings informed guidance statements, which were then evaluated through a three-round Delphi process with an expert panel via web-based questionnaires. Statements focused on intended use, detection of bacterial LRTIs, communication strategies, device features, performance and ease of use of CRP POCT.
The panel of experts included 19 healthcare professionals across several specialties, including general practitioners, community pharmacists, hospital pharmacists and respiratory physicians.
Panellists rated each guidance statement using a 5-point Likert scale, with acceptance, revision or rejection determined using predefined cut-off scores for medians and interquartile ranges. Statements were revised between rounds using the feedback provided by panellists.
In the first round, 49 statements were evaluated; 16 were accepted, nine removed and 24 revised for the second round. Of the 24 statements evaluated in the second round, 17 were accepted and seven were revised. In the third round, consensus was reached on four of the seven statements presented, resulting in 37 final guidance statements. These statements covered key areas, including the appropriate use of CRP POCTs to guide antibiotic prescribing, CRP cut-off values, integration with clinical decision rules, device performance and operational considerations, training requirements and financial reimbursement. The panel emphasised the need for structured guidelines to align CRP POCT use with clinical context and highlighted its role in improving diagnostic confidence while supporting antibiotic stewardship.
This study provides a set of best practice guidance statements to support the use of CRP POCT in the management of LRTIs in primary care. Dissemination and further research are required to assess their impact.
To examine the relationship between the level of satisfaction of Maslow's hierarchy of needs and loneliness, happiness and life satisfaction in elderly individuals.
This cross-sectional, descriptive and correlational study was conducted with the elderly in Turkey.
Data were collected using the Personal Information Form, Maslow's Hierarchy of Needs Assessment Form, UCLA Loneliness Scale Short Form, Oxford Happiness Scale Short Form and Satisfaction with Life Scale. The STROBE checklist was used to guide the presentation of this study.
Participants generally exhibited a significant relationship between the satisfaction levels of Maslow's hierarchy of needs and indicators of mental well-being such as loneliness, happiness and life satisfaction. Key factors influencing the satisfaction of needs included educational level, marital status, economic status and living with a spouse. Moreover, higher levels of life satisfaction and happiness positively impacted overall needs satisfaction, whereas loneliness showed a negative relationship. These findings emphasise the interconnectedness of socio-demographic and psychological factors in shaping well-being in elderly individuals.
The results of this study show that if the level of meeting the needs of the elderly is high, their loneliness decreases and their happiness and life satisfaction increase. Improving the socioeconomic levels of the elderly affects their health. Therefore, it is important for nurses to take a more active role in the development of policies to improve the health of the elderly.
By examining the effects of different levels of Maslow's hierarchy of needs on loneliness, happiness and life satisfaction of elderly individuals, determining important data to improve their psychological and emotional well-being contributes to the development of social support systems and policies that will improve the quality of life of the elderly in society.
To report on the findings from a national survey of UK intensive care units (ICUs) exploring nurse staffing models currently in use and changes since COVID-19.
A survey was designed and distributed using a web-based platform to senior unit leads via Intensive care national audit & research centre contacts.
Senior nurses representing the 331 National Health Service adult ICUs across the UK (across 231 hospitals/155 trusts), including the Channel Islands and Isle of Man.
A 15-item survey.
A total of 196 survey responses representing 300 units, majority general and single units, resulting in a 90.6% unit-level response rate. ICU unit characteristics included the average number of total, level 3 and level 2 critical care beds of 26.36 (SD=21.48), 15.67 (SD=15.33) and 10.96 (SD=8.86), respectively. Most units reported nurse to patient ratios compliant with national guidelines and service specifications. Post-COVID-19 changes to ICU nurse staffing establishments were reported by 44% respondents, including increases in non-registered staff. However, limited data were provided regarding decision-making around and changes to bedside allocation of nurses since COVID-19.
Increased numbers and use of non-registered staff within the ICU is indicative of an alternative staffing model to address nursing shortages. However, more research is needed to understand how this staffing group is being used compared with, and alongside, registered nurses.
Clinicaltrials.gov: NCT05917574.
Chronic diseases requiring long-term treatment, care, and follow-up can negatively affect the health and well-being of caregivers. Mindfulness-based interventions (MBIs) are increasingly used as a mental health intervention to control the psychological problems experienced by caregivers and improve their quality of life.
This systematic review and meta-analysis aimed to provide evidence for a holistic evaluation and synthesis of the effects of MBIs applied to caregivers of adults with chronic disease on the burden, quality of life, and psychological distress.
Studies evaluating the effects of mindfulness-based interventions on caregivers of adults with chronic diseases and published through September 2023 were searched using PubMed, Web of Science, Scopus, and EBSCO. Methodological quality was assessed with the modified JADAD scale, and bias was assessed with the Cochrane risk-of-bias tool for randomized trials. Randomized controlled studies were included. The standardized mean difference with a 95% confidence interval was calculated. Heterogeneity was analyzed using the I 2 test and Q statistic. Publication bias was assessed with the Egger regression test.
This meta-analysis included 12 studies. Pooled evidence found that MBIs resulted in significant improvements in stress, anxiety, depression, and caregiver burden in caregivers of adults with chronic illness but had no significant effects on quality of life, resilience, and mindfulness. The Egger's test showed no evidence of publication bias.
MBIs can be considered as a helpful method to increase psychological well-being and reduce caregiver burden in caregivers of adults with chronic diseases. These findings may direct clinicians to conduct mindfulness-based interventions for caregivers of adults with chronic diseases.
This study aims to determine the relationship between perceptions of nursing presence and intensive care experiences in adult intensive care unit patients'.
Intensive care units (ICUs) are settings where patients have many negative emotions and experiences, which affect both treatment and post-discharge outcomes. The holistic presence of nurses may help patients turn their negative emotions and experiences into positive ones.
A descriptive-correlational design was used and reported according to the STROBE checklist.
The sample consisted of 182 participants. Data were collected using a personal information form, the Glasgow Coma Scale (GCS), the Intensive Care Experience Scale (ICES), and the Presence of Nursing Scale (PONS).
A strong positive correlation existed between total ICES and PONS scores (r = 0.889, p < 0.001). There was a strong positive correlation between PONS total score and ICES subscales (awareness of surroundings (r = 0.751, p < 0.001), frightening experiences (r = 0.770, p < 0.001), recall of experience (r = 0.774, p < 0.001), and satisfaction with care (r = 0.746, p < 0.001)). Males (β = −0.139, p < 0.05), and patients who were university and higher education graduate (β = 0.137, p < 0.05) had higher positive ICU experiences. It was also found length of ICU stay was correlated with ICU experiences and nursing presence.
The more positively the patients perceive nurses, the better ICU experiences they have. Gender and education level were found determinants of adult ICU patients' experiences. ICU length of stay predicted what kind of experience patients have and how much they feel the presence of nurses.
Nurses should make their presence felt completely and holistically by using their communication skills for patients have more positive intensive care experiences. Nurses should consider variables which affects patients' ICU experiences and nursing presence.
FreshRSS 