Search Results (285)

Background/Objectives: Caring behaviors are key components of nursing practice and contribute to patient outcomes and satisfaction. In emergency departments (EDs), where care is delivered under time pressure, caring behaviors may be shaped by organizational constraints. Patients and nurses may perceive caring behaviors differently. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the CBI-24 and CBI-24-P for use in Slovenian EDs, assess the level of caring behaviors among ED nurses, examine differences in perception between nurses and patients, and explore whether selected sociodemographic factors are associated with perceived caring behaviors in the ED. Methods: A multicenter cross-sectional study was conducted between October 2025 and January 2026 in ten EDs in Slovenia. Descriptive and inferential statistical methods were applied. Results: A total of 354 nurses completed the Slovenian CBI-24, and 288 patients completed the Slovenian patient version, designated the CBI-24-P. Caring behaviors were rated highly by both nurses and patients. Among patients, the highest ratings were observed for safety-related aspects of care, such as giving medication (M = 5.42; SD = 0.85) and treating patient information confidentially (M = 5.53; SD = 0.83). Among patients, caring behaviors showed weak positive correlations with age (r_s= 0.131) and weak negative associations with waiting time (r_s = −0.299). Conclusions: Caring behaviors in Slovenian EDs are perceived as high, with emphasis placed on technical competence. Communication, responsiveness, and workflow organization remain relevant areas for further investigation and quality improvement. Full article

This study analyses changes in university students’ self-perceived eco-social competences through active methodologies linked to holistic sustainability and human rights. A multidimensional rubric based on the KNOW–CARE–DO model was applied to assess four eco-social competences: (1) critical contextualisation of knowledge in relation to social, economic, and environmental issues; (2) respect for human rights, diversity, equity, a culture of peace and participation; (3) undertaking actions for the common good and sustainable development; and (4) the application of ethical principles linked to sustainability and human rights. A pre-experimental design incorporating pre-test and post-test measurements was used. The study involved 61 students from universities in Spain, Colombia, and Italy. An open-ended question was included to complement the quantitative data. The results indicate significantly higher self-perceived competence scores at post-test than at pre-test, particularly in the critical contextualisation of knowledge. The rubric demonstrates acceptable-to-high internal consistency, although further psychometric validation is required. Full article

Background/Objectives: Primary Health Care is central to universal health coverage and equity. Nurses can facilitate effective accessibility, but their social imaginaries may influence clinical interaction and the perceived legitimacy of migrants’ demands. The aim of this study was to understand how Primary Care nurses construct social imaginaries about migrants. Methods: An interpretive qualitative study informed by a critical anthropological perspective was conducted. Eight Primary Health Care nurses participated. Purposive sampling was followed by snowball sampling. Between January and July 2025, in-person semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Three themes were identified: (1) the construction of otherness; (2) the migration process; and (3) the “luck” of having healthcare and not being able to demand it. Participants’ discourses combined vulnerability and racialized differentiation with narratives of perceived abuse, deservingness, expected gratitude, and possible informal forms of access regulation. Conclusions: Across the three themes, social imaginaries simultaneously constructed migrants as vulnerable and as users suspected of abuse, linking these representations to judgments of deservingness and the legitimacy of healthcare demands. Primary Health Care nurses may act as facilitators or informal barriers to effective accessibility, supporting culturally sensitive, compassionate, anti-racist, and migrant-sensitive healthcare. Full article

Background: Saudi Arabia’s healthcare system serves an increasingly diverse patient population, yet limited qualitative evidence exists regarding how pediatric nurses navigate cultural complexity in their daily practice. Understanding nurses’ day-to-day experiences of cross-cultural care is essential for strengthening culturally sensitive pediatric services. Purpose: This study explored the experiences of pediatric nurses in providing culturally sensitive care to children and their families in Riyadh, Saudi Arabia. Methods: A qualitative descriptive study was conducted in pediatric units of tertiary hospitals in Riyadh City, Saudi Arabia. Eighteen pediatric nurses participated in semi-structured interviews. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, and reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Four themes emerged: navigating cultural landscapes, describing nurses’ encounters with diverse cultural beliefs and health practices; communication as a bridge and a barrier, reflecting language challenges and strategies for meaningful engagement; balancing professional standards with cultural respect, highlighting the tension between evidence-based care and cultural accommodation; and the emotional labor of cross-cultural caregiving, capturing the personal toll and resilience involved in culturally diverse practice. Conclusions: Pediatric nurses engage in complex interpretive, relational, and emotional work when providing culturally sensitive care. Institutional support through cultural competence training, multilingual resources, and organizational policies is essential for enhancing culturally responsive pediatric nursing practice in diverse healthcare settings. Full article

Background/Objectives: Clinical alarm management in continuous patient monitoring systems remains a major challenge in intensive care units (ICUs). The high frequency of nonactionable alarms contributes to alarm fatigue among healthcare professionals, potentially compromising patient safety, clinical surveillance, and the quality of nursing care. As nurses play a central role in monitoring critically ill patients, evidence-based alarm management strategies are essential to improve the quality of care and patient outcomes. This review aimed to synthesize the scientific evidence on nursing interventions for managing clinical alarms in continuous monitoring systems and their contribution to patient safety and quality of care among critically ill patients. Methods: An integrative literature review was conducted following the methodological framework proposed by Whittemore and Knafl. A comprehensive literature search was performed in CINAHL Plus with Full Text, MEDLINE with Full Text, Supplemental Index, Complementary Index, Academic Search Index, the Directory of Open Access Journals (via EBSCOhost^®), PubMed, Scopus, and ScienceDirect. Studies published between 2020 and 2025 in English, Portuguese, or Spanish were eligible for inclusion. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Nine studies met the eligibility criteria and were included in the final synthesis. Results: The identified interventions were grouped into five main domains: alarm parameter customization, nurse education and training, implementation of structured protocols and alarm management bundles, optimization of monitoring devices and sensors, and interventions addressing human and organizational factors. The evidence indicated that multifaceted and integrated interventions were associated with reductions in nonactionable alarms and improvements in clinical responses to alarms. However, their effectiveness in reducing alarm fatigue appeared to depend on organizational culture, staff engagement, and contextual factors. Conclusions: Effective alarm management requires the consistent implementation of evidence-based nursing interventions. Nurses play a pivotal role in promoting patient safety through clinical expertise, technological competence, and adherence to structured alarm management practices. Strengthening alarm management strategies may contribute to improved quality of care, safer care delivery, and better outcomes for critically ill patients. Full article

Post-hemorrhagic hydrocephalus (PHH) is a serious neurological sequela of severe intraventricular hemorrhage (IVH) in premature infants and remains one of the leading indications for ventriculoperitoneal (VP) shunt placement. Evaluating possible VP shunt-related complications can be challenging because clinical manifestations are often nonspecific, neuroimaging may initially appear unchanged, and microbiological cultures may remain negative. We report the case of a 19-month-old male born at 28 weeks’ gestation who developed Grade IV germinal matrix/intraventricular hemorrhage with bilateral intraparenchymal extension, early periventricular cystic leukomalacia, and post-hemorrhagic communicating hydrocephalus requiring multiple cerebrospinal fluid diversion procedures culminating in long-term VP shunt dependence. His medical history was notable for recurrent neonatal meningitis, secondary epilepsy with previous episodes of status epilepticus, secondary adrenal insufficiency, and severe global developmental delay. He presented with fever, recurrent coffee-ground vomiting, abdominal distension, progressive lethargy, reduced responsiveness, and localized erythematous swelling over the cranial VP shunt reservoir, raising concern for possible shunt-related pathology. During hospitalization, he deteriorated with status epilepticus and respiratory failure, with clinical concern for increased intracranial pressure, requiring admission to the Pediatric Intensive Care Unit (PICU). Laboratory investigations demonstrated leukocytosis, elevated C-reactive protein, cerebrospinal fluid pleocytosis, markedly elevated CSF protein, and CSF glucose of 2.0 mmol/L, for which a paired serum glucose value was unavailable, while repeated blood, urine, wound, and CSF cultures remained negative. Initial computed tomography (CT) demonstrated no significant interval change in the chronic hydrocephalus despite progressive neurological deterioration; however, serial neuroimaging later revealed progressive bilateral extra-axial fluid collections with radiological features suggestive of an evolving subacute subdural hemorrhage. The patient was managed with empirical broad-spectrum intravenous antibiotics, aggressive seizure control, stress-dose corticosteroids, respiratory support, and continuous multidisciplinary monitoring. His neurological and respiratory status subsequently improved, and he returned to his pre-admission neurological baseline before discharge with planned further evaluation at a tertiary pediatric neurosurgical center. This case highlights the diagnostic uncertainty surrounding acute neurological deterioration in a child with shunt-dependent PHH. VP shunt-related infection or malfunction remained important but unconfirmed diagnostic considerations, alongside competing or potentially overlapping contributors including status epilepticus, evolving extra-axial collections, respiratory infection, and endocrine or metabolic decompensation. No single etiology was definitively established. The case emphasizes the importance of serial neurological assessment, consideration of alternative diagnoses, repeat neuroimaging, and multidisciplinary evaluation when initial investigations do not establish the cause of deterioration. Full article

This paper presents a pilot educational workflow that couples 3D remote sensing with heritage-driven pedagogy by engaging architecture master’s students in the documentation and digital archiving of Transylvanian cultural sites. Using terrestrial and mobile 3D scanning, students documented multiple typologies—wooden churches (Târgușor, Tioltiur), historical ensembles (Mociu, Coplean), industrial sites (1 Mai–Luduș, Vânătorilor–Luduș), and an urban street segment (Potaissa)—to generate dense point clouds that served as the basis for geometric reconstruction, semantic interpretation, and condition assessment. The study describes how the characteristics of different construction systems (timber, brick, stone, mixed structures) relate to point-cloud quality, survey coverage, and subsequent CAD/BIM drafting, with attention to the qualitative reading of minor deformations in wooden churches and of degradation patterns in masonry and industrial buildings. We also consider how artefacts in the data (noise, occlusions, registration errors) affect scene understanding and the interpretation of derived observations relevant to condition assessment and, prospectively, to monitoring. For the Tioltiur dual-sensor case, the TLS and SLAM datasets were compared through an internal CloudCompare registration check (final RMS 0.1121 on 50,000 points, fixed scale 1.0 and theoretical overlap 100%), surface-density displays (r = 0.005 for the Z+F dataset and for the GeoSLAM dataset), fitted-wall-plane readings (dip values around 89 deg. and 85 deg.) and a longitudinal section documenting roof/vault deformation. Beyond technical performance, the paper examines the self-reported formative impact on students’ digital skills and their understanding of cultural values, arguing that participation in 3D data acquisition, processing, and interpretation positions them as co-creators of a living digital archive. Pre- and post-workshop questionnaires (n = 13 each) are analysed descriptively—counts, percentages and medians with interquartile ranges—because the two instruments are unmatched and carry no shared identifier, so no paired test is applied; post-workshop self-ratings of technical competence, heritage understanding, archival awareness and collaboration were consistently high (medians 4–5), with uneven access to VR the main gap. By connecting point-cloud-based documentation workflows with heritage education, the project outlines a transferable, monitoring-ready baseline model in which 3D remote sensing supports both careful documentation and the transmission of regional identity and cultural meaning in architectural training. As an exploratory pilot with a small, self-reported sample, the study reports descriptive and qualitative findings rather than validated metric or statistical results. Full article

Background: Malnutrition is prevalent among older adults (OAs), ≥65 years, receiving home care services. Despite recommendations for early detection and multifactorial interventions, a gap remains between routine practice and evidence. We therefore developed a complex intervention for early detection of malnutrition risk in a Danish home care setting, comprising an implementation strategy with staff learning activities and a screening procedure with a start-up conversation and follow-up screenings. This article outlines the feasibility test and process evaluation of the intervention. Methods: Guided by the Medical Research Council (MRC/NIHR) framework for complex interventions and MRC process evaluation guidance, the evaluation was conducted in two parts. Part 1 focused on case-level feasibility, while Part 2 examined implementation feasibility within routine home care practice. Qualitative data were collected through participant observations, informal interviews, semi-structured individual interviews, focus group interviews, and a participatory workshop. Quantitative data were extracted from the electronic patient record (NEXUS, Systematic A/S, Aarhus, Denmark). Qualitative data were analysed using qualitative content analysis, and quantitative data using descriptive statistics. Results: All eligible OAs (12/12) received a start-up conversation in Part 1 compared with 5/16 (31%) in Part 2, while follow-up screenings declined from 61/71 (86%) to 37/50 (74%). Overall, staff perceived the learning activities as useful and were able to deliver the screening procedure. However, delivery and implementation were influenced by time constraints, leadership support, workplace culture, and organisational infrastructures. OAs showed willingness to participate, yet their prerequisites for engagement were more limited than anticipated. Conclusion: The intervention could be delivered in a real-world home care setting, but delivery, implementation, and activation of proposed mechanisms were constrained by resource limitations, competing priorities, workplace culture, and organisational infrastructures. To improve uptake, intervention adaptations and a stepwise implementation approach are recommended. Full article

To the best of our knowledge, this is the first study that centres Indigenous queer (henceforth, Indigiqueer) and Indigenous older people and Elders’ voices to explore the everyday tensions between protecting Indigenous cultural protocols against colonial incursions and the challenges presented by shifts in essentialist understandings of gender in the country now called Australia. There is to date very little written that address this topic, although there are two seminal works that investigate the matters more broadly, one by leading Aboriginal scholar Professor Bronwyn Carlson, and another by Noongar Wardandi scholar Professor Braden Hil. Our study uses a set of vignettes based on two interviews with Indigiqueer people and a yarning circle with Indigenous older people and Elders. The interviews and yarning circle are structured as a discussion between community members to provide some preliminary analysis about contemporary dynamic intergenerational debates within Indigenous communities in which competing understandings of culture, gender, safety, and responsibility coexist. For participants, intergenerationality is seen as central to both harm and healing, feelings of belonging and ostracism and ultimately to current and future Indigenous and Indigiqueer survivance and thrivance. Indigenous older people and Elders demonstrate an openness to different sexualities and an acceptance of sexuality-diverse people but are hesitant to allow gender-diverse people to participate in gendered community activities such as playing the didgeridoo (yidaki). To the contrary, Indigenous queer (henceforth Indigiqueer) participants articulate their fears regarding safety, exclusion, care and social isolation emerging from exclusionist gendered binary protocols. Younger generations are seen by all participants as sites of potentiality, that in combination with the power of shared storytelling and mutually constructed understandings, enable a shift towards greater acceptance, openness, and visibility. The paper also reveals the ways in which Indigiqueer people navigate spatial, cultural and social differences between regional and urban spaces, that are seen as differentially accepting of either their Indigeneity or their gender and sexuality diversity. The study’s findings also demonstrate the importance of Indigiqueer-controlled spaces and culturally safe organisations, that are grounded in community-led practices of care, belonging, and self-determination. Full article

This paper examines the concept of the culture of space in early childhood education and care (ECEC), building on contemporary perspectives that understand space as an active factor in children’s development, learning, and socialization. The study aims to identify and define the dimensions of the culture of space in relevant interdisciplinary literature and to examine their representation in national and international strategic documents related to ECEC. The analysis is based on socio-constructivist perspectives, the phenomenology of space, the concepts of place identity and sense of place, and the Reggio Emilia approach. The findings indicate that the culture of space comprises interconnected physical, social, symbolic, cultural, digital, and pedagogical dimensions that shape children’s experiences and support belonging, identity formation, cultural awareness, spatial competences, and sustainable relationships with the environment. International policy documents published by OECD, UNESCO, and UNICEF emphasize that well-designed learning environments and sensitivity to cultural context are essential indicators of ECEC quality. Space should be understood as a culturally and pedagogically constructed medium that actively supports children’s development, identity formation, and community building. Full article

Comprehensive orientation is essential for ensuring client and patient safety, strengthening safety culture, and supporting workforce competence in social and health care. Although orientation is recognized as an important patient safety intervention, little is known about how comprehensively client and patient safety topics are incorporated into orientation programs. This study evaluated the extent to which client and patient safety topics were incorporated into orientation programs across Finnish wellbeing services counties. Data: A cross-sectional electronic survey was conducted in 2024. The questionnaire was based on the Finnish national client and patient safety orientation framework and included thirty-nine orientation topics covering safety management, occupational safety, safety culture, risk management, medication safety, infection prevention, information security, and emergency preparedness. Responses were requested from ten predefined social and health care service areas in each of Finland’s 23 wellbeing services counties. Fourteen counties participated, yielding 107 responses. Results: Traditional client and patient safety topics were widely incorporated into orientation programs. The highest affirmative responses concerned individual job responsibilities, confidentiality, processing of client and patient information, occupational safety, medication competence, and incident reporting (all 96–99%). In contrast, psychological safety (58%), second victim practices (14%), self-monitoring programs and plans (42% and 54%), safety culture assessment (41%), and client and patient safety in digital and remote services (62%) were incorporated less frequently. Conclusions: This study provides a national overview of client and patient safety orientation practices based on responses from participating Finnish wellbeing services counties. Traditional client and patient safety topics were widely incorporated into orientation programs, whereas psychological safety, second victim support, self-monitoring, and digital safety were less consistently represented. The findings suggest that implementation of patient safety priorities is uneven across safety domains, with newer organizational and systems-oriented topics appearing less embedded in orientation than traditional clinical safety topics. Orientation may therefore be viewed not merely as an onboarding activity but also as a strategic mechanism for implementing patient safety priorities within healthcare organizations. Full article

Background/Objectives: Enteral nutrition is an essential component of care for critically ill patients, and nurses play a key role in its assessment, delivery, and monitoring. Although the Spanish version of the Persenius Scale has previously undergone translation, cross-cultural adaptation, and content validation, its structural validity has not yet been evaluated. Therefore, this study aimed to evaluate the structural validity of the Spanish version of the Persenius Scale in a sample of intensive care unit nurses in Spain. Methods: A cross-sectional study was conducted using an online questionnaire administered to intensive care unit nurses. The analytical sample included 329 participants recruited through non-probability snowball sampling. Sampling adequacy was assessed using the Kaiser–Meyer–Olkin index and Bartlett’s test of sphericity. Principal component analysis with Varimax rotation was performed to evaluate the structural validity of the instrument. Hierarchical cluster analysis was also used to examine the coherence of item grouping. Results: The Kaiser–Meyer–Olkin value was 0.88, and Bartlett’s test of sphericity was significant, supporting the suitability of the data for component analysis. A five-component solution was retained, explaining approximately 58% of the total variance. The components were organizational resources, specialized training, professional responsibility, perceived competence, and technical modality of enteral administration. Organizational resources and professional responsibility showed the most homogeneous loading patterns, whereas several technical practice items demonstrated higher uniqueness and weaker structural integration. Conclusions: The present study provides preliminary evidence regarding the internal structure of the Spanish version of the Persenius Scale by demonstrating a clinically interpretable five-component structure. The instrument may support the assessment of educational, organizational, and professional aspects of enteral nutrition practice among intensive care unit nurses. Full article

Family-centred approaches are being increasingly recognized as integral to inclusive mental health care. Although substantial evidence-based exists for specific interventions particularly family intervention for psychosis, there is no synthesis that maps how family-centred approaches are conceptualized, implemented, and linked to inclusivity across diagnoses, service contexts, and levels of evidence. Existing reviews are largely disorder-specific or outcome-focused and do not examine family-centred care as a system-level strategy for inclusive practice. This scoping review aimed to map and synthesize the existing literature on family-centred approaches used to promote inclusive mental health care for individuals with psychiatric disorders. This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA-ScR reporting guidelines. Searches were conducted in PubMed, PsycINFO, CINAHL, Scopus, Embase, and Web of Science for English-language empirical studies published between 2000 and 2025. Studies involving individuals with psychiatric disorders and any form of family-centred, family-focused, or family-inclusive approach were eligible. Data were charted and analyzed thematically to map intervention types, reported outcomes, and implementation influences; the review did not evaluate intervention effectiveness. Twenty-four studies met the inclusion criteria. Only five themes emerged from this study. Across the literature, family involvement was associated with improved engagement, enhanced communication, and increased caregiver competence. Psychoeducation featured prominently in evidence-based interventions, while newer models emphasized shared decision-making and service co-production. Family-centred approaches are conceptualized in diverse ways across mental health services and are commonly linked to more inclusive and collaborative care. However, the strength of evidence varies substantially between intervention types. This review clarified how family-centred practices are situated across levels of evidence and service contexts, highlighting the need for greater precision in distinguishing established interventions from emerging practices and for system-level strategies to support consistent, culturally responsive family inclusion. Full article

Background/Objectives: Individuals with marginalized sexual and gender identities experience mental health disparities arising from chronic minority stress and systemic barriers within healthcare settings. Mental health professionals occupy a central role in addressing these inequities; however, persistent deficits in professional preparation and cultural knowledge continue to undermine affirming, identity-inclusive care. This study explored the cultural knowledge of Italian mental health professionals regarding LGBTQIA+ health needs, focusing on how such knowledge is conceptualized, enacted, and constrained in clinical practice, using the Culturally Competent Compassion Model as a theoretical framework. Methods: A qualitative study was conducted using semi-structured interviews with 14 Italian mental health professionals (psychologists, psychotherapists, and psychiatrists), purposively selected from a broader qualitative dataset of 33 professionals based on clinical specialization in mental health. Data were analyzed using reflexive thematic analysis. Results: Four themes were identified: (1) training as absent structure; (2) knowing without knowing; (3) the paralysis of partial competence; and (4) stigma as institutional climate. Findings showed that professionals often rely on partial and informal knowledge, experience uncertainty in clinical interactions, and encounter difficulties in translating knowledge into practice. Participants demonstrated awareness of explicit and subtle forms of stigma affecting LGBTQIA+ individuals within healthcare settings. Conclusions: The findings highlight a gap between declarative awareness and self-reported preparedness for clinical practice, underscoring the need for structured training programs integrating theoretical knowledge and clinical skill development. Cultivating cultural knowledge and cultural humility among mental health professionals represents a systemic investment in reducing mental health inequities and improving affirming care for LGBTQIA+ populations. Full article

Background: Mental health services face significant challenges in providing equitable care to ethnic minority and migrant populations. Despite the right to healthcare, disparities in service use among minority communities reflect not only practical barriers but also deeper issues of cultural compatibility between patients and health systems. Aim: This study aimed to provide a systematic overview of the main difficulties encountered by ethnic minority and migrant people when seeking psychological support from mental health services, with a specific focus on linguistic and communicative barriers and organisational and economic barriers. Methods: A scoping review was conducted using the SCOPUS database, searching for peer-reviewed studies focused on the European context. Studies were included if they addressed ethnic minorities’ experiences with mental health services from a user perspective and included primary research of any design. Studies focused exclusively on staff perspectives or not specifically addressing ethnic minorities’ help-seeking were excluded. Twenty studies met the inclusion criteria. A qualitative narrative synthesis was adopted, following PRISMA-ScR guidelines. Results: People with an ethnic or migrant background face specific and compounded barriers when seeking mental health support. Two main categories were identified: linguistic and communicative difficulties, including language distance, limited interpreter availability, and the gap between Western biomedical models and cultural frameworks of distress; and organisational and economic obstacles, including poor knowledge of available services, socioeconomic disadvantage, stigma, and institutional distrust. Discussion: These barriers are deeply structural and cannot be addressed through awareness campaigns alone. Increased access to services is not inherently beneficial unless accompanied by a fundamental transformation ensuring that care is culturally appropriate, safe, and genuinely responsive to minority communities’ needs. Distrust of mental health services may in part reflect a historically grounded and legitimate response to institutions whose practices have not always served the interests of minority groups. Conclusions: Reducing disparities in mental health care requires multi-level intervention, including inclusive policies, training of culturally competent professionals, and a critical rethinking of the models underpinning mental healthcare care. Future research should attend not only to the quantity of service use among minority populations but to the quality, cultural legitimacy, and safety of the care provided. Full article