Search Results (2,397)

The rise in ICU survival rates has introduced new challenges related to the long-term effects of intensive care, known as Post-Intensive Care Syndrome (PICS). Nurses play a key role in these clinics; however, the nature and outcomes of their interventions remain insufficiently understood. Objectives: This review aims to identify nursing interventions for PICS in follow-up clinics. Methods: Using the JBI scoping review methodology, we searched PubMed, Web of Science and CINAHL (via EBSCOhost) in March 2025, and examined grey literature in RCAAP and Open Dissertations (through B-ON). Inclusion criteria, based on JBI’s PCC (Population, Concept, Context), focused on nursing interventions for PICS for patients and families in follow-up. Studies involving children, adolescents, pregnant women, and those receiving end-of-life care were excluded. Results: Encompassing studies from 2005 to 2022 across multiple countries, this review highlights nursing interventions for post-ICU recovery. A total of 394 articles that met our search criteria were found, resulting from searches in the mentioned databases. These were initially exported to Rayyan, and 115 duplicates were removed. The 21 articles that met our inclusion criteria were fully analyzed, and those that effectively answered our questions and met our inclusion criteria were selected. In the end, 9 articles were selected, to which, after an individual analysis of their bibliographic references, 3 more were added, totaling 12 articles submitted to the final analysis. Conclusions: For patients, interventions ranged from debriefing, PICS symptom evaluation, ICU re-visits, health education, cognitive–behavioral therapy and support groups, complemented by home-based physical rehabilitation and virtual reality. Family-focused interventions centered on appointment involvement, educational sessions, patient diary review, and emotional support. These assessments and interventions address the consequences of ICU admission, with the goal of facilitating physical, mental, and emotional rehabilitation of ICU survivors. This review emphasizes the critical role of follow-up consultations in the recovery of both patients and families. A comprehensive assessment using PICS scales and the integration of families into care plans are crucial for optimizing intervention outcomes. Implications for Clinical Practice: The development of evidence-based guidelines for implementation of follow-up clinics for SPICI appointments is necessary. Full article

Background/Objectives: Breastfeeding is widely acknowledged for its benefits to child development and maternal well-being. Yet breastfeeding practices often decline during early childhood transitions, particularly when children enter early childhood education and care (ECEC) services. Research has largely concentrated on healthcare contexts, leaving the educational domain comparatively underexplored in its potential to sustain or hinder breastfeeding continuation. This cross-sectional study examines associations between maternal beliefs regarding the value of breastfeeding and personal, relational, and contextual factors related to breastfeeding continuation within ECEC settings. It also incorporates educators’ perspectives and situates breastfeeding practices within the broader framework of parental ethnotheories. Methods: The study formed part of a pilot parental engagement initiative involving 17 childcare centers in Northern Italy, designed to promote dialogue and supportive practices around breastfeeding within ECEC services. This context is acknowledged when interpreting findings related to organizational climate and educator perspectives. Participants included 490 mothers of children enrolled in ECEC services and 118 educators. Mothers completed questionnaires assessing breastfeeding beliefs and experiences, co-sleeping practices, perceived social support, and parental ethnotheories (independence versus interdependence). Educators reported on their experiences in supporting breastfeeding within the childcare context. Analyses included descriptive statistics, analyses of variance, chi-square tests, and binary logistic regression to examine factors associated with breastfeeding continuation. Results: Mothers strongly endorsed the developmental benefits of breastfeeding and expressed greater alignment with caregiving practices emphasizing interdependence and physical proximity. Continued breastfeeding within childcare settings correlated with interdependence-oriented ethnotheories, younger child age, and higher engagement in co-sleeping practices. Educators reported generally positive views of breastfeeding in childcare, highlighting its contribution to children’s emotional security and maternal calm, alongside its negligible impact on educational organization. Conclusions: ECEC services play a crucial role in sustaining breastfeeding beyond the domestic sphere. Relational practices and organizational climates that welcome breastfeeding can foster continuity of care, strengthen parental engagement, and promote child well-being. Full article

Background/Objectives: Healthcare workers have faced increasing emotional strain driven by organizational constraints, rising workload, and accumulated post-pandemic pressure. To support emotional well-being in primary care professionals, the Catalan Health Institute implemented a large-scale psychoeducational group program in its primary care centers. This study explored its feasibility, acceptability, and the factors shaping real-world implementation from the perspectives of participating professionals and community psychologists who taught it. Methods: A qualitative study was conducted involving five online focus groups held with community psychologists (two groups) and primary care professionals who participated in the program (three groups), selected through purposive sampling. Additional qualitative material was obtained from implementation-related field notes. Session transcripts were analyzed using inductive thematic analysis. The study is registered at ClinicalTrials.gov (NCT05720429). Results: Participants described a context of sustained emotional strain that increased motivation to engage with the program. The sessions were perceived as a valuable protected space for emotional expression, interpersonal connection, and learning self-care strategies. Community psychologists were regarded as key facilitators due to their embedded role and contextual knowledge. However, inconsistent managerial engagement, lack of protected time, competing workloads, and inadequate physical spaces were barriers to successful implementation. Participants proposed strengthening institutional support and offering follow-up sessions to consolidate benefits. Conclusions: The program was positively valued and was perceived to provide individual and team-level benefits. Its sustainability requires stronger organizational commitment and integration into routine practice. Findings underscore the need to complement individual-focused interventions with systemic actions addressing workload, staffing, and organizational culture. Full article

Background: Management of Mental Health Care Users is a critical component of the overall health care system, yet it is not given the serious attention it deserves due to stigma and discrimination against those living with mental health challenges. These results in mental health care users being readmitted to the hospital frequently, despite the poor resources and overburdened health care system. Aim: The aim of this study was to explore and describe the experiences of Psychiatric Nurses regarding the care of Mental Health Care Users in the selected hospitals in Limpopo Province, South Africa. Methods: A qualitative study was followed, where explorative, descriptive, and contextual designs were used. The researcher purposefully selected thirty-four Psychiatric Nurses who have been working in mental health units. Data was collected through unstructured interviews. Thematic analysis was utilized to analyze the data. Results: The study revealed significant challenges, such as poor mental health structures or no mental health unit at all, and this forces Psychiatric Nurses to mix critically ill medical patients with psychotic patients. Furthermore, there is a shortage of staff and treatment to manage users. Conclusions: In conclusion, the study showed that psychiatric nurses face serious emotional and resource-related challenges in caring for mental health care users. This highlights the urgent need for support from institutions, ongoing training, and better working conditions to improve the quality of mental health care. The success of the care, treatment, and rehabilitation of mental health care users depends on the support of MHCUs by family and management. Full article

Human sexual development begins in the prenatal period and continues throughout life, shaped by both biological and psychosocial factors. Somatic development leads to reproductive maturity through several stages regulated by the hypothalamic–pituitary–gonadal axis. Psychosexual development, described in classical theories such as Freud’s and in contemporary models, emphasizes the development of gender identity and sexual behaviors from infancy through early and middle childhood into adolescence, a period characterized by the integration of sexual and emotional components. This developmental trajectory evolves from a biologically driven process into a conscious, socially shaped phenomenon through concretization, mentalization, and socialization. To synthesize current knowledge, this paper is based on a literature review conducted across multiple databases, with studies selected and evaluated for relevance to both somatic and psychosexual development. Understanding the dynamics of these processes is essential for clinical practice, sexual education, and health prevention. It emphasizes integrated clinical practices that employ a multidisciplinary approach, incorporating both medical treatment and psychological support, particularly in the care of children and adolescents with disorders of sexual development. This article presents a comprehensive overview of human sexual development from the prenatal period through adolescence, considering its somatic and psychosexual aspects. Full article

Background: In today’s dynamic healthcare environment, Changi General Hospital (CGH) has positioned staff wellbeing and engagement as fundamental priorities that underpin workforce sustainability and quality care delivery. Recognizing that allied health professionals (AHPs) face unique emotional demands and potential empathy fatigue, the CGH Allied Health Division (AHD) uses three strategic pillars: individual empowerment, leaders as key stewards and institutional support systems to address staff wellbeing and engagement. This paper will evaluate the outcomes of implementing the programs and identifying the barriers and enablers to achieving staff wellbeing and engagement. Methods: It adopts a mixed-methods approach using both quantitative survey data and qualitative feedback. Results: A total of 314 AHPs participated with a mean employment duration of 8.89 years. While 95% agreed that their work was meaningful and 76.8% reported happiness at work, 40.8% did not experience being recognized by the organization and approximately 30% did not find higher management responsive to their needs or transparent in their communication. Qualitative analysis revealed concerns about psychological safety of sharing one’s opinions and concerns, and a desire for better renumeration and career progression. Conclusions: AHPs reported happiness and meaningfulness in their clinical work. However, issues with organizational recognition, higher management responsiveness and transparency, as well as psychological safety were elicited. Working towards addressing fostering psychological safety and enhancing recognition and communication with management are important in order to develop and sustain a thriving healthcare workforce capable of high-quality patient care. Overall, the findings reinforced AHD direction of putting employee wellbeing and engagement as a strategic priority. Full article

Background: and objective: Globally, breast cancer (BC) raises global health concerns, being the most common cancer. Women with BC experience a significant increase in perception of stress. Therefore, this study aims to evaluate the stress levels and associated sociodemographic and clinical factors among BC women in Saudi Arabia. Methods: A cross-sectional study was conducted between January and May 2025. Women diagnosed with BC, who were at least 18 years old, were recruited conveniently from outpatient and inpatient departments in King Fahad Specialist Hospital, Dammam, Saudi Arabia. Data were collected in the Arabic language through self-reported questionnaires, including sociodemographic/clinical characteristics and the Cohen’s Perceived Stress Scale. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 27. Results: A total of 200 participants were included in the study. The mean stress perception score was 26.52 ± 7.34. A high proportion (71.5%) of the sample reported elevated stress. A significant association was observed between age and stress levels. Most women aged 20–40 and 41–60 reported high stress, compared to women in the 61–80 age group (p = 0.003). Among all predictors, age was the only variable significantly associated with stress scores. Increasing age was associated with lower stress levels (B = −0.179, p = 0.013), indicating that younger participants tended to report higher stress. This corresponds to an adjusted decrease of approximately 1.8 points in the PSS-10 score per 10-year increase in age. Although participants with Stage IV cancer showed higher stress scores compared to those with Stage I cancer, this association approached but did not reach statistical significance (p = 0.054). Conclusions: This study highlights the substantial psychological burden experienced by women living with BC in Saudi Arabia. The majority of participants reported high levels of perceived stress. Younger women were particularly vulnerable to elevated stress. These findings highlight the need for targeted psychosocial support within oncology care to improve emotional well-being and quality of life. Full article

Background/Objectives: Patients admitted to intensive care units (ICUs) are confronted with complex clinical situations that impact their physical condition and psychological well-being. Psycho-emotional disorders such as pain, anxiety and post-traumatic stress are highly prevalent in this context, significantly affecting both the patient’s experience and the quality of care provided. Effective communication can help manage patients’ psycho-emotional states and prevent post-ICU disorders. To evaluate the effectiveness of the CONECTEM communicative intervention in improving the psycho-emotional well-being of critically ill patients admitted to the intensive care unit, regarding pain, anxiety, and post-traumatic stress symptoms. Methods: A quasi-experimental study employed a pre–post-test design with both a control group and an intervention group. The study was conducted in two ICUs in a tertiary Hospital in Spain. A total of 111 critically ill patients and 180 nurse–patient interactions were included according to the inclusion/exclusion criteria. Interactions were classified according to the level of the patient’s consciousness into three groups: G1 (Glasgow 15), G2 (Glasgow 14–9), and G3 (Glasgow < 9). Depending on the patient’s communication difficulties, nurses selected one of three communication strategies of the CONECTEM intervention (AAC low teach, pictograms, magnetic board, and musicotherapy). Pain was assessed using the VAS or BPS scale, anxiety using the STAI, and symptoms of PTSD using the IES-R. The RASS scale was utilized to evaluate the degree of sedation and agitation in critically ill patients receiving mechanical ventilation. Data analysis was performed using repeated ANOVA measures for the pre–post-test, as well as Pearson’s correlation test and Mann–Whitney U or Kruskal–Wallis statistical tests. Results: The results showed pre–post differences consistent with pain after the intervention in patients with Glasgow scores of 15 (p < 0.001) and 14–9 (p < 0.001) and in anxiety (p = 0.010), reducing this symptom by 50% pre-test vs. 26.7% post-test. Patients in the intervention group with levels of consciousness (Glasgow 15–9) tended to decrease their post-traumatic stress symptoms, with reductions in the mean IES scale patients with a Glasgow score of 15 [24.7 (±15.20) vs. 22.5 (±14.11)] and for patients with a Glasgow score of 14–9 [(Glasgow 14–9) [30.2 (±13.56) 27.9 (±11.14)], though this was not significant. Given that patients with a Glasgow score below 9 were deeply sedated (RASS-4), no pre–post-test differences were observed in relation to agitation levels. Conclusions: The CONECTEM communication intervention outcomes differed between pre- and post-intervention assessments in patients with a Glasgow Coma Scale score of 15–9 regarding pain. These findings are consistent with a potential benefit of the CONECTEM communication intervention, although further studies using designs that allow for stronger causal inference are needed to assess its impact on the psycho-emotional well-being of critically ill patients. Full article

Medication adherence following myocardial infarction (MI) is essential for effective secondary prevention, yet adherence rates remain suboptimal. Healthcare professionals (HCPs) are central to promoting adherence through clinical decision-making, patient education, and ongoing behavioural support. Understanding how HCPs perceive and experience the factors’ influencing adherence is key to developing effective, context-specific interventions. This study explored HCPs’ perspectives on medication adherence post-MI and identified behavioural determinants influencing medication management across the care pathway. A qualitative descriptive study was conducted using semi-structured interviews with HCPs in the southwest of Ireland. Participants included hospital pharmacists, community pharmacists, general practitioners (GPs), cardiologists, and nurses, recruited through purposive, convenience, and snowball sampling. Interviews were recorded, transcribed verbatim, and analysed using directed content analysis guided by the Theoretical Domains Framework (TDF). Twelve HCPs (eight female) were interviewed between December 2024 and May 2025, including four pharmacists, two GPs, three cardiologists and three nurses. Interviews lasted 30–50 min (mean 41 min). Analysis identified 15 facilitators, 13 barriers, and 7 dual-role determinants across 10 TDF domains. Novel contributions include demonstrating how HCPs’ real-world experiences contextualise adherence issues in the distinct post-MI setting characterised by abrupt care transitions, polypharmacy, and emotional vulnerability and identifying where HCPs feel most constrained and where their expertise could directly inform targeted intervention design. HCPs’ insights reveal complex, context-specific behavioural determinants influencing post-MI medication adherence and highlight the need for multidisciplinary, tailored, and system-level solutions. Enhancing collaboration, supporting patient-centred communication, and addressing resource barriers could empower HCPs to deliver more effective, personalised adherence support and inform the development of targeted intervention strategies. Full article

Background: This study examined how patients and caregivers perceive and experience AI-based care technologies through text mining analysis. The goal was to identify major themes, sentiments, and value-oriented interpretations embedded in their narratives and to understand how these perceptions align with key dimensions of patient-centered care. Methods: A corpus of publicly available narratives describing experiences with AI-based care was compiled from online communities. Natural language processing techniques were applied, including descriptive term analysis, topic modeling using Latent Dirichlet Allocation, and sentiment profiling based on a Korean lexicon. Emergent topics and emotional patterns were mapped onto domains of patient-centered care such as information quality, emotional support, autonomy, and continuity. Results: The analysis revealed a three-phase evolution of care values over time. In the early phase of AI-mediated care, patient narratives emphasized disruption of relational care, with negative themes such as reduced human connection, privacy concerns, safety uncertainties, and usability challenges, accompanied by emotions of fear and frustration. During the transitional phase, positive themes including convenience, improved access, and reassurance from diagnostic accuracy emerged alongside persistent emotional ambivalence, reflecting uncertainty regarding responsibility and control. In the final phase, care values were restored and strengthened, with sentiment patterns shifting toward trust and relief as AI functions became supportive of clinical care, while concerns related to depersonalization and surveillance diminished. Conclusions: Patients and caregivers experience AI-based care as both beneficial and unsettling. Perceptions improve when AI enhances efficiency and information flow without compromising relational aspects of care. Ensuring transparency, explainability, opportunities for human contact, and strong data protections is essential for aligning AI with principles of patient-centered care. Based on a small-scale qualitative dataset of patient narratives, this study offers an exploratory, value-oriented interpretation of how relational care evolves in AI-mediated healthcare contexts. In this study, care-ethics values are used as an analytical lens to operationalize key principles of patient-centered care within AI-mediated healthcare contexts. Full article

Aromatherapy, the therapeutic use of essential oils, is increasingly recognized as a complementary approach to women’s mental health, particularly during hormonally sensitive life stages such as menstruation, pregnancy, postpartum, and menopause. Concerns about the side effects of pharmacological treatments during these periods have driven interest in non-pharmacologic interventions. This narrative review synthesizes current clinical evidence on the efficacy of aromatherapy in alleviating psychological distress in women. A comprehensive literature review between 2000 and 2025 across PubMed, Scopus, and Web of Science databases identified 47 studies focusing on essential oils for anxiety, depression, or stress in female populations. The most substantial evidence supports the use of lavender, bergamot, rose, chamomile, clary sage, and ylang-ylang, with inhalation and massage as the most frequently studied delivery methods. Outcomes include reductions in cortisol, heart rate, and subjective stress, along with improvements in mood and emotional regulation. Aromatherapy demonstrates particular promise in postpartum and perimenopausal care. However, methodological heterogeneity and variability in oil composition limit generalizability. Despite these challenges, the evidence suggests that aromatherapy may serve as a safe, low-cost adjunct for managing mood disorders and stress in women, particularly when integrated into personalized, holistic care strategies. Full article

Technology interventions have great potential to support the complex needs of older adults living in residential aged care, contributing to their general well-being. This scoping review aims to provide an overview of how different technological interventions contribute to the well-being of older adult residents in aged care settings. Specifically, the current objectives for digital interventions, the interaction mechanisms, and the evaluation of their impact on well-being are reviewed following the PRISMA guidelines. We included 26 studies since 2017 covering three databases discussing the impact of technological interventions on social connectedness and cognitive and emotional well-being, and the theoretical models of evaluation applied in these studies. Seven key interaction mechanisms with digital interventions with the objective to enhance social connections, stimulate cognitive functioning, and formulate new models and theories were identified. Our findings show the potential of enhancing the well-being of aged care residents. We discuss our findings under three lenses: User, relational, and contextual experiences, and suggest that these experience categories should inform the focus of future research. This review offers insights into the broader ethical, social, and contextual factors that influence their success, and that can guide future research, inform policy decisions, and improve care practices. Full article

Background: Spine surgeries present challenges for patients, including postoperative pain and difficulties with mobilization. Studies indicate that fear and anxiety prolong recovery; multidisciplinary care, including psychoeducation, which informs patients about their condition, addresses emotional challenges, and teaches coping strategies have benefits on recovery. Objectives: This study investigated whether preoperative psychoeducation improves outcomes in spinal surgery by reducing postoperative analgesic use and accelerating mobilization, with the hypothesis that it decreases medication needs and shortens recovery time. Methods: Data of 100 patients operated on spinal disease were analysed: 50 of them underwent microscope-assisted discectomy for lumbar disc herniation (LDH), and 50 were treated with transpedicular posterior lumbar interbody fusion (PLIF) for monosegmental instability. Each group was subdivided into a psychoeducation group (N = 25) and a control group (N = 25). All patients completed the Surgical Fear Questionnaire (SFQ). Postoperative analgesic use and time to mobilization were analysed. Results: Patients receiving psychoeducation in both groups reported lower preoperative anxiety, required fewer analgesics, and, in the PLIF group, achieved earlier mobilization. A strong correlation was found between SFQ scores and analgesic consumption (p < 0.01). Discussion: Preoperative psychoeducation reduced anxiety, decreased postoperative analgesic use, and enhanced mobilization, suggesting clinical and economic benefits if integrated into standard care. Full article

Women in resource-scarce communities navigate daily scarcity, structural neglect, and gendered violence, leaving profound but often invisible impacts on mental and reproductive health. Women play an active role in the Water–Energy–Food (WEF) space; they provide water, food, and household security daily. This study investigates how chronic deprivation across the WEF nexus shapes experiences of psychological distress, reproductive vulnerability, and social marginalization in South African settings: Lorentzville, a migrant urban informal settlement, and Mqanduli, a peri-urban Eastern Cape community. Using ethnographic methods, including in-depth interviews, focus group discussions, and participatory observation, and an analytical framework combining structural violence and feminist political ecology, we show that insecurity over water, energy, and food constrains reproductive autonomy, amplifies self-reported symptoms of anxiety and depression, and drives coping and adaptation strategies such as informal work, transactional sex, and fragile social support networks. These strategies, while mitigating immediate risks, cannot fully offset systemic harms. By foregrounding women’s lived experiences, this study extends the WEF nexus framework to include embodied, emotional, and reproductive dimensions, linking historical legacies of colonial and apartheid neglect to contemporary inequities. The findings offer critical insights for integrated health, social, and resource policy interventions that center on gender, care, and justice within environmental, wellbeing, and livelihood. Full article

Digital mental health resources have expanded rapidly in the wake of the COVID-19 pandemic, offering new opportunities to improve access to mental healthcare through technologies such as AI chatbots, mobile apps, and online platforms. Despite this growth, significant challenges persist, including low user retention, limited digital literacy, unclear privacy regulations, and insufficient evidence of clinical effectiveness and safety. AI chatbots, which act as virtual therapists or companions, provide counseling and personalized support, but raise concerns about user dependence, emotional outcomes, privacy, ethical risks, and bias. User experiences are mixed: while some report enhanced social health and reduced loneliness, others question the safety, crisis response, and overall reliability of these tools, particularly in unregulated settings. Vulnerable and underserved populations may face heightened risks, highlighting the need for engagement with individuals with lived experience to define safe and supportive interactions. This review critically examines the empirical and grey literature on AI chatbot use in mental healthcare, evaluating their benefits and limitations in terms of access, user engagement, risk management, and clinical integration. Key findings indicate that AI chatbots can complement traditional care and bridge service gaps. However, current evidence is constrained by short-term studies and a lack of diverse, long-term outcome data. The review underscores the importance of transparent operations, ethical governance, and hybrid care models combining technological and human oversight. Recommendations include stakeholder-driven deployment approaches, rigorous evaluation standards, and ongoing real-world validation to ensure equitable, safe, and effective use of AI chatbots in mental healthcare. Full article