Search Results (216)

Background/Objectives: Men have historically contributed significantly to mental health nursing, particularly in inpatient settings, where their presence has supported patient recovery and safety. Despite this legacy, men remain under-represented in the nursing workforce, and addressing this imbalance is critical to workforce sustainability. This study offers a novel contribution by exploring the lived experiences, motivations, and professional identities of men in mental health nursing, an area that has received limited empirical attention. The aim of the study is to examine the characteristics, qualities, and attributes of mental health nurses who are male, which contributes to their attraction to and retention within the profession. Methods: A qualitative interpretive inquiry was conducted among nurses who were male and either currently or previously employed in mental health settings. Two focus groups were conducted using semi-structured questions to explore their career pathways, motivations, professional identities, and perceived contributions. Thematic analysis was used to identify key themes and patterns in their narratives. Results: Seven participants, with 10–30 years of experience, participated. They had entered the profession through diverse pathways, expressing strong alignment between personal values and professional roles. Five themes emerged and centred on mental health being the heart of health, personal and professional fulfillment, camaraderie and teamwork, a profound respect for individuals and compassion, and overcoming and enjoying the challenge. Conclusions: Mental health nurses who are male bring unique contributions to the profession, embodying compassion, resilience, and ethical advocacy. Their experiences challenge traditional gender norms and redefine masculinity in health care. Fostering inclusive environments, mentorship, and leadership opportunities is essential to support their growth. These insights inform strategies to strengthen recruitment, retention, and the future of mental health nursing. Full article

Background: Stigma associated with tuberculosis (TB) continues to undermine patient well-being, treatment adherence, and public health goals and objectives. This study aims to systematically review the literature to identify and synthesize TB stigma reduction interventions published between 2015 and 2025. Methods: Following the PRISMA guidelines, we conducted a comprehensive literature search across PubMed, Scopus, Science Direct, ProQuest, and Google Scholar. Eligible studies included those with qualitative, quantitative, and mixed-methods designs that focused on interventions related to TB-related stigma. We categorized the studies into three groups: (1) intervention development studies, (2) TB treatment programs with stigma reduction outcomes, (3) stigma-specific interventions. Data extraction and quality appraisal were conducted independently by two reviewers using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 15 studies met the inclusion criteria. Five studies focused on co-developing stigma interventions, which incorporated multi-level and multicomponent strategies targeting internalized, enacted, anticipated, and intersectional stigma. Two studies assessed TB treatment-related interventions (e.g., home-based care, digital adherence tools) with incidental stigma reduction effects. The remaining seven studies implemented stigma-targeted interventions, including educational programs, video-based therapy, peer-led support, and anti-self-stigma toolkits. Interventions addressed stigma across individual, interpersonal, institutional, community, and policy levels. Conclusions: This review highlights the evolution and diversification of TB stigma interventions over the past decade. While earlier interventions emphasized education and support, recent strategies increasingly integrate peer leadership, digital platforms, and socio-ecological frameworks. The findings underscore the need for comprehensive, contextually grounded interventions that reflect the lived experiences of people affected by TB. Full article

Background and Objectives: Adverse clinical outcomes are associated with malnutrition and frailty, which are highly prevalent among hospitalized older patients. This study aimed to evaluate their predictive value for the duration of hospitalization, short-term survival, and rehospitalization of patients admitted to internal medicine wards. Materials and Methods: This prospective cohort study included 134 acutely ill patients aged ≥50 years who were hospitalized in an internal medicine department and evaluated within the first 48 h of admission. Nutritional status was evaluated using the Mini nutritional assessment–short form (MNA-SF), Nutritional Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty was evaluated using the FRAIL scale and Clinical Frailty Scale (CFS). The primary outcomes were prolonged hospitalization (>10 days), mortality, and rehospitalization at 3 and 6 months post-discharge. Results: According to MNA-SF, 33.6% of patients were malnourished; 44% had nutritional risk per NRS-2002, and 44.8% were malnourished per GLIM. Frailty prevalence was 53.7% (FRAIL) and 59% (CFS). Malnutrition defined by all three scales (MNA-SF, NRS-2002, GLIM) was significantly associated with prolonged hospitalization (p = 0.043, 0.014, and 0.023, respectively), increased rehospitalization at both 3 months (p < 0.001) and 6 months (p < 0.001). Mortality was also significantly higher among malnourished patients. Higher CFS scores and low handgrip strength were additional predictors of adverse outcomes (p < 0.05). In multivariable analysis, GLIM-defined malnutrition and CFS remained independent predictors of rehospitalization and mortality. Conclusions: Frailty and malnutrition are highly prevalent and independently associated with prolonged hospital stay, short-term rehospitalization and mortality. Routine screening at admission may facilitate early identification and guide timely interventions to improve patient outcomes. These findings might guide hospital protocols in aging health systems and support the development of standardized geriatric care pathways. Full article

This article describes the design and implementation of a Specialized Mental Health Clinical Pastoral Education (CPE) program for clergy and theological students of all spiritual, religious, and cultural backgrounds. Addressing the need for mental health competencies in religious leaders and chaplains, this training equips participants with specialized skills in individual and group mental health spiritual assessment and spiritual care. Program participants become effective members of a multiprofessional team, gain knowledge of mental health philosophies of concordant and discordant spiritual orienting systems, and gain greater relational capacity. The Mental Health CPE Program includes traditional and novel CPE elements: (1) clinical practice, (2) group and individual supervision, (3) didactic presentations and journal clubs, (4) verbatim (Protocols of patient encounters) and case presentations, (5) group leadership training and practica, and (6) experience of faith reflections. This article provides insights into the origins of CPE, a description of the implementation in a free-standing psychiatric hospital, and observed developmental changes of program participants. We include graduates’ anecdotal feedback about their learning experience and its impact on their leadership in chaplaincy and in religious communities. Additionally, we report on areas for future development and further study of the effectiveness of Mental Health CPE. Full article

Gender inequality remains a persistent issue in healthcare, especially in ophthalmology, where women face systemic barriers such as pay gaps, limited surgical opportunities, harassment, and unequal family expectations. Despite increasing entry into the field, women remain underrepresented in leadership, affecting career advancement and patient care. This study examines how virtual platforms, and co-led initiatives can address gender disparities in eye health. In 2021, Women in Ophthalmology, Seva Foundation, and Orbis International launched the Women’s Leaders in Eye Health (WLEH) initiative—a global community promoting mentorship, networking, and leadership development. Starting with virtual webinars and informal networking, the initiative expanded to in-person events in 2023 due to strong global engagement and demand. Early virtual programming, including webinars and “Coffee Hour” sessions, proved effective and laid the groundwork for broader offerings such as mentorship and professional development grants. WLEH’s success underscores the power of collaboration in promoting gender equity. By fostering connections and leadership pathways, WLEH offers a scalable model to break down gender challenges and uplift the next generation of women leaders to deliver more accessible eyecare globally. Full article

This article describes a case study of the partnership between Healthy Birth Initiatives, a community-based organization (CBO) and Black-led public health nurse home visiting program, and the maternal health division of the Providence Health System located in the Pacific Northwest. This study’s purpose was to explore the formation, significance, and impact of this partnership from the perspectives of staff and leadership members from both organizations. We conducted a case study through qualitative interviews with staff, participant observation, and debrief of leadership meetings. We completed a hybrid deductive–inductive thematic analysis of the data, followed by member checking with study participants and other key interest holders. Key facilitators of the CBO–health system partnership included the vital role of leaders in prioritizing the partnership; health system willingness to incorporate new information from the CBO to improve care; and health system utilization of resources to institutionalize changes that emerged from this partnership. Challenges to the CBO–health system partnership included CBO resource limitations; fragmented referral processes and information sharing; and the persistence required to nurture the relationship without formalized roles. This study contributes to the literature by offering staff perspectives on how a CBO–health system partnership formed, successes, early lessons learned, and practical suggestions for how to develop stronger alignment to provide culturally responsive patient-centered care to Black families. Full article

Travestis and transgender women in Brazil face a disproportionate burden of mental health conditions, exacerbated by structural discrimination, violence, and social exclusion. This narrative review synthesizes evidence on the prevalence of depression, anxiety, suicidality, and substance use among travestis and transgender women in Brazil, and examines intersecting social and health disparities. We searched PubMed, Embase, and PsycINFO in April 2025, identifying peer-reviewed studies in English or Portuguese reporting mental health outcomes or associated social determinants of health in this population. Thirty-one studies across twelve different cities (n = 7683) were included and grouped into two thematic domains. Reported prevalence ranged from 16–70.1% for depression, 24.8–26.5% for anxiety, and 25–47.3% for suicidality. Substance use was also highly prevalent, with studies reporting high rates of alcohol (21.5–72.7%), tobacco (56.6–61.6%), cannabis (19–68.9%), and cocaine/crack (6–59.8%) use. Discrimination, violence, economic hardship, and HIV were consistently associated with psychological distress and barriers to care. These findings underscore the urgent need to integrate mental health, gender-affirming care, and HIV services into Brazil’s Unified Health System (Sistema Único de Saúde–SUS), strengthen anti-discrimination and violence-prevention policies, and adopt inclusive public health strategies that prioritize the leadership and lived experiences of transgender, nonbinary, and gender diverse people, particularly amid rising political threats to gender-affirming care. Full article

Background: Competency in providing high-quality, comprehensive patient care is essential for newly qualified dentists. Dental curricula are designed to equip graduates with necessary skills to develop competencies. Outplacement training has been incorporated into most dental curricula to provide broader clinical experience in a real-world situation. Methods: This cross-sectional study aimed to assess (1) the perceived confidence of final-year dental students (FYDSs) at an Australian university with reference to the Australian Dental Council (ADC) professional competencies for newly qualified dentists; (2) the association between perceived confidence and the timing of outplacement training; and (3) students’ perceptions on outplacement training in developing their competencies. Two online surveys were administered to a cohort of FYDSs at the end of the first and second trimesters. ‘Survey 1’ was based on the ADC competency requirements (2022) and assessed aims 1 and 2. The five domains assessed were (1) communication and leadership; (2) critical thinking; (3) health promotion; (4) scientific and clinical knowledge; and (5) person-centred care. ‘Survey 2’ assessed students’ perception on outplacement training and was administered towards the completion of their outplacement to assess aim 3. Results: Students’ perceived competency levels were high across all domains. Those with prior tertiary education were more confident in communication and leadership, health promotion, and scientific and clinical knowledge than students with secondary qualifications. The perceived confidence in professional competencies among FYDSs had no significant association (p > 0.05) with the location or the sequence of outplacement. The thematic analysis of survey 2 responses reported the guidance and constructive feedback received from supervisors while managing cases in a real-life setup as a significant contributor to their confidence development. Conclusions: FYDSs reported a satisfactory level of perceived confidence in professional competencies. Both in-house training and outplacement equally improve the levels of competency development. FYDSs perceive outplacement training as a positive integral component in the development of skills. Full article

Background: European health systems are shifting toward more proactive, person-centered models, thereby highlighting the need to strengthen nurses’ clinical leadership in primary care. Nurse demand management (NDM) has emerged as an innovative practice which allows nurses to autonomously and comprehensively respond to a population’s health needs. However, knowledge on its implementation varies widely, often being intuitive, partly due to the absence of standardized evaluation tools. The xGID instrument aims to measure the degree of NDM adoption in primary care teams (PCTs), activating collective intelligence mechanisms to foster shared diagnosis, organizational reflection, and the generation of targeted recommendations. Methods: We designed and implemented xGID in 47 PCTs in Catalonia, involving 1474 healthcare professionals. Data were collected through structured surveys assessing key dimensions of NDM adoption, including professional autonomy, teamwork, continuity, and accessibility. Results: Overall adoption of NDM was high, with a mean score of 7.6 out of 10. Notable differences emerged between professional groups and practice areas. Nurses tended to be more critical of teamwork, longitudinal care, and accessibility, reflecting the central yet high-pressure role they play in NDM. High-scoring dimensions included professional autonomy and the capacity to act across multiple domains, whereas weaker areas pointed to systemic organizational challenges. Conclusions: The preliminary findings indicate that a standardized tool for NDM evaluation is a cornerstone for identifying contextual barriers and guiding the transformation of care models. Its participatory and strategic approach offers novel pathways to embed data-driven decision-making into daily clinical practice, consolidating NDM as a key pillar of future primary care. Full article

Background: The quality of palliative care (PC) services is closely linked to the effectiveness of interdisciplinary collaboration. A coordinated approach among professionals from different fields fosters holistic, person-centered care, ensuring comprehensive support for patients with complex conditions and their families. In hospital settings, In-Hospital Palliative Care Support Teams (EIHSCPs) play a key role in delivering specialized care, enhancing interdepartmental communication, training other healthcare professionals, and optimizing resources. Strong leadership by PC specialists, combined with effective team management, contributes to symptom relief, improved quality of life, and cost reduction. However, interdisciplinary collaboration presents challenges, including competing priorities, resource constraints, and communication barriers. Despite its recognized benefits, research on its implementation in PC, particularly in Portugal, remains scarce. Objective: This study explores the perspectives and practices of professionals within an EIHSCP, examining team dynamics, interprofessional collaboration, and key facilitators and barriers. Methods: Twelve semi-structured interviews were conducted with physicians, nurses, psychologists, and social workers from the EIHSCP in the Médio Tejo region. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results: The interview findings were organized into three themes: (1) Social Representations and Interdisciplinary Practice; (2) Competencies for Interdisciplinary Practice; and (3) Challenges in Interdisciplinary Practice. Participants consistently highlighted that interdisciplinary collaboration enhances communication between services and improves care quality. While teamwork is central, patient- and family-centered care remains the priority. Key competencies include empathy, ethics, active listening, and cultural sensitivity, alongside structural and procedural elements such as team meetings, integrated communication, and clear referral criteria. Continuous education and professional development are essential. Challenges primarily stem from limited human and material resources, staff workload and stress, communication gaps between hospital and community teams, and insufficient institutional recognition. Suggested improvements focus on investing in ongoing training, strengthening communication and inter-institutional collaboration, and revising the organizational model of PC within Portugal’s National Health Service. Conclusions: Interdisciplinary collaboration in PC is fundamental for holistic, patient-centered care but is hindered by structural and organizational barriers. Full article

Work is a key social determinant of mental health, and adverse organizational conditions in healthcare settings increase psychosocial risks. Leadership influences workplace well-being, yet its impact on mental health and gender inequalities remains underexplored. Despite the feminization of the health sector, disparities persist in leadership access, role expectations, and work–family reconciliation, exacerbating occupational stress. Aims: This study examines leadership practices in public hospitals, focusing on their relationship with mental health, organizational dimensions (recognition and role stress), and gender disparities. It explores the perspectives of both workers and managers to understand how leadership shapes workplace conditions and well-being. Methods: A qualitative, cross-sectional study was conducted as part of the FONDECYT project 1220547. Semi-structured interviews were conducted with 64 workers from public hospitals in Santiago, Chile, including clinical and administrative staff. The analysis supported by Grounded Theory identified key categories: constructive and destructive leadership, recognition, role stress, and gender disparities in leadership. Results: Constructive leadership—characterized by communication, fairness, and recognition—was linked to a healthier work environment and improved well-being. In contrast, destructive leadership (characterized by abuse of power and imposition, or inaction, lack of support, and absence of effective direction) contributed to role stress, workplace mistreatment, and job dissatisfaction. Recognition was a crucial but insufficient motivator, as the lack of formal mechanisms led to frustration. Role stress emerged as a significant risk for well-being, with subordinates experiencing overload, ambiguity, and conflicting expectations. Gender inequalities persisted as women faced more tremendous barriers to leadership and difficulties balancing work and family responsibilities. Workers and managers had differing perspectives, with subordinates prioritizing fairness and recognition while managers emphasized operational constraints. Conclusions: Leadership training should emphasize trust, equity, and recognition to enhance workplace well-being. Institutional policies must address role stress, strengthen formal recognition systems, and promote gender equity in leadership. Future research should integrate quantitative methods to explore leadership’s impact on organizational conditions and mental health outcomes. Full article

The health of primary care professionals is crucial for the health of populations. A lower number of general practitioners per 1000 patients correlates with higher patient mortality. Challenging work demands, work–privacy conflict, and poor leadership quality are associated with higher perceived chronic stress and/or burnout in physician populations. However, studies investigating the influence of all three factors in a single quantitative model are lacking. This study analysed the associations between the mentioned parameters and perceived chronic stress among general practice personnel based on baseline data of the cluster-randomized IMPROVEjob study. It comprised 60 German general practices with 366 participants (84 general practice leaders, 28 employed physicians, 254 practice assistants). Perceived chronic stress (TICS-SSCS), leadership quality (LMX-7, FIF), work–privacy conflict (COPSOQ), and quantitative and emotional work demands (COPSOQ) were measured with validated questionnaires. The factors associated with lower perceived chronic stress were identified using a multilevel regression model approach. The model showed a significant association with less work–privacy conflict (p < 0.001, β = 0.31), lower quantitative work demands (p < 0.001, β = 0.28), and good leadership quality (p < 0.001, β = −0.22). Especially transformational leadership with the dimension ‘innovation of the leader’ was associated with lower perceived chronic stress. The data support the importance of high-quality leadership as a protective factor for perceived chronic stress among general practice personnel, which needs to be considered in future leadership interventions in this setting. Full article

Background: Leadership is present at all levels of nursing and is essential to ensure the continuous improvement of nursing practice environments and the quality of the care provided to patients. This reality, coupled with the growing complexity of today’s health contexts, emphasises the importance of promoting the development of leadership skills in undergraduate nursing students, thus training nurses who are capable of acting as leaders and agents of change. To this end, a scoping review was carried out to map the available scientific evidence on the development of leadership in undergraduate nursing students. Methods: The scoping review was conducted according to two systematic review guidelines. The searches were conducted across a total of five databases for published studies and two databases for the unpublished/grey literature. The data extraction and analysis were performed by two reviewers, who independently screened and extracted data from the selected studies. Results: This review included 25 articles, and four thematic categories were identified—students’ perceptions of leadership; strategies to train leaders in nursing; the evaluation of leadership development; and conceptual models and curricula. The main conclusions highlight the need to reformulate existing curricula, the importance of integrating student-centred pedagogical approaches to promote leadership development, the impact that evaluating leadership development has on the whole process, contributing to the construction of an identity as a leader, and the need for it to be done in a structured and progressive way. Conclusions: The teaching of leadership should be promoted from the beginning of training, in a transversal, continuous, consistent, sustained, and articulated way, incorporating different disciplines, because only in this way will it be possible to train competent nurse leaders who are capable of acting in today’s complex and dynamic health contexts. Full article

Veterinary nurses and technicians are at risk of burnout, which negatively impacts mental and physical health, turnover, and patient care. Workplace contributors to burnout have been identified in this population, but little is known about best practice management strategies. This study used the Delphi method to explore barriers to addressing burnout and develop expert recommendations for workplace management strategies. Forty participants with a minimum of 5 years’ industry experience in leadership, or wellbeing, were recruited via purposive sampling from the USA, UK, Australia, New Zealand, and Canada. Participants completed two anonymous, online, mixed-methods surveys between October 2024 and January 2025. Qualitative survey data were analysed using content analysis to identify codes and categorise solutions. Quantitative data were analysed using descriptive statistics. Barriers to addressing burnout included industry-wide barriers, such as lack of, or unclear, regulation and lack of leadership knowledge, and clinic-specific barriers, such as poor team culture, unwillingness for change, and existing burnout. Thirty-nine solutions were developed and rated as being highly, or very highly effective. These focused on themes such as improving communication, developing progression pathways, and providing leadership training and support. Existing workplace barriers must be evaluated prior to selecting strategies, to maximise effectiveness in specific contexts. Full article

Oncology nurses have long been at the forefront of virtual care, transitioning from telenursing to technology-driven delivery methods that address the evolving needs of cancer patients. Initially developed to overcome barriers to care for rural and underserved populations, virtual care has grown into a critical component of oncology practice. Oncology nurses play a central role in providing timely, personalized, and holistic care, leveraging tools such as remote monitoring, patient-reported outcomes, and mHealth platforms. However, the rapid adoption of virtual care demands a broader focus to sustain its impact. This commentary explores the need to clearly define the role of oncology nurses in virtual care, emphasizing leadership in digital health, the integration of hybrid care models, and workforce training. By addressing these priorities, virtual care can continue to enhance patient outcomes, strengthen nursing-led interventions, and expand the scope of oncology nursing, positioning it as an essential and enduring facet of cancer care delivery. Full article