Search Results (137)

The type of non-professional or professional support received affects the quality of life of the patient and their caregivers. Social support is the type of interaction that is taken by the patient and his caregivers in a problematic, difficult, stressful, or critical situation. Aim: The aim of the study was to assess the impact of social support on the functioning of patients under nursing home care. Material and methods: The study included 148 chronically ill patients under home nursing care. The study used the diagnostic survey method; the research technique was a questionnaire containing basic data about the respondent and the Social Support Scale (SWS) by Krystyna Kmiecik-Baran. Results: The need to continue the causal treatment at home means that the main source of support for care beneficiaries are nurses who provide medical services at the patient’s home, supported by doctors and family members of the patient. According to patients’ subjective assessment of the support they received from nurses, patients rated the informational support provided by nurses highest at 14.3 points and emotional support at 13.3 points (SD 1.776). on a scale where the maximum score was 16 points. In the opinion of the surveyed patients, the value-added support provided was the lowest-rated category by patients, 9.74 points (SD 2.505). Instrumental support was also rated very poorly by the respondents (10.17 points (SD 2.069). In each category, there was no statistically significant difference at the p < 0.05 level in the respondents’ evaluation, which means that the expressed opinion on each type of support from the highest to the lowest evaluation: informational, emotional, instrumental, and evaluative—overlapped in the patient group and the family group. Conclusions: Patients under home care highly appreciated the support provided to them by the nursing staff. Social support for a chronically ill person who requires constant care and care by the nursing staff is a form of direct impact that relieves stress and tension, minimizes the effects of the disease, directly affects the course of treatment and care, and prevents stigmatization. Full article

Background/Objectives: The perspective from which future healthcare professionals view intellectual disabilities affects how people with intellectual disabilities (PWIDs) are perceived and informs care policies and practices. This study aimed to assess healthcare science students’ perceptions of the rights of PWIDs, the students’ social distances toward PWIDs in healthcare, and the students’ competence in providing care, exploring differences by study programs and demographics and examining correlations between them. Methods: The convenience sample comprised 221 medical and 120 nursing students. A general questionnaire for obtaining sociodemographic data, the scale of beliefs about the rights of PWIDs in healthcare (BS), the scale of social distance toward PWIDs (SD), and the “self-assessment of competency (CS) to provide care for PWIDs” scale were used as students’ report measures. Results: The students’ scores on the BS, SD, and CS scales revealed that they generally recognized the rights of PWIDs in healthcare but expressed a moderate level of social distance and limited self-perceived competence in providing care. Medical students demonstrated slightly more progressive beliefs regarding the rights of PWIDs than nursing students (r = 0.12), while nursing students reported higher self-assessed competence levels (r = 0.19). A small gender-related difference was observed in social distance, with female students showing more favorable attitudes. Significant positive correlations were found between beliefs about the rights of PWIDs and social distance (p = 0.435; p < 0.01) and between social distance and self-assessed competence (p = 0.234, p < 0.01), suggesting that students who felt more competent tended to report less social distance. Conclusions: This study provides new data for understanding healthcare science students’ perceptions and readiness to care for PWIDs in the healthcare sector in Serbia. Namely, our students had moderately positive beliefs and a moderate social distance toward PWIDs and reported low competence in providing care. Full article

Background/Objectives: The high sensitivity of paediatric nurses directly influences the quality of nursing care provided to patients. The purpose of this study is to present the most frequent issues faced by paediatric nurses in their everyday work and their responses to difficult situations at work, define the actions applied when a difficult situation occurs, and assess the level of stress and other factors influencing the level of stress experienced by paediatric nurses. Methods: This study was conducted using an original survey form and a standardised psychological questionnaire based on the Perceived Stress Scale (PSS-10) for paediatric nurses. Results: The study involved 416 paediatric nurses and indicated a medium level of stress among the nurses. The median stress level, calculated as the sum of answers to questions based on the PSS-10, was 18 (16.0 ÷ 20.0), and the mean was 17.9 (min–max = 1–30). The median Sten score was 6 (5.0 ÷ 7.0), and the mean Sten score was 5.94 (min–max = 2–9). Nurses aged 21–30 years, who live in a city, have a Bachelor of Science in Nursing or a Master of Science in Nursing, and work ≥ 61 h a week and 161–250 h a month experience a higher level of stress. Factors such as choosing which child to help first, spending a great deal of time filling out medical documentation, obtaining a sick child’s consent to perform nursing procedures which the child does not understand, involving the minor in decision-making, impolite or offensive behaviour from a sick child or their parents, ineffective nursing and treatment methods, providing care against the opinion/views of a sick child or their parents, difficulties in or a lack of understanding of the situation of a sick child and their family, performing nursing procedures that can cause the child pain, and the inability to fulfil a sick child’s request increase the level of stress experienced by paediatric nurses. When a difficult situation occurs at work occurs, the nurses usually meet and talk about the situation with someone close (72.4%) or engage in other activities to avoid thinking about the situation (66.6%). They consult a psychologist/psychotherapist very rarely (9.6%) and a psychiatrist extremely rarely (4.6%). Conclusions: Polish paediatric nurses were found to experience a medium level of stress. Since paediatric nurses are exposed to stress, providing them with psychological care is important. The level of perceived stress is dependent on the nurse’s age, place of residence, and education, as well as weekly and monthly working durations. Paediatric nurses experience many difficult situations in their everyday work that influence their stress levels. Management should pay special attention to difficult workplace situations faced by paediatric nurses and implement regular actions to reduce the levels of stress experienced. Full article

Background: Limited information exists regarding the current practice of transitioning from enteral nutrition (EN) to oral nutrition (ON) and the effect of this process on the relationship between energy and protein requirement, provision, and nutritional status of intensive care and post-intensive care patients. Current practices and policies to the transition from EN to ON based on perspectives, experiences and opinions of health professionals and patients, are neither widely understood nor consistently implemented. Aim: The scoping review aims to summarize the current state of research on the transition process from EN to ON in intensive care unit (ICU) patients and post-ICU patients. The aim is to understand the impact of this process on the relationship between energy and protein requirements, and provision, as well as the impact on nutritional status. Additionally, the review aims to gather insights into the perspectives, experiences and opinions of healthcare professionals and patients regarding the transition process and the removal of enteral feeding tubes. Design: The literature search was conducted in PubMed, Cochrane Library and Scopus. Keywords and MeSH terms were applied, with additional papers identified by snowballing. Publications were manually screened based on inclusion and exclusion criteria to determine eligibility for inclusion. Results: A total of six studies were identified on this topic. One study found that, after the feeding tube was removed after ICU discharge, energy intake decreased from 97.3% to 65% and protein intake decreased from 91.5% to 60.6% of target values within one day after removal. Five additional studies revealed that the removal of feeding tubes is often a primary goal for nurses and physicians on the ward, and the decision to remove the tube is not based on an assessment of potential oral energy and protein intake. Reinsertion of a feeding tube is viewed as a setback by nurses and physicians. The process and decision-making of the tube removal seems to be unclear as well as the involvement of patients in the process. No studies were found examining the correlation between nutritional status and the transition process. Conclusions: Energy and protein intake appear to decrease directly after removal of the feeding tube. The decision to remove a feeding tube is often influenced by the personal opinion of healthcare professionals or institutional practices, rather than on the basis of an assessment of oral energy and protein intake. Additional studies are needed to further explore the transition process, the perspectives and experiences of healthcare professionals, and the impact of the process on energy and protein adequacy as well as the nutritional status of ICU and post-ICU patients. Full article

Background/Objectives: Over the past three decades, emergency medicine in Romania has evolved from a developing specialty into a cornerstone of the national healthcare system. As we reflect on these 30 years, it becomes evident that the lessons learned and the systems developed form a vital foundation for the future. This study aims to explore how the accumulated experience can guide us toward building a more resilient emergency medical system, one that prioritizes quality, ensures patient and provider safety, and embraces modern principles of healthcare management. The objectives of this study were to explore the long-term perspectives of physicians and nurses working in emergency departments (EDs), to determine the triggering factors that may lead to abandoning the specialty, and to identify of malpractice risks arising from doctor–patient interaction. Methods: This study employed an observational design and utilized an opinion questionnaire to assess the participants’ perspectives. Qualitative data were presented as frequencies and percentages. Quantitative data were expressed as means and standard deviations after verifying normal distribution with the Shapiro–Wilk test. Comparisons between groups for qualitative variables were conducted using the chi-square test. For comparisons of quantitative variables between two groups, Student’s t-test was employed following confirmation of homogeneity of variances with Levene’s test. A p-value of < 0.05 was considered statistically significant. Results: Out of 1228 estimated responders, 641 completed the questionnaire. A total of 577 of participants met the inclusion criteria: 256 (44.4%) nurses and 321 (55.6%) doctors, with an average age of the responders of 40.06 years. Nurses reported the highest level of managerial support (83.2%, p < 0.001). EPs had the highest rate of non-participation in working groups for procedures/protocols/guidelines (49.5%, p < 0.001). Intensive care unit medical doctors (ICU-MDs) and EPs were the main groups reporting a deficiency in employer-provided resources to manage conflict situations (63.7%, 61.7%; p <0.001). EPs (28%) reported practicing defensive medicine (inadequate educational support, the absence of clear protocols). Workplace burnout was reported by the ICU-MDs and EPs responders (96.3%; 93.4%; p < 0.001), and 26% of EPs expressed interest in professional reorientation. Conclusions: This study highlights four strategic directions for rebuilding a resilient healthcare system focused on improving quality of care and safety: development of procedures/protocols, managerial reorganization, restoration of healthcare professionals’ trust through new strategies, and academic development. Full article

Background: Although forest therapy services in South Korea have demonstrated mental and physical effects, there is no established system for forest therapy prescriptions. To this end, it is necessary to devise a systematic model for the introduction of forest therapy prescriptions by linking the existing forest therapy infrastructure and medical services. Therefore, this study aimed to derive the components and application plans needed to devise a forest therapy prescription model for the spread of medical-linked forest therapy services and to secure a forest therapy prescription infrastructure. Methods: To this end, Korean and foreign cases of prescription models and healthcare service provision systems were analyzed to derive the necessary components for prescription models. Subsequently, a Focus Group Interview (FGI) was conducted with eight experts in the fields of forest therapy and welfare, psychiatry, and health and nursing, and opinions were derived regarding the conception and empirical application of the forest therapy prescription model through content analysis. Results: As a result of the study, five components (clear role-sharing and a collaboration system, a continuous system, customized service provision, various technologies and content, and a database-based prescription system) were derived from cases of prescription models and healthcare service provision systems according to field. Furthermore, the FGI identified three primary topics: stakeholders’ scope and role, procedures and effectiveness, and additional considerations. Each was categorized into eight sub-categories relevant to the design of the forest therapy prescription model. Conclusions: These results can be used as basic data for devising a systematic Korean forest therapy prescription model in which forest therapy and medical services are linked, providing a foundation for personalized forest therapy prescriptions to be implemented. Full article

On 24 February 2024, Italian physicians, dentists and oral care specialists, students, nurses, psychologists, dental hygienists, and other professionals met (live or online) to discuss controversial issues about medication-related osteonecrosis of the jaw (MRONJ). One section hosted international experts who gave lectures about MRONJ experiences in North America, Europe, and Italy. A second section summarized the principal points of an Italian MRONJ position paper published in February 2024 by experts from the Italian Societies of Oral Pathology and Medicine (SIPMO) and Maxillofacial Surgery (SICMF). The following section collates expert opinions about open issues and required fields of research: different definitions of MRONJ and impact on staging; the assessment of individual MRONJ risk before the start of antiresorptive therapy; surgery and implantology in patients at risk for MRONJ; cancer patients without metastases and prevention of cancer-treatment-induced bone Loss (CTIBL); the role of dental hygiene professionals; combined (medical and surgical) and surgical therapy for MRONJ in-patients and out-patients; and legal aspects and claims related to MRONJ diagnosis and treatment. Scientific contributions from hospitals and universities all over Italy were presented in specific sessions (epidemiology; case series; special case reports; prevention experiences; MRONJ treatment). Conclusions: the conference confirmed the importance of the adequate imaging study of bone in the diagnosis and staging of MRONJ cases, the role of surgery in MRONJ treatment, and the value of oral hygiene in the MRONJ prevention. Full article

Background: A Mediterranean-style dietary pattern (MDP) is embedded across coronary heart disease (CHD) and type 2 diabetes (T2D) clinical guidelines. However, MDP evidence has not consistently been translated into practice. This study aimed to develop, integrate and evaluate implementation strategies to support clinicians in translating MDP evidence into routine care for CHD and T2D in the local context of a public health service. Methods: This study documents the implementation and evaluation phases of a broader knowledge translation project guided by the Knowledge-to-Action cycle. Multi-disciplinary clinicians in the cardiology and diabetes services of two large metropolitan hospitals and a post-acute community service were targeted. Strategies were prioritised utilising theory and stakeholder engagement and included facilitation, building a coalition, the engagement of clinical champions and local opinion leaders, educational meetings, consensus discussions, sharing local knowledge, consumer consultation, and the development and distribution of education materials. Surveys were conducted with clinicians and patients of targeted services to evaluate the reach, acceptability, feasibility, adoption and perceived sustainability of MDP in practice. Results: In total, 57 clinicians (7 dietitians, 29 nurses/diabetes educators, 15 doctors and 6 other allied health professionals) and 55 patients completed post-implementation evaluation surveys. The majority of clinicians agreed an MDP is appropriate to recommend in their clinical setting (95%), and most of the time/always their advice (85%) aligns. Education sessions were attended by 65% of clinicians, of which the majority indicated improved knowledge (100%) and change in practice (86%). Factors deemed most important to maintaining an MDP approach in practice were hard-copy education materials (85%) and access to a dietitian (62%). Of the patients who had received care from a dietitian of targeted services (n = 32, 58%), 100% recalled having discussed ≥1 MDP topic and 89% received education material. Of the patients who had received dietary advice from non-dietetic clinicians (n = 33, 60%), 67% recalled having discussed ≥1 MDP topic and 70% received education material. Conclusions: Targeted and theory-informed implementation reached the majority of surveyed clinicians and patients, and positively influenced the adoption, acceptability and feasibility of an MDP approach in routine care. Ongoing sustainability strategies are crucial with rotating clinician roles. Full article

Background: The Caring Massage^® (CM) consists of nurse–patient physical and mental contact. It promotes empathetic presence and emotional closeness and strengthens trust and safety in the nurse–patient relationship. However, previous studies have underexplored and under-evaluated its effectiveness on different body areas. This study aimed to identify the body areas to be treated and assess CM’s influence on the nurses performing it and patients receiving it. Method: A Delphi study was conducted to gather expert opinions on Caring Massage^®. A preliminary list of body areas and variables influenced by CM was developed from a literature review and submitted to panelists to identify outcomes, achieving an acceptable content validity rate. Patient and nurse variables as influenced by CM were categorized into “Bio-Physiological Outcomes” (BPOs), “Psychological Outcomes” (POs), and “Sociological Outcomes” (SOs). Two Delphi rounds were conducted between July and October 2024. Results: A total of 86 panelists were recruited, who identified 58 variables (7 body areas, 29 patient variables, and 22 nurse variables). Feet, legs, back, hands, shoulders, and arms were identified as key CM treatment areas. Patient outcomes identified as highly influenced by receiving CM were quality of sleep (BPO), emotional well-being (PO), and nurse–patient relationship (SO). Nurse outcomes highly influenced by performing CM were physical well-being (BPO), body respect (PO), and consideration of the patient as a person (SO). Conclusion: Caring Massage^® influences multiple aspects concerning both the patients receiving it and nurses performing it. This study addressed the heterogeneity observed in the literature, providing a foundation for future studies and encouraging further investigations. Full article

Background: Vaccination is one of the most effective ways of protecting individuals against serious infectious diseases and their fatal consequences. Objectives: The aim of this scoping review was to synthesize data on parental attitudes toward vaccination and identify factors influencing the motivators and barriers to children’s vaccination based on Polish studies. Methods: The scoping review process and reporting were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScRs) checklist. In the period between January 2014 and July 2024, the following databases were searched for publications: PubMed, Web of Science, Cochrane, Ebsco, and Scholar Google. Results: A total of 1531 potentially relevant records were reviewed, and 30 original publications from research samples collected in Poland were selected. According to the findings, vaccination rates varied between 100% and 70%, with parental acceptance levels for mandatory vaccination ranging from 99% to 65%. Parents most commonly cited the physician, the nurse, and the Internet as their primary sources of vaccination-related information. Moreover, parental primary motivators for vaccinating their children were prevention against infectious diseases, the opinion that vaccines are safe, and the belief that childhood vaccination is right and effective. The major barriers to vaccination were fear of vaccine side effects and the belief that vaccines are ineffective. Parents that were better educated, were of younger age, lived in cities, and had a higher income were much more likely to vaccinate their children. Conclusions: Understanding parental attitudes toward vaccination may help develop an educational program aimed at combating misinformation and increasing childhood vaccination coverage rates. Full article

Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention. Full article

Background and Objectives: Palliative care is a very important part of medicine, aimed at ensuring an improvement in quality of life and a reduction in distressing symptoms in patients with serious, incurable, progressive diseases. The issues of the accessibility and quality of these services should be a focus for health policymakers and researchers, although it is acknowledged that a significant portion of the public has not heard about this service. For this reason, it is important to investigate the experience of the accessibility and quality of palliative care services in primary healthcare facilities. Materials and Methods: A quantitative study was conducted in institutions providing outpatient and inpatient palliative care services. A total of 784 patients and 219 family members participated in the study. Participants expressed their opinions through a questionnaire containing 24 statements, to which they responded by indicating their level of agreement on a Likert scale. The collected data were analyzed using statistical analysis software. Results: Palliative care services are widely available in large cities, but their accessibility is very limited in small towns and rural areas. Patients and their families are not familiar with the concept of palliative care, often equating it with the provision of treatment and nursing services, and they see the support of clergy as unnecessary. Although patients and their families rate the quality of the services received positively, they note shortcomings related to communication among staff. Conclusions: Palliative care services are provided within the primary healthcare system by specialists with qualifications regulated by legislation; however, patients do not see the need to receive assistance from clergy members. Based on the study results, it can be concluded that in Lithuania, the accessibility of palliative care is ensured in larger cities but is insufficient in smaller towns and rural areas. Patients tend to rate indicators reflecting the quality of palliative care services positively; however, they are not convinced that these services improve their quality of life. Full article

Background: Today’s healthcare requires a modern style of management that adapts to the needs of both patients and employees. Imaging diagnostics has its specificity in the entire area of hospital logistics and influences the organization of work and patient care. Modern managers should have special competencies to meet the expectations of patients, employees, and organizations. Aim: The main purpose of article was to define the role, competencies, and skills that managers should have in the field of diagnostic imaging. Methods: In the research part, a questionnaire survey and in-depth interviewing were used. The research group consisted of 10 managers and 300 medical staff, i.e., radiologists, nurses, and electroradiology technicians. Results: The decision-making role of the manager and their interpersonal skills were recognized to be most crucial. According to the respondents, managers should ensure good work organization and provide safe working conditions. Employees appreciated the manager’s ability to react in crisis situations as well as their high professionalism. The ability to communicate and resolve conflicts in a team was considered the most important psychological and social competence. Conclusions: A good manager, in the opinion of the respondents, is a decision-making, empathetic, and flexible person with strong leadership characteristics. Full article

Objective: Nursing students’ experiences about clinical practice tutoring in a public university from southern Spain and at its two attached educational centres were analysed. Methods: A cross-sectional observational study was carried out. The population was comprised of nursing students attending their fourth year of university during the 2023/2024 academic period, with a final sample of 179 subjects. Sociodemographic data were collected and a validated questionnaire on opinions about the figure of clinical practice tutors was applied, with 34 closed questions offering five answer options. The questions were categorized into 17 dimensions. A question on the students’ satisfaction with tutoring of the practices was included, in addition to an open question to gather the students’ comments and/or suggestions in relation to clinical practice tutoring. The analysis was performed through a data matrix in SPSS. The Kruskal–Wallis test was used to compare the centres according to the questionnaire dimensions, considering p-values < 0.05 to establish statistically significant differences. The open question was analysed using Atlas.ti. Results: Most of the students were women, with an approximate mean age of 23 years old. Significant differences were detected among the centres in almost all dimensions from the questionnaire. High satisfaction levels were obtained in the three centres. A total of 83 verbatims were collected in the open question and grouped into eight categories. Conclusion: Nursing students place significant importance on the role of the clinical tutor. Clinical tutors who demonstrate enthusiasm for teaching, foster a positive environment based on active listening, respect, and the encouragement of autonomy, are essential to enhancing the students’ experience during clinical placements. Full article

The health of adult dogs and cats is affected positively or negatively by their development in utero and throughout postnatal growth. Preventive veterinary care is particularly important when animals are physiologically immature and sensitive to modifiable environmental factors. Veterinary nurses/technicians are often at the forefront of promoting healthy development, reinforcing the work of veterinarians and using their knowledge, experience, and passion to lead initiatives with breeders and pet guardians. This opinion article considers the role of qualified veterinary nurses/technicians in the care of puppies and kittens throughout their developmental life stages—gestation, the suckling period, growth post-weaning to puberty or neutering, and late growth to adulthood. Much of their influence is through the education of pet carers; they provide trustworthy information relevant to the individual pet and focused on the practicalities of best husbandry practices. These include practical advice on recognizing dystocia, neonatal care, weaning, introduction to the new home, the prevention and management of infectious diseases, socialization with conspecifics and humans, habituation to potential environmental stresses, nutrition, oral hygiene, and grooming. The veterinary nurse’s goal is not only to see young pets develop into healthy, well-adjusted adults but also to see pet guardians developing sustainable human–animal bonds. Full article