Search Results (2,026)

Background: Live music, understood as real-time musical performance delivered in the physical presence of patients or other participants, is increasingly incorporated into healthcare settings as an arts-based, non-pharmacological practice intended to support well-being and humanize care. While previous reviews have examined a broad range of music-based interventions in healthcare, limited attention has been given specifically to live music, its contextual characteristics, and the values attributed to its use within hospital environments. Objectives: This scoping review aims to map and synthesize the literature on live music in healthcare settings, focusing on clinical contexts, populations involved, and the therapeutic, psychosocial, and environmental values reported. Methods: A scoping review was conducted following the framework of Arksey and O’Malley. Searches were performed in Web of Science, Scopus and Pubmed using terms related to live music and healthcare settings. Studies published in English or Spanish over the past 20 years were considered. After screening titles, abstracts, and full texts, 81 studies met the inclusion criteria. Results: The studies covered diverse hospital units and patient groups, particularly oncology, neonatal and intensive care, palliative care, and haemodialysis. Reported outcomes were mainly psychological and emotional, including reductions in anxiety, stress, and distress, alongside improvements in mood, well-being, and quality of life. Cognitive, physiological, and environmental benefits were also identified, emphasizing the role of live music in creating supportive and humanized care environments. Most studies were conducted in Europe and North America. Conclusions: Live music is widely implemented in healthcare settings and is associated with benefits extending beyond symptom reduction to experiential and humanizing dimensions of care. This scoping review provides an overview of the existing evidence base and identifies directions for future research in arts and health. Full article

Gestational Diabetes Mellitus (GDM) represents a significant public health concern due to its association with adverse maternal and neonatal outcomes, as well as elevated long-term metabolic risks. Its prevalence varies substantially depending on the diagnostic criteria used and the population studied. Women with GDM frequently experience heightened stress, anxiety, and uncertainty, underscoring the need for accessible information, counseling, and ongoing support to navigate glucose monitoring, dietary adjustments, and treatment regimens. Although clinical management has been extensively studied, research has largely focused on metabolic monitoring and therapeutic interventions, often underemphasizing prevention strategies, women’s informational needs, and maternal psychological well-being. Emerging evidence and international guidelines increasingly advocate for integrating these components into structured, woman-centered GDM care plans that actively involve families. Such approaches empower women to engage in self-management, enhance health literacy, support adherence to lifestyle and pharmacological interventions, and promote sustainable behavioral changes. This narrative review presents a comprehensive, holistic model of care across the perinatal continuum, emphasizing early risk identification, preventive strategies, and multidisciplinary coordination. Core elements include individualized antenatal education, empathetic communication, and family engagement, fostering self-efficacy, continuity of care, and integration of medical, educational, and psychosocial interventions. Equipping healthcare professionals with the competencies to deliver this holistic, woman-centered framework is essential to optimize maternal and neonatal outcomes and mitigate the long-term health consequences of GDM. Full article

Informal waste picking and scrap collection constitute critical yet highly precarious livelihood strategies among economically marginalised women in rural South Africa. This article presents a cross-sectional mixed-methods study, guided by Sen’s Capability Approach as its analytical framework, examining the lived experiences, motivations, and livelihood outcomes of 126 Black African women engaged in scrap collection along the N2 Highway in the Eastern Cape, specifically in Mthatha, Xhora, and Qumbu. The study integrates quantitative descriptive statistics with qualitative thematic analysis derived from structured interviewer-administered questionnaires. The findings indicate that participation in scrap collection is overwhelmingly driven by structural economic constraints, including chronic unemployment, household poverty, and extensive caregiving responsibilities, rather than autonomous occupational choice. The sample is characterised by limited educational attainment, frequently disrupted by poverty, bereavement, early marriage, and early caregiving roles, which collectively constrain access to formal employment opportunities. Participants consistently described scrap collection as physically hazardous, economically insecure, and detrimental to both physical health and psychosocial wellbeing, while remaining indispensable for household survival. Through the lens of the Capability Approach, these conditions reflect severe restrictions in substantive freedoms, particularly in relation to economic security, bodily health and human dignity. Expressions of acceptance are interpreted as manifestations of adaptive preferences formed under conditions of prolonged structural deprivation rather than indicators of genuine agency. The study contributes to informal economy scholarship by demonstrating how intersecting structural inequalities constrain capability sets and limit livelihood trajectories and calls for targeted policy interventions to enhance occupational safety, income security and access to sustainable livelihood alternatives. Full article

Background/Objectives: Grief following the death of a partner is a complex psychosocial process associated with an increased risk of prolonged grief, depression and suicidal ideation. Among lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ+) individuals, these risks are exacerbated by stigma, relational invisibility and family rejection, often resulting in unrecognized or disenfranchised grief. This scoping review aimed to map the available evidence on the experiences of bereavement following the death of a partner among LGBTIQ+ individuals between 2016 and 2026, identifying study types, recurring themes and knowledge gaps relevant to nursing practice. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) extension and the methodology of the Joanna Briggs Institute. Searches were planned in PubMed/MEDLINE, Scopus, CINAHL, PsycINFO and Web of Science (2016–March 2026) using combined terms for grief, partner and LGBTIQ+ populations. Primary qualitative, quantitative and mixed-methods studies, as well as selected grey literature that explicitly addressed grief following the death of a partner in LGBTIQ+ individuals were considered. Results: The search identified 1032 records; after removing duplicates (n = 356), 676 titles/abstracts were screened, and 94 full texts were assessed. Eighteen studies were included, mainly qualitative, and conducted in high-income countries. Key themes included invisibility and lack of recognition of the relationship, managing the disclosure of sexual orientation and gender identity, social isolation and the role of chosen families, and intersectional vulnerabilities in subgroups such as older adults, bisexual people and trans people. Conclusions: The available evidence reflects specific bereavement experiences among LGBTIQ+ individuals that are not adequately captured in traditional models of bereavement care. Significant gaps remain, particularly in Spanish-speaking contexts and in the design and evaluation of nurse-led interventions. This scoping review provides a conceptual basis for future research and for the development of culturally safe clinical practices in supporting LGBTIQ+ individuals through bereavement. Full article

Breast cancer is the most prevalent malignancy among women. The disease and its treatments often lead to physical and psychosocial impairments, compromising quality of life. While exercise and music-based interventions have individually demonstrated benefits on these symptoms, the advantages of their combination remain unexplored. This study evaluates whether a concurrent exercise program, including aerobic and strength training performed while listening to music based on individual preferences, is more effective than the same exercise program without music in improving self-esteem, body image, cancer-related fatigue, physical function (upper and lower limb strength and cardiorespiratory endurance), quality of life, sleep quality, and intolerance of uncertainty in female breast cancer survivors. A single-blind, two-arm, parallel-group, randomized controlled trial will be conducted including 42 women who completed primary treatment for stage 0–III breast cancer at least six months before enrollment. Participants will be randomly assigned to a music-listening concurrent exercise training group (MLTG), or a no music exercise training group (NMLTG), both performing the same 8-week exercise program. The primary outcome will be self-esteem (Rosenberg Self-Esteem Scale). Secondary outcomes include body image, fatigue, upper and lower limb strength, cardiovascular endurance, quality of life, sleep quality, and intolerance of uncertainty. Measurements will be collected using validated and reliable questionnaires and standardized functional tests at baseline, post-intervention, and at 6 months. Data will be analyzed under the intention-to-treat principle. Music listening, particularly when based on individual preferences and synchronized with movement, may enhance mood and exercise performance while modulating reward-related neural pathways. This trial will provide new evidence on a feasible and low-cost strategy to enhance supportive care and physical and psychosocial outcomes in breast cancer survivors. ClinicalTrials.gov (NCT07045961). Ethics Committee code: 2025-0855. Full article

Introduction. Chronic non-cancer pain is highly prevalent and profoundly diminishes quality of life. While pharmacological and interventional treatments are central, its psychosocial and spiritual dimensions remain under-addressed. This pilot study assessed the feasibility of a therapist-led support group intervention for patients with chronic non-cancer pain and explored preliminary psychospiritual outcomes. Methods. A two-arm, non-randomized pilot feasibility study was conducted among 58 outpatients of a university pain management clinic in Poland. Feasibility was assessed through recruitment, retention, attendance, and safety, while preliminary psychological and spiritual outcomes were evaluated using validated self-report instruments. The intervention group (n = 29) participated in eight group sessions combining psychoeducation, mindfulness-based techniques, and supportive dialogue inspired by the Simonton Method. The control group (n = 29) received standard care. Participants completed the Numeric Rating Scale to measure pain intensity, the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, the WHOQOL-BREF, the Spiritual Well-Being Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire-9. Results. The intervention was feasible in terms of physician workload; however, patients adherence varied significantly. At baseline, the control group showed a significantly higher positive affect and existential well-being than did the intervention group. In exploratory within-group analyses, participants in the intervention group showed improved positive affect and reduced anxiety (p < 0.05), whereas existential well-being showed a trend toward improvement (p < 0.06). However, the self-selection design limits causal inferences. Nevertheless, participants reported social connectedness, meaning-making, and enhanced vitality. Discussion. This pilot feasibility study provides preliminary evidence that a therapist-led support group intervention integrating psychoeducation, mindfulness, and supportive components is practicable within multidisciplinary pain management. Further research in a larger, randomized trial is needed to evaluate adherence and safety, as well as clinical effects, more rigorously. Full article

Background: Multiple sclerosis (MS) is a condition that requires long-term, multidisciplinary management. The growing digital transformation in healthcare has highlighted the central role of nurses in supporting key aspects such as patient self-management, continuity of (at home) care, and patient empowerment. However, evidence on nurse-led digital interventions in MS remains fragmented. Objective: To map the available literature on nurse-led digital interventions in MS, focusing on the role of nurses, clinical outcomes, and research gaps. Methods: The review was conducted using the methodological framework of the Joanna Briggs Institute (JBI) and the PRISMA-ScR checklist. A systematic search was performed in PubMed, Scopus, Web of Science, and CINAHL. Studies were included if they described digital or telehealth interventions led or coordinated by nurses in patients with MS. Results: A total of 12 studies published between 2015 and 2025 met the inclusion criteria. Four main thematic areas were identified: (1) telenursing and empowerment-based interventions; (2) mobile and web-based patient self-management programs; (3) digital systems for monitoring and integrated care pathways; and (4) digital interventions targeting symptom management and psychosocial outcomes. Across the studies, nurse-led digital interventions were associated with improvements in self-management, treatment adherence, self-efficacy, and health-promoting behaviors. Positive effects were also reported on clinical outcomes such as fatigue, sleep quality, and balance, as well as on psychosocial variables including quality of life, coping strategies, and emotional well-being. Furthermore, the identified systems, in general, contributed to enhanced continuity of care, patient engagement, and organizational efficiency. Conclusions: Nurse-led digital interventions represent a promising approach in the management of patients with multiple sclerosis, supporting both clinical and psychosocial outcomes while enhancing continuity of care. However, the current evidence base remains limited by small sample sizes, heterogeneity of interventions, and short follow-up periods. Future research should prioritize multicenter randomized studies with larger samples and long-term follow-up to strengthen the evidence. Additionally, the integration of digital interventions into routine clinical practice, along with targeted training for nurses, is essential to ensure sustainability, accessibility, and equitable implementation. Further studies should also explore cost-effectiveness and the impact on caregivers and long-term quality of life. Full article

Lymphoid neoplasms such as multiple myeloma (MM), indolent non-Hodgkin lymphoma, and chronic lymphocytic leukemia are increasingly managed as chronic, relapsing conditions characterized by prolonged surveillance, repeated treatment transitions, and cumulative self-management demands. These trajectories expose patients and caregivers to persistent illness uncertainty, fluctuating fear of progression, symptom and comorbidity burden, communication challenges, and treatment-related workload. This theory-informed framework development paper uses an overview of selected psycho-oncological, hematological, nursing, theoretical, and patient-reported outcome literature to propose the LUMINA framework: Longitudinal illness trajectory, Uncertainty fields, Multidimensional symptom and comorbidity load, Information and interaction context, Navigation work and self-management load, and Adaptive outcomes and alignment. LUMINA is intended as a hypothesis-generating conceptual structure to organize clinically relevant domains, clarify potential relationships among uncertainty, symptom burden, communication, navigation work, and adaptive outcomes, and guide future assessment, validation, and intervention research in chronic lymphoid neoplasms. The framework builds on prior theories of illness uncertainty, treatment burden, workload–capacity balance, fear of recurrence/progression, and lymphoma-specific qualitative work on uncertainty management and psychosocial adaptation. Potential research applications include structured assessment, shared decision-making research, and domain-matched supportive-care concepts; however, these applications remain theoretical and require empirical testing. Future studies should evaluate feasibility, acceptability, construct validity, domain overlap, predictive validity beyond quality of life, and the clinical utility of LUMINA-informed research profiles. Until such validation is available, LUMINA should be interpreted as a conceptual model rather than a validated clinical tool or care pathway. Full article

Although one of the most common coping strategies for medical students is seeking interpersonal support, evidence shows that they often experience social isolation and low levels of emotional support and belonging, putting them at risk for increased stress and depression. In this exploratory systematic review and meta-analysis, we completed a comprehensive literature search including multiple databases to identify interventions used to increase belonging-oriented psychosocial outcomes among medical students. N = 5 articles (k = 7) were eligible for inclusion. Meta-analysis with the random effects model suggests that belonging-oriented psychosocial interventions may have a small, positive effect on improving feelings of belonging, g = 0.25, 95% CI [0.01–0.50], 95% PI [−0.52–1.02], p = 0.045. However, heterogeneity was substantial (Q = 9.92, p of Q = 0.04, I² = 59.69%, T = 0.21, T² = 0.04), and risk of bias was substantial. Subgroup analysis was precluded by the low number of primary studies. Further investigation into belonging-oriented psychosocial support among medical students would be beneficial to determine if these interventions are effective, and if so, ideal intervention types, modalities, facilitators, and durations. Full article

Digital isolation represents a contemporary paradox in which increased connectivity through social media and digital technologies does not necessarily translate into improved social integration or psychological well-being. This review synthesizes current evidence on the relationship between digital environments and mental health, with a focus on mechanisms underlying loneliness, anxiety, depression, and related outcomes. The findings indicate that problematic and passive use of social media—particularly when associated with social comparison processes and Fear of Missing Out (FoMO)—is consistently linked to increased levels of depressive symptoms, anxiety, sleep disturbances, and reduced well-being. At the same time, the evidence highlights substantial heterogeneity, suggesting that the impact of digital technologies is moderated by user characteristics, age, patterns of engagement, and psychosocial context. Importantly, digital technologies may also serve compensatory and protective functions by facilitating social support, especially in conditions of objective isolation. Key mediating mechanisms include cyberbullying, social exclusion, emotional contagion, and internalization of body image standards. The concept of “digital loneliness” emerges as a useful framework for understanding the discrepancy between constant connectivity and perceived relational insufficiency. Practical implications emphasize the need for targeted interventions focusing on digital literacy, healthy usage patterns, and psychosocial support rather than simplistic reduction in screen time. Overall, digital isolation should be conceptualized as a qualitative dysfunction of mediated social interaction rather than a purely quantitative effect of technology exposure. Full article

Introduction: Low back pain is one of the commonly overlooked late complications of an intestinal stoma. Its severity may be associated with impaired quality of life across multiple dimensions of patient functioning. Objective: This cross-sectional study evaluated the impact of low back pain on self-reported health-related quality of life in colostomy patients. Material and Methods: The study was conducted using a cross-sectional questionnaire-based design across 12 regional branches of the Pol-ILKO Association in Poland between December 2023 and September 2024. The study sample consisted of 95 patients. The standardized Oswestry Disability Index (ODI) questionnaire, which assesses the level of disability in patients with back pain, and the WHOQOL-BREF questionnaire, which assesses health-related quality of life, were used in the survey. In addition, detailed data on medical history, past surgical interventions, and stoma self-care skills were collected using an author-developed tool. Results: Greater disability due to back pain is associated with lower self-rated quality of life. The higher the degree of disability as assessed by the Oswestry questionnaire and the higher the number of postoperative complications, the worse the subjective rating of health-related quality of life (HRQoL) (p < 0.05). Factors associated with a significantly (p < 0.05) increased risk of lower back pain include postoperative complications, irrespective of the time since stoma creation, as well as avoidance or restriction of full trunk movements. Preoperative agreement on the stoma site was associated with greater independence in stoma hygiene. Conclusions: The results underscore the importance of early and targeted interventions to improve physical and psychosocial well-being in the subject population, especially at the preoperative stage. More attention should be paid to the needs of colostomy patients, both in hospitals and in outpatient specialty care centers, to improve their overall quality of life and self-assessment of their condition. Full article

Background/Objectives: Anterior direct composite restorations are evaluated through instrumental color matching, clinician appraisal, and patient perception, but these endpoints may diverge by age. This cross-sectional study compared adolescents/young adults (AYA, 15–25 years) with adults/elderly (AE, 50–75 years) for spectrophotometric color difference (ΔE*ab), patient and clinician aesthetic ratings, patient–clinician agreement, and oral-health-related quality of life (OHRQoL). Methods: Consecutive recall patients with at least one anterior direct composite restoration placed ≥6 months earlier were screened; 128 were enrolled, and 126 completed all assessments (AYA n = 64; AE n = 62). Participants completed the OHIP-14 and aesthetic visual analogue scale (VAS) before receiving any USPHS, clinician VAS, or spectrophotometric feedback. A separate clinician, masked to patient scores and spectrophotometric outputs but not to patient age, recorded clinician VAS and modified USPHS criteria. Results: AE restorations showed higher ΔE*ab than AYA restorations (4.8 ± 1.6 vs. 3.2 ± 1.1; p < 0.001), whereas AYA reported lower patient VAS (72.4 ± 12.3 vs. 81.6 ± 10.8; p < 0.001) and higher OHIP-14 psychosocial burden (7.2 ± 2.8 vs. 4.0 ± 2.3; p < 0.001). Clinician VAS was higher in AYA (85.2 ± 7.3 vs. 79.4 ± 8.9; p < 0.001). Patient VAS correlated modestly with ΔE*ab (ρ = −0.38 in AYA; ρ = −0.31 in AE) and more strongly with psychosocial OHIP-14 scores (ρ = −0.54 and −0.47, respectively). Patient-clinician agreement was poor in AYA (ICC = 0.26) and moderate in AE (ICC = 0.58), with larger negative patient-minus-clinician discrepancies in AYA. Exploratory mediation statistically decomposed the age-related patient-satisfaction difference more through patient–clinician discrepancy than through ΔE*ab; causality cannot be inferred. Conclusions: Younger patients may experience dissatisfaction and psychosocial burden despite better instrumental color match. Assessment of anterior composites should combine objective shade measurement with patient-centered expectation clarification, and longitudinal studies should test temporal mechanisms and communication interventions. Full article

Background: Community-based mental health and social interventions focusing on housing stability, integrated care and psychosocial support are being increasingly recognised as essential for improving the mental health and wellbeing of people experiencing homelessness. However, evidence regarding the effectiveness of these interventions remains fragmented across different models of care and study designs. This review synthesises how these interventions address mental health and social determinants of health. Methods: Following PRISMA 2020 guidelines, a systematic search of six electronic databases (2019–2025) was conducted (PROSPERO: CRD420250653260). The review included 29 quantitative, qualitative, and mixed-methods studies examining community-based interventions for people experiencing homelessness and mental health conditions according to predefined eligibility criteria. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Results: Community-based interventions, particularly Housing First models, were frequently associated with improved housing stability, mental health outcomes, and programme retention. Integrated multidisciplinary services and outreach promote psychosocial wellbeing, continuity of care and reducing emergency service use. Peer-led programmes support social integration, although evidence regarding technology-based interventions was inconsistent, with some studies reporting improved engagement and access to support, while others found limited effects on mental health outcomes. Conclusions: Addressing social determinants of health through structured community-based interventions is essential to tackle mental health inequalities. The findings support the implementation of integrated community-based services combining housing, mental health, and social support. These results may inform policymakers, healthcare providers, and community organisations seeking to reduce mental health inequalities among people experiencing homelessness. Full article

Emotional exhaustion has been discussed as a major contributor to work ability problems, with substantial economic, individual, and social consequences. Research largely focuses on specific professions and sometimes overlooks that exhaustion and work overload problems are partly distinct. This study uses a differential analysis to explore working conditions and individual characteristics in employees with emotional exhaustion or perceived work overload, aiming to identify potential common risk factors. A representative German cross-sectional sample of 2289 employees aged 15–67, working at least 10 h per week, was analyzed. Employees with and without treatment for exhaustion, and with and without perceived work overload, were compared using variance analysis. Overloaded employees reported more work demands, while exhausted employees appear to be more often female and not in their preferred occupation. Several psychosocial work factors (e.g., responsibility) were more consistently associated with the overload and exhaustion groups than many of the physical work conditions. Employee characteristics such as openness and internal locus of control appeared to be similarly distributed across groups. Overload without exhaustion can be distinguished from combined exhaustion and overload, suggesting that work overload may occur with or without exhaustion, in relation to individual psychosocial resources. Preventive interventions for work ability may benefit from addressing overload as a distinct risk factor, besides illness-related exhaustion. Full article

Background/Objectives: Caregivers play a critical role in patient care across the pre- and post-transplant periods. However, the demands of caregiving can negatively impact caregivers’ own physical and psychosocial well-being. The Transplant Wellness Program (TWP) is a behavior change intervention that provides exercise support for pre- and post-kidney, pre- and post-liver, and post-lung transplant patients but has not yet included transplant caregivers. Thus, the purpose of this study was to explore the experiences and needs of organ transplant caregivers to inform the development of caregiver-specific support resources for the TWP. Methods: Semi-structured interviews with family caregivers of patients receiving kidney or liver transplant in the TWP were conducted and recorded via Zoom. Interview recordings were transcribed verbatim and analyzed using conventional content analysis. Results: Eight interviews were conducted, with caregivers in both the pre- (n = 4) and post-transplant (n = 4) periods. Four categories resulted from the data: caregiver strain, life changes, individual wellness needs, and caregiving needs. Nine sub-categories further described caregivers’ experiences and opportunities for wellness support. Conclusions: The caregiving experience was characterized by feelings of overwhelm, stress, and uncertainty. This study highlights the need for comprehensive services such as exercise classes, peer support programs, and tangible aide to support transplant caregivers’ well-being. Three caregiver resources were built out of this study and integrated into the TWP. Full article