A Situation-Specific Theory of Self-Care Behaviors in People Living With an Intestinal or Urinary Ostomy.

BackgroundSelf-care is essential for people with Parkinson disease (PD) to minimize their disability and adapt to alterations in physical abilities due to this progressive neurodegenerative disorder. With rapid developments in mobile technology, many health-related mobile apps for PD have been developed and used. However, research on mobile app–based self-care in PD is insufficient.ObjectiveThis study aimed to explore the features and characteristics of mobile apps for self-care in people with PD.MethodsThis study was performed sequentially according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science, and PsycINFO were searched in consultation with a librarian on June 8, 2021. We used keywords including ”Parkinson disease” and ”mobile.”ResultsA total of 17 studies were selected based on the inclusion criteria, including 3 randomized controlled trials and 14 observational studies or quasi-experimental studies. The use of mobile apps for self-care in people with PD focused on symptom monitoring, especially motor symptoms. Motor symptoms were objectively measured mainly through the sensors of smartphones or wearable devices and task performance. Nonmotor symptoms were monitored through task performance or self-reported questionnaires in mobile apps. Most existing studies have focused on clinical symptom assessment in people with PD, and there is a lack of studies focusing on symptom management.ConclusionsMobile apps for people with PD have been developed and used, but strategies for self-management are insufficient. We recommend the development of mobile apps focused on self-care that can enhance symptom management and health promotion practices. Studies should also evaluate the effects of mobile apps on symptom improvement and quality of life in people with PD.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42021267374; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021267374.

Objective: to analyze the nurses’ perspective on the possibility of incorporating the use of mobile applications into their care practice as a strategy for promoting self-care in people with chronic diseases. Method: an exploratory-descriptive study with a qualitative approach. Data were collected between the months of February and March 2023 with 10 nurses who were Master’s degree students in Community Nursing in the Family Health Nursing area from a higher education institution in Nursing in Portugal. The data were analyzed using the content analysis technique proposed by Bardin. The MAXQDA software program was used to facilitate and accelerate qualitative data analysis through coding and categorization. Results: the results were organized into two main categories: challenges for managing the therapeutic regimen and self-care; and strategies for promoting self-care in chronic diseases from the perspective of nurses. The challenges during the Covid-19 pandemic generated elements which hinder and facilitate management of the therapeutic regimen and self-care in people with chronic diseases. From the nurses’ perspective, the use of mobile applications can facilitate promoting self-care in people with chronic illnesses. Conclusion: chronic disease control heavily depends on people’s behaviors and self-management of the disease. The nurses in this study considered that the use of mobile applications can help both healthcare professionals and people with chronic illnesses in promoting health and in the self-care process.

Disrespect and abuse of laboring and child-birthing women in health care is a global problem that violates the universal human rights of childbearing women. There is a lack of reliable and valid tools for measuring these behaviors. One instrument, the Disrespect and Abuse scale, has preliminary data with no established psychometrics in diverse populations. Further analysis is required to ensure the reliability and validity of this tool in diverse populations and health care settings. We examined the psychometric properties of the Disrespect and Abuse scale in diverse international nursing and midwifery populations. A cross-sectional descriptive design was used to measure disrespect and abuse toward women during childbirth. Data were collected from 231 nurses and midwives across international labor and delivery units. Exploratory factor analysis was conducted using principal component analysis with oblimin rotation as the factor extraction method. The psychometric assessment yielded a two-factor structure. Factor 1 consisted of 13 items characterizing physical and verbal abuse. Factor 2 contained nine items reflecting disrespectful behaviors. The Cronbach's alpha coefficients reflected high internal consistency. The scale was shown to be reliable and valid in assessing self-reported disrespectful and abusive behaviors among nurses and midwives in a diverse international sample. Use could assist in the assessment of these behaviors in maternal health care facilities. Further research is warranted to confirm the scale's robustness and applicability across various populations and settings and use the Disrespect and Abuse scale to identify the burden and predictors of mistreatment of women in different health care settings.

Evidence-informed and human rights-based combination prevention combines behavioural, biomedical, and structural interventions to address both the immediate risks and underlying causes of vulnerability to HIV infection, and the pathways that link them. Because these are context-specific, no single prescription or standard package will apply universally. Anchored in 'know your epidemic' estimates of where the next 1000 infections will occur and 'know your response' analyses of resource allocation and programming gaps, combination prevention strategies seek to realign programme priorities for maximum effect to reduce epidemic reproductive rates at local, regional, and national levels. Effective prevention means tailoring programmes to local epidemics and ensuring that components are delivered with the intensity, quality, and scale necessary to achieve intended effects. Structural interventions, addressing the social, economic, cultural, and legal constraints that create HIV risk environments and undermine the agency of individuals to protect themselves and others, are also public goods in their own right. Applying the principles of combination prevention systematically and consistently in HIV programme planning, with due attention to context, can increase HIV programme effectiveness. Better outcome and impact measurement using multiple methods and data triangulation can build the evidence base on synergies between the components of combination prevention at individual, group, and societal levels, facilitating iterative knowledge translation within and among programmes.

Objectives/Goals: The importance of interprofessional communication in healthcare is well documented. However, there has yet to be a theoretical framework for understanding this complex phenomenon. The purpose of this project was to develop a situation-specific theory about the culture of communication in the interprofessional healthcare setting. Methods/Study Population: We conducted individual virtual qualitative interviews with 16 healthcare professionals at different levels and from various disciplines. Participants were practicing clinicians at a tertiary care academic medical center. We transcribed audio-recordings of the interviews verbatim and aligned each transcript for accuracy, confidentiality, and representativeness. Data analysis was conducted using dimensional analysis, including open- and theoretical-coding utilizing an explanatory matrix for theory generation. Results/Anticipated Results: Our findings produced a situation-specific theory on the culture of interprofessional communication in the healthcare setting. Participants described the environments in which they practiced in terms of hierarchical system structures and through a conceptual perspective of resource investment. In other words, they viewed their time and their effort as valuable – and notably, scarce – resources, which they invest in patient care, interprofessional communication, and other tasks. There are two key pathways that characterize the culture of interprofessional communication: collaborative communication and transactional interactions, depending on whether an individual perceives the goals of another person, department, or level of the hierarchical institution as aligned with their own goals. Discussion/Significance of Impact: Positive cultures of interprofessional communication in the healthcare setting depend on perceived goal alignment among individuals, departments, and leadership. Future research can explore how perceptions of goal alignment are developed and empirically test this situation-specific theory in other healthcare system settings.

Screening chest computed tomography (CT) scans reduce lung cancer mortality in high-risk individuals, but less than 20% of eligible individuals are screened in the US. To determine whether a direct-to-patient digital health program increases lung cancer screening. Randomized clinical trial enrolling individuals aged 50 to 77 years who met Centers for Medicare & Medicaid Services criteria for lung cancer screening between April 18, 2022, and May 30, 2023, at 2 academic health systems in the southeastern US. The date of last follow-up was September 30, 2024. Participants were randomized 1:1 to the mPATH-Lung program, a digital health program delivered outside a clinical visit that included a brief decision aid and option to request a screening appointment (n = 669) or enhanced usual care, in which patients were notified of their lung cancer screening eligibility and advised to speak with their primary care clinician (n = 664). The primary outcome was completion of any chest CT within 16 weeks. Secondary outcomes included screening decisions, process measures (screening visits, CT scans ordered), clinical outcomes (lung cancer screening results, lung cancers diagnosed), screening harms, and implementation outcomes. Electronic invitations were sent to 26 909 individuals with a smoking history in their electronic health record; 3267 completed website eligibility questions and 1333 were deemed eligible and enrolled. The mean age was 60.7 years (SD, 6.8 years); 864 (65%) were female; 232 (17%) were Black and 1054 (79%) were non-Hispanic White; and 621 (47%) had commercial insurance and 595 (45%) had public insurance. Chest CT completion was higher in the mPATH-Lung group than in controls (24.5% [164/669] vs 17.0% [113/664]; odds ratio, 1.6; 95% CI, 1.2-2.1). Among patients who completed screening CT, false-positive results occurred in 12.7% (19/150) of mPATH-Lung participants and 8.4% (8/95) of controls. Invasive procedures were performed in 2.0% (3/150) in the intervention group and 1.1% (1/95) in the control group, with no complications. Compared with enhanced usual care, a direct-to-patient digital health intervention increased rates of lung cancer screening. Future research should assess the reach and effectiveness of digital lung cancer screening interventions across diverse populations and health care settings. ClinicalTrials.gov Identifier: NCT04083859.

Background/Aims: Much of the work in antidepressant adherence relies on self-report and small sample sizes with limited racial/ethnic representation. Our study aimed to determine factors associated with poor early adherence to antidepressants in a large diverse sample of patients using pharmacy refill data.

Introduction: Supportive approaches to engaging with people living with dementia in research are needed to ensure that research methods are accessible to and incorporate the experiences of people living with dementia. This study sought to explore how the use of a photo-prompted storytelling technique impacted both the data collected as well as the engagement of people living with dementia in research during the COVID-19 pandemic. We examined an underutilized research method for supporting the engagement of people with dementia in qualitative research through involving participants in constructing a story about a character (Frank) using photos. Methods: This paper presents findings from a project which employed different interviewing techniques with people with dementia. Video recordings of interviews were used to facilitate observation of the engagement of participants in interviews. An observational scale was used to examine the engagement of participants in the interviews. Results: A total of 12 people living with dementia participated in this study. Qualitative content analysis resulted in the identification of several key areas of impact. When interviewed with the photo-prompted storytelling technique, participants tended to engage in reflection of their own experiences and beyond, and the photo-prompted storytelling technique also supported challenges with direct questioning and recall. It was also identified that there were content differences related to the photograph prompts. There was a statistically significant difference in engagement scores when participants were interviewed using photo-prompted storytelling techniques. Conclusion: Findings from this study reinforce the utility of photo-prompted storytelling techniques in supporting the participation people with dementia in qualitative interviews. These techniques may impact the types of data collected through interviews, as well as the engagement of people with dementia in interviews. Further research is needed to determine the impact of specific photograph prompts, as well as applications in a broader range of people living with dementia.

Objective: Psychological safety (PS) is essential for health and social care professionals (HSCPs) working in high-stress environments. While much of the existing research focuses on PS within teams, less is known about HSCPs' lived experiences across diverse health and social care settings. This scoping review aims to synthesise the qualitative literature on PS, identifying key barriers and enablers to its development in health and social care workplaces. Methods: A systematic search was conducted across MEDLINE, PsycINFO, Embase, CINAHL, Scopus, Web of Science, and the Cochrane Library, covering a 20-year period (2004-2024). Eligible studies included primary qualitative research exploring HSCPs' experiences of PS. Screening and data extraction were managed using Rayyan. An inductive thematic synthesis approach was applied to identify key patterns in the data. Results: The review identified several enablers and barriers to PS. The main enablers included (1) feeling safe within the team and (2) personal factors, which encompassed professional skills, experience, social support, and self-care. Conversely, key barriers were identified: (1) the normalisation of traumatic incidents, (2) unsupportive team and management structures, (3) organisational constraints, and (4) a lack of knowledge and training on PS. Conclusions: Understanding the enablers and barriers of PS is critical for improving workplace culture, resilience, and wellbeing among HSCPs. These findings provide a foundation for future research and interventions aimed at strengthening PS at individual, team, and organisational levels across diverse health and social care settings. The results also offer valuable insights for informing policies and practice to ultimately enhance both staff wellbeing and patient care quality.

Black Catholicism

To the extent that they are available for medically eligible patients highly active antiretroviral therapies (HAART) have substantially prolonged the life expectancy and improved the quality of life of people living with HIV. This supplement is devoted to the responses of people living with HIV and describes their experience of living with long termchronic illness. It contains a number of papers detailing findings from research in social sciences recently conducted in France (7) Australia (3) Canada (1) the United Kingdom(1) and the French Caribbean (1) i.e. in countries where HAART have been widely available for about ten years. The thirteen papers examine a number of issues of relevance to living with HIV. The focus ranges from heterosexuals to gay men and there is special concern with the needs and experiences of indigenous and immigrant populations. Several papers address access to and take-up of antiretroviral therapy and health-related quality of life while others examine the day-to-day lives of people living with HIV. These latter papers include discussions of the reproductive desires of those living with HIV their sexual lives and their everyday work and domestic lives. Yet other papers focus on issues related to the disclosure of HIV to others and issues related to stigma and discrimination. (excerpt)

Organizing health care requires addressing the social determinants of health, broadly defined as the social, economic, and environmental factors that influence health outcomes. However, this is often beyond the scope, expertise, and time of medical professionals. As a result, there is an increasing tendency towards interprofessional collaboration in general, with the involvement of social workers in specific. Given the profession’s expertise in ameliorating social problems with respect to different areas of life, social workers are well-equipped to address social determinants in health care settings. In practice, however, the position, roles, and added value of social work are still rather ambiguous and unclear. It is therefore necessary to generate theoretical grounding and empirical evidence on the role of social work in diverse health care settings. The aim of this workshop is twofold. First, we will present the current state-of-the-art in the literature. Second, we will initiate a dialogue to reflect on the meaning and potential of social work in diverse health care systems. In this way, we want to establish an international dialogue aimed at the exchange of differences and similarities. We would like to engage with both healthcare providers (general practitioners, paramedics, …) as well as policy makers and researchers. The workshop consists of three parts. First, the researchers will introduce the topic. Second, participants will be divided into groups and provided with questions related to a case study. The researchers will join these groups to facilitate and summarize the discussion. Third, the researchers will briefly present their own research findings on the following subthemes: 1) The perception of social work and search for collaboration according to general practitioners in Flanders (Nele Feryn) Through semi-structured interviews, general practitioners were asked about the impact of social problems in their practice, their views on social work, collaboration and perceived barriers to shape this cooperation. 2) The transformative potential of social workers in Doctors of the World (Didier Boost) Based on a critical realist evaluation, the role of social workers in Doctors of the World is explored in Antwerp, Belgium. Doctors of the World, an international humanitarian NGO, aims to realize the right to health(care) for vulnerable communities without access to regular care. In addition to the direct provision of emergency and long-term medical care, the organization strives for structural change and advocates for social justice. This practice can potentially provide an ‘enabling niche’ that aligns with the rights-based focus of the social work profession. 3) The involvement of social workers in Flemish palliative care settings (Brent Taels) Through survey questionnaires and focus groups, social workers in Flemish primary and secondary care settings were asked about their involvement in palliative care and the level of appreciation they receive from other care professionals. These findings form the basis for the future development of an intervention to extend the role of social workers in this field. Time schedule: 10 min. introduction + 15 min. of groupwork + 10 min. plenary discussions + 20 min. presentations of the subthemes + 5 min. closing discussion

Cervical cancer causes 350,000 deaths annually, with 90% occurring in low- and middle-income countries (LMICs), despite being largely preventable through vaccination and screening. This review examines innovative approaches to address screening coverage gaps worldwide, analysing both established programmes in high-income countries and implementation strategies for LMICs. Self-sampling technologies demonstrate significant potential to improve the uptake of cervical screening, thereby improving cervical cancer prevention compared to traditional methods, particularly benefiting underserved populations across all healthcare settings. Among self-collection devices, vaginal brushes achieve sensitivity of 94.6% (95% CI: 92.4-96.8) for HPV detection, while novel approaches like the tampon show promising results (sensitivity 82.9-100%, specificity 91.6-96.8%) with high user acceptability. Implementation strategies vary by healthcare context, with high-income countries achieving success through integrated screening programmes and digital solutions, while LMICs demonstrate effective adaptation through community-based distribution (20-35% uptake) and innovative delivery methods. In resource-limited settings, self-sampling increases participation through enhanced patient comfort and cultural acceptability, while reducing costs by 32-48%. Progress toward WHO's cervical cancer elimination goals require careful consideration of local healthcare infrastructure, cultural contexts and sustainable financing mechanisms. Future research priorities include optimising self-sampling technologies for sustainability and scalability, developing context-specific implementation strategies and validating artificial intelligence applications to enhance screening efficiency across diverse healthcare settings.

Global epidemiology of emerging Candida auris

Background Ostomy pouch odor can have a negative impact on the quality of life of people living with a stoma. This study assessed the effectiveness of malodor-reducing ostomy pouch additives under simulated conditions. Methodology The following six commercially available products with different odor control technologies plus a control were assessed: soyethyl morpholinium ethosulphate, zinc ricinoleate (ZnR), ZnR with orange terpenes (ZnR-Orange), a proprietary copper-based deodorant, a proprietary ion mix deodorant, and a terpene blend (TB). Each was added to an ostomy pouch with skatole (a substitute for human fecal odor). Professional olfactometrists rated odors according to intensity, hedonic tone (pleasantness), and character. Results The TB and ZnR-Orange had very weak (<1.0) malodor intensity, with mean (standard deviation [SD]) ratings of 0.6 (1.1) and 0.9 (0.9), respectively. All other products (2.7-3.0) and control (3.7) were statistically higher (stronger intensity) compared with the TB(p < 0.001). The mean (SD) hedonic tone for the TB was 0.8 (1.7) (considered slightly pleasant); all other products (-0.8 to 0.1) and control (-0.9) were statistically lower (p < 0.001). Odor character profiles were broadly comparable, but products with scent additives (TB and ZnR-Orange) were predominantly associated with fragrances. Conclusions This information may help nurses and other healthcare providers when educating ostomates about their options. Other factors such as application mode and recommended dosage may also influence the choice of product. Future research on real-world populations (i.e., ostomates), as well as assessment of lubrication properties, is warranted.