Multiple sclerosis (MS) is an autoimmune-mediated neurodegenerative disorder. The UnitedStates Food and Drug Administration recommends using clinical outcome assessments (COAs) to measure concepts that matter to patients in clinical trials and to document the content validity of the COAs using conceptual models of patient experience. This study aimed to explore and document the patient experience of signs, symptoms, and health-related quality of life impacts of relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) to inform future COA validation research. We conducted a targeted literature review (TLR) and qualitative semi-structured interviews of patients with RRMS and PPMS in the United States of America (USA). Publications and interview transcripts were analyzed, synthesized, and inductively categorized to develop a conceptual model of patient experiences of RRMS and PPMS. Ten publications were reviewed as part of the TLR, and 16 participants (RRMS, n = 7; PPMS, n = 9) were interviewed. Most participants reported fatigue, muscle weakness, difficulty walking, sleep disturbance, and bladder issues. Many participants experienced negative emotional, physical, and social impacts due to the disease. Most participants also described needing to rest and plan/avoid activities, as well as requiring support from their family to manage their symptoms. This study highlights the multidimensional burden of living with RRMS and PPMS. A provisional conceptual model was developed, harmonizing the TLR and interview findings. This conceptual model may be used to promote a better understanding of the patient experience of RRMS and PPMS and to evaluate the content validity of COAs during the development of new drug treatments.

Octopus arms: A phenomenological study on radiotherapy experiences of patients with lung cancer.

A formative service evaluation exploring the experience and levels of satisfaction of patients attending a nurse led bone marrow clinic in one Health and Social Care Trust in Northern Ireland.

• Qualitative usability tests show need for accessible support interfaces like PLM • Vortioxetine or other SOC AD led to similar proportions with PGI-I <2 at week 12 • Higher remission rates observed with long-term vortioxetine compared with other SOC • Greater improvement in well-being and life satisfaction seen in vortioxetine cohort • Most decentralized study participants tracked goals, remained engaged for 6 months Major depressive disorder (MDD) remains a clinical challenge, showing low remission rates with standard-of-care (SOC) antidepressants (ADs). This study evaluated real-world treatment experience with vortioxetine versus SOC ADs through the online peer community PatientsLikeMe (PLM). This observational, prospective, patient-centric, decentralized study recruited adults with MDD using the PLM platform. In this 2-part study, qualitative surveys informed study flow. The quantitative study enrolled participants who started or switched SOC AD monotherapy or vortioxetine within 180 days and had baseline Patient Health Questionnaire-9 scores ≥5. Primary endpoint was proportion with Patient Global Impression of Improvement (PGI-I) score <2 at week 12 (W12). Secondary endpoints included MDD severity, MDD symptoms, and quality of life (QOL). Qualitative survey responses refined the quantitative study design. Quantitative study enrolled 352 receiving SOC and 151 receiving vortioxetine. At W12, proportions with PGI-I scores <2 were similar (vortioxetine vs SOC: 4.5% vs 1.8%; P =0.830). Mean PGI-I scores were similar at W12 (vortioxetine vs SOC: 3.5 vs 3.6; P =0.831) and lower with vortioxetine at W24 (vortioxetine vs SOC: 3.0 vs 3.4; P <0.001). Remission rates at W24 were higher with vortioxetine (11.4%) vs SOC (2.5%; P <0.001). Feelings of anhedonia were significantly less frequent with vortioxetine ( P =0.005). Self-reported data may introduce recall bias. PLM users may have higher health literacy than the general population. Although primary endpoint was not met, long-term vortioxetine was associated with improved global impression, QOL, and life satisfaction, and a higher rate of remission, which can guide clinical decisions and empower patients.

More than 740 000 people identified as female at intake were incarcerated globally as of 2022, reflecting a 60% global increase since the year 2000, with a concomitant increase in gynecologic conditions experienced behind bars. The purpose of this scoping review was to examine the breadth of benign and malignant gynecologic conditions experienced during incarceration, including the prevalence, special management considerations, access to services, and the patient experience. The search strategy included a combination of keywords and subject headings for incarceration and benign or malignant gynecologic conditions with no language or date limits. Studies were eligible for the review if they: (i) discussed a benign or malignant gynecologic condition; (ii) included a population of people experiencing incarceration; and (iii) answered one or more of the four key questions identified prior to the search. One researcher independently screened each reference title and abstract for eligibility, and two reviewers independently screened each full text reference. One researcher extracted data from each study using a data extraction template, with verification and consensus by the primary and senior investigators. After screening, 135 studies corresponding to 137 reports from 38 countries were included in the review. Included studies focused on cervical dysplasia and human papilloma virus (56), normal menstruation (38), vaginitis (36), routine gynecologic care (23), abnormal bleeding (17), pelvic pain (13), menopause (8), urinary incontinence (7), and gynecologic malignancy (5) during incarceration. The included studies demonstrate that across the globe, gynecologic conditions in carceral settings are common and can be exacerbated by the physical and emotional stress of incarceration, trauma histories, lack of access to care, and conditions of confinement in these settings. Gaps in the published literature exist on health education and interventions to address gynecologic health disparities and the gynecologic health needs of aging and older adults. There is a pressing need for parallel efforts at global de-carceration and policy interventions to provide for basic gynecologic needs, decrease intersectional stigma, and improve the conditions of confinement.

Blinatumomab has transformed the treatment of pediatric B-acute lymphoblastic leukemia (B-ALL). However, it presents distinct operational challenges for administration given it is delivered as a continuous infusion and has unique toxicities. The objective of this project was to develop, implement, and evaluate a standardized institutional protocol for blinatumomab administration to optimize safety, efficiency, and patient experience. This quality improvement (QI) initiative was conducted at The Hospital for Sick Children, Toronto, Canada. A multidisciplinary Blinatumomab Working Group developed harmonized standards across five domains: (1) caregiver education, (2) fever management, (3) nursing-led assessments, (4) infusion interruption management, and (5) use of 7-day infusion bags. Patients receiving blinatumomab for upfront therapy or for relapsed disease between July 2024 and August 2025 were included. Demographic and clinical data were extracted from the institutional data warehouse. Outcomes included rates of caregiver education completion, antibiotic use during blinatumomab initiation, and completion of nursing-led assessments. Fifty-three patients received standard of care blinatumomab. All eligible caregivers (100%) completed standardized education. The rate of empiric antibiotic use during blinatumomab initiation decreased from 68% to 22% following adoption of selective antibiotic initiation without increased readmission, or prolonged stay. Nursing assessment completion was 95% for inpatients and 81% for outpatients. Infusion interruptions were managed using a standardized, risk-based algorithm without observed safety events. Implementation of multidisciplinary, standardized blinatumomab administration protocols was feasible and safe. These processes improved antibiotic stewardship, empowered nursing-led care, and reduced practice variability. This framework may inform best practices for the safe and efficient delivery of blinatumomab in other pediatric oncology centers.

Self-management support for pre-hospital patients is urgently needed to bridge the gap between hospital and home. An example of a self-management supporting intervention is PREDOCS (PREvention of Decline in Older Cardiac Surgery patients). However, patients' experiences with this nursing consultation remain unclear. Therefore this study aims to explore experiences of older cardiac surgery patients with a pre-surgery nursing consultation and the influence on their self-management prior to cardiac surgery. A generic qualitative study was conducted using fifteen semi-structured interviews with older cardiac surgery patients selected through purposive sampling. Interviews were thematically analysed. Patients' experiences and the influence on their self-management were divided into two main themes: (1) Taking a role in preparation for open cardiac surgery. Through the entire process of preparation for surgery, patients showed an active or a more avoiding style of preparation. (2) Emotional management. After the PREDOCS consultation, patients mentioned different effects of the consultation in managing their emotions. On the one hand, too detailed information negatively affected their fear, on the other hand, the nurse increased patients' trust. Findings suggest that PREDOCS is not aligned with individual patients' style of preparation. Therefore, PREDOCS needs a more tailored approach taking into account patients' coping styles, anxiety level, need for information and current level and readiness for self-management, to support all patients' self-management. Moreover, the importance of tailored interventions to support self-management should be considered when developing similar interventions for larger scale deployment, as well as the consideration that nurses should be key-figures in supporting patients' self-management.

Men comprise up to 16% of aesthetic patients; however, the unique motivations and experiences of male patients remain understudied. We aimed to synthesize evidence on social, emotional, and psychopathological drivers of male interest in aesthetic procedures and outline clinical implications for aesthetic practitioners.Changing expressions of masculinity, media, and technology, as well as social, romantic, and professional influences, were explored. Research regarding psychopathology and body dysmorphic disorder (BDD) in male aesthetic patients was reviewed.Modern, fluid notions of masculinity have normalized aesthetic interventions among male patients. However, men experience ongoing stigma as a barrier to accessing treatment. Men display similar motivations to women, but report professional drivers more frequently. Mental health concerns and BDD prevalence rates are inconsistently reported among male aesthetic patients, but are likely to predispose males to more challenging treatment experiences. Clinical implications and recommendations for working with male patients are discussed.As men continue to undertake cosmetic procedures more frequently, practitioners should take care to adapt their approaches to the unique preferences of male patients. This includes shifts in language, advertising, consultation, and treatment planning to overcome stigma and barriers to access, while prioritizing safe, ethical care.

Children and young people with intellectual and developmental disabilities (IDD) often face significant challenges in emergency departments (ED), where a high-acuity environment can exacerbate distress, leading to behaviours of concern (BOC). Identifying and managing BOC requires specialised skills, yet many healthcare professionals report a lack of confidence and structured training. Traditional educational models may lack real-world applicability by failing to incorporate the lived experiences of patients and families. The Motivated for Change programme was codeveloped with caregivers to enhance healthcare professionals' ability to identify, mitigate, and de-escalate BOC in children with IDD using simulation-based education (SBE). The programme integrated prelearning modules, interactive lectures, and novel immersive simulations. SBE was codesigned with parents, clinicians and educators to reflect real-world ED challenges and guided child and family-centred approaches. Participants engaged in simulation exercises to practice communication strategies and implement reasonable adjustments in a structured, supportive learning environment. Eighty-two ED healthcare professionals participated in 11 simulation sessions. Postsession surveys revealed SBE was effective in consolidating skills in communication and engagement (100%), identifying BOC (99%), preventing escalation (99%) and de-escalation strategies (96%). Ninety-seven percent felt more confident applying reasonable adjustments in clinical practice. Reflexive thematic analysis identified key learnings, including parent partnership, effective communication, early recognition and intervention and environmental modifications.

A qualitative study of patient perspectives for a mindfulness-based intervention in lung cancer.

Perceived Barriers and Facilitators to Radiology Examinations Among Patients with Parkinson's Disease in Ireland.

Nurses knowledge and attitude toward pain management: Cross sectional, multi-center study from Palestine.

Implementing meaningful activity facilitators to prevent hospital-acquired complications in French geriatric short-stay wards: A qualitative analysis of the context and stakeholder representations.

One in six hospital beds across England is occupied by someone with diabetes. While guidance on inpatient diabetes care is available, national audit data demonstrate that people still experience significant and avoidable diabetes-related harms. This study is unique in exploring how people with diabetes admitted to hospital for any medical reason experienced diabetes care from admission to discharge. It is part of a bigger project aiming to develop and test a Patient Reported Experience Measure for inpatients with diabetes. A qualitative approach was used to explore experiences of inpatient diabetes care. Twenty-seven participants with type 1 or type 2 diabetes, hospitalised for any reason, were recruited using purposive sampling across four acute NHS Trusts in the South of England. Data collected in semi-structured interviews were analysed with reflexive thematic analysis. In diabetes care, the emphasis is on supporting people with self management of their diabetes. The inpatient care setting compromises this by limiting self management behaviours. These restrictions may apply to those who want to and can be actively involved in their diabetes care and may contribute to less effective diabetes management and poorer outcomes. For some participants in this study, diabetes self management was discouraged in three ways. First, their knowledge of their diabetes and willingness to self-manage were not taken into account on admission or in planning their inpatient diabetes care. Second, their involvement in decisions about their ongoing diabetes care was limited. Third, their needs related to diabetes management were not met because of the lack of flexibility in hospital practices and schedules. Inpatient care is not always conducive to diabetes self management. Understanding the patient experience in the inpatient setting related to self management is important in reducing harm to patients while they are in hospital. Our findings emphasise the importance of involving people with diabetes in planning and managing their care while hospitalised. Further work needs to be done to ensure that the knowledge, involvement and flexibility of care of people with diabetes are incorporated into an inpatient setting.

Patient experiences of radiation-induced menopause in cervical cancer: A scoping review.

ObjectivesThis study proposes an evidence-based design guideline for oncology inpatient rooms that addresses the physical, emotional, and psychosocial needs of cancer patients.BackgroundCancer inpatients frequently experience long hospital stays with emotional vulnerability and clinical stress. Growing evidence suggests environmental design can shape patient experience, comfort, and recovery. Yet, current literature lacks an integrated framework for the spatial and sensory needs of this population.MethodA systematic literature review was conducted across Web of Science, Scopus, and PubMed. From an initial pool of 1004 records, 36 studies met the inclusion criteria. Data were thematically analyzed and interpreted using established healthcare design theories.ResultsThe synthesis coalesced a wide range of findings into five core thematic domains: (a) the patient's personal sphere of privacy, control, and identity; (b) the social dimension of balancing solitude with connection; (c) the sensory environment of nature, art, and acoustic well-being; (d) the integration of embedded safety and hygiene; and (e) a culture of responsive and participatory design. The analysis reveals a critical tension between clinical necessity (e.g., infection control) and psychological well-being (e.g., avoiding isolation), highlighting the need for integrated solutions.ConclusionsThe physical environment is an active agent in the cancer care experience. This review presents a comprehensive, patient-centered design framework translating empirical evidence into practical strategies. Despite study design limitations, the findings emphasize creating adaptable, psychologically supportive environments for patients' evolving needs. The proposed guideline is a foundation for future design standards and evidence-driven practice in oncology care.

Incorporating patient priorities care curriculum for older adults with multiple chronic conditions into nurse practitioner education.

A review of evaluation system for Internet hospitals.

Peri-operative hypersensitivity reactions are rare and unpredictable events that can result in significant patient harm. Neuromuscular blocking drugs are one of the leading causes of peri-operative hypersensitivity reactions in many parts of the world. Our retrospective observational cohort study of in adults in New Zealand investigated the incidence and relative risk of a peri-operative hypersensitivity reaction to the various to neuromuscular blocking drugs. We also explored possible cross-sensitivity between the different neuromuscular blocking drugs using skin testing. The incidence of anaphylaxis to neuromuscular blocking drugs was calculated within a subset of our cohort, using confirmed cases of anaphylaxis to each neuromuscular blocking drug as the numerator and number of new patient exposures to the drug as the denominator. We determined the risk of a peri-operative hypersensitivity reaction with individual neuromuscular blocking drugs to be: suxamethonium 1:1500 (95%CI 1000-2500); rocuronium 1:3300 (95%CI 2100-5300); and atracurium 1:15,000 (95%CI 6800-40,000). Female patients were up to eight times more likely to experience a peri-operative hypersensitivity reaction than males. Our skin test results suggest that if a patient experiences a peri-operative hypersensitivity reaction to rocuronium, suxamethonium or vecuronium, then atracurium is the lowest risk alternative. If a patient has had a peri-operative hypersensitivity reaction to atracurium, then rocuronium and suxamethonium are low risk alternatives. We found a significant difference between the rates of peri-operative hypersensitivity reactions with rocuronium and suxamethonium vs. atracurium. The increased risk of a peri-operative hypersensitivity reaction is a factor that should be weighed against the benefits of using suxamethonium or rocuronium. Females may be higher risk than males of reacting to neuromuscular blocking drugs.

Young people in the transition from adolescence to adulthood face particular challenges in psychiatric care. Continuity of treatment is often disrupted, as services are typically divided between child and adolescent psychiatry and adult psychiatry. Few frameworks provide age-appropriate, integrated care for individuals aged 16-25. In Germany, a model project was established to address this gap. It offers treatment tailored to this age group within a cross-sector, integrated care model that combines outpatient and inpatient services under a jointly run ward staffed by both child and adolescent psychiatrists and adult psychiatrists. This study explores the distinctive features of this integrated adolescent ward and examines the experiences of patients and their parents. Semi-structured interviews were conducted with 27 patients and 7 parents. Data were analyzed using qualitative content analysis, focusing on three domains: (1) framework conditions and access to care, (2) the concept and content of treatment, and (3) the environment of the integrated adolescent ward. Participants particularly valued the individualized therapeutic approach, flexible treatment across different settings, and transparent, responsive communication by staff. Age homogeneity and a focus on adolescence facilitated mutual identification and supportive peer interactions. Opportunities for self-determination and participation were also emphasized as important. Findings suggest that specific structural elements contribute to the ward being perceived as an age-appropriate therapeutic environment. Further research should identify and define specific care components of integrated treatment for young people aged 16-25 to enable replication and evaluation of its implementation.