bluuebunny/crossref_metadata_2025_split huggingface dataset:
Latent profile analysis of nurses’ moral courage: a professional values perspective
Authors: Hu Kaili , Zhou Quan , Zhang Yufen , Tian Wei , Wu Minglong 
Published: August 2024

Introduction Nurses’ moral courage (NMC) enhances care quality and patient safety. Nurses’ professional values promote ethical adherence, moral obligation fulfillment, and compliance to prevent ethical violations. It is necessary to explore the current status and influencing factors of moral courage from the perspective of professional values. Aim To investigate the current situation of nurses’ moral courage, analyze the latent profiles of nurses’ moral courage, and explore the influencing factors from the perspective of professional values. Research Design A cross-sectional design was employed. Participants and research context Data were collected through convenient sampling at a tertiary hospital during May 2023 in Wuhan, Hubei province, China. A self-designed web-based questionnaire consisting of demographic characteristics, the Chinese Nurses’ Professional Values Scale-Revised Version (NPVS-R-CV) and the Nurses’ Moral Courage Scale (NMCS) were used for the cross-sectional survey. Latent profile analysis was conducted using the results of 3 explicit indexes of NMCS, and multivariate logistic regression was used to analyze the influencing factors of NMC. Ethical Considerations Research ethics approval (with the code of TJ- IRB 20220543) was obtained from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Findings This study included 966 nurses, predominantly female and under 30 years old, with 91.10% holding a bachelor’s degree. Latent profile analysis identified three moral courage profiles: low-level (31.5%), medium-level (47.2%), and high-level (21.3%). Multivariate logistic regression analysis showed significant positive correlations between professional values and moral courage, with head nurses being significantly more likely to exhibit high moral courage (OR = 3.586, p = 0.013). Conclusions The moral courage of nurses can be classified into 3 subgroups. Nurses’ professional values positively correlate with moral courage, with head nurses showing significantly higher levels of moral courage. Strengthening professional values through training can enhance ethical behavior in nursing, potentially improving patient care and safety.
Measuring trust in healthcare with instruments developed in different disciplines – A scoping review
Authors: Karikumpu Venla , Häggman-Laitila Arja , Terkamo-Moisio Anja 
Published: August 2024

Background Trust is a key character at organizational level. Understanding the level of trust with timely relevant instrument is a significant process to capture the level of trust beyond organizational changes in healthcare. Objectives To gather, assess, and synthesize the items of instruments evaluating trust in healthcare organizations. Design Scoping review methodology. Methods The literature search with deductive-inductive content analysis. The data were charted from articles that involved the use of trust instruments in healthcare organizations. Data Sources Search from eight databases was updated in January 2024 and included peer-reviewed articles published between 2010 and 2023. Results A total of 13 instruments were found measuring trust in the organization, trust in the leader, and trust among peers in healthcare. The items of instruments about trust in the organization included strategic and operational cultures. The trust in the leader consisted of competence, consistency, openness, appreciative acceptance, and loyalty and risk, while instruments about trust among peers included dimensions of moral partnership, common interest, and competent peers. Conclusions Comprehensively measuring trust in the leader, trust in the organization, and trust among peers is significant due to the multifaceted dimension of trust. Measuring trust offers a possibility to recognize the working relationships and cultures in healthcare organizations.
Compassionate nursing in challenging contexts: The importance of judgments
Authors: Peter Elizabeth , Mohammed Shan , Variath Caroline 
Published: August 2024

Background Nurses’ demonstration of compassion is an ethical and often regulatory expectation. While research has been conducted to examine the barriers and facilitators of compassion in nurses, little is known about how nurses develop and express compassion for patients who may be blamed for their health condition. Unvaccinated COVID-19 patients are an example of such patients. Research questions How do nurses provide compassionate care for unvaccinated adults infected with COVID-19? How did the context of COVID-19 vaccination in Canada shape nurses’ relationships with unvaccinated patients? Research design A generic qualitative approach using interviews to gather data was used. Martha Nussbaum’s conceptualization of compassion and its cognitive requirements was employed to add depth to the analysis. Participants and research context Seventeen Registered Nurses, from a range of practice settings, who had cared for unvaccinated patients with COVID-19 participated. Ethical considerations Ethics approval was received, and signed informed consent was obtained. Participants who were the current students of the researchers were excluded. Findings Three themes were identified: 1) Encountering Extreme Workplace Impediments to Compassion. 2) Managing Emotions to Provide “Nonjudgmental Care.” 3) Practicing Narrative Imagination. Discussion The difficult working conditions during the pandemic impeded nurses’ capacity to be compassionate. Yet, none judged their patients’ suffering as trivial, and all provided necessary nursing care. Some initially blamed these patients for the severity of their illness and suppressed their emotions to provide what they called “nonjudgmental care.” Upon reflection, participants recognized that these patients’ life circumstances may have been barriers to vaccination which, in the end, facilitated the development of compassion. Conclusion This research has implications that go beyond that of caring for patients with COVID-19. The ideal of “nonjudgmental care” requires critical re-examination because judgments and emotions are required for compassion.
Management of Kampavata (Parkinson’s Disease) through Panchakarma: A Successful Case Study
Authors: Mandal Sonia , Sawarkar Punam , Singh Varinder , Parwe Shweta , Sawarkar Gaurav 
Published: August 2024

Introduction Parkinson’s disease (PD) affects the central nervous system and is primarily characterized by the degeneration of dopamine-producing cells in the substantia nigra. Early signs include tremor, rigidity, bradykinesia, and postural instability, with later cognitive, sensory, sleep, and emotional issues. Ayurveda correlates these symptoms with Kampavata, primarily linked to Vata (bio-entities) imbalance. The prime aim of this paper is to study Panchakarma’s efficacy in managing Kampavata (PD). Case Presentation This is a case presentation of a 55-year-old male patient who has experienced tremors in the left upper and lower limbs, numbness in the left lower limb, loss of balance for 10 years, abnormal facial expression (masked face), difficulty in speech, and sleep disturbance for 5 years. The patient was treated with Panchakarma therapy for 30 days. Results Following treatment, the patient exhibited significant improvement in symptoms, assessed using the PD composite scale, with the total score decreasing from 68 to 19, along with evaluated by specific examination, bradykinesia test, reflexes, functional activities, and clinical features also notably improved. Discussion Panchakarma therapy, rooted in Ayurvedic principles, shows promise in managing Kampavata, associated with PD. Conservative management focuses on Vata balance, which offers substantial comfort and enhances patient quality of life. Conclusion Panchakarma therapy presents a potential avenue for treating Kampavata, addressing symptoms associated with PD, and improving patient satisfaction and well-being. Further research is warranted to validate these findings and explore the broader applicability of Ayurvedic approaches in neurodegenerative conditions.
Client perspectives: Telehealth for mental health services
Authors: Crawford Joanna , Haffar Sam , Fernando Sunera , Stephens Holly , Harvey Samuel B , Black Melissa 
Published: August 2024

Objective The COVID-19 pandemic required mental health clinicians globally to transition to the delivery of care via telehealth. This study aimed to gain an understanding of clients’ satisfaction with and attitudes towards telehealth mental health services. Method Seventy adults who had attended a clinic for mood and anxiety disorders, and participated in at least one telehealth consultation with a psychologist or psychiatrist, completed an anonymous online survey. Results The majority of participants (81.5%) reported satisfaction with telehealth mental health care provided during the COVID-19 pandemic. However, satisfaction overall was significantly higher amongst participants who had received both telehealth and face-to-face mental health care, compared to participants who received care via telehealth only. Advantages of telehealth care reported included convenience and increased access to mental health clinicians. However, disadvantages of telehealth care included greater difficulty developing a rapport with a clinician and expressing oneself via telehealth. Conclusions Whilst client satisfaction with telehealth mental health care for mood and anxiety disorders is generally high, clinicians should consider the limitations of telehealth from clients’ perspectives. In particular, strategies to enhance therapeutic connection during telehealth sessions may be needed, and client preferences for mode of delivery should be taken into consideration when possible.
An Online Transverse Study of Nurse Leaders’ Cultural Humility in Nursing Practice as Perceived by Hospital Nurses
Authors: Mrayyan Majd T. 
Published: August 2024

Introduction: The term “cultural humility” is often used, but both society and professionals, including nurses, lack a clear understanding of its meaning. This study examined the relationships, predictors, and differences of nurse leaders’ cultural humility in nursing practice, as perceived by hospital nurses. Methodology: A quantitative transverse and correlational study was implemented with a convenience sample of 350 Jordanian registered nurses (RNs). Results: Nurses “agreed” on the presence of nurse leaders’ cultural humility in nursing practice, but it was low. Working rotating shifts, holding a Baccalaureate degree in nursing or less, and having graduated from a private university predicted the perceived nurse leaders’ cultural humility in nursing practice. Most differences in perceived nurse leaders’ cultural humility in nursing practice came from nurses who worked rotating shifts when compared to those who worked day shifts. Discussion: Nurse leaders must practice open communication and embrace a receptive mind-set, as this will help eradicate the tendency of nurse leaders to believe they know “know-it-all.”
Recurrent thrombosis and patency of the arteriovenous access in patients receiving hemodialysis
Authors: Weiss Ryan , Yu Qian , Funaki Brian , Hammes Mary 
Published: August 2024

Background: Thrombosis of the vascular access in patients with end-stage renal disease requiring hemodialysis are common and require timely interventional procedures to restore patency. The aim of the current study was to identify factors having a significant effect on patency rates after access thrombosis. Our hypothesis was the length of time between the initial clotting of the access and the subsequent percutaneous declotting impacts the patency rates of the vascular access. Methods: In this retrospective cohort study, patients with a clotted arteriovenous access between Jan 1, 2011, and Jan 1, 2016, were included. Demographics, access history, and associated details of the access procedure were reviewed from the electronic medical record. Statistical analysis was done using t-test and chi-square or fisher exact tests to compare arteriovenous fistulae (AVF) and arteriovenous grafts (AVG). Primary patency, defined as the time from index procedure to endpoint, was analyzed using the Kaplan-Meier method and log rank test. Results: There were 883 percutaneous declotting procedures reviewed. About 351 procedures were performed in patients with an AVF and 532 with an AVG. The mean time from thrombosis to declotting was 1.71 ± 2.29 days. The overall median primary patency for both AVF and AVG was 43 days with no difference in patency between patients with AVF (39 days) versus AVG (42 days; p = 0.385). The time period from access thrombosis to declotting did not affect patency rates for either AVG or AVF ( p = 0.385). On multivariable analysis, prior intervention (HR: 1.32, 95% CI: 1.14–1.53, p < 0.001) and cardiovascular disease (HR: 1.19, 95% CI: 1.03–1.37, p = 0.016) were independently associated with access patency. Conclusions: Time from thrombosis to declotting did not affect patency rates however once there was a thrombotic event, recurrent thrombosis requiring intervention was common with patency significantly decreased. Future prospective studies to validate our results and study pathogenic mechanisms of recurrent thrombosis are warranted.
Health and social care staff’s recognition of elder abuse perpetrated by family members of persons with dementia: a mixed-method study
Authors: Johansson Linda , Sandberg Jonas , Ernsth Bravell Marie , Östlund Lena 
Published: August 2024

Background: Health and social care staff play a significant role in detecting and reporting abuse among persons with dementia. However, they are often left to their own judgements which can lead to elder abuse not being detected or acted on. The aim was to explore what healthcare and social care staff consider elder abuse, and their experience of elder abuse perpetrated by family members of persons with dementia. Methods: This mixed-method vignette study was conducted in Sweden during the year 2021. In total 39 staff working in dementia care were included. They first answered the Caregiver Scenario Questionnaire and then participated in a group interview. Results: An inconsistency was revealed regarding whether a management strategy for behavioural difficulties included in the Caregiver Scenario Questionnaire should be considered an abusive act or not. No participants were able to identify all five abusive behaviour management strategies. Participants described witnessing 101 abusive acts including different types of abuse of a person with dementia, with emotional/psychological abuse and neglect being most common. Conclusions: Health and social care staff who work close to older persons are able to detect abuse perpetrated by family members. However, inconsistency in defining abusive acts demonstrates the uncertainty in identifying abuse. This may lead to abuse not being identified, but it also creates feelings of inadequacy among staff.
The signature of the gut microbiota associated with psoriatic arthritis revealed by metagenomics
Authors: Liu Wei , Li Chunyan , Xie Wenhui , Fan Yong , Zhang Xiaohui , Wang Yu , Li Lei , Zhang Zhuoli 
Published: August 2024

Background: Gut microbiota is involved in the development of psoriatic arthritis (PsA), but until now, there has been a lack of understanding of the PsA host–bacteria interaction. Objectives: To reveal the labels of gut microbiota in PsA patients and the species and functions related to disease activity. Design: Observational research (cross-sectional) with an exploratory nature. Methods: Metagenomics sequencing was used to analyze stool samples from 20 treatment-naïve PsA patients and 10 age-matched healthy individuals. All samples were qualified for subsequent analysis. Results: Compared with the healthy group, α-diversity was reduced in the PsA group, and β-diversity could distinguish the two groups. Two bacteria with high abundance and correlation with PsA disease activity were identified, Bacteroides sp. 3_1_19 and Blautia AF 14-40. In different functions, K07114 (calcium-activated chloride channel (CaCC) homolog) showed a positive correlation with PsA disease activity (disease activity in psoriatic arthritis, DAPSA) and Tet32 (an antibiotic-resistant gene), and carbohydrate-binding module family 50 was negatively correlated with erythrocyte sedimentation rate. A bacterial co-expression network associated with DAPSA was constructed. The network was centered on the bacteria in the Bacteroides genus, which formed a closely related network and were positively correlated with DAPSA. As another core of the network, K07114 was closely related to multiple bacteria in the Bacteroides genus and is also positively correlated with disease activity. Conclusion: The network composed of Bacteroides is associated with PsA disease activity, and its therapeutic value needs to be further explored. CaCCs may be a key channel for the interaction between Bacteroides and PsA-host.
Secondary use of patient data within decentralized studies using the example of rare diseases in Germany: A data scientist's exploration of process and lessons learned
Authors: Zoch Michele , Gierschner Christian , Andreeff Anne-Katrin , Henke Elisa , Sedlmayr Martin , Müller Gabriele , Tippmann Jenny , Hebestreit Helge , Choukair Daniela , Hoffmann Georg F. , Fritz-Kebede Fleur , Toepfner Nicole , Berner Reinhard , Biergans Stephanie , Verbücheln Raphael , Schaaf Jannik , Fleck Julia , Wirth Felix Nikolaus , Schepers Josef , Prasser Fabian 
Published: August 2024

Objective Unlocking the potential of routine medical data for clinical research requires the analysis of data from multiple healthcare institutions. However, according to German data protection regulations, data can often not leave the individual institutions and decentralized approaches are needed. Decentralized studies face challenges regarding coordination, technical infrastructure, interoperability and regulatory compliance. Rare diseases are an important prototype research focus for decentralized data analyses, as patients are rare by definition and adequate cohort sizes can only be reached if data from multiple sites is combined. Methods Within the project “Collaboration on Rare Diseases”, decentralized studies focusing on four rare diseases (cystic fibrosis, phenylketonuria, Kawasaki disease, multisystem inflammatory syndrome in children) were conducted at 17 German university hospitals. Therefore, a data management process for decentralized studies was developed by an interdisciplinary team of experts from medicine, public health and data science. Along the process, lessons learned were formulated and discussed. Results The process consists of eight steps and includes sub-processes for the definition of medical use cases, script development and data management. The lessons learned include on the one hand the organization and administration of the studies (collaboration of experts, use of standardized forms and publication of project information), and on the other hand the development of scripts and analysis (dependency on the database, use of standards and open source tools, feedback loops, anonymization). Conclusions This work captures central challenges and describes possible solutions and can hence serve as a solid basis for the implementation and conduction of similar decentralized studies.
Using inpatient telehealth for family engagement: A mixed methods study of perceptions from patients, families, and care team providers
Authors: Rosenthal Jennifer L. , Williams Jacob , Bowers Keegan F. , Haynes Sarah C. , Kennedy Lori 
Published: August 2024

Background The Inpatient Telehealth Program permits family to remotely communicate with the patient and care team through secure, live video. We aimed to assess the implementation of this program for family engagement from the perspectives of patients, families, and providers. Methods We used a convergent mixed methods design. The quantitative component was a cross-sectional analysis of surveys assessing patient, family, and provider experience. The qualitative component used thematic analysis of patient, family, and provider interviews plus survey free text responses. We performed memo-writing and coding. We developed hypotheses about relationships among categories and identified analytic themes. We used data transformation and narrative discussion to report the integrated findings. Results Surveys from 214 individuals (33 patients, 145 family, 36 providers) were evaluated. Mean (standard deviation) experience ratings (1-poor, 5-best) were 4.0 (1.5) for patients, 4.6 (0.8) for family, and 4.0 (1.4) for providers. We received 134 free text responses and conducted 21 interviews. Three themes emerged: (1) inpatient telehealth enhanced patient and family experience through strengthened relationships and increased support; (2) inpatient telehealth enhanced patient care through improved information sharing and engagement; (3) low awareness of the program limited adoption. Quantitative and qualitative data aligned in that participants perceived inpatient telehealth to be valuable; however, surveys revealed that patients and providers have relatively lower satisfaction with the program. Conclusion Inpatient telehealth for family engagement was perceived to improve family-centeredness of care. Future work is needed to overcome implementation challenges and to increase awareness of this resource among patients and families.
Impact of Performing Medical Writing/Publishing Workshops: A Systematic Survey and Meta-Analysis
Authors: Astaneh Behrooz , Abdullah Ream , Astaneh Vala , Gupta Sana , Shahraki Hadi Raeisi , Asadollahifar Aminreza , Guaytt Gordon 
Published: August 2024

Objectives Proficiency in medical writing and publishing is essential for medical researchers. Workshops can play a valuable role in addressing these issues. However, there is a lack of systematic summaries of evidence on the evaluation of their impacts. So, in this systematic review, we aimed to evaluate all articles published on the impact of such workshops worldwide. Methods We searched Ovid EMBASE, Ovid Medline, ISI Web of Science, ERIC database, and grey literature with no language, time period, or geographical location limitations. Randomized controlled trials, cohort studies, before-after studies, surveys, and program evaluation and development studies were included. We performed a meta-analysis on data related to knowledge increase after the workshops and descriptively reported the evaluation of other articles that did not have sufficient data for a meta-analysis. All analyses were performed using Stata software, version 15.0. Results Of 23 040 reports, 222 articles underwent full-text review, leading to 45 articles reporting the impacts of workshops. Overall, the reports on the impact of such workshops were incomplete or lacked the necessary precision to draw acceptable conclusions. The workshops were sporadic, and researchers used their own method of assessment. Meta-analyses of the impact on the knowledge showed that workshops could nonsignificantly increase the mean or percentage of participants’ knowledge. Conclusion In the absence of systematic academic courses on medical writing/publishing, workshops are conducted worldwide; however, reports on educational activities during such workshops, the methods of presentations, and their curricula are incomplete and vary. Their impact is not evaluated using standardized methods, and no valid and reliable measurement tools have been employed for these assessments.