BMJ Open最新文献

{"title":"Protocol to evaluate the feasibility of the D-PRESCRIBE intervention adapted to the Belgian community setting (END-IT CS study).","authors":"Catherine Pétein, Tina Chevallereau, Josephine Aikpitanyi, Perrine Evrard, Sandy Tubeuf, Séverine Henrard, Anne Spinewine","doi":"10.1136/bmjopen-2024-085434","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-085434","url":null,"abstract":"<p><strong>Introduction: </strong>Benzodiazepine receptor agonists (BZRA) deprescribing interventions are needed to tackle high BZRA use in the older population. This study aims to assess the feasibility of the D-PRESCRIBE intervention, adapted from Canada to the Belgian community setting. This pharmacist-led intervention comprises a patient educational brochure and a pharmacist-to-prescriber communication tool.</p><p><strong>Methods and analysis: </strong>We will conduct a feasibility study of a cluster randomised controlled trial involving 8-10 community pharmacies (clusters) and aiming to recruit 56-80 patients (≥65 years). Intervention pharmacies will deliver the adapted D-PRESCRIBE intervention and control pharmacies, usual care. Patients will be blinded to group allocation. Quantitative data will be collected at baseline, 3 months and 6 months through patients' and pharmacists' questionnaires, aiming: (1) to test the feasibility of the intervention, (2) to test the feasibility of the study design needed for its evaluation and (3) to perform an exploratory cost-effectiveness analysis. Hence, data about implementation outcomes, mechanisms of impact (ie, mechanisms through which the intervention is supposed to be effective) and contextual factors will be gathered. Patient-centred outcomes will also be collected as they would be in a full cost-effectiveness trial. The feasibility of the study design will be assessed through participation rate, completeness of the data and a satisfaction survey, sent to participants after the 6-month data collection. Data will be analysed using descriptive statistics. To gain a deeper understanding of pharmacists and patients' experience with the intervention, interviews will be conducted after the 6-month data collection and the Theoretical Domains Framework will be used as a deductive framework for analysis.</p><p><strong>Ethics and dissemination: </strong>This study was approved by the Ethics Committee of CHU UCL Namur (NUB: B0392023000036). Participants will receive a summary of the results. Results will also be disseminated through the organisation of a local symposium and a peer-reviewed publication.</p><p><strong>Trial registration number: </strong>NCT05929417.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e085434"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing mental health outcomes among university students: a cross-sectional study in Bangladesh.","authors":"Md Al-Amin, Farhana Rinky, Md Nizamul Hoque Bhuiyan, Roksana Yeasmin, Tasmia Akter, Nowrin Hoque, Sompa Reza","doi":"10.1136/bmjopen-2024-097745","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-097745","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health issues, particularly anxiety and depression, are on the rise among university students globally, including in Bangladesh. However, comprehensive data on the factors influencing mental health outcomes in this group remain limited, hindering the development of effective programmes and interventions.</p><p><strong>Objectives: </strong>This study aims to assess the mental health status of university students in Bangladesh and examine the key factors influencing mental health outcomes.</p><p><strong>Design: </strong>A cross-sectional online survey was conducted in Bangladesh from December 2022 to March 2023.</p><p><strong>Setting: </strong>Universities in Bangladesh.</p><p><strong>Participants: </strong>University students aged 18 and older.</p><p><strong>Outcome measures: </strong>Data were collected through a structured survey that assessed depression and anxiety using the Patient Health Questionnaire and the Generalized Anxiety Disorder scale, as well as dietary diversity through the Individual Dietary Diversity Score.</p><p><strong>Results: </strong>The results showed that while female students exhibited greater dietary diversity, they also had higher obesity rates, whereas male students reported more physical activity. Mental health assessments revealed that 36.1% of participants experienced mild anxiety, 11.5% severe anxiety, 39.8% mild depression and 8.3% severe depression. Binary logistic regression analysis identified significant predictors of anxiety and depression, including gender, personal income, body mass index and screen time. Females were less likely to experience anxiety (crude odds ratios (COR): 0.531, p =0.034) and depression (COR: 0.591, p =0.023) compared with males. Furthermore, low intake of wheat, rice (COR: 2.123, p=0.050) and pulses (COR: 1.519, p=0.050), as well as high consumption of fats, oils (COR: 2.231, p=0.024) and sugary foods (COR: 2.277, p=0.001), were associated with anxiety, while inadequate intake of vitamin A- and C-rich fruits (COR: 1.435, p =0.018) was linked to depression. Overweight students were found to be more susceptible to depression.</p><p><strong>Conclusion: </strong>The findings of the study emphasise the necessity for targeted interventions that promote healthier lifestyles to enhance mental health outcomes among university students in Bangladesh.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e097745"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining experiences and system impacts of publicly funded episodic virtual care: protocol for a cross-provincial mixed methods study.","authors":"M Ruth Lavergne, Julie Easley, Ted McDonald, Agnes Grudniewicz, Stephanie Welton, Nichole Austin, Rebecca H Correia, Shelley Doucet, François Gallant, Emran Hasan, Lindsay Hedden, Tara Kiran, Lauren Lapointe-Shaw, Emily Gard Marshall, Ruth Martin-Misener, David Rudoler, Jennifer Splane","doi":"10.1136/bmjopen-2025-099098","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-099098","url":null,"abstract":"<p><strong>Introduction: </strong>Health systems are under pressure as one in five Canadians have no regular place for primary care, with many experiencing substantial travel times and delays in accessing care. In the context of these urgent needs, platforms for virtual care offer immediate access to care in 'walk-in' style format, with limited continuity for ongoing health needs or coordination with other health services. We refer to these services as episodic virtual care (EVC), to distinguish them from virtual services offered in longitudinal primary care. The governments of Nova Scotia (NS) and New Brunswick (NB) both offer publicly funded EVC and offer a unique opportunity for research.The overarching goal of this work is to learn from the implementation of EVC in NS and NB to understand experiences and system impacts, includingWhat are patient perceptions and experiences of EVC and how do these differ by patient characteristics?What are the characteristics of patients who use EVC and of clinicians who deliver it?What are the system impacts of EVC?</p><p><strong>Methods and analysis: </strong>We will use a cross-sectional survey conducted through an online questionnaire to explore patient perceptions and experiences with EVC. We will also examine how these differ based on the type of care needed, age, gender, residence (urban or rural), immigration and language preference. We will use linked administrative data and quasi-experimental analysis to assess the impacts of EVC on visits to community-based primary care (including in-person walk-in clinics), emergency department visits, prescriptions and referrals for other health services like laboratory testing, imaging and consulting specialist physicians.</p><p><strong>Ethics and dissemination: </strong>This proposal has been reviewed and received approval from the Nova Scotia Health Research Ethics Board. Findings will identify the impacts and trade-offs in the deployment of EVC, which will inform primary care planning. In addition to traditional academic publications and information provided to primary care patients/the public, this study will inform decision-makers across multiple jurisdictions as they contend with the challenge of meeting patients' immediate care needs for access to primary care, while seeking to improve coordination and integration of systems as a whole.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e099098"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' acceptability, adherence and satisfaction on the modified shorter all-oral multidrug-resistant tuberculosis regimen: a two-phase cross-sectional study in Tanzania.","authors":"Julieth Lalashowi, Happiness Mvungi, Zawadi Mwaisango, Doreen Pamba, Athuman Mohamed, Catherine Gitige, Pendomartha Joseph Shayo, Isaac Lekule, Hamim Omary, Riziki Kisonga, Emmanuel Matechi, Stellah G Mpagama, Willyhelmina Olomi, Nyanda Elias Ntinginya, Albino Kalolo","doi":"10.1136/bmjopen-2024-088556","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-088556","url":null,"abstract":"<p><strong>Objectives: </strong>To determine patients' acceptability, satisfaction and adherence to shorter all-oral multidrug-resistant tuberculosis (MDR-TB) regimen in Tanzania.</p><p><strong>Design: </strong>A two-phase cross-sectional study with data collected within 6 months of Removed Injectable modified Short-course regimens for EXpert MDR-TB (RISE) study implementation and the second phase within 15 months of implementation using the same reference populations.</p><p><strong>Settings: </strong>18 health facilities across eight regions of Tanzania.</p><p><strong>Participants: </strong>Rifampicin-resistant TB/MDR-TB patients enrolled in the RISE study.</p><p><strong>Outcome measures: </strong>We assessed patients' acceptability, adherence and satisfaction with the regimen using an interval scale structured questionnaire.</p><p><strong>Results: </strong>The majority of the patients found the shorter oral MDR-TB treatment acceptable, adhered to it well and were generally satisfied. The median score (IQR) for acceptability was 1.7 (1.03-2.00) but it ranged between 1.3 (1.3-2) and 1.7 (1-1.79) for the first and second phases, respectively. Regarding adherence, the median score (IQR) stood at 4 (3.67-4.67) with scores significantly higher in the second phase at 4.33 (4.00-5.007) compared with the first at 4.67 (4.00-5.0), p value=0.01. The overall satisfaction was high at 1.5 (1.33-1.78) but it ranged between 1.22 (1.00-1.78) and 1.42 (1.11-1.78) for the first and second phases, respectively. Worrying about side effects was statistically associated with adherence (p value<0.05). No statistically significant associations were found for acceptability and satisfaction.</p><p><strong>Conclusion: </strong>Generally, the modified shorter oral MDR-TB regimen was accepted, and patients reported good adherence and were satisfied. More engagement with patients could provide more insights into factors that can maximise acceptability, adherence and satisfaction with the regimen.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e088556"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency department presentations related to asthma and allergic diseases in Central Queensland, Australia: a comparative analysis between First Nations Australians and Australians of other descents.","authors":"Desalegn Markos Shifti, Mahmudul Hassan Al Imam, Diane Maresco-Pennisi, Renarta Whitcombe, Peter D Sly, Craig F Munns, Rachel L Peters, Gulam Khandaker, Jennifer J Koplin","doi":"10.1136/bmjopen-2024-091482","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091482","url":null,"abstract":"<p><strong>Objective: </strong>To examine the overall incidence rate and trends in emergency department (ED) presentations related to asthma and allergic diseases in regional Australia with a particular focus on First Nations Australians.</p><p><strong>Design: </strong>A retrospective analysis of data from the Emergency Department Information System.</p><p><strong>Setting: </strong>This study used data from 12 public hospitals in Central Queensland, Australia, a region encompassing regional, rural and remote outback areas.</p><p><strong>Participants: </strong>A total of 813 112 ED presentations between 2018 and 2023.</p><p><strong>Outcome measure: </strong>Asthma and allergic diseases were identified using the International Classification of Diseases-Tenth Revision-Australian Modification codes.</p><p><strong>Results: </strong>There were 13 273 asthma and allergic disease-related ED presentations, with an overall prevalence of 1.6% (95% CI 1.6, 1.7). There was a significantly higher incidence rate of asthma and allergic disease-related ED presentations among First Nations Australians at 177.5 per 10 000 person-years (95% CI 169.3, 186.0) compared with 98.9 per 10 000 person-years (95% CI 97.2, 100.8) among Australians of other descents. The incidence rates, with corresponding 95% CIs, of the four most common cases among First Nations Australians and Australians of other descents, respectively, were as follows: asthma (87.8 (82.0, 93.8) and 40.2 (39.0, 41.3)), unspecified allergy (55.3 (50.8, 60.2) and 36.0 (34.9, 37.1)), atopic/allergic contact dermatitis (17.1 (14.6, 19.9) and 10.6 (10.0, 11.2)) and anaphylaxis (7.2 (5.6, 9.1) and 6.2 (5.7, 6.6)).</p><p><strong>Conclusion: </strong>Our findings highlight a significantly higher rate of asthma and allergic disease-related ED presentations among First Nations Australians compared with Australians of other descents. This underscores the urgent need for targeted healthcare interventions integrating culturally appropriate approaches, alongside additional research to understand causality.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091482"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenomic pathways from racism to preterm birth: secondary analysis of the Nulliparous Pregnancy Outcomes Study: monitoring Mothers-to-be (nuMoM2b) cohort study in the USA to examine how DNA methylation mediates the relationship between multilevel racism and preterm birth in black women: a study protocol.","authors":"Veronica Barcelona, Mitali Ray, Yihong Zhao, Goleen Samari, Haotian Wu, Paolo Reho, Rebecca McNeil, Uma M Reddy","doi":"10.1136/bmjopen-2024-091801","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091801","url":null,"abstract":"<p><strong>Introduction: </strong>Preterm birth is a significant contributor to pregnancy-related morbidity and mortality, particularly affecting black women. Racism is a key driver of perinatal inequities, but mechanisms remain unclear. Epigenomics research offers promise in understanding how environmental exposures, including racism, influence gene expression and adverse pregnancy outcomes. We present our study protocol describing how we will investigate the interactive effects of individual- and structural-level racism on preterm birth within and across black and white women, characterise the blood-based methylome of black pregnant women and identify whether DNA methylation mediates the association between multilevel racism and preterm birth in black women.</p><p><strong>Methods and analysis: </strong>We will conduct a secondary analysis of data from 6843 participants in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b), a longitudinal, prospective cohort study (2010-2014). Individual-level racism was collected using the Experiences of Discrimination scale. Structural racism measures include racial residential segregation, income and racial polarisation, political participation, judicial treatment, homeownership and employment. These measures will be calculated using geocoded participant addresses and publicly available census data for black and white populations. Epigenome-wide methylation analyses will be conducted on stored DNA for all enrolled black women using the EPIC 2.0 BeadChip. Preterm birth was determined by abstraction from participant electronic health records. We will determine the joint effects of individual and structural racism on preterm birth, characterise DNA methylation profiles associated with preterm birth among black women and explore the mediating role of DNA methylation in the association between multilevel racism and preterm birth.</p><p><strong>Ethics and dissemination: </strong>Study procedures were approved by the Columbia University Institutional Review Board (#AAAU0215). This study aims to fill critical knowledge gaps regarding the role of racism and epigenomics in preterm birth among black women.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091801"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with sleep quality among medical students in Vietnam: a national cross-sectional study.","authors":"Cuong Tat Nguyen, Vu Anh Trong Dam, Long Hoang Nguyen, Dung Phung, Tung Son Vu, Huyen Phuc Do, Thuc Minh Thi Vu, Carl Latkin, Roger C M Ho, Cyrus S H Ho","doi":"10.1136/bmjopen-2023-083168","DOIUrl":"https://doi.org/10.1136/bmjopen-2023-083168","url":null,"abstract":"<p><strong>Objective: </strong>This study explored factors associated with sleep quality among medical students in Vietnam.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>The study was conducted from December 2019 to February 2020 among medical students in Vietnam.</p><p><strong>Participants: </strong>Medical students were defined as those enrolled in undergraduate medical programmes. 1284 medical students who met the inclusion criteria participated in this study.</p><p><strong>Outcome measures: </strong>The Pittsburgh Sleep Quality Index (PSQI) was used to measure participants' sleep quality, with a score of 5 or higher indicating poor sleep quality. Multivariable logistic and linear regression models were employed to identify the factors associated with poor sleep quality.</p><p><strong>Results: </strong>36.6% of the study participants had poor sleep quality. There were statistically significant differences in the percentage of poor sleep quality across genders, health-related quality of life, morbidity status and depression (p<0.05). Depression (Coef.=0.54, 95% CI 0.17, 0.91 and OR=1.50, 95% CI 1.13, 1.99) and any morbidity (Coef.=0.64, 95% CI 0.28, 0.99 and OR=1.44, 95% CI 1.09, 1.88) were factors associated with higher PSQI Score and increased risk of poor sleep quality. In contrast, higher health-related quality of life scores (EuroQOL-5 dimensions-5 Levels Index: OR=0.01; 95% CI 0.002, 0.03 and Coef.=-7.11; 95% CI -8.65, -5.56; and EuroQOL-Visual Analogue Scale: OR=0.99; 95% CI 0.98, 1.00 and Coef.=-0.03; 95% CI -0.04, -0.01) were related to lower PSQI Score and reduced risk of poor sleep quality.</p><p><strong>Conclusions: </strong>This study reveals that health conditions and psychological well-being were associated with sleep quality among medical students. Reducing stress, improving quality of life and improving morbidity have the potential to improve the sleep quality of medical students.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e083168"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's perceptions of medicalised pregnancy and childbirth: an exploratory sequential mixed-method protocol study.","authors":"Saeedeh Alizadeh, Roghaiyeh Nourizadeh, Eesa Mohamadi, Abouali Vedadhir, Esmat Mehrabi, Parvin Sarbakhsh, Fatemeh Abbasalizadeh","doi":"10.1136/bmjopen-2024-095152","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-095152","url":null,"abstract":"<p><strong>Introduction: </strong>The present study aimed to develop and assess psychometric properties of an instrument to measure the perception of women regarding the medicalisation of pregnancy and childbirth.</p><p><strong>Method: </strong>This is a sequential exploratory mixed-method protocol study and will be conducted in three phases. In the first phase of the study, the hybrid conceptual model will define and explain the components of medicalisation. The hybrid approach includes a theoretical review (literature review) and a qualitative study. Using the results of the first phase, in the second phase of the study, the primary dimensions and items of the instrument will be developed. In the third phase, the psychometric properties of the designed instrument will be evaluated. Psychometric steps include face validity, content validity and construct validity. The research environment will be Al-Zahra and Taleghani educational centres, as well as health centres of Tabriz city and private offices of midwives and gynaecologists.</p><p><strong>Ethics and dissemination: </strong>Informed consent has been obtained from all subjects. This protocol has been approved by the ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1403.352). The findings will be disseminated through peer-reviewed manuscripts, reports and presentations.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e095152"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse retention in peri- and post-COVID-19 work environments: a scoping review of factors, strategies and interventions.","authors":"Laura Buckley, Linda McGillis Hall, Sheri Price, Sanja Visekruna, Candice McTavish","doi":"10.1136/bmjopen-2024-096333","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-096333","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The COVID-19 pandemic highlighted the deterioration of nurses' working conditions and a growing global nursing shortage. Little is known about the factors, strategies and interventions that could improve nurse retention in the peri- and post-COVID-19 period. An improved understanding of strategies that support and retain nurses will provide a foundation for developing informed approaches to sustaining the nursing workforce. The aim of this scoping review is to investigate and describe the (1) factors associated with nurse retention, (2) strategies to support nurse retention and (3) interventions that have been tested to support nurse retention, during and after the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Scoping review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;This scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. MEDLINE, Embase, CINAHL and Scopus databases were searched on 17 April 2024. The search was limited to a publication date of '2019 to present'.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Qualitative, quantitative, mixed-methods and grey literature studies of nurses (Registered Nurse (RN), Licenced Practical Nurse (LPN), Registered Practical Nurse (RPN), Publlic Health Nurse (PHN), including factors, strategies and/or interventions to support nurse retention in the peri- and post-COVID-19 period in English (or translated into English), were included. Systematic reviews, scoping reviews and meta-syntheses were excluded, but their reference lists were hand-screened for suitable studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction and synthesis: &lt;/strong&gt;The following data items were extracted: title, journal, authors, year of publication, country of publication, setting, population (n=), factors that mitigate intent to leave (or other retention measure), strategies to address nurse retention, interventions that address nurse retention, tools that measure retention/turnover intention, retention rates and/or scores. Data were evaluated for quality and synthesised qualitatively to map the current available evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our search identified 130 studies for inclusion in the analysis. The majority measured some aspect of nurse retention. A number of factors were identified as impacting nurse retention including nurse demographics, safe staffing and work environments, psychological well-being and COVID-19-specific impacts. Nurse retention strategies included ensuring safe flexible staffing and quality work environments, enhancing organisational mental health and wellness supports, improved leadership and communication, more professional development and mentorship opportunities, and better compensation and incentives. Only nine interventions that address nurse retention were identified.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Given the importance of nurse retention for a variety of key outcomes, it is im","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e096333"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective cohort study on characteristics, associated factors and short-term prognosis of sleep and circadian rhythm in intensive care unit: protocol for the SYNC study.","authors":"Tingyu Guan, Jingjing Li, Jin Hou, Wenyan Pan, Xiao Liu, Shining Cai, Yuxia Zhang","doi":"10.1136/bmjopen-2024-091184","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091184","url":null,"abstract":"<p><strong>Introduction: </strong>Acute sleep and circadian rhythm (SCR) disruption can lead to a range of negative physical and mental consequences, such as depression, delirium, respiratory dysfunction and increased mortality. In the intensive care unit (ICU), the unique environment can exacerbate disruptions in SCR. Few studies have identified the characteristics of SCR in the ICU, and the roles of patient characteristics, illness and medical interventions in ICU SCR remain unclear. A single-centre prospective cohort study, called SYNC study (Sleep and circadian rhYthm in iNtensive Care unit), will be conducted to explore the characteristics and associated factors of SCR and investigate the short-term prognosis among patients in the surgical ICU.</p><p><strong>Methods and analysis: </strong>Patients from a surgical ICU at a tertiary teaching hospital will be enrolled. SCR will be assessed by both objective and subjective indicators, including melatonin secretion rhythm, activity rhythm, sleep pattern and perceived sleep quality. Data on eight potential factors that influence SCR, including light exposure, noise level, pain level, nighttime disturbances, mechanical ventilation, sedative and analgesic use, meal pattern and restraints, will be collected. These data will be gathered in the first 3 days after ICU admission. Short-term prognostic indicators, including anxiety, depression, cognitive function, insomnia, activities of daily living, ICU stay, hospital stay and hospital mortality will be collected during the hospital stay and at 1 month after discharge.</p><p><strong>Ethics and dissemination: </strong>The study has been approved by the Ethics Committee of Zhongshan Hospital, Fudan University (B2024-076R). The results of this study will be published in peer-reviewed journals.</p><p><strong>Trial registration number: </strong>NCT06346613.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091184"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}