Abstract

Population ageing is the most important social demographic and healthcare challenge worldwide. There is an increased demand for long-term assistance, particularly institution-based services, for older adults. This study aimed to synthesize qualitative evidence on the transition experience of new residents to nursing homes. A systematic search and meta-synthesis were performed in PubMed, Embase, CINAHL, China National Knowledge Infrastructure, and China Wanfang Database from their inception to February 2024. The CASP evaluation for qualitative studies was used for quality appraisal, while meta-aggregation guided data analysis. Results showed twenty studies concerned the following topics: the pressure and challenges, the transition process, and the needs and expectations of new residents. The analysis identified 77 well-defined findings, eight categories, and three synthesized insights. The transition of new residents to nursing homes is dynamic and can be influenced by key factors, including personal philosophy, maintaining identity, and accepting one’s situation. Families, institutions, and other stakeholders must work together to provide personalized care, services, and satisfactory social support for new residents. Tailored intervention research is required in the future to promote nursing home adjustment.

 Abstract

Background: Some patients in palliative care units do request for euthanasia, regardless of legislation. Whilst studies into the wish to hasten death have explored the biopsychosocial and existential reasons of these requests, little is known about their subjective function which involves the self in social interaction. Aim: To understand the function of requests for euthanasia exploring the motivations and underlying experiences of palliative care inpatients Design: A thematic analysis of in-depth interviews with patient expressing a request for euthanasia, as well as the carer receiving the request and a member of the patient’s family.

Setting: Within 11 french palliative care units, patients capable of being interviewed and of consenting were included. Results: Eighteen patients, 18 carers and 9 relatives were interviewed within 48 hours of their request, then respectively 9, 13 and 5 one week later. Five main themes emerged: the experience of suffering, the fear of a bad death, the recomposition of a space of freedom, the hope of being heard and relieved and the possibility of projecting oneself into a desirable future Conclusion: Requests for euthanasia appear as willful mean to extract oneself from the impasse of an existence paralyzed by suffering. It creates a space for deliberation that promotes negotiation and strengthens the patients’ sense of autonomy. Investigating the relationship between the evolution of euthanasia requests and the palliative care setting could be beneficial, as could encouraging caregivers to adopt a readiness to listen by interacting with patients requesting euthanasia in a way that is not momentarily action-oriented.

Abstract

This work reports the post-pandemic validation of the ENvironmental PRotectors against hOspital work Stress (ENPROS) instrument that measures environmental protectors of hospital work stress. It consists of 40 items and five dimensions: Organization, Job, Management, Physical environment and Teamwork-Psychosocial environment. The validation of the ENPROS model fit in healthcare personnel of the largest public hospital in the Araucanía Region, 2024, is reported. Sample of 450 cases, including doctors, nurses and nursing assistants (mean age 35.73 years; sd = 10.19; 56% women). Structural equation analysis was performed based on a measurement model analyzed with an approach that considers multivariate non-normality through the polychoric matrix and the estimation of the model parameters using the robust estimator resistant to non-normality of diagonal weighted least squares (DWLS). Statistical analysis was performed on the polychoric correlation matrix using a robust and non-normality resistant parameter estimation method called asymptotic free distribution (ADF). The global and incremental goodness of fit indices exceeded the acceptance ranges, with a chi-square value divided by its degrees of freedom of 1.33, a scaled RMSEA of 0.027, and both the comparative fit index CFI 0.981 and the Tuker-Lewis index 0.980 exceeding the acceptance range. Finally, the composite reliability of the instrument presented the following McDonald’s Omega values ​​for each factor: Organization 0.762, Job 0.755, Leadership 0.815, Work Environment 0.714 and Teamwork 0.818. It can be concluded that the instrument presents high Goodness of Fit and Composite Reliability indices. Empirical evidence is provided to support the validation of ENPROS and highlights which of these protectors are considered most important by the healthcare personnel working in this public hospital.

Abstract

Obesity is a multifactorial chronic disease requiring comprehensive management strategies,
including lifestyle modifications, pharmacotherapy, and surgery. With the rise of social media,
platforms like Instagram offer innovative opportunities for delivering lifestyle interventions to
broader audiences. This work explores the impact of a cognitive-behavioral-therapy-based nutritional
intervention conducted via social media on weight, eating behavior, and mental health among
individuals with overweight and obesity. The intervention lasted five weeks and utilized a private
Instagram account to deliver daily nutritional, cognitive, and behavioral content through live sessions,
reels, feed posts, polls, and stories. Standardized dietary plans were shared via email, and selfreported data on weight, waist circumference, and mental health indicators, including stress, anxiety,
and self-esteem, were collected. Engagement metrics, such as participation in live sessions,
comments, and direct messages, were also analyzed. Results showed that participants with obesity
experienced significant improvements in binge eating, uncontrolled eating, self-esteem, stress, and
anxiety, while those with overweight showed improvements in binge eating and stress. Weight loss
correlated with reduced binge eating and cognitive restriction, and emotional and uncontrolled eating
improvements were linked to reduced anxiety and stress. Notably, live session engagement was
associated with decreased binge eating. This results highlights how Instagram can serve as an
effective tool for improving weight management, eating behaviors, and mental health symptoms,
showcasing the potential of social media in addressing obesity through scalable and engaging
interventions.