Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC). Design Qualitative study conducted through semi-structured in-depth interviews. Setting Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses’ autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.
Zusammenfassung. Hintergrund: Die aufgrund der Coronavirus-Pandemie veranlassten Maßnahmen haben weitreichende Folgen für den Alltag von Menschen mit Demenz und ihren pflegenden Angehörigen. Beide Gruppen gehören meist zur Risikogruppe und sollen sich entsprechend stark einschränken. Die Alltagssituation wird dadurch erschwert, dass Betreuungsleistungen und Entlastungsangebote pausieren. Zudem haben Menschen mit Demenz Schwierigkeiten, die Beschränkungen und Hygieneregeln zu verstehen und umzusetzen. Ziel: Die Studie will die aktuelle Lebenssituation aus Sicht der pflegenden Angehörigen und der Menschen mit Demenz beschreiben. Methode: Zu zwei Erhebungszeitpunkten im Frühjahr 2020 wurden Telefoninterviews mit 21 pflegenden Angehörigen und Menschen mit Demenz geführt und inhaltsanalytisch ausgewertet. Ergebnisse: Die Situation wird von den Befragten unterschiedlich erlebt. Besonders die soziale Isolation, der erhöhte Betreuungs- und Pflegeaufwand, die Ungewissheit der Situation und die Zunahme von psychischen Symptomen werden als belastend beschrieben. Bezüglich der Bewältigung der Situation werden die Unterstützung durch das soziale Umfeld, alternative Kommunikationsmöglichkeiten, Erfahrungen mit vergleichbaren Krisen, die Stabilität der Versorgung und der Umgang mit Informationen thematisiert. Schlussfolgerungen: Pflegende Angehörige und Menschen mit Demenz fühlen sich durch die Coronavirus-Pandemie belastet, verfügen häufig jedoch über Bewältigungsstrategien für die besondere Situation. Insbesondere informelle Hilfen sind dabei ein wichtiger Unterstützungsmechanismus.
Identification 1aIdentify the report as a protocol of a systematic review 3 Update 1bIf the protocol is for an update of a previous systematic review, identify as such Registration 2 If registered, provide the name of the registry (e.g., PROSPERO
Background: The lymph node yield is an important surrogate parameter for assessing the oncological radicality of the resection of gastrointestinal carcinomas and a prognostic factor in these diseases. It remains unclear if and to what extent neoadjuvant chemotherapy, radiotherapy or chemoradiotherapy, which have become established treatments for carcinoma of the esophagus, stomach, and rectum and are increasingly used in pancreatic carcinoma, affect the lymph node yield. This systematic review and meta-analysis intents to summarize the available evidence on the topic.Methods: Studies comparing oncological resection of esophageal, stomach, pancreatic and rectal carcinoma with and without prior neoadjuvant therapy are eligible for inclusion regardless of study design. Publications will be identified with a defined search strategy in the electronic databases PubMed and Cochrane Library. The primary endpoint of the analysis is the number of lymph nodes identified in the resected specimen. Secondary endpoints include number of harvested metastatic lymph nodes, operation time, postoperative complications, pTNM staging, and overall and recurrence-free survival time. Using suitable statistical methods, the endpoints between patients with and without neoadjuvant therapy as well as in defined subgroups (neoadjuvant chemotherapy, neoadjuvant radiotherapy, neoadjuvant chemoradiotherapy, and esophageal, gastric, pancreatic, and rectal cancer) will be compared Discussion: This systematic review with meta-analysis is conducted with the aim of summarizing the available evidence regarding the oncological surrogate marker lymph node yield in patients with gastrointestinal carcinomas undergoing surgery after neoadjuvant treatment compared to those operated without neoadjuvant therapy.Systematic review registration: This systematic review has been submitted for registration at PROSPERO, ID: 218459.
BACKGROUND The lymph node yield is an important surrogate parameter for assessing the oncological radicality of the resection of gastrointestinal carcinomas and a prognostic factor in these diseases. It remains unclear if and to what extent neoadjuvant chemotherapy, radiotherapy or chemoradiotherapy, which have become established treatments for carcinoma of the esophagus, stomach, and rectum and are increasingly used in pancreatic carcinoma, affect the lymph node yield. OBJECTIVE This systematic review with meta-analysis is conducted with the aim of summarizing the available evidence regarding the oncological surrogate marker lymph node yield in patients with gastrointestinal carcinomas undergoing surgery after neoadjuvant treatment compared to those operated without neoadjuvant therapy. METHODS Studies comparing oncological resection of esophageal, stomach, pancreatic and rectal carcinoma with and without prior neoadjuvant therapy are eligible for inclusion regardless of study design. Publications will be identified with a defined search strategy in the electronic databases PubMed and Cochrane Library. The primary endpoint of the analysis is the number of lymph nodes identified in the resected specimen. Secondary endpoints include number of harvested metastatic lymph nodes, operation time, postoperative complications, pTNM staging, and overall and recurrence-free survival time. Using suitable statistical methods, the endpoints between patients with and without neoadjuvant therapy as well as in defined subgroups (neoadjuvant chemotherapy, neoadjuvant radiotherapy, neoadjuvant chemoradiotherapy, and esophageal, gastric, pancreatic, and rectal cancer) will be compared. RESULTS As of October 2021, we started with the data collection. CONCLUSIONS This systematic review with meta-analysis is conducted with the aim of summarizing the available evidence regarding the oncological surrogate marker lymph node yield in patients with gastrointestinal carcinomas undergoing surgery after neoadjuvant treatment compared to those operated without neoadjuvant therapy. CLINICALTRIAL This systematic review is registered at PROSPERO, ID: 218459.
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