Objective: To synthesize and conceptualize the lived experiences of older adults with chronic low back pain (CLBP) by systematically reviewing qualitative studies. Data Sources: CINAHL, PsycINFO, and PubMed were searched from their inception years (1961, 1967, and 1996, respectively) to September 2023 to identify qualitative studies on the lived experiences of older adults with CLBP. Study Selection: Eligible qualitative studies included published journal article with qualitative design and analysis, and participants aged ≥65 years with chronic nonspecific low back pain (LBP) that lasted for over 3 months. Of 3669 citations screened, 17 studies met the inclusion criteria. Data Extraction: Findings were analyzed using metasynthesis. Two reviewers independently conducted study selection and data extraction, and the methodological quality of each included study was assessed using the Consolidated Criteria for Reporting Qualitative Research framework. Data Synthesis: Six themes emerged from the analysis: (1) perceived causes of CLBP; (2) interference with daily living; (3) family dynamics; (4) social life; (5) emotional responses to CLBP; and (6) coping strategies. Collectively, CLBP negatively affected older adults’ personal, family, and social life to varying extents. Suboptimal LBP management could lead to negative emotions (eg, depression) and avoidance behaviors. Accepting and adapting to the presence of CLBP, along with a clear diagnosis of LBP, might promote self-management. Conversely, comorbidities and rumination might hinder self-management efforts. Conclusions: Given that the acceptance (acknowledging and adapting to the pain) of CLBP improves self-management of pain in older adults, clinicians should pay attention to the concerns of older adults with CLBP, understand the negative effects of CLBP on them, and provide personalized education and management strategies to enhance their self-management and engagement in value-driven actions.

Twenty-first century transformations have taken place within the framework ofglobalisation of the economy, the spread of information technology and global migrationresulting in increased cultural diversity in many societies. This qualitative studyinvestigated perspective transformation in 18 research students, from Australia, HongKong SAR, and Sweden, participating in an international online course by using Mezirow’stheory of perspective transformation and Kiely’s six forms of transformativechange (intellectual, moral, political, cultural, personal, and spiritual). The approach tolearning facilitated global networking and a commitment to support growth in thestudents’ research practice. Validating the link between research students’ learningexperiences and perspective transformation theory encourages educators to developfuture online educational materials to promote cognitive flexibility and reflexivity andincrease students’ cultural awareness to inform their research practices.

Rationale, Aims and Objectives: Colonoscopy, though common, can be uncomfortable, necessitating routine assessment of patient experience per European guidelines. Positive patient experiences are crucial as they influence willingness for repeat procedures. Patient‐reported experience measures (PREMs) effectively capture patient perspectives through surveys, empowering patients to influence healthcare quality. These surveys identify areas for improvement and inform research, enhancing healthcare and its quality. The Patient Experience Colonoscopy Scale (PECS) is a colonoscopy‐specific PREM that measures adult patient experience after an elective colonoscopy. It consists of items derived from the patient's perspective and has been found to be content valid. The PECS is multidimensional and divided into five constructs: health motivation, discomfort, information, a caring relationship, and understanding. The current study aims to evaluate the measurement properties of the new PREM, called the PECS regarding reliability and construct validity.

Method: The sample comprised 331 adult patients who had undergone an elective colonoscopy at a University Hospital in Sweden. The PECS was evaluated using intraclass correlation coefficients, confirmatory factor analysis, and multi‐ and unidimensional Rasch analyses.

Results: The test−retest reliability was acceptable, with an average intraclass correlation coefficient of 0.72. Construct validity was tested with three different techniques. The confirmatory factor analysis revealed that the theoretical bifactor model containing the five constructs was supported. The multi‐ and unidimensional Rasch analyses showed that approximately 60% of the items had acceptable values. Some violation of local independence and some evidence of differential item functioning with respect to age and gender were identified, but they all made subject matter sense. The PECS is well‐targeted to patients with less positive experiences. The overall evaluation of the construct validity showed the PECS has acceptable measurement properties.

Conclusion: The PECS is a reliable and valid 30‐item colonoscopy‐specific PREM that can play an important role in gathering data for research and quality improvement initiatives that seek to incorporate patient perspectives on colonoscopy experiences. Some potential areas for improvement were found, but the PECS is ready to be utilised in clinical practice for the purpose of collecting patient experiences.

Introduction: Participation is one of the core elements of health promotion, which means that approaches and methods should focus on involvement. The process of involving women with a migration background in health promotion needs to be further explored. Thus, the aim of this study was to explore the development process of a type 2 diabetes health-promotive community-based participatory research intervention among Middle Eastern women with a migration background, living in Sweden. Materials and methods: This study was performed within the context of a community-based participatory research program in Sweden. The design of this study followed the development process of a community-based participatory research conceptual model, including three of the original four dimensions, that is, the context, the partnership process, and the intervention and research dimension. Appropriate methods for data collection were used in the various dimensions. Participants from the community, active in the program, conducted dialogue cafés, together with the core partners of the program, to inventory existing needs as well as what actions were needed for promoting health and thereby prevent type 2 diabetes. Results: The two dialogue cafes resulted in one long term and three short term goals. The third short-term goal—create health circles around food and nutrition was decided to be in focus for this study together with cooperation with the local health care center. The partnership process made it possible to involve relevant collaborators, which resulted in a jointly developed nurse-led educational intervention. Participants and stakeholders were also involved in the process of modifying and elaborating evaluation tools appropriate for the intervention. Discussion/conclusions: The community-based participatory research approach enables the acknowledgement and use of the various kinds of knowledge of all stakeholders, including the community members. In this study, the community members’ knowledge was obtained through participation and dialogue, aimed at balancing power between stakeholders. This approach, that is, developing a community-based participatory research intervention, offers a possibility for the primary health care to engage with the community members and for other stakeholders to work in a health-promotive way.

Background and Aim: Due to ageing, physical changes can affect one's ability to actively engage with others, resulting in limitations in social connections comparable to loneliness. Hence, there is a need for research on how older adults avoid experiencing loneliness and thus promote health through social connections. The aim of this study was to describe the significance of social connections and health in relation to loneliness experienced by older adults living at home.

Methods: Older adults aged 65 years and older ( n  = 16) purposively selected from a longitudinal population‐based multicentre study participated in semi‐structured interviews. The interviews were conducted in January 2024, transcribed verbatim and analysed using inductive content analysis.

Findings: The findings illustrated one main category, Preventing loneliness , and three associated generic categories: The silver lining of connecting with oneself , Being surrounded by meaningful connections and Striving to maintain an active and healthy life.

Conclusion: Preventing loneliness may be one important aspect of healthy ageing. However, for some older adults, time alone offers enrichment and well‐being, with routines playing a key role. Meaningful connections and feeling needed are crucial in preventing loneliness, especially as social networks may decline with age. An active and healthy life also prevents loneliness, though barriers like age‐related limitations must be addressed. It is, therefore, important to address loneliness in society. Furthermore, it is essential that healthcare education incorporates the impact of loneliness on older adults to promote healthy ageing.

BackgroundIn endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity.MethodsThe colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items.ResultsThe Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM.ConclusionThe PECS is a new 30-item PREM instrument designed for adult elective colonoscopy patients after they have undergone the procedure. Each item in the PECS derives from a conceptual model based on a systematic literature review. Patients and healthcare professionals were involved in developing the PECS, which measures colonoscopy-specific patient experiences before, during and after the procedure. The content validity testing positively contributed to the development of the PECS. Psychometric properties need to be evaluated further.

BACKGROUND: Thoracoabdominal aortic aneurysms (TAAA) pose significant risks of morbidity and mortality. Considering the evolving techniques for TAAA intervention and the growing interest in quality of life (QoL) outcomes for decision-making, we aimed to evaluate the impact of patient and perioperative characteristics on short-, medium-, and long-term post-operative QoL in TAAA repair patients.

METHODS: A systematic search was conducted in CINAHL, APA PsycINFO, EMBASE, Medline and Cochrane to identify primary research studies evaluating QoL post TAAA surgery, published in English or Swedish between 01 January 2012 and 26 September 2022. A narrative synthesis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence was assessed using the Critical Appraisal Skills Programme and Joanna Briggs Institute checklists.

RESULTS: Eight studies of low or moderate quality with 455 patients were included. Preoperative QoL in TAAA patients was lower compared to the general population. While there is an initial short-term improvement in post-operative QoL, patients fail to reach baseline levels even after seven years, with physical activity and functioning domains being particularly affected. Experiencing post-operative complications, including paraplegia and cardiovascular events, negatively impacts post-operative QoL. Patients with uncomplicated postoperative status had improved QoL. Prolonged hospital stay negatively affects physical functioning.

CONCLUSIONS: Individuals with TAAA are likely to have lower baseline QoL compared to the general population. Following TAAA repair, post-operative QoL may remain lower than baseline levels, persisting over the long-term. Comorbidities, post-operative complications, and hospitalisation duration appear to exert adverse effects on post-operative QoL.

Introduction: An increasing population and a shortage of identified potential organ donors are causing the waiting list fororgan transplants to grow continuously. Donation after circulatory death (DCD) is a method aimed at meeting the demandfor transplantable organs. However, it presents new challenges in nursing care, and there is a lack of studies investigatingnurses’ attitudes and knowledge of DCD.Objective: The objective of this study was to determine and describe intensive care nurses’ (ICNs’) knowledge, attitudes,and views on DCD before a national implementation in Sweden.Method: This study utilized a cross-sectional mixed-method design. A convenience sampling method was employed, targetingICNs working in four intensive care units in Sweden. A study-specific tool comprising fixed and free-text questions was developed.Fifty-one ICNs participated. Data were analyzed descriptively, and correlation analysis was performed using Spearman’scorrelation. Free-text answers were qualitatively assessed and analyzed. An integrated analysis was conducted to synthesizethe quantitative and qualitative findings.Results: Fifty-three percent reported limited knowledge about DCD. Nurses with previous education on DCD had significantlyhigher knowledge (r=.380, p=.006), were more engaged with the public debate on organ donation (r =.423, p=.002),and considered the ethical aspects of DCD more thoroughly (r=.386, p=.022). The qualitative analysis identified four keycategories: The importance of the team, the need for ethical discussions, increased knowledge of DCD, and unanswered questions andunmet needs. The integrated analysis underscored the need for targeted education, clear guidelines, and ongoing ethical discussionsto prepare ICU nurses for DCD.Conclusion: Nurses educated in organ donor care had better knowledge and a more positive attitude toward DCD implementation.The study also highlights the importance of interprofessional teamwork in DCD implementation. The findings suggest that education on DCD could improve the identification and implementation of DCD donors, addressing the globalshortage of transplantable organs.

Introduction: To minimize the risk of developing foot-ulcers, persons with diabetes are given the advice to daily inspect their feet and to apply skincare formulations. However, commercially available skincare products have rarely been developed and evaluated for diabetes foot care specifically. The primary aim of this randomized controlled trial (RCT) is to evaluate the effects in reducing foot xerosis in persons with diabetes without footulcers using two skincare creams containing different humectants (interventions) against a cream base nonhumectant (comparator). Secondary outcomes are to evaluate differences on skin barrier integrity, lowmolecular weight biomarkers and skin microbiota, microcirculation including transcutaneous oxygen pressure, degree of neuropathy, and HbA1c between intervention-comparator creams. Methods: Two-armed double-blind RCT, registered in ClinicalTrials.gov Identifier: NCT06427889. With 80 % power, two-tailed significance of 2.5 % in each arm, 39 study persons is needed in each arm, total 78 persons, 98 including dropouts, to be able to prove a reduction of at least one category in the Xerosis Severity Scale with the intervention creams compared to the comparator. In one arm, each participant will treat one foot with one of the intervention creams (Oviderm (R) or Canoderm (R)), while the opposite foot will be treated with the comparator cream (Decubal (R) lipid cream), twice a day. If needed, participants are enrolled after a wash-out period of two weeks. The participants will undergo examinations at baseline, day 14 and day 28. Discussion: This RCT evaluate the potential effects of humectants in skin creams against foot xerosis in persons with diabetes.