My Magical Day in the Trauma ICU.

Healing is a difficult concept to describe, quantify, or replicate. It is a complex mixture of personal contributions from the professional providing care, including competence, compassion, and empathy, that conjoins with the needs, sensitivities, and receptivity of the one who is receiving the care. Although it may be difficult to predict all the elements that come together to initiate sustained healing, as well as the long-term impact, it is important to observe the moments that make a difference. For those who study the nature of healing, a patient's reflections can surface the kinds of elements that are present when healing is sustained. [J Contin Educ Nurs. 2024;55(7):326-327.].

Assessing the Potential of Technology to Describe Resident and Staff Interactions in Assisted Living Facilities.

PURPOSE: Falls are a significant financial burden and health hazard for residents in assisted living facilities (ALFs). However, limited capacity to observe residents has hindered understanding of resident-staff interactions within rooms. The current study aimed to describe nurse-resident interactions using data from a remote technology combining computer vision and staff location tracking. METHOD: Eighty-three staff working at an urban ALF with 215 residents were trained at the initiation of the study. Remote surveillance devices were installed in 32 residences and staff and resident interactions were tracked over 170 days. RESULTS: Staff visited residents an average of 20.7 times per day for short durations (mean = 1.08 minutes). Urgent alert response times averaged 3.0 minutes, with faster response times through the mobile application (mean = 2.7 minutes) compared to in-person (mean = 3.3 minutes) response. CONCLUSION: By better understanding staff activity patterns in ALFs, this study has the potential to improve fall prevention and care for residents in ALFs. [Journal of Gerontological Nursing, 50(7), 7-11.].

Technology-based interactive communication simulation addressing challenging communication situations for nursing students.

BACKGROUND: Simulation-based interventions for nursing students addressing challenging communication situations involving geriatric patients and end-of-life care are limited. PURPOSE: This study evaluated the effects of technology-based interactive communication simulations on nursing students' communication knowledge, self-efficacy, skills, compassion, and program satisfaction. METHOD: A randomized controlled repeated-measures design was used with third- and fourth-year nursing students enrolled in five nursing colleges located in five regions in Korea as participants. Participants were randomly assigned to either a technology-based interactive communication simulation or an attention control group. Changes in communication knowledge, self-efficacy, skills, compassion, and program satisfaction were assessed using three self-reported measures and communication skills were measured by the raters. Statistical analyses included descriptive analyses, chi-square tests, t-tests, and a generalized estimating equation model. RESULTS: Eighty students participated in one of the two programs, and 77 in the four-week follow-up test. The intervention group indicated significant improvements in communication knowledge, self-efficacy, skills, and compassion, as well as higher program satisfaction compared with the attention control group. Communication skills as assessed by raters also showed significant change at all assessment time points. CONCLUSION: The technology-based interactive communication simulation program is effective in improving communication skills among nursing students managing geriatric patients and end-of-life care.

Bedside handovers in mental health care: An explorative review.

INTRODUCTION: Involving mental healthcare patients in nursing handover practices seems a promising method for increasing patient participation, empowerment, and shared decision-making but is hardly found in practice. METHOD: An explorative review on bedside handovers in mental health care was conducted. Searched databases included CINHAHL, Web of Science, PubMed, and Embase. The search strategy yielded 3126 articles. Nine articles met the inclusion criteria and were included in this review. RESULTS: Pre- and post-implementation perspectives were described, as well as strategies for implementation. After the implementation of bedside handover, nurses and patients experienced more time spent together and a greater sense of involvement with the care plans could be noticed. DISCUSSION: Being involved in bedside handovers facilitates active participation and open dialogue between nurses and patients. This accelerates the opportunities for patients to take part in shared decision-making and feel recognised as experts in their illness experience. More research on possible differences in effectiveness across different patient diagnoses is recommended. CONCLUSION: Involving patients in mental health care in handover practices seems a promising method but limited research has been done to explore the meaning it has to mental healthcare nurses and patients.

Patient-authored medical record II: A not-knowing approach to psychiatric nursing.

A patient-authored medical record (PAMR) is a narrative-based prescription that is written by a psychiatric patient with help from a nurse. It is a tool specifically designed and developed for psychiatric nursing. We have reported its notable therapeutic effects for Japanese patients and found that the patients had accurate views of how to improve their illness. The present paper, which broadens the scope of this examination, includes the entire process of using this tool, including both patient-authored medical records and follow-up dialogue. We aim to demonstrate how a patient's potentials are leveraged and expanded through the interpretation of such texts through dialogue, in which interpretation takes the form of a conversational question based on not-knowing. Follow-up meetings facilitate the therapeutic process and team collaboration for patients, medical staff, and families. We also reaffirm the soundness and legitimacy of psychiatric patients writing their own prescription with help from a nurse.

Nurses' experience of loss, grief, family health and care targeting patients and families in long-term cancer illness: A qualitative study.

PURPOSE: This study aimed to explore the experiences of registered nurses in hematology departments and primary care settings regarding loss, grief, and family health in adult patients and their families during long-term cancer illnesses. METHOD: A qualitative study was conducted taking a phenomenological hermeneutic approach. Data were collected between February and March 2023 through individual, semi-structured interviews with 12 nurses working in hematology departments and primary care settings in Denmark. The interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS: The analysis resulted in the identification of four main themes with related subthemes: (1) Patients' individual losses leading to grief reactions, (2) Nurses' experience of families grieving the loss of former daily living, (3) Supporting families with family health as an implicit concept, and (4) Overcoming barriers through nurses' care interventions targeting family health. Results showed that nurses encountered various losses and grief reactions affecting both patients and families. Barriers such as experience levels and working conditions affected care quality. Despite challenges, nurses addressed these by utilizing communication, involving families, and directing them to additional healthcare services. CONCLUSION: The study unveiled limited nurse awareness of family health, acknowledging its significance in patient and family care. The findings highlight the importance of improving nurses' comprehension of effectively supporting families as a cohesive unit in the context of long-term cancer illnesses.

A study of latent profile analysis of empathic competence and factors influencing it in nursing interns: a multicenter cross-sectional study.

Background: Empathy, as one of the fundamental principles of nursing professionalism, plays a pivotal role in the formation and advancement of the nursing team. Nursing interns, as a reserve force within the nursing team, are of significant importance in terms of their ability to empathize. This quality is not only directly related to the degree of harmony in the nurse-patient relationship and the enhancement of patient satisfaction, but also plays a pivotal role in the promotion of the quality of nursing services to a new level. Aim: The objective of this study was to gain a deeper understanding of the current state of nursing interns' empathic abilities. To this end, we sought to examine empathic performance under different profile models and to identify the key factors influencing these profile models. Methods: The study utilized 444 nursing interns from 11 tertiary general hospitals in Inner Mongolia as research subjects. The study employed a number of research tools, including demographic characteristics, the Jefferson Scale of Empathy, and the Professional Quality of Life Scale. A latent profile model of nursing interns' empathy ability was analyzed using Mplus 8.3. The test of variability of intergroup variables was performed using the chi-square test. Finally, the influencing factors of each profile model were analyzed by unordered multi-categorical logistic regression analysis. Results: The overall level of empathy among nursing interns was found to be low, with 45% belonging to the humanistic care group, 43% exhibiting low empathy, and 12% demonstrating high empathy. The internship duration, empathy satisfaction, secondary traumatic stress, only child, place of birth, and satisfaction with nursing were identified as factors influencing the latent profiles of empathy in nursing interns (p < 0.05). Conclusion: There is considerable heterogeneity in nursing interns' ability to empathize. Consequently, nursing educators and administrators should direct greater attention to interns with lower empathy and develop targeted intervention strategies based on the influences of the different underlying profiles.

Huella psicosocial del COVID-19 en enfermeras de 4 países de Latinoamérica, año 2021-2022: aprendizajes y desafíos / Psychosocial footprint of COVID-19 in nurses from 4 South American countries, year 2021-2022: learning and challenges / Pegada psicossocial da COVID-19 em enfermeiros de 4 países da América do Sul, ano 2021-2022: aprendizado e desafios

Objetivo: determinar la huella psicosocial de la pandemia por COVID-19 en enfermeras de 4 países de Sudamérica, año 2021-2022. Métodos: estudio de corte transversal, en una muestra de 279 enfermeras: colombianas (86), paraguayas (68), mexicanas (54) y chilenas (71), que cumplieron los criterios de inclusión.Se aplicaron las escalas de Duke-UNC para evaluar apoyo social recibido y confidencial; El cuestionario Medical Outcomes Study-Social Support Survey (MOS) para evaluar apoyo social y el cuestionario de variables de interacción psicosocial (VIP) Resultados: tanto el buen apoyo confidencial como afectivo, se asoció con las variables de vivir con dos o más personas, ser perteneciente a una religión, y trabajar en una unidad con pacientes. El consumo de medicamentos fue significativamente menor en el grupo con buen apoyo confidencial y afectivo, (p=0.012) Conclusiones:la ejecución del rol profesional de la enfermera es conocido como de alta calidad, y con una destacada responsabilidad, especialmente en pandemia por SAR COVID 19. Sin embargo, se aprecian huellas residuales físicas y emocionales en los profesionales de enfermería.

Objective: to determine the psychosocial footprint of the COVID-19 pandemic in nurses from 4 South American countries, 2021-2022. Methods: cross-sectional study, in a sample of 279 nurses: Colombian (86), Paraguayan (68), Mexican (54) and Chilean (71), who met the inclusion criteria. Duke-UNC scales were applied to assess received and confidential social support; The Medical Outcomes Study-Social Support Survey (MOS) questionnaire to assess social support and the psychosocial interaction variables (VIP) questionnaire. Results: both good confidential and affective support were associated with the variables of living with two or more people, belonging to a religion, and working in a unit with patients. Medication consumption was significantly lower in the group with good confidential and affective support, (p=0.012). Conclusions: the execution of the professional role of the nurse is known to be of high quality, and with outstanding responsibility, especially in the SAR pandemic. COVID 19. However, residual physical and emotional traces can be seen in nursing professionals.

Objetivo determinar a pegada psicossocial da pandemia de COVID-19 em enfermeiros de 4 países da América do Sul, 2021-2022. Métodos: estudo transversal, em uma amostra de 279 enfermeiras: colombianas (86), paraguaias (68), mexicanas (54) e chilenas (71), que atenderam aos critérios de inclusão. As escalas de Duke-UNC foram aplicadas para avaliar o suporte social recebido e confidencial; o questionário Medical Outcomes Study-Social Support Survey (MOS) para avaliar o apoio social e o questionário de variáveis de interação psicossocial (VIP). Resultados: tanto o bom apoio confidencial quanto o afetivo estiveram associados às variáveis morar com duas ou mais pessoas, pertencer a uma religião e trabalhar em unidade com pacientes. O consumo de medicamentos foi significativamente menor no grupo com bom apoio confidencial e afetivo, (p=0,012). Conclusões: sabe-se que o desempenho da função profissional do enfermeiro é de alta qualidade, e com destacada responsabilidade, principalmente na pandemia SAR COVID 19. No entanto, traços residuais físicos e emocionais podem ser observados nos profissionais de enfermagem.

[Caregiver-patient communication: A complex process]. / Communication soignant-soigné : un processus complexe.

Caregiver-client communication is a process influenced by many specific elements arising from the context, the content and the form of the message, but also from the inner life of the patient and the caregiver. All these specific factors have an impact on the transmission and reception of the message.

[IPAs mentioning PCS mobilize a care model based on patient partnership]. / Mobilisation par des IPA d'un modèle de soin portant sur le partenariat patient.

The Impact program aims to structure the care provided by advanced practice nurses (APNs) for people with chronic illnesses, based on the humanistic health partnership model. This model, based on patient partnership, is enriched by measurement tools that take into account four determinants of adaptation to chronic illness. Impact aims to improve patient partnership, individualize care and integrate IPAs into a research dynamic.

The Power of Music and Inclusivity at the Bedside.

Using person-centered care in music therapy interventions.

Nursing Students' Perception of Caring for Culturally Diverse Patients: A Hermeneutic Phenomenological Study.

BACKGROUND: This study examined the phenomenon of prelicensure nursing students caring for culturally diverse patients. METHOD: Individual interviews were conducted with undergraduate nursing students using a hermeneutic phenomenological approach. Qualitative research experts conducted the interviews, transcribed the data, and followed van Manen's methodology for analysis. RESULTS: Eleven nursing students participated in the study. Data were collected from April to August 2022. The average length of the student interviews was 32 minutes. Four themes were identified: (1) communication issues; (2) access to care; (3) nurse background; and (4) trust and respect. CONCLUSION: This study highlights the importance of caring for culturally diverse patients. Policymakers and health care leaders can use the findings to support legislative proposals for enhancing culturally diverse patient safety and health equity. Based on these findings, nurse educators and preceptors can adapt their clinical teaching approaches accordingly, and nurse managers can benefit from the results when hiring new graduate nurses. [J Nurs Educ. 2024;63(6):373-379.].

Reading the signs in health visits-Perspectives of adolescents with migration experiences on encounters with school nurses.

AIM: To explore the experiences of health visits within the school health services from the perspective of adolescents with migration experiences. DESIGN: A descriptive qualitative study. METHODS: Data were collected using focus groups and semi-structured individual interviews with adolescents with migration experiences aged 13-17 years old. Analysis was conducted using reflexive thematic analysis. RESULTS: The results described adolescents reading the signs in the guided interaction between them and the school nurses. Reading the signs illustrated the adolescents' continuous interpretation of the interaction with the school nurse, and their decisions on how to respond throughout the health visit. These interpretations influenced the adolescents' shifting willingness to talk about their health and how they adapted to the space of participation provided by the school nurse. The interpretation also influenced their experiences of health visits as focusing on their health without making them feel singled out. CONCLUSION: Although individual considerations might be warranted in health visits with adolescents with migration experiences, the results indicate that similarities in intrapersonal communication in various encounters between adolescents and health professionals might be greater than any differences. Healthcare encounters with adolescents with migration experiences might thus need to be conducted with an awareness that adolescents read the signs in the guided interaction and that similarities in this interaction are greater than any differences.

Intersectionality and Inclusive Serious Illness Communication in the Intensive Care Unit.

Serious illness communication can be especially distressing for patients who are critically ill and their loved ones who experience forms of discrimination based on identities such as their race, gender, sexual orientation, and other intersecting identities. In this article, we discuss the concept of intersectionality and its association with serious illness communication, decision-making, and care in the intensive care unit. Additionally, we present relevant concepts from clinical practice and contemporary nursing and health care literature to support critical care nurses in fostering more inclusive serious illness communication in the intensive care unit.

How Grounded Are Our Ideals? Rethinking Nursing's Covenant of Care.

ABSTRACT: Covenant has been used to describe the special relationship between nurses and patients yet has been misunderstood in nursing literature. Covenantal elements of keeping promises and nurturing relationship resonate with the work of nursing. However, unlimited devotion puts the nurse at risk for exploitation and burnout. One's conceptualization of covenant is important because it impacts beliefs about allegiance, identity, and responsibilities. This article offers a critical analysis of how the conceptualization of covenant in nursing literature compares to a theological understanding of covenant. The covenantal dimension of a nurse's practice is reframed from the nurse-patient relationship to a professional-societal relationship.

Christian Worldview and Caring in Nursing: The Legacy of Sister Simone Roach.

ABSTRACT: Sister Simone Roach, a noted philosopher of caring in nursing, left behind a significant body of theoretical and practical work highlighting the areas of nursing ethics, care/caring, and compassion. This article explores the integration of the moral foundation of agape love in Pauline theology and Roach's human caring in nursing (1992) as the action of agape love. A narrative literature review explores the relationship between the scriptural ethics of St. Paul (Pauline ethics) and Roach's caring in nursing.

The Importance of Nurse-Patient Relationships in the Midst of Substance Misuse: Support for Rural Youth Well-Being.

Nurses working in rural acute and community-based settings are often asked for substance use treatment guidance and education in a health care system with minimal treatment services available. Nursing science provides an alternative answer for nurses to lean on in their clinical practice when working with rural-dwelling youth in the midst of substance misuse. Practical strategies are offered, which nurses may integrate into their routine clinical care to strengthen the nurse-patient relationship and enhance positive attributes among youth. Connective caring practice is essential to support rural youth well-being and recovery in the midst of substance misuse. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 7-11.].

'It was horrible to watch, horrible to be a part of': Midwives' perspectives of obstetric violence.

BACKGROUND: Obstetric violence, including unconsented interventions, coercion and disrespect, violates human rights; impacting the physical and psychosocial health of women. The perspective and experience of midwives related to obstetric violence have been explored in low and middle-income countries, with limited research into the experience of midwives in high income nations. AIM: To explore Australian midwives' perspectives of obstetric violence. METHODS: Thematic analysis of qualitative in-depth interviews with 15 midwives experienced in supporting women during birth. Critical feminist theory underpinned each stage of the research. FINDINGS: Interviews with 15 Australian midwives from diverse care settings were analysed thematically. Four key themes were developed from the data: 'the operationalisation of obstetric violence', 'the impact of obstetric violence' 'the historical and situational context' and 'hope for the future'. Midwives considered entrenched patriarchal structures and gender inequity as fundamental to the occurrence of obstetric violence. This societal scaffold is intensified within health care systems where power imbalances facilitate maternal mistreatment through coercion and grooming women for compliance in the antenatal period. Fragmented care models expose women to mistreatment with continuity models being protective only to a point. Midwives experience their own trauma, as a result of what they have witnessed, and due to the lack of support they receive when advocating for women. CONCLUSIONS: Obstetric violence occurs in Australian maternity systems with unconsented interventions, overmedicalisation, coercion, and disrespect observed by midwives. Care-related trauma impacts on the mental health of midwives, raising workforce concerns for policy makers, consumer advocates and professional bodies.

Relação enfermeiro-pessoa afetada pela Tuberculose fundamentada na teoria do alcance de metas de imogene king / La relación enfermería-Persona afectada por la Tuberculosis, según la Teoría del logro de objetivos de imogene king / The nurse-tuberculosis patient relationship according to Imogene King's theory of goal achievement

Resumo Introdução: As ações desenvolvidas na Atenção Primária à Saúde são um dos pontos fortes de combate à tuberculose. Nesse nível de atenção, o contato contínuo do enfermeiro por meio da consulta de enfermagem permite manter relação com a população adoecida. Diante da relação enfermeiro-pessoa cuidada para o estabelecimento do vínculo e adesão ao tratamento contra tuberculose, compreende-se a importância do referencial teórico de Imogene King para estruturar a interação enfermeiro-pessoa cuidada e oferecer uma dinâmica para esse processo. Objetivo: Analisar a relação enfermeiro-pessoa afetada pela tuberculose fundamentada na Teoria do Alcance de Metas de Imogene King. Método: Estudo descritivo com abordagem qualitativa, com 14 enfermeiros da APS, selecionadas por conveniência. A coleta de dados ocorreu de agosto a novembro de 2018, por meio de entrevista semiestruturada, elaborada com base no Registro Meta-Orientado de Enfermagem de Imogene King. Os dados foram analisados de forme qualitativa pelo Software IRAMUTEQ. A pesquisa foi aprovada pelo Comitê de Ética. Resultados: Após a análise, emergiram quatro classes: 1) relação estabelecida com base no acolhimento; 2) relação enfermeiro-pessoa com tuberculose e o apoio de outros profissionais e familiares; 3) relação estabelecida com vistas ao cumprimento do tratamento; e 4) relação estabelecida para enfrentamento do preconceito diante da tuberculose. Conclusão: O acolhimento, a família e o vínculo entre profissional, paciente e equipe da Atenção Primária à Saúde fortalecem o enfrentamento da doença e reforçam a adesão ao tratamento medicamentoso.

Resumen Introducción: Uno de los puntos fuertes de la lucha contra la tuberculosis son las acciones desarrolladas en la atención primaria de salud. En este nivel asistencial, el contacto continuo de las enfermerías a través de la consulta de enfermería permite mantener una relación con la población enferma. Frente a la relación enfermería-persona para el establecimiento del vínculo y la adherencia al tratamiento contra la tuberculosis, se entiende la importancia del referente teórico de Imogene King para estructurar la interacción enfermería-persona y ofrecer una dinámica para este proceso. Objetivo: Análisis de la relación entre el personal de enfermería y las personas afectadas por la tuberculosis, a partir de la teoría del logro de objetivos de Imogene King. Método: Estudio descriptivo con abordaje cualitativo, con 14 enfermeras de atención primaria de salud, seleccionadas por conveniencia. La recolección de datos ocurrió de agosto a noviembre de 2018, a través de una entrevista semiestructurada, elaborada con base en el registro meta-orientado de enfermería de Imogene King. Los datos fueron analizados cualitativamente utilizando el software IRAMUTEQ. La investigación fue aprobada por el Comité de Ética. Resultados: Después del análisis, surgieron cuatro clases: 1) relación establecida con base en la recepción, 2) relación enfermería-persona con tuberculosis y apoyo de otras personas profesionales y familiares, 3) relación establecida con miras al cumplimiento del tratamiento y 4) relación establecida para combatir los prejuicios contra la tuberculosis. Conclusión: La acogida, la familia y el vínculo entre profesional, paciente y equipo de atención primaria de salud fortalecen el afrontamiento de la enfermedad y refuerzan la adherencia al tratamiento farmacológico.

Abstract Introduction: One of the main aspects in the fight against tuberculosis are the actions developed in Primary Health Care (PHC). At this level of care, the nurse's continuous contact through the nursing consultation allows them to maintain a relationship with the sick population. Regarding the nurse-patient relationship for establishing a bond and the compliance with tuberculosis treatment, we understand the importance of Imogene King's theoretical framework for structuring the nurse-patient interaction and offering a dynamic for this process. Objective: To analyze the nurse-tuberculosis patient relationship based on Imogene King's Theory of Goal Achievement. Method: A descriptive study with a qualitative approach, with 14 PHC nurses, selected by convenience. Data were collected from August to November 2018 through semi-structured interviews based on Imogene King's Meta-Oriented Nursing Record. The data were analyzed qualitatively using the IRAMUTEQ software. The research was approved by the Ethics Committee. Results: After the analysis, four classes emerged: 1) relationship established on the basis of welcoming; 2) nurse-tuberculosis patient relationship and the support of other professionals and family members; 3) relationship established towards treatment compliance; and 4) relationship established to confront prejudice associated with tuberculosis. Conclusion: The welcoming, the family, and the bond between the professional, the patient and Primary Health Care team strengthen the coping with the disease and reinforce the compliance with the pharmacological treatment.

Is elderspeak communication in simulated hospital dementia care congruent to communication in actual patient care? A mixed-methods pilot study.

AIMS: Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. The purpose of this mixed-methods study was to determine if simulation accurately captures elderspeak communication by nursing staff in hospital dementia care. DESIGN: A 3-part mixed-methods design in which (1) three dementia care simulations were designed and validated by a panel of experts, (2) communication by nursing staff completing each simulation was quantitatively compared to communication during actual patient care, and (3) views on the realism were explored using within- and across-case coding. METHODS: Three simulations using different modalities (manikin, role-play, and standardised patient) were designed and validated with eight experts using the Lynn Method. Ten nursing staff were audio-recorded and their communication was coded for elderspeak communication. Results for each simulation were compared using Wilcoxon signed-rank test to recordings taken during actual dementia care encounters. Debriefings were coded for realism and results were converged. RESULTS: The average time using elderspeak during naturalistic care was 29.9% (SD = 20.9%) which did not differ from the average amount of elderspeak used across the three simulations modalities which ranged from 29.1% to 30.4%. Qualitative results suggested a lack of realism with the manikin condition and the nursing staff indicated preference for the simulation with the standardised patient. CONCLUSIONS: Communication elicited in the dementia care simulations was congruent to communication produced in actual dementia care but preference was for the standardised patient. IMPLICATIONS FOR PATIENT CARE: Elderspeak communication can be accurately produced in the simulated environment which indicates that simulation is a valid method for person-centred communication training in nursing staff. IMPACT: Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. Elderspeak communication captured in the simulated environment was congruent to communication nursing staff use during actual patient care to hospitalised persons living with dementia. This study empirically identifies that communication is elicited in similar patterns by nursing staff in the simulated environment compared to the naturalistic care environment which demonstrates that simulation can be used as a valid tool for education and research on person-centred communication. REPORTING METHODS: STROBE. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.