Is the digital economy empowering high-quality tourism development? A theoretical and empirical research from China.

How digital economy (DE) empowers high-quality development of tourism (HQDT) has become a common concern among scholars. Given this, this study clarifies the theoretical connotation of DE enabling HQDT,and finds that: Micro, DE promotes efficiency improvements in tourism enterprises, with its economies of scale and Matthew effect reducing average costs, its economies of scope meeting diversified demand, and its long-tail effect improving supply-demand matching mechanism. Meso, DE can transform and upgrade tourism industry structure through industrial digitization and digital industrialization, and also form a new tourist industry form and value chain through cross-border integration. Macro, DE can stimulate innovation and flexibility of market players, increase new factor inputs in tourism, improve factor allocation efficiency, and advance macro regulation of the tourism market. Accordingly, the study conducts an empirical test based on panel data for 31 provinces in mainland China during 2011-2020. Results show that: ① DE positively influences HQDT, and the sub-dimensions all positively influence HQDT. ② DE has a heterogeneous impact on HQDT and shows spatial spillover effects. Finally, the study concludes with effective paths for DE promoting HQDT: "Promote digital infrastructure construction, accelerate tourism digital transformation, strengthen integration and innovation development, and overcome the challenges of tourism enterprises".

Clinical research nurses perceive their role as being like the hub of a wheel without real power: Empirical qualitative research.

AIM: This study aimed to explore the experiences of being a clinical research nurse (CRN), in Sweden. DESIGN: A qualitative study analysing individual interview data. METHODS: Interviews with 10 participants were conducted in April 2017 and repeated with five participants in May 2022. A semi-structured interview guide was used to cover topics such as experiences of working in a new role and professional challenges related to the role. The transcribed interviews were analysed inductively using qualitative content analysis. RESULTS: The main theme revealed that the CRNs experienced their work role as being like a hub in a wheel, using an ethical compass, but without real power. The six themes identified showed that CRNs worked independently and relied on clinical experiences as nurses but needed more education. They not only had a sense of duty but also too large responsibilities. Furthermore, they viewed their work as valuable and important. However, they needed an accentuated ethical compass and were also affected by power relations that negatively impacted work. CONCLUSION: Working as a CRN means being in a central position and working independently, which requires diverse skills and competencies. CRNs, however, face and manage complex ethical and practical challenges without real power. They experience huge responsibilities but need education and acknowledgement, indicating a need for improvement. This is an important message to stakeholders and managers about the necessity of taking adequate action to support CRNs who are crucial resources in clinical research. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Using symbiotic empirical ethics to explore the significance of relationships to clinical ethics: findings from the Reset Ethics research project.

BACKGROUND: At the beginning of the coronavirus (Covid-19) pandemic, many non-Covid healthcare services were suspended. In April 2020, the Department of Health in England mandated that non-Covid services should resume, alongside the continuing pandemic response. This 'resetting' of healthcare services created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into routine healthcare practices. We draw on data collected as part of the 'NHS Reset Ethics' project, which explored the everyday ethical challenges of resetting England's NHS maternity and paediatrics services during the pandemic. METHODS: Healthcare professionals and members of the public participated in interviews and focus group discussions. The qualitative methods are reported in detail elsewhere. The focus of this article is our use of Frith's symbiotic empirical ethics methodology to work from our empirical findings towards the normative suggestion that clinical ethics should explicitly attend to the importance of relationships in clinical practice. This methodology uses a five-step approach to refine and develop ethical theory based on a naturalist account of ethics that sees practice and theory as symbiotically related. RESULTS: The Reset project data showed that changed working practices caused ethical challenges for healthcare professionals, and that infection prevention and control measures represented harmful barriers to the experience of receiving and offering care. For healthcare professionals, offering care as part of a relational interaction was an ethically important dimension of healthcare delivery. CONCLUSIONS: Our findings suggest that foregrounding the importance of relationships across a hospital community will better promote the ethically important multi-directional expression of caring between healthcare professionals, patients, and their families. We offer two suggestions for making progress towards such a relational approach. First, that there is a change of emphasis in clinical ethics practice to explicitly acknowledge the importance of the relationships (including with their healthcare team) within which the patient is held. Second, that organisational decision-making should take into account the moral significance afforded to caring relationships by healthcare professionals, and the role such relationships can play in the negotiation of ethical challenges.

An empirical assessment of the influence of digital transformation on sports corporate sustainability.

The trend of digital transformation fosters enterprise change, helps cultivate enterprises' own competitive advantages and is crucial to the advancement of sports enterprises' sustainable development in the framework of the emerging digital economy as a national strategy. However, there have been few empirical studies on the microlevel of digital transformation and its impact on the sustainability of sports organizations. Therefore, the sustainable growth dynamic model is used to construct indicators of corporate sustainability by referencing 48 sports corporations listed on Shanghai and Shenzhen A-shares markets and the New Third Board in China from 2012 to 2021. The intrinsic relationship between digital transformation and the sustainable development of sports enterprises and the underlying mechanism of action are explored by constructing a panel fixed effects model, a chain mediating effects model, and a panel threshold model. The most important contribution is as follows: To provide a useful reference for analyzing enterprise digital transformation, a more complete indicator indicating the extent of corporate digital transformation is built. The micro viewpoint broadens our awareness of sustainable development in sports organizations and deepens our understanding of the interaction model between sustainable development and enterprise digital transformation. This study provides methodical evidence and insights for an accurate understanding of digital transformation for sustainable enterprise development, looking into the "black box" of the mechanism between digital transformation and sustainable business development. The results show that digital transformation significantly aids sports enterprises in their pursuit of long-term sustainability. Heterogeneity tests demonstrate the pivotal role of digital transformation in advancing the sustained growth of sports firms and high-tech sports enterprises situated in the eastern region of China. Regarding transmission mechanisms, the chain mediating effect of enterprises' digital transformation on improved technological innovation and TFP, which in turn promote long-term business growth, has yet to be validated. Further examination exposes that within the context of the correlation between digital transformation and the sustainability of corporations, there is a single threshold effect based on financing restrictions and operational costs and a double threshold effect based on operational efficiency.

How do taxi drivers expose to fine particulate matter (PM2.5) in a Chinese megacity: a rapid assessment incorporating with satellite-derived information and urban mobility data.

BACKGROUND: Taxi drivers in a Chinese megacity are frequently exposed to traffic-related particulate matter (PM2.5) due to their job nature, busy road traffic, and urban density. A robust method to quantify dynamic population exposure to PM2.5 among taxi drivers is important for occupational risk prevention, however, it is limited by data availability. METHODS: This study proposed a rapid assessment of dynamic exposure to PM2.5 among drivers based on satellite-derived information, air quality data from monitoring stations, and GPS-based taxi trajectory data. An empirical study was conducted in Wuhan, China, to examine spatial and temporal variability of dynamic exposure and compare whether drivers' exposure exceeded the World Health Organization (WHO) and China air quality guideline thresholds. Kernel density estimation was conducted to further explore the relationship between dynamic exposure and taxi drivers' activities. RESULTS: The taxi drivers' weekday and weekend 24-h PM2.5 exposure was 83.60 µg/m3 and 55.62 µg/m3 respectively, 3.4 and 2.2 times than the WHO's recommended level of 25 µg/m3. Specifically, drivers with high PM2.5 exposure had a higher average trip distance and smaller activity areas. Although major transportation interchanges/terminals were the common activity hotspots for both taxi drivers with high and low exposure, activity hotspots of drivers with high exposure were mainly located in busy riverside commercial areas within historic and central districts bounded by the "Inner Ring Road", while hotspots of drivers with low exposure were new commercial areas in the extended urbanized area bounded by the "Third Ring Road". CONCLUSION: These findings emphasized the need for air quality management and community planning to mitigate the potential health risks of taxi drivers.

Value-Based Integrated Care: A Systematic Literature Review.

BACKGROUND: Healthcare services worldwide are transforming themselves into value-based organizations. Integrated care is an important aspect of value-based healthcare (VBHC), but practical evidence-based recommendations for the successful implementation of integrated care within a VBHC context are lacking. This systematic review aims to identify how value-based integrated care (VBIC) is defined in literature, and to summarize the literature regarding the effects of VBIC, and the facilitators and barriers for its implementation. METHODS: Embase, Medline ALL, Web of Science Core Collection, and Cochrane Central Register of Controlled Trails databases were searched from inception until January 2022. Empirical studies that implemented and evaluated an integrated care intervention within a VBHC context were included. Non-empirical studies were included if they described either a definition of VBIC or facilitators and barriers for its implementation. Theoretical articles and articles without an available full text were excluded. All included articles were analysed qualitatively. The Rainbow Model of Integrated Care (RMIC) was used to analyse the VBIC interventions. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: After screening 1328 titles/abstract and 485 full-text articles, 24 articles were included. No articles were excluded based on quality. One article provided a definition of VBIC. Eleven studies reported-mostly positive- effects of VBIC, on clinical outcomes, patient-reported outcomes, and healthcare utilization. Nineteen studies reported facilitators and barriers for the implementation of VBIC; factors related to reimbursement and information technology (IT) infrastructure were reported most frequently. CONCLUSION: The concept of VBIC is not well defined. The effect of VBIC seems promising, but the exact interpretation of effect evaluations is challenged by the precedence of multicomponent interventions, multiple testing and generalizability issues. For successful implementation of VBIC, it is imperative that healthcare organizations consider investing in adequate IT infrastructure and new reimbursement models. Systematic Review Registration: PROSPERO (CRD42021259025).

Digital transformation and supply chain efficiency improvement: An empirical study from a-share listed companies in China.

This article thoroughly examines the influence of digital transformation on the efficiency of corporate supply chains. As global economic integration accelerates and technological innovations deepen, digital transformation has become key to enhancing core corporate competitiveness. This research, utilizing data from A-share listed companies in China between 2007 and 2022, analyzes how companies improve supply chain efficiency through digital transformation. Furthermore, the study establishes a theoretical framework that demonstrates how digital transformation facilitates supply chain efficiency from the perspectives of internal governance and external competition. The research indicates that digital transformation plays a key role in significantly enhancing supply chain efficiency. Furthermore, the results of the mechanism analysis confirmed that digital transformation contributes to enhancing corporate supply chain efficiency by improving the level of corporate governance and the degree of market competition. The study also finds that the effect of digital transformation on supply chain efficiency varies with different corporate backgrounds, indicating its heterogeneous impact. Lastly, an analysis of economic consequences shows that the increased supply chain efficiency resulting from digital transformation can reduce future external transaction costs, strengthening the company's market position and financial performance. This research provides strategic guidance for firms to develop robust strategies amid the digital wave and offers strong policy recommendations for promoting digital supply chain management and enhancing market adaptability.

Semantic segmentation of urban environments: Leveraging U-Net deep learning model for cityscape image analysis.

Semantic segmentation of cityscapes via deep learning is an essential and game-changing research topic that offers a more nuanced comprehension of urban landscapes. Deep learning techniques tackle urban complexity and diversity, which unlocks a broad range of applications. These include urban planning, transportation management, autonomous driving, and smart city efforts. Through rich context and insights, semantic segmentation helps decision-makers and stakeholders make educated decisions for sustainable and effective urban development. This study investigates an in-depth exploration of cityscape image segmentation using the U-Net deep learning model. The proposed U-Net architecture comprises an encoder and decoder structure. The encoder uses convolutional layers and down sampling to extract hierarchical information from input images. Each down sample step reduces spatial dimensions, and increases feature depth, aiding context acquisition. Batch normalization and dropout layers stabilize models and prevent overfitting during encoding. The decoder reconstructs higher-resolution feature maps using "UpSampling2D" layers. Through extensive experimentation and evaluation of the Cityscapes dataset, this study demonstrates the effectiveness of the U-Net model in achieving state-of-the-art results in image segmentation. The results clearly shown that, the proposed model has high accuracy, mean IOU and mean DICE compared to existing models.

Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China.

BACKGROUND: Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR. METHODS: This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021. RESULTS: COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098-0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05). CONCLUSIONS: Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation.

Is economic growth enough to propel rehabilitation expenditures? An empirical analysis of country panel data and policy implications.

PURPOSE: Rehabilitation is a set of services designed to increase functioning and improve wellbeing across the life course. Despite being a core part of Universal Health Coverage, rehabilitation services often receive limited public expenditure, especially in lower income countries. This leads to limited service availability and high out of pocket payments for populations in need of care. The purpose of this research was to assess the association between macroeconomic conditions and rehabilitation expenditures across low-, middle-, and high-income countries and to understand its implications for overall rehabilitation expenditure trajectory across countries. MATERIALS AND METHODS: We utilized a panel data set from the World Health Organization's Global Health Expenditure Database comprising the total rehabilitation expenditure for 88 countries from 2016 to 2018. Basic macroeconomic and population data served as control variables. Multiple regression models were implemented to measure the relationship between macroeconomic conditions and rehabilitation expenditures. We used four different model specifications to check the robustness of our estimates: pooled data models (or naïve model) without control, pooled data models with controls (or expanded naïve model), fixed effect models with all controls, and lag models with all controls. Log-log specifications using fixed effects and lag-dependent variable models were deemed the most appropriate and controlled for time-invariant differences. RESULTS: Our regression models indicate that, with a 1% increase in economic growth, rehabilitation expenditure would be associated with a 0.9% and 1.3% increase in expenditure. Given low baseline levels of existing rehabilitation expenditure, we anticipate that predicted increases in rehabilitation expenditure due to economic growth may be insufficient to meet the growing demand for rehabilitation services. Existing expenditures may also be vulnerable during periods of economic recession. CONCLUSION: This is the first known estimation of the association between rehabilitation expenditure and macroeconomic conditions. Our findings demonstrate that rehabilitation is sensitive to macroeconomic fluctuations and the path dependency of past expenditures. This would suggest the importance of increased financial prioritization of rehabilitation services and improved institutional strengthening to expand access to rehabilitation services for populations.

COMOKIT v2: A multi-scale approach to modeling and simulating epidemic control policies.

The COVID-19 crisis demonstrated the importance of using models to understand, predict, and manage epidemics, in particular by assessing in advance the effect of different intervention policies. Numerous models have been proposed to answer a wide range of questions, from the impact of open borders to the effectiveness of neighborhood containment to the role of building ventilation in virus dispersion. However, the vast majority of these models are only suited to a scale of representation, analysis, or experimentation. In this article, we present the latest version of the COMOKIT toolbox, which is based on the integration of 3 models (COMOKIT-micro, COMOKIT-meso, and COMOKIT-macro) enabling these questions to be addressed at different geographical scales of analysis and exploration, from the building scale to the scale of entire countries. An application of these 3 models to various questions concerning public health policies against COVID-19 is presented and discussed.

Network science for museums.

This paper introduces network science to museum studies. The spatial structure of the museum and the exhibit display largely determine what visitors see and in which order, thereby shaping their visit experience. Despite the importance of spatial properties in museum studies, few scientific tools have been developed to analyze and compare the results across museums. This paper introduces the six habitually used network science indices and assesses their applicability to museum studies. Network science is an empirical research field that focuses on analyzing the relationships between components in an attempt to understand how individual behaviors can be converted into collective behaviors. By taking the museum and the visitors as the network, this methodology could reveal unknown aspects of museum functions and visitor behavior, which could enhance exhibition knowledge and lead to better methods for creating museum narratives along the routes.

From opt-out to opt-in consent for secondary use of medical data and residual biomaterial: An evaluation using the RE-AIM framework.

BACKGROUND: Patient records, imaging, and residual biomaterial from clinical procedures are crucial resources for medical research. In the Netherlands, consent for secondary research has historically relied on opt-out consent. For ethical-legal experts who purport passive consent undermines patient autonomy, opt-in consent (wherein affirmative action is required) is seen as the preferred standard. To date, there is little empirical research exploring patient feasibility, organizational consequences, and the potential risks for research based on secondary data. Thus, we applied the RE-AIM framework to evaluate the impact of migrating from an opt-out to an opt-in consent process. METHODS: This evaluation was carried out in Radboud University Medical Center, a large tertiary hospital located in the southeast of the Netherlands. All non-acute, mentally competent patients ≥16 years of age registered between January 13, 2020 and June 30, 2023 were targeted (N = 101,437). In line with the RE-AIM framework, individual and organizational consequences were evaluated across five domains: reach, efficacy, adoption, implementation, and maintenance. RESULTS: 101,437 eligible patients were approached of whom 66,214 (65.3%) consented, 8,059 (7.9%) refused consent and 27,164 (26.8%) had no response. Of the 74,273 patients with a response, 89.1% consented to secondary use. The migration to an opt-in consent system was modestly successful; yet notably, differential response patterns by key sociodemographic characteristics were observed. Adaptions to the process flow improved its effectiveness and resulted in a reasonable response over time. Implementation was most affected by budgetary restraints, thus impeding the iterative approach which could have further improved domain outcomes. CONCLUSION: This evaluation provides an overview of logistical and pragmatic issues encountered when migrating from opt-out to opt-in consent. Response bias remains a major concern. Though not always directly transferable, these lessons can be broadly used to inform other health care organizations of the potential advantages and pitfalls of an opt-in consent system.

Predictivism and avoidance of ad hoc-ness: An empirical study.

Predictivism is the thesis that evidence successfully predicted by a scientific theory counts more (or ought to count more) in the confirmation of that theory than already known evidence would. One rationale that has been proposed for predictivism is that predictive success guards against ad hoc hypotheses. Despite the intuitive attraction of predictivism, there is historical evidence that speaks against it. As valuable as the historical evidence may be, however, it is largely indirect evidence for the epistemic attitudes of individual - albeit prominent - scientists. This paper presents the results of an empirical study of scientists' attitudes toward predictivism and ad hoc-ness (n = 492), which will put the debate on a more robust empirical footing. The paper also draws attention to a tension between the ad hoc-ness avoidance rationale of predictivism and the ways philosophers have spelled out the notion of ad hoc-ness.

Driving employee organizational citizenship behaviour through CSR: An empirical study in the context of luxury hotels.

In the recent years, there has been a rising interest among luxury brands to be environmentally responsible and promote employee discretionary behaviour. However, the underlying mechanisms that explain why, when, and how employees demonstrate discretionary environmental attitudes and behaviour in luxury contexts are not well-known. To accelerate this discourse; the current study examines the impact of environmental corporate social responsibility (CSR) on employees' organizational citizenship behaviour towards environment. Drawing insights from social cognitive theory, this study empirically validates a conceptual model through the data collected from 406 employees of luxury hotels and analysed using structural equation modelling. The results confirm the significant effect of environmental CSR on employees' organizational citizenship behaviour towards environment. The results also reveal that employee environmental commitment and green work engagement partially mediate the proposed relationship. Moreover, contrary to expectations, gender did not moderate the influence of environmental CSR on employee environmental commitment and employee green work engagement, whereas the relationship between environmental CSR and organizational citizenship behaviour towards environment was stronger for males than females. We argue that creative environmental CSR assignments in luxury hotel chains help employees develop engagement, identification, and commitment with the environmental strategy of the hotels towards solving grave environmental problems that modern societies are grappling with.

The preparation of children for day surgery from the parent's viewpoint: A mixed methods study.

AIM: The purpose of the study was to describe the preparation of children for day surgery from the parent's viewpoint. DESIGN: Empirical Research Mixed Method. METHODS: The research applied a mixed-methods study design. The study was conducted at the Paediatric Day Surgical Department of one REDACTED between 2018 and 2020 at the same time as an associated randomised controlled conduct trial. Parents of 41 children (ages 2-6 years) completed measures assessing their preparation for day surgery and satisfaction with the procedure. Semi-structured interviews were conducted with 15 parents to better understand their experiences. RESULTS: According to the results, most of the parents (95%) told their children about the upcoming day surgery procedure. The child was prepared for the surgery with cognitive and sensory information, and the preparation usually started at home well before the surgery. The parents' experiences with the most critical aspects of preparing their child included three main categories: (1) usability of the preparation method; (2) content and timing of the preparation method and (3) consideration of the family perspective.

Health information sources and health-seeking behaviours of Filipinos living in medically underserved communities: Empirical quantitative research.

AIMS: To describe sources of health information and health-seeking behaviours of adults (aged ≥18) living in medically underserved communities in the Philippines. DESIGN: This is a secondary, quantitative analysis from a cross-sectional parent study. Participants completed a 10-item, self-report survey on their sources of health information, healthcare providers sought for health and wellness and health-seeking behaviours when ill. Responses were evaluated across two age groups (<60 vs. ≥60 years) and genders using generalized linear mixed models. RESULTS: Surveys were completed by 1202 participants in rural settings (64.6% female, mean age 49.5 ± 17.6). Friends and/or family were their key source of health information (59.6%), followed by traditional media (37%) and healthcare professionals (12.2%). For health promotion, participants went to healthcare professionals (60.9%), informal healthcare providers (17.2%) or others (7.2%). When ill, they visited a healthcare professional 69.1% of the time, self-medicated (43.9%), prayed (39.5%) or sought treatment from a rural health clinic (31.5%). We also found differences in health-seeking behaviours based on age and gender. CONCLUSIONS: Our findings highlight the need to organize programs that explicitly deliver accurate health information and adequate care for wellness and illness. Study findings emphasize the importance of integrating family, friends, media and healthcare professionals, including public health nurses, to deliver evidence-based health information, health promotion and sufficient treatment to medically underserved Filipinos. IMPLICATIONS: New knowledge provides valuable information to healthcare providers, including public health nurses, in addressing health disparities among medically underserved Filipinos. IMPACT: This study addresses the current knowledge gap in a medically vulnerable population. Healthcare professionals are not the primary sources of health information. Approximately one-third of participants do not seek them for health promotion or treatment even when ill, exacerbating health inequities. More work is necessary to support initiatives in low- and middle-income countries such as the Philippines to reduce health disparities. REPORTING METHOD: We adhered to the reporting guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution as our study design and methodology do not make this necessary.

Beyond Parental Acceptance and Rejection: A Commentary on the Findings From Empirical Studies on Forgiveness and Vengeance in the Muslim World.

Drawing on the framework of interpersonal acceptance-rejection theory (IPARTheory), this special issue edited by Ronald P. Rohner, Sumbleen Ali, and Jennifer E. Lansford explores forgiveness and vengeance within the context of the Muslim world. Examination of the precursors of forgiveness and vengeance holds significance because vengeance typically correlates with adverse physical and psychological health outcomes. We suggest ways to advance research outlined in the special issue, such as assessing cross-cultural invariance and using diverse research designs. Moreover, increasing the diversity of socioeconomic status in studies conducted in the Muslim world and exploring hypotheses in high-income countries are necessary for contextually nuanced research. Overall, this special issue offers valuable insights into the dynamics of forgiveness and vengeance and highlights the role of culture and gender on psychological well-being across diverse contexts.

Communication to adult patients undergoing cancer care by non-specialist nurses: a scoping review protocol.

INTRODUCTION: Little is known regarding how non-specialist nurses communicate with patients living with cancer when the patients are receiving care outside of their cancer units/teams. This scoping review aims to identify, examine and report on the currently available evidence about communication by non-specialist nurses when caring for adults living with cancer outside of their cancer care unit/teams. METHODS AND ANALYSIS: A scoping review following the JBI methodology for scoping reviews will be conducted. We will search for empirical studies that meet the inclusion criteria in six databases (MEDLINE, PubMed, CINAHL, Embase, Scopus and PsycINFO). Handsearching in references of included articles will be performed to find additional articles. The population of interest will be non-specialist nurses. Three concepts will be explored, namely (1) all adult patients living with cancer, (2) a focus on three stages of the cancer continuum of care (cancer diagnosis, treatment and survivorship) and (3) a focus on communication between non-specialist nurses and patients living with cancer. We will include studies describing all healthcare settings outside patients' specialised cancer units or oncology teams. After article selection, two reviewers will independently screen titles and abstracts and perform a full-text article review, risk of bias assessments and data extraction. A third reviewer will resolve all disagreements. A narrative summary will provide an overview of how the results relate to the research aims and questions. The included articles will be limited to English and published between 2012 and 2023. ETHICS AND DISSEMINATION: No ethical approval is required since we will use publicly available empirical research sources. This review will provide current research on communication by non-specialist nurses with patients with a cancer diagnosis outside of an oncology setting, evidence that will support effective communication. As such, we aim to disseminate the findings in academic conferences and peer-reviewed journals.