{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:23:26Z","timestamp":1793334206745,"version":"4.5.0"},"reference-count":69,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,6,3]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with cancer are at high risk of developing pressure ulcers at the end of life as a result of their underlying condition or cancer treatment. There are many guidelines which set out best practice with regard to end-of-life skin care. However, the complexity of palliative cancer care often means that it is challenging for nurses to make the appropriate person-centred decisions about end-of-life skin care. This study seeks to explore the perceived importance that nurses place on different factors in their end-of-life skin care for patients with cancer. The utility, face validity and content validity of a prototype decision-making tool for end-of-life skin care will also be evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A mixed-method design will be used to gather data from primary and secondary care nurses working in different hospitals and local authority areas across Wales. Clinical vignettes will be used to gather qualitative and quantitative data from nurses in individual interviews. Qualitative data will be subject to thematic analysis and quantitative data will be subject to descriptive statistical analysis. Qualitative and quantitative data will then be synthesised, which will enhance the rigour of this study, and pertinently inform the further development of an end-of-life skin care decision-making tool for patients with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval to undertake the study has been granted by Cardiff University School of Healthcare Sciences Research Governance and Ethics Screening Committee. Informed consent will be obtained in writing from all the participants in this study. The results of this study will be disseminated through journal articles, as well as presentations at national and international conferences. We will also report our findings to patient and public involvement groups with an interest in improving cancer care, palliative care as well as skin care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-034938","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T02:05:24Z","timestamp":1594001124000},"page":"e034938","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Nurses\u2019 decision-making about cancer patients\u2019 end-of-life skin care in Wales: an exploratory mixed-method vignette study protocol"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5954-0501","authenticated-orcid":false,"given":"Ray","family":"Samuriwo","sequence":"first","affiliation":[{"name":"School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom"},{"name":"Wales Centre for Evidence Based Care, School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candida","family":"Lovell-Smith","sequence":"additional","affiliation":[{"name":"Patient and Public Involvement Representative, North Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Anstey","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Job","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Hopkinson","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,5]]},"reference":[{"key":"2025121409375958000_10.7.e034938.1","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1177\/0269216318776846","article-title":"Patient safety in palliative care: a mixed-methods study of reports to a national database of serious incidents","volume":"32","author":"Yardley","year":"2018","journal-title":"Palliat Med"},{"key":"2025121409375958000_10.7.e034938.2","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1016\/j.ijnurstu.2014.04.009","article-title":"Nurses' pressure ulcer related judgements and decisions in clinical practice: a systematic review","volume":"51","author":"Samuriwo","year":"2014","journal-title":"Int J Nurs Stud"},{"key":"2025121409375958000_10.7.e034938.3","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319846023"},{"key":"2025121409375958000_10.7.e034938.4","first-page":"169","article-title":"Skin changes at life's end (scale): a consensus document","volume":"6","author":"Beldon","year":"2010","journal-title":"Wounds UK"},{"key":"2025121409375958000_10.7.e034938.5","doi-asserted-by":"publisher","DOI":"10.1097\/00129334-200605000-00014"},{"key":"2025121409375958000_10.7.e034938.6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.12968\/ijpn.2015.21.5.225","article-title":"Evidence-Based guidelines for pressure ulcer management at the end of life","volume":"21","author":"Langemo","year":"2015","journal-title":"Int J Palliat Nurs"},{"key":"2025121409375958000_10.7.e034938.7","unstructured":"NPUAP, EPUAP, PPPIA . 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