Patients’ wellbeing and nursing care plans, understanding adherence and relevant factors, a scoping review

Research Article | DOI: https://doi.org/10.31579/2637-8892/305

Patients’ wellbeing and nursing care plans, understanding adherence and relevant factors, a scoping review

  • Sonila Qirko 1,2*
  • Vasilika Prifti 1,2
  • Emirjona Kicaj 1,2
  • Rudina Cercizaj 1,2
  • Enkeleint A. Mechili 2,4
  • Liliana Rogozea 3

1 Transilvania University of Brasov, Brasov, Romania. 

2 Faculty of Health, University of Vlora, Vlora, Albania.

3 Transilvania University of Brasov, Brasov.

4 School of Medicine, University of Crete, Crete, Greece.

 

*Corresponding Author: Sonila Qirko, Transilvania University of Brasov, Brasov, Romania.

Citation: Sonila Qirko, Vasilika Prifti, Emirjona Kicaj, Rudina Cercizaj, Enkeleint A. Mechili, et al, (2024), Patients’ wellbeing and nursing care plans, understanding adherence and relevant factors, a scoping review, Psychology and Mental Health Care, 8(8): DOI:10.31579/2637-8892/305

Copyright: © 2024, Sonila Qirko. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 07 October 2024 | Accepted: 22 October 2024 | Published: 29 October 2024

Keywords: social emotional well-being; nursing care plan; adherence

Abstract

Several studies across the world shows the importance of nursing care focusing on patients’ well-being. The adherence of the nursing plan to the well-being of the patients, focuses on two main variables: the nursing plan and the patient's well-being. 
This review aims to present a literature review on the impact of nursing care plans on patient adherence and their socio emotional well-being. 
The research constitutes a Scoping review that gives evidence from 16 studies published in the period 2015–2023, in English, including patients with chronic diseases and assessing pa-tient’s socio-emotional wellbeing and their adherence to their nursing care plan. We retrieved information on electronic databases of PubMed, Google Scholar, and Cochrane using key-words like nursing care plans, adherence, patient and wellbeing and combination of them. The review is presented following the PRISMA-ScR guidelines. Some studies included in the re-view did not result in high adherence to nursing care plans, affected by various factors such as demographic factors, plans of care, personnel who provided care, face to face and online advice, financial and insurance factors. Most patients show low levels of wellbeing if they were not adherent to nursing care plans, especially the medication adherence issues.
The research findings show that patient’s wellbeing and adherence to nursing care plan are closely related to each other as phenomena. The better the patients feel, the more they are ad-herent to care plans based on evidence. It is important to understand factors that affect non adherence to plans of care in order to reduce negative factors. 
 

1.Introduction:

A nursing care plan is a formal process that correctly identifies existing needs and recognizes a patient’s potential needs or risk [1]. Nursing care planning, as a way of communication among nurses, their patients, and other healthcare providers, begins when the patient is admitted to the healthcare services and is continuously updated throughout in response to his/her changes in condition and evaluation of goal achievement. Planning and delivering individualized or patient-centered care is the basis for excellence in nursing practice [1]. 

Adherence is defined as the extent to which a person’s behavior (in terms of taking medications, following specific regimens, or dealing with lifestyle modification) coincides with medical or health advice [2]. Whereas, nonadherence is the patient’s failure to comply with the prescribed treatment regimen for his/her full recovery from such an illness or disease. According to NANDA nursing diagnoses, non-adherence to the nursing care plan is the behavior of a patient or caregiver that does not correspond with the therapeutic plan agreed upon by the individual, family or guardian, and healthcare practitioner [2]. Non adherence is associated to stressful lifestyles and environments, socioeconomic status [3], contrary cultural or religious beliefs and values, lack of social support, and financial resources, and a compromised emotional state [4]. Lack of adherence is linked with unsatisfactory clinical outcomes, increased hospitalizations, lower quality of life, and higher overall healthcare costs [5, 6].

A patient’s wellbeing is closely linked to the adherence to nursing care. The idea of maintaining a state of ‘wellness’ can be linked to a number of different benefits, including improved physical and mental health, faster recovery time from illness, higher educational attainment, greater productivity and an overall healthier lifestyle [6]. Emotional wellbeing is the ability to practice stress management and relaxation techniques, be resilient, boost self-love, and generate the emotions that lead to good feelings [7].

The scope of nursing practice is defined by a broad foundation of scientific knowledge, including the biological and behavioral sciences, combined with the ability to assist patients, families, and other caregivers in managing their own health needs [8]. Nursing Care Plans, which include diagnoses, interventions, and outcomes, continue to mature and reflect the changing times and needs of its readers, as well as the needs of those for whom care is provided [9]. The implementation of nursing interventions is essential in enhancing patient outcomes and guaranteeing the provision of exceptional patient-focused healthcare. Nursing interventions are defined as actions taken by nurses to promote health, prevent illness, and manage the physical, emotional, and social needs of patients [10].  

Among the factors that influence clinical utilization of the nursing process are the issues of formulating or stating the nursing diagnosis. Nurses carried out various nursing interventions that were not based on the nursing diagnosis. They were also not evaluating the rendered care, thus the nursing process in totality was not being implemented [11]. The nurses in this context exclusively focused on the problems of the patients that are associated with medical diagnosis or treatment; hence, failing to embrace professional nursing. From the researchers’ clinical experiences, nurses follow the medical orders of doctors to the last; and at times, they are unable to provide any better care to patients who in a specific day were not reviewed by their medical doctors. Hence, the nurses do not take the initiative in patients’ care; as professionals are expected to do [12].

The body of research to support nursing plans and their positive effects on patient wellbeing is ever-increasing and gaining momentum. Nurses continue to study both independent and collaborative interventions for effectiveness and desirable outcomes such as increased positive feelings, lower hospital days, less mortality and morbidity, and fewer costs of health care provided [13,14]. Nurses and other health care staff may greatly contribute to increasing the adherence of patients to care through education, communication, reinforcement, and written advice, thus influencing the wellbeing of the patients and their quality of life [15]. This study aims to present the relation between nursing care plans and patients well-being. We have focused on the specific factors related to treatment regimens, including socio demographic, economic, and health care personnel variables, in order to find strategies that improve patients’ quality of life. A comprehensive review of 16 studies published from 2015 to 2023 provide specific information of nursing approaches that promote and enhance well-being of chronically ill patients among various settings and populations.

2.Methods

2.1 Protocol and registration 

The current study is a Scoping review, which we considered appropriate and effective in reaching the goal of our study. According to Munn et.al.  in 2022 a scoping review synthesizes evidences to identify and map the evidence on a specific topic or issue, irrespective of source [16]. 

This review was presented following the Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA-ScR) guidelines [17]. 

2.2 Eligibility criteria

According to the review’s aim and objective, we set some inclusion and exclusion criteria. Inclusion criteria were:

Full articles to be presented in English language, exploring wellbeing and nursing care plan adherence especially medication adherence. 

Qualitative, and/or qualitative-based, and/or descriptive, and/or quantitative, and/or cross-sectional, and/or observational studies, experimental studies. 

Included patients, nurses, healthcare workers and family members. 

The review excluded studies not written in English, published before 2015 for the relevance to nursing care plans implementation periods, did not include implementations of nursing care plans and did not include chronic patients. 

2.3 Information sources 

To find the studies needed for the review, we performed an electronic search between December 1st, 2022 to December 1st, 2023. The search was conducted through databases of PubMed presenting (69 studies), Google Scholar (2 studies), and Cochrane library (79). 

2.4 Search strategy

The search strategy consisted of two concepts regarding the aim of the study: (1) Patient’s socio-emotional wellbeing, (2) factors that have an impact on adherence to nursing plan. We used keywords and combinations such as adherence to nursing care plans, wellbeing in health care, quality of life, evidence-based care plans, factors that affect the adherence, chronic patients and their adherence to nursing care plans, health care policies in improving adherence etc. 

2.5 Selection of sources of evidence 

Research articles part of electronic search were selected in order to evaluate the adherence to the nursing care plan for the well-being of the patients were included in this study.

In three databases we retrieved altogether 150 studies retrieved by relevant key words decided by the researchers. After removing 38 study duplicates and 40 for years of publication out of the eligibility criteria, the researchers identified the relevant articles, and full texts were assessed. The studies in the three databases were manually reviewed by two independent authors (V.P and E.K) following the inclusion and exclusion criteria. In cases of disagreements, the main reviewer assessed the articles (S.N.). For evaluation of the articles, initially they were evaluated and screened by title and after by reading the abstracts and relevance of their aims. All the charting was done by hand by the researchers.

2.6 Data items

After careful study of the selected articles, we presented characteristics of the studies as follow: the year and country of research, the aim of the study, the methodology, results and conclusions. 

2.7 Critical appraisal of individual sources of evidences 

We did not perform a critical appraisal of individual sources of evidences.

  1. Syntheses of the results

A collection of the information from the studies included is presented according to the country of study, patient population, type of studies, details about the adherence intervention factors such as demographic factors, socio- economic factors etc. Another set of information was about the methods of delivery and type of interventions to improve adherence to care plans according to individual problems of each patient, and a summary of the outcomes of these factors found to affect adherence to care plans. The studies included in this review had different factors mentioned that had their impact on adherence to nursing care plans. 

3.Results

Selection of sources of evidence

We identified a total of 150 studies in three electronic databases. After removing 38 study duplicates and 40 for years of publication we screened 72 articles by abstract and tittle, excluding 30 of them. Of 40 articles for five of them we did not find them in the full form accessible, two were reviews, four did not have nursing care plans clearly presented, 11 were published before 2015 but the articles were relatively old, and two did not include nurses in their education plans. The following PRISMA- ScR flow chart presents the information as follows:

Figure 1: PRISMA-ScR

3.1 Characteristics of sources of evidence

This review included 16 articles published between 2015 and December 2023.Three studies were conducted in 2015, 2017 and 2020 respectively. Three studies were published in 2021, two studies in 2018, four in 2022 and two in 2023. The articles were conducted in various countries such as four in the USA [8,18,19,26]; two in China [21, 22], one in Poland [20], 

one in Singapore [23], one in Greece [24]; one in Australia [25]; two in South Africa [27, 28]; one in the Netherlands [29]; one in Colombia [30]; and one in Belgium, Portugal and Italy [31], one in Indonesia [32]. There were four observative studies, five cross sectional studies, three experimental studies, two mix methods studies, one qualitative and one quasi experimental study in this scoping review, all presented in table 1 (annex 1).

Year, Country,

Authors

Type of studyCharacteristics of patients involvedAdherence levelFactors affecting the adherenceWellbeing impact on adherence stated

 Sevilla-Cazes, et al

2018

USA

Observational Qualitative

patients

31 Chronic heart patients, males and females in home care and readmitted in hospitalLow adherence

Unclear recommendations

Better care in hospitals

Financial issues

Patients were in despair mental state.

Transformed adherence to adaption.

Kisielska et al

2022

Szczecin

Observational Prospective cohort112 patients after liver transplantMedium level adherenceHigh social support, time since surgery, age, gender.Majority had low or no depressive symptoms

Souliotis, et al.

 

2022

Greece

Cross sectional

250 patients with lung cancer

 

Few patients displayed poor adherence; whereas the corresponding percentage among physicians was 12.4%.Communication gaps between patients and physicians. Long waiting periods to meet the physicians.None stated

Gough K, et.al.

 

2022

Australia

 

Experimental

112 Women on radiotherapyHigh level of adherence to the group who got nurse consultations face to face.Adherence to the tailored specialist nurse consultations was satisfactory, while to telephone consults were less than satisfactoryComplete adherers reported significantly lower levels of psychological distress and significantly higher levels of physical, emotional and functional wellbeing before radiotherapy.

Yoon S, Kwan YH

Singapore

2023

 

Qualitative25 patients with hypertensionLow levels

therapy-related dimension

patient-related dimension

healthcare team and system-related dimension

cultural beliefs

Cultural factors need to be taken into consideration from health care personnel

Panahi et.al.

2021

 

USA

Cross-sectional study796 participantsGood levels of adherenceYounger age, lifestyle, long treatment with medications in the clinic and continuity of careBetter general adherence was associated with better chronic disease management

Ramkisson S, et.al

2017

South Africa

A cross-sectional study401 participants with diabetesPoor adherence

Social support,

level of anxiety, social dysfunction, age, public versus private sector

Social support endorsed better levels of well-being.

McDowelBD, et.al

 

2020

 

USA

Cross sectional studyWomen (N = 1138) who had completed treatment for Stage 0-III, ductal carcinoma breast cancerCare coordinated by health care providers increased quality of lifeThe interaction between health care providers and patients, low health literacy reduced quality of life.Better quality of life is translated in better wellbeing

Zhang LL, et.al

 

2022

 

China

 

Experimental

 

144 patients cranial trauma patients

 

Better treatment adherence and compliance in home collaborative careType of intervention, collaboration teamBetter adherence to collaborative interventions brough higher levels of wellbeing

Li Y, et.al

2021

China

Experimental263 patients with breast cancerIncreased adherence to exerciseNurse interventionsBetter quality of life post intervention

Spikes T, et.al

2020

USA

 

Observational Cross-sectional study85 hypertensive African-American womenLow levels of adherenceDimension of HTN beliefs were associated with medication adherence, illness perception, incomeNot clear

Teunissen DT, et al

2015

Netherlands

 

Observational study

 

16 trained NP treated 103 female patients with UI. working in the same practice.Nurse care practitioner provided care and adherence to treatment increased.Lack of improvement of the UI and difficulties in performing the exercisesIncreased quality of life from interventions of nurse practitioners

Fords GM, et al

2017

South

Africa

A qualitative approach with a descriptive phenomenological design10 women with HIV during prenatal periodWomen with HIV were adherent to treatmentLoneliness, lack of support, concern of unborn child wellbeingNone stated

Vargas-Escobar LM, et al.

Bogota

Columbia

2022

Cross-sectional, observational-analytical study

 

151 adult patients with cardiovascular diseases

108 family members

High Self care agency increased adherence to treatment

family functioning,

type of care received

None stated

Seys et al

 

2018

Belgium, Portugal, Italy

Cross sectional

 

257 COPD patients and 284 health care professionals

High adherence in groups with care plans provided

 

Education provided by team of health care providers, implementation of a care pathwayReduced readmission rates brought better quality of life

Jujuk Proboningsih et al 

 

2023 

Indonesia 

Quasi experimental 50 patients with hypertension High adherence in intervention group The experimental group received guided modules, and fear ad forgetfulness were factors that had impact on adherence Chronic care model nursing interventions increase adherence   

Table 1: Characteristics of the studies

3.2 Factors affecting adherence

After a careful review of the articles included, we separated them into 12 categories found to be important. The categories are as below: socio demographic factors, economic factors, communication, well-being, quality of life, health insurance, type of support, health care personnel, consulting, family roles and health care policies. A more detailed description is provided in table 2. 

Factor CategorySpecific FactorsInfluence on Adherence and Well-Being
Socio demographic factors Gender [8], Race and Gender, Social Support and Depression [19], Marital Status [21], Age [21, 26, 30], Lower Education [21, 24-26, 30]

Patients with Low levels of education present lower adherence levels. 

Social support, depression, and marital status significantly impact adherence. 

Age and gender are also influential factors.

Economic factorsFinancial family Support [27, 30]Economic support from family improves adherence to nursing care plans.
CommunicationCommunication Between Health Personnel and Patients [24, 25, 27, 29, 32]Proper communication improves adherence, while communication barriers lower adherence.
Well-BeingEmotional Well-Being [18], Depression and Anxiety [20, 23, 25, 28, 29]Emotional well-being and depression and anxiety treatment are crucial for improving adherence.
Quality of lifeNursing Care Affects Quality of Life [20], Implementation of Nursing Care Pathways [22, 31]Nursing care improves quality of life, and nursing care pathways are associated with higher adherence levels and lower readmission rates.
Health insuranceHealth Insurance and Health Systems [26, 28]When patients have good health insurance and health systems are efficient adherence to nursing care plans and treatment is higher.
Support  

Social and Family Support [27], Working with Families [27]

Nurses, nurse practitioners and health care collaborators [25,29]

Good social and family support help to achieve better well-being and higher adherence. 

Health care personnel plays an important role in adherence to treatment plans. 

Consulting and interventions 

Face to face compared to telephone advise [19,25] 

Home interventions [22,31, 32]

When patients are advised face to face and at home their adherence is higher, on the contrary over the phone consults show lower adherence to the treatment plans.

Guided modules improved adherence levels.   

Family roles Family functions [28,30]Family roles, and hope for the future of children increase adherence, particularly in HIV women and chronic patients with cardio vascular diseases. 
Health care policies Intervention policies [18, 24, 27, 28, 30]Policy interventions enhance communication among patients and nurses, and help families to be included in care plans. 

Table 2: The review studies divided by categories by specific factors

We also studied the positive and negative factors that affect adherence to nursing care plans among chronically ill patients. The information is presented in table 3. 

Factor CategoryStudiesSpecific FactorsInfluence on Adherence and Well-Being

Socio demographic factors 

 

[8, 19, 21, 24-26, 30]

Higher education 

Economic stability

Access to health care insurance 

Lower education

Lack of social support

Communication[24, 25, 27, 29, 32]

Effective communication between healthcare providers and patients 

Clear communication about treatment plans and instructions 

Supportive nursing care plans and evidence-based practices

Communication barriers
Well-Being[18, 20, 23, 25, 28, 29]

Positive emotional states

Hope for the future 

Mental health disorders (e.g., depression, anxiety)
Health care provider role [25,29, 32]Involvement of healthcare providers (e.g., nurse, nurse practitioner)Lack of involvement or support from healthcare providers

Home care interventions

  Family Functioning

[22,31] [28,30]

Home care interventions based on nursing care plans supported by family members 

Implementation of nursing care pathways

Family conflict or lack of support
Health care policies [18, 24, 27, 28, 30]

Policy interventions improving communication between patients and healthcare personnel

Investments in healthcare systems to improve quality of life 

Accessible and comprehensive healthcare services

Lack of policy interventions addressing communication barriers 

Inadequate healthcare system infrastructure

Fragmented healthcare system

Table 3: Specific positive and negative factors that impact adherence to nursing care plans
 

4.Discussion

4.1 Summary of evidence

The 16 studies included in this scoping review examined patients’ adherence to treatments and care plans and the factors that influenced this process. The studies revealed positive and negative factors that greatly affect the adherence to health care plans, including health care work settings, patients’ conditions, loss of family roles, lack of family support, and lack of communication from the team, type of insurance, instruction methods, etc. Results showed that patients are not keen on following nursing care plans, including medication treatment, exercise, diet and nutrition and other aspects of disease treatment. 

We found a relationship between gender and adherence to therapeutic recommendations to be unequivocal in one of the studies where women were more adherent than men, [15, 25], but on the contrary when it came to young women with chronic diseases, they were mostly non adherent. Some research authors have demonstrated lower adherence to treatment recommendations after organ transplantation among men emphasizing that type of pathology plays a significant impact on adherence to treatment plan. This may be because men think that they do not need lots of medication, they can be strong and neglect the plan of care [34-36].

The level of adherence to care plans strongly influences the patients’ wellbeing [12, 14, 20, 22], especially the patients with chronic diseases who are less adherent and have higher levels of emotional distress [19]. 

On the contrary to these findings, a study by Williams et al., concluded that symptoms of depression and bipolar diseases do not have an impact on the adherence to treatment of patients with Hepatitis C, because psychotropic medication helps them adhere to the treatment [33]. Among adults, depressive symptoms have been correlated with poor adherence to anti-epileptic medications, oral medications for cancer and controller medications for persistent asthma [40-42].

One of the findings in the review was that the care plans should focus on the preservation of the family caregiver role, as the patients who are not adherent to care plans have a hard time to perform this role [6]. Similar results came from Marsicano in 2015, stating that the focus of the care plan is on the supportive care rendered by family members, significant others, or caregivers responsible for meeting the physical/emotional needs of the patient. With limited access to health care for many people, most diseases are diagnosed and managed in an outpatient setting, so including the family in alleviating the caregiver-lost role of the patient is important [35]. 

Similar to this conclusion, the review from Rubin BK, 2018, stated that family members wanted to get involved in the care of their family, wishing to work closely with nurses and doctors, in order to improve treatment adherence by implementing nursing care plans This can meliorate significantly patient experience with the healthcare system and increase their satisfaction of the services received [37]. 

Lack of education and cultural and socio-economic issues that affect the quality and adherence to nursing management of young women with gestational diabetes, and this need to be addressed in order to optimize care for women. Women are less adherent to diabetes treatment because of their low educational level and not understanding the nursing instructions and continuation of care [18]. These findings are in the same line with the review conclusions of Gast et. al., stating that low levels of education have a negative impact on the level of adherence to treatment of diseases, expensive medications etc. [38].

We noticed in this review that the type of consultations such as the ones face to face [20], advice given by nurses play a better role in helping patients adhere to the plans of care, while when the advice is provided by tele-health other health care professionals [14], offer lower levels of adherence. On the same line with these findings the review from Marques conducted in 2021 concluded that when caregivers and patients work together as a team face to face, many problems that come from improper communication are resolved [39].

One interesting finding in this review was the role of home care model provided by agencies with low and high level of care [6, 25]. Home care without clear instructions and not covered by state insurance agencies reduced the adherence to nursing care plans. This for the fact that no progress on the improvement of the diseases created more frustration and low adherence to the patients. While, the less financial burden creates the plan of care, the odds to follow this plan are higher. On the other hand, the review from Wilder. M, in 2021 found that Structural determinants of health inequities, such as employment, income, and education, were not significantly associated with medication adherence [ 43].

The support offered by health care professionals especially from nurses found in several studies of the review [14, 20, 22]. The patients stated that the higher the support from peer sessions guided by nurses and nursing coordination increased the adherence to treatment care plans. The same results are revealed by Amineh R. in 2020 stating that information on care plans should be done through a model of co-construction between the patient and the health professional. Well supported and educated patients were able to understand their condition and treatment resulting in higher adherence compared to those who lacked support and information [44].

This study has its strength and weakness. This is the first review that presents studies exploring factors that influence adherence to nursing care plans and their effect in wellbeing amongst heterogenous populations with various health problems. The data revealed were rich and settings were different in different countries from undeveloped to developed ones. The study followed the Preferred Reporting Items for Scoping Reviews -ScR guidelines to collect and evaluate the included studies, but we only used some electronic databases. Critical appraisal could not be performed because of the heterogenicity of the data and methods used. Populations included in the study were from different parts of the world and countries with significant changes in their factors affecting the adherence to nursing care plans especially medication adherence. 

5. Limitations

The review followed PRISMA-ScR guidelines, but this review has its limitations. It is not registered in a protocol on the web. We excluded studies in languages other than English and included only quantitative studies. The studies included explored only the perspectives of patients, but not the nurses’ opinions or data which would provide further detailed information on this topic. 

6. Conclusions

In total, 16 studies were consulted regarding patients’ well-being and their adherence to nursing care plans according to their individual characteristics. A normal complex process that includes emotional, physical, spiritual, social, and intellectual responses and behaviors by which individuals, families, and communities incorporate an actual, anticipated, or perceived loss into their daily live activities. The nurses play an active role in improving adherence to treatment plans thus helping to increase the quality of life and level of wellbeing. Among factors that have a significant role in improving or worsening the adherence to treatment plans are socio demographic factors, role of families in providing support, type of communication, health care policies etc. Improving communication among health care teams and family, providing peer and family support, providing care supported by health care policies will improve adherence rates and increase quality of life in patients with chronic diseases. 

Supplementary Materials:

none 

Author Contributions: SN

“Conceptualization, SN. and VP.; methodology, SN.; formal analysis, S.N.; investigation, E.K.; resources, RC.; data curation, VP.; writing—original draft preparation, S.N.; writing—review and editing, S.N. V.P; visualization, V.P.; supervision, L.R.; All authors have read and agreed to the published version of the manuscript.”

Funding:

“This research received no external funding” 

Institutional Review Board Statement:

“Not applicable” 

Informed Consent Statement:

Not applicable.

Data Availability Statement:

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

Acknowledgments:

 None

Conflicts of Interest:

“The authors declare no conflicts of interest.” 

Appendix A

,

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

img

Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

img

Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

img

Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

img

Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

img

Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

img

Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

img

Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

img

Luiz Sellmann