Implementation of Integrative Nursing for Patients With Cancer Receiving Inpatient Care: Protocol for a Convergent Parallel Mixed Methods Evaluation
Bibliographic record
Abstract
BACKGROUND: Integrative nursing (IN) involves the application of external naturopathic nursing interventions, such as compresses, embrocations, and therapeutic baths and washes. As part of a university hospital project, patients receiving oncology care in participating wards receive IN interventions as supportive care during their hospital stay as part of a consultation service. OBJECTIVE: This study aims to investigate the acceptance, feasibility, and contextual conditions of implementing IN in inpatient care and to evaluate perceptions, experiences, and perceived impact of IN interventions from multiple stakeholder perspectives. METHODS: We used a convergent parallel mixed methods approach guided by the Consolidated Framework for Implementation Research. The evaluation consists of 5 substudies reflecting multiple perspectives on the project. Patients, relatives, and hospital staff will participate. Substudies include a single-arm pre-post questionnaire (substudy 1) and semistructured interviews (substudy 2) with patients, a cross-sectional survey of relatives (substudy 3), semistructured interviews with health care professionals (substudy 4), and analysis of project-related documentation (substudy 5). Qualitative data will be analyzed using qualitative content analysis, and quantitative data will be analyzed using descriptive and inferential statistical methods. RESULTS: Following separate analyses of each substudy, the findings will be integrated and triangulated to generate overarching meta-inferences. The recruitment phase lasted from October 2023 to January 2025. Data collection was completed in March 2025. As of October 2025, after data verification and plausibility checks, data analysis is ongoing. The first results are expected to be published in 2026. CONCLUSIONS: This study presents a mixed methods research protocol aimed at exploring the implementation of IN within a university hospital setting. It is expected to provide a theory-based contribution to IN implementation in inpatient care while also offering insights into its potential effects at the patient level. The study is anticipated to advance understanding of how IN can be sustainably embedded in hospital practice and to provide actionable insights for improving patient-centered supportive care. TRIAL REGISTRATION: German Clinical Trials Register DRKS00032318; https://drks.de/search/de/trial/DRKS00032318. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/74405.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.135 | 0.075 |
| Meta-epidemiology (narrow) | 0.004 | 0.003 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.033 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".