JMIR Research Protocols

Approximately 25% of combat veterans with posttraumatic stress disorder (PTSD) seek treatment for traumas involving potentially morally injurious events (PMIEs), which involve acts of commission, omission, or betrayal that deeply transgress one’s sense of right and wrong. The sequelae of exposure to PMIEs, called “moral injury,” are associated with functional and psychiatric impairment and disrupt veterans’ sense of identity and meaning, ability to connect with and trust others, and engender disturbing guilt, shame, rage, and disgust. Currently, no first-line treatments directly address moral injury, and evidence-based treatments for PTSD may be limited because they were derived from civilian contexts, poorly fit the war zone context, and do not allow veterans to discuss the details of the PMIEs with other veterans.

Early childhood development (ECD) programs refer to policies and programs aimed at protecting young children’s rights to achieve their full potential. Parenting interventions are effective at improving children’s cognitive development and overall well-being. However, there is limited evidence on how to effectively implement and integrate such programs into routine service delivery at scale. The Government of China launched the ECD program in 2013 and the ECD scale-up program in 2023.

Family carers of older adults often experience significant mental health challenges, including anxiety and depression. Although online coaching interventions have been found to reduce anxiety and depressive symptoms in carers, only a few studies have examined the broader impact of applying online self-help interventions for enhancing resilience and overall well-being in carers. This study evaluates the effectiveness of a self-directed e-coaching intervention for family carers of older adults aimed at reducing anxiety and depressive symptoms, while also assessing its impact on enhancing their resilience and overall well-being, particularly for those with mild levels of carer needs.

Frontline workers across multiple occupations operate in high-stress, trauma-exposed environments characterized by chronic demands and irregular schedules, increasing risk of burnout, depression, and poor sleep. Emerging evidence highlights the role of 24-hour movement behaviors in relation to mental health. Despite growing attention, research remains fragmented and often focuses on individual behaviors rather than their combined influence. This protocol outlines a scoping review designed to map existing evidence and identify research gaps.

Mis-triage represents a global concern, with reported rates ranging from 15% to 33%. Understanding its causes and contributing factors is essential for ensuring patient safety. Currently, available studies have mainly focused on evaluating triage systems rather than investigating the human factors affecting triage performance. A major limitation in triage evaluation studies is the lack of standardized criteria to assess patient acuity and the absence of a clear consensus on how to measure triage accuracy. Most studies rely on retrospective data, which often fail to capture real-life clinical complexity. Therefore, the underlying causes and consequences of mis-triage remain partially understood.

Nursing theory and conceptual models are central to nursing as a knowledge discipline, yet theory is often perceived as abstract and difficult to operationalize in education and practice. This theory-practice tension suggests variability in nurses’ and nursing students’ capability to access, interpret, critique, and apply theoretical knowledge in ways that shape praxis. Nursing theoretical literacy (NTL) is an emerging, practice-oriented literacy construct that may help specify this capability; however, its conceptual boundaries, contextual uses, and measurement approaches remain unclear.

Current data analysis and coordination methods do not effectively support nurses and midwives in risk reduction, as retrospective reporting does not allow real-time insights and precludes proactive, preventive care. Analysis of administrative data within Australia’s health care sector to predict risk may help address this shortcoming. Predictive analytics can transform these data into meaningful insights, identifying harm risk profiles that benefit the performance of Australian and international clinical programs. Importantly, these tools may support nurses and midwives in preventing adverse events and predicting high-risk situations. Researchers, in collaboration with local health network staff, will develop a proof-of-concept predictive risk algorithm. The “predictive harm response management algorithmic tool to reduce adverse events in healthcare settings” program (project DHCRC-0156) will provide real-time insights via an interactive dashboard, enabling nurses, midwives, and health administration to assess risks and optimize resources in health care settings. This protocol details the algorithm development activities for subproject 1a, predictive risk model development, which aims to develop and pilot-test a predictive harm algorithm across 2 South Australian local health networks.

Insomnia during pregnancy is a modifiable risk factor for depression. Research in nonpregnant populations and preliminary findings in a pregnant population suggest that targeting insomnia with digital cognitive behavioral therapy for insomnia (CBT-I) may prevent depression.

Approximately 40%‐60% of children diagnosed with autism spectrum disorder (ASD) exhibit challenging behaviors such as aggression, elopement, self-injury, and property destruction that can endanger the health and safety of the child or others, often cause significant distress for families, and hinder the child’s developmental progress. Although behavioral treatments grounded in the principles of applied behavior analysis have been shown to effectively reduce or eliminate these behaviors, significant gaps remain in how to deliver these interventions equitably.

Odontectomy is a common surgical procedure often associated with significant preoperative anxiety, particularly when performed under general anesthesia. Anxiety can lead to physiological changes, such as increased blood pressure and heart rate, and may affect anesthetic requirements and postoperative recovery. Virtual reality (VR) has emerged as a promising non-pharmacological intervention to reduce anxiety through immersive distraction.

Every patient receiving kidney replacement therapy that is, hemodialysis, peritoneal dialysis or a kidney transplant, should have an advanced treatment escalation plan. This should include a decision on cardiopulmonary resuscitation (CPR) status. The existing literature suggests kidney replacement therapy recipients who undergo in-hospital CPR have outcomes similar to the general population. However, these data originate exclusively from North America and Taiwan, do not include transplant recipients, and neurological outcomes are poorly reported. This paucity of evidence influences how kidney replacement therapy recipients, their families and care providers make informed discussions on CPR status and may leave kidney replacement therapy recipients vulnerable to false assumptions of poor suitability.

Chronic pain affects approximately 12 million individuals in Germany and significantly impairs quality of life. Although multimodal treatment approaches—combining physical, psychological, and behavioral strategies—are considered the gold standard, access to specialized multidisciplinary pain treatment, including physiotherapy and psychological interventions, is often hampered by long waiting times, which highlights the need for scalable, low-threshold treatment options. Digital health interventions, particularly those grounded in established therapeutic models, offer a promising solution to bridge this treatment gap. The German Digital Health Care Act has opened pathways for reimbursable digital applications, such as CHRONIC, which is grounded in acceptance and commitment therapy as a third-wave cognitive behavioral therapy framework and integrates selected cognitive behavioral techniques, mindfulness-based strategies, and physiotherapy into a structured web-based program.