Conservatism in nursing is frequently referenced in discussions of clinical practice and professional culture, yet it remains conceptually underexamined. This commentary proposes an analytical distinction between two forms of conservatism in nursing: constructive conservatism, which reflects context-sensitive clinical caution that supports patient safety and professional responsibility, and inhibitory conservatism, which manifests as inertia, silence, or resistance that may constrain evidence-based practice and professional development. Rather than treating conservatism as an inherently positive or negative attribute, the paper situates its different forms across clinical, organizational-cultural, and professional levels. By clarifying these conceptual boundaries, this commentary aims to stimulate more precise scholarly dialogue and guide future empirical research on conservatism in nursing.
Background Caring for people with mental health conditions has traditionally been a family issue. In industrialized countries, responsibility shifted in the early 19th century to large psychiatric institutions, often located in rural, tranquil settings where nature was considered therapeutic. More recently, policy has emphasized recovery-oriented, community-based models in which informal caregivers collaborate closely with healthcare professionals. In many low- and middle-income countries, limited formal services, shortages of trained staff, and long distances to care mean families remain the primary caregivers, often alongside traditional healers and religious leaders. Methods This scoping review, conducted in accordance with Joanna Briggs Institute guidelines, synthesizes informal caregivers' perspectives on mental healthcare in Tanzania. A comprehensive search completed on June 30, 2025, across Embase, MEDLINE, PsycINFO, Web of Science, and Scopus identified 1795 unique records; 153 were reviewed in full. Of 95 Tanzania-focused articles, 12 examined informal caregiving. Results The studies reported discontinuity of care and follow-up, limited access to psychotropic medications, transportation problems, and challenges managing patients' symptoms and behaviors. Informal caregivers described healthcare system constraints, including family violence, shortages of healthcare personnel, centralized services, medication scarcity, and weak infrastructure, which limit delivery of best practices, particularly in rural regions. Conclusion Overall, mental health in Tanzania remains profoundly family-centred: informal caregivers are consistently present yet experience work overload, emotional distress, and unmet support needs. These findings underscore the importance of strengthening community-based services and integrating informal caregiver support.
Background Laparoscopic cholecystectomy is considered the gold standard treatment for gallstones and acute cholecystitis; however, postoperative pain remains a common issue that affects recovery and patient satisfaction. This study aimed to investigate the effect of suction irrigation with 2% lidocaine on postoperative pain reduction. Methods In this triple-blind randomized clinical trial, 70 patients with gallstones who underwent laparoscopic cholecystectomy at Arak University of Medical Sciences were enrolled. Participants were randomly assigned, using block randomization, to either the control group (suction irrigation with 0.9% normal saline) or the intervention group (100 mL of 0.9% saline containing 2 mg/eq of 2% lidocaine) administered for 5–10 min during the final stage of surgery. Pain intensity in the shoulder, abdomen, and right upper quadrant was assessed at 2, 6, 12, and 24 h postoperatively using the Visual Analog Scale (VAS). Analgesic consumption was also recorded at predefined intervals. Data were analyzed using IBM SPSS Statistics version 23. Baseline characteristics were compared using appropriate statistical tests, and an ordinal logistic regression model was used to evaluate the association between the intervention and postoperative pain after adjustment for potential confounding variables. Results Seventy patients were equally allocated to the intervention and control groups. Pain severity was significantly lower in the lidocaine group at 2, 6, and 12 h after surgery (P < 0.05), with no significant difference observed at 24 h (P = 0.055). Ordinal logistic regression showed that treatment group, age, and postoperative assessment time were significant predictors of postoperative pain. After adjustment for potential confounders, patients in the lidocaine group had significantly higher odds of experiencing lower pain levels than those in the normal saline group (OR = 4.21, 95% CI: 2.34–7.24, P < 0.001). Conclusion Peritoneal irrigation with 0.9% saline plus 2% lidocaine is more effective than saline alone in reducing postoperative pain, hospital stay, and overall treatment costs after laparoscopic cholecystectomy.
Background Self-management is essential for cancer patients, especially those with Totally Implantable Venous Access Ports (TIVAP), as they must independently manage symptoms and maintain device hygiene. However, various barriers can impede effective self-care. Aim To assess self-management behaviours and explore perceived barriers associated with TIVAP self-management among colorectal cancer patients. Additionally, to examine the relationship between these barriers and self-management behaviours and identify significant predictors of poor self-management. Methods A descriptive cross-sectional study was conducted among 250 colorectal cancer patients using TIVAP at Ayadi-Almostakbal Oncology Centre in Alexandria, Egypt. Data were collected through validated self-report tools assessing self-management behaviours and perceived barriers. Descriptive statistics, Pearson correlation, and binary logistic regression were employed for data analysis. Results Findings indicated that 68.8% of participants exhibited unsatisfactory self-management, particularly in the planning, emotional adjustment, and knowledge domains. Physical limitations due to chemotherapy (88%) and lack of knowledge (80%) were the most frequently reported barriers. Statistically significant negative correlations were observed between perceived barriers and self-management behaviours, with physical limitations showing the strongest correlation (r = −0.61). Multiple regression analysis identified factors independently associated with poorer self-management behaviours, explaining 58% of the variance in self-management. Conclusion Colorectal cancer patients with TIVAP displayed generally poor self-management behaviours, significantly associated with physical, psychological, and informational barriers. The findings support the need for targeted nursing interventions to address these barriers.
Conservatism in health care is frequently invoked in clinical discourse, yet its meaning remains conceptually unstable. It is often used to describe a wide range of practices, from prudent restraint and watchful waiting to clinical inertia or resistance to innovation. This ambiguity matters because, in contemporary health systems shaped by overdiagnosis, overtreatment, intervention bias, and rising costs, the ability to distinguish evidence-based restraint from harmful underuse has become increasingly important. This commentary clarifies conservatism in health care as a mode of cautious, evidence-sensitive clinical judgment rather than an ideological reluctance to act. It defines evidence-based conservatism as the deliberate selection of the least invasive or least intensive effective intervention, coupled with continuous reassessment and readiness to escalate care when clinically indicated. The discussion distinguishes this orientation from related but ethically and operationally distinct constructs, including defensive medicine, clinical inertia, and unreflective resistance to change. The commentary further examines the clinical, nursing, and policy implications of conservative decision-making. It argues that, when applied proportionately and in context, conservatism can reduce low-value care, minimize iatrogenic harm, support patient-centered practice, and improve resource stewardship. At the same time, if poorly defined or misapplied, it may reinforce outdated routines or conceal unjustified care delays. By proposing core strategic principles and illustrating their relevance to nursing practice, this paper offers a conceptual foundation for understanding conservatism as a legitimate and accountable component of high-value, safety-oriented care.
