Belitung Nursing Journal最新文献

Background: Preoperative anxiety is a significant concern for patients undergoing surgery, as it can lead to adverse effects such as increased postoperative pain, delayed wound healing, prolonged hospital stays, higher incidences of postoperative complications, and even mortality. Preoperative anxiety is particularly common in patients undergoing cardiac surgery, but it is often overlooked and warrants further investigation.

Objective: This study aimed to explore preoperative anxiety and its predictors, including fear of surgery, preoperative sleep quality, perception of illness severity, and perceived social support among adult patients undergoing elective cardiac surgery.

Methods: A cross-sectional study was conducted with 142 adult patients undergoing elective cardiac surgery using simple random sampling. Data were collected from patients in the Class III Grade A general hospital in Wenzhou, China, between October 2023 and March 2024. Questionnaires were used to gather information about patients' demographic characteristics, fear of surgery, preoperative sleep quality, perception of illness severity, perceived social support, and preoperative anxiety. Descriptive statistics, Pearson correlation analysis, and multiple linear regression were employed for data analysis.

Results: The total score for preoperative anxiety was 15.98 ± 4.95. Fear of surgery, preoperative sleep quality, perception of illness severity, and perceived social support explained 37.3% of the variance in preoperative anxiety (Adjusted R² = 0.373, F _(4,142) = 26.77, p <0.05). Fear of surgery was the strongest predictor (β = 0.539, p <0.001), followed by preoperative sleep quality (β = -0.166, p <0.05) and perceived social support (β = -0.138, p <0.05). Perception of illness severity was not a significant predictor of preoperative anxiety.

Conclusion: Preoperative anxiety in adult patients undergoing elective cardiac surgery is significantly influenced by factors such as fear of surgery, preoperative sleep quality, and perceived social support. Nurses can implement targeted interventions to reduce preoperative anxiety. These interventions may include addressing the fear of surgery through health education and psychological counseling. Furthermore, improving the hospital environment to promote a calm and quiet atmosphere can enhance sleep quality. Encouraging social support to help patients build confidence in the success of their surgery and their ability to recover is also recommended.

Background: Stigma is a significant issue among patients with cervical cancer undergoing postoperative chemotherapy, yet the factors contributing to stigma are not well understood. While research has explored the relationships between self-efficacy, illness perception, self-esteem, social support, and stigma, fewer studies have focused on Chinese patients, and even fewer have specifically examined stigma within this population.

Objective: This study aimed to describe stigma and assess its association with self-efficacy, self-esteem, illness perception, and social support in postoperative chemotherapy patients diagnosed with cervical cancer.

Methods: A total of 132 participants were recruited from the gynecology department of Wenzhou Medical University's First Affiliated Hospital using a random sampling technique. Data were collected between December 2023 and April 2024 using validated instruments. Descriptive statistics and Spearman's rank correlation were used for data analysis.

Results: The average stigma score was 76.3 (SD = 10.84), indicating a high level of stigma. Self-efficacy, self-esteem, illness perception, and social support were negatively correlated with stigma (r = -0.085, r = -0.158, r = -0.254, r = -0.238, all p <0.05).

Conclusion: All participants experienced significant stigma. The negative correlations found between stigma and self-efficacy, self-esteem, illness perception, and social support offer a theoretical basis for developing nursing interventions to reduce stigma in these patients.

Background: Metabolic syndrome (MetS) is a cluster of chronic conditions, including central obesity, hypertension, impaired glucose metabolism, and dyslipidemia (low HDL, high LDL, and triglycerides). A diagnosis of MetS is made when three or more of these symptoms are present. If left unmanaged, MetS can lead to serious health complications such as cardiovascular disease and type 2 diabetes. Over time, individuals with MetS may experience a decline in their health-related quality of life (HRQoL), especially due to its chronic nature.

Objective: This study aimed to evaluate the effects of changes in MetS status on HRQoL.

Methods: This study employed a cross-sectional design. Secondary data from the cohort study of Non-Communicable Disease (NCD) risk factors, conducted by the Health Research and Development Agency of the Ministry of Health of the Republic of Indonesia in Bogor City, was used. Data from four follow-up periods (2011/2012 to 2017/2018) were analyzed. A total of 874 respondents were selected via total sampling based on inclusion and exclusion criteria. Data were collected in 2021, which included measures of knowledge, health check-ups, and HRQoL using the SF-36 questionnaire. Statistical analyses, including chi-square tests, t-tests, and multiple regression analyses, were conducted to examine the associations between MetS status and HRQoL.

Results: Descriptive analysis revealed that 19% (171 participants) had worsened MetS status, while 80.4% (703 participants) showed improvement. Chi-Square analysis found that respondents with worsening MetS status were 1.6 times more likely to experience poor HRQoL in the physical dimension (95% CI = 1.1-2.3), but no significant effect was found for the mental dimension (PR = 1.1, 95% CI = 0.8-1.6). Multiple logistic regression analysis revealed that comorbidities interacted with worsening MetS status to significantly affect HRQoL in the physical dimension. The adjusted prevalence ratios (PR) were 27.5 (95% CI = 10.3-73.2) for those with comorbidities and 9.2 (95% CI = 5.7-15.0) for those without comorbidities, after controlling for age, mental health, BMI changes, routine health checks, and knowledge.

Conclusion: Changes in MetS status towards worsening have a significant negative effect on HRQoL, particularly in the physical dimension. The presence of comorbidities in individuals with worsening MetS status greatly increases the risk of poor HRQoL. Healthcare professionals and nurses should consider the interaction between MetS and comorbidities in patient management. Nurses are encouraged to monitor HRQoL in patients with MetS, promote education on managing comorbidities, and collaborate across disciplines to enhance patient care and intervention programs aimed at improving HRQoL.

Background: A child with congenital heart disease requires complex surgeries and intensive postoperative care, causing significant stress for caregivers. Muslim caregivers, in particular, rely on their faith for strength.

Objective: To explore the experiences of Muslim mothers caring for children who have undergone open heart surgery due to congenital heart disease.

Methods: The study used a qualitative descriptive design conducted between February and June 2023. Data were collected through in-depth interviews with 12 Muslim mothers selected through purposive sampling, and thematic analysis was employed for data analysis.

Results: Three main themes identified: 1) Strengthening faith and trust in God, which includes two subthemes-embracing acceptance amidst divine attribution and utilizing faith and belief as a wellspring of spiritual shelter, 2) Cultivating patience and resilience in life, encompassing two subthemes-endurance in caring with unconditional love and fostering resilience for coping strategies, and 3) The significance of social support systems, consisting two subthemes-healthcare professionals' support and family support.

Conclusions: This study revealed the complex emotional experiences, including sadness, loss, uncertainty, and resilience, of Muslim mothers whose children face open heart surgery and highlighted the vital role of holistic support from healthcare professionals and families. Recommendations in line with holistic nursing principles include providing comprehensive information, faith-based psychological support, and involving the family's caregiving capacity. The study also calls for further research within the holistic nursing context, including programs to enhance psychosocial support in similar situations.

Background: Acute coronary syndrome (ACS) is a severe cardiovascular condition that can lead to acute myocardial infarction (AMI), resulting in significant morbidity and elevated mortality rates.

Objective: This study aimed to examine complications arising from ACS in patients admitted to a tertiary hospital and identify the influencing factors.

Methods: A cross-sectional study was conducted between February and December 2021 among patients diagnosed with ACS at the tertiary hospital in Northeastern Thailand. The sample included 133 participants hospitalized for ACS. Simple random sampling was employed, with data collected from the patient registry by selecting 15 individuals at a time until the target of 1,998 patients was reached. Statistical analyses included descriptive statistics, Chi-Square test, Fisher's exact test, and binary logistic regression to identify significant predictors of complications in this population.

Results: Factors influencing the occurrence of major adverse cardiac events (MACE) included cardiac function and the need for cardiopulmonary resuscitation (CPR). Patients with New York Heart Association (NYHA) class II-IV had a significantly higher risk of MACE compared to those with NYHA class I (p <0.001; 95% CI, 2.008-10.984). Additionally, patients who received CPR were 4.15 times more likely to experience MACE than those who did not receive CPR (p <0.05; 95% CI, 1.029-16.729).

Conclusions: This study demonstrated that cardiac function and the necessity for CPR significantly influence the development of MACE in patients with ACS. These findings highlight the importance of thorough evaluation and monitoring by healthcare teams during hospitalization, particularly for patients with abnormal cardiac function or a history of CPR. Prompt identification and targeted interventions for high-risk individuals can improve outcomes and reduce complications. Nurses should prioritize follow-up evaluations for ACS patients with NYHA class II-IV or those who have undergone CPR, as these individuals are at elevated risk for developing MACE.

Background: Central venous catheter-related infections (CVC-RIs) are a significant concern in intensive care units (ICUs), contributing to increased morbidity, mortality, and healthcare costs. Nurses play a crucial role in preventing these infections through proper catheter care, adherence to aseptic techniques, and early detection of complications. However, knowledge gaps may hinder effective infection prevention and patient outcomes.

Objective: This study aimed to evaluate ICU nurses' knowledge of CVC-RI prevention and identify factors influencing their knowledge.

Methods: A cross-sectional study was conducted among 202 ICU nurses in Al-Jouf, Saudi Arabia, from April to June 2023. Data were collected using a self-reported questionnaire assessing knowledge across eight domains: CVC-RI pathophysiology, diagnosis, catheter insertion sites, frequency of CVC changes, skin antisepsis, dressing changes, use of antibiotics/antiseptic ointments, and general CVC care. Statistical analyses included frequency, percentage, mean, standard deviation, Mann-Whitney, Kruskal-Wallis, and univariate and multivariate logistic regression.

Results: The mean knowledge score was 5.8 ± 2.3. The highest knowledge was observed in catheter insertion sites (47.8% of the total score), followed by CVC-RI diagnosis (34.9%) and dressing change frequency (40.3%). The lowest score was in CVC-RI pathophysiology (14.6%), indicating a significant knowledge gap. Age, education, training on CVC-RI prevention, and the source of information significantly influenced knowledge (p <0.05). Multivariate analysis revealed that education (p = 0.002) and receiving information on CVC-RI (p = 0.007) were significant predictors of higher knowledge. Nurses who received information from the Infection Control Unit demonstrated the highest knowledge levels (p = 0.008).

Conclusion: The findings emphasize the need for targeted educational programs and continuous professional development to address knowledge gaps in CVC-RI prevention. Healthcare institutions should prioritize up-to-date curricula, ongoing training initiatives, and reliable information sources to enhance ICU nurses' ability to prevent catheter-related infections and improve patient care outcomes. It is essential for nurses to actively engage in ongoing training to close knowledge gaps and enhance their role in infection prevention.

Background: Sociocultural and behavioral factors have a multifaceted impact on maternal health. In Thailand, cultural influences significantly shape behaviors of diabetes self-management in women. However, the experience of self-managing diabetes in pregnant women with preexisting Type 2 Diabetes Mellitus (T2DM) remains unclear.

Objectives: The study aimed to explore challenges and support factors of diabetes self-management among pregnant women with preexisting T2DM in Thailand, and to compare these factors between women in two groups (optimal and suboptimal maternal health outcomes).

Methods: A convergent mixed-methods study was conducted at a tertiary hospital (March to October 2022). Eligible participants were Thai pregnant women, aged 20-44, diagnosed with T2DM. Participants first completed a questionnaire and then were interviewed about diabetes self-management. Maternal health outcomes (i.e., gestational weight gain and glycated hemoglobin [HbA1c]) were reviewed and extracted. Descriptive statistics were used for quantitative analysis, while directed content analysis was used for qualitative data. Side-by-side matrices were used to describe the qualitative subthemes with quantitative results.

Results: Twelve Thai pregnant women participated in the study, aged 27 to 40 years, with gestational ages ranging from 7 to 38 weeks and T2DM diagnoses spanning from 3 weeks to 10 years. Half of the participants were obese before pregnancy. Weight gain patterns revealed that 41.67% had inadequate gain, 33.33% had optimal gain, and 25% had excessive gain. HbA1C levels indicated that 75% had good glycemic control. Three women achieved optimal weight gain and glycemic control, while nine exhibited suboptimal health outcomes. We identified six main themes: 1) challenges at the individual level in managing diabetes, 2) support factors at the individual level for diabetes management, 3) challenges at the interpersonal level in controlling diet, 4) interpersonal support factors for managing diabetes, 5) challenges at the societal level in accessing healthcare, and 6) societal support factors for healthcare access.

Conclusion: The findings suggest that managing diabetes during pregnancy necessitates dynamic, patient-centered care throughout the pregnancy journey. Regarding the clinical implication, it is important to tailor approaches to the Thai context and to prioritize education and boost women's confidence in managing diabetes throughout pregnancy.

Background: Engaging in health-promoting activities is crucial for maintaining overall well-being. However, parents of children with disabilities often face unique challenges that can impact their ability to engage in such activities. These challenges may include increased caregiving responsibilities, limited access to resources, and emotional and physical burdens, which may hinder their involvement in health-promoting behaviors.

Objective: This study aimed to assess and compare health-promoting activities among parents of children with and without disabilities, with a focus on identifying key differences and associated factors that influence their health and well-being.

Methods: A quantitative cross-sectional study was conducted with 118 parents of children aged 3 to 18 years recruited via social media and centers for children with disabilities in the Kingdom of Saudi Arabia. Data were collected using the eight-item Health-Promoting Activities Scale (HPAS) and demographic variables. The study utilized descriptive statistics, chi-square test, t-test, and ANOVA for data analysis, conducted using SPSS version 25.

Results: The results showed that parents of children with disabilities had significantly lower HPAS scores (31.73 ± 10.21) compared to parents of children without disabilities (34.83 ± 8.05), although this difference was not statistically significant (p = 0.082). Parents of children with disabilities reported significantly lower frequencies of spiritual or rejuvenating personal time (p = 0.032) and social activities (p = 0.011). Additionally, higher education (p = 0.023) and better health status (p = 0.005) were positively associated with higher HPAS scores among parents.

Conclusion: This study's findings highlight the significant impact that caring for a child with a disability can have on parents' health-promoting behaviors. Factors such as education and health status were found to play a crucial role in shaping these behaviors. The results suggest the need for tailored interventions and support programs by nurses and healthcare providers to enhance the well-being of parents of children with disabilities.

Background: Self-management behaviors are essential to take care of chronic obstructive pulmonary disease (COPD). However, data on COPD self-management practices in Sri Lankan adults is limited. Therefore, identifying the level of COPD self-management and examining its influencing factors are essential for healthcare providers to manage COPD effectively.

Objectives: This research aimed to describe the level of self-management behaviors and determine whether dyspnea, perceived stress, COPD knowledge, and social support can predict self-management in adults with COPD in Colombo, Sri Lanka.

Methods: A predictive correlational study was conducted, and 108 adults with mild to moderate COPD were recruited from the central chest clinic in Colombo, Sri Lanka, from March to April 2024 using a simple random sampling technique. A self-administered questionnaire was used to gather data included demographic characteristics. The other instruments used were the COPD Self-Management Scale, the Perceived Stress Scale, the COPD Knowledge Questionnaire, and the Perceived Social Support Scale. Descriptive statistics and multiple regression were used for data analysis.

Results: The study showed a moderate self-management level with a mean of 3.04 ± 0.35. All variables could explain 41.7% of the variance in self-management among adults with mild to moderate COPD and COPD self-management behaviors significantly predicted by dyspnea (β = 0.212, p = 0.006), perceived stress (β = -0.195, p = 0.018), COPD knowledge (β = 0.263, p = 0.001), and perceived social support (β = 0.366, p <0.001).

Conclusion: The study shows evidence that a program to intervene targeting COPD knowledge and perceived social support, in addition to reducing dyspnea and perceived stress, can be beneficial in promoting better self-management behaviors among adults with mild to moderate COPD.

Background: To effectively advance person-centered care (PCC) practice, it is important to equip healthcare providers with person-centered values and beliefs while simultaneously transforming their work environment to align with PCC. Thus, instruments to measure caring practice status in nursing competency for psychiatric-specific behavioral limitations, ethico-moral behavior, technology use, and PCC need to be developed.

Objective: This study developed the Technological Competency as Caring in Psychiatric Nursing Instrument (TCCNPNI) to measure practice status and test its content and construct validity.

Methods: Five different phases were followed: 1) Literature Review; 2) Operational definition of the construct and development of items; 3) Two-round Delphi method; 4) Validity measure; and 5) Reliability measure. The online survey was conducted in 2024.

Results: The developed instrument comprises 22 items with a 4-factor structure: competency to practice caring and person-centered care (Factor 1); competency to recognize and respond to ethical issues in psychiatry (Factor 2); competency to utilize technology in psychiatry (Factor 3); and competence to practice care for the preservation of human dignity and shared decision making (Factor 4). Cronbach's alpha for the entire scale was 0.864, while that for factors 1-4 was 0.911, 0.814, 0.773, and 0.64, respectively. Cumulatively, these four factors contributed 49.6% and explained nearly 50% of the total data. Item-total correlation values were 0.6 or higher among factors 1-3. However, factor 4, for which items were Q30, Q33, Q34, and Q35 (r = 0.03, 0.04, 0.21, 0.11, respectively), were inverted items and had low I-T correlation values. These low correlations suggest that these items capture different concepts. The developed TCCNPNI allows for the measurement of the practice of nursing as caring in psychiatry, the state of ethico-moral behavior, and the practice status of technological competency as caring in psychiatric nursing.

Conclusion: This study demonstrated satisfactorily and efficiently evaluated the practice status of technological competency in psychiatric nurses' caring. Measuring technological competency as caring in psychiatric nursing can be an important adjunct for in-service education in psychiatric hospitals or formalized nursing education in nursing universities.