Nursing & Health Sciences最新文献

Supporting youth mental health is a priority; currently, one in 10 young people experience a mental health disorder. Accordingly, integrated youth health services are a focus for service development both in the United Kingdom and internationally. Less attention is given to inpatient settings and the experiences of young people who use them. This in-depth qualitative study aimed to understand the experiences of people aged 16-25 years, admitted to inpatient mental health settings, and the experiences of staff caring for them. Individual interviews with seven inpatient young people and three focus groups with staff (N = 27) were conducted. An Interpretative Phenomenological Analysis (IPA) methodology with a polyvocal design was used. Young people reported how the impact of restriction, lack of inclusion, information, and transparency affected their experiences. Relationships with other young people and staff were important while shared experiences were especially salient. Staff identified difficulties of working within a system divided into separate services while attempting to work flexibly with young people. Future practice needs to enhance relational, inclusive, and flexible working practices to optimize care delivery.

The COVID-19 pandemic has severely impacted global healthcare systems and significantly affected individuals living with HIV. In South Africa, where the HIV epidemic is prevalent, strict lockdown measures were introduced to curb COVID-19 transmission. This study explores the effects of these lockdown regulations on the initiation of antiretroviral therapy (ART) among HIV-positive individuals in Johannesburg. Employing a quantitative retrospective chart review design, the research analyzed ART initiation trends in Soweto before, during, and after the lockdowns using medical records from selected clinics in Region D. Data were collected with a checklist, and descriptive analysis was performed. The findings revealed a 40% decrease in ART initiation at community health centers (CHCs) during the lockdowns, compared to a 20% decrease in clinics. Additionally, clinics maintained a patient retention rate of 75%, whereas CHCs saw only 55%. These results highlight significant disparities in healthcare access and outcomes during the pandemic, indicating that COVID-19 threatens to reverse progress in the global HIV response, emphasizing the need for targeted interventions to sustain advancements in fighting HIV.

To investigate the predictive relationships between frailty, nutritional factors, and Quality of Life (QoL) on the vulnerability of older adults enrolled in Primary Health Care (PHC) in an urban area. This was a cross-sectional study conducted with community-dwelling older adults. Participants receiving care in PHC in two Brazilian municipalities located in a sparsely populated region were recruited. The instruments used were Vulnerable Elders Survey (VES-13), Mini Nutritional Assessment (MNA), Edmonton Frailty Scale (EFS), and Medical Outcomes Study Short Form-36 (SF-36). Association analyses, Spearman's correlation, and binary logistic regression were used. A total of 323 individuals were included. Binary logistic regression revealed frailty (EFS) as the main predictor of vulnerability (R² = 0.20; p < 0.001; OR = 1.35 [95% CI: 1.24-1.48]), with functional independence (R² = 0.25; p < 0.001; OR = 3.9 [95% CI: 2.74-5.73]) and functional performance (R² = 0.17; p < 0.001; OR = 3.21 [95% CI: 2.21-4.67]) being the domains that most strongly increased the odds of vulnerability. Impaired nutrition showed a consistent predictive association (R² = 0.11; p < 0.001; OR = 0.82 [95% CI: 0.76-0.89]). Frailty and poor nutritional status were predictors of vulnerability, with particular emphasis on physical-functional aspects. QoL showed a moderate to strong correlation with vulnerability, especially in the physical domains.

This study aimed to develop and validate the Scale of Women's Privacy Perception in Infertility Treatment (SWPPIT) to assess privacy perceptions during infertility diagnosis and treatment. A methodological design was used in two phases. In phase one, scale items were developed through qualitative observations and interviews with women undergoing ART. In phase two, validity and reliability were tested on 370 women at a private IVF center. Construct validity was established via exploratory and confirmatory factor analyses, and reliability was assessed using Cronbach's alpha and test-retest methods. The SWPPIT revealed a single-factor structure, explaining 45.19% of the variance, with factor loadings between 0.30 and 0.87. It demonstrated high internal consistency (Cronbach's alpha = 0.949) and excellent test-retest reliability (r = 0.98, p < 0.001). The final scale comprises 37 items rated on a 5-point Likert scale. The SWPPIT is a reliable and valid tool for evaluating women's privacy perceptions in ART settings, enabling healthcare professionals to address privacy concerns and enhance patient-centered care.

The purpose of this study was to explore the experience of treatment-related decision fatigue in patients with recurrent papillary thyroid cancer. Patients with recurrent papillary thyroid carcinoma who were followed up in thyroid surgery wards and outpatient clinics of three tertiary hospitals in Jiangsu Province were included in this study. Semi-structured interviews were conducted from January to April 2024. Inductive content analysis was used to identify themes. A total of 21 participants, aged 24-58 years, were interviewed. Two themes and six sub-themes were identified: manifestations of decision fatigue including impulsive decision making, hesitation, aggravation of negative emotions, and decision making is a burden; and consequences of decision fatigue including decision regret and delay in decision making. Our study identified the manifestations and adverse consequences of decision fatigue in patients with recurrent papillary thyroid cancer, and helped medical staff to identify and develop personalized interventions as early as possible to help patients make appropriate treatment decisions and improve the quality of decision-making and patient treatment outcomes.

The global rise in infertility highlights the need for personalized informational and psychological support. Digital health technology offers a promising avenue; however, knowledge gaps remain regarding optimal delivery methods, outcomes, and limitations. This scoping review synthesizes recent evidence on complementary interventions using technology for individuals with infertility undergoing reproductive technology-assisted interventions and evaluates their effectiveness and limitations. Seven databases were systematically searched to identify studies published in English or Korean between 2000 and December 2023. The risk of bias was assessed using the Joanna Briggs Institute checklist, and data were synthesized using a standardized template. Of 1353 screened studies, 16 were selected, featuring interventions such as web-based programs, mobile applications, and online meetings. Positive outcomes were observed in knowledge, stress reduction, self-efficacy, coping, and dietary behaviors. However, mixed results were found for fertility-related stress, depression, and anxiety, with no significant improvements in fertility-related quality of life, health behaviors, and pregnancy rates. While digital interventions show promise, further research is needed to validate their effectiveness through large-scale randomized controlled trials and to develop standardized assessment tools for better implementation and evaluation.

This retrospective cross-sectional study analyzed data from 2011 to 2021 across 154 countries to explore the relationship between gender equality, measured by the Gender Equality Index (GEI), female dementia incidence, and gender disparities at global and regional levels. Higher GEI scores were linked to elevated dementia incidence among women and an expanding female-male disparity, with the strongest associations observed in resource-limited countries undergoing rapid social and lifestyle transitions. Multiple regression identified GEI as the most significant predictor of both female dementia incidence and gender disparity, while economic affluence and urbanization showed no independent effects. Findings highlight a paradox: although gender equality advances women's access to education, employment, and healthcare, it may simultaneously increase exposure to dementia-related risk factors, including chronic stress, work-life imbalance, and lifestyle changes such as greater smoking and alcohol use. These results emphasize the importance of gender-sensitive public health strategies that address unintended health consequences of social progress. Interventions should prioritize stress management, workplace mental health, and lifestyle modification while accounting for disproportionate caregiving responsibilities, thereby supporting equitable cognitive health outcomes for women worldwide.

This study explores how medical and nursing students' personal bereavement experiences influence anticipated professional bereavement reactions and the mediating role of death attitudes. An online cross sectional survey was conducted with 405 medical and nursing students from Mainland China. Data included basic demographics, personal bereavement experiences within the past 2 years, death attitudes, and anticipated short-term professional bereavement reactions (anticipated SBR). Comparisons were made between students with and without bereaved experiences, and mediation pathways of "bereavement experience-death attitude-anticipated SBR" were analyzed. Students with personal bereavement scored significantly higher on overall anticipated SBR and its factors (frustration & trauma, guilt, grief, and moved). Approach acceptance partially mediated the relationship between bereavement and overall SBR, specifically influencing guilt and grief but not frustration & trauma or moved. Previous grief experiences impact anticipations about subsequent ones across different types of loss. Personal loss experiences within the past 2 years influence medical and nursing students' anticipated professional bereavement reactions by shaping death attitudes, and approach acceptance specifically mediates the relationship with expected guilt and grief.

This study aimed to determine the effects of preoperative mobilization education enhanced with the Teach-Back method on postoperative mobilization, recovery, and satisfaction in patients undergoing gynecological oncology surgery. This was a two-arm parallel-grouprandomized-controlled trial registered at https://www.clinicaltrials.gov (NCT05845086) and reported according to the Consolidated Standards of Reporting Trials checklist. The study was conducted with 102 patients between September 2023 and March 2024. The Patient Mobility Scale, Observer Mobility Scale, Postoperative Recovery Index, and Newcastle Satisfaction with Nursing Care forms were used to collect data. The intervention group received preoperative mobilization education enhanced with the Teach-Back method, besides the usual care; however, the control group received only usual clinical care. The patients in the intervention group exhibited higher levels of mobilization, recovery status, and satisfaction with nursing care than those in the control group. Preoperative mobilization education using the Teach-Back method effectively improved the mobilization process, recovery, and satisfaction of patients undergoing gynecological oncology surgery. Nurses working in the clinic should empower patients with knowledge and use the Teach-Back method in skill-oriented patient education.

Mental health disorders are a significant concern for older adults. Technology has the potential to provide support and companionship, which may improve mental health outcomes. This pilot experimental study explored the feasibility and potential effectiveness of the Ai-Aun chatbot in enhancing mental health among older adults in Thailand. Forty-four participants were randomly divided into an experimental group (n = 22) and a control group (n = 22). The experimental group interacted with the Ai-Aun avatar chatbot on an Android phone for 15 days. Mental health was assessed using the Thai Geriatric Mental Health Assessment Tool, and post-test scores were compared using ANOVA. The results showed a significant difference between the two groups, F(1, 42) = 15.85, p < 0.001, with an effect size of η² = 0.27. Satisfaction with the chatbot was notably high, with 81.8% of participants reporting ease of use and interactivity. These preliminary findings suggest that the Ai-Aun chatbot shows potential as a tool to enhance mental health among Thai older adults.