Clinical Nursing Research最新文献

The purpose of this study was to determine magnitude and associated factors of maternal near miss among women seeking obstetric and gynecologic care. A hospital based cross-sectional study design was implemented in selected public hospitals of Tigrai. Systematic random sampling method was used to select study participants. Data were entered to epi data manager version 4.1 and exported to Statistical Package for social science version 20 for analysis. Bivariate and multivariate logistic regression was used to identify factors associated with maternal near miss. The magnitude of maternal near miss was found to be 7.3%. Regression analysis showed that, mothers who reside in rural area, had distance of greater than 10 km, referred from low level health institution, and mothers had no antenatal care follow up were significantly associated with maternal near miss. Therefore, promoting antenatal care and increasing awareness in rural areas related with maternal health care services is recommended.

Major depressive disorder and anxiety disorders are among the major public health issues. Therefore, identifying predictors of symptoms of depression and anxiety holds fundamental importance to avoid the aggravation of these conditions. Muscle strength and function (e.g., handgrip strength and timed-stands test) are widely recognized predictors of health outcomes; however, their association with symptoms of depression and anxiety is still not completely understood. This study investigated the associations between handgrip strength and timed-stands test scores with symptoms of depression and anxiety. In addition, we examined whether individuals exhibiting greater strength levels demonstrate reduced symptoms of anxiety and depression compared to those with lower levels of strength. This is a community-based, cross-sectional study. Participants were recruited through social media and underwent a semi-structured interview to record sociodemographic characteristics, comorbidities, use of tobacco and medication, and symptoms of anxiety (Beck's Anxiety Inventory [BAI]) and depression (Beck's Depressive Inventory [BDI]). Subsequently, anthropometric characteristics, handgrip strength, and functionality (i.e., timed-stands test) were assessed. In all, 216 individuals were evaluated. The adjusted regression model showed an inverse association between handgrip strength and anxiety (β = -0.22; 95% CI [-0.38, -0.07]; R² = 0.07, p = .005) and depression symptoms (β = -0.25; 95% CI [-0.42, -0.07]; R² = 0.05, p = .006). Similarly, timed-stands test scores were associated with anxiety (β = -0.33; 95% CI [-0.54, -0.13]; R² = 0.09, p = .002) and depression (β = -0.32; 95% CI [-0.56, -0.09]; R² = 0.06, p = .008). Furthermore, the low-strength group showed higher values on the BAI (9.5 vs. 5.9 arbitrary units; p = .0008) and BDI than the high-strength group (10.8 vs. 7.9 arbitrary units; p = .0214). When individuals were stratified by the timed-stands test, the low timed-stands group demonstrated higher values on the BAI (9.9 vs. 5.5 arbitrary units; p = .0030) and BDI than the high timed-stands group (11.2 vs. 7.5 arbitrary units; p < .0001). The results highlight muscular parameters as significant predictors associated with anxiety and depression symptoms.

Prenatal depression is highly prevalent, but its relationship with the multidimensional burden of physical symptoms during pregnancy remains underexplored. The aim of this study was to examine the relationship between pregnancy-related physical symptom burden, including frequency, severity, and impact on life and pregnancy adaptation to prenatal depression, and to identify predictors of depression during pregnancy. The study was cross-sectional in design. A hospital-based setting providing comprehensive maternity care services from outpatient to inpatient. The sample consisted of two hundred forty-three pregnant individuals aged 20 and above with no major obstetrical complications. Structured questionnaires including demographic and obstetrical characteristics, depression, symptom burden, and pregnancy adaptation were used for data collection. Multiple linear regression analyses were performed to identify significant predictors of depression. The study revealed that approximately 32% of the variance in depression scores could be explained by the combined effects of pregnancy-related physical symptom burden and pregnancy adaptation. Specifically, low-level pregnancy adaptation, high-level symptom impact on life, unmarried status, and mid-level symptom severity were identified as the main predictors of prenatal depression among low-risk pregnant individuals. The findings contribute to the existing knowledge base, emphasizing the significance of addressing and managing pregnancy-related physical symptom burden while promoting effective adaptation to pregnancy as a means to mitigate the risk of prenatal depression.

The school nurse has a crucial role in the United States and the United Kingdom and has their own expertise dedicated to school assistance for children, families, school staff, and the community. This study aims to identify the role and skills of the school nurse and understand the effects of COVID-19 on nursing skills in the following countries: The United States, the United Kingdom, and Italy. A Scoping Review was conducted following the JBI methodology for scoping reviews, following the PRISMA-ScR guidelines. Three databases were consulted: PubMed, Cinahl, and Scopus. In all, 58 studies met the eligibility criteria and were included. 93.1% of the studies were carried out in the United States, 5.2% in the United Kingdom, and 1.7% in Italy. 34.5% of the articles were published in 2020, 15.5% in 2021, 31% in 2022, and 19% in 2023. 22.4% of the studies included in the review concerned health promotion and education. Regarding the methodology of the studies, 41.5% of the studies were commentary papers, 15.5% were observational studies, and 12% were cross-sectional studies. Considering the effects of the school nurse in the United States and the United Kingdom, it is possible to reflect on how the systematic presence of a nurse could also have benefits in Italy.

Screening for adolescent sexual activity is a vital aspect of comprehensive pediatric care. Adolescents engage in risky sexual behaviors. Thus, a complete and accurate sexual health history can assist in the prevention and treatment of disease, prevention of unwanted pregnancy, treatment of existing diseases, and optimal planning of future healthcare for adolescents. Current evidence shows that provider-focused strategies improve the delivery of preventive services, including sexual health screenings. In this initiative, we assessed and examined pre- and post-screening rates for sexual activity among adolescents by advanced practice providers. This multi-site initiative was implemented in four school-based health centers and a school-linked center that included 2,102 unique patients ages 9 to 24 years. Our biphasic intervention included education for advanced practice providers and electronic health record modifications. Pre- and post-data collection was conducted to determine changes in the rate of screening for sexual activity during a primary care adolescent health visit over a 3-year period. Data were collected via retrospective medical chart review and analyzed in three time periods for comparison from 2018 to 2021. Screening rates for sexual activity increased significantly after the intervention (all p < .001) with the likelihood more than double that of the year before it was implemented. The intervention was deemed to be a feasible and cost-effective strategy to improve the provider's willingness and ability to provide more adolescent sexual health screenings.

Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t-test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program.

Purpose: To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics.

Setting/sample: A total of 810 participants across eight sites located in three countries.

Measures: Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test.

Analysis: Both univariate and multivariant analyses were used.

Results: Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = -1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84-31.98, p < .001), hip-waist ratio (β = -2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R² = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = -0.10, p = .120). Among the covariates, age (β = -0.16, p < .001), gender (β = -0.43, p < .001), education (β = 0.08, p = .026), and hip-waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R² = .081). We found a modest significant relationship between physical function and functional exercise capacity (r = 0.27).

Conclusions: Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.