Research in Nursing & Health最新文献

This study investigates the psychometric properties of the Mutuality Scale in a sample of patient-caregiver dyads following a recent episode of coronary heart disease. A cross-sectional analysis was conducted. Factorial validity was tested with confirmatory factory analysis. Internal consistency reliability was investigated with the model-based internal consistency reliability index. Pearson's correlation coefficient was used to test convergent validity between mutuality and other theoretical and empirical variables associated with it. We included 150 patient-caregiver dyads (patient: mean age 65 years, 77% males, 71% married; caregiver: mean age 54 years, 21% males, 71% married). The CFA testing the theoretical four-factors (love, shared pleasurable activities, shared values, and reciprocity) of mutuality demonstrated adequate fit to the data in both the patient and caregiver version of the scale. Reliability estimates were adequate for the whole scale (model-based internal consistency index = 0.95). Significant positive correlations were observed between mutuality and self-care behaviors, and caregiver preparedness, supporting convergent validity. The Mutuality Scale demonstrated satisfactory structural and convergent validity and reliability in patient-caregiver dyads after the onset of a coronary heart disease event.

Postpartum depressive symptoms (PDS) are a common mental health condition among women after delivery. Although various causative factors have been reported, PDS remains a challenging condition to predict and prevent. The disruption of the gut microbiota due to antibiotic exposure has been reported to affect psychiatric conditions. Similarly, previous research suggests that antibiotic exposure during pregnancy could be related to PDS. Therefore, this prospective study examines the association between antibiotic exposure during pregnancy and PDS for 6 months after delivery. Data were obtained from 65,272 mothers from the Japan environment and children's study, a prospective birth cohort study. The ratios of maternal PDS at 1 and 6 months after delivery were 12.3% and 10.1%, respectively. During pregnancy, 10.7% of women took antibiotics orally. Antibiotic exposure during pregnancy was associated with an increased risk of PDS only at 6 months after delivery (OR = 1.13, 95% CI [1.00, 1.26]), adjusted for potential confounding factors. An increase in Edinburgh Postnatal Depression Scale scores in relation to antibiotic exposure during pregnancy was primarily observed via psychological distress during pregnancy. Although a causal link was not established, antibiotic exposure during pregnancy may be a contributing risk factor for PDS. Therefore, when antibiotic administration is required, clinical practitioners and perinatal care providers should consider the potential risk for PDS.

The social determinants of health (SDOH) have been recognized as an important contributor to an individual's health status. A valid and reliable instrument is needed for researchers and clinicians to measure SDOH. However, there is considerable variability in the screening methodologies, as well as a lack of standardization in definitions and methods for capturing and reporting SDOH data for both electronic health record software vendors and national experts on SDOH. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE) is a commonly used instrument for measuring SDOH. We evaluated the psychometric properties of the PRAPARE instrument in patients with coronary heart disease (CHD) and heart failure (HF), focusing on its reliability and validity for assessing SDOH. We assessed internal consistency, test-retest reliability, and construct validity using data from 234 patients with CHD and/or HF recruited from outpatient clinics in Kentucky. The PRAPARE instrument demonstrated high internal consistency (KR-20 score: 0.76) and test-retest reliability (correlation coefficient: 0.88). Factor analysis identified three distinct factors (Factor I: basic necessities and services, Factor II: housing and personal well-being, and Factor III: insurance, education, and work situation) of SDOH. PRAPARE scores were significantly correlated with depressive symptoms (PHQ-9 scores) and functional outcomes of sleep (FOSQ-10 scores). PRAPARE is a reliable and valid instrument for assessing SDOH in patients with CHD and HF, highlighting its potential for clinical and research applications.

While the coronavirus disease 2019 (COVID-19) pandemic has declined, many survivors continue to suffer debilitating symptoms, such as fatigue, pain, and foggy thoughts. Sustained COVID-19 symptoms, or Long COVID, challenge health care resources and economic recovery. This article describes the methodology, implementation, and results of an observational study investigating how time since diagnosis may affect lingering symptoms among the adult COVID-19 population. The descriptive distribution and overall symptoms experience by individuals' characteristics were examined. Random samples from two patient cohorts (n = 147 in 2020-2021 and n = 137 in 2021-2022) were recruited from a COVID-19 patient registry in mid-Michigan. Samples were drawn from a pool of patients ≥ 3 months following their COVID-19 diagnosis. Overall symptoms experience (number, severity, interference) was self-reported using a comprehensive symptom inventory. The findings showed that 66% of the 2020-2021 cohort and 47% of the 2021-2022 cohort reported ≥ 1 lingering symptom with an average of 11.2 (±3.0) and 8.9 (±3.3) months, respectively, after COVID-19 diagnosis. Females reported significantly more symptoms (p = 0.018), higher symptom severity (p = 0.008) and interference (p = 0.007) compared to males. Compared to patients admitted to emergency departments, outpatients reported significantly lower symptom severity (p = 0.020) and less symptom interference (p = 0.018). Our analyses showed that a moderate proportion (43%) of adults remained symptomatic nearly a year after COVID-19 infection and time since diagnosis did not affect symptom experience in either cohort. Female sex and admission setting are important factors to consider for managing and studying Long COVID.

This study determines video's effect on pregnant women's pain, anxiety, and perception of labor using virtual reality glasses during the active and transition phases of childbirth. This randomized controlled study was conducted with 60 pregnant women (30 in each group) admitted to the delivery room of a hospital. The data were collected by personal information form, visual comparison scale-pain, visual comparison scale-anxiety, and perception of birth scale. While there was no significant difference between the groups in terms of pre-intervention pain measurement in the active and transition phases, post-intervention pain measurement in the active and transition phases in the intervention group was found to be significantly lower than the control group. Anxiety measurement was also found to be significantly lower in the intervention group in the active and transition phases than in the control group after the intervention. It was determined that in the intervention group, anxiety measurements tended to decrease after the intervention compared to the pre-intervention period, while in the control group, anxiety measurements tended to increase continuously in the active and transition phases. Perceptions of birth in the postpartum period were similar. The use of virtual reality during childbirth reduces pain and anxiety at birth but does not affect the perception of birth. The use of virtual reality interventions as a nonpharmacological method can be included in childbirth preparation training. Trial Registration: NCT05495009.

To translate and adapt the English version of the Caregiver Contributions to Self-Care of Heart Failure Index (CC-SCHFI) to Chinese, and further to investigate the psychometric properties of the Chinese version of CC-SCHFI in a cohort of caregivers of people with heart failure. CC-SCHFI translation and cross-cultural adaption were performed. 240 caregivers were recruited to complete the instrument. The internal construct reliability was evaluated by Cronbach's α and item-to-total correlations. The concurrent validity was tested by using the CACHS which also measures caregivers' contribution to HF self-care. Psychometric analysis was performed with confirmatory factor analysis (CFA). We evaluated 4-factor structure for caregiver contribution to self-care maintenance scale, 1-factor structure for caregiver contribution to self-care management scale and 2-factor structure for confidence in contributing to self-care scale. All the subjects successfully completed the interviews in an average of 12.3 ± 3.2 min. The internal consistency reliability analysis of the CC-SCHFI showed Cronbach α of 0.83. All items showed adequate discrimination, with the item-total correlation coefficient of greater than 0.4. The scores of CC-SCHFI scales were significantly correlated with the CACHS scale scores. The correlation coefficients ranged from 0.341 to 0.765, indicating acceptable concurrent validity. For CFA, all factor loadings were significant at > 0.30 and generally medium to high. The simplified Chinese version of CC-SCHFI is a psychometrically reliable instrument with empirically supported validity, which can be applied to clinical evaluation of the contribution of caregivers to HF self-care. Compared with CACHS, CC-SCHFI can be more easily completed and simultaneously maintains acceptable concurrent validity. Further studies are warranted to investigate the combined use of these two instruments among other populations.

Nurses are required to decide on priorities; however, how they prioritize the interventions toward patients with delirium is still unclear. Therefore, expanding the knowledge on (a) how nurses prioritize interventions to manage episodes of delirium and (b) the underlying prioritization patterns were the aims of this study. The Q-methodology was applied in 2021. A systematic review to identify the recommended interventions for patients with delirium was performed, and a nominal group technique was used to select those interventions that are applicable in daily practice (35 out of 96 identified). Then, using a specific scenario, 56 clinical nurses working in hospital medical (n = 31), geriatric (n = 15), and postacute (n = 10) units were asked to order the 35 interventions (from -4 the lowest to +4 the highest priority) using a Q-sort table. Averages (confidence interval at 95%) were calculated at the group level, and a by-person factor analysis was applied to discover underlying patterns of prioritization at the overall and at the individual levels. At the group level, "Ensuring a safe environment (e.g., reducing bed height)" was ranked as the highest priority (2.29 out of four); at the individual level, three prioritization patterns accounting for a total variance of 50.21% have emerged: "Individual needs-oriented" (33.82% variance explained; 41 nurses); "Prevention-oriented" (8.47%; five nurses); and "Cognitive-oriented" (7.92%; six nurses). At the group level, nurses prioritize safety while caring for patients with delirium; however, at the individual level, they follow three different patterns of prioritization oriented toward diverse aspects, suggesting uncertainty in the actions to be taken-with potential implications for patients.

Women of reproductive age with cancer face unique considerations in terms of fertility. The related decision-making process is complicated, and insufficient support can lead to decisional conflict. The aim of this qualitative systematic review was to identify and integrate qualitative evidence regarding the fertility decision-making process of women of reproductive age undergoing treatment for cancer. A qualitative systematic review was conducted following the Joanna Briggs Institute's methodology. Eight electronic databases were searched from inception to June 2023 for articles describing qualitative studies of the fertility decision-making process of women of reproductive age with cancer. Only original, full-text literature was examined, no limitation was placed on the publication language. Finally, 18 studies were included in a thematic analysis. We identified three analytical themes, namely "Perceived changes in fertility," "Influential participants in the decision-making process" and "Hard fertility decision-making processes of women," and nine descriptive themes that described the three analytical themes in detail. The results of qualitative synthesis emphasized that for women of reproductive age with cancer, fertility decision-making is a complex and dynamic process. These patients had experienced decisional conflict. Decision support from health care professionals was considered to be essential, and the use of patient decision aids in clinical settings was recommended. The synthesis results clarify women's fertility decision-making process, decision needs and the influencing factors, which offer evidence to guide the development of applicable patient decision aid tools to provide high-quality fertility services to women. TRIAL REGISTRATION: PROSPERO Registration Number: CRD42023434490.

High blood pressure and excess weight during pregnancy can have adverse outcomes. This randomized controlled trial evaluated the effects of a nurse-led smartphone application-based lifestyle intervention on blood pressure, body weight, and pregnancy outcomes in pregnant women with gestational hypertension between August and December 2023. Pregnant women, between 20 and 28 weeks of gestation, were allocated to the intervention or control group. Control group (n = 99) received standard high-risk pregnancy management, while intervention group (n = 96) also received lifestyle guidance via a nurse-led smartphone application. Intervention group experienced longer gestations (p = 0.007), higher neonatal weights (p = 0.028), and lower incidences of pre-eclampsia (p < 0.001), small for gestational age infants (p = 0.003), and preterm births (p = 0.023) compared to control group. The mixed-effect models for repeated measures showed that the nurse-led smartphone application intervention had no impact on body mass index, while significantly reducing systolic and diastolic blood pressure measurements (β = -1.666, 95% confidence interval, CI: -2.814 to -0.519, p = 0.005 and β = -2.247, 95% CI: -3.349 to -1.145, p < 0.001, respectively). Both systolic and diastolic blood pressures showed a downward trend from 28 weeks (p < 0.05). The nurse-led smartphone application-based lifestyle intervention significantly reduced adverse pregnancy outcomes and positively influenced blood pressure management in pregnant women with gestational hypertension.