Public Health Nursing最新文献

Objective: To assess the effect of newborn care education programs on mothers' self-confidence, care knowledge, and exclusive breastfeeding behavior and anxiety.

Methods: We searched for intervention studies comparing newborn care education programs versus standard care for mothers in five comprehensive databases (July 2024). The risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. The R software version 4.2.2 software was used to perform the meta-analysis on mothers' self-confidence, care knowledge, exclusive breastfeeding behavior, and anxiety, and the GRADE approach was used to evaluate the certainty of evidence.

Results: Twenty trials involving 6136 mothers were included. The results of meta-analysis revealed that newborn care education program improved mothers' confidence scores (SMD = 1.25, 95% CI: [0.22, 2.28], p < 0.05), care knowledge level scores (SMD = 1.05, 95% CI: [-0.00, 2.09], p < 0.05), the frequency of exclusive breastfeeding (RR = 1.15, 95% CI: [1.10, 1.20], p < 0.05), and significantly decreased anxiety scores (SMD = -0.40, 95% CI: [-0.73, -0.07], p < 0.05) than standard care programs.

Conclusion: Our evidence supports the benefits of newborn care education programs in improving mothers' self-confidence, care knowledge, exclusive breastfeeding behavior (optimal duration of more than 6 months), and reducing anxiety. Newborn care education program is beneficial to mothers both in behaviors and psychology state of taking care of newborn. It is recommended conducting more well-designed intervention with large samples to verify current findings.

Objective: It was aimed to explore the relationship between successful aging and self-neglect and factors affecting successful aging among community-dwelling older people.

Methods: This cross-sectional study was conducted with 316 participants aged 60 years and older in a Family Health Center (FHC). The data were collected by using the questionnaire form, Successful Aging Scale and Self-Neglect Scale. The questionnaire form includes sociodemographic characteristics, independence (Katz Daily Life Activities Scale) and well-being status (WHO-5 Well-Being Index), psychosocial support (Multidimensional Perceived Social Support Scale), and depressive symptoms (two questions-complaints such as feeling depressed or hopeless and loss of interest and inability to enjoy life).

Results: Participants had a mean age of 67.5 (SD: 6.5) years, 55.4% were female. A strong positive correlation was determined between successful aging score and self-neglect score (r = 0.741, p < 0.001). Factors affecting successful aging were age, working status, education level, body mass index, physical activity, subjective health perception, health screening status, self-neglect level, depressive symptoms, independence in activities, well-being status, and psychosocial support. Gender, income status, chronic disease presence, cigarette and alcohol use, living alone, and family type did not affect it. According to multivariate linear regression, the factors affecting successful aging were age, psychosocial support presence, and self-neglect level (p < 0.05).

Conclusion: Older people have low successful aging and self-neglect scores. Successful aging is better at a young age, in the presence of psychosocial support and a low level of self-neglect. It is recommended to increase the existence of psychosocial support for them and to plan interventions to reduce self-neglect.

Objective: To measure a multivariate analysis of social media addiction and cognitive-behavioral physical activity associated with several sociodemographic characteristics in adolescent girls.

Design and methods: A cross-sectional study. The sample consisted of adolescent girls studying in a vocational high-school in the Middle-Black-Sea region in Türkiye (n = 333). A questionnaire, Social Media Addiction Scale-for-Adolescents (SMAS-A), and Cognitive-Behavioral Physical Activity Questionnaire (CBPAQ) were used to collect the data.

Results: The mean age was 15.35 (SD = 1.15), and 29.4% were the ninth-class students. Of the adolescent girls, 85.9% were social-media users, 59.8% used the internet 2-hours-or-more/daily, 67.9% declared themselves as moderately-active. The mean scores of the SMAS-A and the CBPAQ were 3.40 (SD = 1.61) and 21.03 (SD = 7.64), respectively. There was a significantly-negative correlation between cognitive-behavioral physical activity and social-media addiction levels. The One-Way MANOVA results showed significant differences in the academic level, family income, mother education, and physical activity measurement application usage affected to cognitive-behavioral physical activity. Social media usage habit affected to the social media addiction level.

Conclusions: Daily internet usage time and self-declared physical activity level were the mutually affected factors. School nurses should act to improve healthy social media usage habits to promote well-being and encourage the positive attitudes towards regular physical activity in this population.

Objective: To perform an economic evaluation to determine whether or not teledermatology (TD) units in primary care (PC) centers offer an alternative in terms of cost-utility and cost per quality-adjusted life years (QALYs) to conventional dermatology consultations (face-to-face dermatology [F-F/D]) at the hospital from the perspective of the Public Health System (PHS) and the patients.

Methods: This is a randomized, controlled, nonblinded, and multicenter study. During 6 months, data from 450 patients (TD: 225 vs. F-F/D: 225) were collected. From both perspectives, costs, quality of life, and costs per QALYs were analyzed. The QALY scores were estimated from the EuroQol-5D-5L (EQ5D-5L) questionnaire responses.

Results: From the perspective of the PHS, the cost per patient was 53.04% lower in the TD group (p < 0.001). Hospital visits decreased by 72.43% in the TD group (p < 0.001). From the patients' perspective, TD reduced costs per patient by 77.59% (p < 0.001). The cost per QALY was 63.34% higher in the F-F/D group (p < 0.001). The TD group's total costs were 56.34% lower (p < 0.001). Furthermore, patients in the TD group gained 0.05 QALYs more than those in the F-F/D group (p = 0.004).

Conclusions: This study shows that TD units in PC represent a significant cost-effective alternative to conventional hospital follow-up. To enhance TD in PC, it is important to introduce remote consultation platforms incorporating artificial intelligence for prediagnosis. This will enable general practitioners and nurses to make more accurate initial assessments. It is also crucial to provide thorough training to healthcare personnel using these technologies to ensure more efficient and personalized care. Public health nurses will benefit from gaining new skills in managing digital tools, which will help in the early identification of dermatological diseases and reduce unnecessary referrals to specialists. This will optimize resources and improve response times for patients.

Objectives: Compliance is crucial for patients to control and manage their high blood pressure. This study assesses the compliance levels of hypertensive patients in China and explores the factors influencing compliance.

Design: A descriptive, cross-sectional design was conducted.

Sample: A total of 371 hypertensive patients were recruited from six County hospitals and 12 township health centers in Zhejiang Province, China.

Measure: Patient compliance was measured using the Hypertensive Patient Scale (CHPS). Independent-sample T-test or variance analysis was applied to analyze CHPS scores by sociodemographic factors, and linear regression was used to explore the significant correlates of the total CHPS score.

Results: The total score of CHPS was 50.18 ± 6.12. Among the seven domains, drug treatment and lifestyle had the highest and lowest average scores, 3.59 ± 0.87 and 2.74 ± 0.73, respectively. The total score of CHPS positively associated with age (β = 0.075, p = 0.028), > 7 years of hypertension (β = 1.896, p = 0.022; Ref: < 3 years), and negatively associated with males (β = -2.224, p = 0.001; Ref: female) and rural area (β = -2.008, p = 0.007; Ref: urban area).

Conclusion: These findings highlight the importance of related measurements of the local "health-oriented" healthcare system. Primary health professionals should strengthen their health behavior intervention capacity and improve hypertension management among their patients.

Aim: To explore public health nurses' competence (namely knowledge, skills, and attitudes) in relation to long-term breastfeeding and their experience of the need for additional training on the subject.

Design: The study design was quantitative, descriptive, and cross-sectional.

Sample: Public health nurses (n = 270).

Methods: Data were collected with the Long-Term Breastfeeding Competence Scale (LBCS) online survey. Data analysis was done with Spearman's correlation analysis and binary logistic regression analysis.

Results: Slightly more than half of the respondents had a good level of knowledge and skills. The majority had a baseline positive attitude toward long-term breastfeeding, but the attitude became more negative as the age of the breastfed child increased. Better competence was associated with younger age, parenthood, an additional degree in midwifery, and breastfeeding specialist certification. Knowledge and skills, and attitudes revealed a high correlation: the higher the knowledge and skills level, the more positive attitudes. Respondents with better knowledge and skills experienced more often the need for additional training on the subject.

Conclusions: This study addresses that public health nurses lack competence in relation to long-term breastfeeding. This may compromise the quality of breastfeeding guidance for families in healthcare settings.

Background: This research was conducted in descriptive type to determine the disaster risk perception and sustainable earthquake awareness of nursing students studying at public and private universities.

Methods: The study sample consisted of 400 nursing students studying at one public and one private university. The research was conducted between April and May 2023. The data were collected using a Sociodemographic Form, University Students Disaster Risk Perception Scale (USDRPS), and Sustainable Earthquake Awareness Scale (SEAS). Data were collected online using a questionnaire created on Google Forms. Analyses included frequency, percentage, mean, standard deviation values, independent groups t-test, post-hoc Tukey test, LSD, and ANOVA test.

Results: Of the students, 61.8% had a disaster experience, 17.4% had lost a relative in the disaster, and 76.8% did not consider themselves prepared for a possible disaster. In the study, the exposure sub-dimension score of the disaster risk perception scale was found to be higher in students who had disaster experience than in those who did not (p = 0.032). Nursing students from the private university had higher sustainable earthquake awareness scores than those studying at the state university (p = 0.001). The mean scores of female students on the earthquake preparedness and preparation application sub-dimensions showed a significant difference compared to the scores of male students (p = 0.016). In the study, sustainable earthquake awareness total and earthquake preparedness sub-dimension scores were higher in second-year nursing students than in students of other years (p = 0.042; 0.015). Those who had received disaster training had low scores on the uncontrollable sub-dimension of the disaster risk perception scale, and high scores on the total SEAS and earthquake-structure relationship, earthquake preparedness, and earthquake preparation application sub-dimensions (p < 0.05).

Conclusions: In the study, three out of four students did not find themselves prepared for disasters. Those who had disaster experience had higher disaster risk perceptions. Students who had received disaster-related training had more positive earthquake preparedness, earthquake-structure relationship, and earthquake preparation applications than those who had not. Students who were female and were in the second year had higher earthquake awareness. Studies can be carried out to inform people about the pre-disaster and preparation stages to raise awareness about disasters at universities. Education on disaster management can be integrated into courses from the first years of university.

Objective: This review aimed to consolidate existing knowledge on this phenomenon by incorporating direct testimonies from individuals who have experienced breast cancer.

Methods: A thorough metasynthesis of qualitative studies was conducted. English articles published prior to September 18 2023 were searched from eight databases, including PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database, and the Wipu Database. After screening the titles, abstracts, and full texts, six articles were finally included in the quality appraisal and metaaggregation.

Results: A total of 30 research findings were distilled and integrated into three themes: causes of fear of cancer recurrence (FCR); feelings of FCR; coping with FCR; and six subthemes: disease treatment factors; psychological factors; FCR is worry and fear; overcoming; negative response; positive response.

Conclusions: FCR is a subjective feeling; it is influenced by the interplay between the external environment (adjuvant therapy) and internal environment (psychological factors). Therefore, future care measures should be designed comprehensively, considering the individual characteristics of breast cancer survivors and the external environment. This could be the primary focus for addressing FCR in cancer patients in the future.

Background: eHealth literacy interventions have emerged as a new approach in management of stroke survivors. Its effect on knowledge and clinical outcomes presents an inconsistent result in literature.

Objectives: We aim to evaluate the impact of eHealth interventions on health literacy, clinical metrics, adherence to healthy behaviors, stroke recurrence, mortality, and health-related quality of life in stroke survivors.

Methods: We systematically searched six databases (PubMed, Cochrane Library, CINAHL, EMBASE, Web of Science, ProQuest) up to February 21, 2024, selecting articles that meet these criteria: (i) patients with stroke; (ii) intervention with education content; (iii) eHealth interventions included telehealth, mobile phone, internet or computer; (iv) randomized controlled trials. The mean differences (MD) and standardized mean differences (SMD) between groups were measured. Risk of bias was evaluated using the Cochrane tool.

Results: From 16 studies involving 9646 participants, we observed that eHealth interventions significantly improved systolic blood pressure (MD = -2.78 mmHg, 95% confidence interval (CI) [-4.67 to -0.88], p = 0.004), medication adherence (SMD = 0.28, 95% CI [0.04 to 0.52], p = 0.023), and health-related quality of life (SMD = 0.21, 95% CI [0.04 to 0.37], p = 0.013). Meta-regression found that age modified the effect size of systolic blood pressure (p = 0.027). There was insufficient evidence to conclude effects on other outcomes. The quality of evidence was moderate. Outcome variation may be due to the diversity in eHealth intervention approaches. The limited number of studies precluded the subgroup analysis. More interactive interventions with longer follow-ups were more effective.

Conclusions: eHealth interventions may benefit stroke survivors in terms of blood pressure, medication adherence, and health-related quality of life.

Implications for nursing policy: eHealth literacy interventions could be implemented to improve the management of stroke survivors, especially in the context of resource limitations.

Trial registration: PROSPERO registration number: CRD42024502470.

Objective: To develop and implement a tiered training model for neighborhood caregiving volunteers and to evaluate its impact on participants' knowledge, behaviors, and attitudes toward caregiving services.

Design and methods: We employed a mixed-methods research design. Participants included 32 neighborhood care volunteers and six seed volunteers. The neighborhood volunteer training program comprised three phases: Development (establishing the tiered training structure), Testing (conducting a pilot study), and Promotion (refining the training curriculum and service model, followed by community practice).d This study primarily evaluated the training outcomes of participants in the promotion phase, with additional qualitative interviews to capture the volunteers' experiences.

Results: Quantitative data analysis showed that graded healthcare training significantly improved volunteers' caregiving knowledge, self-efficacy, and perceptual behavior. Course satisfaction was highest with advanced caregiver training, followed by basic caregiver and volunteer caregiver-instructor training. Qualitative analysis revealed three themes: (1) improved volunteer role effectiveness, (2) positive service experience, and (3) positive, personal understanding of health.

Conclusions: Providing progressive training and adequate support for volunteers is crucial. Volunteer trainers or management units should emphasize creating positive experiences for volunteers, fostering their abilities, and promoting their willingness to remain engaged in community health services.