Asian Nursing Research最新文献

Purpose: This study aimed to inform a basis for nursing intervention through investigating the clinical risk factors for prolonged length of stay (PLOS) in patients with chronic acalculous cholecystitis (CAC) after cholecystectomy and constructing a predictive model.

Methods: The prediction model for the PLOS in CAC patients after cholecystectomy was developed using a retrospective research design. Data were extracted from Medical Information Mart for Intensive Care IV (MIMIC-IV). Logistic regression was used to explore the influencing factors of PLOS using the interpolated data. A variety of statistical methods, such as receiver operating characteristic (ROC) analysis, decision curve analysis (DCA) analysis, 5-fold cross-validation method, and SHapley Additive exPlanations (SHAP), were conducted to assess, validate, and interpret the nomogram model.

Results: The study included 204 CAC patients who underwent cholecystectomy. The average age was 60.23 ± 14.30 years, with 65.2% experiencing a PLOS. Multivariable logistic regression analysis showed that age (OR=1.04, 95%CI: 1.01-1.08), calcium (OR= 0.48, 95%CI: 0.24-0.93), ciprofloxacin (OR= 3.08, 95%CI: 1.14-9.91), fentanyl (OR= 4.08, 95%CI: 1.36-14.53), and mild liver disease (MLD) (OR= 0.30, 95%CI: 0.11-0.76) may be the influencing factors for PLOS. The nomogram model based on the five variables demonstrated moderate discrimination capacity according to ROC and DCA analyses. The ROC results based on the 5-fold cross-validation method revealed that the average AUC was .75 (.67-.83) in the training set, .71 (.54-.88) in the validation set, and .72 (.53-.90) in the test set. SHAP analysis identified age as the most influential factor, followed by calcium, fentanyl, ciprofloxacin, and MLD.

Conclusion: The nomogram model, based on age, calcium, fentanyl, ciprofloxacin, and MLD, demonstrated moderate discrimination capacity in predictive PLOS in CAC patients after cholecystectomy. These findings may support the identification of at-risk patients and inform early nursing interventions.

Purpose: This study aims to develop and validate a reliable and comprehensive scale to measure human papillomavirus (HPV) literacy, addressing its contribution to public health education and intervention strategies.

Methods: This methodological and cross-sectional design research sample consisted of 407 individuals. The study data were collected via the HPV literacy scale and personal information form. In the scale's validity and reliability phase, content validity, item analyses, and exploratory and confirmatory factor analyses were performed.

Results: In this study, the internal consistency reliability of the scale was found to be .97. The item-total score correlation values of the scale were between .557 and .788. The factor loading between the items varied between .544 and .798, and the total variance explained was 66.7%. As a result of EFA, a three-factor structure with an eigenvalue exceeding 1 was obtained. In the confirmatory factor analysis, it was determined that the fit indices were at an acceptable level (CMIN/DF=4.40, RMSEA= 0.072, CFI= 0.94, NFI=0.92, AGFI=0.87 and GFI=0.89).

Conclusion: According to the analysis, the scale is a valid and reliable tool that can be applied to Turkish society.

Purpose: Gallbladder polyps pose a health concern among nurses, and early identification is essential for timely intervention and risk management. This study aimed to identify key risk factors and validate an early warning model for GBP specifically tailored to nurses using a retrospective cohort design.

Methods: A cohort of 3,507 nurses was recruited from a tertiary care hospital in northern China, with 3,181 participants after exclusions. The cohort was divided into training (2,407 cases) and validation (774 cases) subsets. Logistic regression analysis of demographic, lifestyle, and biochemical factors was used to develop a prediction model for GBP. Model performance was assessed using sensitivity, specificity, ROC curves, calibration curves, and the Hosmer-Lemeshow test.

Results: The prevalence of GBP increased from 1.45% in 2013 to 12.7% in 2022. Key predictors included age, gender, walking time, fried food consumption, and total bilirubin levels. The model demonstrated moderate accuracy with an area under the curve of 0.64 in the training cohort and 0.65 in the validation cohort. Sensitivity reached 60%, specificity was 64-65%, and the negative predictive rate was 92%. Internal validation using bootstrap resampling confirmed model stability.

Conclusions: The early warning model for GBP among nurses demonstrated fair discriminative performance and reliable calibration, indicating potential clinical utility. The model can facilitate early intervention and strengthen occupational health management. Further research should aim to refine the model and validate it across diverse populations to enhance generalizability and accuracy.

Purpose: In developing countries, delayed diagnosis and limited access to treatment often complicate the post-operative course for children with congenital heart disease, who require complex care to optimize cardiac function. Effective recovery depends on collaboration between healthcare providers and parents, with health education serving as a critical support mechanism. However, research in these settings has faced limitations restricting generalizability, and the role of nurses in health education remains underutilized. This study aimed to evaluate the effectiveness of a nurse-led health education program for parents of children undergoing congenital heart surgery.

Methods: A quasi-experimental design was employed in a Vietnamese pediatric cardiac facility. Eligible parent-child dyads were assigned to control or intervention groups based on enrollment period, separated by a washout period. The intervention group received five teaching sessions facilitated by teach-back plus standard care, while the control group received standard care only. Data were collected at admission, discharge, first and second outpatient appointments. Co-primary outcomes were parental knowledge and child weight.

Results: One hundred thirty-eight dyads were recruited (control: n = 74; intervention: n = 64). Primary caregivers were mothers (92.8%) in their 30s, with high school the most common education level. Children's median age: 6 months (IQR = [2.43, 14.47]), with 50% (n = 69) undergoing low-to-moderate risk surgical procedures. Compared to controls, the intervention group showed significantly greater parental knowledge (b = -3.24, 95% CI [-3.79, -2.70], p<.001), increased child weight (b = -0.07, 95% CI [-0.11, -0.04], p<.001), lower risk of abnormal oxygen saturation (RR = 2.53, 95% CI [1.14, 5.59], p = .022).

Conclusions: Nurse-led health education can enhance parental knowledge and improve child growth and cardiac function, highlighting its potential implications in routine pediatric cardiac care, particularly in resource-constrained settings. Further research should confirm long-term effects and broader applicability.

Trial registration: ACTRN12623000388617p (18/04/2023).

Purpose: Owing to Japan's aging population, increasing healthy life expectancy is a major public health concern, and conditions such as sarcopenia and sarcopenic obesity pose significant health risks. However, few studies have examined their prevalence and related factors in the general older population. This study investigated the prevalence and related factors of sarcopenia and sarcopenic obesity among community-dwelling older adults in Japan.

Methods: Data were obtained from 6,072 participants aged ≥ 65 years in the XXXX Cohort Study (anonymized for review). Sarcopenia and sarcopenic obesity were determined by a score ≥ 4 for the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire and a body mass index (BMI) ≥ 25 kg/m². Primary demographic data, data regarding lifestyle habits, and physical and mental health information were collected and the associations between these factors and sarcopenia and sarcopenic obesity were assessed.

Results: Of the 6,072 participants (2,680 men and 3,392 women; mean age 73.9 ± 4.5 years), 9.5% had suspected sarcopenia. The logistic regression analysis revealed significant associations between suspected sarcopenia and age, BMI, pain/discomfort, anxiety, depression, and motor function decline for men and women. Hypertension, smartphone use, exercise habits, and social withdrawal were risk factors for women. The prevalence of sarcopenic obesity among the participants with suspected sarcopenia was 35.8% for men and 31.4% for women. Sarcopenic obesity was significantly associated with hypertension in men and women compared with sarcopenia only.

Conclusion: The prevalence of suspected sarcopenia and sarcopenic obesity was high among community-dwelling older adults and associated with various physical and mental factors. Early detection and multi-aspect interventions for suspected sarcopenia and sarcopenic obesity are essential for extending the healthy life expectancy of the general older Japanese adult population.

Purpose: Middle-aged men after myocardial infarction (MI), particularly those at risk for heart failure (HF), require sustained health behaviors for effective long-term self-care. This study evaluated the one-year efficacy of a mobile app-based weekly self-monitoring program grounded in the Information-Motivation-Behavioral Skills model.

Methods: A single-blind, randomized controlled trial was conducted with 68 post-MI men who underwent percutaneous coronary intervention and had a left ventricular ejection fraction (LVEF) <50%. Participants were randomly assigned to the experimental group (n=35), who used With Your Heart, a mobile app developed for this study. The app included a weekly self-monitoring checklist with algorithm-based feedback, and participants additionally received nurse counseling during outpatient visits every three months. The control group (n=33) received standard lifestyle education through a leaflet at baseline. Outcomes were measured at baseline, 3, 6, and 12 months. Data were analyzed using repeated measures ANOVA to examine group × time interactions, with Bonferroni correction applied for post-hoc comparisons.

Results: Average age of the experimental group was 58.01 (±8.52) years and 57.35 (±9.63) years in the control group. Overall, 85.3% experienced a first-time MI, whereas 14.7% had a recurrent MI. Significant group × time interaction effects were found for health behaviors (F=10.24, p<.001) and illness perception (F=3.15, p=.026). The experimental group demonstrated sustained improvements in health behaviors across all follow-up points and reduced negative illness perception at 3 and 6 months. Resilience was significantly higher in the experimental group overall, although no interaction effect was observed. Depression decreased over time in both groups, with no between-group differences.

Conclusion: Weekly app-based self-monitoring significantly improved health behaviors and favorably influenced psychological outcomes, particularly illness perception and resilience, in middle-aged post-MI men at risk for HF. These findings support app-based self-monitoring as a feasible digital healthcare strategy to promote lifestyle modification in risk patients during outpatient care.

Purpose: This study aimed to investigate the influence of disease activity, disease-related knowledge, illness perception and coping strategies on psychological distress in patients with Crohn's disease, using a path analysis based on common-sense-model.

Methods: This was a cross-sectional study. A total of 399 adult patients were recruited from an online support community in Korea between October and December 2024. Data were collected through online self-reported questionnaires, using the Harvey-Bradshaw Index, the Inflammatory Bowel Disease Knowledge, the Korean version of the Brief Illness Perception Questionnaire, the Korean version of the Coping Strategy Indicator, and the Korean version of the Kessler Psychological Distress Scale. The data were analyzed using SPSS/WIN 24.0 and AMOS 29.0. Path analysis was used to examine how disease-related knowledge and disease activity influences psychological distress through illness perception and coping strategies.

Results: Both disease activity and disease-related knowledge were found to influence psychological distress through a serial mediation effect of illness perception and avoidance coping. The avoidance coping model showed acceptable model fit. Disease activity and disease-related knowledge had a negative effect on avoidance coping. The path from disease-related knowledge to avoidance coping showed the strongest effect within the research model.

Conclusions: This study demonstrated the need for an integrated approach to reduce disease activity and increase disease-related knowledge factors to effectively alleviate psychological distress in patients with Crohn's disease.

Purpose: This study aimed to identify distinct trajectories of self-rated health (SRH) among frail older adults and examine sociodemographic and health-related factors associated with each trajectory group.

Methods: A secondary analysis was conducted using data from Waves 5-9 of the Korean Longitudinal Study of Aging (KLoSA). Of 10,436 participants, 552 community-dwelling adults aged 65 years or older who met the frailty criteria were included. Group-based trajectory modeling was applied to identify SRH trajectories, and multinomial logistic regression was performed to examine predictors of trajectory group membership, with the high-health declining group serving as the reference.

Results: Five SRH trajectories were identified: Low-Declining SRH (Group 1), Increasing SRH (Group 2), Decline-Then-Increasing SRH (Group 3), Moderate-Declining SRH (Group 4), and High-Declining SRH (Group 5; reference). Compared with the reference group, Group 1 exhibited lower levels of weekly physical activity (OR = 0.47), social participation (OR = 0.46), and income (OR = 0.59), as well as a higher prevalence of hypertension, diabetes, and denture use. Group 2, which showed linear improvement, included more women (OR = 0.35) and individuals with lower income (OR = 0.52). Group 3 was less likely to receive the Basic Old-Age Pension (OR = 0.31), suggesting relatively higher socioeconomic status. Group 4 demonstrated lower social participation (OR = 0.54) and higher prevalence of hypertension (OR = 1.69).

Conclusion: Frail older adults demonstrate heterogeneous SRH trajectories. Social participation, health behaviors, and economic resources are key determinants of SRH patterns. SRH may serve as a practical screening indicator for identifying high-risk groups and informing tailored community-based care strategies.

Purpose: This study aimed to investigate the impact of delirium on prolonged intensive care unit (ICU) stay in critically ill older patients.

Methods: This prospective observational study included 198 consecutive older patients who were admitted to three ICUs at a tertiary hospital in South Korea. Delirium was assessed using the Korean Nursing Delirium Screening Scale, and a prolonged ICU stay was defined as eight days or longer. Multivariable logistic regression analysis was performed to evaluate the impact of delirium on prolonged ICU stay in critically ill older patients.

Results: In critically ill older patients, the prevalence of delirium and prolonged ICU stay were 37.8% and 34.3%, respectively. Older patients with delirium during their ICU stay had a significantly higher risk of prolonged ICU stay compared to those without delirium (odds ratio [OR] = 5.21, p < .001, 95% confidence interval [CI]: 2.22-12.19). We suggest that delirium is a strong predictor of prolonged ICU stay in critically ill older patients.

Conclusions: Enhancing ICU nurses' knowledge of delirium in critically ill older patients can facilitate the early recognition of patients at risk upon admission. Therefore, establishing an early and systematic delirium screening system in ICUs is essential for promptly identifying high-risk patients and delivering individualized, evidence-based delirium care. Such efforts may contribute to reducing prolonged ICU stay and improving clinical outcomes in critically ill older patients.

Purpose: The purpose of this study was to explore the smoking experiences of female call center employees, focusing on the factors that facilitate smoking and the perceived barriers to smoking cessation within their specific occupational context.

Methods: Qualitative focus group interviews and thematic analysis were used to examine the experiences of female employees at two call centers.

Results: The findings showed that the 25 female call center employees characterized smoking as a functional aspect of their job, suggesting that it is not simply a personal habit but an integral component of workplace dynamics. This perspective revealed the complex role of smoking as a coping mechanism for stress, a facilitator of social engagement, and a contributor to the cultural fabric of the workplace. The analysis delineated three primary themes: (1) "Smoking, a working drug: Indispensable elements at work," highlighting smoking's necessity for job performance; (2) "Smoking is normal in my life: Daily use of smoking," indicating its habitual nature; and (3) "Just holding off, not permanently quitting," describing challenges in achieving lasting cessation.

Conclusion: Smoking among female call center employees stems from workplace culture and occupational stress rather than from personal choice.