Asian Nursing Research最新文献

Purpose: This study evaluated the Korean Social Anxiety Scale for Adolescents (K-SAS-A) using Rasch analysis, examined gender-related differential item functioning (DIF), and assessed measurement precision in a school-based sample.

Methods: Self-report data from 481 Korean adolescents (ages 14-16; 49.9% girls) were analyzed with the Andrich Rating Scale Model. We evaluated category functioning, item fit, dimensionality (PCA of residuals), local independence (residual correlations), reliability/separation, and gender DIF (ETS classification).

Results: The original five-category scale showed insufficient separation between categories 2 and 3; collapsing to a four-category format improved category functioning and overall fit. Seven items (#2, #5, #9, #10, #11, #13, #15) were removed based on misfit and content considerations. The refined instrument satisfied unidimensionality (first contrast eigenvalue = 1.8) and local independence (residual |r| ≤ .28). Person separation = 2.22 (reliability = .83; ≈3.3 strata); item separation = 8.11 (reliability = .99). In the full item set, two items (#1, #18) showed slight-to-moderate gender DIF; no meaningful DIF remained in the proposed nine-item short form, which consists of items #3, #4, #6, #7, #8, #12, #14, #16, and #17.

Conclusions: A four-category response format and a nine-item short form yield a unidimensional, reliable measure of adolescent social anxiety with reduced respondent burden. Minor redundancy between two items (#6, #12) warrants consideration in future refinements.

Purpose: To investigate the interconnections among kinesiophobia, self-efficacy, Type D personality, and physical activity (PA) among patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). The explicit objective was to investigate whether self-efficacy mediated and Type D personality moderated the relationship between kinesiophobia and PA in this population.

Methods: Between November 2021 and October 2022, 328 patients who had undergone PCI were enrolled from cardiac wards at three different hospitals. The participants were instructed to finalize the International Physical Activity Questionnaire, the Tampa Scale of Kinesiophobia for Heart, the Cardiac Exercise Self-Efficacy Instrument, and the Type D Personality Scale. We used SPSS 22.0 and the PROCESS macro for the statistical analysis.

Results: (1) Mediation analysis revealed that kinesiophobia had a direct predictive effect on PA, and self-efficacy partially mediated this relationship. (2) This study demonstrates that kinesiophobia influences PA both directly and indirectly via self-efficacy, with Type D personality moderating the association between kinesiophobia and self-efficacy as well as the direct link between kinesiophobia and PA. However, Type D personality does not moderate the effect of self-efficacy on PA. The simple slope graph reveals that patients with Type D personality exhibited substantially lower levels of PA than those with non-Type D personality as kinesiophobia increased. Patients with Type D personality had weaker self-efficacy than those without Type D personality when it came to strong kinesiophobia.

Conclusions: Self-efficacy and Type D personality play important roles in the relationship between kinesiophobia and PA. Interventions after PCI should focus on reducing kinesiophobia and enhancing self-efficacy to improve PA. Personality assessment allows tailored strategies, with Type D patients requiring targeted approaches for fear and emotion regulation, while non-Type D patients may benefit more from self-efficacy enhancement.

Purpose: Advanced schistosomiasis, the most severe stage of Schistosoma japonicum infection, profoundly impairs patients' quality of life (QoL) and increases vulnerability to anxiety and depression. Since 2004, China has launched a medical assistance program for the patients with access to medical and/or surgical treatment, in which health workers have incorporated nursing interventions to address these challenges. This meta-analysis evaluated the effects of nursing interventions on QoL, anxiety, depression, and complications in advanced schistosomiasis patients.

Methods: Seven databases (PubMed, Web of Science, The Cochrane Library, CBM, CNKI, VIP, and Wanfang) were systematically searched for randomized controlled trials (RCTs) up to August 1, 2024. Data were analyzed using Review Manager 5.4 and R 4.2.3. Outcomes included QoL (WHOQOL-BREF, KPS), anxiety (SAS), depression (SDS), and complications. The protocol was previously registered with PROSPERO (CRD42023406707).

Results: A total of 23 studies with 2232 patients were included. Nursing interventions improved QoL with greater benefits observed in longer intervention periods. Anxiety (SMD -1.52, 95% CI -2.10 to -0.94) and depression (SMD -1.13, 95% CI -1.43 to -0.84) scores were markedly reduced. The risk of complications decreased by 64% (RR 0.36, 95% CI 0.27 to 0.48). Subgroup analyses highlighted age as a key modifier of intervention efficacy.

Conclusions: Nursing interventions effectively enhance QoL, alleviate psychological distress, and reduce complications in advanced schistosomiasis patients. These findings advocate for integrating structured nursing protocols into China's national healthcare programs and global schistosomiasis management strategies.

Purpose: To identify predictors of various dimensions of unmet care needs and longitudinally investigate the unmet care needs, psychological distress and quality of life (QoL) over a three-month post-treatment period of Taiwanese non-muscle invasive bladder cancer (NMIBC) survivors.

Methods: This preliminary study employed a longitudinal repeated measurement design (the day after surgery (T0) and 1 (T1) and 3 (T2) months after completing treatment) with a convenience sampling in NMIBC survivors (n = 50).

Results: The results of the study revealed that the highest levels of unmet care needs were the informational and physical/psychological domains and significant improvements in unmet care needs, anxiety levels, and various QoL domains were noted over the 3-month period. Predictors varied by four domains of unmet care needs: higher anxiety levels were associated with greater unmet needs across domains (β = 0.60 ∼ 0.18); concerns about future worries predicted higher physical/psychological needs (β = 0.07); bloating and flatulence symptoms predicted greater informational and medical care needs (β = 0.07 ∼ 0.04); and the presence of informal caregiver support was linked to higher physical/psychological needs (β = 1.99). Receiving more transurethral resection of bladder tumor (TURBT) cycles was associated with lower communication and medical care needs (β = -1.05 ∼ -1.38).

Conclusion: The preliminary study indicated that survivors' diverse dimensions of unmet care needs varied by personal characteristics, psychological distress and QoL. It is recommended to closely monitor NMIBC survivors especially while undergoing 1-2 cycles of TURBT and experiencing anxiety, concerns about the future worries, and bloating and flatulence symptoms, to alleviate the impacts of their care needs. In addition, these survivors may be beneficial from the provision of tailored survivorship care plans (SCPs) to enhance their diverse unmet care needs.

Purpose: In the era of longevity, oral health has become increasingly important for maintaining the quality of life of older adults. However, the factors that influence their oral health remain unclear. Given that oral health tends to decline with age, it is crucial to identify the early predictors of changes in the oral health of older adults. Therefore, this study identified the factors influencing changes in the oral health of Korean older adults.

Methods: This retrospective study used nationally representative panel data from the 2018 and 2020 waves of the Korean Longitudinal Study of Aging. The study population of 3,859 individuals aged 65 or older was divided into four groups (Good-Good, Good-Poor, Poor-Good, and Poor-Poor groups) based on changes in their oral health, as assessed by the Geriatric Oral Health Assessment Index. Data were analyzed using multinomial logistic regression to examine factors influencing changes in oral health, with the Good-Good group set as the reference category.

Results: Individuals in the Poor-Poor group were the highest in number (33.7%). Factors affecting oral health changes included age, education level, body weight status, diabetes, heart disease, depression, cognitive impairment, and Medicaid coverage. Being underweight or overweight and having cognitive impairment contributed to declining oral health. Depression showed a dual association, being linked to both improvement and persistence of poor oral health. Furthermore, diabetes, heart disease, being underweight, and insufficient healthcare coverage perpetuated poor oral health. These factors explained 29.9% of the variance in oral health changes among older adults.

Conclusion: Study findings highlight the need for multi-level actions in clinical care, community health promotion, and policy to expand dental insurance. Future research should extend longitudinal analyses, address unmet oral health needs, and draw cross-national insights to inform strategies and policies for healthy aging.

Objective: This review aimed to evaluate the effectiveness of digital health interventions (DHIs) for gestational diabetes mellitus (GDM) management, focusing on the improvement of blood glucose and lipid levels, as well as maternal and neonatal outcomes.

Methods: The PubMed, Embase, Cochrane Library, and CINAHL databases were searched for studies published up to September 30, 2024. Randomized controlled trials evaluating the effects of DHIs for gestational diabetes were included. The search terms included concepts related to gestational diabetes, digital health, and randomized trials. The quality of the included studies was assessed using the Cochrane Risk of Bias 2.0 tool. Meta-analyses were performed using the Review Manager software (RevMan version 5.4).

Results: A total of 26 studies were included. DHIs significantly reduced postprandial glucose levels (SMD = -0.67, 95% CI: -1.25 to -0.08) and improved both off-target fasting glucose (MD = -3.70, 95% CI: -3.83 to -3.57) and off-target postprandial glucose (MD = -4.56, 95% CI: -6.64 to -2.48) levels. DHIs also improved lipid profiles, resulting in a reduction in total cholesterol (SMD = -0.25, 95% CI: -0.49 to -0.01) and triglyceride levels (SMD = -0.28, 95% CI: -0.51 to -0.04) and an increase in HDL cholesterol levels (SMD = 0.28, 95% CI: 0.05 to 0.52). Further, DHIs enhanced compliance with blood glucose monitoring (MD = 15.86, 95% CI: 10.92 to 20.79). However, no significant effects were observed on fasting glucose and HbA1c levels and delivery and postnatal outcomes.

Conclusion: DHIs offer a promising solution for managing GDM, particularly through postprandial glucose control, lipid regulation, and self-monitoring adherence. Their limited impact on fasting glucose and HbA1c levels and perinatal outcomes suggests that enhanced personalization, professional integration, and long-term monitoring are essential to maximize their effectiveness. Digital health strategies should evolve into comprehensive care models that support maternal and neonatal health, particularly in high-risk situations.