Development and pre/post testing of a decision aid supporting Chinese parental and young women’s HPV vaccination decision-making

ABSTRACT

We developed and tested the acceptability and utility of a novel HPV vaccination decision aid (DA) among Chinese young women aged 18–26 years and parents of adolescent girls aged 9–17 years. From March to May 2016, a total of 101 parents plus 109 young women completed baseline surveys assessing their HPV vaccination knowledge, decision self-efficacy, decision conflict, and HPV vaccination intention. Two weeks after receiving the DA, 84 (83.2%) parents and 92 (84.4%) young women completed re-assessments. Chi-square tests or t-tests were performed to compare the before-and-after differences. Cohen’s d was calculated to indicate the effect size. After reading the DA, both participating young women’s and parents’ knowledge of HPV vaccination (Cohen’s d = 0.62 among young women and d = 0.59 among parents) and decision self-efficacy (d = 0.38 among young women and d = 0.59 among parents) significantly increased. Both young women’s and parents’ decision conflict (d = ?0 · 98 and ?1.06) significantly decreased. The proportion of young women intending to receive HPV vaccination and parents deciding to vaccinate daughters against HPV significantly increased (p < 0 · 0001). The DA showed good acceptability and utility facilitating HPV vaccination decision-making for most Chinese young women and parents of adolescent girls. Further randomized controlled trials of this tool are essential.     

以格林模式为指导的健康宣教对尖锐湿疣患者情绪及自我效能的影响

目的探讨以格林模式为指导的健康宣教对尖锐湿疣患者情绪及自我效能的干预作用。方法将220例尖锐湿疣患者按就诊时间分为两组,各110例。对照组予以常规护理干预,观察组在此基础上实施以格林模式为指导的健康宣教,观察6个月,治疗后随访6个月统计复发率。干预前后采用医院自制尖锐湿疣患者健康知识调查问卷调查健康知识掌握情况,采用焦虑自评量表、抑郁自评量表评定焦虑、抑郁情绪,采用医学应对问卷评定应对方式,采用一般自我效能感量表评定自我效能。干预后采用纽卡斯尔护理满意度量表评定护理满意度。结果干预后观察组尖锐湿疣患者健康知识调查问卷总分及尖锐湿疣疾病知识、自我保健知识评分显著高于对照组(P<0.01),焦虑自评量表、抑郁自评量表评分显著低于对照组(P<0.01)。干预后观察组一般自我效能感量表评分及医学应对问卷的面对、自我效能评分显著高于对照组(P<0.01),回避、屈服评分显著低于对照组(P<0.01)。观察组复发率显著低于对照组(P<0.05),总满意率显著高于对照组(P<0.01)。结论以格林模式为指导的健康宣教能提高尖锐湿疣患者健康知识掌握度及自我效能水平,有效缓解其不良情绪,改变其应对方式,降低复发率,提高患者满意度。     

情景模拟健康教育在晚期肺癌患者癌痛管理中的应用

目的 探讨情景模拟健康教育在晚期肺癌患者癌痛管理中的应用效果，旨在提高晚期肺癌患者提高癌痛应对和管理能力。方法 采用便利抽样法，选取2019年5月-2020年5月在同济大学附属上海市肺科医院肿瘤科住院的晚期肺癌患者60例为研究对象，按其住院时间先后顺序分为对照组（n=30）和观察组（n=30）。对照组患者给予肺癌常规护理及健康教育，观察组在其基础上给予情景模拟健康教育干预，主要围绕正确认识癌痛、癌痛自我评估、癌痛应对、躯体功能应对和负性心理情绪调试等展开。分别于患者入院第1天及第7天评估患者疼痛管理效能及情绪状况。结果 入院第1天，两组患者慢性疼痛自我效能感量表和中文版简式-简明心境问卷得分组间比较，差异无统计学意义（P＞0.05），入院第7天，组间比较有统计学差异（P＜0.05）。结论 情景模拟健康教育可有效提高晚期肺癌患者疼痛管理自我效能，改善患者负性心理情绪，进而提高其生活质量，值得临床进一步应用和推广。     

Community-based savings groups,women’s agency,and maternal health service utilisation: Evidence from Mozambique

ABSTRACT

This study, using data collected as part of an ongoing programme evaluation, investigates whether participation in Saving Groups (SGs)—a community-owned microfinance intervention focused on poor households – is associated with maternal health service utilisation, and whether this association is mediated by women’s agency – as measured by self-efficacy and decision-making autonomy. We compared maternal health service utilisation among SG members (n=105) and non-members (n=100) in rural Mozambique. We estimated prevalence ratios for SG membership and women’s agency using Poisson regression while controlling for confounding factors. We also estimated mediation effects for women's agency. The results showed that SG membership is associated with four or more antenatal care (ANC) visits, skilled birth attendant (SBA) use, and postnatal care within 48?h of delivery. Self-efficacy mediated the relationship between SG membership and ANC vists and SBAuse, but not postnatal care; whereas women’s decision-making autonomy mediated the relationship with SBA use and postnatal care, but not ANC visits. This study suggests that the impact of SG membership on use of maternal health services goes beyond improvements in household income and may operate through women’s agency by giving women the ability to realize their preference for quality health care.     

恶性肿瘤患儿父母疾病不确定感状况、自我效能及相关影响因素分析

目的:探究恶性肿瘤患儿家长疾病不确定感及自我效能的影响因素。方法:选取在本院接受治疗的64例恶性肿瘤患儿,其家长人数64人,对患儿家长进行问卷调查,调查表包括自我效能调查表、一般情况调查表、疾病不确定感量表。对影响家长不确定感、相关因素及自我效能情况进行分析。结果:恶性肿瘤患儿父母疾病不确定感总分为(91.34±11.35)分;积极应对、一般自我效能感与父母疾病不确定感为负相关性(P<0.05);多重线性回归分析表示,能够影响患儿家长疾病不确定感的主要因素为自我效能、积极应对能力、患儿病情状况及家长文化水平(P<0.05)。结论:为了能够降低家长对疾病的不确定感,需要对其进行护理干预增强患儿家属对疾病的认知能力,从而降低患儿的心理压力,进一步提升治疗效果。     

Parenting self-efficacy in fathers of medically complex infants: A longitudinal study

IntroductionInfants with medical complexity have multiple complex chronic conditions and require specialized intensive care. One important factor in optimizing infant health and development is parenting self-efficacy (PSE). The purpose of this study was to examine parental self-efficacy in fathers over time.MethodsA longitudinal survey study was conducted with fathers of medically complex infants. We used the validated Karitane Parent Confidence Scale to assess PSE and multivariable linear regression examined the associations between father and infant characteristics on PSE.ResultsFathers (n = 27) were white (74%), married (85%), high school educated (37%), with incomes ≥ $US50,000 (66%). Father's mean PSE score was 39.28 (±3.9). Hispanic ethnicity and total number of chronic conditions were significant predictors of lower PSE in fathers.ConclusionsFathers of medically complex infants reported low PSE. More strategic interventions need to focus on self-efficacy and creating opportunities for connection between fathers and infants.     

Return to Work Self-Efficacy (RTWSE-19) Assessment for Patients with Acute Work-Related Low Back Pain

Nurse practitioners (NPs) often see patients with occupational back pain. Research indicates that hesitation to return to work (RTW) is largely due to perceptions of being unable to resume job tasks or meet expectations. This pilot study evaluates whether the Return-to-Work Self-Efficacy–19 (RTWSE-19) questionnaire, which has been used for injuries at other anatomical sites, is appropriate for lower back pain. The RTWSE-19 was administered to 30 patients who presented with a complaint of an acute work-related back pain; however, it was found to be nonpredictive of RTW, suggesting that NPs should identify other tools to assess their patients’ ability to RTW.     

Longitudinal relationships between two self-efficacy types and stress in active older adults in Taichung City,Taiwan

Self-efficacy has recently become a topic of interest in mental health research. We examined the relationships among physical activity (PA) self-efficacy, general self-efficacy, and stress through the longitudinal study design. In the first year (Y1), 322 older adults who lived in Taichung City, Taiwan, participated in our study. Two years later (Y2), 161 of them again responded to the same questionnaire, which included PA self-efficacy, general self-efficacy, and stress scales. The questionnaire data were analyzed through hierarchical regression analysis. We observed that PA self-efficacy was significantly and positively correlated with general self-efficacy and that both were significantly and negatively correlated with stress at Y1 and Y2. Therefore, enhancing PA self-efficacy can be an effective element of programs designed to reduce stress in older adults.     

The Interplay of Pain-Related Self-Efficacy and Fear on Functional Outcomes Among Youth With Headache

Pain-related self-efficacy and pain-related fear have been proposed as opposing predictors of pain-related functional outcomes in youth with chronic pain. Self-efficacy is a potential resiliency factor that can mitigate the influence that pain-related fear has on outcomes in youth with chronic pain. Drawing from theoretical assertions tested among adults with chronic pain, this study aimed to determine whether pain-related self-efficacy mediates the adverse influence of pain-related fear on functional outcomes in a sample of youth with chronic headache. In a cross-sectional design of 199 youth with headache, self-efficacy was strongly associated with fear, disability, school impairment, and depressive symptoms. Pain intensity and self-efficacy were only modestly related, indicating that level of pain has less influence on one's confidence functioning with pain. Self-efficacy partially mediated relationships between pain-related fear and both functional disability and school functioning but did not mediate the relationship between pain-related fear and depressive symptoms. These results suggest that confidence in the ability to function despite pain and fear avoidance each uniquely contributes to pain-related outcomes in youth with chronic headache. These results further suggest that treatment for chronic headache in youth must focus not only on decreasing pain-related fear but also on enhancing a patient's pain-related self-efficacy.PerspectivePain-related self-efficacy is an important resiliency factor impacting the influence of pain-related fear on functional disability and school functioning in youth with headache. Enhancing self-efficacy may be a key mechanism for improving behavioral outcomes. Clinicians can reduce pain-related fear and enhance pain-related self-efficacy through interventions that encourage accomplishment and self-confidence.