Development and psychometric evaluation of the Relocation Stress Syndrome Scale-Short Form for patients transferred from adult intensive care units to general wards

ObjectiveThis study aimed to develop the Relocation Stress Syndrome Scale-Short Form as an assessment tool for relocation stress experienced by intensive care unit patients after transfer to general wards.MethodsThis study included 535 intensive care unit patients at two tertiary care hospitals in South Korea from May to December 2018. Data were collected through face-to-face interview, using a structured questionnaire. Study 1 was conducted to estimate the factorial structure, and reliability of the scale. Study 2 was conducted to confirm the factorial structure of the scale.Main outcomesStudy 1 found that the new instrument had a good reliability (α = 0.92) and validity. In study 2, confirmatory factor analysis supported a three-factor structure and the scale continued to demonstrate good psychometric properties. The criterion validity showed that a low level of relocation stress syndrome was associated with higher satisfaction with the transfer process (r = −0.58, p < .001) and good general health status (r = −0.51, p < .001).ConclusionThe 10-item Relocation Stress Syndrome Scale was developed with appropriate validity and reliability. This scale can be used to assess relocation stress of patients in transition periods. This new scale requires cross-cultural validation.     

急性脑卒中患者入院时迁移应激的现象学研究

目的 了解急性脑卒中患者入院时迁移应激的感受。方法 采用现象学研究方法,对15例急性脑卒中患者进行访谈。结果 急性脑卒中患者入院时存在迁移应激,入院前感受表现出思绪与行为紊乱,不信任感;入院时体验为解决问题的迫切感、危机隐患（高度关注环境改变、过分关注医疗仪器噪音）、角色行为冲突及寻求关注与支持（渴望获得家庭支持、对恢复健康的需求增加）。结论 急性脑卒中患者入院时普遍存在迁移应激症状,且症状表现多为负性体验,医护人员应协助患者加强家庭支持,降低危机隐患,提高急性脑卒中患者的自我应对能力及身心健康。     

Parenting Stress in Families of Children with Cornelia de Lange Syndrome and Down Syndrome

We assessed similarities and differences in self-reported stress (Parenting Stress Index: Short Form [PSI-SF]), patterns of challenging child behavior (Nisonger Child Behavior Rating Form [NCBRF]), and characteristics of autism (Gilliam Autism Rating Scale 2nd Edition [GARS-2]) across two distinct groups of children and young adults 5 to 24 years old: Cornelia de Lange Syndrome (CdLS, n = 25, M _age (SD) = 11.4 (4.7) years), and Down syndrome (DS, n = 23, M _age (SD) = 13.4 (6.0) years). Parents were recruited from the CdLS-USA Foundation and DS parent support groups across the United States. The study focused on identifying specific patterns of (a) parenting stress and (b) challenging behavior and autism-like characteristics in children with CdLS and DS. It was found that parents of CdLS children experienced far more stress than those of children with DS, and the difference could not be explained completely by demographic variables or children’s developmental level. Rather it appears that the especially elevated stress in parents of children with CdLS can be traced in significant part to the children’s high levels of challenging behavior, low levels of pro-social behavior, and self-injury / stereotypy. Additional results revealed that children with CdLS exhibited significantly higher levels of challenging behavior and autism-like characteristics, and lower levels of pro-social behavior, and appropriate communicative behaviors. Multivariate regression showed that optimum prediction of stress for the total sample was yielded by a combination of the child’s elevated self-injury / stereotypy and decreased social interaction skills (R ²  = 0.217, R ² _adj  = 0.182, p _model  = 0.004), and the addition of the child’s diagnosis significantly increased predictability, R ²  = 0.273, R ² _adj  = 0.223, p _model  = 0.003. The elevated stress in parents of children with CdLS appears to be focused primarily on their children’s specific difficult child behaviors, a factor that was of much less concern to parents of children with DS. Results are discussed in terms of a possible behavioral phenotype for CdLS and future research on early intervention for parenting stress. It is noted that parenting stress in the CdLS sample is so high as to be unmeasurable (i.e., ceiling effect) in a large minority of the parents, and this makes it an urgent priority to develop well-targeted early interventions for parenting stress in these families.     

Parenting Stress in CHARGE Syndrome and the Relationship with Child Characteristics

This study investigates the parental perception of stress related to the upbringing of children with CHARGE syndrome and its association with behavioral and physical child characteristics. Parents of 22 children completed the Nijmegen Parenting Stress Index-Short, Developmental Behavior Checklist, and Dutch Vineland Screener 0-12 and reported their child’s problems with hearing, vision and ability to speak. Parenting stress was high in 59% of the subjects. Behavioral problems on the depression, autism, self-absorbed and disruptive behavior scales correlated positively with parenting stress. A non-significant trend was found, namely higher stress among the parents of non-speaking children. No associations were found with other child characteristics, i.e. level of adaptive functioning and intellectual disability, auditory and visual problems, deafblindness, gender, and age. Raising a child with CHARGE syndrome is stressful; professional support is therefore essential for this population. More research into other possible influencing characteristics is needed to improve family-oriented interventions. Since CHARGE is a rare syndrome, closer international collaboration is needed, not only to expand the group of study subjects to increase statistical power, but also to harmonize research designs and measurement methods to improve the validity, the reliability, and the generalization of the findings.

Relocation support groups for corporate wives

Nurses can provide relocation support groups to focus on coping skills, stress management, and peer support for relocated women. Support groups can promote a healthier adjustment to relocation. Although depression and anxiety scores were not statistically decreased by participating in support groups, verbal responses from respondents indicated that the support groups were a valuable intervention.     

SARS病人心理应激反应及干预

目前SARS已波及到 3 0余个国家和地区 ,患病人数达70 0 0余人。由于人们对SARS的认识不足 ,加之该病传染性强 ,给人类造成了一定程度的恐惧。为使SARS病人克服心理障碍 ,顺利地渡过隔离治疗期 ,尽快康复 ,我们对 3 2例病人进行了必要的心理干预 ,现介绍如下。1　SARS病人心理反     

Relocation: the impact on staff nurses

To stay competitive in the marketplace, many hospitals are renovating their physical plants to a more hotel-like appearance. Others are downsizing their units, reflecting the decreased demand for acute care beds. As these changes are made, patients and nurses are temporarily relocated to other places in the institution. How does this relocation of nurses impact their professional functioning and self-esteem? Based on their study of four groups of nurses who were relocated, the authors discuss their recommendations for making relocation a positive experience.     

Relocation among ethnic elders. A review--part 2

Relocation to more supportive housing is a potentially stressful life event for older adults. Under the best of circumstances, the older adult will be relatively healthy and able and willing to participate in relocation decisions. However, this is not always possible. Nurses have a critical role to play in helping families identify the most appropriate housing alternative, helping plan the relocation, and helping older adults adjust to their new homes. Relocation is particularly stressful for ethnic elders who may not understand the housing options available, or may fear prejudicial treatment and exclusion in the various settings. Nurses need to take time for careful assessment of the older adults' preferences, and to provide information needed to help them make relocation decisions within the context of their existing support networks.     

Older Adult Relocation: Considerations for Nurse Practitioners

The projected trends of the senior and baby-boomer population represent a projected demographic change that is nothing short of astounding. The nation's older adult population will continue to swell and, by 2035, will make up approximately 18% to 23% of the total population, nearly doubling this current age segment. With this significant and inevitable shift in demographics, individual, family, and community needs will increase proportionally. Nurse practitioners in primary care settings need to be cognizant of these trends and provide proactive assessments and health promotion advice to older patients and their families.     

Relocation and the characteristics of hospital and hostel regimes

Drawing on evidence from a research evaluation of a local community care programme, this paper explores whether relocation from a British National Health Service mental handicap hospital into local authority hostels (supervised residential facilities) brought about a qualitative change in the residential environment of movers towards less restrictive management practices and caring routines, more responsive attitudes towards their rights and needs as individuals, and greater control over their own lives. The conclusions point to the existence of a substantial measure of overlap in the fundamental characteristics of the hospital and hostel regimes.     

血清同型半胱氨酸与阻塞性睡眠呼吸暂停低通气综合征患者氧化应激的关系

目的：探讨不同疾病程度的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清同型半胱氨酸（Hcy）和丙二醛（MDA）及谷胱甘肽（GSH）水平的变化。方法选取2008年6月～2013年12月就诊于苏州大学附属第一医院睡眠中心的患者行多导睡眠监测,依据多导睡眠图（PSG）监测结果确诊为OSAHS的117例患者被分成3组：轻度OSAHS、中度OSAHS、重度OSAHS,选取同期经PSG监测呼吸暂停低通气指数（AHI）＜5次/h的33名健康者为对照组,所有受试者均被记录睡眠呼吸监测相关指标和晨起采取空腹肘静脉血4 mL,采用循环酶法测定Hcy,紫外分光光度比色法测定MDA、GSH。结果血清MDA水平：重度组显著高于对照组、轻度组、中度组[（7.33±1.04）比（4.55±0.87）、（5.39±1.28）、（6.77±0.66）μmol/L]（均P＜0.05）。血清GSH水平：轻、中度组均显著高于对照组[（6.49±2.10）、（7.52±1.50）比（4.21±1.39）mg/L]（均P＜0.05）,但重度组[（4.62±1.40）mg/L]与对照组差异无统计学意义（P＞0.05）。血清Hcy水平：轻、中度组均显著高于对照组[（10.30±1.98）、（13.31±2.63）比（8.72±0.68）μmol/L]（P＜0.05）,但重度组[（9.53±1.84）μmol/L]与对照组差异无统计学意义（P＞0.05）。结论氧化应激损伤水平与抗氧化水平在OSAHS患者疾病的不同阶段,变化不完全一致。Hcy的改变与抗氧化水平GSH改变同步,与疾病的严重程度不同步。氧化应激的作用可能是OSAHS患者血清Hcy水平改变的内在机制。     

Relocation stress in critical care: a review of the literature

1. Transfer to the ward following a period in intensive care may cause stress for patients. 2. A review of the literature reveals that this phenomenon has been described in a number of different ways, such as transfer stress, transfer anxiety, translocation syndrome and, more recently, relocation stress. 3. This paper reviews the various concepts before arriving at a more operational definition of the phenomenon. 4. It attempts to reveal what causes this phenomenon and to what extent it exists. 5. Patients' responses to transfer are identified and the physical and psychological problems that have been associated with discharge from intensive care are discussed. 6. Lists of interventions that the literature suggests may reduce or prevent this phenomenon from occurring are reviewed. 7. Recommendations for practice development and further research are made.