Living experiences of middle-aged adults with early knee osteoarthritis in prediagnostic phase

Purpose: The aim of this study was to understand the living experiences of middle-aged Taiwanese adults with early knee osteoarthritis (OA). Methods: A qualitative research design was used in this study. Participants (n?=?17) were recruited by purposive sampling from orthopedic clinics at two medical centers in northern Taiwan. Data were collected through in-depth interviews from July to December 2010. The data were transcribed verbatim and summarized by content analysis. Results: The results indicated that the lived experiences could be grouped into 4 main themes: awareness; surmise of causes; acquisition of strategies; and the search for confirmative diagnosis. Conclusions: This study found that patients’ knowledge is insufficient for recognition of the presence of early OA. There is a need for clinicians to integrate knowledge of OA into the health education system and to develop interventions for early knee osteoarthritic patients. Patients’ disease cognition must be promoted so that their ability to process early symptoms of this disease will improve.

Implications for Rehabilitation

• Awareness, surmise of causes, and acquisition of strategies are repetitive circles. Patients pursue the true cause for their knee joint disease and seek confirmative diagnosis when the symptoms do not improve or when they became worse.

• The information patients have is insufficient to know the presence of degenerative osteoarthritis disease.

• There is a need for clinical practitioners to integrate knowledge of osteoarthritis into the health education system to increase awareness and to develop appropriate interventions for patients with early knee OA.

     

Aspects of control and substance use among middle‐aged and older adults with bipolar disorder

High prevalence rates of alcohol and substance use disorders have been reported among persons with bipolar disorder (BD). In the present study, we explored the daily experiences of middle‐aged and older adults living with BD who reported regular substance use and the ways in which participants expressed ‘control’ in relation to their use of alcohol and other substances. Semistructured, in‐depth interviews were conducted with 12 participants (nine women and three men), aged 36–57 years of age (mean = 49 years). Thematic analyses identified emergent themes and patterns in participants’ life histories. The theme of ‘control’ emerged as central to participants’ reports, and was organized into four categories: (i) substance use to control BD symptoms; (ii) substance use provides a sense of being in control; (iii) methods of controlled substance use; and (iv) not having control: overreliance on substances. Implications of the present study include the need for nurses to openly discuss the use of alcohol and other drugs with persons with BD, provide health information and screening, and determine whether persons with BD feel they have control over their substance use. Several lines of research with persons who have BD and use substances are suggested.     

Self‐management program for obesity control among middle‐aged women in Korea: A pilot study

Aim: The aim of this study was to determine the effectiveness of a 12 week self‐management intervention program, as compared to a structured exercise intervention, for obesity control among middle‐aged women in Korea. Methods: A quasi‐experimental study was conducted with 27 women in a self‐management group and 24 in a structured exercise group for 12 weeks. The self‐management group received interventions that included walking at a convenient time and place, keeping healthy dietary habits, group workshops, phone counseling, and mobile phone short message services. The structured exercise group received a structured exercise intervention, which involved three 1 h walking classes per week at the health center. Both groups received baseline assessments before starting the interventions and at 12 weeks. The data were analyzed by using two sample t‐tests, a paired t‐test, and the χ²‐test. Results: After 12 weeks, there were significant changes in the health behavior, amount of body fat, and blood pressure of the participants in both intervention groups, but there was no significant difference in their body composition, blood profile, or blood pressure. Conclusion: Both the self‐management and the structured exercise programs were effective in controlling obesity in middle‐aged obese women in Korea. However, considering the chronic nature of obesity, the self‐management program would be more beneficial, compared to the structured exercise program, as it allows people to exercise at a convenient time and place and to learn how to cope with their lifestyle barriers.     

Health promotion behavior in middle‐aged Koreans: A cross sectional survey

This cross‐sectional study was conducted to verify self‐efficacy, self‐esteem, and social support as characteristics of health promotion behavior in middle‐aged Koreans, and the influence of social support on self‐efficacy and self‐esteem with respect to health promotion behavior. Data were collected from 310 subjects in South Korea using a self‐administered questionnaire. We found a significant finding that self‐efficacy positively influences health promotion behavior, focusing on the moderating effect of social support. Self‐efficacy affected health promotion behavior (P < 0.01) as did social support. Mean self‐efficacy, self‐esteem, health promotion behavior, and social support scores were 50.27, 29.35, 124.39, and 76.51, respectively. This finding provides strong evidence that social support can be used as a model to understand health promotion behavior. Individualized nursing interventions based on social support and self‐efficacy theory should be utilized in high‐risk middle‐aged patients so as to assist and improve health promotion behavior. Also, in community practice settings, nurses should consider that increased social support and self‐efficacy are required to improve health promotion behaviors.     

The experiences of adult ventilator‐dependent patients: A meta‐synthesis review

Studies exploring the perceptions of patients whose lives are maintained by mechanical ventilation highlight the stressful nature of this type of experience. The objective of this meta‐synthesis study was to describe the nature of the experience of adult ventilator‐dependent patients. A systematic literature search of English and Chinese databases was undertaken, covering the period between 1970 and 2012. Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A total of 1004 papers were identified from various database and hand searches. Nineteen papers were critically appraised and 16 met inclusion criteria. Five meta‐synthesis themes emerged from the analysis: (1) the feelings of fear due to being dependent on a ventilator and the loss of control of life; (2) disconnection with reality; (3) impaired embodiment; (4) construction of coping patterns; (5) trust and caring relationship. Suggested implications for practice include enhancing the trust relationship with health professionals, as well as nursing actions throughout the suction procedure relating to release of patient's psychological distress and empowering their resilience factors.     

Graduated nurses' experiences with baccalaureate thesis writing: A qualitative study

This study explores the perceptions of newly graduated nurses regarding the baccalaureate thesis (BT) writing process. A qualitative approach with content analysis was adopted. Thirteen newly graduated nurses participated in the study. The inclusion criterion was having completed the BT during their university education as nurses within 3 years of the study. Information was obtained through semistructured interviews. Data collection began in June 2018 and ended in March 2019, once saturation of information was reached. Three major categories were identified: the beginning of the process, the advantages of Baccalaureate thesis writing, and the teacher's role. The participants expressed that their training focused on a synthetic and particular type of writing that is necessary for clinical scenarios but not suitable for scientific academic texts. Additionally, reflective diaries were described as a powerful writing practice during their studies. Participants conceive the realization of the baccalaureate thesis as a difficult process, especially as regards selecting, synthesizing, and writing about the available information, processes that they indicated generate anxiety. Academic writing skills should be specifically included in the nursing curriculum.