A description of stressors and coping strategies among parents of critically ill children—a preliminary study

The purpose of this preliminary study was to describe (1) perceived stressors and (2) coping strategies among parents of critically ill children.Stress and coping within this population has been subjected to little research. The research that has been reported is predominantly quantitative. The validity of this research is unclear.Five parents of children in a pediatric intensive care unit (PICU) setting were interviewed. They were asked to describe the principal sources of stress (stressors) they encountered and how they dealt with these (coping strategies). The interviews were content analysed.Five categories of stressors were identified. These included parental role conflict, concern for child, environment, friends, and child's siblings.Five categories of coping strategies were identified. These included things you think about, actions directed toward other people, drawing on support from others, things you do, and things you draw on from the environment.The findings of this study have highlighted deficiencies within the existing literature on stress and coping within this population.There is a need for further qualitative research in this area. This will foster the development of a better understanding of the experience of parents for caregivers and provide a foundation for further research.     

Shift nurses’ social jetlag,anxiety, and premenstrual symptoms: A cross-sectional study

BackgroundAlthough rotating shifts are essential for nurses to ensure optimal patient care, rotating shifts expose them to an imbalanced circadian rhythm. Shift work leads to nurses experiencing diminished sleep quality, which affects their wakefulness and judgment, curtails work performance, and affects care quality.AimTo investigate the relationship among social jetlag, anxiety, and premenstrual symptoms in nurses working in 8-hour rotating shiftsMethodsParticipants were 194 shift-working nurses in three South Korean university hospitals from March 21 to April 2 in 2021. Chronotype and social jetlag were assessed using the Munich Chronotype Questionnaire for Shift Workers. Anxiety was measured with the State-Trait Anxiety Inventory X-1. Premenstrual symptoms were measured using the Shortened Premenstrual Assessment Form. This cross-sectional study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.FindingsAmong participants, the mean overall social jetlag was 3 hours 45 minutes. Hierarchical regression analysis revealed that social jetlag (on evening shift) and anxiety significantly influenced nurses’ premenstrual symptoms. Moreover, individuals’ chronotype and preference to work the night shift were identified as predictors of premenstrual symptoms.DiscussionNurses working on shifts are bound to experience greater social jetlag compared with the general population and are at an elevated risk of deteriorated quality of life. Nursing managers should consider individuals’ chronotypes and social jetlag when establishing shift schedules and identify strategies that relieve anxiety in nurses working in rotating shifts.ConclusionSocial jetlag and anxiety adversely affect premenstrual symptoms in female nurses working in 8-hour rotating shifts.     

Are concern for face and willingness to seek help correlated to early postnatal depressive symptoms among Hong Kong Chinese women? A cross-sectional questionnaire survey

BACKGROUND: Face (lian) is a pervasive phenomenon in Chinese culture, exerting an immense and subtle influence on the behavior of people. Coupled with the inherent stigma of mental illness, concern for face may lead women to deny having early postnatal depressive symptoms and to refrain from seeking help from others. OBJECTIVE: The aim of the study was to explore how the traditional Chinese value of face and their willingness to seek help is associated with early postnatal depressive symptoms in Hong Kong. DESIGN: A cross-sectional comparative study design was adopted. SETTINGS: The samples were taken from three postnatal wards in a university-affiliated regional hospital. PARTICIPANTS: One thousand four hundred and sixty-five women who had given birth on 2-5 days postpartum were invited to participate in this study and 1200 women (81.9%) completed the questionnaires. Women with a history or family history of depression were excluded. METHODS: Multivariate logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) to estimate the relationships among concern for face, willingness to seek help, and early postnatal depressive symptoms. RESULTS: The results indicated that 413 (34.4%) of the participants had early postnatal depressive symptoms. Women with high protective face, who "keep a low profile to avoid attention" (p<0.01), and women with high acquisitive face, who "get ahead through social achievement" (GAT) (p<0.05), were found to be more likely to show early postnatal depressive symptoms after adjusting for demo-socio-economic, obstetric, and neonatal variables. Women with high GAT were found to be 1.36 times less likely to seek help during early postnatal period (p<0.05). Depressed women were found to be less likely to seek help (p<0.05). CONCLUSIONS: Concern for face and willingness to seek help were important correlates associated with postnatal depressive symptoms. Health care professionals should make extensive efforts and provide more health education to reach out to these women and their families.     

A cross-sectional study on oncology nurses’ knowledge and practice of oral mucositis among cancer patients in Jordan

ObjectivesThis study was conducted to evaluate oncology nurses’ knowledge and compliance with oral mucositis (OM) management guidelines.MethodsA cross-sectional design with a nonparticipant observation approach was utilized. In phase Ⅰ, a cross-sectional convenience sample (n = 140) of oncology nurses completed the knowledge test. In phase Ⅱ, a random sample (n = 20) of oncology nurses from participants in phase Ⅰ was observed during their practice.ResultsFifty-seven (40.7%) of the participants had an unsatisfactory level of knowledge. Most of them had knowledge deficits regarding pathology, OM definition, assessment, scoring, treatment, and patient education and advice. A significant difference existed among nurses with diploma, bachelor, and postgraduate degrees as determined by one-way ANOVA (P = 0.001). There were no significant difference between average scores of male and female nurses were higher than those of nurses (P = 0.45). No significant difference was observed among knowledge scores of nurses with different job titles (P = 0.51). The average score of male nurses in terms of skill performance was higher than that of female nurses (29.20 ± 2.10 vs 27.10 ± 1.80) without statistical significance.ConclusionThe knowledge and compliance with OM management guidelines among Jordanian oncology nurses need to be improved. National OM prevention and management guidelines are adopted in Jordan. Continuing education and training are also recommended.     

Benefits of belly dance on quality of life,fatigue, and depressive symptoms in women with breast cancer – A pilot study of a non-randomised clinical trial

Objective

To analyse the influence of belly dance on the quality of life, fatigue, and depressive symptoms in women with breast cancer.

Why don’t women volunteer to give blood? A study of knowledge,attitude and practice of women about blood donation,Yazd, Iran, 2005

The most important aim of all blood transfusion centres is to recruit blood donors from low-risk groups of society to donate blood voluntarily and regularly. In the city of Yazd, Iran, only 5% of blood donors are women. The aim of this study was to assess barriers of donation of blood by women and the level of knowledge, attitude and practice regarding blood donation. In this cross-sectional study, 1602 women were selected by cluster sampling method and asked to fill a specially formatted questionnaire. Data were analysed by ANOVA and the t-test. Levels of knowledge were different between the various groups. Illiterate women and housewives had the least levels of knowledge. Fifteen per cent of the women had donated blood at least once in the past. The most important motivational factor was sense of moral duty with a spiritual reward and the most important barriers for donating blood were anaemia, fear, lack of time and difficulty in access to donation sites. A significant percentage of women had false beliefs about blood donation. Increase in the level of knowledge of women and correction of false beliefs should be the topmost priority. Further studies are needed to determine whether addressing anaemia and women's health can tend to increase the number of female blood donors.     

The obese patient. A statistical study and analysis of symptoms,diagnosis and metabolic abnormalities. Sex differences—Treatment

The American Journal of Digestive Diseases -     

Knowledge of,and participation in,advance care planning: A cross-sectional study of acute and critical care nurses’ perceptions

BackgroundNurses have a core role in facilitating discussions and enacting decisions about end-of-life issues for patients in hospitals. Nurses’ own knowledge and attitudes may influence whether they engage in meaningful end-of-life conversations with patients.AimsTo determine in a sample of nurses working in acute and critical care hospital wards:1) their knowledge of advance care planning, including the authority of substitute decision-makers and legal validity of advance directives;2) their own participation in advance care planning decision-making practices; and3) associations between nurses’ socio-demographic characteristics; clinical expertise; and knowledge and behaviour in relation to advance care planning practices.DesignQuestionnaire-based, cross-sectional study.Setting and participantsThe study was conducted with 181 registered and enrolled nurses employed in acute and critical care wards of three metropolitan hospitals in Australia.ResultsNurses were least knowledgeable about items relating to the authority of medical (56%) and financial (42%) substitute decision-makers. Few nurses had prepared advance directives (10%) or appointed medical (23%) or financial (27%) decision-makers, when compared to discussing end-of-life wishes (53%) or organ donation (75%). Overall, 15% of nurses had not engaged in any advance care planning practices. Nurses who had cared for 11–30 dying patients in the last six months were more likely to have an increased knowledge score. Older nurses were more likely to participate in a greater number of advance care planning practices and an increase in shifts worked per week led to a significant decrease in nurses’ participation.ConclusionNurses have a key role in providing advice and engaging dying patients and their families in advance care planning practices. Nurses’ own knowledge and rates of participation are low. Further education and support is needed to ensure that nurses have an accurate knowledge of advance care planning practices, including how, when and with whom wishes should be discussed and can be enacted.     

Relationships between nurses’ empathy,self-compassion and dimensions of professional quality of life: A cross-sectional study

BackgroundJob stress and burnout are common among healthcare professionals, and nurses in particular. In addition to the heavy workload and lack of recourses, nurses are also confronted with emotionally intense situations associated with illness and suffering, which require empathic abilities. Although empathy is one of the core values in nursing, if not properly balanced it can also have detrimental consequences, such as compassion fatigue. Self-compassion, on the other hand, has been shown to be a protective factor for a wide range of well-being indicators and has been associated with compassion for others.ObjectivesThe main goal of this study was to explore how empathy and self-compassion related to professional quality of life (compassion satisfaction, compassion fatigue and burnout). In addition, we wanted to test whether self-compassion may be a protective factor for the impact of empathy on compassion fatigue.Methods and participantsUsing a cross-sectional design, 280 registered nurses from public hospitals in Portugal's north and center region were surveyed. Professional quality of life (Professional Quality of Life), empathy (Interpersonal Reactivity Index) and self-compassion (Self-compassion Scale) were measured using validated self-report measures.ResultsCorrelations and regression analyses showed that empathy and self-compassion predicted the three aspects of professional quality of life. Empathic concern was positively associated with compassion satisfaction as well as with compassion fatigue. Mediation models suggested that the negative components of self-compassion explain some of these effects, and self-kindness and common humanity were significant moderators. The same results were found for the association between personal distress and compassion fatigue.ConclusionsHigh levels of affective empathy may be a risk factor for compassion fatigue, whereas self-compassion might be protective. Teaching self-compassion and self-care skills may be an important feature in interventions that aim to reduce burnout and compassion fatigue.     

Incidence of and risk factors for post–intensive care syndrome among Chinese respiratory intensive care unit patients: A cross-sectional,prospective study

BackgroundPatients transferred from the respiratory intensive care unit (ICU) can experience post–intensive care syndrome (PICS), which comprises cognitive, psychological, and physical disorders that seriously affect the quality of life. Therefore, it was necessary to explore the incidence of and the risk factors for PICS among respiratory ICU patients.ObjectivesThis study evaluated PICS among respiratory ICU patients and explored the risk factors for PICS.MethodsThis cross-sectional, prospective study was performed at one hospital in China. Using convenience sampling, 125 respiratory ICU patients from August 2018 to June 2019 were recruited for the study. The Mini-Mental State Examination, Confusion Assessment Method for the Intensive Care Unit, Hospital Anxiety and Depression Scale, Medical Research Council Scale, activities of daily living scale, Pittsburgh Sleep Quality Index, and the 14-item fatigue scale were used to comprehensively assess the patients' cognitive status, psychological status, and physiological status when entering the ICU and 2 weeks after leaving the ICU. Factors affecting PICS were measured using researcher-created questionnaires of patients’ general information and disease-related information.ResultsFifteen patients were lost to follow-up. Fifty-nine patients had PICS (incidence rate, 53.6%). Logistic regression showed that risk factors for PICS were age, invasive mechanical ventilation, noninvasive ventilator-assisted ventilation, and coronary heart disease (P < 0.05).ConclusionThe PICS incidence was high. Older age, longer invasive mechanical ventilation times, longer noninvasive ventilator times, and coronary heart disease were risk factors for PICS. ICU medical workers in China should pay more attention on PICS, know the risk factors, and implement preventive measures.     

A cross-sectional study of clinical emergency department nurses’ occupational stress,job involvement and team resilience

IntroductionThe occupational stress of clinical nurses has drawn increasing attention. It has been proven that occupational stress is related to job involvement, and job involvement affects team resilience. However, research on the relationship between emergency nurses’ occupational stress, job involvement and team resilience is lacking.AimTo explore relationships between occupational stress, job involvement, and team resilience among a sample of emergency nurses and determined significant influencing factors of occupational stress in emergency departments.MethodsIn four hospitals in Shandong, China, 187 emergency room nurses participated in a study. The Utrecht Work Engagement Scale, the Chinese version of the Stressors Scale for Emergency Nurses, and a scale for evaluating the team resilience of medical professionals were used to collect data.ResultsThe overall occupational stress score of nurses working in the emergency departments in Shandong province was 81.07 ± 25.80. The results of Single-factor analysis demonstrated that the scores indicating the occupational stress for emergency nurses differed significantly with respect to age, education level, marital status, children, professional title, work experience and work shift (P < 0.05). Additionally, there is a negative correlation between job involvement and team resilience and occupational stress. Multiple linear regression results showed that the job involvement, team resilience and work shift were statistically significant influencing factors of the level of occupational stress (change R² = 17.5 %, F = 5.386, P < 0.001).ConclusionsStronger team resilience and more active job involvement resulted in lower occupational stress levels experienced by emergency nurses.     

Health literacy in patients with intermittent claudication in relation to clinical characteristics,demographics, self-efficacy and quality of life – A cross-sectional study

BackgroundIntermittent claudication requires treatment with secondary prevention to reduce disease progression and the risk of cardiovascular events and to improve quality of life. Health literacy and self-efficacy are important preconditions for the health behaviour changes necessary for adhering to secondary prevention.AimEvaluate health literacy in patients with intermittent claudication regarding clinical characteristics, demographics, self-efficacy and quality of life.MethodsA cross-sectional study evaluating health literacy, self-efficacy and quality of life using questionnaires. Patients with intermittent claudication from vascular units in the south of Sweden were included.ResultsIn total, 158 patients were included, of which, 52.5% reported “inadequate” (0-8 points) or “problematic” (9-12 points) health literacy with no differences between men and women. A significant higher proportion of patients living alone reported “inadequate” or “problematic” health literacy than “sufficient” (13-16 points) health literacy. Patients with “sufficient” health literacy reported significantly higher self-efficacy and quality of life and were more physically active than patients with “inadequate” or “problematic” health literacy. Also, patients with a university degree reported a significantly higher ability to “access” (seek, find and obtain) and “understand” (comprehend the accessed) information relevant to health.ConclusionThe majority of patients with intermittent claudication have “inadequate” or “problematic” health literacy. Also, an “inadequate” or “problematic” health literacy level is more common among patients living alone, and education level appears to be more important when “accessing” and “understanding” information relevant to health. This illuminates the importance of not only the patients’ health literacy but also demographics when planning for secondary prevention.     

Does self-compassion mitigate the relationship between burnout and barriers to compassion? A cross-sectional quantitative study of 799 nurses

BackgroundBurnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. However, the association between burnout and compassion and, more specifically, barriers to compassion in medicine is unclear. This article evaluates the associations between burnout and barriers to compassion and examines whether dispositional self-compassion might mitigate this association.HypothesisConsistent with prior work, the authors expected greater burnout to predict greater barriers to compassion. We also expected self-compassion – the ability to be kind to the self during times of distress – to weaken the association between burnout and barriers to compassion among nurses.MethodsRegistered nurses working in New Zealand medical contexts were recruited using non-random convenience sampling. Following consent, 799 valid participants completed a cross-sectional survey including the Copenhagen Burnout Inventory, the Barriers to Physician Compassion scale, and a measure of dispositional self-compassion.ResultsAs expected, greater burnout predicted greater barriers to compassion while self-compassion predicted fewer barriers. However, self-compassion mitigated the association between burnout and burnout related barriers to compassion (but not other barriers). The interaction suggested that suggested that the association was stronger (rather than weaker) among those with greater self-compassion.DiscussionUnderstanding the lack of compassion and the effects of burnout in patient care are priorities in health. This report extends evidence on the association between burnout and compassion-fatigue to show that burnout also predicts the experience of specific barriers to compassion. While self-compassion predicted lower burnout and barriers, it may not necessarily reduce the extent to which burnout contributes to the experience of barriers to compassion in medicine. Implications for understanding how burnout manifests in barriers to clinical compassion, interventions and professional training, and future directions in nursing are discussed.     

A population-based study of exclusive breastfeeding in Icelandic women: is there a relationship with depressive symptoms and parenting stress?

This study investigated whether postpartum depressive symptoms and parenting stress are related to exclusive breastfeeding in mothers at 2-3 months postpartum. Data were collected from 734 Icelandic mothers postpartum. Parenting stress, depressive symptoms, feeding methods and demographical data were assessed by self-administered questionnaires. A high level of maternal education increased the likelihood of exclusive breastfeeding whereas lower maternal education, high levels of depressive symptoms, twins and single motherhood reduced the likelihood of exclusive breastfeeding. It is concluded that depressive symptoms are related to lower levels of exclusive breastfeeding and that exclusive breastfeeding becomes more likely with higher level of maternal education.     

«The Göteborg Quality of Life Instrument» - A psychometric evaluation of assessments of symptoms and well-being among women in a general population

Objective - To examine with psychometric analysis techniques the potential for constructing valid composite variables of »The Göteborg Quality of Life Instrument«.

Design - Prospective population study of women in 1974–75 and in 1980–81.

Setting - City of Göteborg, Sweden.

Participants - Representative samples of the general population of women in five age strata between 44 and 66 years of age in 1974–75, followed 1980–81 including new cohorts of women aged 26 and 38. 1302 women were examined in 1974–75 and 1408 in 1980–81.

Main outcome measure - »The Göteborg Quality of Life instrument«, constructed in the early 1970s to measure symptoms and well-being in a population study of men.

Results - Four multi-item scales were identified with satisfactory reliability and validity, i.e., they met defined criteria of multi-item scales and benefit from higher reliability than single questions. The psychological symptom scale comprised all ten questions intended to reflect depression and tension, while the physical symptom scale included all six pain questions, the general symptoms dizziness, breathlessness, and nausea, and general fatigue that belonged to both symptom scales. The social well-being scale comprises all well-being questions believed to reflect the broad concept of life satisfaction. The physical-mental wellbeing scale reflected satisfaction with both general and mental health. Several symptom and well-being questions were clearly outside the main clusters and should be treated as single items.

Conclusions - Use of a few, distinct scales instead of a number of single questions should increase statistical power because the number of comparisons is greatly reduced and problems of chance findings are thus minimized.     

Patterns of fatigue related to advanced disease and radiotherapy in patients with cancer—a comparative cross-sectional study of fatigue intensity and characteristics

Goals of work  This cross-sectional comparative study was designed to explore and describe the prevalence and patterns of cancer-related fatigue in patients with advanced cancer as well as patients undergoing curative radiotherapy. Another aim was to explore the association of anxiety and depression with fatigue. Materials and methods  Patients with an advanced stage of disease (n = 228) and patients receiving radiotherapy (n = 81) completed the Borg Category Ratio Scale, the Multidimensional Fatigue Inventory and the Hospital Anxiety and Depression Scale. Main results  Patients with advanced disease had an increased probability of experiencing all aspects of fatigue except for mental fatigue as compared to patients undergoing radiation, e.g., odds ratio 11.5 (CI 5.8–22.7) for physical fatigue. Higher scores for depression than for anxiety were reported when patients had high levels of fatigue, with 23% of the patients classified as anxious and 39% depressed. Conclusions  The present study was carried out in order to address a gap in research by comparing the multidimensional aspects of fatigue in different groups of cancer patients. It is the intensity of fatigue that seems to be related to the underlying exposure to radiation or to the level of disease burden rather than the different fatigue profiles, such as the relation between physical and mental aspects.     

Generalised anxiety disorder symptoms and utilisation of health care services. A cross-sectional study from the “Northern Finland 1966 Birth Cohort”

Objective: To analyse the utilization of health care services of people who tested positive for GAD compared to those who tested negative. Setting: A cross-sectional study from the Northern Finland 1966 Birth Cohort. Subjects: A total of 10,282 members followed from birth in a longitudinal study were asked to participate in a follow-up survey at the age of 46. As part of this survey they filled in questionnaries concerning health care utilization and their illness history as well as the GAD-7 screening tool. Althogether 5,480 cohort members responded to the questionnaries. Main outcome measures: Number of visits in different health care services among people who tested positive for GAD with the GAD-7 screening tool compared to those who tested negative. Results: People who tested positive for GAD had 112% more total health care visits, 74% more total physician visits, 115% more visits to health centres, 133% more health centre physician visits, 160% more visits to secondary care, and 775% more mental health care visits than those who tested negative. Conclusion: People with GAD symptoms utilize health care services more than other people.

• Key Points

• Generalised anxiety disorder (GAD) is a common but poorly identified mental health problem in primary care.

• People who tested positive for GAD utilise more health care services than those who tested negative.

• About 58% of people who tested positive for GAD had visited their primary care physician during the past year.

• Only 29% of people who tested positive for GAD had used mental health services during the past year.