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Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors associated with fall occurrence and fall frequency among community-dwelling older adults in Korea, with particular emphasis on SDOH.
A cross-sectional study design.
We used a large nationwide sample (n = 9746) from the 2023 National Survey of Older Koreans. The number of falls in the past year served as the dependent variable. Independent variables included a range of socioeconomic and environmental variables as SDOH, alongside biological and behavioral variables. A zero-inflated negative binomial (ZINB) regression analysis was employed to address excess zeros and overdispersion in fall count data.
Among participants, 94.8% experienced no falls, 3.2% reported a single fall, and 1.9% reported recurrent falls. In the logit model for fall occurrence, higher household income level, absence of age-friendly housing, higher access to parks, and lower access to welfare centers were associated with higher risk of fall occurrence. In the count model for fall frequency, higher education level, presence of age-friendly housing, and outdoor mobility barriers were associated with higher fall frequency within the at-risk group.
The findings provide empirical evidence on the critical roles of SDOH in falls among community-dwelling older adults. Specifically, a ZINB regression analysis identified distinct sets of SDOH associated with fall occurrence versus fall frequency, highlighting the complex and multifaceted nature of fall patterns among older adults.
Healthcare providers and policymakers seeking to reduce falls should implement tailored, SDOH-integrated strategies by addressing the different mechanisms underlying fall occurrence and fall frequency.
Assess US registered nurse genomic competency.
Administered the Genetics and Genomics Nursing Practice Survey (GGNPS).
GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utilization in nursing practice. Distributed by the American Nurses Association via email and online to US registered nurses. Results are analyzed using descriptive statistics and compared to 2010 data.
1065 registered nurses responded. Most (41%) were Master's prepared, actively seeing patients (51%) and 66% considered it very important to learn more about genomics. Most (55%) reported their genomic knowledge was poor yet 51% reported a patient initiated a genetic discussion with them in the past 3 months. 66% completed all knowledge score items with a median score of 9/12, no change from 2010. Only 26% had heard of the Essential Competencies. Most reported no genomic curricular content (64%); had not attended a genomic course since licensure (64%); intended to learn more about genomics (70%); and would attend a course on their own time (79%).
Nurses felt genomics was important but have capacity deficits. Despite genomic discoveries and evidence-based practice guidelines that impact healthcare quality and safety, 20 years after the Genomic Competencies were established (2005) nursing genomic practice capacity remains low.
Genomics is critical to the safe, quality nursing practice regardless of the level of academic training, clinical role, or specialty.
To examine the paradox of representation without power in nursing leadership and to highlight how gendered hierarchies persist in academic, clinical, and policy arenas despite nursing's predominantly female composition.
Existing systems of evaluation and promotion often reproduce inequities by undervaluing relational and collaborative leadership styles—forms of leadership intrinsic to nursing practice. This commentary draws on global and contextual perspectives to advocate for accreditation and institutional metrics that integrate equity indicators and recognize inclusive leadership as a marker of excellence.
Advancing gender equity in leadership is both an ethical and strategic imperative. Embedding equity education and inclusive leadership development within nursing curricula from the earliest stages of professional formation is essential to reshape the future of nursing leadership.
Promoting gender equity in leadership will strengthen nursing's contribution to health systems, enhance organizational resilience, and advance equitable patient care.
Burnout, a form of moral suffering, has become more commonplace among health care workers in recent years. Measures of general resilience have been widely used to capture improvement in burnout but lack the ability to capture the anguish that comes with burnout from a moral standpoint. The purpose of this analysis was to understand whether moral resilience is uniquely related to burnout beyond a measure of general resilience in a sample of interprofessional health care workers.
Secondary analysis of cross-sectional survey data.
In total, 702 interprofessional health care workers participated in a cross-sectional survey. Key measures included the Rushton Moral Resilience Scale (RMRS), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Hierarchical multiple regression modeling was used to examine the effect of moral resilience (RMRS) in predicting the three dimensions of burnout (MBI-HSS) over and above general resilience (CD-RISC-10).
Moral resilience explained five, six, and 4% of variance for personal accomplishment, depersonalization, and emotional exhaustion, respectively, after accounting for general resilience (CD-RISC-10) and all covariates.
Findings highlight the clear conceptual differences between general and moral resilience and their unique relationship to burnout. Accounting for moral resilience will facilitate an improved multi-level response to moral suffering among health care workers.
Measuring and understanding the differences between general resilience and moral resilience is vital for us to better facilitate the necessary support(s) for health care workers experiencing moral suffering. This will contribute to more sustainable clinical environments, reduced burnout and suffering, and improved patient outcomes.
With an aging population worldwide, pressure injury (PI) is becoming a critical challenge for healthcare professionals. We aimed to investigate the difference in PI trend globally across age groups from 1990 to 2021.
This study utilized data from the Global Burden of Diseases (GBD) 2021 to determine the age-standardized incidence rate (ASR) of PI stratified by age groups from 1990 to 2021. Estimated annual percentage changes (EAPCs) were calculated to measure corresponding temporal trends.
Over three decades, the incident cases of PI have doubled from 1.1 million to 2.5 million worldwide. The incidence of PI showed an exponential rise with increasing age groups in 2021. The significant increasing trends were observed in the population aged 20–54 years (EAPC = 0.11) and 55+ years (EAPC = 0.55) from 1990 to 2021. The ASR among males has increased from 32.53 to 33.34 per 100,000 population, with an EAPC of 0.27, while the ASR among females decreased. The ASR was increased with higher income levels and the highest ASR was observed in the high-income region (49.95 per 100,000 population). Among six regions, the Americas had the highest ASR in 2021 (90.20 per 100,000 population), while South-East Asia showed the fastest increase (EAPC = 1.22).
The global burden of PI is a growing global health problem among the elderly population, particularly in the Americas. A greater incidence burden in males and high-income level regions was found. This study advocates for urgent attention to coping strategies for aging populations and older people with PI.
This study advocates for urgent attention to coping strategies for aging populations.
Sensory balance is the individual's ability to regulate internal and external sensory stimuli to remain in a functional and balanced state.
This study aims to explore in depth the experiences of psychiatric nurses caring for trauma victims in building sensory balance and well-being.
Psychiatric nurses caring for trauma victims may be constantly exposed to intense sensory stimuli such as yelling and agitation. It is known that post-traumatic stress disorder and burnout are seen in nurses caring for these individuals; however, it is noteworthy that studies on how this process is reflected sensoryly in individuals are limited.
Snowball sampling method was used in this qualitative phenomenological study. In-depth interviews were conducted with 14 volunteer psychiatric nurses caring for trauma victims. Data were collected using a semi-structured interview form and analyzed using Colaizzi's method. COREQ guidelines were adhered to throughout the research process.
Four categories and a total of eight themes were obtained from the in-depth interviews. “Traces of Traumatic Contact, Emotional Armor and Inner Distance, Transformation through Exhaustion, Institutional Silence and Seeking Solidarity”.
This study shows that psychiatric nurses caring for trauma victims are both professionally and individually traumatized and face the risk of losing their identity. It has also been found that nurses withdraw both sensorially and emotionally and experience burnout. But in some cases this process transforms into the development of awareness and maturity. It was also found that despite adverse working conditions, contact with nature, silence and collegial solidarity played a protective role in rebuilding well-being.
This study addresses in depth the sensory, emotional and identity impacts experienced by psychiatric nurses caring for trauma victims and draws attention to the effects of these conditions on the process of well-being construction. The results of the study provide important points for the development of education, self-care and institutional support mechanisms to support nurses' well-being.
Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.
To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.
Meta-research study.
A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.
A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16–22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having “some concerns”, largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were “Delivery of care” and “Physical functioning”.
Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
Incarceration significantly impacts inmates health, particularly marginalized groups like transgender persons, due to systemic oppression and inadequate healthcare. This study aims to understand transgender prisoners' health management experiences.
An interpretative phenomenological approach was used. Data were collected through in-depth interviews with eight transgender inmates in Barcelona, Spain, and analyzed using the seven-step Colaizzi method.
Three primary themes emerged: (1) Navigating Vulnerability in Healthcare Dynamics, which highlighted experiences of stigma and inadequate care; (2) The Quest for Wellbeing Amidst Uncertainty, underscoring concerns regarding treatment continuity; and (3) Negotiating a Landscape of Violence, revealing experiences of harassment and discrimination.
This study highlights the need for culturally competent, person-centered healthcare policies in prisons, particularly for transgender individuals. Addressing the specific health needs of transgender inmates is crucial for enhancing their overall well-being. This emphasizes the importance of systemic reforms to improve care provision for transgender prisoners.
Prison nurses must prioritize person-centered approaches, ensure continuity of gender-affirming treatments, and provide empathetic mental health support to enhance trust and improve the overall well-being of transgender inmates.
Conducting bias assessments in systematic reviews is a time-consuming process that involves subjective judgments. The use of artificial intelligence (AI) technologies to perform these assessments can potentially save time and enhance consistency. Nevertheless, the efficacy of AI technologies in conducting bias assessments remains inadequately explored.
This study aims to evaluate the efficacy of ChatGPT-4o in assessing bias using the revised Cochrane RoB2 tool, focusing on randomized controlled trials in nursing.
ChatGPT-4o was provided with the RoB2 assessment guide in the form of a PDF document and instructed to perform bias assessments for the 80 open-access RCTs included in the study. The results of the bias assessments conducted by ChatGPT-4o for each domain were then compared with those of the meta-analysis authors using Cohen's weighted kappa analysis.
Weighted Cohen's kappa values showed better agreement in bias in the measurement of the outcome (D4, 0.22) and bias arising from the randomization process (D1, 0.20), while negative values in bias due to missing outcome data (D3, −0.12) and bias in the selection of the reported result (D5, −0.09) indicated poor agreement. The highest accuracy was observed in D5 (0.81), and the lowest in D1 (0.60). F1 scores were highest in bias due to deviations from intended interventions (D2, 0.74) and lowest in D3 (0.00) and D5 (0.00). Specificity was higher in D5 (0.93) and D3 (0.82), while sensitivity and precision were low in these domains.
The agreement between ChatGPT-4o and the meta-analysis studies in the same RCT assessments is generally low. This indicates that ChatGPT-4o requires substantial enhancements before it can be used as a reliable tool for bias risk assessments.
The AI–based tools have the potential to expedite bias assessment in systematic reviews. However, this study demonstrates that ChatGPT-4o, in its current form, lacks sufficient consistency, indicating that such tools should be integrated cautiously and used under continuous human oversight, particularly in evidence-based evaluations that inform clinical decision-making.
To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.
Qualitative descriptive study.
Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.
We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.
Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.
This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.
Smoking is the leading cause of preventable deaths. The training of professionals on brief tobacco interventions (BTIs) increases the effectiveness of these interventions.
To assess the effectiveness of an online training program on BTI based on the 5As and 5Rs model in acquiring anti-tobacco brief advice competencies among nurses.
Quasi-experimental study with a pre-test and post-test design, with a control group and without random assignment. In the experimental group (EG), online training was provided in three sections: BTI theoretical content and methodology, clinical scenario videos, and feedback. Each scenario assessed the 5As and 5Rs as a validated instrument (BTI-Prof(C)). The control group (CG) only assessed the three videos of clinical scenarios. In both groups, competence was measured at the following points in time: T0 (before the training), T1 (at the end of the training), and T2 (after 90 days). The efficacy of the intervention was measured through a two-way ANOVA, and the variation rate was calculated from T0 to T1 and from T0 to T2.
236 nurses participated (157 EG; 79 CG). The mean age was 42.9 years, and 76.7% were women. There was a significant group*time interaction in the three cases, indicating that the online BTI training increases the competence of these professionals in clinical scenario 1 (F = 10.210; p ≤ 0.001; η 2 = 0.081), clinical scenario 2 (F = 6.235; p = 0.002; η 2 = 0.051), and clinical scenario 3 (F = 11.271; p ≤ 0.001; η 2 = 0.090).
A brief, asynchronous, and online intervention using standardized video-based cases is effective in improving nurses' BTI competence. This type of training can be a useful option for the National Health System as part of a global and continuous strategy for nurses to perform BTI.
An asynchronous online training program provides nurses with standardized, evidence-based tools to implement brief tobacco interventions in routine care, offering a scalable and practical solution to strengthen preventive strategies in health systems.
The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations.
A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded.
A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed.
The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience.
This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges.
Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically, taking a leadership role includes both acting as a knowledge multiplier and increasing the health literacy of the general population.
As healthcare systems confront rising demands and workforce shortages, advanced practice nursing (APN) has emerged globally as a vital strategy to improve care delivery and address systemic gaps, particularly in primary care facilities in low- and middle-income countries like the Philippines.
Qualitative case study.
This study was conducted in a rural setting in the Philippines and draws on a preceding mixed-methods case study that explored task shifting and advanced nursing practice in primary care facilities. Using purposeful sampling, 41 nurses, physicians, academics, policymakers, and recipients of care participated in interviews and focus group discussions. Qualitative data were thematically analyzed in ATLAS.ti, and quantitative data were descriptively analyzed in JASP. Findings were integrated into the APN framework tailored to primary care in low- and middle-income countries (LMICs).
Although the Philippines lacks a formal APN policy, nurses informally fulfill many advanced practice roles aligned with Hamric's model, particularly in direct patient care, leadership, collaboration, and evidence-based practice. Key enabling competencies include health promotion, systems thinking, and policy implementation—environmental barriers such as a lack of regulatory frameworks, educational pathways, and financing limit APN institutionalization.
This study proposes a contextualized advanced practice nursing (APN) model, which is relevant for LMICs, particularly in primary care facilities facing workforce shortages and rising NCD burdens. To institutionalize APN roles, key reforms should include investments in education, certification, financing, and regulation. Settings implementing initiatives to attain universal health coverage can serve as entry points for recognizing APN functions through competency-based systems.
The study proposes a contextualized APN framework for low-resource settings, showing that formalizing expanded nursing roles through education and certification can enhance access to quality care and advance UHC in underserved areas.
With ambient listening systems increasingly adopted in healthcare, analyzing clinician-patient conversations has become essential. The Omaha System is a standardized terminology for documenting patient care, classifying health problems into four domains across 42 problems and 377 signs/symptoms. Manually identifying and mapping these problems is time-consuming and labor-intensive. This study aims to automate health problem identification from clinician-patient conversations using large language models (LLMs) with retrieval-augmented generation (RAG).
Using the Omaha System framework, we analyzed 5118 utterances from 22 clinician-patient encounters in home healthcare. RAG-enhanced LLMs detected health problems and mapped them to Omaha System terminology. We evaluated different model configurations, including embedding models, context window sizes, parameter settings (top k, top p), and prompting strategies (zero-shot, few-shot, and chain-of-thought). Three LLMs—Llama 3.1-8B-Instruct, GPT-4o-mini, and GPT-o3-mini—were compared using precision, recall, and F1-score against expert annotations.
The optimal configuration used a 1-utterance context window, top k = 15, top p = 0.6, and few-shot learning with chain-of-thought prompting. GPT-4o-mini achieved the highest F1-score (0.90) for both problem and sign/symptom identification, followed by GPT-o3-mini (0.83/0.82), while Llama 3.1-8B-Instruct performed worst (0.73/0.72).
Using the Omaha System, LLMs with RAG effectively automate health problem identification in clinical conversations. This approach can enhance documentation completeness, reduce documentation burden, and potentially improve patient outcomes through more comprehensive problem identification, translating into tangible improvements in clinical efficiency and care delivery.
Automating health problem identification from clinical conversations can improve documentation accuracy, reduce burden, and ensure alignment with standardized frameworks like the Omaha System, enhancing care quality and continuity in home healthcare.
Patients with advanced cancer can suffer from serious distress like death anxiety and depression, in addition to facing a reduced quality of life. Death education interventions have been shown to improve these outcomes, but their effectiveness remains unclear, especially in the advanced stages.
This meta-analysis aimed to examine the efficacy of death education interventions on death anxiety, depression, and quality of life in advanced cancer sufferers, and to explore the influence of the intervention site, duration, the age of participants, and dyadic relationships with caregivers on the effectiveness of these interventions.
A meta-analysis of randomized controlled trials was performed.
A systematic search of 10 electronic databases identified 19 eligible RCTs with 1531 participants. Data were extracted and analyzed via Review Manager 5.4. Subgroup analyses were performed on the basis of the intervention site, duration, age of participants, and presence of caregivers.
In comparison to the control intervention, the death education intervention notably alleviated death anxiety (SMD = −2.11, 95% CI: −5.91 to −0.89, p = 0.008) and depression (SMD = −0.45, 95% CI: −0.72 to −0.18, p = 0.001). Quality of life (SMD = 0.86, 95% CI: 0.39–1.33, p = 0.0003) was also significantly improved. Subgroup analyses revealed that interventions with longer durations, conducted in professional settings, and targeting younger patients were more likely to be effective in reducing depression and enhancing the quality of life. Interventions without family companionship were more effective in improving depression, while interventions with family companionship were more effective in improving quality of life.
Death education interventions are effective at improving death anxiety, depression, and quality of life in patients with advanced cancer. Tailoring interventions to individual features and cultural backgrounds is crucial to achieving the best effect.
Death education is an effective and important intervention measure that can help patients with advanced cancer better cope with death anxiety and depressive emotions and improve their quality of life. Clinical medical workers should select appropriate death education programs based on the specific conditions of patients and provide necessary support and guidance.
CRD42024565376
Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of group interventions with SARs on various outcomes (physical, cognitive, psychological, quality of life, therapeutic engagement, and sociality) for older adults, and the factors that influence their effectiveness.
A literature search was conducted using five databases (Web of Science, PubMed, Scopus, PsycINFO, and MEDLINE) in October 2024. The research team selected and analyzed the studies applying a narrative synthesis.
In all, 25 articles were identified, 15 of which were deemed of good quality. We found that companion robots are commonly used in group interventions for older adults that consist of physical, cognitive, and combined physical and cognitive activities. Insufficient evidence was identified on the effectiveness of physical interventions and groups with physical and cognitive activities on health outcomes (i.e., physical, cognitive, psychological, and quality of life). Regarding the cognitive group interventions, positive physical outcomes (i.e., improved sleep quality, decreased pulse rate, and increased pulse oximetry), improved cognitive function, positive psychological outcomes (i.e., decreased agitation, depression, anxiety, and loneliness, and increased positive emotions) were found; however, the positive effects in terms of cognitive level and certain psychological outcomes were comparable to the control groups. Mixed results were reported for quality of life in older adults. Across the three types of interventions, robots facilitated engagement and increased the sociality of most older adults. The effectiveness depended on the cognitive function of the older adults, the presence of staff, the type of robot, and the schedule of the interventions.
Research gaps have been identified, and more rigorous studies investigating the effectiveness of different types of group interventions in older adults are needed before applying SARs in group interventions on a large scale.
Given the importance of group interventions in nursing care of older adults, healthcare professionals can use socially assistive robots in such interventions to assist in caring for older adults.
Older adults may experience a wish to die in the context of deteriorating health, a loss of autonomy, loneliness, or depression. Home care workers may likewise experience burden or symptoms of depression as a result of prolonged contact with this physical and emotional suffering. Training initiatives that can support the well-being of home care workers are therefore important.
To describe the typical profile of older adults who express a wish to die to their home care worker, and to examine whether a psycho-educational intervention for care workers exploring the end-of-life process and self-care strategies had an impact on the older adult's wish to die and on the care worker's perceived burden and depressive symptoms.
Quasi-experimental, longitudinal study involving non-randomized experimental and control groups and follow-up at 3–6 months post-intervention.
At the start of the study, all care workers (n = 126) provided sociodemographic information (age, gender) for themselves and the care recipient, and completed the Karnofsky Performance Status scale and the Assessment of the Frequency and Extent of the Desire to Die (AFEDD) interview to provide a baseline measure of the care recipient's functional status and wish to die. They also completed the Beck Depression Inventory (BDI) and Zarit Burden Interview (ZBI) as a measure of their own perceived burden and depressive symptoms. The AFEDD, BDI, and ZBI were completed again by care workers at 3 and 6 months post-intervention.
The typical profile of care recipients was a woman aged 85.5 years who required considerable support and assistance and who had at least occasionally experienced a wish to die, although these thoughts were not always verbalized. Scores on the AFEDD remained relatively stable over the follow-up period in both the control and experimental groups. There was no significant association between the older adult's wish to die and depressive symptoms in the care worker across the study period. However, a positive and significant correlation between a wish to die in the older adult and perceived burden in the care worker was observed at 6 months post-intervention in both the total sample (p = 0.032) and among controls (p = 0.028). By contrast, this significant association was not found for care workers in the experimental group (p = 0.376), suggesting that the psycho-educational intervention may have had a protective effect.
Although further studies are needed to corroborate and extend these findings, the results suggest that psycho-educational interventions aimed at increasing home care workers' understanding of the end-of-life process and which introduce them to self-care strategies may help to reduce their perceived burden when the older person for whom they are caring expresses a wish to die.
Home care workers may find it challenging to care for an older adult who expresses a wish to die. Psycho-educational interventions that enhance care workers' understanding of the end-of-life process and teach them self-care strategies could help to support their well-being and their ability to provide adequate care.
Pregnancy can cause stress for couples, potentially leading to anxiety. However, most studies on antepartum anxiety focus on expectant mothers, ignoring the expectant fathers and the stress transmission between couples. We aim to examine the mediation of dyadic coping between antepartum anxiety and stress in expectant mothers and fathers.
We implemented a cross-sectional study in Guangzhou, China, from October 2023 to January 2024.
Three-hundred and twenty-nine Chinese pregnant couples completed the Perceived Stress Scale, the Dyadic Coping Inventory, and the State–Trait Anxiety Inventory. The actor-partner interdependence mediation model was used for data analysis.
Expectant mothers experienced antepartum anxiety symptoms at a rate of 42.6%, while the rate for expectant fathers was 32.5%. Regarding the actor effects, stress was positively associated with antepartum anxiety in expectant mothers (β = 0.66, 95% confidence interval CI [0.56, 0.74]) and fathers (β = 0.58, 95% CI [0.42, 0.70]), with dyadic coping acting as a mediator (expectant mothers: β = 0.08, 95% CI [0.03, 0.14]; fathers: β = 0.11, 95% CI [0.04, 0.19]). Regarding the partner effects, maternal dyadic coping was positively associated with paternal stress (β = 0.10, 95% CI [0.01, 0.19]).
The study highlights the interplay of stress, dyadic coping, and antepartum anxiety in expectant mothers and fathers, emphasizing the need to assess their antepartum anxiety and implement couple-centered interventions to enhance their psychological well-being during the first trimester of pregnancy.
This study highlights the importance of assessing antepartum anxiety in both expectant mothers and fathers, emphasizing the mediation of dyadic coping in reducing stress and anxiety. The findings support the integration of couple-centered mental health interventions into routine antepartum care to enhance psychological well-being during pregnancy.
FreshRSS 