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To refine fall risk assessment scale among older adults with cognitive impairment in nursing homes.
A cross-sectional survey.
Mokken analysis was conducted to refine the assessment scale based on unidimensionality, local independence, monotonicity, dimensionality, and reliability. Data were gathered from cognitively impaired older adults in a nursing home from January to February 2023. Trained nursing assistants conducted face-to-face assessments and reviewed medical records to administer the scale.
Emotion and State Dimension did not meet unidimensionality criteria (H = 0.14), particularly item Q9, which also violated local independence. Monotonicity analysis showed all items exhibited monotonic increases. After refinement at c = 0.3, the scale consists of nine items. With increasing c-values, the first seven items were ultimately retained to form the final version of the scale. Both optimised scales (9-item and 7-item) satisfied reliability requirements, with all coefficients (Cronbach's α, Guttman's lambda-2, Molenaar-Sijtsma, Latent Class Reliability Coefficient) ≥ 0.74.
The scale is suitable for assessing fall risk among older adults with cognitive impairment, with a unidimensional scale of the first seven items recommended for practical use. Future efforts should refine the scale by exploring additional risk factors, especially emotion-related ones.
The refined 7-item scale provides nursing home staff with a practical, reliable tool for assessing fall risk in cognitively impaired older adults, enabling targeted prevention strategies to enhance safety and reduce injuries.
The refined 7-item scale provides nursing home staff with a reliable, practical, and scientifically validated tool specifically designed for assessing fall risk in older adults with cognitive impairment. Its simplicity enables efficient integration into routine clinical workflows, empowering caregivers to proactively identify risk factors and implement timely, targeted interventions. This approach directly enhances resident safety by translating assessment results into actionable prevention strategies within daily care practices.
This study was reported in accordance with the STROBE guidelines.
No Patient or Public Contribution.
To critically assess the impact of theory-guided positive psychological interventions on the quality of life of breast cancer patients and survivors.
Systematic review and meta-analysis.
A comprehensive literature search was conducted across seven electronic databases from inception to August 2024. Randomised controlled trials that examined the effects of theory-guided positive psychological interventions on adult breast cancer patients or survivors and reported quality of life outcomes were included. Screening, data extraction and critical appraisal were independently performed by the reviewers using the revised Cochrane risk-of-bias tool (RoB2). A meta-analysis was conducted using RevMan Web. The study was reported following the PRISMA 2020 Statement.
Five randomised controlled trials were included. Only two of these studies showed a low risk of bias across all quality measures. The meta-analysis demonstrated a significant improvement in quality of life following theory-guided positive psychological interventions, with low heterogeneity. Subgroup analyses revealed that interventions lasting either less than or longer than 3 weeks, and both group-based and individual-based formats, had positive effects on quality of life. Additional psychological benefits were observed including reductions in depressive symptoms, anxiety, perceived stress and improvements in post-traumatic growth, resilience, hope and perceived benefits. One study also reported improvements in sleep quality.
The findings demonstrate that theory-guided positive psychological interventions can potentially significantly improve quality of life in breast cancer patients. However, the limited number of studies underscores the need for further high-quality research to validate these findings and identify the most effective intervention characteristics.
Our systematic review highlights that theory-guided positive psychological interventions show promise as an effective strategy for improving the quality of life in breast cancer patients. These interventions can enhance psychosocial support strategies, paving the way for better-informed approaches that lead to improved patient outcomes.
No patient or public contribution.
The systematic review and meta-analysis had been registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration ID number: CRD42024581382
Disease severity negatively affects health-related quality of life (HRQOL) among people with heart failure (HF). However, the underlying mechanisms remain underexplored. Illness perceptions and depression serve as potential mediators of this relationship, but the evidence supporting this is limited.
To investigate the relationships among disease severity, illness perceptions, depression and HRQOL in people with HF, as well as to explore the mediating roles of illness perceptions and depression in the relationship between disease severity and HRQOL.
People with HF were recruited from a tertiary hospital in China between January and May 2023. All the participants were assessed for disease severity, illness perceptions, depression, HRQOL and sociodemographic and clinical characteristics. The mediation analysis was performed using PROCESS macro in SPSS. The STROBE checklist was followed.
This study recruited 164 subjects. Disease severity had a significant total effect on HRQOL (β = 0.716, 95% CI: 4.475, 12.068). The results showed that illness perceptions mediated the relationship between disease severity and HRQOL (β = 0.172, 95% CI: 0.042, 0.337), accounting for 24.02% of the total effect. However, a significant mediating role of depression in this relationship was not found. Furthermore, we found that illness perceptions and depression sequentially mediated the relationship between disease severity and HRQOL (β = 0.194, 95% CI: 0.005, 0.395), which accounted for 27.09% of the total effect.
The effect of disease severity on HRQOL is sequentially mediated by illness perceptions and depression. Illness perceptions are important predictors of HRQOL. Targeted interventions should be employed to improve illness perceptions, thereby enhancing HRQOL among people with HF.
Medical staff can carefully assess patient's illness perceptions and implement appropriate strategies to enhance these illness perceptions, thereby improving their HRQOL.
No patient or public contribution.
To examine the information needs of breast cancer patients during the initial phase of treatment and to analyse the factors that influenced these needs.
Providing comprehensive and timely information during early breast cancer treatment is crucial for informed decision-making and effective coping. Healthcare providers must address these needs to enhance patient support and improve outcomes.
A cross-sectional study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
A total of 123 post-mastectomy patients were selected through purposive sampling and completed the Thai version of the Sri Lankan Information Needs Assessment Questionnaire-BC (SINAQ-BC). Direct associations between demographic data and information needs were analysed descriptively, while bivariate analysis and linear regression were used to identify significant predictors of information needs.
The findings revealed that patients exhibited high overall information needs (224.7/260.0), with the greatest demand focused on physical care, treatment and diagnosis. In contrast, needs related to disease specifics and psychosocial care were less prominent. A total of 94 respondents (76.4%) expressed a particularly high demand for information regarding physical care. Education level was identified as an influencing factor, accounting for 7.7% of the variance in information needs among women with breast cancer.
Patients with higher education levels had significantly greater information needs. Nursing staff should provide customised information packages that are tailored to the participants' education levels. Further testing of the Thai version of the SLINQ-BC would also be warranted.
Patients are increasingly expected to manage their own care even as medical treatment grows more complex and technical. Nursing staff can contribute to the care of patients by being ready to evaluate, monitor and address breast cancer patient's individual information needs in the early stage of treatment based on factors such as educational level.
No patient or public contribution because the nature of the study's design, data analysis and writing did not require patient or public contribution.
Patients with coronary heart disease (CHD) will have a series of sexual problems, and their sexual life quality can be affected. However, a standardised evaluation tool for patients with CHD was lacking. Therefore, this study aimed to develop a sexual life quality questionnaire for patients with CHD and to evaluate its psychometric properties.
Based on previous phenomenological studies, literature analysis and group discussion, questionnaire items were formed. After two rounds of expert consultation and pre-survey, the questionnaire items were modified. Items were screened by item analysis. Exploratory factor analysis and confirmatory factor analysis were used to explore and confirm the structure of the questionnaire. Content validity and criterion validity were evaluated using the expert consultation and correlation analysis, respectively. The questionnaire reliability was evaluated using internal consistency, split half reliability, and test-retest reliability.
The sexual life quality questionnaire of patients with CHD was developed, which included two versions: male version and female version. The male version of the questionnaire contains 3 dimensions and 20 items, while the female version contains 3 dimensions and 17 items. After reliability and validity test, the two versions of the questionnaire have good reliability and validity.
In this study, the sexual life quality questionnaire of patients with CHD was developed and its psychometric properties were confirmed, which can be used to evaluate the sexual life quality of patients with CHD.
The development of a sexual life quality evaluation tool for patients with coronary heart disease to provide objective and quantitative tools for clinical staff to evaluate patients' sexual life status.
Patients were invited to participate in a questionnaire survey for this study.
To estimate the effects of nurse-led self-care interventions on people with heart failure (HF).
Research evidence of the effects of nurse-led HF self-care interventions on patient outcomes is scant.
A systematic review and meta-analysis of randomised controlled trials (RCTs).
Six databases (MEDLINE, Embase, Web of Science, CENTRAL, CINAHL and PsycINFO) were searched from the inception to December 2022 to identify eligible studies.
RCTs published in English that evaluated the impact of nurse-led HF self-care interventions on quality of life, anxiety, symptom burden, sleep quality, healthcare service utilisation and mortality were included. The risk of bias in included studies was assessed using RoB 2.0. We conducted data syntheses using the R software and graded the quality of the evidence using the GRADE approach. The systematic review was conducted in accordance with the PRISMA.
Twenty-five studies with 2746 subjects were included. Our findings demonstrated, that compared to the controls, nurse-led self-care interventions improved QOL (SMD: .83, 95% CI: .50–1.15, moderate evidence), anxiety (MD: 1.39, 95% CI: .49–2.29, high evidence) and symptom burden (SMD: .81, 95% CI: .24–1.38, low evidence) in people with HF. No significant effects were found in all-cause hospital readmission and all-cause emergency department visit. Research evidence on sleep quality, cardiac-related hospital readmission, cardiac-related emergency department visit and all-cause mortality remained unclear.
Our review suggests that nurse-led HF self-care interventions have favourable effects on the QOL, anxiety and symptom burden. Further, well-designed RCTs are warranted to address the gaps identified in this review.
The results indicated that nurse-led HF self-care interventions could improve QOL, anxiety and symptom burden in people with HF. Nurse-led self-care intervention could be integrated into current HF management practices.
The study aimed to identify factors associated with participation in Phase II cardiac rehabilitation and to assess patient perceptions towards the usage of technologies in cardiac rehabilitation.
Despite efforts to promote utilisation of cardiac rehabilitation (CR), participation among patients remains unsatisfactory. Little is known of patient decision to participate Phase II CR in a multi-ethnic country.
A cross-sectional study design.
A consecutive sampling of 240 patients with coronary heart disease completed Coronary Artery Disease Education Questionnaire (CADE-Q) II, Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS) and Cardiac Rehabilitation Barriers Scale (CRBS).
Seventy per cent of patients (mean age 60.5 [SD = 10.6] years, 80.8% male) participated in phase II cardiac rehabilitation. Self-driving to cardiac rehabilitation centres, higher barriers in perceived need/health care and logistical factors were significantly associated with decreased odds of participation. Patients with more barriers from comorbidities/functional status, higher perceived social support from friends, and anxiety were more likely to participate. Chinese and Indians were less likely to participate when compared with Malays. More than 80% of patients used both home and mobile broadband internet, and 72.9% of them would accept the usage of technologies, especially educational videos, instant messenger, and video calls to partially replace the face-to-face, centre-based cardiac rehabilitation approach.
Several barriers were associated with non-participation in phase II cardiac rehabilitation. With the high perceived acceptance of technology usage in cardiac rehabilitation, home-based and hybrid cardiac rehabilitation may represent potential solutions to improve participation.
By addressing the barriers to cardiac rehabilitation, patients are more likely to be ready to adopt health behaviour changes and adhere to the cardiac rehabilitation programme. The high perceived acceptance of using technologies in cardiac rehabilitation may provide insights into new delivery models that can improve and overcome barriers to participation.
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