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This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.
A systematic review and meta-analysis following the PRISMA 2020 guidelines.
Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.
Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.
Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.
E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.
Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.
This study adhered to the PRISMA checklist.
No patient or public involvement.
The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)
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 explore the latent categories and influencing factors of dyadic decision self-efficacy among stroke patients and their caregivers.
A cross-sectional survey involving 305 patient-caregiver pairs was conducted using standardised questionnaires. Latent profile analysis was used to identify dyadic self-efficacy categories and multinomial logistic regression was employed to analyse influencing factors.
The dyadic decision self-efficacy of stroke patients and their caregivers was classified into three categories: low common decision self-efficacy group (35.6%), patients' high decision self-efficacy and caregivers' moderate decision self-efficacy group (38.6%), and high common decision self-efficacy group (25.8%). Influencing factors included patients' education level, income and health literacy, as well as caregivers' education, caregiving duration and social support.
The levels of dyadic decision self-efficacy among stroke patients and their caregivers are heterogeneous. Clinicians can develop targeted interventions involving both patients and caregivers, based on the population's characteristics and influencing factors, to improve their dyadic decision self-efficacy.
This study was conducted and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
The objective of this systematic review was to evaluate the measurement properties of pressure injury risk assessment tools for cancer patients using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology, and to serve as a reference for clinical nurses in their hospital duties when choosing high-quality assessment tools.
A systematic review based on COSMIN methodology.
The English literature in PubMed, Embase, Web of Science, Cochrane Library, CINAHL and the search period ranged from the inception of the database to September 30, 2024.
Two reviewers independently screened the studies, extracted the data, and evaluated the methodological quality and measurement properties of the included studies.
Seven studies met the inclusion criteria. Two tools—the PUSO (Pressure Ulcer Scale in Oncology) and the Cuire scale—demonstrated sufficient evidence of content validity and structural validity, meeting the COSMIN quality standards. None of the studies reported the cross-cultural validity, stability, and measurement error of the assessment tool.
Following the COSMIN assessment, the PUSO and the Cuire were developed using rigorous procedures, ensuring sufficient overall quality for content validity, structural validity, and other measurement properties. We recommend their use across various environments, based on the quantity and content of specific items. The PUSO was recommended for clinical screening, whereas the Cuire scale was deemed more suitable for use in outpatient, community, and scientific research settings. However, these measurement properties are not without flaws, and their clinical application requires further validation.
Advanced cancer not only affects the physical, psychological, and social functions of patients, but it also impacts their adolescent children. There is a dearth of information regarding the understanding of family functioning and specific needs of patients with advanced cancer and their adolescent children.
This qualitative study aimed to explore the experience and needs regarding family functioning of patients with advanced cancer and their adolescent children, as well as understanding potential approaches for maintaining positive family functioning.
A descriptive qualitative study was employed.
This study was conducted at three tertiary hospitals in Changsha, China, from January to September 2023. Purposive sampling was adopted to recruit participants. 17 stage III and IV patients with cancer and 11 adolescent children were interviewed.
Face-to-face individual interviews were conducted among patients with advanced cancer and their adolescent children. The data analysis employed Braun and Clarke's thematic analysis method. The McMaster family functional model theoretical framework was utilised to facilitate the identification and organisation of topics, ensuring a comprehensive analysis of the data.
Six themes were identified: communication challenges; impaired family role functioning; positive/negative feelings; over-involvement; change of behaviour control pattern; Needs for medical and psychological support. Both patients with advanced cancer and their adolescent children expressed collective views and needs regarding family functioning.
The findings of this study reveal an understanding of family functioning and needs among patients with advanced cancer and their adolescent children. The identified themes provide valuable insights for designing and implementing targeted intervention strategies.
Nursing interventions should focus on helping patients with advanced cancer and their adolescent children improve family functioning and communication skills. The findings indicate that communication challenges are a significant aspect of impaired family functioning, necessitating targeted interventions to enhance communication. Healthcare providers should be trained to recognise the diverse communication needs of families, which include providing resources for age-appropriate communication, counselling, and guidance on maintaining family routines. Enhancing the communication skills of patients and their children is crucial for addressing problem-solving needs and mitigating negative feelings, thereby fostering a more supportive family environment.
To investigate the physical activity levels of lung cancer survivors, analyse the influencing factors, and construct a predictive model for the physical activity levels of lung cancer survivors based on machine learning algorithms.
This was a cross-sectional study.
Convenience sampling was used to survey lung cancer survivors across 14 hospitals in eastern, central, and western China. Data on demographic, disease-related, health-related, physical, and psychosocial factors were also collected. Descriptive analyses were performed using SPSS 25.0, and predictors were identified through multiple logistic regression analyses. Four machine learning models—random forest, gradient boosting tree, support vector machine, and logistic regression—were developed and evaluated based on the Area Under the Curve of the Receiver Operating Characteristic (AUC-ROC), accuracy, precision, recall, and F1 score. The best model was used to create an online computational tool using Python 3.11 and Flask 3.0.3. This study was conducted and reported in accordance with the TRIPOD guidelines and checklist.
Among the 2231 participants, 670 (30%), 1185 (53.1%), and 376 (16.9%) exhibited low, moderate, and high physical activity levels, respectively. Multivariate logistic regression identified 15 independent influencing factors: residential location, geographical region, religious beliefs, histological type, treatment modality, regional lymph node stage, grip strength, 6-min walking distance, globulin, white blood cells, aspartate aminotransferase, blood urea, MDASI score, depression score, and SRAHP score. The random forest model performed best among the four algorithms, achieving AUC-ROC values of 0.86, 0.70, 0.72, and 0.67, respectively, and was used to develop an online predictive tool (URL: http://10.60.32.178:5000).
This study developed a machine learning model to predict physical activity levels in lung cancer survivors, with the random forest model demonstrating the highest accuracy and clinical utility. This tool enables the early identification of low-activity survivors, facilitating timely, personalised rehabilitation and health management.
The development of a predictive model for physical activity levels in lung cancer survivors can help clinical medical staff identify survivors with relatively low physical activity levels as early as possible. Thus, personalised rehabilitation plans can be formulated to optimise quality of life during their survival period.
Physical activity has been used as a nonpharmacological intervention in cancer patient rehabilitation plans. However, a review of past studies has shown that lung cancer survivors generally have low physical activity levels. In this study, we identified the key factors influencing physical activity among lung cancer survivors through a literature review. We constructed a prediction model for their physical activity levels using machine learning algorithms. Clinical medical staff can use this model to identify patients with low physical activity levels early and to develop personalised intervention plans to improve their quality of life during survival.
The study adhered to the relevant EQUATOR reporting guidelines, the TRIPOD Checklist for Prediction Model Development and Validation.
During the data collection phase, participants were recruited to complete the questionnaires.
To investigate the effects of the Family-Centred Empowerment Model on informal caregivers on individuals with chronic diseases.
The Family-Centred Empowerment Model may help address informal caregivers' challenges in chronic disease management, including caregiver burden. However, its effectiveness for informal caregivers of chronic disease patients remains unclear.
Systematic review and meta-analysis of randomised controlled trials and quasi-experimental studies.
The review followed the PRISMA 2020 guidelines. A comprehensive search was conducted in EMBASE, PubMed, Cochrane Library, Web of Science, CINAHL, CNKI, SinoMed and Wanfang Data from their inception to January 2024. Two investigators independently evaluated study quality using the Cochrane Risk of Bias Tool and the Joanna Briggs Institute checklist.
This review included 22 studies. The meta-analysis demonstrated that the Family-Centred Empowerment Model significantly reduced caregiver burden, stress and anxiety. Subgroup analyses further revealed a positive effect on reducing caregiver burden across both paediatric and adult patient populations. Additionally, the intervention's effect on caregiver burden remained significant for 1–3 months following the intervention. While the model did not significantly affect the pooled outcome for care ability, subgroup analyses indicated that the model was more effective at improving care ability 3 weeks post-intervention compared to immediately after the intervention.
The Family-Centred Empowerment Model for informal caregivers of chronic disease patients may help reduce caregiver burden, stress and anxiety, while gradually improving care ability. However, it has no significant effect on depression or family function.
The review provides valuable evidence to guide clinicians in implementing the Family-Centred Empowerment Model for informal caregivers of chronic disease patients. By applying this model, caregivers can reduce burdens, stress and anxiety while enhancing their care abilities.
As a systematic review and meta-analysis, these details did not apply to our work.
PROSPERO (CRD42024505357)
The geriatric nutritional risk index (GNRI) predicts adverse outcomes in chronic diseases, but its prognostic value for major adverse limb events (MALE) in elderly patients with peripheral artery disease (PAD) remains unverified; thus, this study aimed to establish the association between GNRI and MALE.
A multicenter, prospective study.
From January 2021 to August 2022, 1200 patients with PAD aged ≥ 60 years were enrolled. Patients were stratified by GNRI value (At-risk group: ≤ 98 vs. No-risk group: > 98). Data were analysed through Kaplan–Meier curves, multivariable Cox regression, restricted cubic spline (RCS) modelling, and subgroup analyses.
Among 1036 completers (13.7% attrition rate), 275 (26.5%) developed MALE during a mean follow-up of 18.9 ± 8.0 months. Kaplan–Meier analysis demonstrated significantly higher MALE incidence in patients in the At-risk group (log-rank p < 0.001). Adjusted Cox models revealed a 45% increased MALE risk in patients in the At-risk group (HR 1.45, 95% CI 1.12–1.86, p = 0.005). RCS identified a non-linear L-shaped relationship (p = 0.006) with inflection at GNRI = 95: Below 95, each 1-unit GNRI increase reduced MALE risk by 9% (HR 0.91, 95% CI 0.88–0.95, p < 0.001), while no significant association existed above 95. Subgroup analyses confirmed consistency across subgroups (all p-interaction > 0.05).
GNRI exhibits a non-linear L-shaped association with MALE risk in elderly patients with PAD, demonstrating critical prognostic utility below the 95 inflection point. Routine GNRI monitoring should be prioritised for patients with GNRI < 95 to guide preventive interventions.
GNRI should be incorporated as a routine risk assessment tool for elderly patients with PAD, with particular vigilance required for those with GNRI < 95. Prioritising nutritional screening and intervention in patients with GNRI < 95 may potentially improve clinical outcomes.
Patients contributed to this study by completing follow-up assessments.
This study followed the STROBE guidelines.
The relationship between occupational stress and the quality of nursing care in the operating room (OR) is an area that has not been thoroughly explored in the literature. The present study was designed to examine the correlation between job-related stress and the quality of care delivered by nurses in the OR setting.
A cross-sectional survey was administered to OR nurses at our institution from 1 April to 30 April 2023. Participants were asked to complete a demographic questionnaire and several validated scales: the Good Perioperative Nursing Care Scale (GPNCS), the Operating Room Nurses' Job Stressor Scale (ORNJSS), the Self-rating Anxiety Scale (SAS), and the Self-rating Depression Scale (SDS).
A total of 171 OR nurses participated. The mean score for nursing quality was 143.01 (SD 19.44), job stressors scored an average of 94.12 (SD 22.57), anxiety scores averaged 54.13 (SD 15.76), and depression scores averaged 59.41 (SD 15.03). A robust inverse correlation was identified between the nursing quality score and the job stressor score (r = −0.641). Furthermore, the nursing quality score exhibited significant negative correlations with both anxiety (r = −0.658) and depression (r = −0.626) scores.
The findings of this study demonstrate a substantial inverse correlation between the quality of perioperative nursing care and the intensity of occupational stressors, as well as the prevalence of anxiety and depressive symptoms among OR nurses. It is imperative for hospital management to contemplate and implement interventions aimed at mitigating work-related stress and bolstering the psychological well-being of OR nursing staff.
To investigate the latent profiles and correlates of self-management behaviours in Chinese rheumatoid arthritis patients and the effects of different latent profiles on the quality of life of rheumatoid arthritis patients.
A cross-sectional survey was used to study rheumatoid arthritis patients. The five dimensions of the Rheumatoid Self-Management Competence Scale were used as exogenous indicators for potential categorisation, and the effects of potential categorisation were analysed by mixed regression to explore the effects of different categorisations on quality of life.
Self-management behaviours of rheumatoid arthritis patients were classified into three latent profiles: low self-management daily life management group (25.7%), medium self-management medical behaviour management group (57.3%) and high self-management daily life management group (17.0%). Age, literacy level, per capita monthly income, joint functional status, self-efficacy, health literacy, disease perception level and social support were significant correlates of self-management status in patients with rheumatoid arthritis. Patients in the ‘high self-management daily life management group’ reported the best quality of life, while those in the ‘low self-management daily life management group’ reported the worst quality of life.
There was significant heterogeneity in self-management skills among rheumatoid arthritis patients. Healthcare professionals should develop personalised interventions based on self-management profiles in patients with rheumatoid arthritis in order to enhance patients' self-management ability and improve their quality of life.
Few studies have discussed the differences in the various dimensions of rheumatoid self-management levels, and self-management care measures need to be improved for different levels of self-management. This study categorised the level of self-management in rheumatoid arthritis patients into three profiles. The results of this study may provide more personalised interventions for patients with rheumatoid arthritis.
The study adhered to the STROBE checklist.
The subjects of the study were outpatient rheumatoid arthritis patients. Prior to the survey, patients were informed about the purpose of the study, informed consent was given to them and signed and they filled out the questionnaire independently. For patients who were unable to fill out the questionnaire, the study members explained it objectively to them and helped them select the appropriate option.
To explore the heterogeneity of disease-specific anxiety profiles among patients with chronic obstructive pulmonary disease (COPD) using latent profile analysis (LPA), and to identify the associations between distinct anxiety subtypes and inhaler medication adherence in patients with COPD.
Adherence to inhaled medication among patients with COPD continues to be suboptimal. Anxiety, a common comorbidity, may exacerbate this issue. However, the specific relationship between anxiety and adherence to inhaled medications remains unclear.
A prospective cohort study was conducted following the STROBE Checklist.
A prospective observational study employed the Anxiety Inventory for Respiratory Disease (AIR) to assess disease-specific anxiety in patients with COPD. Inhaler medication adherence was evaluated using the Test of Adherence to Inhalers (TAI) 6 months after initiating treatment. Latent Profile Analysis (LPA) was performed to identify distinct anxiety subtypes. Multiple linear regression analysis was conducted to examine the associations between identified anxiety subtypes and adherence dimensions, adjusting for sociodemographic and clinical variables.
Among 298 COPD patients, the overall AIR score was 5 (IQR: 2–11). Using LPA, three distinct anxiety subtypes were identified: Low Anxiety—Irritable Subtype (57.05%), Moderate Anxiety—Tense Subtype (26.85%) and High Anxiety—Anticipatory Subtype (16.10%). Through multiple linear regression analysis, the High Anxiety—Anticipatory Subtype was significantly associated with lower inhaler medication adherence among COPD patients.
This study revealed three latent profiles of disease-specific anxiety among COPD patients. The High Anxiety–Anticipatory Subtype was associated with a lower inhaler medication adherence in individuals with COPD after initiating treatment.
Identifying the relationship between disease-specific anxiety and inhaler medication adherence in patients with COPD after initiating treatment underscores the need for healthcare providers to assess anxiety during patient visits and prioritise patients with high anticipatory anxiety. When high anxiety adversely affects inhaler medication adherence, targeted interventions should be developed to improve adherence and prognosis.
No patient or public contribution.
To explore frail older adults' preferences and needs regarding mobile health (mHealth) exercise interventions in China. Additionally, it sought to identify the nudge strategies necessary for initiating and sustaining exercise behaviours among frail older adults.
A qualitative study.
The semi-structured interviews were conducted between April and May 2024 from two communities in Changsha, China. The data were analysed using a deductive framework analysis aligned to nudge theory, and an inductive thematic analysis to gather relevant needs and preferences.
This study involved 14 participants with pre-frailty or frailty, aged 60–82 years (median age of 64 years). While participants were generally receptive to new technologies, lower levels of health literacy and competing priorities often hindered their participation. Three primary functionality requirements were as follows. (1) Profession engagement: tailored exercise prescription, professional and timely feedback and guidance; (2) personalised knowledge encompassing pain management, successful cases and inspiration; (3) beneficial, tailored, dynamic, fragmented, challenging exercise courses. Participants showed positive attitudes towards simplification nudges, gamification nudges, social nudges, trustworthy nudges, reminder nudges, economic nudges, feedback nudges and pre-commitment nudges. Addressing privacy concerns was essential to build trust and acceptance among older adults.
These findings emphasised the importance of designing mHealth interventions that address frail older adults' specific needs and preferences while incorporating effective nudge strategies to promote engagement and adherence. Future researchers should explore wearables, ChatGPT language models, virtual coaching assistants, exercise snack to further optimise the experience and analyse the effects of nudges in mHealth exercise interventions among older adults.
Exercise systems or app development for frail older adults should meet three basic functionality and essential nudge strategies.
The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting.
Older adults' engagement and interview data contribute a lot.
To investigate the status of discharge readiness of patients undergoing daytime lung cancer surgery and analyse its influencing factors.
This was a cross-sectional study.
In this study, patients who underwent daytime lung cancer surgery from August 2022 to February 2023 at a Tertiary Care Hospital in Shanghai were selected via the convenience sampling method. A general data questionnaire, the Readiness for Hospital Discharge Scale, the Brief Illness Perception Questionnaire and the 10-item Connor Davidson Resilience Scale were used to assess 203 patients. Multiple linear regression analysis was used to analyse the factors influencing discharge readiness.
The total Readiness for Hospital Discharge Scale score for patients who underwent daytime lung cancer surgery was 72.76 ± 20.91. Multiple regression analysis revealed that residence, monthly family income, the presence of postoperative adverse effects, illness perception and resilience were influencing factors for discharge readiness (p < 0.05), with illness perception (β = −0.391, p < 0.001) and resilience (β = 0.317, p < 0.001) being the most significant factors, which together explained 44.9% of the total variance.
The discharge readiness of day surgery patients with lung cancer is moderate, indicating room for improvement. Clinical practice should focus on lower-income, rural or postoperative patients with adverse reactions. Additionally, promoting patients’ positive perceptions of their illness and increasing their resilience can further enhance their discharge readiness.
The reporting of the study was guided by the STROBE checklist: cross-sectional studies (Table S1).
Healthcare professionals should focus on assessing patients’ readiness for discharge, consistent with the World Health Organization's emphasis on patient-centred discharge planning. We recommend (1) establishing post-discharge support systems for rural and low-income patients, (2) including resilience-building interventions in preoperative education and (3) adopting a multiform health promotion approach to change negative illness perceptions and coping strategies. Additionally, we strongly advocate for the development of nurse-led transitional care plans that address both medical and psychosocial needs to optimise patient recovery and long-term well-being.
To evaluate the accuracy of different pressure injury risk assessment tools in paediatrics and identify risk assessment tools with the best predictive performance.
A systematic review and network meta-analysis.
Eight electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, China Knowledge Resource Integrated Database, Weipu Database, Wanfang Database and Chinese Biomedical Database were comprehensively searched. The study was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines 2020. Two researchers independently conducted article screening, data extraction and quality assessment. Statistical analysis was performed using R 4.3.1 and Stata 14.0.
A total of 20 articles were included in this study, involving 4908 patients and 13 pressure injury risk assessment tools for children, of which 15 articles were included in the network meta-analysis. The results showed that the Paediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET) had the highest superiority index, with the relative sensitivity (0.7, 95% confidence interval, CI: 0.0–1.5) and the relative specificity (1.4, 95% CI: 0.7–1.8). The next was Braden-Q combined with the Glamorgan scale, with a superiority index of 7.08, a relative sensitivity of 1.1 (95% CI: 0.5–1.5) and a relative specificity of 1.3 (95% CI: 0.8–1.7).
This study suggested that the PPUPET can comprehensively evaluate medical device-related pressure injuries in children, the Braden-Q scale had a better predictive performance for children aged 21 days–8 years in general paediatric departments, and the Glamorgan scale was suitable in the Paediatric Intensive Care Unit.
This review highlights that clinical practitioners should select appropriate assessment tools based on different departments and the age of children to accurately assess the risk of pressure injuries in children.
No Patient or Public Contribution.
PROSPERO CRD42023470769. http://www.crd.york.ac.uk/PROSPERO/#recordDetails.
ECMO techniques are commonly used to save critically ill patients with life-threatening conditions. The importance of ECMO nurses in the ECMO team and in caring for patients has been demonstrated, but the impact of the core competency dimension on ECMO nurses has not been explored. The level of core competence of ECMO nurses in the intensive care unit (ICU) is also influenced by mutiple factors. Moreover, the training of ECMO specialist nurses is closely related to the research of core competencies, and there are inconsistencies in training standards and diverse training contents in the exploratory stage, which still need to be improved.
To understand the current status of core competencies of ECMO nurses in tertiary hospitals in mainland China and to provide a reference basis for revising the core competencies training programme for ECMO nurses.
A multicentre cross-sectional survey.
A total of 307/322 (response rate: 95.3%) participants from ICUs of 16 tertiary hospitals in China took part in this study, and the total core competency score of ECMO nurses was (179.87 ± 46.22), with the highest-scoring dimension being personal attributes (3.87 ± 0.87) and the lowest-scoring dimension being professional development abilities (2.75 ± 0.96). The results of multiple linear regression analysis showed that gender, age, title, years of ICU experience, average number of ECMO patients per year in the department, number of ECMO trainings and whether or not they have participated in ECMO scenario simulation trainings are independent influences on the core competencies of ECMO nurses (all p < 0.05).
The level of core competence of ECMO nurses within ICUs in China needs to be improved, and nursing administrators should develop effective improvement measures to comprehensively enhance the overall level of core competence of ECMO nurses. The core competency level of ECMO nurses and its influencing factors were understood in this study, and the foundation for the construction of the core competency training program for ECMO nurses was laid. Management, training, and evaluation of ECMO nurses were informed by this study.
The core competency level of ECMO nurses was studied and analysed, which provided a reference for the management, training and evaluation of ECMO nurses in the ICU and the qualification criteria for ECMO specialist nurses. It is novel and clinically practical because it is innovative to evaluate the comprehensive competence of ECMO nurses in clinical practice from the perspective of the core competency framework. The influencing factors of the core competency level, combined with the research of relevant literature and qualitative interviews with ECMO nurses, have the opportunity to formulate training programmes and apply them to clinical practice, which reflects the meaningful relationship between this study and clinical practice.
We chose the STROBE Statement in the EQUATOR checklist for my study.
To investigate the incidence and the factors associated with paternal postpartum depression amongst new fathers in Singapore.
A prospective repeated measures study was conducted from September 2023 to March 2024.
A total of 200 fathers aged 21 years and above who had a neonate born at full term and no serious health events for both mother and neonate were recruited from a local hospital via convenience sampling. Fathers completed questionnaires at the third trimester of pregnancy (baseline) and 1 month postpartum. Multiple regression analyses were used to identify significant factors associated with postpartum depression in fathers.
The incidence of paternal postpartum depression was 5.26% at 1 month post-childbirth, using the Edinburgh Postpartum Depression Scale (EPDS). Using the Gotland Male Depression Scale (GMDS), 7% of the fathers were identified with high risk of depression and 14.3% of the fathers had moderate depressive symptoms. Paternal postpartum depression at 1 month post-childbirth could be predicted by paternal postpartum depression scores at baseline measured by EPDS and GMDS, as well as by baseline perceived social support and parental self-efficacy at 1 month post-childbirth.
This study found that a considerable number of fathers in Singapore are at risk of postpartum depression. There is an urgent need for the development of more comprehensive tools to measure postpartum depression in fathers that are culturally adapted to the local context.
Early screening during antenatal visits enables timely intervention and access to support, benefiting the entire family. Nurses could help fathers to be more involved by extending patient education and teaching infant care skills to both parents. When counselling patients, the involvement of extended family members and navigating new roles as caregivers of a new baby and breadwinners are important considerations for new parents.
This study is the first of its kind to measure the incidence of postpartum depression amongst new fathers in an urban multicultural Asian setting, like Singapore. The study found that the incidence of postpartum depression in fathers were 5.26% when measured using EPDS and 14.3% when measured using GMDS at 1 month postpartum. These findings could inform future family-centred and father-specific interventions to improve the mental health outcomes of new parents.
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.
No patient or public contribution.
To investigate the status and influencing factors of caring readiness among parents of children undergoing liver transplantation transitioning from the intensive care unit, and to explore the associations between caring readiness and other variables.
A cross-sectional study.
A total of 126 parents of children who underwent liver transplantation at a tertiary hospital in China took a questionnaire survey via convenience sampling. Independent t-test, ANOVA and correlation analysis were conducted to analyse the data. Multivariable stepwise linear regression was used to analyse the influencing factors of caring readiness. The PROCESS macro (Model 4) was used to verify the mediating effect of caregiver burden between social support and caring readiness.
The STROBE checklist was used as a guideline in this study.
The mean score of caring readiness among parents of children who had undergone liver transplantation and were transitioning from the intensive care unit was 23.62 ± 5.34. Multivariable stepwise linear regression analysis indicated that experience with caregiving, intensive care unit length of stay, social support and caregiver burden were the factors associated with caring readiness, explaining 18.6% of the variance in caring readiness among parents. Caregiver burden partially moderated the relationship between social support and caring readiness (20.93%).
The study shows caring readiness was moderate among parents of children who have undergone liver transplantation and are transitioning from the intensive care unit. It reveals that lack of caregiving experience and children's short intensive care unit length of stay should be emphasised, preventing inadequate readiness of parents. Furthermore, enhancing social support interventions and burden-reduction strategies are important for improving parents' caring readiness.
The findings demonstrate that health care professionals should provide timely and appropriate intervention strategies to enhance parents' caring readiness, which could potentially be achieved by increasing social support and reducing caregiver burden.
Parents of children who underwent liver transplantation participated in this study via a questionnaire survey.
To map the diabetes-related content exposure of older adults with Type 2 diabetes mellitus, and explore the association between the exposure and self-management and the mediation effects of self-efficacy.
Cross-sectional study.
This study was conducted among 257 eligible older adults with Type 2 diabetes mellitus from five communities in China. Diabetes self-management and self-efficacy were measured with standardised assessment tools. The variable of diabetes-related content exposure was generated by the collection of all content exposure and the transformation of Q-methodology. Descriptive statistics and the relative mediation effect model were used to do the analyses.
Among the participants, 61.1% had hyperbeneficial content exposure, 13.6% had hypobeneficial content exposure, 24.9% had irrelevant content exposure, and 0.4% had harmful content exposure. Compared with those with irrelevant content exposure, older adults with hyperbeneficial content exposure exhibited higher self-management scores (β = 0.448, 95% CI = 0.174–0.721); in the mediation model, the relative direct effect of hyperbeneficial content exposure on self-management remained significant (β = 0.377, 95% CI = 0.104–0.650), and self-efficacy significantly mediated this relationship (β = 0.071, 95% CI = 0.011–0.154). The relative mediation effect accounted for 15.8% of the relative total effect. Conversely, no significant effect of hypobeneficial content exposure on self-management was observed.
Social media can empower the self-management of older adults with Type 2 diabetes mellitus exposed to hyperbeneficial contents, with self-efficacy serving as a significant mediator. In contrast, exposure to hypobeneficial contents on social media did not lead to significant improvement in the self-management. This suggests that not all diabetes-related contents on social media are equally beneficial, and the relevance of information matters.
Healthcare providers should consider leveraging social media platforms in conjunction with traditional education programmes to enhance the self-management of older adults with Type 2 diabetes mellitus. Older adults with Type 2 diabetes mellitus may search positively diabetes-related hyperbeneficial contents on social media.
The report of this study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines.
No patient or public contribution.
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