Nevin Manimala

Appl Nurs Res. 2025 Apr;82:151926. doi: 10.1016/j.apnr.2025.151926. Epub 2025 Feb 13.

ABSTRACT

AIM: To examine the effect of gender role stress on psychological distress in pregnant women.

BACKGROUND: Recognition and prevention of potential psychological as well as physiological adversities during pregnancy are critical in terms of reducing their impacts on mother and baby health and developing preventive health services.

METHODS: This cross-sectional study was conducted with 182 volunteer pregnant women in Türkiye. Data were collected using a Personal Information Form, an Obstetric Characteristics Information Form, the Feminine Gender Role Stress Scale (FGRSS), and the Kessler Psychological Distress Scale (K10-PDS). Data analysis included independent samples t-test, one-way analysis of variance, Duncan test, Pearson correlation coefficient, and linear regression analysis.

RESULTS: The mean K10-PDS score of the pregnant women was 37.55 ± 8.87, which showed they were likely to have a severe mental disorder. There was a statistically significant difference between scale scores according to education level, perceived income, intervention of people outside the home, marital adjustment, and the presence of a health problem during the current pregnancy (p < 0.05). It was determined that there was a weak negative relationship between the FGRSS and K10-PDS (r = -0.283; p < 0.001) and that feminine gender role stress had an effect on psychological distress (F = 7332; p < 0.001).

CONCLUSIONS: The results of the study draw attention to pregnant women’s need for psychological support. To reduce the adverse psychological effects of gender role stress on pregnant women in prenatal care services, studies on factors affecting adaptation to the pregnancy process can be planned.

PMID:40086945 | DOI:10.1016/j.apnr.2025.151926

Appl Nurs Res. 2025 Apr;82:151925. doi: 10.1016/j.apnr.2025.151925. Epub 2025 Feb 17.

ABSTRACT

AIMS: In this study, researchers investigated experiences and key elements of effective support programs that promote recovery in nurses who identify as second victims in Australia.

DESIGN: Sequential explanatory mixed methods investigated experiences of nurses who identify as second victims, including support received and any educational and training included.

METHODS: Data were collected using survey and in-depth interviews. Survey data were analysed using descriptive and non-parametric testing and thematic analysis was used to analyse qualitative data.

RESULTS: Forty-three nurses indicated involvement in a patient safety incident in the previous five years with 27 nurses completing the survey. Thirty-seven percent reported experiencing psychological distress and 33% physical symptoms. Only 4% reported experiencing weak colleague support while 22% reported poor supervisor and 56% poor organisational support. Qualitative data from seven interviews revealed five themes identified included the Education and training; Environment surrounding the event; Burden of reporting; a ‘You’ve just got to get on with it’ culture; and Ways to action positive change.

CONCLUSION: Empathy and support from trained peer support colleagues were key elements to recovery of nurses who identified as second victims. The role of culture, and family values and beliefs in support of second victims need further investigation. Support programs need to address, not only psychological consequences of a patient safety event on the nurse, but also physical ramifications. Support of supervisors and organisations following a patient safety event may facilitate retention of nurses. The role of education and training in support programs requires further investigation.

PMID:40086944 | DOI:10.1016/j.apnr.2025.151925

Appl Nurs Res. 2025 Apr;82:151924. doi: 10.1016/j.apnr.2025.151924. Epub 2025 Feb 10.

ABSTRACT

There is growing recognition of advance directives (AD) in dementia, however a gap remains between their perceived importance and actual implementation. This emphasizes the need to enhance healthcare professionals’ support for people with dementia (PWD) with regards to making AD. This study aimed to investigate the competence, difficulties, and support needs of nurses in assisting institutionalized PWD to make AD. This mixed methods study included both quantitative and qualitative data analysis. Purposive sampling was used to recruit potential participants, and a self-developed questionnaire was used for data collection. Data were analyzed using descriptive statistics and t-test for quantitative information, and content analysis for qualitative information. A total of 188 questionnaires from 19 institutions were completed. The scores of knowledge, attitudes and skills in assisting PWD with making AD were 33.9, 39.4 and 39.5, respectively. The nurses stated that the difficulties in assisting PWD with making AD were a lack of relevant expertise, understanding the AD, and that they were unsure of how to handle conflicting viewpoints within the family. More in-service training and online courses on dementia and AD were required, as well as the creation of health education pamphlets and patient decision aids to help PWD and their families make decisions about AD. The results of this study can serve as a reference for understanding the competencies, improvements, needed support and in-service education of nurses in an institutional setting to assist PWD with making AD. We recommend the promotion of AD through related leading associations and their institutions.

PMID:40086943 | DOI:10.1016/j.apnr.2025.151924

Appl Nurs Res. 2025 Apr;82:151923. doi: 10.1016/j.apnr.2025.151923. Epub 2025 Feb 8.

ABSTRACT

AIM: The aim of this study was to evelop a predictive model, estimating the probability of an in-hospital fall using previously identified associated words, and word combinations in daily nursing records. To assess the difference in discriminatory ability between the predictive model and currently used screening questions.

BACKGROUND: Hospital falls are a persistent challenge. Identifying patients at high risk before fall incidents occur is essential to optimize preventive measures and reduce the burden on nursing staff.

METHOD: Words from daily nursing records were used as predictive variables to construct and validate the model. The DeLong’s test was used to determine statistical differences between the developed model and the current screening questions.

RESULTS: A total of 3255 consecutive admissions of patients aged 70 and over were included, of whom 110 experiences a fall. Upon internal validation, the predictive text model demonstrated moderate discriminatory ability (AUC-ROC 0. 737 (CI 95 % 0. 683-0.791)) and good calibration across a range of the risk groups. Compared to the screening questions (AUC-ROC 0.603 (CI 95 % 0.555-0.652)) the text model (AUC-ROC 0.734 (CI 95 % 0.679-0.788)) showed significantly better discriminatory ability (DeLong’s – 3.93, p ≤0.001).

CONCLUSION: Daily nursing records can be used to estimate the probability of in-hospital falls. A text-based predictive model outperforms the currently employed screening questions and provides insights for the efficient use of fall prevention interventions. Further research should focus on improving the accuracy and external validation of the model and implementation strategies.

PMID:40086942 | DOI:10.1016/j.apnr.2025.151923

Appl Nurs Res. 2025 Apr;82:151922. doi: 10.1016/j.apnr.2025.151922. Epub 2025 Feb 8.

ABSTRACT

BACKGROUND: Improving healthcare professionals’ digital health competence is critical to providing safer care. However, there is still a lack of empirical studies exploring the factors influencing healthcare professionals’ digital health competence, even though significant investments have been made to advance digitalisation of healthcare globally.

AIM: This study aimed to identify the key characteristics influencing healthcare professionals’ digital health competence.

METHODS: Cross-sectional data was collected from 252 healthcare professionals using two instruments measuring the digital health competences and the associated educational and organisational factors in 2024 via an online and paper-based survey. Univariate and binary logistic regression analyses were performed to identify the key characteristics influencing digital health competence.

RESULTS: Higher levels of education, working in a hospital, more professional experience, and increased use of digital solutions at work or during free time were associated with higher digital health competence. Higher qualifications were linked to greater digital health competence across several factors, with postgraduate degrees increasing health-related counselling competence and undergraduate degrees enhancing work-related attitudes and evaluating digital solutions. Professionals with university qualifications and those working in hospital settings showed higher ICT competence, while more years of professional experience increased ethical competence in using digital solutions.

CONCLUSIONS: Digital health competence development should prioritise healthcare professionals with lower educational levels. Additionally, such initiatives should include supporting those who work in non-hospital settings, have less professional experience, and use digital solutions less frequently at work or in their free time. Professional experience increases ethical competence in using digital solutions. Continuous professional development interventions and organisational policies should consider these factors to improve healthcare professionals’ digital health competences.

PMID:40086941 | DOI:10.1016/j.apnr.2025.151922

Appl Nurs Res. 2025 Apr;82:151920. doi: 10.1016/j.apnr.2025.151920. Epub 2025 Feb 2.

ABSTRACT

INTRODUCTION: Self-care is essential for health promotion, disease management and social justice. Robust, theory-based tools are needed for its measurement. The Self-care Inventory (SCI) was developed to measure self-care behaviours in adults regardless of their health status. The aims of this study are to measure validity of the SCI in an Italian sample and measurement equivalence in US and Italian samples.

METHODS: We recruited 340 Italian and 294 US adults with convenience sampling. The Self-care Inventory, new General Self-Efficacy Scale, Positivity Scale, Perceived Stress Scale, and a clinical and sociodemographic questionnaire were administered online. Confirmatory factor analysis (CFA) was used to assess the factor structure of the SCI. Measurement equivalence testing was conducted using Multiple Group Confirmatory Factor Analysis, testing configural, metric, scalar, and strict invariance. For the Italian version of the SCI, reliability and construct validity were also tested.

RESULTS: The SCI factorial structure was confirmed by CFA in the Italian sample. As for measurement equivalence, the Self-care maintenance scale demonstrated full metric and partial scalar invariance, indicating similar cognitive frameworks between US and Italian respondents. The Self-care Monitoring and Self-care Management scales achieved partial metric invariance. Reliability indices were satisfactory: Cronbach’s alpha and Global Reliability Index ranged from 0.69 to 0.84, and test-retest reliability values ranged from 0.70 to 0.84. Construct validity was supported by significant correlations between SCI scales and measures of self-efficacy, positivity, and perceived stress.

CONCLUSION: The SCI is valid and reliable for measuring self-care behaviours in the Italian population. Measurement equivalence show that SCI can be used cross-culturally and results from Italian and US samples are comparable. Our results support the use of the SCI in national and international self-care research and practice.

PMID:40086939 | DOI:10.1016/j.apnr.2025.151920

Appl Nurs Res. 2025 Apr;82:151917. doi: 10.1016/j.apnr.2025.151917. Epub 2025 Jan 30.

ABSTRACT

AIM: To explore the impact of e-health literacy (e-HL) on health-related quality of life (HRQOL) in young adults with type 2 diabetes (T2D), focusing on the mediating roles of diabetes self-efficacy and self-care behaviors.

BACKGROUND: If glucose levels are not kept within the target range, people with T2D may experience complications such as retinopathy, kidney disease, and cardiovascular disorders.

METHODS: The participants were 150 young adults, aged 18 to 39, with T2D. We assessed e-HL, diabetes self-care behaviors, diabetes self-efficacy, and HRQOL through a structured online survey. Data were analyzed using IBM SPSS Statistics, incorporating Pearson’s correlation and PROCESS macro mediation analysis.

RESULTS: E-HL, diabetes self-efficacy, and diabetes self-care behavior together accounted for 40.6 % of the variance in HRQOL. Higher e-HL was significantly correlated with improved HRQOL. A significant mediating effect of diabetes self-efficacy in the relationship between e-HL and HRQOL was observed, with an effect size of 0.300 ([95 % confidence interval = 0.055, 0.577]). However, the mediating effect of diabetes self-care behavior in the relationship between e-HL and HRQOL through diabetes self-efficacy was small and not statistically significant.

CONCLUSIONS: This study underscores the critical role of e-HL in enhancing HRQOL among young adults with T2D. It highlights the need for targeted digital health education, especially in subgroups with lower educational levels or poor health habits. The findings advocate for tailored interventions to boost self-efficacy and self-care behaviors, thereby improving overall quality of life in this population.

PMID:40086937 | DOI:10.1016/j.apnr.2025.151917

J Neurosurg Pediatr. 2025 Mar 14:1-8. doi: 10.3171/2024.12.PEDS24523. Online ahead of print.

ABSTRACT

OBJECTIVE: Spinal column shortening (SCS) is an emerging alternative to traditional untethering in cases of secondary tethered cord syndrome. It was originally described and applied in adult patients with spinal dysraphism. In the more recent past, SCS has been used in pediatric patients. A comparison between pediatric and adult patients undergoing SCS has not been performed previously.

METHODS: A retrospective analysis was conducted on 19 patients (11 children, 8 adults) who underwent SCS procedures from November 30, 2020, to July 21, 2024, at the University of Oklahoma. Outcomes were assessed based on changes in pain, overall symptom burden, subjective bowel/bladder symptoms, and objective testing of urodynamic function. The median follow-up period was 30 months (range 10-41 months).

RESULTS: Most vertebral column resections were performed at the T12 level (79%), with T10-L2 being the most common fusion level (68%). There were no significant preoperative differences in clinical features between children and adults. Both children and adults experienced significant reductions in pain (p = 0.002 and p = 0.018, respectively) and overall symptom burden (p < 0.001 and p = 0.003, respectively). Complete symptom resolution was achieved in 63% of children and 25% of adults. Improvements in objective urodynamic function were observed but were not statistically significant in either group (p = 0.082 for children, p = 0.351 for adults). However, only children reported significant improvement in bowel/bladder function (p < 0.01). The difference in surgical metrics or postoperative clinical features was not significant between children and adults.

CONCLUSIONS: SCS procedures appear to be effective in reducing pain and overall symptom burden in both pediatric and adult patients with complex tethered cord syndrome. SCS seems to improve bowel/bladder symptoms in children specifically. Further research with larger cohorts and longer follow-up periods is warranted to confirm these findings and assess long-term outcomes.

PMID:40085929 | DOI:10.3171/2024.12.PEDS24523

J Orthop Surg (Hong Kong). 2025 Jan-Apr;33(1):10225536251328099. doi: 10.1177/10225536251328099. Epub 2025 Mar 14.

ABSTRACT

Introduction: Chondroblastoma (CBL) is a rare benign bone tumor with potentially local recurrence and metastases. At present, the local recurrence risk factors are controversial. The purpose of this study is to analysis local recurrence factors in our medical center. Methodology: A retrospective analysis was conducted on 18 male and 10 female patients who presented at our hospital between 2016 and 2023. The clinical data included radiological images, histological results, treatment modalities, functional outcomes, and local recurrence rates. Surgical interventions comprised curettage, followed by bone grafting and adjunctive techniques. Furthermore, all patients were stratified into two groups based on tumor volume, with a threshold of 25 cm³, to explore the relationship between tumor volume and recurrence. Results: Among the 28 patients, with an average age of 13 years (range: 9 to 16 years) and an average follow-up duration of 33 months (range: 8 to 91 months). The mean Musculoskeletal Tumor Society (MSTS) score was 27 points (range: 14 to 30). Notably, recurrence was observed in 3 pediatric patients. A statistically significant difference in recurrence rates was found between tumors with volumes less than 25 cm³ and those greater than 25 cm³ (p < .05). Conclusion: Curettage, combined with alcohol as an adjuvant, resulted in local control and good outcomes in most pediatric patients. It was noteworthy that a larger tumor size correlated with an increased likelihood of recurrence.

PMID:40085921 | DOI:10.1177/10225536251328099

NCHS Data Brief. 2024 Nov;(516).

ABSTRACT

INTRODUCTION: This report presents the prevalence of diagnosed, undiagnosed, and total diabetes in U.S. adults during August 2021-August 2023. Trends in diagnosed, undiagnosed, and total diabetes prevalence in adults from 1999-2000 through August 2021-August 2023 are also shown.

METHODS: Prevalence of self-reported diagnosed, undiagnosed, and total diabetes was estimated using August 2021-August 2023 National Health and Nutrition Examination Survey data. Diagnosed diabetes was defined as answering “yes” to the question: “Other than during pregnancy, have you ever been told by a doctor or health professional that you have diabetes or sugar diabetes?” Undiagnosed diabetes was defined as reporting never receiving a diabetes diagnosis from a healthcare provider and 8- to 24-hour fasting plasma glucose greater than or equal to 126 mg/dL or hemoglobin A1c greater than or equal to 6.5%. Total diabetes was the combined prevalence of diagnosed and undiagnosed diabetes. Standard errors of percentages were estimated using Taylor series linearization. Pairwise differences between groups were evaluated using t statistics, and stated differences were statistically significant at p less than 0.05. Orthogonal contrasts were used to test for linear trends except for trends over time, where a linear regression model was used accounting for the unequal time between survey cycles.

KEY FINDINGS: During August 2021-August 2023, the prevalence of total, diagnosed, and undiagnosed diabetes in U.S. adults was 15.8%, 11.3%, and 4.5%, respectively. The prevalence of total and diagnosed diabetes was higher in men than among women and decreased with increasing educational attainment. The prevalence of total, diagnosed, and undiagnosed diabetes increased with increasing age and increasing weight status. The age-adjusted prevalence of total and diagnosed diabetes increased from 9.7% to 14.3% and from 5.9% to 10.1%, respectively, between 1999-2000 and August 2021-August 2023.No change was seen between 2017-March 2020 and August 2021-August 2023.

PMID:40085919