Maternal Health Literacy in Pregnant Women: A Concept Analysis.

OBJECTIVES: Maternal health literacy (MHL) plays a vital role in pregnancy outcomes, healthcare researchers should further analyze, refine, and develop this concept. This study aims to clarify the definition of MHL in pregnant women through a analysis of the concept. METHODS: Walker and Avant's concept analysis approach was used to analyze the concept of MHL. A search of the literature was completed using the databases PubMed, CINAHL, Web of Science (WOS), and the Science and Technology Index (SINTA) for years 2001-2021; literature search included grey literature, publications from the government and academic institutions, and available both in English and Indonesia. A total of 12 articles were reviewed. RESULTS: MHL is a multifaceted and comprehensive concept. This study presents a working definition of MHL during pregnancy as the skills enabling women to access, comprehend, evaluate, and apply health information related to pregnancy, which are necessary for making decisions for improving and maintaining both maternal and fetal health. Guided by Walker and Avant's method, the major attributes and outcomes are determined in this study. CONCLUSION: Healthcare professionals can utilize this analysis to familiarize their institutions with the MHL concept, emphasize its importance, and apply it to practice. This contributes to enhancing the body of knowledge on MHL and potentially improving maternal health outcomes.

Psychological distress, sexual satisfaction and quality of life of gynaecological cancer patients and their spouses during cancer survivorship: A comparison of husbands and wives.

AIMS AND OBJECTIVES: To investigate the psychological distress, sexual satisfaction, and quality of life of gynaecological cancer survivors and their spouses during cancer survivorship. BACKGROUND: The survival rate of patients with cancer is increasing owing to advances in medical treatment technology. Spouses are the closest companions of gynaecological cancer survivors. Patients with gynaecological cancer and their spouses face different situations and challenges after experiencing cancer invasion. DESIGN: Questionnaire-based cross-sectional study. METHODS: Convenience sampling was employed, and 180 participants, including patients with gynaecological cancer and their spouses, were enrolled. A structured questionnaire was used to investigate the psychological distress, sexual satisfaction, and quality of life of gynaecological cancer survivors and their spouses during acute, extended, and permanent survivorship. The STROBE checklist guided the study preparation. RESULTS: For gynaecological cancer survivors and their spouses, (1) severe psychological distress was present during acute survivorship, with anxiety extending until permanent survivorship; (2) no significant differences were observed in pre- and post-treatment sexual satisfaction, although pre-treatment sexual satisfaction was higher than post-treatment sexual satisfaction in all three cancer survivorship stages and (3) quality of life decreased during acute survivorship and gradually improved with time. CONCLUSIONS: Psychological distress, sexual satisfaction and quality of life of gynaecological cancer survivors and their spouses worsened during acute survivorship and improved over time until permanent survivorship. RELEVANCE TO CLINICAL PRACTICE: Gynaecological cancer survivors and their spouses experience anxiety and depression from diagnosis confirmation until permanent survivorship (>5 years survival). Therefore, clinical nurses' sensitivity to emotional distress in cancer survivors and their spouses can be improved and a consistent and routine evaluation method has been established for the early detection of such emotional distress. The results of this study can provide a reference for clinical healthcare professionals and contribute to a better quality of care.

Factors related to sleep quality in hospitalized antepartum women: A cross-sectional study.

This study investigated the sleep quality and its psychological correlates among hospitalized antepartum women. A cross-sectional correlation study design and convenience sampling were conducted in the gynecological ward of a medical center in northern Taiwan. A total of 101 hospitalized antepartum women were recruited. A self-administered structured questionnaire including demographic profiles, State-Trait Anxiety Inventory (STAI), Antepartum Hospital Stressors Inventory (AHSI), and Pittsburgh Sleep Quality Index (PSQI) was used for the study. Bivariate and multiple linear regressions were used to analyze the data. A majority of the participants had poor sleep quality (82.8%), based on the global PSQI score. Sleep quality correlated with age, marital and employment status, parity, method of conception, multiple gestation, history of pregnant complications, anxiety symptom and hospital stressors which explained 21% of the variance in sleep quality. This study found a high prevalence of poor sleep quality in hospitalized antepartum women. Anxiety symptom was a significant predictor of sleep quality. Healthcare providers should be encouraged to assess sleep and emotional status in antepartum women during hospitalization and provide them appropriate interventions to improve sleep and reduce anxiety symptoms and hospital stressors.

Cette étude a examiné la qualité du sommeil et ses corrélats psychologiques chez les femmes hospitalisées en période antepartum. Une conception d'étude de corrélation transversale et un échantillonnage de commodité ont été menés dans le service de gynécologie d'un centre médical du nord de Taiwan. Au total, 101 femmes hospitalisées en période antepartum ont été recrutées. Un questionnaire structuré auto-administré comprenant des profils démographiques, l'inventaire des traits d'état d'anxiété (STAI), l'inventaire des facteurs de stress de l'hôpital avant l'accouchement (AHSI) et l'indice de qualité du sommeil de Pittsburgh (PSQI) a été utilisé pour l'étude. Des régressions linéaires bivariées et multiples ont été utilisées pour analyser les données. Une majorité des participants avaient un sommeil de mauvaise qualité (82,8 %), sur la base du score PSQI global. La qualité du sommeil était corrélée à l'âge, à la situation matrimoniale et professionnelle, à la parité, à la méthode de conception, aux grossesses multiples, aux antécédents de complications liées à la grossesse, aux symptômes d'anxiété et aux facteurs de stress hospitaliers, ce qui expliquait 21 % de la variance de la qualité du sommeil. Cette étude a révélé une prévalence élevée de mauvaise qualité du sommeil chez les femmes hospitalisées en période antepartum. Les symptômes d'anxiété étaient un prédicteur significatif de la qualité du sommeil. Les prestataires de soins de santé devraient être encouragés à évaluer le sommeil et l'état émotionnel des femmes antepartum pendant leur hospitalisation et à leur proposer des interventions appropriées pour améliorer le sommeil et réduire les symptômes d'anxiété et les facteurs de stress hospitaliers.

Factors influencing health-related quality of life in women with endometriosis: A cross-sectional study.

This study aimed to assess the health-related quality of life and identify its associated factors in women with endometriosis. A cross-sectional correlation study design and convenience sampling were conducted in the gynecological outpatient clinic of a teaching hospital in northern Taiwan. A total of 216 women with endometriosis were recruited. The data were collected using structured questionnaires and analyzed using descriptive and inferential statistics. Participants reported a moderate level of health-related quality of life. The most significant impact of endometriosis on health-related quality of life was emotional well-being, followed by feeling of control or powerless, pain, social support, and self-image. Educational attainment, menstrual cycle, period length, perceived menstrual flow, symptom distress, and self-management strategies explained 66% of the variance in health-related quality of life. Factors influencing health-related quality of life in women with endometriosis play a key role in promoting women's well-being. Interventions based on these related factors should be developed and taken into practice to effectively manage the disease-related symptoms for women with endometriosis and thereby improve their overall health-related quality of life.

Early autoimmunity and outcome in virus encephalitis: a retrospective study based on tissue-based assay.

To explore the autoimmune response and outcome in the central nervous system (CNS) at the onset of viral infection and correlation between autoantibodies and viruses. METHODS: A retrospective observational study was conducted in 121 patients (2016-2021) with a CNS viral infection confirmed via cerebrospinal fluid (CSF) next-generation sequencing (cohort A). Their clinical information was analysed and CSF samples were screened for autoantibodies against monkey cerebellum by tissue-based assay. In situ hybridisation was used to detect Epstein-Barr virus (EBV) in brain tissue of 8 patients with glial fibrillar acidic protein (GFAP)-IgG and nasopharyngeal carcinoma tissue of 2 patients with GFAP-IgG as control (cohort B). RESULTS: Among cohort A (male:female=79:42; median age: 42 (14-78) years old), 61 (50.4%) participants had detectable autoantibodies in CSF. Compared with other viruses, EBV increased the odds of having GFAP-IgG (OR 18.22, 95% CI 6.54 to 50.77, p<0.001). In cohort B, EBV was found in the brain tissue from two of eight (25.0%) patients with GFAP-IgG. Autoantibody-positive patients had a higher CSF protein level (median: 1126.00 (281.00-5352.00) vs 700.00 (76.70-2899.00), p<0.001), lower CSF chloride level (mean: 119.80±6.24 vs 122.84±5.26, p=0.005), lower ratios of CSF-glucose/serum-glucose (median: 0.50[0.13-0.94] vs 0.60[0.26-1.23], p=0.003), more meningitis (26/61 (42.6%) vs 12/60 (20.0%), p=0.007) and higher follow-up modified Rankin Scale scores (1 (0-6) vs 0 (0-3), p=0.037) compared with antibody-negative patients. A Kaplan-Meier analysis revealed that autoantibody-positive patients experienced significantly worse outcomes (p=0.031). CONCLUSIONS: Autoimmune responses are found at the onset of viral encephalitis. EBV in the CNS increases the risk for autoimmunity to GFAP.

Associated factors of sexual dysfunction among postpartum women in Taiwan- a cross-sectional study.

Sexual function among postpartum women is often overlooked by health-care professionals. This study aimed to investigate associated factors of sexual dysfunction among postpartum women. This study used a cross-sectional study design. A total of 135 postpartum women from a teaching hospital in northern Taiwan who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. A multiple linear regression was using to identify the predictors of sexual dysfunction among Taiwanese postpartum women. Results indicated that the categories of sexual dysfunction that most commonly experienced in postpartum women were lack of sexual desire, delay or absence of orgasm, pain during intercourse, and inability to become physically aroused. Parity, types of delivery, perineal laceration, breastfeeding, postpartum fatigue, and postpartum depression were significantly associated with sexual dysfunction (p< .05). Sexual counseling and mental support should be necessary for women at risk of postpartum sexual problems such as nulliparous with perineal laceration, breastfeeding mothers, experiencing postpartum fatigue and depressive symptoms to improve their sexual health and quality of life.

La fonction sexuelle des femmes en post-partum est souvent négligée par les professionnels de la santé. Cette étude visait à étudier les facteurs associés au dysfonctionnement sexuel chez les femmes en post-partum. Cette étude a utilisé un plan d'étude transversal. Au total, 135 femmes en post-partum provenant d'un hôpital universitaire du nord de Taiwan et répondant aux critères d'inclusion ont été recrutées. SPSS version 22.0 a été utilisé pour analyser les données, y compris une analyse descriptive et bivariée. Une régression linéaire multiple était utilisée pour identifier les prédicteurs de dysfonctionnement sexuel chez les femmes taïwanaises en post-partum. Les résultats ont indiqué que les catégories de dysfonctionnement sexuel les plus fréquemment rencontrées chez les femmes en post-partum étaient le manque de désir sexuel, le retard ou l'absence d'orgasme, la douleur pendant les rapports sexuels et l'incapacité d'être physiquement excitée. La parité, les types d'accouchement, les lacérations périnéales, l'allaitement, la fatigue post-partum et la dépression post-partum étaient significativement associés à la dysfonction sexuelle (p < 0,05). Des conseils sexuels et un soutien mental devraient être nécessaires pour les femmes présentant un risque de problèmes sexuels post-partum, telles que les nullipares présentant une lacération périnéale, les mères allaitantes, les femmes souffrant de fatigue post-partum et de symptômes dépressifs, afin d'améliorer leur santé sexuelle et leur qualité de vie.

The influence of opioid-taking self-efficacy and social support on pain management satisfaction in outpatients with cancer pain.

PURPOSE: The purpose of this study was to explore the correlations between patients' opioid-taking self-efficacy, social support, and their pain management satisfaction, and to evaluate the effect of social support and opioid-taking self-efficacy in explaining the variance in pain management satisfaction. METHODS: We used a cross-sectional and correlational research design and recruited 123 cancer patients via convenience sampling. We used the following instruments: the Opioid-Taking Self-Efficacy Scale, the Inventory of Socially Supportive Behavior, and the Chinese version of the Pain Treatment Satisfaction Scale. RESULTS: There were significant and negative correlations between opioid-taking self-efficacy and pain management satisfaction (r = - .43, p < .001) and between social support and pain management satisfaction (r = - .47, p < .001). Using a hierarchical regression analysis, social support and opioid-taking self-efficacy explained 17.20% and 5.20%, respectively, of the variance in pain management satisfaction. CONCLUSIONS: The results of this study confirm the importance of social support and opioid-taking self-efficacy in influencing pain management satisfaction. We recommend that professional care providers develop relevant intervention aimed at improving patients' pain management satisfaction.

Factors influencing the coping strategies of liver cancer patients undergoing transarterial chemoembolization.

AIM: This study explored the association between social support, resilience and coping strategies among patients with liver cancer and evaluated the extent to which patients' use of various coping strategies can be explained by social support and resilience. METHODS: This cross-sectional study comprised 119 patients who experienced transarterial chemoembolization related to liver cancer and who completed the Social Support Scale, the Resilience Scale and the Ways of Coping Checklist-Revised. RESULTS: Results indicated a significant positive correlation between social support and use of problem-focused coping strategies and overall coping strategies. In addition, results showed a significant positive correlation between resilience and use of problem-focused strategies, emotion-focused strategies and overall coping strategies. Social support accounted for 14% of variance in use of problem-focused strategies and 7.6% of the variance in overall coping strategies. Resilience accounted for 30.5% of the variance in use of problem-focused strategies, 8.5% in use of emotion-focused strategies and 21.6% of overall coping strategies. CONCLUSION: Results of this study highlight the importance of social support and resilience in patients' coping strategies related to liver cancer treatment.

Factors associated with the utilization of antenatal care services among pregnant women in Eswatini - A cross-sectional study.

The study aimed to assess the utilization of antenatal care services and its associated factors among pregnant women in Eswatini. A cross-sectional study was adopted. Convenience sampling was conducted in a public referral hospital in central Eswatini from 1st of August to the 30 of September 2021. A total of 400 newly delivered women who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. Results indicated that only 13% of pregnant women booked their first ANC in the first trimester and 24.8% of them attended less than four ANC visits. Maternal education, gestational age, gravity, pregnant-related complications, medical history, and maternal health literacy were significantly associated with the utilization of ANC services (p < .05). To increase the utilization of ANC service, healthcare professionals should pay special attention to pregnant women with tertiary education, gave birth below 38 weeks, multi-gravities, medical history, and poor maternal health literacy.

Dual versus Single Antiplatelet Therapy in Medically Treated Acute Myocardial Infarction Patients with Baseline Thrombocytopenia - Insights from a Multi-Institute Cohort Study.

Background: The safety and efficacy of dual antiplatelet therapy (DAPT) in medically treated acute myocardial infarction (AMI) patients with baseline thrombocytopenia (platelet count < 150 × 103/uL) are unclear. Methods: In this multi-institute retrospective cohort study, we included 468 patients with medically treated AMI with baseline thrombocytopenia and separated them into single antiplatelet therapy (SAPT) and DAPT groups according to the discharge anti-thrombotic strategy. The primary outcome was net clinical adverse events (NACEs), defined as a composite of death, ischemic events (myocardial infarction, ischemic stroke, and transient ischemic attack), and major bleeding within 30 days. Results: There were 168 patients in the SAPT group (100 taking aspirin and 68 taking clopidogrel) and 300 in the DAPT group. A primary outcome occurred in 35 (24.11 per 100 patient-months) patients in the SAPT group and 39 (14.26 per 100 patient-months) patients in the DAPT group [adjusted hazard ratio (HR): 0.67; 95% confidence interval (CI): 0.40-1.10; p = 0.1145]. Kaplan-Meier curves showed favorable results in the DAPT group (log-rank p = 0.0243). Bleeding events occurred in 18 (10.71 per 100 patient-months) patients in the SAPT group and 18 (6.40 per 100 patient-months) patients in the DAPT group (adjusted HR: 0.66; 95% CI: 0.32-1.36; p = 0.2573). Conclusions: DAPT versus SAPT as discharge anti-thrombotic strategy in thrombocytopenic patients with medically treated AMI did not significantly improve NACEs at 30 days. However, there was a trend towards favorable outcomes in the DAPT group. These results should be interpreted carefully with respect to the relatively limited trial population and study design.

The health concerns related to hysterectomy among Taiwanese women with uterine fibroids- a mixed-methods study.

This study aimed to assess health concerns after hysterectomy from different perspectives among Taiwanese women with uterine fibroids. A mixed-methods was used in this study. In a cross-sectional study, 95 patients completed a structured questionnaire (Health Concern Questionnaire-HCQ). Face-to-face interviews with 5 patients were implemented for the qualitative component from OBS-GYN outpatient departments at two hospitals in Northern Taiwan. Participants who met the following criteria, 20 years of age or older, conscious alert without mental disturbances were recruited to this study. Descriptive statistics were calculated for social demographic variables and HCQ. A content analysis was used to analyze the qualitative data. The mean age was 46.28 of 95 patients. Findings of the present study showed that the most health concerns among patients with UFs after hysterectomy are hysterectomy-related complications, follow by impacts on daily life, body image and female identity, and intimacy and sexual relations. The findings of qualitative interviews supported the above findings. In addition, the information needs of post-operative self-care were identify in this qualitative interviews. The results of this research study could help healthcare professionals to address women's health concerns and provide adequate care for Taiwanese women with uterine fibroids after hysterectomy.

Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease.

BACKGROUND: Patients with multivessel disease (MVD) often pursue complete revascularization (CR) during percutaneous coronary intervention (PCI) to improve prognosis. However, angiographic CR is not always feasible and is associated with some procedure-related complications in heart failure (HF) patients with MVD. Clinical selective incomplete revascularization (IR) may be reasonable for these high-risk patients, but its role in long-term outcomes remains uncertain. METHODS: Six hundred patients with HF and MVD submitted to PCI were enrolled. Major adverse cardiac events (MACEs) were defined as a composite of recurrent myocardial infarction, any revascularization, and all-cause mortality at 5 years. RESULTS: During a mean follow-up period of 3.7 ± 1.9 years, there was no significant difference in 5-year MACEs between selective IR and successful angiographic CR in HF patients with MVD. However, patients who failed CR had a significantly greater incidence of 5-year MACEs than those in the other two groups (failed CR: 46.4% vs. selective IR: 27.7% vs. successful CR: 27.8%, p < 0.001). CONCLUSIONS: Long-term outcomes of selective IR were comparable with those of successful angiographic CR in HF patients with MVD. However, patients that failed CR showed 2.53-fold increased risk of MACEs compared to patients undergoing either selective IR or successful angiographic CR. A more comprehensive planning strategy should be devised before PCI in HF patients with MVD.

Psychometric testing of the support and control in birth scale.

BACKGROUND: The Support and Control in Birth (SCIB) scale primarily measures the perceived support and control of expectant mothers during childbirth, thereby obtaining an understanding of their birth experiences. The advantages of this scale are its good reliability and validity and that it consolidates birth support and control. However, a Chinese version of the scale has yet to be developed. Therefore, this study sought to evaluate the validity and reliability of a Chinese version of the Support and Control in Birth Scale (C-SCIB). METHODS: A total of 228 postpartum women participated in this study. The C-SCIB scale was developed through a translation and back translation, followed by an evaluation of its content validity by a group of experts. Cronbach's α internal consistency and test-retest reliability were used to test the reliability of the scale. In addition, criterion-related validity (predictive validity and concurrent validity) and construct validity were used to test the validity of the scale. RESULTS: The C-SCIB scale showed good results in terms of the item-level and scale-level content validity indices. The Cronbach's α internal consistency was 0.81, and its test-retest reliability was 0.96. The confirmatory factor analysis results showed the overall goodness-of-fit was parsimony fit indices. The predictive validity analysis showed a significant positive correlation between the C-SCIB scale and the Questionnaire Measuring Attitudes About Labor and Delivery (r = 0.31, p < 0.01). Furthermore, the concurrent validity analysis showed a significant and moderate correlation between the C-SCIB and the Bryanton Adaptation of the Nursing Support in Labor Questionnaire (r = 0.49, p < 0.01) as well as the Labor Agentry Scale (r = 0.51, p < 0.01). CONCLUSION: The C-SCIB scale was proven to have good reliability and validity, and thus can be used to measure the degree of support and the locus of control perceived by expectant women during labor.

Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross-sectional study.

AIMS AND OBJECTIVES: The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. BACKGROUND: As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health-related quality of life. DESIGN: This study adopted a cross-sectional correlational research design. The STROBE checklist for cross-sectional studies was used as a reference for reporting the study. METHODS: A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. RESULTS: Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = -0.38), comorbidity index (ß = -0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. CONCLUSIONS: Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. RELEVANCE TO CLINICAL PRACTICE: The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle.

Disaster Knowledge, Skills, and Preparedness Among Nurses in Bengkulu, Indonesia: A Descriptive Correlational Survey Study.

INTRODUCTION: Registered nurses have to adequately prepare to respond to disasters, as they have become increasingly frequent worldwide. The aim of this study was to identify the factors influencing registered nurses' disaster preparedness in Bengkulu, Indonesia. METHODS: This study used a descriptive correlational study design. A total of 130 registered nurses working in 2 governmental hospitals in Bengkulu, Indonesia, were recruited by using a convenience sampling technique. A self-administered questionnaire, the Disaster Preparedness Evaluation Tool, was used to determine their current levels of registered nurses' disaster preparedness. RESULTS: The registered nurses reported a moderate level of disaster knowledge, skills and preparedness. Their knowledge and skills were significantly correlated with disaster preparedness (r = 0.39-0.71, P < 0.01). Three significant factors associated with disaster preparedness were identified in this study: educational level, disaster knowledge, and disaster skills (R2 = 0.31, F = 12.60, P < 0.001). DISCUSSION: Continuing disaster drills training and implementing a formal disaster educational program into nursing curriculum and professional development are recommended to achieve effective disaster preparedness in the hospital setting.

Paradoxical Effects of Sodium-Calcium Exchanger Inhibition on Torsade de Pointes and Early Afterdepolarization in a Heart Failure Rabbit Model.

Calcium homeostasis plays an important role in development of early afterdepolarizations (EADs) and torsade de pointes (TdP). The role of sodium-calcium exchanger (NCX) inhibition in genesis of secondary Ca rise and EAD-TdP is still debated. Dual voltage and intracellular Ca optical mapping were conducted in 6 control and 9 failing rabbit hearts. After baseline electrophysiological and optical mapping studies, E4031 was given to simulate long QT syndrome. ORM-10103 was then administrated to examine the electrophysiological effects on EAD-TdP development. E4031 enhanced secondary Ca rise, EADs development, and TdP inducibility in both control and failing hearts. The results showed that ORM-10103 reduced premature ventricular beats but was unable to suppress the inducibility of TdP or EADs. The electrophysiological effects of ORM-10103 included prolongation of action potential duration (APD) and increased APD heterogeneity in failing hearts. ORM-10103 had a neutral effect on the amplitude of secondary Cai rise in control and heart failure groups. In this model, most EADs generated from long-short APD junction area. In conclusion, highly selective NCX inhibition with ORM-10103 reduced premature ventricular beat burden but was unable to suppress secondary Ca rise, EADs development, or inducibility of TdP. The possible electrophysiological mechanisms include APD prolongation and increased APD heterogeneity.

[The Life Impacts and Symptom Distress in Women With Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery].

BACKGROUND: The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery. PURPOSE: To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women. METHODS: A cross-sectional and correlational research design was used and a total of 110 women with pelvic organ prolapse who had not yet undergone pelvic reconstruction surgery were recruited in the gynecological clinics of one medical center in Taiwan. RESULTS: Daytime urination frequency was the most prevalent urinary tract symptom noted by the participants; vaginal protrusion was the most prevalent pelvis-related symptom noted; and depression and anxiety were the most prevalent life impacts noted. Moreover, greater lower-urinary-tract symptom distress was associated with greater pelvic-symptom distress. Furthermore, greater lower urinary tract and pelvic symptom distresses were associated with a greater negative impact on life. Education background and pelvis-related symptoms were the explained variances in pre-surgery life impacts. CONCLUSIONS: Women with pelvic organ prolapse should pay particular attention to symptoms that include: daytime urinary frequency, vaginal protrusion, and emotional problems including depression and anxiety. Education background and level of symptom distress should be taken into consideration when caring for the life impacts of this vulnerable group of women.

Predictors of Fatigue among Female Patients on Hemodialysis.

The purposes of this study were to identify the level of fatigue and to examine the predictors of fatigue in female patients on hemodialysis. The subjects for this study were 130 female patients at one hemodialysis unit in northern Taiwan. On univariate analyses, patients with higher levels of fatigue were more likely to be older, and have less education, lower serum albumin levels, sleep disturbances, and perceived higher level of hemodialysis stressors. The findings of this study can help nephrology nurses recognize fatigue as an important nursing issue for female patients on hemodialysis. It is necessary to provide support, information, and alternative solutions for improving their fatigue.

[Nursing care for ovarian cancer patients with intraperitoneal chemotherapy].

Ovarian cancer, known as a "silent killer", is the leading cause of gynecologic cancer death. Standard treatments for ovarian cancer are debulking surgery combined with platinum chemotherapy drugs to prolong the survival of patients. According to clinical trials run by the American Society of Gynecologic Oncology, patients who received intraperitoneal (IP) chemotherapy survived longer on average than patients who received intravenous chemotherapy alone. Thus, intraperitoneal chemotherapy is a new potential approach for treating ovarian cancer patients. However, the toxicities and undesirable complications of IP chemotherapy are the major challenges of this treatment approach. This article helps nurses recognize the toxicities and complications of IP chemotherapy and may be used as reference for future revisions to patient care guidelines.