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1.
J Adv Nurs ; 79(4): 1564-1574, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36534395

RESUMO

AIM: Using the theory of planned behaviour, the aim of this study was to examine predictors of intention to screen patients for intimate partner violence among Thai nursing students. METHODS: We employed a cross-sectional, anonymous online survey study with convenience sampling of senior nursing students from across Thailand in April 2019. We administered the Intimate Partner Violence Screening Intention, Nursing Students, a 36-item tool, and analysed relationships between students' intentions and attitudes, subjective norms and perceived behavioural control towards intimate partner violence screening. PROCESS was used to test mediation analyses. RESULTS: Of N = 639 respondents. Most (90%) reported intention to screen patients for intimate partner violence. Approximately 41% reported having no intimate partner violence training in their nursing school. Results of the multiple logistic analysis showed that attitudes (OR: 8.5; 95% CI 1.2-4.6) and subjective norms (OR: 4.4; 95% CI 1.4-4.6) significantly predicted intention, whereas perceived behavioural control (OR: 1.7; 95% CI 0.5-4.9) did not. Moreover, attitudes and subjective norm significantly mediated the association between providing a screening tool at clinical sites, and intention. CONCLUSIONS: Attitudes and subjective norms were significant predictors of intention of intimate partner violence screening. However, participants lacked adequate role models and training. Future research should improve the predictive power of the framework by integrating additional constructs such as the availability of screening tools, the presence of role models, to design and evaluate effective training and support for future nurses to address intimate partner violence in practice. IMPACTS: It is time to seriously consider integrating intimate partner violence content and training into the Thai nursing curriculum, and address the policies, guidelines, and practice culture. PATIENT OR PUBLIC CONTRIBUTION: The study was designed to examine predictors of intention to screen patients for intimate partner violence. Thai senior nursing students were contributed in the design and conduct of the study. However, the study did not include input from the public or the intended participants.


Assuntos
Violência por Parceiro Íntimo , Estudantes de Enfermagem , Humanos , Intenção , Estudos Transversais , População do Sudeste Asiático , Tailândia , Inquéritos e Questionários
2.
J Clin Nurs ; 29(23-24): 4748-4758, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32979288

RESUMO

BACKGROUND: Identifying factors related to intimate partner violence (IPV) screening intentions of future nurses is critical, but no studies specific to this research area exist in Thailand; nor does any validated instrument currently exist to systematically evaluate Thai nursing students' IPV training or measure their readiness to address IPV. The purpose of this study was to develop the Intimate Partner Violence Screening Intention, Nursing Students (IPVSI-NS) for Thai nursing students and identify components explaining their intentions to screen for intimate partner violence (IPV). METHOD: We designed a Thai-language, culturally appropriate 36-item instrument based on the theory of planned behavior (TPB), which describes intentions as the precursors of actual behaviour. We then conducted an anonymous cross-sectional online survey of female senior Thai nursing students (N = 594). Principal component analysis with varimax methods was used to examine the component structure of the instrument. The internal consistency reliability and convergent construct validity were evaluated. See Supporting File S1. RESULTS: A six-component structure was evident which explained 59.56% of variance and identified: attitudes (advantages and disadvantages of screening), subjective norms (support from important people, and opinions of important people and policy) and perceived behavioural control (training experience, teamwork, facility resources and screening barriers). CONCLUSION: The IPVSI-NS, based on the TPB, provides a psychometrically sound, reliable and valid tool for Thai nursing educators and researchers to advance nursing education, practice and research regarding IPV. RELEVANCE TO CLINICAL PRACTICE: Provides support for the components of the TPB (attitude, subjective norm and perceived behavioural control) as an excellent fit to predict intention of IPV screening for future clinical nurses. Implications for future research and educational practice are discussed.


Assuntos
Violência por Parceiro Íntimo , Análise de Componente Principal , Estudantes de Enfermagem , Estudos Transversais , Feminino , Humanos , Intenção , Idioma , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tailândia
3.
J Psychosoc Oncol ; 38(5): 592-611, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32552446

RESUMO

PURPOSE: Young breast cancer survivors (YBCS) face unique challenges in coping with disease, distress, and relationship concerns. The purposes of this study were to understand the acceptability and feasibility of an online Mindfulness-Based Intervention (MBI) for YBCS and their partners (i.e., Couples Mindfulness-Based Intervention: C-MBI) and to compare the effectiveness of the C-MBI to a closely-matched control, an online MBI for individuals (I-MBI). METHODS: YBCS and their partners were recruited. Couples were randomly assigned to an 8-week C-MBI (couples = 41) or to I-MBI (couples = 36), which included one-hour video modules, a manual, and guided-meditation audios. Both couple members participated in the C-MBI; only the YBCS participated in the control I-MBI. Participants answered surveys about individual- and couple-level functioning at baseline and post-intervention. RESULTS: Online delivery was shown to be feasible and acceptable. For YBCS and their partners, levels of perceived stress, anxiety, depression, and fatigue were lower after the intervention, in both conditions. Unexpectedly, however, participating in the C-MBI appeared to have detrimental effects on dyadic adjustment and relationship quality. CONCLUSION: Although YBCS and their partners reported online delivery was acceptable and benefited well-being, for couple-based MBIs to have benefits for relationship functioning, it may be necessary for couples to have the support of other couples and an instructor. Online delivery may be particularly acceptable and effective for clinical populations, including YBCS. Medical professionals may be more likely to recommend online-MBI programs to cancer survivors, because the programs are of little or no cost.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Intervenção Baseada em Internet , Atenção Plena , Parceiros Sexuais/psicologia , Adaptação Psicológica , Adulto , Neoplasias da Mama/terapia , Sobreviventes de Câncer/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
4.
Support Care Cancer ; 27(2): 495-503, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29980907

RESUMO

PURPOSE: Lymphedema is a potential complication of breast cancer treatment. This longitudinal substudy aimed to prospectively assess arm measurements and symptoms following neoadjuvant chemotherapy and axillary dissection in the ACOSOG/Alliance Z1071 trial to characterize the optimal approach to define lymphedema. METHODS: Z1071 enrolled patients with cT0-4, N1-2, M0 disease treated with neoadjuvant chemotherapy. All patients underwent axillary dissection. Bilateral limb volumes, circumferences, and related symptoms were assessed pre-surgery, 1-2 weeks post-surgery, and semiannually for 36 months. Lymphedema definitions included volume increase ≥ 10% or limb circumference increase ≥ 2 cm. Symptoms were assessed by the Lymphedema Breast Cancer Questionnaire. RESULTS: In 488 evaluable patients, lymphedema incidence at 3 years by ≥ 10%-volume-increase was 60.3% (95% CI 55.0-66.2%) and by ≥ 2 cm-circumference increase was 75.4% (95% CI 70.8-80.2%). Symptoms of arm swelling and heaviness decreased from post-surgery for the first 18 months and then were relatively stable. The 3-year cumulative incidence of arm swelling and heaviness was 26.0% (95% CI 21.7-31.1%) and 30.9% (95% CI 26.3-36.3%), respectively. There was limited agreement between the two measurements (kappa 0.27) and between symptoms and measurements (kappa coefficients ranging from 0.05-0.09). CONCLUSIONS: Lymphedema incidence by limb volume and circumference gradually increased over 36 months post-surgery, whereas lymphedema symptoms were much lower. These findings underscore the importance of prospective surveillance and evaluation of both limb measurements and symptom assessment. Lymphedema incidence rates varied by definition. We recommend that ≥ 10% volume change criterion be used for lymphedema evaluation for referral for specialist care. TRIAL REGISTRATION: NCT00881361.


Assuntos
Axila/fisiopatologia , Neoplasias da Mama/etiologia , Neoplasias da Mama/terapia , Sobreviventes de Câncer/psicologia , Extremidades/crescimento & desenvolvimento , Excisão de Linfonodo/métodos , Linfedema/etiologia , Linfedema/terapia , Terapia Neoadjuvante/efeitos adversos , Adulto , Idoso , Neoplasias da Mama/patologia , Feminino , Humanos , Linfedema/patologia , Pessoa de Meia-Idade , Estudos Prospectivos , Cirurgiões , Estados Unidos , Adulto Jovem
5.
J Interpers Violence ; 37(7-8): NP3832-NP3855, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-32842841

RESUMO

Male victims of rape and sexual violence (SV) constitute a highly stigmatized group who doubly suffer the trauma of SV and hegemonic notions of real masculinity that punishes weakness and vulnerability in men. This double exposure produces a stigmatizing identity (i.e., male victim stigma) that is embedded in grand narratives about male SV. However, helping professionals have been implicated in this (de)stigmatizing process. Few studies describe the role victim service providers (VSPs) play as (de)stigmatizing agents. This study is among the first to explore VSP narratives on their stigma awareness and stigma management practices. Story-focused interview methods elicited responses from 11 VSPs (nine females and two males, age: 29-65 years) across the United States representing diverse victim-serving professions. Interviews were face-to-face or by phone, lasting between 45 and 90 minutes. Interviews were transcribed verbatim and analyzed using power-sensitive Foucauldian discourse analysis (or FDA, suitable for analyzing language and meanings linked to power dynamics). Our analysis was guided by a meaning-forming social constructionist approach. With some narrative convergence and disconvergence, three strings of narratives with supporting excerpts were identified, namely (a) stigma awareness shaped by discursive and material forces, (b) labeling as a (de)stigmatizing tool, and (c) connecting through authentic empathy (AE). The concept of AE is recommended as a possible model of care and stigma management approach in therapeutic spaces. We define AE as an aptitude to credibly provide nonjudgmental, stigma-free care, based on personal histories with trauma, membership in a stigmatized group, or an earned involvement with members of the same group. Findings bear implications for stigma-informed practices and future research to address the unique unmet needs of stigmatized male victims.


Assuntos
Bullying , Vítimas de Crime , Estupro , Adulto , Idoso , Empatia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual
6.
Campbell Syst Rev ; 18(3): e1271, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36909881

RESUMO

Background: A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors. Objectives: To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors. Search Methods: We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis. Selection Criteria: We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English. Data Collection and Analysis: We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes (Outcome by Time) were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's d) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the Z-statistic with a p-value of 0.05. Cochran's Q test and Higgins' I 2 statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis. Main Results: Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced depression among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), anxiety among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, p = 0.00, I 2 = 25%), and physical violence victimization among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce PTSD (SMD = -0.04, 95% CI = -0.14 to 0.06, p = .46, I 2 = 0%), or sexual violence victimization (SMD = -0.02, 95% CI = -0.14 to 0.11, I 2 = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses. Authors' Conclusions: The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.

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