Gender Differences in How Parents, Peers, and Exposure to Sexually Explicit Materials Influence the Intention to Engage in Casual Sex among Adolescents and Young Adults in Taiwan: Applying the Theory of Planned Behavior.

The aims of this study were to examine gender differences in how parent-child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials affect the intention to engage in casual sex among adolescents and young adults in Taiwan. This cross-sectional survey study recruited 767 participants (348 men and 419 women) aged 15-24 years. The survey collected data on participants' intention to engage in casual sex, their attitude toward and perception of casual sex based on the theory of planned behavior (TPB) (favorable attitude, perceiving positive social norms toward casual sex, and perceived control over involvement), parent-child and peer discussions about sexual issues, and exposure to sexually explicit materials. The results of multiple regression analysis revealed that parent-child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials were significantly associated with the intention to engage in casual sex. The results of structural equation modeling (SEM) further supported that favorable attitude, perceiving positive social norms toward casual sex, and control over involvement mediated the associations. For men, decreased favorable attitude mediated the negative association between parent-child discussions and casual sex intention; increased favorable attitudes and decreased control over involvement mediated the positive associations between peer interactions and casual sex intention. For women, decreased control over involvement mediated the positive association between exposure to sexually explicit materials and casual sex intention. The associations between peer interaction and subjective norms of acceptance, perceived control over involvement, and casual sex intention were stronger in men than in women; the association of favorable attitudes with casual sex intention was also stronger in men than in women.

Safe sexual behaviors intention among female youth: The construction on extended theory of planned behavior.

AIM: To examine female youth's intentions for safe sex with the relationship partners based on the extended theory of planned behaviour (TPB) model and explore the direct and indirect impact of parent-child communication about sex, peer interaction related to sexual issues, and exposure to sexually explicit materials on female youth's safe sexual behaviour intentions. DESIGN: A non-experimental, cross-sectional research design. METHODS: A convenience sampling was employed for data collection and 731 female youth aged 15-24 years old were recruited in 2013-2014. An anonymous, self-report structured questionnaire was used as a research instrument to collect participants' basic information and measure the internal and additional variables in the extended TPB model. RESULTS: The extended TPB model explained 42-45% of the total variance. Perceived behavioural control (PBC) and subjective norms had a positive effect on female youth's intentions for contraceptive use, condom use, and dual use with relationship partner; PBC was found to have the greatest influence. Among the additional variables in the extended TPB model, more parent-child communication about sex was found to lead to more positive dual use intentions. More peer interaction related to sexual issues was found to lead to less dual use intentions. CONCLUSIONS: To improve female youth's sexual health, the priorities are to reinforce their PBC and subjective norms and enhance parent-child communication about sex. Future efforts should strengthen sex education in families and schools and shape a social environment that facilitates safe sex. IMPACT: The extended TPB model can successfully predict female youth's safe sexual behaviour intentions. Empowering female youth to establish a sense of subjectivity and awareness of being a mature individual with physical autonomy, is importance for their sexual health.

Registered nurses are at increased risk of hospitalization for infectious diseases and perinatal complications: A population-based observational study.

BACKGROUND: Nursing staff spend long periods in high-risk working environments. OBJECTIVE: The purpose of this study was to compare the hospitalization risk between nursing staff and the general population. DESIGN: This study adopted a retrospective observational design. SETTING: Data from the Taiwan National Health Insurance Research Database from 2011 to 2013 were analyzed. METHOD: The standardized hospitalization ratio model was used to analyze the relative risk of hospitalization for various diseases between nursing staff and the general population. RESULTS: A total of 33,267 numbers of nursing staff in Taiwan were hospitalized, an overall crude hospitalization rate of 21.5%. After controlling for gender, calendar year, and age of nursing staff, the standardized hospitalization ratio of female nursing staff was significantly higher compared to the general population for infectious and parasitic diseases (SHR = 121.05, 95% CI = 112.66-129.89), diseases of the respiratory system (SHR = 105.12, 95% CI = 100.60-109.80), complications of pregnancy, childbirth, and the puerperium (SHR = 102.59, 95% CI = 100.85-104.35), and diseases of the skin and subcutaneous tissue (SHR = 109.71, 95% CI = 101.10-118.86). CONCLUSIONS: Nursing staff have a significantly higher hospitalization risk compared to the general population for infectious and parasitic diseases, diseases of the respiratory system, complications of pregnancy, childbirth, and puerperium, and diseases of the skin and subcutaneous tissue. This may be associated with the job characteristics and environment of nursing staff.

Transformation of quality of life in prenatal women with nausea and vomiting.

PROBLEM: Nausea and vomiting not only cause physical discomfort in pregnant women but also impact their quality of life. BACKGROUND: Few longitudinal studies have been conducted to investigate QOL of women over the course of pregnancy. AIM: To examine the transformation of health-related QOL and related factors among pregnant women with NV during three trimesters. METHODS: A longitudinal research design with convenience sampling was used. A structural questionnaire was used to repeatedly measure the data of 101 pregnant women with NV during the first, second, and third trimesters. A generalized estimating equation (GEE) was used to analyze the collecting data. FINDINGS: The results showed significant differences in symptom distress, prenatal stress, and health-related QOL among the three trimesters in pregnant women with NV (p<0.001). The scores of symptom distress, prenatal stress, and health-related QOL in the first trimester were significantly higher than those in the second and third trimesters (p<0.001). The GEE indicated that the trimester of pregnancy, severity of NV, symptom distress, and prenatal stress were key factors for the transformation of health-related QOL of women with NV during pregnancy. DISCUSSION: The findings of this study are seminal in terms of understanding the relationships between symptom distress, prenatal stress and health-related QOL in pregnant women with NV over the course of a pregnancy. CONCLUSION: This study can serve as a reference for designing interventions (i.e., professional support) for women in different pregnancy stages to improve their health-related QOL during pregnancy.

Push and pull: Exposure of young Taiwanese women to sexually explicit materials.

This study was designed to understand young Taiwanese women's perception of sexually explicit materials (SEMs). Researchers conducted six focus group discussions with 38 young women between the ages of 18 and 22 in Taiwan in 2009-2010 and used content analysis to analyze the data based on the push-pull theory. The results showed that the exposure of young women to SEMs was a sexual exploration process from no sexual activity to future sexual activity. This process was affected by the interactions of three powers: push power, pull power, and personal factors. The push power included factors, such as parents and social values, which failed to satisfy their sexual curiosity and provide them with autonomy. The pull power included SEMs and peer influence, which increased sexual arousal stimuli and curiosity to try sexual activity. The most important personal factors were young women's growth, including sexual curiosity, cognition of SEMs, and gender equity in freedom to make sexual decisions. Understanding this push-pull process regarding SEM can help health-care providers with their own discourses in addressing sex and influence young women's participation in desired, protected, and enjoyable sex when sufficiently ready.

Gender differences? Internet use and parent-child communication about sex toward sexual attitudes among early adolescents in Taiwan.

BACKGROUND: With the progress of information technology, early adolescents are able to access sex-related information through the Internet easily. This information has been shown to have a significant influence on the sexual health of this population. In addition, parent-child communications about sex affect the sexual health of adolescents. Few empirical studies have focused on early adolescents and gender differences. PURPOSE: This study explores gender differences between early adolescents in terms of the use of the Internet to obtain sex-related information, parent-child communication, and sex-related knowledge and attitudes. METHODS: This cross-sectional and comparative study uses an analysis of covariance and a hierarchical regression for data analysis. The researchers recruited 457 sixth-grade boys (n = 204) and girls (n = 253) in southern Taiwan as participants and used a structured questionnaire to collect data. RESULTS: Participants exhibited significant differences in terms of Internet usage behavior, parent-child communications about sex, and sex-related knowledge and sexual attitudes. The male participants spent more time on "recreation and entertainment" activities on the Internet, whereas their female peers spent significantly more time searching for information. Regarding parent-child communications about sex, girls had better mother-child communications than boys. In addition, no gender-based difference was found for father-child communications about sex. The knowledge of physical changes occurring during puberty and of menstrual healthcare among female participants was superior to their male counterparts. Girls had a more informed sexual attitude, particularly with regard to issues of gender roles, relationships with the opposite gender, and the social aspects of sex. Sex-related knowledge and parent-child communication about sex were the two major predictors of sexual attitudes for boys and girls, respectively. CONCLUSIONS: To develop healthy sexual attitudes among early adolescents, nursing professionals, families, and schools should enhance sex-related knowledge and parent-child communications, especially with boys. Early adolescence is a key time to provide sex education and Internet-safety education to both boys and girls to improve their sexual health. This study may serve as a reference for families, schools, researchers, and policymakers for promoting the sexual health of early adolescents.

Traditional Chinese medicine perspective on constitution transformations in perinatal women: A prospective longitudinal study.

BACKGROUND: Pregnancy is an important stage in life for many women. Humans are complex organisms that are prone to exhibiting gradual alterations in their constitutions that fluctuate with age, diet, and living environment. This is particularly true during the pre- and postnatal periods, in which qi and blood are required to ensure foetal growth. AIM: To examine women's constitutional transformation of pre-pregnancy, pregnancy, and postpartum. METHODS: A prospective, longitudinal study was conducted, and structural questionnaires were used to collect data. The participants were healthy pregnant women 21-49 years of age. Data were collected at six times: during the first (weeks 6-13), second (weeks 14-27), and third (weeks 28-40) trimesters and during the postnatal admission (1-week postnatal) and home self-care (6-week and 6-month postnatal) periods, yielding 86 valid questionnaires. A cubic polynomial regression analyses with generalised estimation equations (GEEs) method was used to reveal the trend of constitution score by different constitutions. FINDINGS: Significant differences (p < .0001) for the scores of Yang-Xu (yang-deficiency), Yin-Xu (yin-deficiency), and Tan-Shi-Yu-Zhi (phlegm-dampness and blood-stasis) constitutions were observed at pre-pregnancy, pregnancy, and 6 months postpartum. A least significant difference test showed that the scores obtained in the pregnancy period and at 6 months postpartum were higher than those of pre-pregnancy, indicating mitigated constitutional imbalance during postpartum. The highest scores of the Yang-Xu and Tan-Shi-Yu-Zhi constitutions occurred in the first trimester (36.02 ± 8.00 vs. 30.00 ± 7.21), and the highest scores of Yin-Xu constitution occurred in the third trimester (32.95 ± 7.48). The lowest scores of the Yang-Xu constitution were obtained at 6 months postpartum (25.24 ± 5.63) and during pre-pregnancy (25.26 ± 4.82), and those of the Yin-Xu and Tan-Shi-Yu-Zhi constitutions were observed in the pre-pregnancy (25.48 ± 4.46 vs. 19.94 ± 3.09). The 6-month postnatal scores of the Yang-Xu constitution nearly recovered to the prenatal level, whereas those of the other two constitutions did not. CONCLUSION: The results indicate that women's constitutions underwent changes throughout the perinatal stages. These findings provide a valuable reference for healthcare professionals in administering perinatal care and demonstrate empirical evidence for use in future intervention-based research.

Effects of professional support on nausea, vomiting, and quality of life during early pregnancy.

The purpose of this study was to examine the effectiveness of a professional support (PS) intervention (including individualized health education and supportive phone calls) in reducing the severity of nausea and vomiting (NV) and improving the quality of life (QOL) of women in early pregnancy. An experimental pretest/posttest design with a control group was used. Participants were recruited from a regional teaching hospital in southern Taiwan. The women in the experimental group (n = 40) received the PS intervention, while those in the control group (n = 39) only received routine nursing care. Analysis of covariance and mixed models were used to compare the experimental and control groups while adjusting for covariates. The severity of NV and the perceived level of symptom distress were significantly lower in the experimental group than in the control group during weeks 2 and 4, and the women in the experimental group showed a significant improvement in their QOL in week 4 (p < .05). However, there was no significant difference between the two groups in body weight at week 4 (p = .501). These findings provide empirical evidence in support of the effectiveness of PS in reducing the severity of NV and improving QOL for women during early pregnancy. This intervention could be routinely applied in prenatal nursing health education. Future studies could apply the concept of PS to different populations and health issues.

[Shenghua soup: a study of the relationships among related knowledge, expected effectiveness, and consumption behavior in postpartum women].

BACKGROUND: Women in Taiwan are concerned about postpartum personal healthcare, and over 90% consume Shenghua soup as part of their postpartum recovery regimen. However, knowledge regarding Shenghua soup is inadequate among this population. Therefore, the correlation between Shenghua soup knowledge and consumption behavior deserves further clarification. PURPOSE: The study explores the relationships among Shenghua soup knowledge, expected effectiveness, and consumption behavior in postpartum women. METHODS: A descriptive and correlational research design recruited a convenience sample of 515 < 30-days postpartum women from local specialty hospitals and postpartum centers. RESULTS: (1) Participant education level had a significant impact on Shenghua soup consumption behavior. Those with bachelor and master school degrees earned a higher average score than those educated to the senior high school level; (2) Knowledge correlated significantly and positively with expected effectiveness (r = .14, p < .001) and consumption behavior (r = .12, p < .001). Consumption behavior correlated positively with expected effectiveness (r = .11, p < .05); (3) Marital status, knowledge and expected effectiveness were identified as significant predictors of Shenghua soup consumption behavior; (4) Principal sources of participant information on Shenghua soup were family members (30.84%), media (26.65%), and medical staff (16.44%); (5) Knowledge scores for over half of participants were in the "wrong" to "no idea" range; and (6) 66.6% of participants took Chinese and Western medicines to help uterine contraction, while 76% had consumed Shenghua soup. CONCLUSIONS: Findings indicate that postpartum women in Taiwan have insufficient and incorrect knowledge regarding Shenghua soup; hold positive expectations regarding Shenghua soup effectiveness; and have a high Shenghua soup consumption rate. This study may serve as a postpartum care reference for healthcare professionals to improve the postpartum health of women.

Relationships among Constitution, Stress, and Discomfort in the First Trimester.

The purpose of this study was to explore correlations among constitution, stress, and discomfort symptoms during the first trimester of pregnancy. We adopted a descriptive and correlational research design and collected data from 261 pregnant women during their first trimester in southern Taiwan using structured questionnaires. Results showed that (1) stress was significantly and positively correlated with Yang-Xu, Yin-Xu, and Tan-Shi-Yu-Zhi constitutions, respectively; (2) Yin-Xu and Tan-Shi-Yu-Zhi constitutions had significant correlations with all symptoms of discomfort, while Yang-Xu had significant correlations with all symptoms of discomfort except for "running nose"; (3) Tan-Shi-Yu-Zhi constitution and stress were two indicators for "fatigue"; Tan-Shi-Yu-Zhi was the indicator for "nausea"; Yang-Xu and Yin-Xu were indicators for "frequent urination." Our findings also indicate that stress level affects constitutional changes and that stress and constitutional change affect the incidence of discomfort. This research can help healthcare professionals observe these discomforts and provide individualized care for pregnant women, to nurture pregnant women into neutral-type constitution, minimize their levels of discomfort, and promote the health of the fetus and the mother.

Relationships between critical thinking ability and nursing competence in clinical nurses.

AIM AND OBJECTIVE: To examine the relationships between critical thinking ability and nursing competence in clinical nurses. BACKGROUND: There are few evidance-based data related to the relationship between critical thinking ability and nursing competence of clinical nurses. DESIGN: A cross-sectional and correlation research design was used. METHODS: A total of 570 clinical nurses at a medical centre in southern Taiwan were recruited into this study. Two self-report questionnaires, the Watson-Glaser Critical Thinking Appraisal (WGCTA) and the Nursing Competence Scale (NCS), were used to collect data. RESULTS: The critical thinking ability of clinical nurses was at the middle level. The highest score for the subscales of the WGCTA was 'interpretation ability' and the lowest was 'inference ability'. The nursing competence of clinical nurses was at the middle level and above. The highest score for the subscales was 'caring ability' and the lowest was 'research ability'. Critical thinking ability had a significantly positive correlation with nursing competence. Critical thinking, working years, educational levels and position/title were the significant predictors of nursing competence, accounting for 32·9% of the variance. CONCLUSIONS: Critical thinking ability had a significantly positive correlation with nursing competence. The critical thinking ability of clinical nurses with a master's degree was significantly better than those with a bachelor's degree or a diploma and nurses with over five working years was significantly better than those with under five years. RELEVANCE TO CLINICAL PRACTICE: The findings of this study can further serve as a reference for nursing education to improve nursing curricula and teaching strategies for nurse preparation. It could also be a guideline for nursing administration personnel in on-the-job training and orientation programs for nursing staff.

Biomarkers and perceived emotional stress in early-stage pregnant taiwanese women with nausea and vomiting.

The purpose of this study was to compare physiological and psychological reactions among Taiwanese women with different degrees of severity of nausea and vomiting (NV) during pregnancy. Based on their scores on the Index of Nausea, Vomiting, and Retching (INVR), 59 pregnant women ≥ 18 years of age, with single gestations and without diagnosed pregnancy complications or hospitalizations were divided into two groups: mild or less (scores 0-8, n = 33) and moderate or severe (scores 9-32, n = 26). A single blood sample was obtained early in pregnancy during a prenatal visit to examine the biochemical data related to NV and stress. The INVR and Perceived Stress Scale were also administered at this time. Human chorionic gonadotropin (hCG) and leptin levels were significantly different between the two groups, whereas IFN-α, IL-2, TNF-α, adiponectin, perceived stress, and cortisol showed no significant differences. The cutoff point between high and low levels of NV severity was consistent between INVR scores (psychological reactions) and hCG level (physiological reactions). Logistic regression analysis indicated that leptin levels accounted for 24.4% of the variance for NV in early pregnancy. A further multiple linear regression analysis showed that NV, first trimester pregnancy body mass index (BMI), and age explained 72.4% of the variance in leptin levels. The findings of this study add new information to the understanding of the biomarkers and perceived emotional stress in early-stage pregnant women with high and low severities of NV.

Relationships between leptin, HCG, cortisol, and psychosocial stress and nausea and vomiting throughout pregnancy.

The purposes of this prospective, longitudinal study were to examine the relationships between leptin, human chorionic gonadotropin (hCG), cortisol, and psychosocial stress and nausea and vomiting (NV) in women with mild-to-moderate NV throughout pregnancy. Participants comprised 91 pregnant women recruited from prenatal clinics in southern Taiwan. Data analysis using one-way analysis of variance (ANOVA) indicated that leptin, hCG, cortisol levels, and Index of Nausea, Vomiting, and Retching (INVR) scores, but not stress (measured with the Visual Analog Scale, VAS) scores, were significantly different among the three trimesters. The average INVR score and hCG level decreased from the first to third trimesters (p < .0001 for both). The average leptin and cortisol levels increased from the first to third trimesters (p = .001 and p < .0001, respectively). Analysis using mixed models indicated that the INVR scores decreased significantly in a progressive manner through the stages of pregnancy and were significantly lower in the second and third trimesters. Findings reveal that stress/VAS and hCG may both be significantly and independently associated with INVR scores. Future research should examine psychosocial reactions in addition to exploring other biochemical markers related to NV and stress.

Relationships among smoking, drinking, betel quid chewing and pregnancy-related nausea and vomiting in Taiwanese aboriginal women.

A cross-sectional survey was conducted to investigate the associations among smoking, drinking, betel quid chewing and pregnancy-related nausea and vomiting (N/V) in Taiwanese aboriginal women. A total of 901 aboriginal women from 11 hospitals were recruited into this study. A structured questionnaire on demographic and obstetric information, smoking history, alcohol consumption, betel quid chewing habits, and N/V by checklist was used to collect data. The findings of this study indicated that the prevalence of N/V, maternal smoking, drinking, and betel quid chewing were 75.6% (n = 682), 22.8% (n = 201), 31.9% (n = 287), and 34.7% (n = 313) respectively. Multiple logistic regression with adjustment for age, body mass index and antiemetics use revealed significant relationships between smoking habits and N/V before confirmation of pregnancy and during pregnancy. In comparison with those who did not smoke, women smoking in excess of 10 cigarettes a day before pregnancy were 1.65 times more likely to develop N/V; and women smoking in excess of 10 cigarettes a day during pregnancy were 2.79 times more likely to develop N/V. Based on the findings of this study, smoking was associated, with a dose-response effect, with pregnancy-related N/V. Reducing the intake of cigarettes could decrease the risk of pregnancy-related N/V. Health care providers should help these women decrease their uncomfortable symptoms and improve their experiences of pregnancy and birth outcome during critical times.

Development of a Chinese short form of the Prenatal Self-Evaluation Questionnaire.

AIMS: To develop a short-form version of the Chinese Prenatal Self-Evaluation Questionnaire and to examine its reliability and validity. Background. Health professionals are short of screening instruments, especially in Chinese, to assess adaptation of pregnant women. DESIGN: A cross-sectional research design was used. Pregnant women who visited prenatal clinics in southern Taiwan were recruited for this study. This study was conducted in two phases. The first phase was to develop a Chinese short form of the Prenatal Self-Evaluation Questionnaire, using a convenience sample that consisted of 600 pregnant women. The second phase was to examine the reliability and validity of the short-form Chinese Prenatal Self-Evaluation Questionnaire, and used a convenience sample consisting of 225 pregnant women. Internal consistency and split-half reliability were used to assess reliability. Construct, convergent and discriminate validities were conducted to assess the validity. RESULTS: Item, correlation, factor and cluster analyses were used to eliminate 35 items from the questionnaire and to retain 44 items in phase one. The correlation coefficient between the short-form Chinese Prenatal Self-Evaluation Questionnaire and the original Chinese Prenatal Self-Evaluation Questionnaire was 0.95, indicating that the short-form Chinese Prenatal Self-Evaluation Questionnaire was acceptable. In phase two, 35 items were eventually retained and divided into six factors: concern for well-being of self and baby (seven items), acceptance of pregnancy (six items), identification of a motherhood role (three items), preparation for labour (six items), relationship with own mother (eight items) and relationship with husband (five items), accounting for 50.42% of the total variance. The convergent and discriminant validities were good, because the correlation coefficients between subscales and the total scale as well as between subscales and subscales were 0.57-0.71 and 0.18-0.41 (p < 0.01), respectively. The Cronbach's alpha and split-half reliabilities of the short form were 0.90 and 0.88, respectively. CONCLUSIONS: A 35-item Chinese short form of the Prenatal Self-Evaluation Questionnaire was developed. The results of this study can be used as a measurement tool for widespread, cost-effective clinical assessment and further research. RELEVANCE TO CLINICAL PRACTICE: Use of the new tool may help nurses to understand the adaptation status of pregnant women and thereby provide suitable nursing care for good adaptation to pregnancy as well as enhanced quality of life.

A longitudinal study of nausea and vomiting, fatigue and perceived stress in, and social support for, pregnant women through the three trimesters.

Nausea and vomiting (NV), fatigue, stress and social support during pregnancy have been well documented using cross-sectional research designs. However, few studies have addressed the patterns and relationships for these variables using a longitudinal research design. The purpose of this study was to examine the patterns of and relationships among NV, fatigue, perceived stress, and social support in pregnant women throughout the three trimesters. A prospective and longitudinal study was conducted from 2003 to 2005. Data were collected on four different measures: the Index of Nausea, Vomiting, and Retching (INVR), the Visual Analog Fatigue Scale (VAFS), the Perceived Stress Scale (PSS), and the Brief Social Support Questionnaire (BSSQ). A total of 91 pregnant women were recruited from prenatal clinics in southern Taiwan. One-way ANOVA indicated that INVR scores and fatigue were significantly different among the three trimesters, but that perceived stress and social support were not. Post hoc analyses, using least significant difference testing, indicated that the first trimester was associated with significantly higher levels of NV than were the second and third trimesters. The first and third trimesters had significantly higher fatigue levels than did the second trimester. Mixed models indicated that the differences among INVR scores among the three trimesters were independent of gravidity, planned pregnancy and age. The difference in fatigue between the first and second trimesters was independent of gravidity, planned pregnancy and age, but fatigue was positively associated with NV. Perceived stress was positively correlated with NV. However, when further examining the relationships among the key variables by adding fatigue, perceived stress was found to positively correlate with fatigue and not NV, and negatively correlated with social support. The findings of this study provide a more comprehensive understanding and evidence-based data of the patterns of and relationships among the above four key variables for pregnant women throughout the three trimesters. This will help health care professionals to provide more effective and appropriate care strategies based on the different stages of pregnancy.

Relationships between nausea and vomiting, perceived stress, social support, pregnancy planning, and psychosocial adaptation in a sample of mothers: a questionnaire survey.

BACKGROUND: Women worldwide experience pregnancy-related nausea and vomiting yet tolerate this significant prenatal stressor. The physical and emotional stress caused by pregnancy-related nausea and vomiting may influence maternal psychosocial adaptation yet few studies have examined these relationships. OBJECTIVES: The purpose of the study was to examine the relationships between nausea and vomiting, perceived stress, social support and their ability to predict maternal psychosocial adaptation among Taiwanese women during early pregnancy. DESIGN: A correlational, cross-sectional research design. SETTING: Four prenatal clinics in Taiwan. PARTICIPANTS: Women (n=243) who had completed the 6-16 week of gestation consented to participate. METHODS: Subjects completed four self-report questionnaires in additional to providing demographic data: Index of Nausea, Vomiting, and Retching (INVR), Perceived Stress Scale (PSS), Interpersonal Support Evaluation List (ISEL), and the Prenatal Self-Evaluation Questionnaire (PSEQ). RESULTS: Pregnancy-related nausea and vomiting was experienced in varying degrees by 188 (77.4%) women. Stepwise multiple regression analysis revealed that 37.6% of the variance in maternal psychosocial adaptation was explained by the severity of nausea and vomiting, perceived stress, social support, and pregnancy planning. CONCLUSIONS: Women at higher risk for poor maternal psychosocial adaptation have not planned their pregnancy and experience severe pregnancy-related nausea and vomiting. Severe pregnancy-related nausea and vomiting associated with high-perceived stress levels may be mediated by social support.

6-shogaol (alkanone from ginger) induces apoptotic cell death of human hepatoma p53 mutant Mahlavu subline via an oxidative stress-mediated caspase-dependent mechanism.

Mahlavu cells, poorly differentiated and p53 mutants of a human hepatoma subline, are known to be highly refractory to a number of chemotherapeutic agents and radiotherapy due to their high expressions of multidrug resistance gene-1 (MDR-1) and Bcl-2 proteins. Thus, it is desirable to search for an alternative strategy for effective eradication of this type of cancer cells. We present evidence here for the first time that 6-shogaol (6-SG), an alkanone isolated from the rhizomes of ginger, can effectively induce apoptotic cell death of Mahlavu cells via an oxidative stress-mediated caspase-dependent mechanism. The cascade of events in 6-SG-induced apoptosis of these cells involved an initial overproduction of reactive oxygen species (ROS) followed by a severe depletion of intracellular glutathione (GSH) contents. Both events consequently entailed a significant drop in mitochondrial transmembrane potential (DeltaPsim), which ultimately activated the activities of caspases 3/7 resulting in the DNA fragmentation. Interestingly, we also found that N-acetylcysteine (NAC), an antioxidant and a precursor of GSH biosynthesis, could offer a near complete protection of apoptotic cell death exerted by 6-SG. Similarly, exogenously added GSH could also provide protection with an equal efficacy. However, it was paradoxical that both Boc-Asp(OMe)-fmk (a broad caspases inhibitor) and cyclosporin A (an mitochondrial permeability transition opening inhibitor) could only partially protect these cells from 6-SG-induced apoptosis. Taking these data into consideration, it is obvious that GSH depletion is the major contributing factor in arbitrating 6-SG-induced apoptosis of Mahlavu cells. In conclusion, we provide here a novel modality that can help to eradicate a p53 mutant of human hepatoma cells by using a natural consistent isolated form of ginger. These data also provide evidence to reaffirm the notion that consumption of certain foodstuffs can be beneficial to health because some of the constituents contained in them may be anticarcinogenic.

A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation.

A cross-sectional and comparative research design with convenience sampling was used to recruit pregnant women from prenatal clinics in southern Taiwan between 2002 and 2003 to examine the differences in perceived stress, social support, and maternal psychosocial adaptation among women with different severities (mild or less than mild, moderate, and severe) of nausea and vomiting during pregnancy. A total of 150 pregnant women participated in this study. One-way analysis of variance indicated that perceived stress was significantly different among the 3 groups. The least significant difference post-hoc test revealed that pregnant women with mild nausea and vomiting had significantly lower stress than did pregnant women with severe nausea and vomiting. The severity of nausea and vomiting was significantly associated with the Prenatal Self Evaluation Questionnaire subscales for "acceptance of pregnancy" and "fear of helplessness and loss of control in labor." Social support and maternal psychosocial adaptation were not significantly different among these three groups. The degree of perceived stress and maternal psychosocial adaptation may be related to the severity of nausea and vomiting during pregnancy.

Experience of Taiwanese women living with nausea and vomiting during pregnancy.

Two common symptoms of pregnancy are nausea and vomiting, which, for some women, cause great discomfort and profoundly impact daily life. A descriptive phenomenological method was used to understand how Taiwanese women deal with nausea and vomiting during pregnancy. A purposive sample of 10 expectant mothers participated in the study. A transcription of each informant's verbal description of her nausea and vomiting experience was made and analyzed using Colaizzi's phenomenological methodology. Four themes emerged from the interview data after inductively analyzing the narrative content concerning nausea and vomiting: 1) understanding nausea and vomiting, 2) finding coping strategies, 3) psychosocial adaptation, and 4) needing support. The results also indicated the importance of social support to pregnant women's health, including instrumental and emotional forms of support. Health professionals, however, were not mentioned in the mothers' narratives as a source of support. The issues of social support, language translation, and western and eastern perspectives on nausea and vomiting and cultural differences in perceptions of their severity are discussed.