Clinical analysis, diagnosis, and treatment strategies for otogenic brain abscesses.

Objective: To explore the clinical features, diagnosis, and treatment strategies for otogenic brain abscesses (OBA). Methods: Clinical data from 10 patients with OBA were analyzed retrospectively. Clinical characteristics, diagnosis, and treatment experiences were summarized. Results: Two were first diagnosed in the Department of Otorhinolaryngology, 5 in Neurosurgery, and 3 in other departments. There were 6 cases of temporal lobe abscess and 4 cases of cerebellar abscesses. Five cases were accompanied by 1 or more intracranial complications. Headache is a common presentation in all cases. The main pathogenic bacteria were anaerobic bacteria. All patients had no previous ear or brain surgery history, and no history of traumatic brain injury, 7 received surgical treatment in the neurosurgery and/or otolaryngology department. Two patients died, the other 8 fully recovered and so were discharged. Conclusions: Diagnosis and treatment of OBA must involve multiple departments. Multidisciplinary consultation (MDT) is crucial to the success of the first OBA diagnosis. The diagnosis and treatment team develops personalized treatment plans by integrating MDT treatment opinions and combining the actual condition of patients, thereby making the diagnosis and treatment of OBA accurate and timely.

Utility of the capability, opportunity, and motivation behaviour (COM-B) model in explaining the negative association between pre-pregnancy body mass index and exclusive breastfeeding at six weeks postpartum.

The mechanisms underlying the negative associations between pre-pregnancy body mass index (BMI) and exclusive breastfeeding remain poorly understood. Thus, the study aimed to determine whether the negative associations between high pre-pregnancy BMI and exclusive breastfeeding at six weeks postpartum are mediated by components of the capability, opportunity, and motivation behaviour (COM-B) model. In this prospective observational study, we assigned 360 primiparous women to a pre-pregnancy overweight/obese group (n = 180) and a normal-BMI group (n = 180). A structural equation model was designed to study how capabilities (onset of lactogenesis II, perceived milk supply, breastfeeding knowledge, and postpartum depression), opportunities (pro-breastfeeding hospital practices, social influence, social support), and motivations (breastfeeding intention, breastfeeding self-efficacy, and attitudes towards breastfeeding) affected exclusive breastfeeding at six weeks postpartum in groups of women with different pre-pregnancy BMIs. In all, 342 participants (95.0%) possessed complete data. Women with high pre-pregnancy BMI were less likely to exclusively breastfeed at six weeks postpartum than women with a normal BMI were. We observed a significant negative direct effect of high pre-pregnancy BMI on exclusive breastfeeding at six weeks postpartum and a significantly negative indirect effect of high pre-pregnancy BMI via the explanatory mediating variables of capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy) on exclusive breastfeeding at six weeks postpartum. Our findings support certain capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy), partially explaining the negative association between high pre-pregnancy BMI and exclusive breastfeeding outcome. We suggest that interventions aimed at promoting exclusive breastfeeding among women with high pre-pregnancy BMI should address the capacity and motivation factors specific to this population.

How Advanced Practice Nurses Can Be Better Managed in Hospitals: A Multi-Case Study.

The labor markets for care professionals are a perennial topic of discussion. Advanced practice nurses (APN), as an advanced role in nursing, arose to solve the shortage of primary health care professionals. Prior research has advanced several areas of exploration for APNs' training or employing methods in Chinese hospitals. However, this leaves a key imperative unexplored: the management strategy of APNs in hospitals. The present study seeks to explore the management strategy of APNs in Chinese hospitals. The resource orchestration theory served as the guide as the multi-case study method investigated 18 case hospitals, gathered information from a variety of case data sources, and summarized the management strategies for hospitals' advanced practice nurses. Four types of APN management strategies-expert customized type, hierarchical linkage type, multidisciplinary benefit type, and professional penetration type-have been identified through resource orchestration. Hospitals can utilize the APN management strategy model as a guide to manage APNs in accordance with the unique characteristics of APN resources.

Associations between pro-inflammatory cytokines and fatigue in pregnant women.

Background: Fatigue is one of the most prevalent symptoms among pregnant women. In patients with various diseases, pro-inflammatory cytokines are associated with fatigue; however, such associations are unknown in pregnant women. Objectives: The objective of this study was to examine the associations between pro-inflammatory cytokines and prenatal fatigue. Methods: A cross-sectional study was conducted on 271 pregnant Chinese women in their third trimester of pregnancy. Patient-reported Outcome Measurement Information System (PROMIS) was used to evaluate women's prenatal fatigue. Using enzyme-linked immunosorbent assay (ELISA), the serum concentrations of four pro-inflammatory cytokines, including tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1ß), interleukin 6 (IL-6) and interleukin 8 (IL-8), were measured. The data was analyzed by correlation analysis and general linear regression analysis. Results: In this sample, the mean (standard deviation) of fatigue scores was 51.94 (10.79). TNF-α (r = 0.21, p < 0.001), IL-6 (r = 0.134, p = 0.027) and IL-8 (r = 0.209, p = 0.001) were positively correlated to prenatal fatigue, although IL-1ß was not. TNF-α (ß = 0.263, p < 0.001), along with sleep quality (ß = 0.27, p < 0.001) and depression (ß = 0.376, p < 0.001) independently predicted prenatal fatigue. Conclusions: TNF-α was identified as an independent biomarker for prenatal fatigue in our study. Reducing pro-inflammatory cytokines may be a unique method for lowering prenatal fatigue and, consequently, enhancing mother and child health.

Trajectory patterns and factors influencing perinatal fatigue among Chinese women from late pregnancy to 6 months after delivery.

Background: Perinatal fatigue among women is related to the clinical outcomes of mothers and infants. Perinatal fatigue changes over time, and the trajectory varies according to the predictors and outcomes of the mothers. This, however, has not been documented in any study. Objectives: This study aimed to identify and characterize the trajectory patterns of perinatal fatigue among women from late pregnancy to 6 months after delivery. Methods: We used growth mixture modeling to estimate the trajectory of perinatal fatigue at 28 gestational weeks (T0), 37 gestational weeks (T1), 3 days (T2), 1 week (T3), 6 weeks (T4), and 6 months (T5) after delivery with (n = 1,030). The Mann-Whitney U test and binary logistic regression were used to tie the selected trajectory classes to predictors and outcomes. Results: There were two distinct patterns of perinatal fatigue in women: "persistently high" (11.1%, n = 114) and "persistently low" (88.9%, n = 916). Levels of perinatal fatigue among women in the "persistently high" group were higher than those in the "persistently low" group across the six measurements. Complications, fatigue at T0, and employment status in late pregnancy were all significant predictors of trajectories. Additionally, the "persistently high" group had a greater prevalence of difficult baby care and weight retention and a lower prevalence of exclusive breastfeeding. Conclusions: Our study proved the heterogeneity and characteristics of perinatal fatigue among women. Future research should concentrate on developing intervention packages targeted at specific individuals in order to alleviate perinatal fatigue in women.

Role of Perinatal Biological Factors in Delayed Lactogenesis II Among Women With Pre-pregnancy Overweight and Obesity.

BACKGROUND: Pre-pregnancy overweight and obesity are negatively associated with delayed onset of lactogenesis II (OL), but the mechanisms by which these conditions affect OL are still unclear. OBJECTIVES: To identify biological factors related to pre-pregnancy overweight/obesity and determine whether these biological factors were associated with delayed OL in this population. METHODS: In this prospective observational study, we assigned 72 primipara to a pre-pregnancy overweight/obese group (n = 36) and a normal-weight group (n = 36). Blood samples were collected at 37 w of gestation and 48 h postpartum and assayed for levels of the following hormones: leptin, insulin, estradiol, prolactin (PRL), progesterone, and oxytocin. The primary outcome was timing of OL, estimated by maternal perception of breast fullness. We used linear-regression analysis to determine associations between hormones and delayed OL. RESULTS: Sixty-three participants (87.5%) had complete data. OL occurred later in overweight/obese than in normal-weight women (p < .001). Compared with the normal-weight group, the overweight/obese group showed higher leptin levels at both times of observation and exhibited a slower drop in estrogen concentrations from 37 w of gestation to 48 h postpartum (all p < .05). After adjusting for confounding factors, leptin concentrations in late pregnancy and the magnitudes of decline in estrogen concentrations at 48 h postpartum were correlated with OL. CONCLUSION: Women who were overweight/obese before pregnancy had elevated leptin levels in late pregnancy and a delayed decline in estrogen concentrations at 48 h postpartum. Both of these phenomena were related to delayed OL in this population.

Patterns of Adherence to Secondary Prevention Measures Among Chinese Patients With Coronary Artery Disease: A Longitudinal Study.

BACKGROUND: Adherence to secondary prevention measures among patients with coronary artery disease (CAD) affects patient prognosis, whereas patients' adherence behaviors change over time. OBJECTIVES: The aims of this study were to identify adherence trajectories to secondary prevention measures including medication-taking and a heart-healthy lifestyle and to estimate predictors of adherence trajectories among patients with CAD. METHODS: This longitudinal study enrolled 698 patients with CAD who received a percutaneous coronary intervention in China. Demographics, clinical characteristics, adherence to secondary prevention measures, and patient-related factors including disease knowledge, self-efficacy, and health literacy were measured during hospitalization. Adherence behaviors were followed at 1, 3, and 6 months, and 1 year after discharge. Group-based trajectory models estimated adherence trajectories, and multinomial logistic regression identified trajectory group predictors. RESULTS: Four trajectory groups were identified for medication-taking adherence: sustained adherence (39.9%), increasing and then decreasing adherence (23.1%), increasing adherence (23.4%), and nonadherence (13.6%). The 3 adherence trajectory groups for a heart-healthy lifestyle were sustained adherence (59.7%), increasing adherence (28.3%), and nonadherence (12.0%). Married patients were more likely (odds ratio [OR], 3.42; 95% confidence interval [CI], 1.56-7.52) to have sustained adherence to medication-taking. However, patients with higher disease knowledge were less likely (OR, 0.93; 95% CI, 0.87-0.99) to be adherent. Patients who were not working (OR, 2.25; 95% CI, 1.03-4.92) had higher self-efficacy (OR, 1.21; 95% CI, 1.08-1.37). Those with higher health literacy (OR, 1.18; 95% CI, 1.01-1.38) were more likely to have sustained adherence to a heart-healthy lifestyle. However, patients having no coronary stents (OR, 0.36; 95% CI, 0.19-0.70) were less likely to have done so. CONCLUSIONS: Trajectories of adherence to secondary prevention measures among mainland Chinese patients with CAD are multipatterned. Healthcare providers should formulate targeted adherence support, which considers the influence of disease knowledge, self-efficacy, and health literacy.

Prediction of Changes in Adherence to Secondary Prevention Among Patients With Coronary Artery Disease.

BACKGROUND: Healthcare providers are concerned about adherence to provider recommendations in coronary artery disease management. Seeking patient-related factors influencing changes in adherence over time is necessary for formulating suitable intervention measures-especially among diverse populations. OBJECTIVE: To explore whether health literacy, self-efficacy, and disease knowledge predict changes in adherence over time (between baseline and 3 months) to secondary prevention recommendations for Chinese coronary artery disease patients. METHODS: A longitudinal study was performed for 662 patients following percutaneous coronary intervention in China. Self-reported data were collected at baseline during hospitalization and at a 3-month telephone follow-up. Variables included demographics, health literacy, self-efficacy, disease knowledge, and adherence to secondary prevention recommendations for medication taking and a heart-healthy lifestyle. Multinomial logistic regression identified predictors of adherence changes over time. RESULTS: Patients were categorized into three groups: sustained/declined to nonadherence between baseline and 3 months, improved to adherence, and sustained adherence. The number of patients in sustained/declined to nonadherence group was small. Absence of stents predicted sustained/declined to nonadherence to medication and lifestyle over time. Health literacy was not associated with adherence changes over time. Higher self-efficacy scores were associated with lower likelihood of sustained/declined to nonadherence to a healthy lifestyle over time, whereas higher disease knowledge scores were associated with higher sustained/declined to nonadherence to medication. CONCLUSIONS: Adherence to secondary prevention 3 months after discharge was relatively good in Chinese patients with coronary artery disease who received percutaneous coronary intervention. Absence of stents and lower self-efficacy can predict the poor adherence changes, which should be considered in formulating follow-up care.

Relationship between adherence to secondary prevention and health literacy, self-efficacy and disease knowledge among patients with coronary artery disease in China.

BACKGROUND: Adherence to secondary prevention is an indispensable part of the management of patients with coronary artery disease. Finding patient factors affecting their adherence behaviours is important for improving the treatment effect and limiting further disease progression. AIMS: To examine the association between health literacy, self-efficacy, disease knowledge and adherence to secondary coronary artery disease prevention in patients in China. METHODS: In this cross-sectional study, 598 patients with coronary artery disease were enrolled in two tertiary hospitals in China during a hospitalisation for receiving percutaneous coronary intervention. Patient-reported data were collected on demographics, health literacy, self-efficacy, disease knowledge and adherence to secondary coronary artery disease prevention (medication-taking and heart-healthy lifestyle (exercise, reducing/eliminating alcohol intake and smoking, low salt and fat diet, stress reduction)). Chi-squared tests and regression analyses were performed. RESULTS: The proportions of recalled self-report of adherence to medication-taking and a heart-healthy lifestyle immediately prior to the coronary artery disease hospitalisation were 84.7% and 53.2%, respectively. In logistic regression, health literacy, self-efficacy and disease knowledge was significantly associated with non-adherence to secondary coronary artery disease prevention. Limited health literacy demonstrated a 1.61-fold odds for non-adherence to a heart-healthy lifestyle. Each score increase of self-efficacy and disease knowledge had 0.98-fold odds and 1.05-fold odds of non-adherence to a heart-healthy lifestyle. CONCLUSIONS: Adherence to medication-taking was relatively good in Chinese patients prior to coronary artery disease hospitalisation, but adherence to heart-healthy lifestyle behaviours should be improved. Health literacy, self-efficacy and disease knowledge should be taken into account when intervening to improve secondary coronary artery disease prevention.

The relationship between neutrophil-lymphocyte ratio and onset of lactation among postpartum women: A prospective observational cohort study.

BACKGROUND: Delayed onset of lactation is a key factor in the low rate of exclusive breast-feeding in 6 months after caesarean section. The mechanism of delayed onset of lactation is not clear. Milk production depends largely on mitochondrial adenosine triphosphate synthesis, and the neutrophil-lymphocyte ratio is closely related to mitochondrial deoxyribonucleic acid copy number and adenosine triphosphate production. Presently, it is unclear whether a difference in the neutrophil-lymphocyte ratio exists between those undergoing vaginal delivery and those undergoing caesarean delivery and, if so, whether the difference correlates to the time of onset of lactation. OBJECTIVES: To identify whether the neutrophil-lymphocyte ratio at 24 hours after delivery is different between mothers delivering by caesarean section and those giving birth vaginally and whether the neutrophil-lymphocyte ratio is related to the delayed onset of lactation. DESIGN: The study adopted a prospective cohort study design. SETTINGS: Maternity units of an Obstetrics & Gynecology Hospital. PARTICIPANTS: 327 mother-infant pairs who met inclusion/exclusion criteria and were followed up to the time of onset of lactation. METHODS: Mother-infant pairs were allocated to the vaginal birth group or the caesarean section group according to birth method. The neutrophil-lymphocyte ratio was calculated as the absolute value of neutrophils divided by the absolute value of lymphocytes based on full blood counts. Before delivery, full blood counts were obtained from medical records. After delivery, blood samples were drawn 24 hours postpartum, and blood cells were classified and counted. The onset of lactation was confirmed by the maternal perception of breast fullness. The neutrophil-lymphocyte ratio and its relationship with lactation onset were analyzed by multivariable regression. RESULTS: The neutrophil-lymphocyte ratios of both groups were elevated after delivery. Based on the covariance analysis, after adjusting for baseline full blood counts before delivery, the neutrophil-lymphocyte ratio in the caesarean group was higher than the ratio in the vaginal group after delivery (p = .000). In addition, after adjustment for confounding factors, multivariable regression analyses showed that an increased neutrophil-lymphocyte ratio was correlated with delayed onset of lactation (95% confidence interval 0.285-1.646). CONCLUSIONS: The neutrophil-lymphocyte ratio in the caesarean section group was higher than that in the vaginal delivery group and was related to a delayed onset of lactation. Given the decreased mitochondrial copy number in the elevated neutrophil-lymphocyte ratio and therefore the associated reduction in adenosine triphosphate synthesis, these findings may elucidate the mechanism for delayed onset of lactation in caesarean section births.

Relationship between patient's health literacy and adherence to coronary heart disease secondary prevention measures.

AIMS AND OBJECTIVES: To examine the relationship between health literacy (HL) and adherence to secondary coronary heart disease (CHD) prevention behaviours in patients in China. BACKGROUND: Adherence of patients to secondary CHD prevention behaviours is important in order to slow or reverse disease progression. The relationship between HL and adherence is varied across populations and warrants further research in order to inform nurses caring for such patients how to direct their teaching. DESIGN: A descriptive cross-sectional design. METHODS: A total of 598 patients with CHD were recruited during hospitalisation for a myocardial revascularization procedure at either of two tertiary hospitals in China. Data were collected by self-report on demographics, HL and adherence to secondary CHD prevention behaviours (medication-taking and heart-healthy lifestyle) prior to this admission. HL was measured by the short version of European Health Literacy Survey Questionnaire (HLS-EU-Q16), while adherence was measured with the Medical Outcomes Study Specific Adherence Scale (MOS-SAS). Descriptive, chi-square test and regression analyses were conducted. The study was reported based on STROBE checklist. RESULTS: Overall, 74.5% of the patients had limited HL. Adherence rates to medication-taking and heart-healthy lifestyle were 84.7% and 53.2%, respectively. HL was not significantly associated with medication adherence, but in regression models patients with limited HL demonstrated significantly increased odds for nonadherence to heart-healthy lifestyle (OR 1.69). CONCLUSION: HL was not significantly associated with medication adherence but was related to heart-healthy lifestyle adherence. RELEVANCE TO CLINICAL PRACTICE: Nurses should assess the health literacy of discharging patients with CHD and focus on patients with limited health literacy to improve heart-healthy lifestyle behaviours, and not just taking medications.

Correction to: Re­fracture and correlated risk factors in patients with osteoporotic vertebral fractures.

In the Original publication of the article, the funding ID has been incorrectly published as (815602390) in the Acknowledgements.

Re-fracture and correlated risk factors in patients with osteoporotic vertebral fractures.

Re-fracture risk is higher following osteoporotic fracture. However, there is no accurately reported rate of re-fracture incidence in southwest China. The purpose of this study was to describe the osteoporotic vertebral fracture (OVF) survival for re-fracture state and analyze the risk of re-fracture. This historical cohort study was conducted in four hospitals in southwest China. Patients aged ≥ 50 years (n = 586) with OVF who were supposed to receive anti-osteoporosis drugs after the fracture were included (2012-2017). Telephone follow-up and referring case files were used to estimate the survival for re-fracture and identify the determinants of re-fracture. A total of 555 patients completed the follow-up investigation. Overall, 285 patients experienced a re-fracture, and the longest follow-up investigation time was 72 months. The survival rates for re-fracture at 12 months, 24 months, 36 months, and 48 months were 82.0%, 71.5%, 61.7%, and 34.0%, respectively. The factors correlated with re-fracture hazard were advanced age [hazard ratio (HR) = 1.996], being female (HR = 1.342), smoking (HR = 1.435), history of hypertension (HR = 1.219) and diabetes (HR = 3.271), and persistence of taking anti-osteoporosis drugs after fracture [0-3 months, 4-6 months, 7-12 months, and more than 12 months (HR = 0.703)]. OVF patients with advanced age, who were female, smoked, had fracture with hypertension or diabetes, and who complied poorly with anti-osteoporosis drug treatment presented higher prevalence of re-fracture and low anti-osteoporosis adherence in southwest China. The management of anti-osteoporosis after fracture is necessary in this area.

Effect of pumping pressure on onset of lactation after caesarean section: A randomized controlled study.

Caesarean section is associated with weaker newborn suction pressure. This nonblinded, randomized trial explored the effect of suction pressures generating by a breast pump on mothers' onset of lactation and milk supply after caesarean section. A high pressure group (-150 mmHg), a low pressure group (-100 mmHg), and a control group (none) were generated under computer random assignment with concealed allocation in 2 tertiary hospitals. The breast pumping began within 2 hr after caesarean operation (6 times a day and 30 min per time) until onset of lactation. The primary outcomes were the timing of onset of lactation, milk supply, and mother's satisfaction in lactation, using both intention-to-treat and per-protocol analyses. The secondary endpoints were the pumping-related pain, nipple injury, and maternal fatigue. All 164 women randomized were included in analysis. The breast pumping at -150 mmHg optimally advanced the timing of the onset of lactation and increased daytime milk supply. The pumping also appeared to boost mothers' confidence in lactation. The results in the per-protocol population (n = 148) were consistent with those of intention-to-treat population (n = 164). However, the pumping aggravated maternal nipple pain and fatigue, though there was no statistical significance. The findings suggest that a higher pumping pressure within the range of normal vaginally born infant suction could promote onset of lactation and milk supply among mothers giving birth by caesarean section. The pumping could also enhance mothers' confidence in breastfeeding.

Are Prolactin Levels Linked to Suction Pressure?

BACKGROUND: Suction pressure has been reported to be a key driving force of lactation. An infant's sucking at its mother's breasts is the major stimulus to post-natal prolactin (PRL) secretion, and PRL is the essential hormone for lactation and milk production. It is unknown what role suction pressure has in PRL secretion and milk supply postnatally. OBJECTIVES: To explore the relationship between the suction pressure, PRL level, lactation, and milk supply in breastfeeding mother-infant dyads. METHODS: Healthy women with normal full-term infants were enrolled (n = 122). Data collection included suction pressure, PRL level, and the mother's perception of both the onset of her lactation and her milk supply at 1 month. Suction pressure was measured with a pressure sensor connected to a tube placed alongside the nipple. The chemiluminescence method was used to quantify maternal serum PRL level both before and after a breastfeed to explore the effect of suckling on PRL increment. The mother's perception of the onset of her lactation was evaluated by the mother's sense of fullness in her breast. The mother's perception of milk supply was evaluated by using the H&H Lactation Scale. RESULTS: Data from 117 participants were included in this analysis. Low suction pressure, a shorter gestational age, a high pre-gestational body mass index (BMI), and high infant birth weight were associated with a smaller than average PRL increment. High suction pressure, longer sucking duration, and a low gestational weight gain were related to a mother's perception of an earlier onset of her lactation. However, low suction pressure, a high frequency of giving formula, a small PRL increment, and the mother's perception of a later onset of her lactation were correlated with her perception of an insufficient milk supply. CONCLUSIONS: Suction pressure varied directly with the post-natal PRL increment. Suction pressure was associated with the timing of the mother's perception of her lactation. Strong suction pressure by the infant is likely to enhance the mother's confidence in her lactation. Additionally, sucking duration, frequency of giving formula, maternal BMI, and infant birth weight played a role in early breastfeeding success.

Intraoral Vacuum of Breast-Feeding Newborns Within the First 24 Hr: Cesarean Section Versus Vaginal Delivery.

OBJECTIVES: To explore whether newborns born via Cesarean section have a weaker intraoral vacuum compared with those born vaginally and to determine whether a weaker intraoral vacuum is related to a delayed onset of lactation. METHODS: For this prospective cohort study, 71 mother-infant dyads were enrolled and divided into birthing groups, vaginal or Cesarean. The newborn intraoral vacuum was measured via a tube placed alongside the nipple and connected to a pressure sensor during a breast-feeding session within the first 24 hr after birth. Onset of lactation was confirmed by maternal perception of breast fullness. The intraoral vacuum and its relationship with the onset of lactation were analyzed. RESULTS: After adjustment for confounding factors, the peak intraoral vacuum was -19.50 kPa in the vaginal group, which was significantly stronger than the -13.78 kPa in the Cesarean group (p = .005). Additionally, the baseline intraoral vacuum in the vaginal group (-2.35 kPa) was significantly stronger than that in the Cesarean group (-1.18 kPa; p = .022). Strength of the newborn intraoral vacuum was associated with the time of onset of maternal lactation. CONCLUSION: Cesarean section may weaken newborns' intraoral vacuum within the first 24 hr after birth. Stronger intraoral vacuum was related to earlier onset of lactation. Early intervention aimed at the weaker intraoral vacuum should be provided to promote the onset of lactation.

Survey on vision-related quality of life and self-management among patients with glaucoma.

PURPOSE: The aim of the study was to investigate the vision-related quality of life in glaucoma patients and identify the possible predictors for outcomes. METHODS: A total sample of 167 subjects with glaucoma was recruited using a convenience sampling strategy. The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Glaucoma Self-Management Questionnaire were used for assessing vision-related quality of life and self-management behavior, respectively. The demographic and disease-related data were also collected. RESULTS: Regarding the vision-related quality of life, the lowest scores were for general health (32.78±23.59), followed by general vision (46.35±19.52). The highest score was for the dimension of color vision (89.02±20.76). Multiple linear regression analysis demonstrated that self-management behavior, positive glaucoma family history, and binocular visual acuity were predictors of vision-related quality of life in this patient group. CONCLUSIONS: The current study indicates that vision-related quality of life in glaucoma patients is at a moderate level in China. Self-management behavior is an important predictor. Demographic data may not increase the explanatory effect. Future research should focus on how to integrate self-management skills into routine nursing practice for patients with glaucoma.

Patients' experience of living with glaucoma: a phenomenological study.

AIM: To explore the life experiences of those living with glaucoma and describe their strategies to deal with the consequences of this disorder. BACKGROUND: Glaucoma, the second most common cause of worldwide blindness, often imposes limitations on the daily functions of its victims, thus resulting in a decline in their quality of life and high costs in healthcare. METHODS: A hermeneutical phenomenological research approach was adopted. Fourteen people with glaucoma were selected for in-depth interviews, and another ten were interviewed in two focus groups. Participants were recruited from a specialized eye hospital in Shanghai. The data were collected from July to September 2009. An interpretive analysis of the data was performed. FINDINGS: The core theme was identified while interpreting the data on the patients' life experiences as 'learning to living with glaucoma' by one of our participants. The meaning of this is demonstrated in four interwoven themes: (1) seeking support; (2) coping with everyday tasks; (3) living with future uncertainties; and (4) adapting to the declined quality of life. CONCLUSION: This paper provides an insight into the living experiences of the patients with glaucoma using 1-on-1 and focus-group interviews, suggesting that the latter can also offer a means of phenomenological inquiry. We found that those with glaucoma can experience uncertainty surrounding treatment, illness prognosis and family members' risk status. In addition, the Chinese culture can influence the patients' strategies of maintaining a healthy lifestyle. In helping those with glaucoma considerations should be taken towards the feelings of future uncertainty that may develop.