Utilisation of the health belief model to study the behavioural intentions relating to obesity management among university students: a cross-sectional study.

BACKGROUND: Overweight and obesity are excessive fat accumulations linked with many health problems, including heart diseases, type 2 diabetes and cancer. Multiple studies have demonstrated that beliefs about overweight, obesity and self-efficacy play essential roles in the success of interventions for obesity management. OBJECTIVES: This study aimed to identify the perceptions of university students of overweight and obesity using the health belief model (HBM) and to analyse their association with the body mass index (BMI) categories of the students. DESIGN: A cross-sectional questionnaire-based study and a multistage sampling technique were used to ensure the recruitment of students from selected colleges of Jazan University-Saudi Arabia. SETTING: Six colleges of Jazan University were randomly selected to ensure equal representation of health sciences, sciences and humanities colleges. PARTICIPANTS: A total of 579 students completed an online survey between January and April 2023. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measures were demographic characteristics and HBM constructs. Secondary outcome measures were behavioural intentions relating to obesity management. RESULTS: This study demonstrated that gender and self-reported family history of obesity were significantly correlated with the BMI categories of the students (p <0.001). Students in the underweight category showed the highest mean score for perceived severity (3.62 ±0.08). Perceived self-efficacy in exercise and diet was significantly associated with BMI categories, with adjusted ORs of 2.82 (2.10 to 3.79) and 1.51 (1.09 to 2.09), respectively. Perceived barriers to healthy eating and regular physical activity were significantly related to the behavioural intentions of obesity management. Multivariate logistic regression showed that perceived severity, perceived cues to action, perceived barriers and self-efficacy in dieting and exercise were significant predictors of behavioural intentions for the management of obesity. CONCLUSION: This study underscores the need for tailored health promotion strategies that consider the perceptions and beliefs of people about the management of obesity.

Breast cancer awareness messages: investigating response among Lebanese women.

While national Lebanese studies done on breast cancer attest to the importance of awareness campaigns none, however, examine the type of content that most effectively reaches women. The purpose of this study, therefore, was to examine, through an experiment, the effectiveness of direct versus indirect messaging, in altering knowledge, risk perception, attitudes, behaviors and self-efficacy among two groups of women, those aged 18-40 and 41-65 years. Findings suggest that the designed breast cancer communication messages were perceived as informative, trustworthy and believable regardless of message type. An interaction effect indicated that the older age group (41+) who were exposed to the indirect message felt more confident in taking proactive measures than the 18- to 40-year-old participants. In addition, those exposed to the indirect message were more likely to behave as communicated than those in the direct message condition. At the very least, the messages, both direct and indirect, helped minimize misconception or correct people's knowledge about the subject. This shows that participants and by extension people, in general, pay attention to breast cancer awareness messaging. Making these messages available to all age groups and motivating them to take proactive/preventative measures becomes even more significant, especially with the higher incidence of cancer among women aged 18-40 years in Lebanon.

Effects of a 'Rebuilding Myself' intervention on enhancing the adaptability of cancer patients to return to work: a randomized controlled trial.

OBJECTIVES: To explore the effects of a 'Rebuilding Myself' intervention on enhancing the adaptability of cancer patients to return to work. METHODS: A single-center, single-blind, randomized controlled trial design was used. Eligible patients who were receiving routine hospital treatment were recruited from the university-affiliated hospital in our city. Patients in the control group only received usual care, while patients in the intervention group received additional 'Rebuilding Myself' intervention. Adaptability to return to work, self-efficacy of returning to work, mental resilience, quality of life and work ability were measured at baseline, the 6th and 12th of the intervention. The general estimation equations were used to compare the overall changes of each outcome index between the two groups at different time points. Considering that there may be patient shedding and rejection, Per-Protocol and Intention-to-Treat analysis were used to analyze the data in this study. RESULTS: There were statistically significant differences between the two groups of patients in the cancer patients' adaptability to return to work, self-efficacy to return to work, mental resilience, work abilities, the physical, emotional, cognitive function, fatigue, insomnia and overall health status dimensions of quality of life (P < 0.05). And no significant difference was found in other dimensions (P > 0.05). The group effect, time effect, and interaction effect of patients' return to work adaptability and return to work self-efficacy were statistically significant in both groups (P < 0.05). Mental resilience, working ability, and quality of life had obvious time effect and interaction effect (P < 0.05). CONCLUSION: This intervention could improve cancer patients' adaptability to return to work, self-efficacy to return to work, mental resilience, work abilities and quality of life. And it can be further expanded to improve the adaptability of patients to return to work, then to help patients achieve comprehensive rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS: The application of 'Rebuilding Myself' interventions can effectively improve the adaptability of cancer patients returning to work. TRIAL REGISTRATION: This study was registered at the Chinese Clinical Trial Registry (Registration number: ChiCTR2200057943) on 23 March, 2022.

Boosting self-efficacy and improving practices for smoking prevention and cessation among South American cancer care providers with a web-based algorithm.

BACKGROUND: Digital technologies have positively impacted the availability and usability of clinical algorithms through the advancement in mobile health. Therefore, this study aimed to determine if a web-based algorithm designed to support the decision-making process of cancer care providers (CCPs) differentially impacted their self-reported self-efficacy and practices for providing smoking prevention and cessation services in Peru and Colombia. METHODS: A simple decision-making tree algorithm was built in REDCap using information from an extensive review of the currently available smoking prevention and cessation resources. We employed a pre-post study design with a mixed-methods approach among 53 CCPs in Peru and Colombia for pilot-testing the web-based algorithm during a 3-month period. Wilcoxon signed-rank test was used to compare the CCPs' self-efficacy and practices before and after using the web-based algorithm. The usability of the web-based algorithm was quantitatively measured with the system usability scale (SUS), as well as qualitatively through the analysis of four focus groups conducted among the participating CCPs. RESULTS: The pre-post assessments indicated that the CCPs significantly improved their self-efficacy and practices toward smoking prevention and cessation services after using the web-based algorithm. The overall average SUS score obtained among study participants was 82.9 (± 9.33) [Peru 81.5; Colombia 84.1]. After completing the qualitative analysis of the focus groups transcripts, four themes emerged: limited resources currently available for smoking prevention and cessation in oncology settings, merits of the web-based algorithm, challenges with the web-based algorithm, and suggestions for improving this web-based decision-making tool. CONCLUSION: The web-based algorithm showed high usability and was well-received by the CCPs in Colombia and Peru, promoting a preliminary improvement in their smoking prevention and cessation self-efficacy and practices.

E-PROOF: E-intervention for protein intake and resistance training to optimize function: A study protocol.

BACKGROUND: Accounting for more than 60% of cancer survivors, older (≥65 years) cancer survivors have a 2- to 5-fold risk of physical function impairment, compared to cancer-free peers. One strategy to improve physical function is dietary and resistance training interventions, which improve muscle strength and mass by stimulating muscle protein synthesis. The E-PROOF (E-intervention for Protein Intake and Resistance Training to Optimize Function) study will examine the feasibility, acceptability, and preliminary efficacy of a 12-week randomized controlled trial of an online, tailored nutritional and resistance training education and counseling intervention to improve physical function and associated health outcomes (muscle strength, health-related quality of life (HRQoL), self-efficacy, and weight management). METHODS: In this study, 70 older cancer survivors will be randomized to one of two groups: experimental (receiving remote behavioral counseling and evidence-based education and resources), and control (general survivorship education). We will examine the intervention effects on physical function, muscle strength, HRQoL, self-efficacy, weight, and waist circumference during a 12-week period between the experimental and control groups. Three months following the end of the intervention, we will conduct a follow-up assessment to measure physical function, muscle strength, and HRQoL. SIGNIFICANCE AND IMPACT: This study is the first synchronous, online protein-focused diet and resistance training intervention among older cancer survivors. This novel study advances science by promoting independent health behaviors among older cancer survivors to improve health outcomes, and provide foundational knowledge to further address this growing problem on a wider scale through online platforms.

Short-time mentoring - enhancing female medical students' intentions toward surgical careers.

BACKGROUND: Women pursuing a career in surgery or related disciplines are still in the minority, despite the fact that women compose at least half of the medical student population in most Western countries. Thus, recruiting and retaining female surgeons remains an important challenge to meet the need for surgeons and increase the quality of care. The participations were female medical students between their third and fifth academic year. In this study, we applied the well-established psychological theory of planned behavior (TPB) which suggests that the intention to perform a behavior (e.g. pursuing a career in surgery) is the most critical and immediate predictor of performing the behavior. We investigated whether a two-part short-mentoring seminar significantly increases students' intention to pursue a career in a surgical or related specialty after graduation. METHOD: The mentoring and role-model seminar was conducted at 2 days for 90 minutes by six inspiring female role models with a remarkable career in surgical or related disciplines. Participants (N = 57) filled in an online survey before (T0) and after the seminar (T1). A pre-post comparison of central TPB concept attitude towards the behavior, 2) occupational self-efficacy and 3) social norm) was conducted using a paired sampled t-test. A follow-up survey was administered 12 months later (T2). RESULTS: The mentoring seminar positively impacted female students' attitude towards a career in a surgical specialty. Female students reported a significantly increased positive attitude (p < .001) and significantly higher self-efficacy expectations (p < .001) towards a surgical career after participating in the mentoring seminar. Regarding their career intention after the seminar, female students declared a significantly higher intention to pursue a career in a surgical specialty after graduating (p < .001) and this effect seems to be sustainable after 1 year. CONCLUSION: For the first time we could show that short-mentoring and demonstrating role models in a seminar surrounding has a significant impact on female medical student decision´s to pursue a career in a surgery speciality. This concept may be a practical and efficient concept to refine the gender disparity in surgery and related disciplines.

Perceived control, self-management efficacy, and quality of life in patients treated with radiation therapy for breast cancer: a longitudinal study.

OBJECTIVE: This longitudinal study aims to examine the present state of perceived control, self-management efficacy, and overall quality of life (QoL) in patients with breast cancer undergoing radiotherapy, and gain insight into the dynamic trends and factors that influence the quality of life experienced by patients during the course of radiotherapy. METHODS: Participants completed the Cancer Experience and Efficacy Scale (CEES), Strategies Used by People to Promote Health (SUPPH), and Functional Assessment of Cancer Therapy- Breast (FACT-B). The data was analyzed using the software SPSS26.0. Repeated measures analysis of variance (ANOVA) and mixed-effects linear models were used to analyze trends in perceived control, self-management efficacy, and QoL at three-time points, as well as factors affecting QoL during radiotherapy. RESULTS: Perceived control and self-management efficacy were associated with QoL over the course of the radiotherapy. Self-management efficacy (ß = 0.30, P < 0.001), presence of chemotherapy (ß = 18.33, P = 0.024), and duration of illness (ß = 2.25, P = 0.028) had a positive effect on the change in QoL, while time (ß = - 2.95, P < 0.001), cancer experience (ß = - 0.46, P < 0.001), and type of medical insurance (ß = - 2.77, P = 0.021) had the negative effect on the change in QoL. CONCLUSION: The QoL, perceived control, and self-efficacy of patients with breast cancer show dynamic changes during radiotherapy. The higher the self-efficacy, the better the QoL, and the worse the QoL when the sense of disease control is poor. At the same time, more attention should be paid to the QoL of breast cancer radiotherapy patients with a long course of the disease, receiving chemotherapy, and different medical payment methods.

Internet-based eHealth technology for emotional well-being among the older adults with a family cancer history: full mediation effects of health information self-efficacy and cancer fatalism.

BACKGROUND: Older adults with a family cancer history (FCH) face an increased cancer risk, which may adversely impact their emotional well-being. Internet-based eHealth technologies (IETs) provide a potential solution to this challenge. This study examines the influence of using IETs on the emotional well-being of older adults with FCH. It also delves into the mediating pathways through health information self-efficacy and cancer fatalism. METHODS: This study conducted a mediation analysis using data from the Health Information National Trends Survey (HINTS 6) collected from March 2022 to November 2022, focusing on older adults with FCH who had previously searched for cancer-related information (N = 1,280). RESULTS: In the mediation model, no positive direct associations between IETs usage and emotional well-being were found. Only health information self-efficacy and cancer fatalism were found to mediate the relationship between IETs usage and emotional well-being serially (ß = 0.007, 95% CI [0.003, 0.012]). CONCLUSIONS: The findings inform health information professionals and healthcare practitioners on enhancing the impact of IETs usage on individual health information self-efficacy, which mitigates cancer fatalism, contributing to better emotional well-being in the digital era.

A study on the correlations of PRL levels with anxiety, depression, sleep, and self-efficacy in patients with prolactinoma.

Purpose: The purpose of this study was to explore the factors influencing PRL levels in patients with prolactinoma and to investigate the correlations between anxiety, depression, sleep, self-efficacy, and PRL levels. Methods: This retrospective study included 176 patients with prolactinoma who received outpatient treatment at the Affiliated Hospital of Zunyi Medical University from May 2017 to August 2022. The general information questionnaire, Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS), and General Self-Efficacy Scale (GSES) were used for data collection. A generalized estimating equation (GEE) model was used to analyze the factors influencing PRL levels in patients with prolactinoma. GEE single-effect analysis was used to compare PRL levels at different time points between anxiety group and nonanxiety group, between insomnia group and normal group, and between low, medium, and high self-efficacy groups. Results: The median baseline PRL level and the PRL levels at 1, 3, 6, and 12 months of follow-up were 268.50 ng/ml, 122.25 ng/ml, 21.20 ng/ml, 19.65 ng/ml, and 16.10 ng/ml, respectively. Among patients with prolactinoma, 59.10% had anxiety (HADS-A score = 7.35 ± 3.34) and 28.98% had depression (HADS-D score = 5.23 ± 3.87), 9.10% had sleep disorders (AIS score = 6.10 ± 4.31) and 54.55% had low self-efficacy (GSES score = 2.13 ± 0.83). Educational level, tumor size, number of visits, sleep quality, anxiety level, and self-efficacy level were found to be factors influencing PRL levels in patients with prolactinoma (P<0.05). Higher PRL levels were observed in the anxiety group compared to the non-anxiety group (P<0.001), in the insomnia group compared to the normal group (P<0.05), and in the low self-efficacy group compared to the medium and high self-efficacy groups (P<0.05). Conclusion: PRL levels in patients with prolactinoma are related to education level, tumor size, number of visits, anxiety, self-efficacy, and sleep but not depression. PRL levels were higher in patients with anxiety, low self-efficacy, and sleep disorders.

Physical Activity Levels and Social Cognitive Theory Correlates among Adults with Crohn's Disease: Preliminary Results from a Cross-Sectional Analysis.

There is increasing research and clinical interest in physical activity (PA) as an adjuvant therapy for improving health outcomes among persons with Crohn's disease. To date, little is known regarding PA behavior and its cognitive and behavioral correlates in Crohn's disease. Thus, we assessed self-reported PA and its social cognitive theory (SCT) correlates in a sample of persons with Crohn's disease. Data on demographic and clinical characteristics, disease activity, leisure-time PA, and SCT variables were collected from 30 participants with Crohn's disease (90% White, 60% female) through an online survey. SCT variables assessed included exercise self-efficacy, social support, outcome expectations, goal setting, and planning. Analyses involved comparing PA levels and SCT survey scores using independent sample t-tests and non-parametric bivariate correlations. The majority of participants were in clinical remission (60%) and over half (57%) were classified as physically active, yet the mean PA level was lower than normative values for adults. Females (n = 18) and participants who reported previous surgery for Crohn's disease (n = 18) were almost twice as physically active as male participants and those without a history of Crohn's disease-related surgery, respectively (p's < 0.05). Overall, participants who reported greater exercise goal setting behaviors had higher levels of PA (rs = 0.34; p < 0.05). These findings highlight lower overall levels of PA in persons with Crohn's disease, and exercise goal setting represents a potential target of behavior change interventions for increasing PA in this population.

The Moderating Role of HIV Stigma on the Relationship between Perceived Social Support and Antiretroviral Therapy Adherence Self-Efficacy among Adult PLHIV in South Africa.

BACKGROUND: People living with human immune deficiency virus (PLHIV) grapple with distinct challenges, including HIV stigma which affects their antiretroviral therapy (ART) adherence self-efficacy. This study investigates the interaction of HIV stigma and perceived social support on ART adherence self-efficacy among adult PLHIV in South Africa. METHODS: This study utilized a cross-sectional design that involved 201 participants selected using time location sampling at a tertiary health facility in Durban. RESULTS: HIV stigma was significantly and negatively associated with self-efficacy (ß = -7.860, t = -4.654, p = .001), with variations across different stigma levels (ß = -5.844, t = -4.003, p = .001). Social support was significantly and positively associated with self-efficacy at lower HIV stigma levels (ß = 7.440, t = 3.887, p = .001), in contrast to higher levels (ß = -2.825, t = 1.400, p = .163). CONCLUSION: Social support significantly influences ART adherence self-efficacy, particularly at lower levels of HIV stigma, but the effect of support weakens as stigma intensifies.

The relationship between perceived social support and antiretroviral therapy adherence self-efficacy among adult PLHIV in South Africa: The influence of HIV stigma.People living with HIV face unique challenges, such as HIV stigma, which impact their ability to adhere to antiretroviral therapy (ART). This study examined how HIV stigma and perceived social support affect the ART adherence self-efficacy of adults living with HIV in South Africa. This survey involved 201 participants who were selected by using time location sampling at a health facility in Durban, South Africa. The study found that HIV stigma had a significant and negative impact on self-efficacy (ß = −7.860, t = −4.654, p = .001), with variations depending on the level of stigma (ß = −5.844, t = −4.003, p = .001). On the other hand, social support had a significant and positive impact on self-efficacy at lower levels of HIV stigma (ß = 7.440, t = 3.887, p = .001), but this effect weakened at higher levels of stigma (ß = −2.825, t = 1.400, p = .163). Social support plays an important role in influencing self-efficacy, especially when HIV stigma is lower. However, the significant impact of social support diminishes as HIV stigma becomes more intense.

Social support and medication adherence among adult myasthenia gravis patients in China: the mediating role of mental health and self-efficacy.

BACKGROUND: Myasthenia gravis (MG), a rare chronic neuromuscular disorder, is characterized by progressive physical decline and requires long-term pharmacological treatment. Due to the decline of physical and social abilities, MG patients are in great need of social support, including tangible and emotional support. This study aims to examine the association between social support and medication adherence and the possible mediating effects of mental health and self-efficacy among MG patients. METHODS: A cross-sectional analysis of a nationwide MG registry was conducted on 865 patients under oral medication treatment in China between June and July 2022. Validated scales were used to measure the respondent's mental distress (Four-item Patient Health Questionnaire), social support (Modified Medical Outcomes Study Social Support Scale), self-efficacy for medication use (Self-efficacy for Appropriate Medication Use Scale), and medication adherence (Morisky Medication Adherence Scale, MMAS). RESULTS: The association between social support and medication adherence and possible mediating effects of mental distress and self-efficacy were tested by structural equation model, with significant demographic and disease-related factors adjusted. The respondents showed a very low level of medication adherence (71.2% poor adherence; 1.4% high adherence; mean MMAS = 4.65). The level of social support was positively associated with medication adherence, and such association was fully mediated by two indirect pathways: through self-efficacy (ß = 0.07, proportion mediated = 63.8%); and through mental distress and then self-efficacy (ß = 0.01, proportion mediated = 6.7%). CONCLUSION: Provision of social support and interventions on mental health with emphasis on improving self-efficacy for medication use may effectively improve medication adherence among MG patients.

[Perceived work self-efficacy, and characteristics of return to work in women survivors of breast cancer at two reference centers in Colombia]. / Autoeficacia laboral percibida, y características del retorno al trabajo en mujeres supervivientes de cáncer de mama en Colombia.

OBJECTIVE: Return to work and permanence in employment of women who survive breast cancer are topics that become important as incidence and survival rates increase. Self-efficacy as a modifiable element is of special interest in this process. The objective of this study is to measure the level of self-efficacy in female breast cancer survivors, according to sociodemographic, work and treatment characteristics and their relationship with return to work. METHODS: This was a cross-sectional study, based on a survey of breast cancer patients about their demographic and work characteristics, the return to work process, permanence in the same job and the level of work self-efficacy. Differences in the level of self-efficacy with respect to characteristics were evaluated using bivariate analyses and hypothesis statistical testing. A value of p<0.05 was considered statistically significant. RESULTS: One hundred and twenty-four women were included, 87.9% had returned to work, the majority (56.4%) between one and six months after treatment, 67.7% remained in the same job. Higher levels of work self-efficacy were related to a higher probability of returning to work and staying there, and a shorter time to return to work; these differences were statistically significant. CONCLUSION: Occupational health and risk prevention services must consider and strengthen work self-efficacy and organizational support in breast cancer survivors to achieve a successful return to work.

OBJETIVO: El objetivo de este estudio es analizar el nivel de autoeficacia en mujeres supervivientes de cáncer de mama, según las características sociodemográficas, laborales y de tratamiento y su relación con la reincorporación laboral. Métodos: Estudio transversal, basado en una encuesta a pacientes de cáncer de mama de dos centros oncológicos sobre sus características demográficas, laborales, el proceso de retorno al trabajo, la permanencia en el mismo empleo y el nivel de autoeficacia laboral. Se evaluaron las diferencias en el nivel de autoeficacia con respecto a las características mediante análisis bivariado y pruebas estadísticas de contraste de hipótesis. Un valor de p<0.05 se consideró estadísticamente significativo. RESULTADOS: Se incluyeron 124 mujeres, de las cuales 87,9% habían retornado al trabajo, la mayoría (56,4%) entre uno y seis meses después del tratamiento, y el 67,7% permanecían en el mismo empleo. Los niveles superiores de autoeficacia laboral se relacionaron con una mayor probabilidad de retorno al trabajo y permanencia en el mismo, y menor tiempo de reincorporación, siendo estas diferencias estadísticamente significativas. Conclusión: La autoeficacia laboral y el apoyo organizacional son recursos que los servicios de salud laboral y prevención de riesgos deben considerar y fortalecer para ayudar a un retorno exitoso y sostenido al trabajo en supervivientes de cáncer de mama.

Effect of continuity nursing based on the theory of Knowledge-Attitude-Practice on quality of life, self-efficacy, and treatment compliance in elderly patients with benign prostatic hyperplasia.

OBJECTIVE: The purpose of this study was to analyze the impact of continuity nursing based on the theory of Knowledge-Attitude-Practice (KAP) on the quality of life, self-efficacy, and treatment compliance in elderly patients with benign prostatic hyperplasia (BPH). METHODS: In this single-center, randomized controlled study, a total of 232 elderly BPH patients who received treatment at our hospital from June 2020 to June 2022 were selected as the research subjects. They were randomly divided into the research group (n = 116) and the control group (n = 116). The control group received conventional interventions, while the research group received continuity nursing based on the theory of KAP on the basis of control group. Anxiety, depression, self-care agency, quality of life, self-efficacy, treatment compliance, and nursing satisfaction were compared between these 2 groups. RESULTS: Before nursing intervention, both groups showed a decrease in SAS and SDS scores after the intervention. Furthermore, self-care ability, self-care responsibility, self-concept, health knowledge level, role function, emotional function, somatic function, cognitive function, social function, and General Self-Efficacy Scale scores increased. Additionally, the research group demonstrated lower/higher levels than the control group (P < .05). The research group exhibited higher treatment compliance (P = .002) and greater nursing satisfaction compared to the control group (P = .014). CONCLUSION: Continuity nursing based on the theory of KAP can improve negative emotions in elderly BPH patients, enhance their self-efficacy and treatment compliance, and achieve better clinical outcomes.

An online intervention to improve oncology health professional self-efficacy in communicating with carers: Hybrid effectiveness-implementation evaluation of the eTRIO program.

OBJECTIVES: Many oncology health professionals (HPs) report communicating with carers as complex; and receive limited carer-relevant training. We developed an online HP education program for supporting and managing carer involvement (eTRIO). We aimed to assess whether HPs' self-efficacy in carer communication, knowledge, and decision-making preferences improve following eTRIO. Satisfaction and implementation potential were assessed. METHODS: This type 1 hybrid effectiveness-implementation study used a pre-post single arm intervention design. HPs completed baseline measures, the eTRIO online module, and measures at 1- and 12-weeks post-intervention. Measures included: self-efficacy in carer communication (13-items), applied knowledge (7-items), preference for carer involvement in decisions (1-item). Fifteen of participants completed feedback interviews which underwent thematic analysis. User analytics were collected and analysed. RESULTS: Fifty-six HPs completed baseline measures, 42 completed post- and follow-up measures. At baseline mean self-efficacy score was 88. HPs showed a statistically significant increase in self-efficacy post-intervention (mean = 105.8, CI [12.99, 20.47]), maintained at 12-weeks (mean = 101.1, CI [8.00, 15.72]). There were no changes in knowledge or decision-making preferences. Program engagement and satisfaction were high, 86.7% participants rated eTRIO as very/extremely helpful. CONCLUSIONS AND PRACTICE IMPLICATIONS: eTRIO provided HPs with confidence to effectively engage with carers and manage complex situations such as family dominance. These gains are noteworthy, as conflict with families/carers contributes to HP burnout.

Comparative effectiveness of implementation strategies for Accelerating Cervical Cancer Elimination through the integration of Screen-and-treat Services (ACCESS study): protocol for a cluster randomized hybrid type III trial in Nigeria.

BACKGROUND: Despite the increased risk of cervical cancer (CC) among women living with HIV (WLHIV), CC screening and treatment (CCST) rates remain low in Africa. The integration of CCST services into established HIV programs in Africa can improve CC prevention and control. However, the paucity of evidence on effective implementation strategies (IS) has limited the success of integration in many countries. In this study, we seek to identify effective IS to enhance the integration of CCST services into existing HIV programs in Nigeria. METHODS: Our proposed study has formative and experimental activities across the four phases of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Through an implementation mapping conducted with stakeholders in the exploration phase, we identified a core package of IS (Core) and an enhanced package of IS (Core+) mostly selected from the Expert Recommendations for Implementing Change. In the preparation phase, we refined and tailored the Core and Core+ IS with the implementation resource teams for local appropriateness. In the implementation phase, we will conduct a cluster-randomized hybrid type III trial to assess the comparative effectiveness of Core versus Core+. HIV comprehensive treatment sites (k = 12) will be matched by region and randomized to Core or Core+ in the ratio of 1:1 stratified by region. In the sustainment phase, we will assess the sustainment of CCST at each site. The study outcomes will be assessed using RE-AIM: reach (screening rate), adoption (uptake of IS by study sites), IS fidelity (degree to which the IS occurred according to protocol), clinical intervention fidelity (delivery of CC screening, onsite treatment, and referral according to protocol), clinical effectiveness (posttreatment screen negative), and sustainment (continued integrated CCST service delivery). Additionally, we will descriptively explore potential mechanisms, including organizational readiness, implementation climate, CCST self-efficacy, and implementation intentions. DISCUSSION: The assessment of IS to increase CCST rates is consistent with the global plan of eliminating CC as a public health threat by 2030. Our study will identify a set of evidence-based IS for low-income settings to integrate evidence-based CCST interventions into routine HIV care in order to improve the health and life expectancy of WLHIV. TRIAL REGISTRATION: Prospectively registered on November 7, 2023, at ClinicalTrials.gov no. NCT06128304. https://classic. CLINICALTRIALS: gov/ct2/show/study/NCT06128304.

Factors Influencing Health Promotion Lifestyle in Female Breast Cancer Survivors: The Role of Health Behavior Self-Efficacy and Associated Factors.

OBJECTIVES: To examine the factors influencing health-promoting lifestyles and the changes in health behavior self-efficacy and health-promoting lifestyles among female breast cancer survivors over a 6-month period. METHODS: A longitudinal design with purposive sampling was deployed. Data collection occurred at the baseline (T1), 3 months (T2), and 6 months (T3). In total, 53 breast cancer survivors agreed to participate. All participants completed the first two rounds of data collection, 49 participants completed data collection at the 6-month mark (T3). The Chinese versions of the Self-Rated Abilities for Health Practices Scale (SRAHP) and the Health-Promoting Lifestyle Profile (HPLP) were used. RESULTS: Health behavior self-efficacy and health-promoting lifestyle scores increased over time. Age, impaired cardiac function, those taking a career break, psychological well-being, and responsible health practice in self-efficacy for health behaviors were significant predictors of health-promoting lifestyle. CONCLUSIONS: Younger breast cancer survivors, those taking a career break, and those with poor health behavior self-efficacy were less likely to engage in a health-promoting lifestyle and may require guidance in improving overall health behaviors. IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers should not only be aware of the suboptimal health promotion lifestyle in breast cancer survivors but also focus on enhancing health behavior self-efficacy. This is particularly crucial for younger breast cancer survivors or those currently unemployed.

Perioperative knowledge, self-efficacy and clinical practices related to postoperative delirium care in older people across geographical regions in Australia.

INTRODUCTION: In older people undergoing surgery, there is a lower tolerance for complications. This highlights the need for documented clinical practices on proper prevention, pre-screening and management of complications such as postoperative delirium (POD). Evidence-based clinical practice guidelines exist for delirium management; however, the management of delirium in clinical settings differs widely. OBJECTIVE: This study aims to develop an understanding of the knowledge, components of self-efficacy (confidence/competence), and clinical practice related to POD care among preoperative and recovery nurses across different types of geographical locations in Australia. DESIGN: A 27-item online survey was sent out to professional associations focused on perioperative care across Australia. The participants included practicing registered nurses specialising in perioperative care. The main outcome measures were Knowledge, confidence/competence and clinical practice relating to POD care in older patients. FINDINGS: Respondents were categorised into two groups-major cities and rural and remote. Mean age was 46.3 years for respondents in Australian major cities and 49.5 for the comparison group. There was a statistically significant difference between Australian major cities and 'rural and remote' in confidence in detecting hyperactive delirium, 25.2% versus 11.7% respectively as well as managing hyperactive delirium, 13.8% versus 1.7%, respectively. Similar results were also observed on hypoactive delirium. Respondents from both groups did not mirror the ideal situation in managing a hyperactive delirium. DISCUSSION: Results from this study are inconclusive and there is no clear-cut observation in clinical practice or knowledge between the two geographical categories in this study. CONCLUSION: The absence of a distinct strategy with POD prevention highlights the need for a uniform approach and consensus on POD prevention and management in older people. This can be achieved by creating more awareness and education through professional development related to POD.

The Effect of the Neuman Systems Model-Based Training and Follow-up on Self-Efficacy and Symptom Control in Patients Undergoing Chemotherapy.

In this article, the authors aimed to determine the effect of the training and follow-up based on the Neuman systems model provided to patients undergoing chemotherapy on their self-efficacy and symptom control. The study was carried out with a randomized controlled experimental study model design. The sample consisted of 102 patients including 52 in the experimental group and 50 in the control group. The data were collected using the Patient Information Form, the Cancer Behavior Inventory-Brief (CBI-B), and the Edmonton Symptom Assessment Scale (ESAS). A personal training program prepared according to the Neuman systems model was applied to the experimental group patients. In the intergroup comparison of the experimental and control group patients, there was an increase in the posttest CBI-B scores and a decrease in the ESAS scores in the experimental group compared to the control group, and the intergroup difference was statistically significant (p < .05). According to the results, to improve the self-efficacy and symptom control in patients undergoing chemotherapy, using this education and follow-up program is recommended.

Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy.

PURPOSE: The study aimed at evaluating the Effectiveness of Comprehensive Intervention Programme (CIP) on Quality of life (QOL), fatigue, self-efficacy, and psychosocial distress among Head and Neck Cancer (HNC) patients receiving radiotherapy treatment. METHODS: Single-centre non-RCT time series study was conducted among 134 HNC patients (67 observed, followed by 67 subjected to CIP). FACT- H&N, FACT-F, Cancer Behavior Inventory and psychosocial distress scales were used to assess QOL, fatigue, self-efficacy, and psychosocial distress respectively. CIP was provided to the intervention arm twice a week during the course of radiation therapy along with the standard care; the control arm received only standard care. Data were collected before commencing radiotherapy, and post-test assessments were carried out at the end of radiotherapy treatment, and at 3 and 6 months after completion of radiotherapy. RESULTS: Repeated measures ANOVA revealed a statistically significant improvement with CIP in QOL (F (1.917) = 454.103, p = 0.001), fatigue (F (2.106) = 183.775, p = 0.001), self-efficacy (F (2.429) = 190.861, p = 0.001), and psychosocial distress (F (2.288) = 290.105, p = 0.001) in the intervention arm. CONCLUSION: The CIP implemented to address multitude of issues in HNC patients receiving radiotherapy, proved to be effective in reducing the impact of treatment on QOL, fatigue, self-efficacy and psychosocial distress in HNC patients receiving radiotherapy.