Educational intervention for family caregivers of older adults with delirium: An integrative review.

AIM: To propose educational strategies to prevent delirium in older adults. DESIGN: Integrative review. METHODS: This review followed the methodology of Whittemore and Knafl (J Adv Nurs 52(5):546-553, 2005. 10.1111/j.1365-2648.2005.03621.x). DATA SOURCES: A literature search was performed of the PubMed, CINAHL, Embase, Cochrane Library CENTRAL, and Scopus databases on 8 July 2022. RESULTS: Three themes of educational interventions were identified: capacity building, resource provision and enhancement of relationships, collectively termed Fa-CARE. Educational interventions improved family caregivers' knowledge about delirium, their anxiety; depression; self-efficacy; and attitudes. Among older adults, these interventions improved the duration, severity and incidence of delirium; functional abilities; and length of hospital stay. CONCLUSION: Providing education to family caregivers benefits both those caregivers and the older adults. When planning educational intervention, diverse and innovative approaches need to be considered. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study can guide family education regarding the care of older adults with delirium. IMPACT: Educational interventions positively impacted both family caregivers and older adults with delirium. Educational interventions provide family caregivers with resources, improve their capacity for delirium management, and enhance their relationships with older adults. This study suggests future directions in education for family caregivers of older adults with delirium. REPORTING METHOD: This review adhered to the EQUATOR guidelines by using the PRISMA 2020 checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Risk and protective factors for a salutogenic sense of health in adolescents with Moyamoya disease.

PURPOSE: To identify the risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease based on Antonovsky's salutogenesis theory. METHODS: This study used a qualitative descriptive design. We interviewed adolescents diagnosed with Moyamoya disease and their parents and experts with experience in treating them from 4 July 2019 to 10 October 2019. Data analysis was performed according to the process of deductive content analysis based on Antonovsky's salutogenesis theory. RESULTS: This study identified risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease. Risk factors were closely related to problems with friends, parent relationships and academic work. Protective factors were identified as emotional support through interpersonal relationships, positive attitudes to the disease situation, ability to understand and predict patterns of symptoms, increasing strength to resolve the state of tension and developing available resources. CONCLUSION: The factors affecting a salutogenic sense of health in adolescents were identified reflecting on the characteristics of the developmental stage of adolescents and the symptoms and situations that are unique to adolescents. It is important for adolescents with Moyamoya disease to recognize available resources and use them appropriately to successfully manage the state of tension caused by stress.

Features and diversity of symptoms of moyamoya disease in adolescents: A cluster analysis.

AIMS: The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease. DESIGN: A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals. METHODS: To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13-19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010-December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log-likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two-step method. RESULTS: The physical symptoms experienced by adolescents with moyamoya disease were 'limb weakness' - the most common - followed by a 'headache,' 'difficulty in speech,' and 'nausea/vomiting.' A total of five symptom clusters were derived: cluster 1 was characterized by 'limb weakness'; cluster 2 participants were asymptomatic or experienced 'convulsions'; cluster 3 experienced 'difficulty in speech' and 'facial paralysis'; cluster 4 is prone to 'dizziness' and 'pins and needles'; and cluster 5 displays 'headaches' and 'nausea/vomiting'. CONCLUSION: This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents. IMPACT: These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents.

Stress and mood of adults with moyamoya disease: A cross-sectional study.

Moyamoya disease in adults is a chronic, progressive disorder characterized by fine collateral vessel networks in the brain. The disorder can lead to negative mood and stress, which, left unresolved, may increase adverse health outcomes. We conducted a cross-sectional survey to examine stress and mood of adults with moyamoya disease. Participants were recruited at a university hospital in Seoul, Korea. Data were collected through questionnaires and review of participants' electronic medical records. A total of 109 adults participated. Significant correlations were found between perceived stress, anxiety, and depression. Adults with moyamoya disease experience anxiety, depression, and stress related to the risk of cerebral hemorrhage or ischemia, similar to those with other cerebrovascular disease. If negative mood and stress were uncontrolled, those can cuase adverse health outcomes. Health professionals caring for people with moyamoya disease should carefully observe their stress and mood and develop interventions tailored to stages of disease to help them manage. The study results provide baseline information for understanding the level of, and the factors associated with, stress and mood.

What is the concept of parental 'emotional transference' to children? A Walker and Avant concept analysis.

PROBLEM: Human emotions come from relationships with others, and emotional states can be transferred to others through emotional transfer, leading people to experience identical emotions unconsciously. Emotional transference is not a new concept; however, no concept analysis has been performed on emotional transference from parents to children. ELIGIBILITY CRITERIA: A literature search was conducted of terms related to 'emotional transference', (e.g. 'emotional transfer' and 'affective transference') in the following databases: PubMed, CINAHL, ProQuest, RISS and DBPIA published between 1987 and 2016; documents were published in English or Korean. SAMPLE: Forty-four studies met review criteria. RESULTS: This review highlighted analysis of the concept of emotional transference from parent to child, a unidirectional process. The apparent attributes which are of importance to the child during parental interaction consist of parental expression (facial, voice, postural), child's interpretation of parental emotional expression and child's emotional formation. CONCLUSIONS: Understanding parental emotional transference to children is very important in effecting positive outcomes in the nursing environment. IMPLICATIONS: Nurses need to be aware that parental emotional transference to children and its attributes essential to assessment and intervention. Further study and education are needed to develop nursing care for children.

Effect of Unshaven Hair with Absorbable Sutures and Early Postoperative Shampoo on Cranial Surgery Site Infection.

BACKGROUND: Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study. METHODS: A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison. RESULTS: Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site. CONCLUSION: Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation.

Mediating effects of fatigue on the relationship between sleep quality and the quality of life of shift-working nurses.

The mediating role of fatigue in the relationship between the quality of sleep and quality of life of shift-working nurses has been predicted in previous studies. Interventions that focus on improving the quality of life of a nurse, who works 24 h shifts in close proximity to patients, should take the mediating role of fatigue into account. This study investigates the mediation of fatigue in the relationship between sleep quality and quality of life for shift-working nurses. This cross sectional study collected self-reported questionnaire responses on variables including sleep quality, quality of life, and fatigue of shift-working nurses. We performed a three-step mediating effect verification procedure with 600 study participants. We found a negative and significant correlation between sleep quality and quality of life, a significant positive correlation between sleep quality and fatigue, and a negative correlation between quality of life and fatigue. We found: (1) that the quality of sleep affects the quality of life of shift-working nurses, (2) that the quality of sleep is correlated with the degree of fatigue, and (3) that the degree of fatigue is high, which means that quality of life decreases. Thus, it is necessary to develop and apply a strategy to reduce shift-working nurses' fatigue to improve their sleep quality and quality of life.

Factors influencing nursing students' knowledge, attitudes, and infection management behavior for emerging respiratory infectious diseases: A cross-sectional study.

Understanding the factors influencing infection management behavior related to Emerging Respiratory Infectious Diseases (ERIDs) among nursing students is important because nursing students play a vital role in preventing the spread of ERIDs. This study aimed to determine factors influencing infection management behavior related to ERIDs among nursing students in Korea. In this cross-sectional survey study, data were collected from May 3 to June 30, 2022, using a questionnaire. Data collected from 481 nursing students were analyzed using descriptive statistics, an independent t-test, a one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression using the SPSS program. The key factors influencing respondents' ERID-related infection management behavior were attitude (ß = 0.554, p<0.001) and knowledge (ß = 0.282, p<0.001). The explanatory power of this model was 40.2%, and the regression model was found to be statistically significant (F = 27.935, p<0.001). To improve nursing students' ERID-related infection management behavior, their knowledge of and attitudes toward ERIDs should be enhanced by repeatedly providing them with accurate professional information about ERIDs. Therefore, intensive efforts should be taken to develop a systematic educational program that can help nursing students better perform infection management.

Development and effects of salutogenesis program for adolescents with moyamoya disease: A randomized controlled trial.

BACKGROUND: Disease-specific interventions for management and health behavior implementation are needed to improve the health and quality of life of adolescents with moyamoya disease. OBJECTIVE: This study aimed to develop a program for adolescents with moyamoya disease based on the salutogenesis theory, which focuses on the process of enhancing health through successful adaptation to external stressors, and to evaluate its effectiveness. METHODS: A randomized controlled trial was performed according to the CONSORT guidelines. This preliminary research and experimental treatment were conducted at a Severance Hospital ward and outpatient clinic among 48 participants randomized into the intervention (seven sessions of salutogenesis program, n = 24) or the control group (one session of one-to-one moyamoya disease education program, n = 24) from September 6, 2018 to January 4, 2019. Changes in the following study outcomes were reported: "knowledge of moyamoya disease," "social support," "sense of coherence," "moyamoya disease health behavior," "stress," "depression," "subjective health status," "frequency of ischemic symptoms," and "quality of life". RESULTS: The salutogenesis program improved the knowledge and social support of adolescents with illness-related problems and helped them attain healthy behaviors and stress reduction. It was confirmed to be effective in improving their quality of life. CONCLUSIONS: The salutogenesis program for adolescents with moyamoya disease effectively improved the generalized resistance resources and sense of coherence in adolescents with moyamoya disease. TRIAL REGISTRATION: Korean Clinical Research Information Service registry, KCT0006869.

Validity and reliability of the Korean caregiver contribution to self-care chronic illness inventory.

The contribution of caregivers to self-care for chronically ill patients is important for improving patient outcomes. The Caregiver Contribution to Self-Care Chronic Illness Inventory (CC-SC-CII) has been used to assess caregivers' contributions to three distinct aspects of self-care (maintenance, monitoring, and management) globally. This study aimed to examine the psychometrics of the Korean version of the CC-SC-CII with 230 family caregivers (mean age = 49.8 years, 70% women) of patients with chronic illness. We demonstrated that the CC-SC-CII-Korean has good reliability with acceptable internal consistency and construct validity for all three factors using confirmatory factor analysis. The CC-SC-CII-Korean is a reliable and valid instrument to measure the contributions of Korean caregivers to the self-care of patients with chronic illnesses.

Telehealth interventions to support self-care of stroke survivors: An integrative review.

Background: Self-care is essential for stroke survivors to recover from neurological disorders caused by stroke and to prevent recurrences. Self-care behaviors are activities that individuals undertake to prevent recurrence and complications, and have a positive effect on the quality of life of patients. Telehealth is an emerging technology through which self-care intervention can be provided from a distance. Review-based research is needed to determine the value and development of telehealth-based self-care interventions for stroke survivors. Objective: Based on the middle range theory of self-care of chronic illness, to provide an effective guide when developing telehealth self-care interventions for stroke survivors by comprehensively understanding telehealth interventions to support self-care of stroke survivors. Methods: An integrative review, this study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). The key search terms included combinations of concepts related to stroke survivors and self-care, and telehealth. The research year of searched publications was not limited, and five electronic databases (PubMed, Ovid-MEDLINE, Ovid-EMBASE, CINAHL and Cochrane Library) were searched. Results: Four attributes were identified that represented telehealth's functions that appeared to be associated with a self-care intervention for stroke survivors. These included introducing the concept of interaction, monitoring, education, and store and forward. These self-care interventions were found to influence the behaviors of stroke survivors' self-care maintenance (physical activity and treatment adherence), self-care monitoring (blood pressure, healthy behaviors, health diet, psychological well-being, glucose control, and depression), and self-care management (sense of control, healthcare resource utilization, social integration, and support). Conclusions: The results of this study can provide a guide for developing effective telehealth self-care intervention by identifying the attributes of telehealth self-care intervention for stroke survivors.

Structural equation model based on salutogenesis theory for evaluating factors affecting health-related quality of life in adolescents with moyamoya disease.

Moyamoya disease is a cerebrovascular disorder and a significant chronic health concern requiring regular monitoring to control the disease and its related complications. We examined a hypothetical model by integrating the concepts of a structural health-related quality-of-life model based on the salutogenesis theory, and to identify how social support, sense of coherence, and stress contribute to health behaviors, subjective health status, and quality of life in adolescents with moyamoya disease among 239 adolescents in Korea. A structural equation model was used to analyze the data. The fitness of the hypothetical model with the salutogenesis theory was satisfactory, showing that the goodness-of-fit index = 0.91, adjusted goodness-to-fit index = 0.90, comparative fit index = 0.92, normed fit index = 0.91, incremental fit index = 0.91, standardized root mean squared residual = 0.04, root mean square error of approximation = 0.07, parsimony normed fit index = 0.61, parsimony goodness of fit index = 0.51. The model explained 68.9% of quality of life. Health behavior (ß = -0.173, p = 0.467) and stress (ß = -0.557, p < 0.001) had significant direct and total effects on quality of life. Sense of coherence had a significant direct (ß = 0.371, p = 0.003), indirect (ß = 0.220, p = 0.013), and total (ß = 0.590, p < 0.001) effect on quality of life. This study found that sense of coherence was significant factors contributing to lower stress, improved health status, and quality of life in adolescents with moyamoya disease. To improve the quality of life for adolescents with moyamoya disease, comprehensive nursing interventions need to be developed and applied.

Cultural factors affecting the self-care of cancer survivors: An integrative review.

PURPOSE: For cancer survivors, self-care is an important factor that can improve health and quality of life. Cultures known to inform human behavior can influence self-care, such as prioritizing various self-care practices or utilizing other resources. The impact of culture on cancer survivors' self-care has not been adequately investigated to date. The purpose of this integrative review is to summarize and synthesize the past empirical literature examining cultural factors affecting cancer survivors' self-care. DESIGN: An integrative review was conducted. METHODS: This study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). A literature search was conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science (WOS), and the International Bibliography of the Social Sciences (IBBS) computerized databases with the guidance of a medical librarian. RESULTS: The review incorporated 16 articles. Cultural values, cultural beliefs, fatalism, social norms, faith/religion, sexual roles, and customs were identified as cultural factors affecting the self-care of cancer survivors. These cultural factors were found to influence the behaviors of cancer survivors' health maintenance (healthy life and psychological well-being), self-care monitoring (physical symptoms and complication symptoms), and self-care management (coping with symptoms and response to symptoms). CONCLUSION: The results of this study provide valuable insights into the cultural influence of cancer survivors on self-care behaviors, and healthcare providers can promote self-care behaviors if they understand cultural factors and develop nursing interventions that take cultural influences into account.

Use of Mobile Apps for Self-care in People With Parkinson Disease: Systematic Review.

BACKGROUND: Self-care is essential for people with Parkinson disease (PD) to minimize their disability and adapt to alterations in physical abilities due to this progressive neurodegenerative disorder. With rapid developments in mobile technology, many health-related mobile apps for PD have been developed and used. However, research on mobile app-based self-care in PD is insufficient. OBJECTIVE: This study aimed to explore the features and characteristics of mobile apps for self-care in people with PD. METHODS: This study was performed sequentially according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science, and PsycINFO were searched in consultation with a librarian on June 8, 2021. We used keywords including "Parkinson disease" and "mobile." RESULTS: A total of 17 studies were selected based on the inclusion criteria, including 3 randomized controlled trials and 14 observational studies or quasi-experimental studies. The use of mobile apps for self-care in people with PD focused on symptom monitoring, especially motor symptoms. Motor symptoms were objectively measured mainly through the sensors of smartphones or wearable devices and task performance. Nonmotor symptoms were monitored through task performance or self-reported questionnaires in mobile apps. Most existing studies have focused on clinical symptom assessment in people with PD, and there is a lack of studies focusing on symptom management. CONCLUSIONS: Mobile apps for people with PD have been developed and used, but strategies for self-management are insufficient. We recommend the development of mobile apps focused on self-care that can enhance symptom management and health promotion practices. Studies should also evaluate the effects of mobile apps on symptom improvement and quality of life in people with PD. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021267374; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021267374.

The Moyamoya Health Behavior Scale for Adolescent Patients: Measurement Tool Development and Psychometric Evaluation.

Clinical practitioners treating moyamoya disease recognize the need for a systematic approach to better manage the disease in adolescent patients with the disease. Methods: This study aimed to develop and evaluate the validity and reliability of a disease scale which measures the health-related behaviors of adolescents with moyamoya disease. Results: The final 12-item Moyamoya-HB Scale for adolescents was categorized by three sub-domains: implementation of treatment for moyamoya disease (four items); health promoting behavior for moyamoya disease (four items); and health coping behavior for moyamoya disease (four items). Overall, these factors explained 68.97% of the total variance. The results of the confirmative factor analysis supported the construct, convergent and discriminant validity of the three sub-domains. The Moyamoya-HB Scale for adolescents also demonstrated a concurrent validity with the Korean Adolescents' Health Behaviors Tool (r = 0.59, p < 0.001). Reliability analysis showed an acceptable-to-high Cronbach's alpha of 0.865 in total, and the subscales ranged from 0.800 to 0.841. Conclusions: Initial findings support the Moyamoya-HB Scale as a reliable and valid measure of health behaviors in adolescents with moyamoya disease.

Mood and Stress Evaluation of Adult Patients With Moyamoya Disease in Korea: Ecological Momentary Assessment Method Using a Mobile Phone App.

BACKGROUND: Moyamoya disease (MMD) is a known progressive obstructive cerebrovascular disorder. Monitoring and managing mood and stress are critical for patients with MMD, as they affect clinical outcomes. The ecological momentary assessment (EMA) method is a longitudinal study design by which multiple variable assessments can be performed over time to detect momentary fluctuations and changes in psychological dimensions such as mood and stress over time. OBJECTIVE: This study aimed to identify predicting factors associated with momentary mood and stress at both the within-person and between-person levels and to examine individual fluctuation of mood over time in the short term using an EMA method combined with a mobile phone app. METHODS: Participants aged older than 18 years were recruited from a tertiary hospital in Seoul, Korea, between July 2018 and January 2019. The PsyMate scale for negative affect (NA) and positive affect (PA) and the Trier Inventory for Chronic Stress Scale were uploaded on patient mobile phones. Using a mobile app, data were collected four times a day for 7 days. Pearson correlations and mixed modeling were used to predict relationships between repeatedly measured variables at both the between-person and within-person levels. RESULTS: The mean age of the 93 participants was 40.59 (SD 10.06) years, 66 (71%) were female, and 71 (76%) were married. Participants provided 1929 responses out of a possible 2604 responses (1929/2604, 74.08%). The mean momentary NA and PA values were 2.15 (SD 1.12) and 4.70 (SD 1.31) out of 7, respectively. The momentary stress value was 2.03 (SD 0.98) out of 5. Momentary NA, PA, and stress were correlated (P<.001) and varied over time in relation to momentary variables. Common momentary variables associated with momentary mood and stress at both the within-person (level 1) and between-person (level 2) levels were identified. Momentary NA increased when being alone and being at the hospital at both levels, whereas momentary PA increased when eating or drinking, resting, being at a café, restaurant or a public place but decreased when being alone at both levels. Momentary stress increased when being at the office, at a public place, or as the time of the day went by but decreased when resting or during the weekend. Different factors affecting mood and stress at different levels were identified. Fluctuations in individual momentary mood over time at the within-person level were captured. CONCLUSIONS: The EMA method using a mobile phone app demonstrated its ability to capture changes in mood and stress in various environmental contexts in patients with MMD. The results could provide baseline information for developing interventions to manage negative mood and stress of patients with MMD based on the identified predictors affecting mood and stress at two different levels.