Decision Regret and Vaccine Hesitancy among Nursing Students and Registered Nurses in Italy: Insights from Structural Equation Modeling.

This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R2 = 31.3%) and Concerns (R2 = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R2 = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance.

Correction: Development of a Core Outcome Set for Family and Community Nursing: Protocol for a Delphi Study.

[This corrects the article DOI: 10.2196/51084.].

Development of a Core Outcome Set for Family and Community Nursing: Protocol for a Delphi Study.

BACKGROUND: Family and community nurses (FCNs) play a crucial role in delivering primary care to patients within their homes and communities. A key aspect of their role involves various health interventions, which are influenced by their unique competencies, such as health promotion, advanced clinical knowledge, and strong interpersonal skills. However, it is essential to understand which specific health outcomes these interventions impact to better understand the relationship between FCNs' skills and the health results. OBJECTIVE: This study aims to outline the steps we will take to develop a set of core outcomes. These outcomes will be particularly sensitive to the health interventions carried out by FCNs, providing a clearer picture of their practice's impact. METHODS: A Delphi survey will be used for this research, conducted from January to December 2024. The process will involve 5 steps and input from 3 stakeholder categories. These stakeholders will help identify a preliminary list of outcomes that will form the basis of our core outcome set (COS). RESULTS: This guideline will be beneficial for a wide range of stakeholders involved in COS development, including COS developers, trialists, systematic reviewers, journal editors, policy makers, and patient groups. As of January 2024, we have successfully completed the first stage of the study, with the stakeholder group approving the reported outcomes and assigning participant lists for each stakeholder group. CONCLUSIONS: This study will provide a roadmap for identifying the key health outcomes influenced by the interventions of FCNs. The multistakeholder, multiphase approach will ensure a comprehensive and inclusive process. Ultimately, the findings will enhance our understanding of FCNs' impact on health outcomes, leading to more effective primary care strategies and policies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51084.

A Child with Crohn's Disease: Problems and Stress Level of Parents-Caregivers-A Cross-Sectional Study.

Crohn's disease (CD) is a chronic inflammatory bowel disease. The perception of the disease, its troublesome symptoms and the highly involved treatment mean that living with CD requires not only the affected child having to learn to cope with it, but also their parents. The aim of the study was to examine the problems and levels of stress in parents-caregivers of children with CD. The study was cross-sectional and conducted using the diagnostic survey method. An original questionnaire was used to assess the socio-demographic situation and problems of caring for a child with CD, and the standardised PSS-10 questionnaire was added. The study group consisted of 60 parents who accompanied their children during hospitalization. The surveyed caregivers of children with CD found it difficult to maintain a specialised diet and deal with the need for hospitalization and the chronic use of medications. Access to the necessary knowledge about the disease posed the least difficulty in everyday life for a child with CD. The vast majority of parents (50, 83.34%) felt a high level of stress related to caring for a child with CD and, simultaneously, a lack of acceptance of the child's disease (39, 65%). The age of the respondents did not have a statistically significant effect on the occurrence of problems related to everyday functioning. The acceptance of the child's disease by the parents and informal caregivers of children with CD reduced their stress level. Parents could count on support from their relatives but, unfortunately, institutional support was not properly provided.

Quality of Life of Polish Patients with Lymphoma Treated Systemically.

Research on the quality of life has become of great importance. It is used by clinical researchers to compare the impact of treatment regimens on patients. The choice of treatment method may significantly depend on the patient's opinion. A cross-sectional study was conducted using the method of a diagnostic questionnaire survey. The research tools were the authors' questionnaire and the standardized WHOQOL-BREF. The study was conducted among patients with lymphoma, treated systemically. More than half of the surveyed patients assessed their overall quality of life as good (50%) and very good (6%), while the expressed satisfaction with health most often ranged from neutral (38%-neither good nor bad) to dissatisfactory (30%) and very dissatisfactory (6%). As regards the detailed domains, the area of physical functioning was rated the lowest, while for the remaining domains-psychological, social, environmental-values above average (60.38-64.30) were observed. Social support, particularly from the immediate family, resulted in a higher assessment of the quality of life. The occurrence of side effects related to anticancer treatment and the disease had a statistically significant impact on the decrease in the quality of life, particularly in the physical domain.

Self at Risk: Self-Esteem and Quality of Life in Cancer Patients Undergoing Surgical Treatment and Experiencing Bodily Deformities.

Self-esteem is an important factor determining QoL after surgical procedures leading to bodily deformities associated with cancer treatment. However, there are few data on which components of self-esteem are most closely related to QoL. The article presents two studies that aim to fill this gap. Study 1 concerns changes in global self-esteem and QoL in patients treated surgically for oral cancer (n = 35); Study 2 concerns changes in explicit and implicit self-esteem and QoL in women with breast cancer undergoing mastectomy (n = 96). The study was longitudinal with two measurements: before and after surgery. Both studies used the EORTC QLQ-C30 and Rosenberg's SES questionnaires. In Study 2, the Implicit Association Test (IAT) was additionally performed. The patients' global QoL and self-esteem deteriorated after surgery. In Study 1, patients with higher initial self-esteem showed a greater range of decreased self-esteem and QoL than patients with initially low self-esteem. In Study 2, the largest decreases in various dimensions of QoL and explicit self-esteem were observed in women with fragile self-esteem. A group of women with high explicit and implicit self-esteem showed the best QoL after mastectomy. Cancer patients with high, fragile self-esteem are at risk of the greatest deterioration in QoL and self-image after cancer surgery. These people should be given special psycho-oncological care.

Assessment by Women on Selected Aspects of Quality of Life and on Disease Acceptance after Undergoing Urogynecological Procedures for Urinary Incontinence.

Urinary incontinence is a common social and health problem that affects both men and women. Women, however, are twice as likely as men to experience unintentional and involuntary bladder emptying due to their anatomical structure and biological functions. Urinary incontinence is associated with great discomfort, a sense of shame, and a significant reduction in self-esteem, often resulting in the limiting of, or withdrawing from, professional, social, and community life. The aim of this study was to evaluate selected aspects of the quality of life and disease acceptance by women who had undergone urogynecological procedures for urinary incontinence. The study encompassed 77 women. The diagnostic tools used in the study were the Polish versions of the King's Health Questionnaire (KHQ), the Acceptance of Illness Scale (AIS), and the authors' own survey questionnaire. From the undertaken research, we found that women with urinary incontinence who underwent urogynecological procedures rated their overall health well. What worsened the most regarding the quality of life of women post-procedure for urinary incontinence was the impact of bladder problems on their lives and the discomfort they felt due to bladder problems. The relationship between the time elapsed since the procedure and the quality of life of the respondents with regard to the emotions they experienced was also found to be significant. The longer the time since the procedure, the lower the intensity of negative emotions, and thus the higher the quality of life. Despite the varied opinions of the respondents about the impact of bladder dysfunction on various areas of their lives, acceptance of the disease, as measured by the AIS scale, appeared to be high.

Mapping the literature on decision regret in patients with non-communicable diseases (NCDs): a scoping review protocol.

INTRODUCTION: Decision regret refers to feelings of remorse or dissatisfaction with a decision made regarding the treatment. Mapping the meaningful aspects of decision regret in patients with non-communicable diseases (NCDs) is necessary to provide a comprehensive understanding of the phenomenon and inform the development of effective interventions to address it. For this reason, this protocol aimed to describe the methodological aspects of a scoping review focused on mapping all the meaningful aspects of decision regret in patients with NCDs and provide a conceptual and comprehensive framework of the phenomenon. METHODS AND ANALYSIS: The study described in this protocol will be performed following the Joanna Briggs Institute (JBI) methodology for scoping reviews. The anticipated starting time is July/August 2023 and the anticipated end of the review is June 2024. This scoping review will include quantitative, qualitative, primary and secondary literature, as well as grey literature on decision regret in patients with NCDs. The systematic search will be performed by consulting PubMed, Embase, Scopus, CINAHL, the Cochrane Library and Google Scholar. English-language articles from any context will be eligible for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers and extracting data. Disagreements among reviewers will be solved through consensus meetings. Results will be presented in relation to the review question by employing tables, figures and narrative summaries. ETHICS AND DISSEMINATION: This scoping review did not require ethical approval since it involves a literature review and does not include new data collection from human participants. The results of the review will provide a summary of the available literature on decision regret experienced by patients with NCDs, which is crucial for developing preventive educational interventions in situations where multiple therapeutic options are available.

Social Support in a Cancer Patient-Informal Caregiver Dyad: A Scoping Review.

Social support that includes promoting healthy behaviours throughout the oncology pathway, from diagnosis to treatment to survival, can leverage existing support networks and improve the health of patients and family members in supportive roles. This scoping review aimed to identify and summarise the impact of social support on the patient-informal caregiver relationship during cancer treatment. Inclusion criteria were related to a high focus on dyadic cancer patient-informal caregiver relationships, considering a population of adult cancer patients in active hospitalisation on an oncology ward, and published between 2012 and 2022 to get a portrait of the literature that might influence the current practice. A systematic search using the "Population, Concept, and Context" framework was performed in PubMed, Web of Science, SCOPUS, EBSCO Medline, and CINAHL: 13 articles from the 16,425 pre-qualified articles published between 2012 and 2022. The narrative synthesis of the included studies highlighted that social support, encompassing its different forms within the context of dyads, is frequently associated with an enhanced quality of life, hope, and resilience of both patients and informal caregivers. However, it is important to recognize that the support interventions provided to patients, particularly caregivers, were frequently not thoroughly evaluated or explained, and the sample sizes of the included studies were often limited. Therefore, this review clarified the social and clinical potential of social support for the patient-informal caregiver relationship, paving the way for future robust studies that require to be powered and designed on specific outcomes to allow informing the practice on specific recommendations.

A Model of Social Support for a Patient-Informal Caregiver Dyad.

Background: Close persons (informal caregivers) are the most important providers of support indicated by cancer patients. Cancer affects couples as a codependent system. The aim of this study was to investigate the factors influencing the multidimensional aspect of social support in a cancer patient-informal caregiver dyad. Methods: The research project was cross-sectional. The diagnostic survey method and the survey technique were used. The study was conducted using standardised research tools: BSSS, POS, SSCS, TIPI, ET, SPT, and the authors' own tool for sociodemographic assessment. Results: Patients and caregivers experienced injustice, exclusion, and a sense of loss with a similar intensity. Statistically significant differences between the examined patients and their caregivers were obtained for the support currently received (p < 0.01), emotional support (p < 0.05), and the general level of protective buffering support (p < 0.001). A higher level of information support for caregivers increases the need for support and a sense of support for patients. Conclusion: The quality of functioning and mental well-being of patients is directly influenced by the way their caregivers experience the situation of caring for them; negative or positive states of caregivers, affecting the condition of patients, may affect the course of treatment and contribute to or delay the improvement of the state of health. The subjective sense of support in patients during treatment depends on the need for help that is shown to their caregivers. The sense of support variable is subjective and sometimes disproportionate to the support received and given. Therefore, both the patient and their loved one should be provided with care during the treatment process. In the treatment process, both patients and their caregivers need more protective buffering support that allows them to overcome difficulties related to stress, anxiety, and insecurity, thus weakening their negative effects rather than functional support: emotional, information, instrumental, or material.

Model of Social Support for Patients Treated for Cancer.

Social support can be one of the main factors in better assessing the quality of life at any stage of the recovery process. It should meet the patient's needs so that they can develop constructive methods of coping with the disease. In order to explain the factors influencing social support for cancer patients, a theoretical research model was formulated. It is presented in a graphic form in this article. In order to verify the model, the authors' questionnaire and other standardised questionnaires were used. The experimental group consisted of 170 hospitalised oncological patients being treated for cancer. Personality structure, through its relationship with state of health (0.40) and attitude developed to the disease (0.64), influenced the support experienced by the treated patients (0.40). The surveyed patients, who were characterised by positive self-esteem and experience of life satisfaction despite various difficult situations, perceived to a greater degree the emotional and instrumental support provided to them. During cancer treatment, those patients who showed a need for help and did not experience negative emotions were characterised by an increased need for support. The research results can be introduced into evidence-based medical practice, which could significantly improve the quality of nursing and medical care for patients.

Longitudinal Health-Related Quality of Life Study among Cervical Cancer Patients Treated with Radiotherapy.

Quality of life studies in medicine, particularly in oncology, have become a basic tool used to assess patient's performance in different types of cancer and different modalities of treatment. The aim of this study was a subjective evaluation of the quality of life in cervical cancer patients treated with radiotherapy. The study has a longitudinal character and comprises four stages: before treatment, at the end of treatment, 5 months and 5 years after treatment. Standardized questionnaires such as EORTC QoL C30, HADS (European Organisation for Research and Treatment of Cancer Quality of life C30 Hospital Anxiety and Depression Scale) and the authors demographic-clinical assessment survey were the study tools. Physical functioning was assessed as the highest before treatment and depreciated to the lowest value 5 years after treatment. Emotional functioning was the lowest before treatment and then decreased again in the fourth stage of the assessment. Global quality of life was the lowest in the fourth stage of the study. Memory and concentration were fairly good at every stage of the study, with the highest score at the end of the treatment. At stages 3 and 4, the respondent's social functioning was the best, followed by the ability to fulfil their social role. General health and quality of life were assessed by the respondents on a level slightly above average, though five years after treatment the score was slightly below average.

Analysis of the health situation of women referring to breast cancer screening in Poland.

PURPOSE: To analyze the health situation of women referring to breast cancer screening. METHODS: The study was conducted at "Certus" Medical Center in Myslenice (Malopolska Province). A total of 808 women aged 51-69 years were enrolled. The protocol of the study was approved by the administration of the medical center where it was conducted. The survey consisted of 24 descriptive and single/multiple choice questions referring to health behaviors related to breast cancer prevention. RESULTS: Most often the women received information about breast cancer prevention from specialist physicians [24%]. Only 14% of the participants reported radio, press and Internet as an important source of information. Only 12% of the respondents declared that they self-examined their breasts systematically every month, and 35% stated that their breasts had been examined by a physician during recent years. A statistically significant relationship was found between the primary source of information about breast cancer prevention and the educational level of the study participants (p=0.0008). CONCLUSIONS: Considering the Polish Central Statistical Office estimates, according to which the proportion of persons older than 65 years is projected to grow up to 22.3% by 2030, we may expect further increase in breast cancer incidence. Improvement of the epidemiological situation in Poland, which is worse than in other European countries, requires continuation of multidirectional activities, among them population-based education and active screening.

The mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses.

AIMS: The purpose of this study was to determine the mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses. BACKGROUND: Working stress and strain cause high mental load and can lead to job burnout among oncology nurses. Sense of coherence protects against the negative consequences of occupational mental load and may prevent professional burnout. MATERIALS AND METHODS: The study was carried out with 165 oncology nurses from chemotherapy departments. The data were collected from April to September 2013 using the Antonovsky Sense of Coherence Scale, Meister questionnaire, and Maslach Burnout Inventory. RESULTS: Manageability mediated the relations between Mental Load and both Emotional Exhaustion and Depersonalization. Meaningfulness exerted significant mediational effect on the relationship between Mental Load and Depersonalization. Manageability and Meaningfulness attenuate the unfavourable effect of Monotony and Unspecific load on motional Exhaustion and Depersonalization. CONCLUSIONS: Sense of coherence, especially Manageability and Meaningfulness, seems to be an important resource for oncology nurses, buffering the negative impact of mental load on well-being of nurses. Strengthening the sense of coherence can be helpful in preventing or dealing with professional burnout.

Perceived social support and the sense of coherence in patient-caregiver dyad versus acceptance of illness in cancer patients.

BACKGROUND: Acceptance of illness is a significant determinant of further coping with a disease. Development of illness acceptance may be associated with the sense of coherence and perception of social support. Cancer is an example of a crisis situation, which affects both the patient and his/her close relatives. Consequently, acceptance of illness may be influenced by factors originating from both sides of caregiver-patient dyad. The aim of this study was to analyse direct and indirect interrelationships between perceived support and the sense of coherence in patient-caregiver dyad, and acceptance of illness in cancer patients. DESIGN: Cross-sectional study. METHODS: The study included 80 dyads composed of cancer patients and their caregivers. Only cancer patients undergoing oncological treatment at the time of the study, for at least 3 months but no longer than 12 months, were enrolled. All subjects completed perceived support subscale included in the Berlin Social Support Scales, sense of coherence-29 questionnaire to determine the sense of coherence and Acceptance of Illness Scale. RESULTS: Compared to cancer patients, their caregivers presented with significantly lower levels of perceived social support and weaker sense of coherence. The sense of coherence in caregivers and patients was determined by their perceived support levels. The sense of coherence in caregivers turned out to be a key resource influencing acceptance of illness in cancer patients, both directly and indirectly, via their perceived social support and their sense of coherence. CONCLUSIONS: The sense of coherence, an intrinsic psychological factor determined by social support, is an important determinant of illness acceptance. Functioning of cancer patients is also modulated by psychosocial characteristics of their caregivers. RELEVANCE TO CLINICAL PRACTICE: Greater support offered to caregivers may substantially strengthen the sense of coherence in caregivers and cancer patients and, therefore, may improve the functioning of patient-caregiver dyad in a situation of neoplastic disease.

Sense of Coherence vs. Mental Load in Nurses Working at a Chemotherapy Ward.

OBJECTIVE: The aim of this study was to analyze the relationship between the sense of coherence and the level of mental load among nurses working at a chemotherapy ward. METHODS: The study, conducted in 2013, included 164 nurses working at inpatient chemotherapy wards in Krakow, Poznan, Kielce, and Gliwice (Poland). The mean age of the study participants was 43.07±7.99 years. The study was based on a diagnostic survey with Antonovsky's Sense of Coherence Scale (SOC-29) and Meister questionnaire. RESULTS: The levels of Mental Load, Monotony and Unspecific Load, correlated inversely with the levels of Coherence, Manageability, Meaningfulness, and Comprehensibility. Longer work experience was associated with lower levels of Coherence, Manageability and Comprehensibility and higher levels of Mental Load, Overload and Monotony. Age of nurses correlated inversely with the Manageability level. Heavy mental and physical workload turned out to be the main factor causing dissatisfaction of the study participants. CONCLUSIONS: Longer work experience and lower levels of Coherence are associated with higher risk for mental overload.

The need for support among cancer patients - a preliminary study.

PURPOSE: To analyze the demand for support among cancer patients subjected to systemic treatment or radiotherapy. METHODS: The study included 321 cancer patients treated in three Polish oncology centers. More than 73% of the responders were diagnosed with cancer not earlier than a year prior to the study. Most of the patients received chemotherapy (74.8%); nearly a half of the subjects (46.7%) were subjected to radiotherapy and every tenth person received hormonal therapy. The subjects were examined with the Berlin Social Support Scales (BSSS). RESULTS: Emotional and informative support were the most frequently needed forms of support. Age and sex did not exert significant effect on the need for support and the level of received support. Individuals with higher education showed the lowest scores of support seeking. The availability of instrumental support displayed the lowest score, especially among the individuals treated at daily chemotherapy units. The type of oncological treatment did not change the patients' perception of support. CONCLUSIONS: Irrespective of their demographic and clinical characteristics, cancer patients should be provided with emotional, informative and instrumental support.

Quality of life in cervical cancer patients treated with radiation therapy.

AIMS AND OBJECTIVES: To evaluate the quality of life in hospitalised patients with cervical cancer treated by radiation therapy. BACKGROUND: Aside from clinical variables, the quality of life should be considered in the planning and monitoring of the therapeutic process in patients with cancer. Although it is widely known that this parameter can have a considerable impact on the therapeutic outcome, it is not routinely screened in oncological patients. DESIGN: Survey. METHODS: The study was performed in six cancer centres in Poland between June 2004-December 2005, and included 205 women hospitalised for any stage of cervical cancer. The EORTC QLQ-C30 questionnaire (v.3) was used to evaluate the patients' quality of life. The survey was conducted three times: (1) stage 1 - before treatment, on admission, (2) stage 2 - after treatment, at discharge, and (3) stage 3 - five to six months after treatment. RESULTS: Physical functioning was assessed the worst before the radiation treatment and increased gradually throughout further stages; all interstage differences proved to be significant. In contrast, emotional functioning was scored the highest before the initiation of the treatment and was the lowest at stage 2, a difference that proved to be significant. Role functioning was highest immediately after the treatment and the lowest prior to the treatment. Differences between stages proved to be significant. Financial problems increased their negative impact on the quality of patients' lives significantly throughout consecutive stages of this study. Age and cancer stage did not significantly influence the way participants perceived their global health, physical, cognitive, emotional and social functioning, nor their financial difficulties. Overall, the quality of life was evaluated as highest immediately after the end of radiotherapy. CONCLUSION: Although this study revealed that patients with cervical cancer subjected to radiotherapy are satisfied with their global quality of life, attention should be paid to certain dimensions of the latter (i.e. emotional functioning and role functioning) during post-treatment period. RELEVANCE TO CLINICAL PRACTICE: The ability to performing everyday activities independently is perceived as the most important during all stages of the cervical cancer treatment, and therefore, appropriate support in this matter is necessary on the part of the nursing personnel.