Exploring the knowledge, attitudes, behaviors and training needs of obstetric and gynecological nurses regarding COVID-19 during the peak period of the pandemic in middle-risk areas of China: A cross-sectional study.

Background: COVID-19 has become a global pandemic, which necessitates that health workers be capable of protecting themselves and their patients. This article aimed to describe knowledge levels, attitudes, behaviors and training needs regarding COVID-19 among obstetric and gynecological nurses in medium-risk areas during the pandemic. Method: A cross-sectional survey of obstetric and gynecological nurses in medium-risk areas was performed during the peak period of the pandemic in China. The main survey tool was the self-designed COVID-19 Knowledge, Attitude, Behavior and Training Needs Questionnaire. Pearson correlation analysis was conducted to analyze the relationships among knowledge, attitudes, behaviors and training needs. Results: A total of 599 nurses were recruited, of whom 27.7% failed the knowledge part of the questionnaire. Positive correlations were found between knowledge and attitudes (r = 0.100, P = 0.015) and between attitudes and behaviors (r = 0.352, P = 0.000) regarding occupational protection against COVID-19. A total of 88.5% of nurses preferred online training to traditional training, and more than 70% believed that demonstration of and training in operations by their own department were effective ways to learn about how to protect themselves against COVID-19. Conclusion: The higher the level of knowledge about the disease was, the more positive the attitude toward occupational protection, and consequently, the more actively protective behaviors were adopted. Training affected nurses' knowledge of COVID-19 occupational protection and promoted positive attitudes, which further facilitated the effective prevention and control of the disease. Online training with demonstrations are recommended for COVID-19 training of nurses.

COVID-19 vaccine uptake and hesitation among men and women preparing for pregnancy: a cross-section survey based on the theory of planned behavior.

BACKGROUND: Given the accelerated speed of COVID-19 vaccine research and administration, the main barriers to herd immunity appear to be concerns about safety and efficacy. Men and women preparing for pregnancy may have the same concerns about COVID-19 vaccination, but few studies have focused on COVID-19 vaccine uptake and hesitation among them. METHODS: A cross-sectional study was conducted among men and women who were preparing for pregnancy in Southwest China. The questionnaire was designed based on the theory of planned behavior (TPB). Multiple logistic regression was used to explore the determinants of the behaviors of COVID-19 vaccination. RESULTS: A total of 2878 participants completed the survey. A total of 53.89% of participants received at least one dose of the COVID-19 vaccine. A total of 45.21% of participants would receive the COVID-19 vaccine in the future. A total of 0.90% of participants never thought about receiving the COVID-19 vaccine. Multiple logistic regression model 1 showed that female participants (OR:5.497, 95%CI: 4.292-7.041), participants who never received influenza vaccine (OR:2.664, 95%CI: 1.908-3.718), participants who had never been tested for COVID-19 (OR:2.244, 95%CI:1.504-3.349), participants who had higher score of negative attitude (OR:1.448, 95%CI: 1.219-1.719), participants who had lower scores of injunctive norms (OR:0.440, 95%CI: 0.360-0.537) and descriptive norms (OR:0.105, 95%CI: 0.088-0.126) were more likely to delay COVID-19 vaccination. Model 2 showed that participants who had lower scores for positive attitude (OR: 0.406, 95% CI: 0.230-0.716), injunctive norms (OR: 0.283, 95% CI: 0.130-0.614) and descriptive norms (OR: 0.060, 95% CI: 0.038-0.094) were more likely to refuse COVID-19 vaccination. CONCLUSIONS: The COVID-19 vaccination rate of men and women preparing for pregnancy was significantly lower than the average vaccination rate of China. Gender, protective health behaviors, vaccination attitudes, and subjective norms had effects on the vaccination behaviors of couples preparing for pregnancy.

Discharge teaching, patient-reported discharge readiness and postsurgical outcomes in gynecologic patients undergoing day surgery: a generalized estimating equation.

BACKGROUND: Gynecologic patients undergoing day surgery are discharged in an intermediate stage of recovery. The quality of discharge teaching and discharge readiness are important to patients' postsurgical outcomes, but little research has focused on them. METHODS: Quality of discharge teaching and discharge readiness were measured, and Spearman correlations were conducted. Postsurgical outcomes were recorded on postoperative Day 1, postoperative Day 7, and postoperative Day 28. Generalized estimating equations were used to explore factors that influence postsurgical outcomes. RESULTS: Discharge teaching was verified to be positively correlated with the discharge readiness of participants. The generalized estimating equations indicated that discharge teaching skills, effects of doctors and nurses, patient-reported physical conditions and social support following discharge were protective factors for postsurgical outcomes. CONCLUSIONS: Doctors and nurses should improve discharge teaching skills and effects to improve the postsurgical outcomes of gynecological patients undergoing day surgery. At discharge, doctors and nurses should assess patients' physical condition and facilitate a social support system.

The associations between infertility-related stress, family adaptability and family cohesion in infertile couples.

To explore the association between infertility-related stress, family adaptability and family cohesion in infertile couples and the determinants of infertility-related stress in infertile couples. Fertility Problem Inventory (FPI) and Family Adaptability and Cohesion Evaluation Scales (FACESII-CV) were used to measure the infertility-related stress and family adaptability and cohesion of infertile couples. T-test, ANOVA and multiple comparisons (LSD) were conducted to compare the FPI scores of different demographic characteristics subgroups. Stepwise multivariate linear regression was used to explore the determinants of infertility-related stress. Women had greater global stress than men (P < 0.001). Women scored higher on desired family adaptability, cohesion dissatisfaction and adaptive dissatisfaction than men (P = 0.039, P = 0.036, P = 0.008). FPI scores were higher in men and women who lived in rural (P < 0.001, P < 0.001). Family cohesion and education level was negatively correlated with infertility-related stress in men. Family adaptability and education level was negatively correlated with infertility-related stress in women. Healthcare providers should pay more attention and give more support to infertile couples who lived in rural or with low education level, and provide easier medical accessing for them. Moreover, healthcare providers should value more the family function and family support in intervention of reducing infertility-related stress.

Risk of type 2 diabetes mellitus after gestational diabetes mellitus: A systematic review & meta-analysis.

Background &objectives: Women with gestational diabetes are at an increased risk of being diagnosed as type 2 diabetes, but the postpartum screening rate is low. To provide evidence-based data for health providers and promote postpartum screening, this systematic review and meta-analysis was conducted to access the risks of type 2 diabetes mellitus (T2DM) diagnosis after gestational diabetes mellitus (GDM) in different demographic and maternal subgroups. Methods: MEDLINE, Embase and Cochrane Library were searched systematically. Unadjusted relative risks (RRs) and 95 per cent confidence intervals (CIs) were calculated and pooled using a random-effects model. Heterogeneity was assessed with Cochrane's Q text and by calculating I2 values. Subgroup analyses were conducted to address the disparities of type 2 diabetes conversion after gestational diabetes in different demographic and maternal subgroups. Results: 1809 publications were screened and 39 cohort studies including 2,847,596 women were selected. In these studies, 78,893 women were diagnosed as T2DM at six weeks or later after delivery. The unadjusted RRs of women diagnosed T2DM at six weeks or later after delivery ranged from 1.32 (95% CI, 0.46-3.37) to 47.25 (95% CI, 2.95-758.01) with a pooled unadjusted RR of 8.92 (95% CI, 7.84-10.14). Older women, women with a family history of diabetes, Black and non-Hispanic White women and women living in Europe and South-East Asia had a higher risk of developing T2DM after GDM. Interpretation & conclusions: It is suggested that healthcare providers may focus on older women with GDM and women with GDM and a family history of diabetes. Black and non-Hispanic White women with GDM may receive more attention, and healthcare providers, especially those in Europe and South-East Asia, may pay more attention to preventive measures for postpartum T2DM.

Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China.

ABSTRACT: The physical and psychological condition of patients with gynaecological cancer has received much attention, but there is little research on spirituality in palliative care. This study aimed to investigate spiritual well-being and its association with quality of life, anxiety and depression in patients with gynaecological cancer. A cross-sectional study was conducted in China in 2019 with 705 patients diagnosed with primary gynaecological cancer. European Organisation for Research and Treatment of Cancer quality of life instruments (EORTC QLQ-SWB32 and EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale were used to measure spiritual well-being, quality of life, anxiety and depression. Univariate and multiple linear regression analyses were performed to examine associations between spiritual well-being, quality of life, anxiety and depression. Functioning scales and global health status were positively correlated with spiritual well-being (P < .05). Anxiety and depression were negatively correlated with spiritual well-being (P < .05). Depression (-0.362, P < .001) was the strongest predictor of Existential score. Anxiety (-0.522, P < .001) was the only predictor of Relationship with self. Depression (-0.350, P < .001) and Global health (0.099, P = .011) were the strongest predictors of Relationship with others. Religion (-0.204, P < .001) and Depression (-0.196, P < .001) were the strongest predictors of Relationship with someone or something greater. Global health (0.337, P < .001) and Depression (-0.144, P < .001) were the strongest predictors of Global-SWB. Well spiritual well-being is associated with lower anxiety and depression, and better quality of life. Health providers should provide more spiritual care for non-religious patients and combine spiritual care with psychological counselling to help patients with gynaecological cancer, especially those who have low quality of life or severe symptoms, or experience anxiety or depression.

Effects of breastfeeding education based on the self-efficacy theory on women with gestational diabetes mellitus: A CONSORT-compliant randomized controlled trial.

BACKGROUND: Women with gestational diabetes mellitus (GDM) face big challenges of breastfeeding. In order to improve breastfeeding self-efficacy and breastfeeding rate of them, we formulated perinatal individualized interventions based on self-efficacy theory and conducted a randomized controlled trial to verify the effectiveness. METHODS: We conducted a randomized controlled trial. The perinatal individualized interventions based on the self-efficacy theory including 4 phases were led by the International Board Certified Lactation Consultant (IBCLC). Women allocated to the control group received usual care for lactation support during the antenatal and postnatal period. Data collection occurred at admission, discharge, 6 weeks postpartum, 4 months postpartum, and 6 months postpartum. RESULTS: We enrolled 226 women with GDM, 113 in the intervention group and 113 in the control group. The scores of breastfeeding self-efficacy in the intervention group were significantly higher than those in the control group at discharge, at 6 weeks, 4 months, and 6 months postpartum (P < .05). We found higher rates of exclusive and any breastfeeding in the intervention group at discharge (Exclusive: 25.2% vs 13.5%, P < .05; Any: 94.4% vs 89.4%, P > .05), at 6 weeks postpartum (Exclusive: 75.5% vs 62.5%, P < .05; Any: 100.0% vs 96.2%, P > .05), at 4 months postpartum (Exclusive: 68.9% vs 43.3%, P < .05; Any: 94.3% vs 83.7%, P < .05) and at 6 months postpartum (Exclusive: 55.8% vs 36.9%, P < .05; Any: 88.5% vs 64.1%, P < .05). CONCLUSION: Perinatal individualized breastfeeding education based on the self-efficacy theory had positive effects on breastfeeding self-efficacy and breastfeeding rate of women with GDM.