Effectiveness of a self-determination theory-based intervention for nursing home residents with depression: A randomized controlled trial.

Objective and rationale: The prevalence of depression among older adults residing in nursing homes has risen. While physical activity interventions based on the self-determination theory have been shown to reduce depressive symptoms among students and middle-aged adults, research in nursing home residents is scarce. This study aimed to investigate whether physical activity can alleviate depressive symptoms in nursing home residents over an extended period. Methods: Between September 2020 and August 2021, 46 nursing home residents in Shenyang were randomly assigned to either a control group (n = 23) or an intervention group (n = 23). The control group followed a standard physical activity programme, whereas the intervention group underwent a programme based on self-determination theory. Both groups were monitored for 24 weeks post-intervention. Depression scores were assessed using the Geriatric Depression Scale, sociodemographic data collected via a self-designed questionnaire, cognitive function evaluated using the Mini-Mental State Examination, and weight and body fat measured using the Omron KARADA Scan Body Composition and Scale. Results: Depression scores were measured at five time points: baseline (T0), weeks 12 (T1), and 24 (T2) of the intervention, and weeks 12 (T3) and 24 (T4) during follow-up. Both groups exhibited a trend of decline by more than five points. The intervention group demonstrated more favourable pre-to-post changes in depression scores compared to the control group. Conclusions: A physical activity intervention based on self-determination conceptual framework has been proven to be effective for nursing home residents with depressive symptoms, also aiding in the maintenance of their physical activity levels. This study offers a theoretical foundation for the development of intervention programmes by researchers and identifies potential intervention strategies for caregivers in nursing homes. Trial Registration: The Chinese Clinical Trial Registry (ChiCTR2200060598) (June 5, 2022).

Views on Suspected Adverse Drug Events in Older Adults with Chronic Conditions: A Qualitative Study.

Purpose: To explore how elderly patients with chronic conditions identify and cope with suspected adverse drug events (ADEs) in northern China with the aim of encouraging the elderly to participate in medication safety monitoring. Patients and Methods: A purposive sampling method was adopted to select 15 elderly patients with chronic conditions from a medical center in northern China for semi-structured-interviews, and the data were collated and analyzed through thematic framework analysis. Results: Five major themes and 12 subthemes were refined, namely (1) lack of knowledge: poor awareness of the medications and ambiguous knowledge of ADEs, (2) barriers to identifying suspected ADEs: unawareness and uncertainty, seeking alternative explanations, and limited access to information, (3) the basis for identifying suspected ADEs: time cues and actively seeking communication (4) coping with suspected ADEs: cope with it themselves, not talking to the health care provider on their own initiative and actively seeking communication, and (5) expectations: desire for more reliable information and hope to be safeguarded for medication safety. Conclusion: Due to the lack of relevant knowledge and limited access to information, the elderly were limited in identifying suspected ADEs, but they were positive towards participating in medication safety monitoring and hoped to obtain reliable medication information and detailed medication assessment by enhancing communication with medical professionals in order to achieve medication safety.

Ginger (Zingiber officinale Roscoe) preparations for prophylaxis of postoperative nausea and vomiting: A Bayesian network meta-analysis.

ETHNOPHARMACOLOGICAL RELEVANCE: Ginger has been proposed for prevention of postoperative nausea and vomiting (PONV), however it remains equivocal whether ginger can be an alternative option and which certain preparation is optimal for PONV prophylaxis. AIM OF THE STUDY: We conducted a network meta-analysis (NMA) to compare and rank relative efficacy for PONV control among all available ginger preparations collected in the databases. METHODS: Eligible records were identified by retrieving Medline (via Pubmed), Embase, Web of Science, CENTRAL, CNKI, WHO ICTRP and ClinicalTrials.gov for randomized controlled trials that investigated the efficacy of ginger therapies for the prophylaxis of PONV. A bayesian NMA within random-effects models was implemented. Certainty of evidence for estimates was investigated following GRADE framework. We prospectively registered the protocol (CRD 42021246073) in PROSPERO. RESULTS: Eighteen publications comprising 2199 participants with PONV were identified. Ginger oil (RR [95%CI], 0.39 [0.16, 0.96]) appeared to have the highest probability of being ranked best to decrease the incidence of postoperative vomiting (POV), with statistical significance compared with placebo, based on high to moderate confidence in estimates. With regard to reducing postoperative nausea (PON), statistically superiority was not observed in ginger regimens compared with placebo based on moderate to low certainty of evidence. Reduction in antemetic use and nausea intensity were noticed in ginger powder and oil. Ginger was significantly associated with better efficacy for Asian, older age, higher dosage, preoperative administration, hepatobiliary and gastrointestinal surgery. CONCLUSIONS: Ginger oil appeared to be superior to other ginger treatments for the prophylaxis of POV. With regard to reducing PON, ginger preparations indicated no obvious advantages.

Exploring psychosocial adaptation among people with chronic skin disease: A grounded theory study.

AIM: Chronic skin disease (CSD) often has devastating effects on the physiological, psychological and social aspects of patients, who must adapt to them. However, it is not clear how patients adapt, especially with regard to their psychosocial adaptation (PSA). This research explored a theoretical model of PSA among people with CSD. DESIGN: Following constructivist grounded theory methodology, a qualitative study was undertaken between August 2018 and June 2019. METHODS: Observation and semi-structured interview were conducted with included participants (n=19). Data were iteratively coded and analyzed by constant comparison following the key stages of initial, focused, axial and theoretical coding until saturation was achieved. RESULTS: When individuals face the impacts of disease, they try to adjust to adapt it. The findings showed the core category (self-cognitive) and the contributing categories (impacts of chronic skin disease, contextual factors, physiological experiences, psychological experiences, social experiences, and positive and negative psychosocial adaptations) of the PSA among people with CSD. The process of PSA among people with CSD was not linear throughout the disease and was instead entwined within a set of complexes (contextual factors-experience) interactions. The consequences of PSA included positive and negative aspects. The theoretical model of PSA among people with CSD will provide us with information needed to develop accurate assessment and effective intervention strategies. Understanding that PSA among people with CSD is a complex, dynamic, and interactional process may provide evidence for further assessing and meeting the needs of people.

Development of health behaviour questionnaire for breast cancer women in Mainland China.

AIM: To develop a questionnaire on the health behaviour of breast cancer women with adjuvant endocrine therapy and to test its reliability and validity. DESIGN: An instrument-development study was applied that comprised three steps: conceptualization, item generation, content validity and field testing of the health behavior properties. METHODS: On the basis of literature review, the conceptual framework and initial items of each dimension of were designed. The questionnaire investigation was divided into two steps: pre-experiment (group 1) and psychometrics evaluation (group 2). Correlation procedure and factor analysis were employed to rescreen the items. Reliability testing and validity testing were conducted to analyse the psychometric properties of questionnaire. RESULTS: Exploratory and confirmatory factor analyses yielded a five-factor solution. Cronbach's α was 0.93, the sub-semi-reliability of the questionnaire was 0.79 and internal consistency coefficients was 0.70.

Adherence status to Adjuvant Endocrine Therapy in Chinese Women with Early Breast Cancer and its influencing factors: A cross-sectional survey.

OBJECTIVE: Despite the proven benefits of adjuvant endocrine therapy, adherence to oral endocrine therapy in breast cancer treatment is a substantial problem. The aim of this study was to assess adherence to adjuvant endocrine therapy by women in China for the first 5 years, and to identify its influencing factors. METHODS: Stratified sampling method was adopted to select 1875 cases of breast cancer patients for cross-sectional telephone follow-up. Compliance to medications was assessed using the Morisky Medication Adherence Scale. Status of endocrine therapy was assessed using nine additional questions. Binomial regression was used when assessing the factors associated with persistence, multinomial regression models were used to assess factors associated with compliance. RESULTS: Of 888 patients who started adjuvant endocrine therapy, 769(86.6%) persisted and 119 (13.4%) discontinued. 760 patients who completed Morisky Medication Adherence Scale, the compliance was 7.4% low, 42% medium, and 50.6% high. The type of medication, duration of medication and side effects had an impact both on persistence and compliance. Age, history of radiotherapy and caregivers only had an impact on persistence. CONCLUSIONS: Medication adherence was affected by many factors. Special attention and interventions should be given to women taking tamoxifen in the 2nd to 3rd year of medication, and aromatase inhibitors in the 1st to 2nd year. Further prospective design studies are needed to explore effective measures to improve medication adherence of women with breast cancer treated by endocrine therapy.

Factors influencing medication-taking behaviour with adjuvant endocrine therapy in women with breast cancer: A qualitative systematic review.

AIMS: To explore the experience and feelings associated with the endocrine therapy treatment trajectory in women with breast cancer and what affects medication taking behaviour. DESIGN: Qualitative systematic review. DATA SOURCES: Qualitative studies were extracted from PubMed, EMBASE, CINAHL, PsycINFO from inception of each database until February 2019. REVIEW METHODS: The systematic search method SPIDER (sample, phenomenon of interest, design, evaluation, research type) was used. Thematic synthesis of the qualitative data was used. RESULTS: A total of 478 were identified in the initial search. Only 17 articles met inclusion criteria and were included in this review. Five analytical themes and 17 descriptive subthemes were identified. CONCLUSIONS: The systematic review highlights knowledge, balancing the scales, self-efficacy and support influence medication taking behaviour to women with breast cancer. IMPACT: The medication taking behaviour of breast cancer women can be classified into four types: acceptance/persistence, bearing/suffering, hesitation/adjustment, refusing/abandoning. The four types can switch from one to another. Medication taking behaviour is affected by knowledge, balancing the scales, self-efficacy, and support. The medical institutions, communities, and families can gain knowledge of the treatment experiences of women to better understand medication taking behaviour and those at risk for non-adherence. Women wanted different types and amounts of information. Healthcare providers should be aware of patient preferences and take targeted interventions to help them receive treatment.

The psychosocial adaptation of patients with skin disease: a scoping review.

BACKGROUND: Skin disease is a global public health problem that often has physiological, psychological and social impacts. However, it is not very clear how to adapt to these impacts, especially psychosocial adaptation of patients with skin disease. METHODS: We searched EMBASE, PubMed, CINAHL and PsycINFO from 2009 to 2018. The following themes were extracted from the included articles: the concepts, related factors, and interventions for psychosocial adaptation of patients with skin disease. Two reviewers independently screened and analyzed. RESULTS: From 2261 initial records, 69 studies were identified and analyzed. The concept of psychosocial adaptation in patients with skin disease was referred to under an assortment of descriptions. The related factors for psychosocial adaptation in patients with skin disease included the following: demographic factors (sex, age, education level, ethnicity, BMI, sleep quality, marital status, exercise amount, family history, the use of topical treatment only, personality and history of smoking); disease-related factors (disease severity, clinical symptoms, localization and duration); psychological factors (anxiety/depression, self-esteem, body image, stigma and suicidal ideation); and social factors (social support, social interaction, sexual life, economic burden and social acceptance). Despite being limited in quantity, several studies have clarified the benefits of adjuvant care in the form of cognitive behavioral training, educational training and self-help programs, all of which have become common methods for dealing with the psychosocial impacts. CONCLUSIONS: Based on the previous literatures, we constructed a protocol of care model for psychosocial adaptation in patients with skin disease. It not only provided the direction for developing new instruments that could assess psychosocial adaptation statue, but also a basis for helping patients adjust to changes in skin disease.