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1.
Artigo em Inglês | MEDLINE | ID: mdl-38470507

RESUMO

PURPOSE: This systematic review (SR) of SRs evaluates the effectiveness of vasopressin alone or in combination with other drugs in improving the outcomes of cardiac arrest (CA). METHODS: Using a three-step approach, we searched five databases to identify all relevant SRs. Two reviewers independently selected suitable studies, assessed study quality, and extracted relevant data. If an outcome was reported by multiple SRs, a re-meta-analysis was conducted as needed; otherwise, a narrative analysis was performed. RESULTS: Twelve SRs covering 16 original studies were included in this review. The meta-analysis results revealed a significant increase in survival to hospital admission for patients with in-hospital CA (IHCA) or out-of-hospital CA (OHCA) receiving vasopressin alone compared with that for those receiving epinephrine alone. Furthermore, the return of spontaneous circulation (ROSC) was significantly increased in patients with OHCA receiving vasopressin with epinephrine compared with that in those receiving epinephrine alone. Compared with patients with IHCA receiving epinephrine with placebo, those receiving vasopressin, steroids, and epinephrine (VSE) exhibited significant increases in ROSC, survival to hospital discharge, favorable neurological outcomes, mean arterial pressure, renal failure-free days, coagulation failure-free days, and insulin requirement. CONCLUSION: VSE is the most effective drug combination for improving the short- and long-term outcomes of IHCA. It is recommended to use VSE in patients with IHCA. Future studies should investigate the effectiveness of VSE against OHCA and CA of various etiologies, the types and standard dosages of steroids for cardiac resuscitation, and the effectiveness of vasopressin-steroid in improving CA outcomes.

2.
Aust Crit Care ; 37(2): 212-221, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37455212

RESUMO

BACKGROUND: A ventilator bundle is an effective preventive strategy against the development of ventilator-associated pneumonia (VAP). However, in clinical practice ventilator bundle implementation is poor. Understanding the barriers to ventilator bundle implementation in low- and middle-income countries can inform the development of effective implementation strategies to reduce the burden of VAP. OBJECTIVES: The primary objective of this study was to explore the barriers and facilitators of ventilator bundle implementation perceived by healthcare professionals (HCPs) working in intensive care units (ICU) in Nepal. The secondary objective was to prioritise the barriers when developing implementation strategies. METHODS: This study used a pragmatic approach comprising a series of methods to identify the implementation strategies: (i) Barriers and facilitators were explored using a qualitative study design. Twenty-one HCPs selected using the maximum variation sampling technique from a large tertiary hospital, completed semistructured interviews. All the interviews were recorded, transcribed word-by-word, and uploaded into NVivo for analysis using the thematic analysis approach. (ii) After analysis, nine participants were selecteded to determine the priority order of the barriers using a barrier identification and mitigation tool. RESULTS: The data analysis revealed five main themes and 19 subthemes that affected ventilator bundle implementation. The main themes were provider-related factors, organisational and practice-related factors, performances of work, environmental conditions, and patient-related factors. The common barriers were job insecurity, poor knowledge, negative attitude, insufficient equipment, and severity of patient disease. Common facilitators were educational training, equipment functioning, adequate staff, strong leadership, and organisational support. Finally, eight main barriers were prioritised to target the change. CONCLUSION: The barriers to implementing ventilator bundles in ICUs were identified. Focussing on addressing the prioritised barriers may aid in improving patient care and safety in ICUs. Results may guide HCPs in the development of implementation strategies to reduce the burden of VAP.


Assuntos
Unidades de Terapia Intensiva , Pneumonia Associada à Ventilação Mecânica , Humanos , Nepal , Pesquisa Qualitativa , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Ventiladores Mecânicos
3.
J Cardiovasc Nurs ; 38(5): 443-453, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35507028

RESUMO

BACKGROUND: Hypertension affects more than 1 billion people worldwide. Hypertension management guidelines recommend regular exercise to control blood pressure. Tai Chi is a low-impact, low- to moderate-intensity exercise that has numerous health benefits. OBJECTIVE: The aim of this study is to perform a review of meta-analyses and summarize the existing information on the health benefits of Tai Chi for patients with hypertension. METHODS: This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Eight health-related databases were systematically searched from their inception to March 2021 to identify the relevant meta-analyses. Two reviewers independently assessed the methodological quality of the evidence. RESULTS: A total of 6 relevant meta-analyses were included in this review: 3 were rated as critically low in quality, 2 were rated low, and 1 was rated high. In the included meta-analyses, Tai Chi showed many benefits for patients with hypertension. In addition to improving blood pressure, the blood lipid profile, blood sugar, body measurements, and quality of life of patients improved significantly after practicing Tai Chi. CONCLUSION: Tai Chi may be considered an effective and safe alternative exercise for patients with hypertension.

4.
Geriatr Nurs ; 54: 280-301, 2023 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-39491262

RESUMO

This review aimed to explore the experiences of mobile telepresence robots (MTRs) among older adults (OAs) using a systematic mixed-studies approach. Ten electronic databases were searched for published and unpublished studies from inception to January 2022. The mixed methods assessment tool was used to assess the quality of the studies. A results-based convergent synthesis was employed to integrate quantitative and qualitative results. A total of 3,816 records were retrieved, and 43 studies were included, involving 1,568 participants across 19 countries. More than half of the selected studies had high methodological quality. After integrating findings from seven qualitative subthemes and eight quantitative categories, four themes emerged: (1) enjoyable experience, (2) willingness and acceptance, (3) promoting social connectedness, and (4) improved psychosocial and physiological well-being. The MTRs show promising benefits for OAs and their families. Future research should improve the design and functionalities of MTRs to customize different OAs.

5.
Soc Work Health Care ; 62(8-9): 263-279, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37338823

RESUMO

Individuals within the Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) community who are diagnosed with cancer experience inequitable treatment in healthcare systems worldwide, resulting in dissatisfaction, communication challenges with healthcare providers, and a deep sense of disappointment. Stigma, discrimination, and perceived homophobia further heighten the risk of psychological and attitudinal disorders, including depression and suicidal tendencies, among LGBTQ cancer patients. To comprehensively assess the discrimination faced by LGBTQ cancer patients and gain deeper insights into their needs and experiences, we conducted a systematic review following PRISMA guidelines. We searched for relevant articles using specific keywords in reputable databases such as PubMed, Google Scholar, and PsycINFO. We rigorously evaluated article quality using the CASP (Critical Appraisal Skills Programme) checklist. From a total of 75 eligible studies, we carefully selected 14 studies, specifically examining LGBTQ cancer patients who were currently undergoing or had previously undergone cancer treatment. The studies revealed various factors, including unmet needs related to anxiety and depression, instances of discrimination, disparities in care, and inadequate support systems. A majority of patients expressed dissatisfaction with their cancer care and continued to encounter discrimination and disparities throughout their treatment journeys. Consequently, this led to heightened levels of anxiety, stress, depression, and negative perceptions of healthcare providers. Based on these findings, we recommend providing specialized training to social workers and healthcare providers. This training will equip them with the necessary skills and knowledge to deliver culturally sensitive care tailored to the unique needs of LGBTQ cancer patients. By addressing discrimination, reducing disparities, and fostering an inclusive environment, healthcare professionals can strive to ensure that LGBTQ cancer patients receive the care they deserve.


Assuntos
Neoplasias , Minorias Sexuais e de Gênero , Pessoas Transgênero , Feminino , Humanos , Comportamento Sexual/psicologia , Identidade de Gênero , Estigma Social , Neoplasias/terapia , Neoplasias/psicologia
6.
Worldviews Evid Based Nurs ; 19(1): 16-27, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35014147

RESUMO

BACKGROUND: An aging population and required hypertension control are global concerns that burden the healthcare system. Text messaging interventions have been developed to support hypertension management, but their effects on the older population are unknown. OBJECTIVES: This review aimed to identify the effects of a text messaging intervention on hypertension management among older adults. METHODS: Four English and two Chinese databases with randomized controlled trials published between January 2010 and December 2020 were searched. The mean age of the participants was 60 years or above. Participants were also diagnosed with hypertension. The Cochrane risk-of-bias tool was used for the critical appraisal. Data in each study were extracted, and a meta-analysis was presented in terms of mean difference (MD) and standardized mean difference (SMD). RESULTS: A total of 1670 records were screened, of which six were included in the final review. The intervention of the included studies lasted up to 6 months, and one-way text messaging was commonly used. Meta-analysis showed that a text messaging intervention significantly reduced systolic blood pressure (MD = -6.11, p < .01) but not diastolic blood pressure. Regarding medication adherence, a moderate effect was noted with the use of text messaging among older adults with hypertension (SMD = 0.65, p = .01). LINKING EVIDENCE TO ACTION: A text messaging intervention can improve hypertension management among older adults. The standardized content of one-way text messaging is suggested to be delivered weekly.


Assuntos
Telefone Celular , Hipertensão , Envio de Mensagens de Texto , Idoso , Pressão Sanguínea , Humanos , Hipertensão/terapia , Adesão à Medicação , Pessoa de Meia-Idade
7.
BMC Nurs ; 20(1): 24, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33468102

RESUMO

BACKGROUND: Exploration of professional development experiences of male nurses can help develop evidence-based strategies to attract males into nursing. The study aims to investigate the advantages and disadvantages of being a male in nursing profession that male nurses and male nursing students experience in their professional development. METHODS: A descriptive qualitative research was designed. Purposive sampling was applied and 24 males (12 nursing students and 12 clinical nurses) participated. Semi-structured individual interviews were used in data collection. Thematic analysis was used in data analysis. RESULTS: Professional development of male nurses was related to three interplayed identities: a man, a nurse, and a minority. Three themes emerged relating to the professional development of the males: "feeling role strains" "taking perceived advantage of masculine traits" and "taking an egalitarian viewpoint". There was no clear line between the gender-related advantages and disadvantages as factors influencing professional development can be turned by the males from barriers to facilitators. CONCLUSIONS: Male nurses perceive nursing as equally suitable for males and females and make use of masculine traits to thrive in their professional development.

8.
BMC Nurs ; 19(1): 104, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33292195

RESUMO

BACKGROUND: Macau and the Mainland China have different political and socio-economic policies but are both influenced by Chinese culture. By comparing the professional development experiences of male nurses from Macau and the Mainland, this study aims to explore factors influencing the recruitment and retention of male nurses. METHODS: A collaborative, qualitative approach was adopted in which researchers from Macau and the Mainland were jointly involved in carrying out interviews and analyzing data. A total of 24 clinical male nurses were invited, with 12 each from Macau the Mainland. Recruitment was based on purposive sampling from various health institutions in the two regions. Semi-structured interviews were conducted in 2017-2018 with similar interview guidelines for both Macau and the Mainland sites. Thematic analysis was used for data analysis, and Nvivo11 Plus software was used to facilitate the analysis. RESULTS: Key facilitators/barriers to recruitment and retention of male nurses were clustered under the two research questions: 1) What are the factors influencing the recruitment of male nurses? 2) What are the factors influencing the retention of male nurses? Males in Macau and the Mainland experienced pressure while entering nursing because of the stereotype that nursing is a feminine occupation. However, males in Macau chose nursing as a college major under their own volition while males in the Mainland were mostly forced into nursing. The males in Macau hardly thought of leaving nursing while their Mainland counterparts constantly felt uncertain about their professional future. The males on both sides hoped to thrive in career development. While the Macanese tended to pursue advanced programs in specialty nursing for better health care in the frontline, the Mainlanders wanted to get promoted to leave the frontline. CONCLUSION: Male nurses in Macau and Mainland share some common experiences in professional development but have different views and values regarding nursing.

9.
BMC Emerg Med ; 18(1): 58, 2018 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-30572841

RESUMO

BACKGROUND: In the emergency department, it is important to identify and prioritize who requires an urgent intervention in a short time. Triage helps recognize the urgency among patients. An accurate triage decision helps patients receive the emergency service in the most appropriate time. Various triage systems have been developed and verified to assist healthcare providers to make accurate triage decisions. The triage accuracy can represent the quality of emergency service, but there is a lack of review studies addressing this topic. METHODS: A literature search was conducted in four electronic databases where 'emergency nursing' and 'triage accuracy' were used as keywords. Studies published from 2008 January to 2018 August were included as potential subjects. Nine studies were included in this review after the inclusion and exclusion criteria were applied. RESULTS: Written case scenarios and retrospective review were commonly used to examine the triage accuracy. The triage accuracy from studies was in moderate level. The single-center studies which held better results than those from multi-center studies revealed the need of triage training and consistent training between emergency departments. CONCLUSIONS: Regular refresher triage training, collaboration between emergency departments and continuous monitoring were necessary to strengthen the use of triage systems and improve nurse's triage performance.


Assuntos
Triagem/normas , Triagem/tendências , Enfermagem em Emergência , Serviço Hospitalar de Emergência , Humanos
10.
Nurse Educ Today ; 139: 106209, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-38663054

RESUMO

BACKGROUND: Effective intimate care can significantly impact the clinical outcomes of patients. However, conducting intimate care, which involves exposing and touching sexually sensitive areas of the body, presents challenges and anxieties for student nurses, particularly when providing care for patients of the opposite sex. OBJECTIVES: This study aims to identify the challenges and struggles encountered by student nurses when providing intimate care for patients of the opposite sex, as well as to explore the coping strategies employed by the students. DESIGN: A constructivist grounded theory research approach. SETTINGS: The study was conducted in Macau, a Special Administrative Region of China. PARTICIPANTS: Twenty-six student nurses across various stages of their education, and three clinical mentors. METHODS: Purposive and theoretical sampling techniques were utilized to recruit participants. Semi-structured interviews were conducted. The data analysis was in line with the principles of constructivist grounded theory research. RESULTS: A two-stage adaptation model was established, demonstrating a dynamic pathway of student nurses toward intimate care. The first stage 'gendered confinement in intimate care' was characterized by student nurses' negative feelings and lack of nurse-patient interactions; the second stage 'emancipation to gendered confinement' was characterized by the development of constructive therapeutic nurse-patient relationships. The successful transfer was achieved through students' reconstructing the meaning of intimate care and nursing profession in three interplayed types: objectification of patients' body, moral authority of nursing care, and legitimisation of nursing profession. While the transfer process involved the students' intentional efforts to de-sexualize intimate care, clinical mentors facilitated the process. CONCLUSION: Student nurses' adaption to intimate care is a dynamic process which enhances the construction of the nursing professional identity. Support from nursing educators can facilitate student nurses' coping with intimate care-related challenges.


Assuntos
Teoria Fundamentada , Relações Enfermeiro-Paciente , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Feminino , China , Masculino , Pesquisa Qualitativa , Adaptação Psicológica , Adulto , Bacharelado em Enfermagem/métodos , Entrevistas como Assunto , Atitude do Pessoal de Saúde
11.
Healthcare (Basel) ; 12(3)2024 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-38338219

RESUMO

BACKGROUND: Dementia has become one of the leading causes of death across the world. AIMS: The aim of this study was to investigate the incidence, prevalence, and mortality of dementia in China between 2010 and 2020, and to investigate any geographical, age, and sex differences in the prevalence and incidence of dementia. METHODS: Five databases were searched. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the included studies. A random-effects meta-analysis was performed to estimate the pooled prevalence of dementia. Subgroup analysis was based on the type of dementia. The incidence and mortality of dementia were synthesized qualitatively. RESULTS: A total of 19 studies were included. The meta-analysis showed that the prevalence of dementia was 6% (95%CI 5%, 8%), the prevalence of Alzheimer's disease (AD) was 5% (95%CI 4%, 6%), and the prevalence of vascular dementia (VaD) was 1% (95%CI 0%, 2%). The subgroup analysis showed that the prevalence rates of dementia in rural (6%, 95%CI 4%, 8%) and urban areas were similar (6%, 95%CI 4%, 8%). Deaths due to dementia increased over time. CONCLUSION: The prevalence, incidence, and mortality of dementia increased with age and over time. Applying consistent criteria to the diagnosis of cognitive impairment and dementia is necessary to help with disease monitoring. Promoting dementia knowledge and awareness at the community level is necessary.

12.
Heart Lung ; 63: 98-107, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37839229

RESUMO

BACKGROUND: Ventilator bundles are suggested to prevent ventilator-associated pneumonia (VAP), but significant variations in the effects of the bundle on patient outcomes have been reported. OBJECTIVES: To synthesize the evidence and evaluate the effects of the ventilator bundle on patient outcomes among critically ill adult patients. METHODS: A broad search was performed in seven databases for relevant articles published from January 2002 to November 2022. Randomized controlled trials and quasi-experimental studies investigating the effects of implementing ventilator bundles in adult intensive care units (ICUs) were included. Two independent reviewers performed the study selection, data extraction, and risk of bias assessment. All data for meta-analysis were pooled using the random-effects model. RESULTS: After screening, 19 studies were included in the meta-analysis. Evidence of low-to-moderate certainty showed that the ventilator bundle reduced the rate of VAP (risk ratio [RR] = 0.64; P = 0.003), length of ICU stay (mean difference [MD] = -2.57; P = 0.03), mechanical ventilation days (MD = -3.38; P < 0.001), and ICU mortality (RR = 0.76; P = 0.02). Ventilator bundle was associated with improved outcomes, except mortality. CONCLUSIONS: The ventilator bundle, especially the IHI ventilator bundle, was effective in decreasing the incidence of VAP and improving most of the VAP-related outcomes. However, given the low-to-moderate certainty of evidence and high heterogeneity, these results should be interpreted with caution. A future study that adopts hybrid implementation trials with high methodological quality is needed to confirm the effects of the ventilator bundle on patient outcomes.


Assuntos
Pneumonia Associada à Ventilação Mecânica , Respiração Artificial , Adulto , Humanos , Respiração Artificial/efeitos adversos , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Pneumonia Associada à Ventilação Mecânica/etiologia , Unidades de Terapia Intensiva , Ventiladores Mecânicos , Estado Terminal/terapia
13.
Healthcare (Basel) ; 12(8)2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38667606

RESUMO

Perceived health and distresses are associated with the practice of lifestyle modifications, which increases the risk of diabetes and hypertension-related complications. This study aimed to define the characteristics and distribution of perceived health and distresses across the states between people with diabetes and hypertension. Data were derived from a national survey of US adults aged ≥18 years who were interviewed via phone call. Perceived health and distresses were assessed through corresponding questions. An amount of 333,316 respondents (43,911 with diabetes and 130,960 with hypertension) were included in the analysis; 61.8% of people with diabetes and 74.5% of people with hypertension reported having good or better health, while residents in the Southwest region perceived poor health statuses and more distresses. Education level (diabetes: odds ratio [OR] = 0.47-0.79, hypertension: OR = 0.42-0.76), employment status level (diabetes: OR = 1.40-2.22, hypertension: OR = 1.56-2.49), and household income (diabetes: OR = 0.22-0.65, hypertension: OR = 0.15-0.78) were significant factors associated with poorly perceived health among people with diabetes and hypertension, and the use of technology and strategies for policymakers are suggested to improve the perceived health status in this regard.

14.
JMIR Public Health Surveill ; 10: e48776, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38916938

RESUMO

BACKGROUND: Mental health disparities have been documented among lesbian, gay, and bisexual (LGB) adults in the United States. Substance use disorders and suicidal ideation have been identified as important health concerns for this population. However, the interrelationships among these factors are not well understood. OBJECTIVE: This study aims to investigate the interrelationships among mental health, substance use disorders, and suicidal ideation among LGB adults in the United States using a population-based statewide survey. METHODS: Our study was an observational cross-sectional analysis, and the data for this study were collected from a sample of LGB adults who participated in the statewide survey. The survey collected information on mental health, substance use disorders, and suicidal ideation using validated measures. Descriptive statistics and inferential data analysis were conducted to explore the interrelationships among these factors. RESULTS: The results showed that LGB adults who reported higher levels of depression and drug abuse and dependence also reported higher levels of suicidal tendency and mental illness. Inferential data analysis using χ2 tests revealed significant differences in depression score (χ22=458.241; P<.001), drug abuse and dependence score (χ22=226.946; P<.001), suicidal tendency score (χ22=67.795; P<.001), and mental illness score (χ22=363.722; P<.001) among the 3 sexual identity groups. Inferential data analysis showed significant associations between sexual identity and mental health outcomes, with bisexual individuals reporting the highest levels of depression, drug abuse and dependence, suicidal tendency, and mental illness. CONCLUSIONS: This study provides important insights into the interrelationships among mental health, substance use disorders, and suicidal ideation among LGB adults in the United States. The findings underscore the need for targeted interventions and research aimed at addressing the mental health needs of sexual minority populations. Future research should aim to better understand the underlying mechanisms driving these disparities and develop culturally sensitive and tailored interventions that meet the unique needs of LGB individuals. Reducing stigma and discrimination against sexual minority populations is also crucial to improving their mental health outcomes.


Assuntos
Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Ideação Suicida , Humanos , Adulto , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Masculino , Estudos Transversais , Feminino , Estados Unidos/epidemiologia , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Inquéritos e Questionários , Saúde Mental/estatística & dados numéricos , Bissexualidade/psicologia , Bissexualidade/estatística & dados numéricos , Idoso
15.
Asian Nurs Res (Korean Soc Nurs Sci) ; 17(3): 158-166, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37295501

RESUMO

PURPOSE: Controlling blood pressure minimizes the risk of cardiovascular events among patients with hypertension. Despite regular follow-ups, the hypertension management for patients aged ≥45 years is limited as evidenced from a decreased control rate. This pilot study aimed to test a theory-guided educational program for community-dwelling patients with hypertension. METHODS: Sixty-nine patients with hypertension aged ≥45 years and having high blood pressure (>130/80 mmHg) were recruited in this two-arm pilot randomized controlled trial. Participants in the intervention group underwent a program guided by the Health Promotion Model, whereas those in the control group received usual care. Data were collected at baseline, week 8, and week 12 and used to assess the blood pressure, pulse pressure, self-efficacy, and adherence to hypertension management. Data were analyzed using a generalized estimating equation based on the intention-to-treat principle. Process evaluation was conducted to assess the feasibility and acceptability of the educational program. RESULTS: The results obtained using the generalized estimating equation revealed that the educational program led to reduction in the systolic blood pressure (ß = -7.12, p = .086) and pulse pressure (ß = -8.20, p = .007) and to improve self-efficacy (ß = 2.61, p = .269) at week 12. The program had a small-to-moderate effect on the reduction of systolic blood pressure (effect size = -0.45) and pulse pressure (effect size = -0.66) and self-efficacy (effect size = 0.23). The participants were highly satisfied with the educational program. CONCLUSIONS: The educational program was found to be feasible and acceptable and may be incorporated into current hypertension management practices at the community level. TRIAL REGISTRATION: ClinicalTrials.gov with identifier: NCT04565548.


Assuntos
Hipertensão , Envio de Mensagens de Texto , Humanos , Projetos Piloto , Vida Independente , Hipertensão/terapia , Pressão Sanguínea/fisiologia
16.
Chronic Illn ; 19(3): 581-590, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-35603631

RESUMO

OBJECTIVES: Hypertension is a well-known global risk factor associated with significant morbidity and mortality. Medication use and urban-rural disparities in medication usage patterns affect hypertension management. We investigated patient characteristics across different geographical areas to determine factors that affect medication use among Chinese patients aged ≥ 45 years, diagnosed with hypertension. METHODS: Data were extracted from the China Health and Retirement Longitudinal Study 2018. We recorded differences in medication use, advice from healthcare providers, and health-related behaviors between urban and rural areas. RESULTS: The study included 2115 patients with hypertension (mean age 62.06 years). Advice received and medication use were significantly lower in patients from rural areas than in those from urban areas. Our findings showed that urban residence, comorbidities, advice regarding lifestyle changes, and smoking were positive predictors of medication use, whereas alcohol consumption and regular exercise reduced the likelihood of medication use. DISCUSSION: We observed urban-rural disparities in hypertension management, and several strategies, including distribution of reminders and written materials can be integrated into current clinical practice to improve the rate of medication use among rural residents with hypertension.


Assuntos
Disparidades em Assistência à Saúde , Hipertensão , População Rural , População Urbana , Idoso , Humanos , Pessoa de Meia-Idade , China/epidemiologia , População do Leste Asiático , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Estudos Longitudinais , Fatores de Risco
17.
Nurse Educ Pract ; 73: 103822, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37951066

RESUMO

AIM: To explore experiences of sexual harassment among nursing students in an East Asian region and to gain knowledge of the underlying factors influencing nursing students' conceptualization of and response to sexual harassment. BACKGROUND: Nursing students are susceptible to sexual harassment due to gender and power inequality in healthcare systems. Sexual harassment has an adverse impact on the students' physical and mental health. Studies on sexual harassment among nursing students are limited and reported significantly varied occurrence prevalence in different cultures. Feminist identity theory can provide a framework to examine social-culturally constructed perceptions of sexual harassment. DESIGN: A qualitative descriptive study. METHODS: The study was conducted in Macau, a Special Administrative Region of China. Purposive sampling was applied. Twenty-six nursing students and five nursing educators participated in the study. Semi-structured interviews were conducted. Thematic analysis was used to analyze the interview data. A series of measures were applied to enhance the trustworthiness of the study. RESULTS: While most of the students had not experienced or heard of sexual harassment, a limited number claimed sexual harassment as a frequently encountered instance. The students expressed uncertainty about what constituted sexual harassment, mainly due to a lack of exposure to information on sexual harassment. They were caught in a dilemma between exerting nursing professional virtues and exposing the misconduct of the suspected perpetrators, leading to taking passive approaches of ignoring and avoiding as the primary coping strategies. In contrast, nursing educators advocated proactive approaches as coping strategies to address sexual harassment. CONCLUSIONS: A conflict between nursing professional identity and feminist identity is observed among nursing students. Healthcare institutions and nursing schools should develop interventions to enhance nursing students' assertiveness to sexual harassment.


Assuntos
Assédio Sexual , Estudantes de Enfermagem , Humanos , Assédio Sexual/psicologia , Adaptação Psicológica , Pesquisa Qualitativa , China
18.
JMIR Public Health Surveill ; 9: e45697, 2023 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-36940169

RESUMO

BACKGROUND: Practicing healthy lifestyles can reduce the risk to develop noncommunicable diseases and the related mortality. Studies showed that practicing healthy lifestyles could enhance disease-free life expectancy and preserve bodily functions. However, engagement in healthy lifestyle behavior was suboptimal. OBJECTIVE: This study aimed to define individuals' lifestyle characteristics before and during COVID-19 and determine the factors associated with practicing a healthy lifestyle. This cross-sectional study was conducted using data from the 2019 and 2021 Behavioral Risk Factor Surveillance System surveys. METHODS: US individuals aged ≥18 years were interviewed via phone call. Healthy lifestyles were assessed through corresponding questions regarding the maintenance of optimal body weight, physical activity, daily consumption of at least five portions of fruits and vegetables, current smoking status, and alcohol consumption. Missing data were imputed using a package in the R statistical software. The effects of practicing a healthy lifestyle on cases without missing data and those with imputation were reported. RESULTS: There were 550,607 respondents (272,543 and 278,064 from 2019 and 2021, respectively) included in this analysis. The rates of practicing a healthy lifestyle were 4% (10,955/272,543) and 3.6% (10,139/278,064) in 2019 and 2021, respectively. Although 36.6% (160,629/438,693) of all 2021 respondents had missing data, the results of the logistic regression analysis for cases without missing data and those with imputation were similar. Of the cases with imputation, women (odds ratio [OR] 1.87) residing in urban areas (OR 1.24) with high education levels (OR 1.73) and good or better health status (OR 1.59) were more likely to practice healthier lifestyles than young individuals (OR 0.51-0.67) with a low household income (OR 0.74-0.78) and chronic health conditions (OR 0.48-0.74). CONCLUSIONS: A healthy lifestyle should be strongly promoted at the community level. In particular, factors associated with a low rate of practice of healthy lifestyles should be targeted.


Assuntos
COVID-19 , Comportamentos Relacionados com a Saúde , Adulto , Humanos , Feminino , Adolescente , Estudos Transversais , COVID-19/epidemiologia , Estilo de Vida Saudável , Estilo de Vida
19.
Am J Mens Health ; 17(6): 15579883231205521, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38093710

RESUMO

This study aimed to investigate the prevalence of lower urinary tract symptoms (LUTS) in older men (N= 3056) with benign prostatic hyperplasia (BPH) and its effects on their sexual function and mental health. Descriptive, correlation, and regression analyses were used to explore the relationships between prostate and lower urinary tract health and psychological well-being. Better prostate and lower urinary tract health positively affected psychological well-being, and sexual function also had a positive influence. LUTS have an adverse impact on sexual function and mental health. Early intervention is crucial for mitigating the negative impact of LUTS on the quality of life in older men. Addressing prostate and lower urinary tract health issues through appropriate interventions may improve psychological well-being. Health care professionals must consider the adverse effects of BPH and LUTS on sexual function and mental health, and implement interventions to enhance the overall quality of life in older men.


Assuntos
Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Masculino , Humanos , Idoso , Hiperplasia Prostática/complicações , Bem-Estar Psicológico , Qualidade de Vida , Próstata , Sintomas do Trato Urinário Inferior/etiologia
20.
Arch Gerontol Geriatr ; 103: 104796, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36058045

RESUMO

This overview study examined and synthesized the effect of Tai Chi (TC) on the physical conditions, psychological conditions, cognitive abilities, and quality of life (QoL) of older adults. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Using Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, PubMed, Scopus, and Web of Science, English-language systematic reviews (SRs) published within the latest decade (2010-2020) were included. SRs with meta-analysis were selected if TC was the examined intervention and older adults was the targeted population. A total of 16 SRs covering 89 original studies were included. A number of the pooled results of the included SRs were inconclusive. Taking into consideration of the new meta-analyses of this study, TC significantly improved most outcomes, including the mobility, pain level, physical function, psychological distress, depressive symptoms, anxiety, global cognitive function, mental speed and attention, learning ability, verbal fluency, executive function, and QoL of older adults. TC can be an effective intervention for older adults for improving physical and psychological conditions, cognitive abilities, and QoL. Additional high-quality studies with larger samples investigating the effectiveness of TC in older adults are warranted.

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