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Wang L, Wang H, Fang J, Yao M. Analysis of the nursing value of continuity care in the recovery of ureteral stone patients after Pneumatic ballistic lithotripsy: An observational study. Medicine (Baltimore) 2024; 103:e39682. [PMID: 39287228 PMCID: PMC11404949 DOI: 10.1097/md.0000000000039682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
This study aims to assess nursing methods' effects on ureteral stone patients post-Pneumatic ballistic lithotripsy with double J-tube placement. Through comparing interventions' impact on recovery, complications, and overall quality of life, the study aims to establish a more effective nursing protocol for this patient group. This study investigates ureteral stone patients who underwent PL and subsequent double J-tube placement between January 2020 and October 2023. A total of 100 eligible subjects (n = 100), meeting the inclusion and exclusion criteria, were divided into an intervention group (n1 = 50) and a control group (n2 = 50) according to different treatments. The control group received routine in-hospital care combined with outpatient follow-up, while the intervention group underwent continuous care using the Omaha system. Nursing effects pre- and post-intervention were assessed using questionnaires, clinical indicators, and the Omaha evaluation system, evaluating aspects such as cognition, behavior, and status in terms of environment, psychosocial aspects, physiology, and health behavior. Additionally, complications during double J-tube placement and pain scores were compared among the patients. Prior to the intervention, no statistically significant differences were observed between the scores of both groups across environmental, psychosocial, physiological, and health behavioral domains. Subsequent to the nursing intervention on the first postoperative day, at discharge, and post-discharge, a statistically significant variance was evident between the groups across these domains (P < .05). Furthermore, the intervention group exhibited notably lower rates of infection, hematuria, and residual or fragmented stones, all significantly lower with a P-value of <.05, compared to the control group. While a reduction in tissue damage and acute kidney injury was observed in the intervention group compared to the control group, this difference did not reach statistical significance. Notably, 92% of patients in the intervention group reported no pain during the nursing intervention, in contrast to only 52% in the control group. Continuity care utilizing the Omaha system demonstrates favorable outcomes in managing double J stent placement post-PL among ureteral stone patients, notably leading to a significant reduction in both pain levels and the incidence of associated complications.
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Affiliation(s)
- Lingying Wang
- Department of Surgery, She County People's Hospital, Huangshan, Anhui, China
| | - Hong Wang
- Department of Surgery, She County People's Hospital, Huangshan, Anhui, China
| | - Jianghong Fang
- Department of Surgery, She County People's Hospital, Huangshan, Anhui, China
| | - Minye Yao
- Department of Nursing, Huangshan Shoukang Hospital, Huangshan, Anhui, China
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Kofman YB, Selbe S, Szentkúti P, Horváth-Puhó E, Rosellini AJ, Lash TL, Schnurr PP, Sørensen HT, Galea S, Gradus JL, Sumner JA. Sex Differences in Psychopathology Following Potentially Traumatic Experiences. JAMA Netw Open 2024; 7:e240201. [PMID: 38386319 PMCID: PMC10884878 DOI: 10.1001/jamanetworkopen.2024.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Importance Various psychopathology may follow trauma; however, sex differences in these ranging manifestations of posttraumatic psychopathology remain understudied. Objective To investigate sex-specific incidence of posttraumatic psychopathology. Design, Setting, and Participants This population-based cohort study of Danish national health registries included a cohort of individuals who experienced a potentially traumatic event (PTE) from 1994 to 2016. Individuals were further categorized by presence of any pretrauma psychopathology. A comparison group of individuals who experienced a nontraumatic stressor (nonsuicide death of a first-degree relative) was examined as a reference cohort. Exposures At least 1 of 8 PTEs (eg, physical assault, transportation accident) derived through health registry International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, with additional qualifiers to improve classification accuracy. Main Outcomes and Measures Incidence of 9 categories of ICD-10 psychiatric disorders recorded in registries within 5 years of PTEs. The standardized morbidity ratios (SMRs) for psychopathology outcomes were also calculated to compare individuals experiencing PTEs with those experiencing a nontraumatic stressor. Results This study included 1 398 026 individuals who had been exposed to trauma (475 280 males [34.0%]; 922 750 females [66.0%]). The group of males who had been exposed to trauma were evenly distributed across age, while most females in the trauma-exposed group were aged 16 to 39 years (592 385 [64.2%]). Males and females were equally distributed across income quartiles and predominantly single. Following PTEs, the most common diagnosis was substance use disorders for males (35 160 [7.4%]) and depressive disorders for females (29 255 [3.2%]); incidence proportions for these and other disorders were higher among males and females with any pretrauma psychopathology. Certain PTEs had elevated onset of various psychiatric disorders and some sex differences emerged. Following physical assault, associations were found with schizophrenia or psychotic disorders for males (SMR, 17.5; 95% CI, 15.9-19.3) and adult personality disorders for females (SMR, 16.3; 95% CI, 14.6-18.3). For noninterpersonal PTEs, males had larger SMRs for substance use, schizophrenia or psychotic disorders, and adult personality disorders (SMR, 43.4; 95% CI, 41.9-45.0), and females had larger SMRs for depressive disorders (SMR, 19.0; 95% CI, 18.6-19.4). Sex differences were also observed, particularly when considering pretrauma psychopathology. For example, among interpersonal PTEs, males were most likely to develop substance use disorders after physical assault, whereas females were more likely to develop various disorders, with stronger associations seen for females without pretrauma psychiatric diagnoses. Among noninterpersonal PTEs, exposure to toxic substance showed robust associations with psychopathology, particularly in those without pretrauma psychopathology, with sex-specific differences across psychiatric categories. Conclusions and Relevance Mental disorders after trauma were wide-ranging for males and females, and sex differences in patterns of posttraumatic psychopathology were more pronounced when accounting for pretrauma psychopathology. Findings provide new insights for sex-relevant PTEs and their mental health consequences. It also outlines future directions for advancing understanding of a constellation of posttraumatic psychopathology in males and females.
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Affiliation(s)
- Yasmin B Kofman
- Department of Psychology, University of California, Los Angeles
| | - Sophie Selbe
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Peter Szentkúti
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Erzsébet Horváth-Puhó
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Anthony J Rosellini
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Paula P Schnurr
- National Center for PTSD Executive Division, White River Junction, Vermont
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Henrik Toft Sørensen
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
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Ellehave SM, Thomsen LLH, Frederiksen MS, Overgaard C. Initial programme theory development: The first step in a realist evaluation of a cross-sectoral intervention for expectant Danish parents living with psychosocial risks. PLoS One 2023; 18:e0295378. [PMID: 38117815 PMCID: PMC10732377 DOI: 10.1371/journal.pone.0295378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/21/2023] [Indexed: 12/22/2023] Open
Abstract
A distinct inequality in maternity care exists, and women with psychosocial risks are at a greater risk of adverse birth outcomes. In several high-income countries, a psychosocial risk assessment early in pregnancy is recommended so that expectant parents are offered an appropriate level of care which facilitates relevant, tailored interventions for those in need. In 2017, a cross-sectoral and interdisciplinary intervention for expectant parents with psychosocial risks was developed and implemented in the North Denmark Region. The development process of the intervention has not been reported and theory-based knowledge about how supportive interventions bring about change for expectant parents with psychosocial risks is scarce. Through the initial phase of a realist evaluation, we aimed to elicit key contexts and mechanisms of change regarding the intervention for expectant parents with psychosocial risks. Through an initial programme theory, this article illustrates how, for whom and in which contexts the intervention is intended to work. Data is comprised of intervention documents, 14 pilot observations and 29 realist interviews with key stakeholders. A thematic analytical approach inspired by retroductive thinking was applied to identify and analyse patterns related to the incentive of the intervention, its structure, intended outcomes, generative mechanisms and contextual matters. Generative mechanisms responsible for bringing about change in the intervention were identified as healthcare professionals' approach, continuity, trust, early intervention and social network. Cross-sectoral collaboration and healthcare professionals' competencies were assumed to be central stimulating contextual factors. The initial programme theory developed in this study will serve as the basis for further refinement via empirical testing in a later phase of the realist evaluation.
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Affiliation(s)
- Sara Mandahl Ellehave
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Louise Lund Holm Thomsen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
| | - Marianne Stistrup Frederiksen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
| | - Charlotte Overgaard
- The Unit of Health Promotion, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
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Ngai FW, Lam W. Couple-based interpersonal psychotherapy for first-time parents: A process evaluation. J Pediatr Nurs 2023; 72:e193-e200. [PMID: 37385939 DOI: 10.1016/j.pedn.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE First-time parents have an increased risk of depression during the transition to parenthood, which has long-term adverse effect on the infant development. Interpersonal psychotherapy (IPT) has been shown to effectively reduce postnatal depression. The objectives of this study were to explore first-time parents' perceptions of a couple-based IPT program and to identify positive and negative influences on the effectiveness of the intervention through a process evaluation. DESIGN AND METHODS A process evaluation was conducted as part of a randomized controlled trial of a couple-based IPT program. A program satisfaction questionnaire was used to assess the participants' satisfaction with the structure, process and outcome of the program. Semi-structured telephone interviews were conducted with a purposive sample of 44 first-time parents who had received the couple-based IPT. The interview data were analyzed by thematic analysis. RESULTS The qualitative findings showed that the parents perceived couple-based IPT as useful for enhancing their interpersonal relationship, emotional control and competence in child care. The successful implementation of the couple-based IPT program was influenced by its delivery by midwives, the interactive lessons used to engage the participants, the close fit of the teaching contents to the needs of first-time parents and the flexible program schedule and delivery mode. CONCLUSIONS The process evaluation indicates that couple-based IPT is an acceptable and feasible intervention for first-time parents to facilitate a healthy transition to parenthood. PRACTICE IMPLICATIONS The couple-based IPT can be used as an adjunct to standard care to promote perinatal health.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, FG427, Hung Hom, Kowloon, Hong Kong Special Administrative Region.
| | - Winsome Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
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Gram P, Thomsen LLH, Andersen CG, Overgaard C. Trusting parent-professional relationships in interprofessional interventions for expectant and new parents in vulnerable positions: A realist evaluation. J Interprof Care 2023:1-11. [PMID: 36883786 DOI: 10.1080/13561820.2023.2183185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 03/09/2023]
Abstract
Interprofessional collaboration and trusting parent-professional relationships can be key to delivering interprofessional care to meet the needs of expectant and new parents in vulnerable positions. This, however, presents challenges. This study aimed to gain deeper understanding of how and under what circumstances trusting parent-professional relationships develop and work within interprofessional team-based care for this group, from the professionals' perspectives. Realist evaluation was undertaken based on 14 semi-structured, realist interviews with midwives and health visitors and 11 observations. Multiple interrelated mechanisms were identified including patient/family-centered care, timely and relevant interprofessional involvement in care, gentle interprofessional bridging, transparency of intervention roles and purposes, and relational continuity. Good interprofessional collaboration was a primary condition for these mechanisms. Developed, trusting relationships supported parents' engagements with interprofessional care and constituted a supportive safety net that promoted parenting skills and coping abilities. We identified harmful mechanisms: distanced encounters, uncertainty of interprofessional involvement, and compromising the safe space. These mechanisms caused distrust and disengagement. Ensuring trusting parent-professional relationships within interprofessional team-based care demands each professional involved competently engages in relational work and interprofessional collaboration. Uncontrollability is thus influenced regarding interpersonal connection and potentially gives an explanation when trust-building efforts fail.
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Affiliation(s)
- Pernille Gram
- Department of Health Science and Technology, The Research Team for Women's, Child & Family Health, Aalborg University, Gistrup, Denmark
| | - Louise Lund Holm Thomsen
- Department of Health Science and Technology, The Research Team for Women's, Child & Family Health, Aalborg University, Gistrup, Denmark
| | - Clara Graugaard Andersen
- Department of Health Science and Technology, The Research Team for Women's, Child & Family Health, Aalborg University, Gistrup, Denmark
| | - Charlotte Overgaard
- Department of Health Science and Technology, The Research Team for Women's, Child & Family Health, Aalborg University, Gistrup, Denmark
- Unit of Health Promotion, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
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Cibralic S, Pickup W, Diaz AM, Kohlhoff J, Karlov L, Stylianakis A, Schmied V, Barnett B, Eapen V. The impact of midwifery continuity of care on maternal mental health: A narrative systematic review. Midwifery 2023; 116:103546. [PMID: 36375410 DOI: 10.1016/j.midw.2022.103546] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Systematic reviews have shown that midwifery continuity of care programs lead to improvements in birth outcomes for women and babies, but no reviews have focused specifically on the impact of midwifery continuity of care on maternal mental health outcomes. OBJECTIVE To systematically review the available evidence on the impact of midwifery continuity of care on maternal mental health during the perinatal period. METHOD A systematic search of published literature available through to March 2021 was conducted. A narrative approach was used to examine and synthesise the literature. RESULTS The search yielded eight articles that were grouped based on the mental health conditions they examined: fear of birth, anxiety, and depression. Findings indicate that midwifery continuity of care leads to improvements in maternal anxiety/worry and depression during the perinatal period. CONCLUSION There is preliminary evidence showing that midwifery continuity of care is beneficial in reducing anxiety/worry and depression in pregnant women during the antenatal period. As the evidence stands, midwifery continuity of care may be a preventative intervention to reduce maternal anxiety/worry and depression during the perinatal period.
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Affiliation(s)
- Sara Cibralic
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
| | - Wendy Pickup
- South Western Sydney Local Health District, New South Wales, Australia
| | | | - Jane Kohlhoff
- University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Karlov
- University of New South Wales, Sydney, New South Wales, Australia; South Western Sydney Local Health District, New South Wales, Australia
| | | | | | - Bryanne Barnett
- University of New South Wales, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia; South Western Sydney Local Health District, New South Wales, Australia
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Ejlertsen C, Rosenstrøm S, Kristensen IH, Brødsgaard A. Engaging in partnerships is the key to preserving and creating a trustful collaboration with vulnerable families: A focus group study. Midwifery 2022; 114:103440. [DOI: 10.1016/j.midw.2022.103440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/22/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022]
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