Purpose This study involved a meta-synthesis of qualitative research concerning the experiences of women with infertility and infertility treatments. Based on an analysis of emotional changes and adaptation processes, it aimed to propose an interaction model encompassing expectation, loss, and resilience and clarify the conceptual meaning of each component.
Methods Thomas and Harden’s five-step qualitative meta-synthesis methodology was employed. A total of 22 studies published between 2014 and 2024 were comprehensively analyzed and synthesized. The findings were integrated into a model representing the experiences of women undergoing infertility and infertility treatments.
Results The meta-synthesis identified six key themes: changes in identity and inner growth; strengthening resilience through the roles of spouses, family, and peers; strategies for recovery and growth; support systems amidst economic and social burdens; life in the tension of waiting and hope; and the reconfiguration of couple and family relationships. Based on these themes, a dynamic interaction model, named the Model of Psychological Changes and Resilience (PCR Model), was developed to illustrate the interrelationships among expectation, loss, and resilience. The conceptual implications of these relationships were also explicated.
Conclusion The cyclical interplay between expectation and loss among women experiencing infertility is intensified by social ideologies and cultural contexts, while resilience is strengthened through overcoming distress and finding meaning in life. Further quantitative research is necessary to validate these relationships in clinical settings by obtaining empirical data that apply this model.
Purpose This study was conducted to develop a conceptual framework for understanding non-adherence to self-management among patients with Chronic Obstructive Pulmonary Disease (COPD). This was accomplished through a literature review, in-depth interviews with patients, and a survey of healthcare professionals featuring semi-structured open-ended questions. Methods First, a systematic literature review was conducted across five databases. Next, 25 patients with COPD participated in detailed interviews that included seven semi-structured questions. Subsequently, 15 healthcare professionals completed a survey about factor categories and specific factors associated with non-adherence to COPD self-management. Categories and factors identified at least once across these three methods were documented. Finally, two researchers conducted preliminary mapping of the relationships between factor categories and individual factors, which was assessed for face validity by a third researcher. All processes were conducted from March 28, 2022, and January 30, 2023. Results The research revealed eight factor categories and 53 individual factors associated with non-adherence to COPD self-management. The categories encompassed personal, socioeconomic, disease-related, functional, treatment- related, health system-related, and environmental characteristics. The literature review, patient interviews, and survey of healthcare professionals yielded 35, 19, and 44 factors, respectively. Twelve factors were identified using all three sources. All processes were conducted from March 28, 2022, and January 30, 2023. Conclusion In this study, quantitative and qualitative methods were employed to develop a conceptual framework for non-adherence to COPD self-management. The findings indicate that effective self-management of this condition requires not only patient effort but also adaptations to complex treatment regimens, societal perceptions, and workplace environments.
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Purpose This scoping review aimed to identify the current state of the application of theories in research related to advance care planning and to analyze the types and characteristics of the theories applied.
Methods: Using the scoping review methodology presented by Arksey & O'Malley, the articles published from 2010 to 2022 were searched by combining the terms "advance care planning," "theory," and "model" in five electronic databases; PubMed, CINAHL, EMBASE, KMBASE, and KISS.
Results: Thirty-two studies were identified. Theory-based research has been actively conducted since 2019, with a total of 25 theories applied. Psychological theories were the most prevalent, accounting for 75.0% of the applications, followed by sociological theories (12.5%), public health theories (6.3%), and one nursing theory (3.1%). Theories were utilized to create a framework for data analysis, establish a philosophical underpinning, develop intervention frameworks, and derive new tools.
Conclusion: Various theories have been applied to research on advance care planning, yet the application of nursing theory has been limited. To optimize end-of-life care and advance care planning from a nursing perspective, further research incorporating nursing theory is essential.
Purpose After Transarterial Chemoembolization (TACE), patients may experience Post-Embolization Syndrome (PES), which is characterized by abdominal pain, fever, and nausea/vomiting. Various risk factors, including demographic, clinical, laboratory, and radiological data, have been reported. This study aimed to identify sex-specific risk predictors of PES following TACE. Methods This retrospective study included 1,495 patients who underwent TACE and were discharged from January 1, 2014 to December 31, 2021. The demographic, clinical, laboratory, and radiological characteristics of the patients undergoing TACE were analyzed. Descriptive statistics, the χ2 test, the independent t-test (or Mann-Whitney U test), Spearman correlation analysis, and logistic regression were used. Results The incidence of PES was higher in female (43.9%) than in male (37.3%). Multivariate logistic regression analysis Alanine aminotransaminase (ALT) levels as the only independent predictor of PES in female patients (Exp [B]=1.01, 95% Confidence Interval [CI]=1.00~1.01). The risk factors of PES in male patients were a tumor >5 cm in diameter (Exp [B]=2.51, 95% CI=1.46~4.32), the amount of lipiodol (Exp [B]=1.27, 95% CI=1.01~1.60), C-Reactive Protein (CRP) levels (Exp [B]=1.11, 95% CI=1.02~1.21), ALT level (Exp [B]=1.00, 95% CI=1.00-1.01), lymphocyte levels (Exp [B]=0.98, 95% CI=0.96~0.99), and right posterior section (S6-S7) (Exp [B]=0.71, 95% CI=0.55-0.92). Conclusion Oncology nurses should be aware of sex-specific differences in PES risk and monitor clinical, laboratory, and radiological data to evaluate PES in female and male after TACE. The results of this study will serve as basic data for establishing a clinical decision-supporting system.
Purpose This study aimed to identify variables influencing the sexual adjustment of patients who underwent radical prostatectomy in order to establish a structural model and intervention strategy for improving patients’ sexual adjustment. Methods Participants were 179 patients who received follow-up care after undergoing radical prostatectomy at two university hospitals in South Korea. Data were collected from July to November, 2017 using structured questionnaires. The exogenous variables were urinary symptoms and age, and the endogenous variables were sexual function, self-esteem, depression, couple intimacy, and sexual adjustment. The collected data were analyzed using SPSS 21.0 and AMOS 21.0. Results The goodness-of-fit measures of the final hypothetical model were satisfactory, as follows: χ2 /df=2.68, GFI=.91, CFI=.90, RMSEA=.09, SRMR=.07. Sexual function, self-esteem, and couple intimacy had direct and total effects on sexual adjustment in patients who underwent radical prostatectomy, and age had only an indirect effect. These variables explained 66.5% of sexual adjustment among patients. Urinary symptoms and depression did not show any significant effects, however. Conclusion To improve sexual adjustment in patients who underwent radical prostatectomy, it is imperative to establish active and effective nursing interventions to strengthen their sexual function, self-esteem, and couple intimacy, considering their age.
PURPOSE The purpose of this study was to construct and test a predictive model for physical activity adherence for secondary prevention among patients with coronary artery disease. METHODS Two hundred and eighty-two patients with coronary artery disease were recruited at cardiology outpatient clinics in four general hospitals and the data collection was conducted from September 1 to October 19, 2015. RESULTS The model fit indices for the final hypothetical model satisfied the recommended levels: χ2/dF=0.77, adjusted goodness of fit index=.98, comparative fit index=1.00, normal fit index=1.00, incremental fit index=1.00, standardized root mean residual=.01, root mean square error of approximation=.03. Autonomy support (β=.50), competence (β=.27), and autonomous motivation (β=.31) had significant direct effects on physical activity adherence for secondary prevention among patients with coronary artery disease. This variable explained 35.1% of the variance in physical activity adherence. CONCLUSION This study showed that autonomy support from healthcare providers plays a key role in promoting physical activity adherence for secondary prevention among patients with coronary artery disease. The findings suggest that developing intervention programs to increase feelings of competence and autonomous motivation through autonomy support from healthcare providers are needed to promote physical activity adherence for secondary prevention among patients with coronary artery disease.
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PURPOSE The aim of the study was to create a structural model based on Wilson and Cleary's Conceptual Model of Patient Outcomes. Secondly, the intention was to identify variables influencing the health-related quality of life (HRQoL) as reported by patients with thyroid cancer. METHODS A total of 201 patients with thyroid cancer were recruited from an outpatient clinic. Data were collected from June to November, 2015, using a structured questionnaire. The questionnaire included the Quality of Life-Thyroid Scale, Thyroid Stimulating Hormone (TSH), Medical Outcome Study Social Support Survey, MD Anderson Symptom Inventory-Thyroid, the Brief Illness Perception Questionnaire, and general characteristics of patients. The data were analyzed using the SPSS/WIN 21.0, AMOS 21.0, and SmartPLS 3.2.3 programs. RESULTS The fitness of the hypothetical model with the Wilson and Cleary model was satisfactory, showing that the coefficients of determination (R2) were between .101 and .692 and the predictive relevance (Q2) were between .124 and .320. The model explained 69.2% of the HRQoL. Symptom experience, functional status, disease perception, and social support directly and indirectly affected HRQoL. Age and TSH had an indirect influence on the HRQoL with the mediation effect of reported symptom experience. CONCLUSION To improve the quality of life for patients with thyroid cancer, comprehensive nursing interventions need to be developed and applied. Decreasing the reported symptoms, changing the perception of the disease, improving functional status, and increasing social support may contribute to a higher quality of life among patients with thyroid cancer.
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PURPOSE The purpose of this study was to identify the factors associated with compliance with standard precautions among hemodialysis unit nurses. METHODS A cross-sectional study design was used. One hundred ninety six nurses were recruited from 18 hemodialysis units in South Korea. Data were analyzed using SPSS/WIN 23.0 to provide descriptive statistics to describe the characteristics of the sample and variables. A hierarchical linear model was used to analyze effects of individual and hospital characteristics on nurses' compliance with standard precautions. RESULTS The majority of the sample was female (98%) and reported receiving in-service education on infection control (80%). The participants' average year of work experience in hemodialysis units was 7 years and the average nurse-patient ratio was 7:1. At the individual level, the perception of patients' severity, the length of work experience in hemodialysis unit, and the safety climate on infection prevention practices were significantly associated with nurse's compliance with standard precautions. At the hospital level, clinics showed a lower compliance with standard precautions than general hospital or university hospital. CONCLUSION In order to enhance compliance with standard precautions among hemodialysis unit nurses, it is imperative to warrant safety climate on infection prevention practice at clinics and develop infection control educational program for nurses with less work experience in hemodialysis units.
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