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Minerva Surgery Jul 2024
PubMed: 38953427
DOI: 10.23736/S2724-5691.24.10415-7 -
Pediatric Blood & Cancer Jul 2024Adolescence and young adulthood are vulnerable developmental periods for individuals with sickle cell disease (SCD), particularly given the impact of social inequities,...
BACKGROUND
Adolescence and young adulthood are vulnerable developmental periods for individuals with sickle cell disease (SCD), particularly given the impact of social inequities, challenges with transitioning to adult healthcare services, and increased risk for morbidity and mortality. Systems of power, such as institutionalized and interpersonal manifestations of bias, could impact SCD transfer and engagement in adult care through their influence on healthcare transition readiness; yet research in this area is limited.
OBJECTIVE
To characterize how systems of power impact transition readiness factors described in the Social-ecological Model of AYA Readiness for Transition to Promote Health Equity (SMART-E) framework at the patient, caregiver, and practitioner levels.
METHODS
Pediatric adolescents and young adults (AYA), transferred AYA, caregivers, and practitioners participated in semi-structured focus groups and individual interviews examining health equity and systems of power during healthcare transition. Focus groups/interviews were transcribed and coded using a deductive approach via the updated SMART-E framework.
RESULTS
Ten pediatric AYA with SCD, nine transferred AYA with SCD, eight caregivers, and nine practitioners participated in a focus group or interview. Qualitative findings across reporters emphasize the impact of systems of power (e.g., racial bias and disease stigma) on knowledge, skills and self-efficacy, beliefs and expectations, goals and motivation, and emotions and psychosocial functioning at the patient, caregiver, and practitioner levels.
CONCLUSION
Systems of power are prevalent with respect to transition barriers for AYA with SCD and their supports. Structural, institutional, and individual factors with potential to reduce the influence of systems of power should be further identified and targeted for intervention.
PubMed: 38953147
DOI: 10.1002/pbc.31156 -
Frontiers in Clinical Diabetes and... 2024With diabetes self-management continuing to become more complex for older adults, self-management programs have been shown to support this population in meeting their...
OBJECTIVES
With diabetes self-management continuing to become more complex for older adults, self-management programs have been shown to support this population in meeting their multifaceted medical needs. Building on our previous systematic review and meta-analysis, we aimed to update the literature on the effectiveness of diabetes self-management programs and investigate the impact of specific self-management interventions on clinical and patient-reported outcomes.
METHODS
We updated our literature search in the following databases: Medline, EMBASE, PsychINFO, CINAHL and Cochrane Database of Randomized Controlled Trials from November 2013 to July 2023 for studies that may fit our inclusion criteria. Two independent reviewers screened and extracted data from the included group of studies.
RESULTS
A total of 17 studies with 21 comparison arms met the inclusion criteria, totalling 5976 older adults (3510 individuals randomized to self-management programming and 2466 to usual care). The pooled effectiveness of diabetes self-management programs in older adults on glycemic control (hemoglobin A1C) was a reduction of -0.32 (95% CI -0.44, -0.19). Specifically, the most effective approach on glycemic control (A1C) was the use of feedback (-0.52%; 95% CI -0.68, -0.36). Overall, self-management programs improved behaviour change outcomes, with feedback interventions being most effective (standardized mean difference [SMD] 0.91; 95% CI 0.39, 1.43). The effect of self-management programs on body mass index, weight and lipids were statistically and clinically significant.
CONCLUSIONS
The evidence for diabetes self-management programs for older adults demonstrates a small but clinically meaningful reduction in A1C, improvement in patient-reported outcomes (behaviour, self-efficacy, knowledge), and other clinical outcomes (BMI, weight and lipids). The specific strategy used in diabetes self-management programs for older adults should be considered to achieve optimal results on outcomes.
PubMed: 38952998
DOI: 10.3389/fcdhc.2024.1348104 -
Frontiers in Psychology 2024Workplace loneliness has become a prevalent experience among employees in organizations; however, there is limited empirical research on how leaders can address and...
BACKGROUND
Workplace loneliness has become a prevalent experience among employees in organizations; however, there is limited empirical research on how leaders can address and mitigate this issue. Drawing upon self-determination theory and empowering leadership theory, this study examines the impact of empowering leadership on workplace loneliness by exploring the mediator of role breadth self-efficacy and the moderator of leader-member conversational quality.
METHODS
A time-lagged research design was used, collecting data through a two-wave online survey involving 531 employees in Chinese public sectors. The participants consisted of 321 males and 210 females, with an average age of 35 years (SD = 7.36).
RESULTS
Our findings indicate that empowering leadership positively influences employees' role breadth self-efficacy, reducing their workplace loneliness. Moreover, leader-member conversational quality strengthens this indirect effect, suggesting that empowering leadership is more effective in reducing workplace loneliness when leader-member conversational quality is high.
CONCLUSION
This study expands and enriches research on the antecedents of workplace loneliness from the leadership approach, providing valuable insights for organizations to implement interventions that effectively alleviate employees' workplace loneliness.
PubMed: 38952823
DOI: 10.3389/fpsyg.2024.1387624 -
Frontiers in Psychology 2024Narrative identity allows individuals to integrate their personal experiences into a coherent and meaningful life story. Addictive disorders appear to be associated with... (Review)
Review
Narrative identity allows individuals to integrate their personal experiences into a coherent and meaningful life story. Addictive disorders appear to be associated with a disturbed sense of self, reflected in problematic and disorganized self-narratives. In recent literature, a growing body of research has highlighted how narrative approaches can make a dual contribution to the understanding of addiction: on the one hand, by revealing crucial aspects of self structure, and, on the other, by supporting the idea that addiction is a disorder related to unintegrated self-states in which dissociative phenomena and the resulting sense of 'loss of self' are maladaptive strategies for coping with distress. This conceptual review identified the main measures of narrative identity, i.e., narrative coherence and complexity, agency, and emotions, and critically examines 9 quantitative and qualitative studies (out of 18 identified in literature), that have investigated the narrative dimension in people with an addictive disorder in order to provide a synthesis of the relationship between self, narrative and addiction. These studies revealed a difficulty in the organization of narrative identity of people with an addictive disorder, which is reflected in less coherent and less complex autobiographical narratives, in a prevalence of passivity and negative emotions, and in a widespread presence of themes related to a lack of self-efficacy. This review points out important conceptual, methodological and clinical implications encouraging further investigation of narrative dimension in addiction.
PubMed: 38952822
DOI: 10.3389/fpsyg.2024.1409217 -
Frontiers in Public Health 2024The number of clinical nurses in China experiencing professional burnout is increasing yearly, posing a serious challenge to the public health sector. Implementing...
BACKGROUND
The number of clinical nurses in China experiencing professional burnout is increasing yearly, posing a serious challenge to the public health sector. Implementing effective intervention strategies is key to reducing the level of occupational burnout. At present, training aimed at alleviating occupational burnout among clinical nurses is very limited, with common training programs focusing on addressing external factors of occupational burnout rather than the internal cognitive issues of clinical nurses. Self-efficacy and future time perspective are both aspects of an individual's internal self-cognition. Meanwhile, the relationship between clinical nurses' self-efficacy, future time perspective, and occupational burnout is not clear, and further research is needed to verify this.
OBJECTIVE
This study aims to reveal the relationship between clinical nurses' self-efficacy, future time perspective, and occupational burnout, and to explore the mediating role of future time perspective between self-efficacy and occupational burnout among clinical nurses, providing a scientific reference for training directions to improve occupational burnout.
METHODS
This study used a cross-sectional design, conducting a questionnaire survey with 529 practicing clinical nurses using the General Demographics Questionnaire (GDQ), the General Self-Efficacy Scale (GSES), the Zimbardo Time Perspective Inventory (ZTPI), and the Maslach Burnout Inventory-General Survey (MBI-GS). SPSS software version 26.0 was used to analyze the correlation between variables, and AMOS 26.0 was used to test the mediation effect.
RESULTS
Clinical nurses' self-efficacy had a negative predictive effect on occupational burnout (r = -0.503, < 0.001). Future time perspective showed significant differences in regression coefficients on both the paths of self-efficacy (r = 0.615, < 0.001) and occupational burnout (r = -0.374, < 0.001). Future time perspective played a partial mediating role between self-efficacy and occupational burnout, accounting for 33.8% of the total effect.
CONCLUSION
This study suggests a significant correlation between clinical nurses' self-efficacy, future time perspective, and occupational burnout. Self-efficacy can directly affect occupational burnout in clinical nurses and can also indirectly affect occupational burnout through the future time perspective.
Topics: Humans; Burnout, Professional; Self Efficacy; Adult; Female; Surveys and Questionnaires; Male; China; Cross-Sectional Studies; Nurses; Middle Aged
PubMed: 38952734
DOI: 10.3389/fpubh.2024.1363450 -
Pakistan Journal of Medical Sciences Jul 2024To assess the effects of comprehensive nursing intervention on quality of life, self-efficacy, gastrointestinal reaction and immune function of patients with breast...
Effects of comprehensive nursing intervention on quality of life, Self-efficacy, gastrointestinal reaction and immune function of patients with breast cancer undergoing chemotherapy.
OBJECTIVE
To assess the effects of comprehensive nursing intervention on quality of life, self-efficacy, gastrointestinal reaction and immune function of patients with breast cancer undergoing chemotherapy.
METHODS
This was a retrospective study. One hundred and twenty patients receiving chemotherapy after breast cancer surgery were randomly divided into the experimental group and the control group(n=60) from January 2021 to January 2023. Patients in the perioperative period, the experimental group were given comprehensive nursing intervention, while those in the control group were given conventional specialist nursing intervention. The differences in quality of life, self-efficacy, gastrointestinal reaction, immune function and patient satisfaction between the two groups were compared and analyzed.
RESULTS
After the intervention, the SF-36 scores in the experimental group were significantly higher than those in the control group (P=0.00), the efficacy indicators were significantly improved compared to the control group(P=0.00); the scores of gastrointestinal symptoms in the experimental group were significantly lower than those in the control group after the intervention(P<0.05). The indexes of CD3, CD4 and CD4/CD8 in the experimental group after the intervention were significantly higher than those in the control group(P=0.00); The patient satisfaction in the experimental group was 100%, which was significantly higher than 92% in the control group, with statistically significant differences(P=0.02).
CONCLUSION
Comprehensive nursing intervention leads to a variety of benefits in the treatment of patients with breast cancer during postoperative chemotherapy, such as relieving patients' gastrointestinal reactions, improving their immune function and quality of life, besides effectively improving their self-efficacy, which is worthy of clinical application.
PubMed: 38952519
DOI: 10.12669/pjms.40.6.7857 -
American Journal of Psychotherapy Jul 2024Countertransference is a basic tenet of psychodynamic theory. Although it was initially considered an unwelcome phenomenon in psychiatry, attitudes have shifted, and...
Countertransference is a basic tenet of psychodynamic theory. Although it was initially considered an unwelcome phenomenon in psychiatry, attitudes have shifted, and many mental health professionals now consider it to be a useful therapeutic tool. In this article, the author discusses countertransference as defined by the International Psychoanalytical Association's Inter-Regional Encyclopedic Dictionary of Psychoanalysis (IRED) and examines its clinical impact by using constructed vignettes of psychodynamic psychotherapies to illustrate theoretical points. As IRED delineates, countertransferences may exist at the conscious or unconscious level. In addition, the author suggests that countertransference may also exist at the preconscious level. Clinicians' examination of all levels of countertransference has the potential to be revelatory and facilitate therapeutic action, whereas unexamined countertransference can interfere with effective treatment. For this reason, self-reflection on the part of psychiatrists is essential.
PubMed: 38952225
DOI: 10.1176/appi.psychotherapy.20230035 -
ACS Nano Jul 2024Immunotherapy can potentially suppress the highly aggressive glioblastoma (GBM) by promoting T lymphocyte infiltration. Nevertheless, the immune privilege phenomenon,...
Immunotherapy can potentially suppress the highly aggressive glioblastoma (GBM) by promoting T lymphocyte infiltration. Nevertheless, the immune privilege phenomenon, coupled with the generally low immunogenicity of vaccines, frequently hampers the presence of lymphocytes within brain tumors, particularly in brain tumors. In this study, the membrane-disrupted polymer-wrapped CuS nanoflakes that can penetrate delivery to deep brain tumors via releasing the cell-cell interactions, facilitating the near-infrared II (NIR II) photothermal therapy, and detaining dendritic cells for a self-cascading immunotherapy are developed. By convection-enhanced delivery, membrane-disrupted amphiphilic polymer micelles (poly(methoxypoly(ethylene glycol)-benzoic imine-octadecane, mPEG--C18) with CuS nanoflakes enhances tumor permeability and resides in deep brain tumors. Under low-power NIR II irradiation (0.8 W/cm), the intense heat generated by well-distributed CuS nanoflakes actuates the thermolytic efficacy, facilitating cell apoptosis and the subsequent antigen release. Then, the positively charged polymer after hydrolysis of the benzoic-imine bond serves as an antigen depot, detaining autologous tumor-associated antigens and presenting them to dendritic cells, ensuring sustained immune stimulation. This self-cascading penetrative immunotherapy amplifies the immune response to postoperative brain tumors but also enhances survival outcomes through effective brain immunotherapy.
PubMed: 38952208
DOI: 10.1021/acsnano.4c06183 -
Oncology Jul 2024Introduction Retinoblastoma treatment and follow-up is complex and varies between patients. Pathways of care can enhance quality of care, patient outcomes, safety,...
Introduction Retinoblastoma treatment and follow-up is complex and varies between patients. Pathways of care can enhance quality of care, patient outcomes, safety, satisfaction, and resource optimization. Developing a pathway of care for retinoblastoma was identified as a top research priority by the retinoblastoma community. This study aimed to co-design and pilot a pathway of care called the "Retinoblastoma Journey Map" tailored for caregivers of newly diagnosed children with retinoblastoma. Methods A working group of patients, health professionals and researchers used human-centred design to ideate, prototype and refine the Retinoblastoma Journey Map. Caregivers of affected children were recruited to use and evaluate the Map. Mixed-methods data was collected on feasibility, acceptability, usability and perceived impact on communication, self-efficacy, anxiety, depression, and the quality of physician-patient interaction. Results The Retinoblastoma Journey Map consisted of an illustrated roadmap with 25 child-friendly stickers covering clinical treatment, medical education and milestones. Quantitative analysis revealed that the Map was feasible, acceptable, and usable; however, no significant effect on communication, self-efficacy, anxiety, depression or quality of physician-patient interaction was observed. Qualitative analysis identified 6 themes: Primary Use, Challenges, Impact, Limitations, Feasibility, Acceptability and Usability, and Unmet Needs. Conclusion A pathway of care for retinoblastoma, co-designed by researchers, health professionals and patients, was usable, acceptable, and feasible by caregivers of children with retinoblastoma. While significant effects on communication and physician-patient interaction were not observed, 'legacy building' - documentation of the pathway of care by families for later education of their child - emerged as an unanticipated yet important use of the Retinoblastoma Journey Map.
PubMed: 38952137
DOI: 10.1159/000540055