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Aim: The aim of this work is to examine the effectiveness of a psychoeducational intervention on self‐efficacy (primary outcome), anxiety, depression, treatment adherence, and health‐related quality of life (HRQoL) of patients undergoing haemodialysis. Methods: A two‐group randomized controlled trial of 124 patients (65 and 59 patients in the intervention and control groups, respectively) recruited from a tertiary hospital in Singapore was conducted. Data were collected from January 2015 to June 2016. Outcomes were measured at baseline and 1, 3, and 6 months after the intervention. General linear model was used to analyse data. Results: Our findings showed significant group effect on HRQoL (effects of kidney disease on daily life; p = 0.041), time effect on all outcomes (p < 0.05; except for treatment adherence behaviours and HRQoL [burden of kidney disease]), and group * time interaction effect on anxiety (p = 0.040) and depression (p = 0.003), with the intervention group reporting better outcomes. Conclusions: The positive effects of our intervention on patients' self‐efficacy, psychological well‐being, treatment adherence attitudes, and HRQoL implied its potential use in dialysis/renal centres to improve patients' self‐care and health outcomes. Summary statement: What is already known about this topic? Patients undergoing haemodialysis commonly encounter physical and psychological health challenges due to the complexity of the disease and long‐term treatment regimens.Improving self‐efficacy in self‐care could improve patients' psychological well‐being, treatment adherence, and health‐related quality of life among these patients.Limited literature is available on how psychoeducational intervention can improve health outcomes of patients undergoing haemodialysis. What this paper adds? The psychoeducational intervention positively reduced haemodialysis patients' anxiety and depression and improved treatment adherence attitude and health‐related quality of life. The implications of this paper: The psychoeducational programme could be integrated into routine care in renal or dialysis centres to enhance the health outcomes of patients undergoing haemodialysis.Future studies should incorporate technology in the delivery of psychoeducational interventions to improve their accessibility and sustainability. [ABSTRACT FROM AUTHOR]

Aims: To synthesize the effectiveness of web‐based psychosocial interventions on self‐efficacy, anxiety, depression, quality of life (QoL), non‐specific psychological and cancer‐specific distress among patients with colorectal cancer (CRC). Design: A systematic review and meta‐analysis. Data sources Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021. Review methods: Experimental/quasi‐experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta‐analyses and narrative syntheses were performed. Results: Nineteen studies consisting of 1386 participants were identified. Cognitive‐behavioural therapy delivered online was the most common trialled web‐based psychosocial intervention. Meta‐analyses revealed no positive effect for self‐efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p <.01) and minimal benefit for QoL (mean difference [MD] 2.83, 95% CI: −0.31 to 5.98, p =.08) but significant positive effects for anxiety (MD −2.23, 95% CI: −3.31 to −1.14, p <.01) and depression (MD −2.84, 95% CI: −4.09 to −1.59, p <.01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress. Conclusion: Web‐based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self‐efficacy and QoL remains inconsistent. More adequately powered, well‐designed trials with targeted and theory‐based interventions are required to ascertain findings. Impact By highlighting the potential of web‐based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web‐based care delivery in light of COVID‐19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes. PROSPERO registration number: CRD42021261396 [ABSTRACT FROM AUTHOR]

Aims and objective: To explore the experiences and support needs of parents of children with recently diagnosed autism spectrum disorder (ASD) in Singapore. Background: Raising a child with ASD is challenging for parents, especially in the initial period following the diagnosis. Limited studies have focused on parents' perspectives. Design: A qualitative descriptive design study. Methods: Thirteen parents were recruited from a developmental and behavioural paediatric outpatient clinic of a tertiary hospital in Singapore from October–December 2018. Adult parents, who were primary caregivers of 2–10‐year‐old children diagnosed with ASD in the preceding 3 months to 2 years, were recruited. Semi‐structured individual face‐to‐face interviews were conducted based on an interview guide. Thematic analysis was used to analyse the data. Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist was used for reporting. Results: Common themes were analysed using constant comparative method to generate results. Four themes emerged after 13 interviews: (1) adjusting psychologically, (2) changing lifestyle, (3) contending with hurdles to services and (4) needing informational, tangible and emotional support. Conclusions: Findings suggested a need for more formal support networks, targeted resource platforms and accessibility of services to help support parents better after receiving a diagnosis of ASD in their child. Relevance to clinical practice: Enhancing current healthcare and social policies to improve the provision of standardised and targeted information to parents, establishing formal support networks, facilitating access to childcare services, and involving domestic helpers/nannies as dedicated caregivers and trainers could better support parents. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To explore the experiences of patients who underwent a Support availability, Thinking positively with acceptance, Overcoming social stigma, Minimizing negative feelings, Analyzing self‐efficacy in stoma care (STOMA) psychosocial intervention programme for people with colorectal cancer with stoma. Background: The STOMA psychosocial intervention programme was developed to improve stoma‐related health outcomes for patients with colorectal cancer and stoma. Evaluation was carried out to explore their experiences. Design: A qualitative exploratory approach was adopted. Methods: A total of 13 people with colorectal cancer, who were: (a) scheduled for surgery that resulted in a surgical formation of stoma at a tertiary public hospital in Singapore, and (b) were allocated to the intervention group and received the STOMA psychosocial intervention programme, were recruited for the qualitative evaluation study (September to November 2016). Participants were asked to comment on the contents and delivery methods of the intervention, and the effect of the presence of family members during the sessions. Thematic analysis was used to analyse the data. Findings: Four themes were generated: (a) individual attitudes towards stoma, (b) benefits of the STOMA psychosocial intervention programme, (c) strengths of the STOMA psychosocial intervention programme, and (d) recommendations for future programmes. Conclusion: The qualitative evaluation reflected the benefits of the intervention programme in improving the outcome of people with colorectal cancer with stoma with its multimodal and multidimensional approach. Trial Registration Number: ISRCTN41915584. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives To examine the factors influencing adherence to urate-lowering therapy in patients with gout in Singapore. Background Gout is the most common type of chronic inflammatory arthritis. Urate-lowering therapy is used to treat gout by reducing serum uric acid levels. However, adherence to urate-lowering therapy among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout. Design Cross-sectional, descriptive correlational study. Methods A convenience sample of outpatients ( n = 108) was recruited between October 2014-January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data. Results Although 44.4% of the participants were high adherers to urate-lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity and being married were factors positively influencing medication adherence. Conclusions This study revealed moderate adherence to urate-lowering therapy in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence. Relevance to clinical practice Findings from this study allow healthcare providers to quickly and easily identify patients who may have low adherence. Nurses should take the lead in educating patients on the mechanism of urate-lowering therapy and highlight the importance of adhering to it. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To present a synthesis and summary of midwives' perceptions on the facilitators and barriers of physiological birth. Background: Medicalisation of birth has transformed and dictated how birthing should take place since the 20th century. Midwives' perceptions on their role within this medicalised environment have not been well documented. Design: An integrative literature review. Data sources and review methods: Primary research articles published in English from the period of 2004 to 2015 were included in this review. The Joanna Briggs Institute's critical appraisal forms were used to appraise the quality of the articles. Data were identified from CINAHL, PubMed, PsycINFO, ScienceDirect, and Scopus. Results: Eighteen articles were reviewed. Lack of knowledge due to inadequate training, existing obstetrician‐led practices, and midwives' negative perceptions of physiological birth were identified as barriers in the literature. Facilitators like shared decision‐making, women's preferences, teamwork, institutional support, and midwives' positive perceptions of physiological birth promoted physiological birth. Most of the studies were conducted in Western countries. Conclusion: Midwives face barriers and facilitators when promoting physiological birth during their clinical practise. Future studies exploring midwives' perceptions of physiological birth are needed, especially in Asia where cultural and organizational factors may differ from Western countries. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the perceptions of parents on their child's vaccination in Singapore. Background Vaccination is a key part of health care, and the management of vaccination for children has gained increasing interest globally. Previous studies found that parents had multiple concerns and low confidence in making vaccination decisions for their children. As no study in this area has been conducted in Singapore, the views and needs of parents regarding their child's vaccination remain unknown. Design Descriptive qualitative study. Methods Purposive sampling was used to recruit 19 parents of children undergoing routine vaccination in a clinic in Singapore. Semistructured face-to-face or telephone interviews were conducted using an interview guide and were audiorecorded. Thematic analysis was used to analyse the data. Results The thematic analysis generated four themes from 15 subthemes. Theme 1 summarised the factors promoting vaccination uptake, theme 2 was factors impeding vaccination compliance, theme 3 described parents' supportive roles before, during and after the vaccination, and theme 4 was about parents' need for improvement in vaccination services, information and communication with healthcare professionals. Conclusions This study provided insight into parental views, experiences and needs regarding their child's vaccination. The results suggest a need for developing intervention programmes addressing information needs and pain management strategies to improve parents' experiences regarding their children's vaccination. Relevance to clinical practice Healthcare professionals and policymakers should take actions to improve parents' experiences regarding their child's vaccination by minimising the impeding factors and improving services, information provided and communications with parents. [ABSTRACT FROM AUTHOR]

Aim To explore first-time fathers' postnatal experiences and support needs in the early postpartum period. Background The postnatal period is a stressful transition period for new fathers. It is imperative to understand their needs and experiences to provide appropriate support for them. The majority of previous studies were based in Western countries and explored fathers' needs during pregnancy and childbirth, with few studies conducted in the postnatal period. In Singapore, a multiracial society with differing paternal cultural values from its Western counterparts, there is considerable need to examine the experiences and needs of first-time fathers. Design A descriptive qualitative design was used. Methods Data were collected from November 2015-January 2016. Fifteen first-time fathers were recruited from two postnatal wards of a public hospital, using a purposive sampling method. A semi-structured interview guide was used to conduct face-to-face interviews. A thematic analysis was conducted and ethics approval was sought for this study. Results Four overarching themes and seventeen subthemes were generated. The four overarching themes were: (1) No sense of reality to sense of responsibility; (2) Unprepared and challenged; (3) Support: needs, sources, experience and attitude; and (4) Future help for fathers. Conclusion Fathers undergo a transition phase where they have unmet support needs during the early postnatal period. Understanding and addressing these needs may facilitate smooth transition to fatherhood. This study's findings can be used to involve fathers and design future supportive educational programs to promote positive parenting experiences and family dynamics. [ABSTRACT FROM AUTHOR]

This paper summarizes the empirical evidence concerning health-related quality of life ( HRQoL) of patients with coronary heart disease ( CHD) and attempts to identify its significant predictors. A systematic search of the literature from 2002 to 2012 was conducted using seven electronic databases ( CINAHL, Science Direct, Medline, Scopus, PsycINFO, Pub Med and Web of Science) using the search terms ' HRQoL'. ' CHD', 'social support', 'depression', 'anxiety', 'psychosocial factors', 'sociodemographic factors', 'clinical factors' and 'predictors'. A total of 1052 studies were retrieved, of which 24 articles were included in this review. Previous studies have consistently demonstrated the negative impact of CHD on HRQoL, citing three major types of predictive factors: sociodemographic, clinical and psychosocial factors. Studies have also highlighted the advantageous use of HRQoL as a gauge for treatment satisfaction and efficacy. There are, however, few studies that collectively investigate the relationship among concepts such as HRQoL, anxiety and depression, social support, and sociodemographic and clinical factors in relation to CHD. This review highlights the need to conduct further study on HRQoL of patients with CHD in the Asian context. Such research will promote patient-centric care and improved patient satisfaction through incorporation of the concept of HRQoL into clinical practice. [ABSTRACT FROM AUTHOR]

This study aimed to develop a Chinese Mandarin version of the Mental Health Inventory (CM:MHI). The English version MHI was translated into Chinese (simple Chinese character) using the forward-backward translation method while establishing the semantic equivalence and content validity. A convenience sample of 204 coronary heart disease (CHD) patients was recruited to evaluate the internal consistency, concurrent validity and construct validity of the CM:MHI. Forty patients completed the CM:MHI to evaluate the test-retest reliability after 2 weeks. The CM:MHI demonstrated good semantic equivalent rate (92%) and satisfactory content validity index (0.91). The internal consistency was acceptable for total and all subscales with Cronbach's alpha greater than 0.70, with the exception of the subscale of Emotional Ties (Cronbach's alpha = 0.64). The test-retest reliability was also satisfactory with intraclass correlation coefficients higher than 0.75. The concurrent validity was acceptable with significantly strong correlations between the CM:MHI and the Chinese Mandarin versions of Short Form 36 Health survey and Hospital Anxiety and Depression Scale. Confirmatory factor analysis further supported the five-factor structure of the CM:MHI. The CM:MHI demonstrated to be a valid and reliable measure for assessing psychological distress and well-being in Chinese-speaking CHD patients. [ABSTRACT FROM AUTHOR]

Aim To examine the effects of a therapeutic play intervention for children on parents' perioperative anxiety, the relationship between parents' and their children's anxiety and to explore parents' perceptions of the intervention. Background Therapeutic play intervention was found to reduce children's perioperative anxiety. Little is known about how such an intervention for children affects their parents' anxiety. Design A mixed method of randomized controlled trial with qualitative process evaluation was used. Methods Ninety-five pairs of parents and children were recruited between November 2011-August 2013 and randomized into a control or an intervention group. The State Anxiety Scale for Children and the State Anxiety Scale for Adults were used to measure children's and parents' anxiety, respectively, at baseline, on surgery day and around 24 hours after surgery. Parents were interviewed about their perceptions of the intervention. Data were analysed using SPSS version 22·0 and thematic analysis. Results There was no difference in parents' anxiety after participating with their child in the intervention compared with usual care. There were significantly positive relationships between parents' and their children's baseline anxiety and parents' postoperative anxiety and their children's pre-operative anxiety. Four themes were identified: reducing anxiety, increasing knowledge and understanding about anaesthetic procedure, the worthiness of attending the intervention and suggestions for improvement of the intervention. Conclusions Therapeutic play intervention had no significant effect on parents' perioperative anxiety. Parents' and their children's perioperative anxiety are correlated. Parents perceived the intervention as helpful preparation for themselves and for their children undergoing elective surgery. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine parents' knowledge about and attitudes towards pain management, use of pain relief strategies and satisfaction with their children's postoperative pain management, as well as the relationships among these variables. Background Children's postoperative pain is inadequately managed worldwide. Despite increasing emphasis on parental involvement in children's postoperative pain management, few studies have examined parents' management of their child's postoperative pain in Singapore. Design A descriptive correlational study. Methods A convenience sample of 60 parents having 6- to 14-year-old children undergoing inpatient elective surgery in a public hospital in Singapore was recruited. Data were collected one day after each child's surgery using the Pain Management Knowledge and Attitudes questionnaire and the Parents' Use of Pain Relief Strategies questionnaire. Descriptive statistics, Mann-Whitney U tests, Kruskal-Wallis tests and Spearman's rank correlation coefficient were used for data analyses. Results Parents displayed moderate levels of knowledge, attitudes and use of pain relief methods in relation to their children's postoperative pain and pain management. They were generally satisfied with the management of their child's postoperative pain. There was significant difference in Parents' Use of Pain Relief Strategies scores between parents with and without previous experience of caring for their hospitalised child. Statistically significant positive correlations were found between parents' knowledge and attitude, knowledge and satisfaction, attitude and satisfaction, knowledge and pain relief strategies, as well as attitude and pain relief strategies. Conclusion This study indicates the need to provide parents with more information regarding their children's postoperative pain management. Future studies are needed to develop educational interventions for parents to improve their knowledge and attitudes, which will eventually improve their use of pain relief strategies for their children. Relevance to clinical practice Health professionals need to provide more information to equip parents with knowledge and skills regarding paediatric postoperative pain management. [ABSTRACT FROM AUTHOR]

Aim To examine the effectiveness of a postnatal psychoeducation programme in enhancing maternal self-efficacy and social support and reducing postnatal depression among primiparas. Background Primiparas experience various challenges during the early postnatal period with low self-efficacy, depression and lack of social support. Support in the form of postnatal educational programmes is needed to improve these outcomes of primiparas. Design A randomized controlled two-group pre-test-post-test design was adopted. Methods Data were collected from June-December 2012 in a public hospital in Singapore from 122 primiparas, who were randomly assigned to the intervention ( n = 61) or control group ( n = 61). The intervention group received postnatal psychoeducation programme and routine care while the control group received routine care only. The Maternal Parental Self-Efficacy scale, Perinatal Infant Care Social Support scale and Edinburgh Postnatal Depression Scale were used to measure outcomes of maternal parental self-efficacy, social support and postnatal depression. The mean percentage changes of all three outcome variables from baseline to 6 and 12 weeks postpartum between groups were used when performing repeated measures multivariate analysis of covariance. Results The intervention group had significantly higher scores of maternal parental self-efficacy and social support and lower scores of postnatal depression at 6 and 12 weeks postpartum when compared with the control group. Conclusion The postnatal psychoeducation programme was effective in improving maternal outcomes and hence could be introduced as routine care with ongoing evaluation in the postnatal period. Future studies could focus on the effects of this programme on other populations. Trial registration no: ISRCTN15886353. [ABSTRACT FROM AUTHOR]

Aim To report a study protocol of a randomized controlled trial examining if a symptom self-management programme helps patients with acute myocardial infarction self-manage their physical and psychological symptoms. Background In addition to physical conditions, people with acute myocardial infarction often experience psychological symptoms. However, there is limited empirical evidence on how to help individuals self-manage these psychological symptoms. Design A single-blinded, randomized controlled trial is proposed. Methods A convenience sample of 90 will be recruited. Eligible participants will be adult patients with acute myocardial infarction hospitalized at a tertiary hospital in Singapore. Participants will be randomly assigned to one of the three treatment groups: Intervention 1 and standard care ( n = 30), Intervention 2 and standard care ( n = 30) and standard care alone ( n = 30). Data will be collected by self-reported questionnaires, physiological measures and open-ended questions. Quantitative data will be analysed by descriptive statistics, t-test, analysis of covariance and repeated measures analysis of variance. Open-ended questions will be analysed by content analysis. Discussion This study will identify a potentially efficacious symptom self-management programme for patients with acute myocardial infarction. If the efficacy of the programme is demonstrated, the programme can be integrated into hospital services to improve patient care. A new teaching method (virtual reality-based teaching) and new teaching materials (virtual reality videos and relaxation videos) derived from this study can be offered to patients. Future research with larger samples and multi-centre recruitment can be undertaken to further test the efficacy of the interventions. [ABSTRACT FROM AUTHOR]

Aims To report a study protocol that evaluates the effects of a psychosocial intervention on patients with a newly formed stoma. Background With the loss of a significant body function and distorted body image, stoma patients experience physical, psychological and social challenges. Nurses have an important role in helping patients' make a smooth transition to living with their stoma. Limited studies have examined the effects of psychosocial interventions on improving stoma-related health outcomes. Design A randomized controlled trial is planned. Methods Eighty-four patients with newly formed stoma in a tertiary hospital in Singapore (Research Ethics Committee approval obtained in January 2013) will be recruited. Participants will be randomly assigned to either a control group who receive routine care or an intervention group who receive STOMA psychosocial intervention besides routine care. Outcome variables include stoma care self-efficacy, days to stoma proficiency, length of hospital stay, acceptance of stoma, anxiety and depression and quality of life. Data will be collected at four time points: before randomization and intervention (baseline), on the day of discharge (mid-intervention), at 4 weeks after discharge (postintervention 1) and at 4 months after discharge (postintervention 2). Discussion This study will develop a psychosocial intervention programme, which may improve patients' stoma-related outcomes. The findings will provide direction to health professionals about education and the type of support that could be offered to patients concerning stoma care in the hospital setting, which will eventually improve their quality of life. [ABSTRACT FROM AUTHOR]

This study examined Chinese fathers' feelings about their partners' delivery and views on their presence during labour and birth. A questionnaire survey was conducted with 403 fathers whose partners gave birth in one provincial hospital in China. Data were analysed by descriptive statistics, χ2-test and content analysis. The results indicated that more than 80% of fathers experienced feelings of pride related to fatherhood and of love towards their partners and newborns. Significant differences in fathers' feelings were found between subgroups with regard to age, education, employment, presence in the delivery room, method of birth and whether preparatory visits had been made to the hospital. The majority who answered an open-ended question on the meaning of fathers' presence in the delivery room held a positive attitude towards fathers' presence at labour and birth, as their presence could empower their partners and provide psychological support. This study indicates fathers' presence at delivery and birth is important and that younger fathers need more support. It also provides evidence for clinical practice and future interventions to improve fathers' psychological health and experiences. [ABSTRACT FROM AUTHOR]

Aim To examine if therapeutic play intervention could reduce perioperative anxiety, negative emotional manifestation and postoperative pain in children undergoing inpatient elective surgery. Background Children undergoing surgery commonly experience anxiety and postoperative pain and exhibit negative emotional manifestations. Previous studies have shown inconsistent conclusions about the influence of therapeutic play on children's perioperative anxiety, negative emotional manifestation and postoperative pain. Design A randomized controlled trial was used. Methods Suitable children were recruited from November 2011-August 2013. They were randomized to receive either routine care (control group, n = 47) or a 1-hour therapeutic play intervention (experimental group, n = 48). Children's state anxiety, negative emotional manifestations and postoperative pain were measured at baseline, on the day of surgery and around 24 hours after surgery. Repeated measures analysis of covariance ( ancova) and univariate ancova adjusting for all possible confounding factors were used in the data analysis. Results The time effect of state anxiety was significant, but no group and interaction (group x time) effects between the control and experimental groups were found. Compared with the control group, children in the experimental group demonstrated significantly lower scores of negative emotional manifestations prior to anaesthesia induction and postoperative pain. Conclusions Therapeutic play intervention is effective in reducing negative emotional manifestations before anaesthesia induction and in reducing postoperative pain in children undergoing inpatient elective surgery. These results suggest that it is useful to give children with therapeutic play intervention prior to inpatient elective surgery. [ABSTRACT FROM AUTHOR]

Tools to measure the quality of life of Chinese myocardial infarction ( MI) patients in mainland China are small in numbers. For this study, 210 Chinese patients with MI were recruited to examine the psychometric properties of the Chinese Mandarin version of the Mac New Heart Disease questionnaire. Thirty-five participants managed to complete the retest after 2 weeks. The Mac New Heart Disease questionnaire had acceptable internal consistency, test-retest reliability and concurrent validity. The principal components analysis identified three factors which accounted for 56.6% of the variance. The Mac New Heart Disease questionnaire demonstrated good reliability and validity to be used as a health status measurement tool, and is ready for clinical use in the assessment of the quality of life of Chinese MI patients in mainland China. [ABSTRACT FROM AUTHOR]

Aim To report a study protocol that tests the effectiveness of an educational intervention on outcomes of parents and their children who undergo inpatient elective surgery. Background Inadequate children's postoperative pain management remains a global problem. Parents are required to be involved in their child's pain assessment and management, yet they often lack relevant knowledge and skills. Education is an effective strategy for enhancing a person's knowledge, attitudes and behaviour. However, few studies have examined its effectiveness in parents and their children undergoing inpatient elective surgery. Design Randomized controlled trial and embedded qualitative process evaluation. Methods One hundred and sixty-two pairs of participants (each comprised of one parent and his/her child undergoing inpatient elective surgery) will be recruited (protocol approved in January 2013). Participants will be randomized to either a Control group (routine care), an Intervention group 1 (routine care and an educational intervention with face-to-face teaching), or an Intervention group 2 (routine care and an educational intervention without face-to-face teaching). Outcome measures will include parents' knowledge, attitude and behaviour related to postoperative pain management; their child's postoperative pain; and parents' satisfaction with their child's pain management at baseline and around 6, 12 and 24 hours after the operation. Discussion A standardized educational intervention protocol and detailed study procedure have been developed in this study to improve parents' knowledge, attitude and behaviour related to postoperative pain management and reduce their child's postoperative pain. [ABSTRACT FROM AUTHOR]

The aim of this paper is to examine the relationships among nurses' knowledge of, attitudes towards and level of competence in nursing practice, as well as factors influencing nurses' competence in nursing practice, in typhoon disaster relief work. A cross-sectional descriptive study was conducted using a self-developed questionnaire to obtain data from 607 nurses working in four tertiary hospitals and two secondary hospitals in Fujian, China, in November 2011. Our findings show that the nurses' average percentage scores on their responses to questions in the domains of knowledge, attitudes and practice were 66.33%, 68.87% and 67.60%, respectively. The findings demonstrated a significant positive relationship between nurses' attitudes and their practice. Nurses' working unit, prior training in typhoon disaster relief, current position of employment and attitudes were significant predictors of nurses' competence in practice. The results indicate that strategies need to be developed for nurses to improve their knowledge, attitudes and practice. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the health-related quality of life and psychological well-being of patients with benign prostatic hyperplasia and identify the predictive factors of health-related quality of life. Background Benign prostatic hyperplasia is highly prevalent in ageing men and causes bothersome lower urinary tract symptoms, which has a negative impact on their health-related quality of life. The current practice of managing benign prostatic hyperplasia focuses on relieving physical symptoms. However, the impact of benign prostatic hyperplasia on the patients' health-related quality of life and psychological well-being remains understudied, especially in the Asian population. Design A descriptive correlational survey study. Methods A convenience sample of 97 patients with benign prostatic hyperplasia was recruited at an outpatient urology clinic of a tertiary hospital in Singapore. The health-related quality of life, lower urinary tract symptoms and psychological well-being of the participants were assessed using the 12-item Short-Form Health Survey, International Prostate Symptom Score and the Hospital Anxiety and Depression Scale, respectively. Results The health-related quality of life scores were low with physical and mental health component scores of 47·0 and 48·9, respectively, as assessed by the 12-item Short-Form Health Survey. There was a high prevalence of anxiety (10·3%) and depression (21·6%). Correlation analysis revealed significantly negative relationships between lower urinary tract symptoms, anxiety, depression and physical and mental health dimensions of the 12-item Short-Form Health Survey. Multiple linear regression analysis further identified that postvoid residual urine and lower urinary tract symptoms were predictive factors of the physical health dimension, whereas anxiety and depression were predictive factors of the mental health dimension of the 12-item Short-Form Health Survey. Conclusions The health-related quality of life of patients with benign prostatic hyperplasia was poor, and their psychological well-being was severely affected. Postvoid residual urine, lower urinary tract symptoms, anxiety and depression were identified to be significant predictive factors of the health-related quality of life of patients with benign prostatic hyperplasia. Relevance to clinical practice Findings from this study provide useful evidence-based information for healthcare professionals in the development and implementation of effective and culturally sensitive interventions to improve the health-related quality of life and psychological well-being of patients with benign prostatic hyperplasia. [ABSTRACT FROM AUTHOR]

Aim To report a trial protocol that evaluates the effectiveness of postnatal psychoeducation programme in improving maternal parental self-efficacy and social support and in reducing postnatal depression among primiparas. Background Primiparas encounter physical, psychosocial and newborn care challenges in the early postnatal period. However, primiparas do not receive adequate professional support after early discharge from hospitals, thus hindering their adaptation to new role as mothers and smooth transition to motherhood. Postnatal psychoeducation programmes have been shown to be effective in improving pregnant women's health. However, there is a lack of theory-based, postnatal psychoeducation interventions for primiparas. Design A randomized controlled trial of two-group pretest and repeated posttests is proposed. Methods The study will recruit a minimum of 114 primiparas on the day of discharge from a Singaporean public hospital (protocol approved in May 2012). Eligible participants will be randomly allocated to either a control group (receiving routine care) or an experimental group (receiving a postnatal psychoeducation programme besides routine care). Outcome measures include maternal parental self-efficacy, social support and postnatal depression. Data will be collected at baseline (on the day of discharge), 6 and 12 weeks postpartum. Discussion This will be the first study of its kind that will use rigorous study design to evaluate a theory-based innovative postnatal psychoeducation programme on maternal outcomes. The study may identify a potentially effective way of enhancing primiparas' self-efficacy and social support, which may in turn reduce their risk of postnatal depression. The Sigma Theta Tau International Upsilon Eta Chapter funded this study. [ABSTRACT FROM AUTHOR]

Aim To develop and examine the effectiveness of a home-based self-help psychoeducation programme on health-related quality of life, stress level, anxiety and depression symptoms, self-efficacy, cardiac risk factors and health service use of outpatients with coronary heart disease. Background Hospital-based cardiac rehabilitation programmes have been shown to improve, effectively, the quality of life of patients with coronary heart disease. However, a majority of these patients do not participate in these programmes, while those who do enrol in these programmes fail to complete the programmes. Design Randomized controlled trial with repeated measures. Methods This study was approved and received the grant in July 2013. A convenience sample of 128 coronary heart disease outpatients will be recruited from a tertiary hospital in Singapore. Participants are randomly assigned to the 4-week experimental group and will participate in the programme or the control group who will not participate in the programme. The outcome measures include the: 12-item Short Form Health Survey, Perceived Stress Scale, Hospital Anxiety and Depression Scale and General Self-Efficacy Scale. Data will be collected at baseline, then 4 and 16 weeks from baseline. At the end, a process evaluation will be conducted to assess the acceptability, strengths and weaknesses of our programme based on the participants' perspectives. Discussion Our programme offers coronary heart disease patients an additional option to the existing cardiac rehabilitative services in Singapore hospitals. It aims to help them manage their disease effectively by reducing cardiac risk factors and improve their health-related quality of life and psychological well-being. [ABSTRACT FROM AUTHOR]

The above article from Journal of Advanced Nursing, published online on 26th June 2014 in Wiley Online Library () has been retracted by agreement between the journal Editor-in-Chief and John Wiley & Sons Ltd. The retraction has been agreed due to considerable overlap with the following papers: Zhu L.-X., Ho S.-C., Sit J.W.H., He H.-G. (2014) Effect of a transtheoretical model-based stage-matched exercise intervention on exercise behavior and angina in patients with coronary heart disease: a randomized controlled trial. Journal of Cardiovascular Nursing DOI: . Zhu L.-X., Ho S.-C., Sit J.W.H., He H.-G. (2014) The effects of a transtheoretical model-based exercise stage-matched intervention on exercise behavior in patients with coronary heart disease: A randomized controlled trial. Patient Education and Counseling 95, 384-392. Reference Zhu L-X., Ho S-C., Sit J.W.H. & He H-G. (2014) Effects of a transtheoretical model-based exercise stage-matched intervention on exercise behaviour and quality of life in patients with coronary heart disease: a randomized controlled trial. Journal of Advanced Nursing. doi: [ABSTRACT FROM AUTHOR]

Aim and objective To examine the correlation between maternal parental self-efficacy and social support as well as predictors of self-efficacy in the early postpartum period. Background Maternal parental self-efficacy is important for mothers' adaptation to motherhood. Lack of support could result in decreased maternal parental self-efficacy in newborn care. Limited studies have focused on maternal parental self-efficacy in the postpartum period in Asia and none in Singapore. Study design A correlational study design was adopted. Methods Data were collected from both primiparas and multiparas during the first to third days postpartum in a public hospital, using the Perceived Maternal Parental Self-efficacy and Perinatal Infant Care Social Support Scales. The data were analysed using descriptive and inferential statistics. Results Maternal parental self-efficacy in newborn care and the level of social support that mothers received were moderate. In terms of the social support subscales, informational and instrumental support was lower than emotional and appraisal support. Informal support from husbands, parents and parents-in-law was the main source of support. A significant correlation was found between maternal parental self-efficacy and total social support in addition to the informational, instrumental and appraisal subscales of functional support. The predictors of maternal parental self-efficacy were parity, social support and maternal age. Conclusion The findings highlight the predictors and correlates of maternal parental self-efficacy in newborn care and the social support needs of mothers in the early postpartum period. Healthcare professionals could provide more information and instrumental support and involve family members to enhance maternal parental self-efficacy. Relevance to clinical practice Because maternal parental self-efficacy and social support in the early postpartum period are interrelated components, they could be assessed to identify at-risk mothers. There is a need to develop perinatal educational programmes to provide culturally competent individualised support to mothers in need. [ABSTRACT FROM AUTHOR]

Aims To test the impact of stress on psychological and physical health, and examine the mediating effects of coping on the stress-health relationships among nursing students. Background Stress is associated with various physical and psychological symptoms in nursing students. Numerous studies examined the relationships among stress, coping and health; nevertheless, a mechanism of coping has not been fully explored in Thai nursing students. Design This study adopted a cross-sectional, descriptive correlational research design. Methods A convenience sample of 335 nursing students were recruited from a University in Thailand from 2005-2007. We used self-reported questionnaires to collect information; and analysed data using descriptive statistics and structural equation modelling. Results Nursing students with high levels of stress reported poorer physical health and higher psychological distress. Stress had a stronger effect and explained more variances on psychological distress than on poor physical health. The partial mediation of coping was observed. Specifically, 77·00% of the effects of stress on poor physical health and 11·30% on psychological distress were mediated by coping. Conclusion Evidence from this study contributes to the nursing science and has implications to nursing practice. Stress among nursing students should be monitored and effectively managed to prevent deleterious effects on their health. Nursing interventions focusing on coping skill training could be developed and delivered. Future research may examine the effectiveness of the interventions and/or to further explore variables associated with psychological distress in nursing students. [ABSTRACT FROM AUTHOR]

Aim To report a trial protocol to determine if a therapeutic play intervention leads to significant reduction in perioperative anxiety, negative emotional manifestations and postoperative pain of children undergoing inpatient elective surgery and in their parents' perioperative anxiety. Background Children undergoing surgery often experience anxiety, exhibit negative emotional manifestations pre-operatively and postoperative pain. Previous studies report that therapeutic play intervention has positive effects on anxiety reduction, while few studies have examined the effects of such intervention on children undergoing major elective surgery. Design Randomized controlled trial with repeated measures is proposed. Methods This study will recruit 106 pairs of 6-14-year-old children undergoing elective surgery in a Singaporean public hospital and their parents (protocol approved in October 2011). Eligible participants will be randomly allocated to either a control group (receiving routine care) or an experimental group (receiving 1-hour therapeutic play intervention plus routine care). Outcome measures include children's anxiety, emotional manifestation and postoperative pain, their parents' anxiety and process evaluation. Data will be collected at baseline (3-7 days before the operation), on the day of surgery and around 24 hours after the surgery. Discussion This study will identify a clinically useful and potentially effective approach to prepare children for surgery by reducing anxiety of both children and their parents during the perioperative period. The reduction of anxiety may lead to reduction of postoperative pain, which will eventually improve the physical and psychological well-being of children. This study was funded by the National Medical Research Council in Singapore. [ABSTRACT FROM AUTHOR]

Aims To examine the relationship between perioperative anxiety and postoperative pain in children and adolescents undergoing elective surgical procedures and the differences in children's perioperative anxiety and postoperative pain among subgroups of demographics. Background While anxiety and pain are regarded as two common problems experienced by children and adolescents perioperatively and the relationship between them has been reported in previous studies, there has been no review paper examining this phenomenon. Design A quantitative systematic review. Data sources Nine electronic databases were searched for studies published in English from the inception date of the databases to December 2010, using various combinations of search terms of 'adolescents', 'anxiety', 'child', 'pain', 'surgery' and 'correlation/relationship'. Review methods Using the Joanna Briggs Institute's comprehensive systematic review strategies, relevant studies were independently appraised and extracted by two reviewers using the standardized critical appraisal instruments and data extraction tool from Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Results Ten studies were included in this review from 943 studies initially retrieved. Children and adolescents who had higher level of perioperative anxiety experienced a higher level of postoperative pain. Inconclusive evidence was found regarding differences of perioperative anxiety and postoperative pain between demographic subgroups of gender, age and past surgical experience. Conclusion Results of this review inform healthcare providers of the role perioperative anxiety plays on children's and adolescents' postoperative pain and indicate the need to use interventions to reduce perioperative anxiety and, therefore, optimize their postoperative pain management during the perioperative period. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effect of non-pharmacological staged interventions on fatigue and dyspnoea in patients with chronic obstructive pulmonary disease. A randomized controlled trial was conducted with 64 patients in a tertiary hospital in China from 2010 to 2011. Patients were randomly assigned to the control group ( n = 32), who received routine care, and the intervention group ( n = 32), who received additional non-pharmacological staged interventions. The Multidimensional Fatigue Inventory and the five-grade Medical Research Council dyspnoea scale were used to collect data at baseline and after 6 weeks. Compared with the control group, patients in the intervention group had significantly lower scores on general fatigue ( P < 0.001), physical fatigue ( P < 0.001), reduced activity ( P < 0.001) and reduced motivation ( P = 0.03) and had better relief of dyspnoea ( P = 0.02). Our study showed that non-pharmacological staged interventions were effective in relieving fatigue and dyspnoea in patients with chronic obstructive pulmonary disease. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore postoperative pain management experiences among school-aged children. Background Ineffective postoperative pain management among children has been commonly reported. School-aged children are able to evaluate how their pain is managed and what their preferred strategies are. Most studies in pain management have adopted quantitative methods and have overlooked children's pain management experiences. Design This is a qualitative study using face-to-face interviews. Methods Data were collected from 15 school-aged children admitted to a tertiary hospital in Singapore by in-depth interviews conducted between November 2010 and January 2011. Data were analysed by thematic analysis. Results Five themes were identified: children's self-directed actions to relieve their postoperative pain (e.g. using cognitive-behavioural methods of distraction and imagery, physical method of positioning, sleeping and drinking, seeking other people's help by informing parents and crying and using pain medications); children's perceptions of actions parents take for their postoperative pain relief (assessing pain, administering pain medications, using various cognitive-behavioural, physical methods and emotional support strategies, assisting in activities and alerting health professionals); children's perception of actions nurses take for their postoperative pain relief (administering medication, using cognitive-behavioural methods, emotional support strategies and helping with activities of daily living) and suggestions for parents (using distraction and presence) and nurses (administering medications, distraction and positioning) for their postoperative pain relief improvement. Conclusions This study contributed to the existing knowledge about children's postoperative pain management based on their own experiences. Children, their parents and nurses used various strategies, including pain medication and non-pharmacological methods, especially distraction, for children's postoperative pain relief. Relevance to clinical practice This study provides evidence for health care professionals to consider using more pain relief strategies when caring for children postoperatively and provide guidance for children to practice these strategies. [ABSTRACT FROM AUTHOR]

Aims and objectives. To enhance understanding of the experience of parents in managing their children's postoperative pain in Singapore. Background. Parents play a significant role in their hospitalised child's postoperative pain care. Their active involvement may contribute to accurate pain assessment and effective pain management for their child. However, there is a lack of in-depth research exploring the experience of parents involved in their children's postoperative pain management. Design. This study adopted a descriptive qualitative approach, which is situated in the interpretive paradigm. Method. Semi-structured interviews were conducted to collect data from 14 parents whose children were hospitalised in one of the three paediatric surgical wards in a hospital in Singapore in December 2009. Thematic analysis was used to analyse the data. Results. Three themes were identified: 'Actions used by parents to alleviate their child's postoperative pain', 'Factors influencing parents' management of their child's postoperative pain' and 'Parents' needs in the process of caring for their child's postoperative pain'. Parents used a range of non-pharmacological pain relief interventions for their child. Parental roles and expectations, bond between parent and child, support from nurses, family and own religious beliefs, as well as children's age and maturity level were factors which promoted parental participation, whereas parents' negative feelings, knowledge deficit and nurses' busy schedule were hindering factors. Parents expressed needs for more involvement in their child's care, adequate rest and information support from nurses. Conclusions. This study highlights the importance of involving parents in their child's postoperative pain management. It provides evidence for health care professionals to pay attention to factors that may influence parental participation and, therefore, guide their practice. Relevance to clinical practice. Nurses need to provide parents with support and education to facilitate their roles and improve their child's postoperative pain management. [ABSTRACT FROM AUTHOR]

He H-G, Vehviläinen-Julkunen K, Pölkki T, Pietilä A-M. International Journal of Nursing Practice 2010; 16: 254–261 Chinese parents' perception of support received and recommendations regarding children's postoperative pain management The aims of this study are to describe Chinese parents' perceptions of informational and emotional support received from nurses and their recommendations for improvement in the management of their child's postoperative pain. Data were collected using a questionnaire survey completed by 206 parents of 6- to 12-year-old child hospitalized in 12 wards in five provincial hospitals in Fujian Province, China, in 2004. Findings indicated that parents experienced negative feelings such as worry (91%) and anxiety (59%). Most of them reported they had received sufficient information on outcomes of surgical procedure (85%) and postoperative recovery process (84%), but fewer reported they had received sufficient information on pain medication (51%) and non-pharmacological pain-relieving methods (59%). Parents made some recommendations, which centred mainly on nurses' use of non-pharmacological methods. Findings suggest that parents need more information related to pain management and their understanding of the information should be ensured. [ABSTRACT FROM AUTHOR]