Search

Background: People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well‐being. Methods: An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. Results: Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. Conclusion: A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep. [ABSTRACT FROM AUTHOR]

Purpose: Rural older people living with HIV (PLH) in the United States are a population of growing size and significance. A better understanding of factors associated with quality of life (QOL), depressive symptoms, and stress in this population—especially modifiable factors—could inform future interventions. Methods: Online or on paper, we surveyed 446 PLH aged 50+ residing in rural counties across the United States (Mage = 56, 67% male, 67% White, and 23% Black). Associations between social support, HIV stigma, satisfaction with medical care, discrimination in health care settings, and structural barriers and health‐related QOL, depressive symptoms, and perceived stress were assessed using multiple linear regressions. Findings: Controlling for demographics, greater social support was associated with better QOL, fewer depressive symptoms, and less stress. Greater HIV stigma was associated with more depressive symptoms and stress. Satisfaction with care was associated with better QOL and less stress. Discrimination in medical settings was associated with lower QOL and more depressive symptoms and stress. Finally, experiencing more structural barriers was associated with lower QOL and more depressive symptoms and stress. Conclusions: In addition to engagement in care and viral suppression, QOL and mental health are also critical considerations for rural older PLH. Increasing social support, reducing or providing skills to cope with HIV stigma, improving quality of care, reducing discrimination and stigma in medical settings, and reducing or mitigating the impact of structural barriers present potential targets for interventions aiming to improve the well‐being of older rural PLH. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents an integrated literature review of the quality of life (QOL) in parents of individuals with Autism Spectrum Disorder (ASD). The rate of ASD is increasing. Parents of children with ASD have higher levels of stress and burden, which may lead to lower QOL. Design and Methods: A comprehensive, electronic search was performed to retrieve 15 relevant articles, including 5565 participants. An integrative review was performed to appraise and synthesize findings. Results: QOL was found to be lower in parents of children with ASD in physical, psychological, and social health and in spirituality, as compared with adults who were not parents of children with ASD. The strongest risk factor for parental QOL was the severity of the diagnosis of ASD. Protective factors for parental QOL were parent education level and levels of severity of ASD in the child. Practice Implications: Nurses can support families impacted by ASD, particularly severe ASD, through tailored resources to support early diagnosis and intervention, through the support of policies affecting low‐income families, and through increased awareness of severe ASD and its' impact on the child and the family. [ABSTRACT FROM AUTHOR]

Supportive counseling and facilitated referrals to support organizations have shown positive effects on mental health and coping with domestic and family violence. However, the reasons why and how such effects are significant remain unknown. The current paper used data from a randomized controlled trial of a psychosocial intervention implemented in Nepal among 140 abused pregnant women. The hypothesized mediating effects of self‐efficacy and social support on mental health and quality of life of abused pregnant women were tested using serial mediation analyses. Significance of parameter estimates and bias‐corrected 95% confidence intervals (CIs) for the indirect effects were generated using bootstrapping. The postintervention changes in self‐efficacy and social support were found to have significant mediating effects on the relationship between the intervention and changes in both mental health and quality of life of participants post intervention. The positive effects on outcomes were seen at follow‐up as well, though to a lesser extent. Further interventions should focus on enhancing abused women's self‐efficacy and social support to ensure their positive mental health and better lives. [ABSTRACT FROM AUTHOR]

Background: Young adults with type 1 diabetes (T1D) face complex health challenges, including a heightened risk for distress. To counter this distress, there is a need to develop accessible, acceptable comprehensive care solutions that integrate diabetes and mental health care to enhance self‐efficacy and counter mental health challenges in this population. Objective: To describe the engagement of individuals with lived experience of T1D and mental health challenges in the development of a recruitment strategy to support the co‐design of an innovative integrated care programme. Results: Seven individuals with lived experience formed a Partner Advisory Council (PAC) to recruit young adults (18–29 years old) living with T1D, their friends or family and health researchers and professionals in co‐design interviews (n = 19) and co‐design events (n = 12). The PAC played a key role in developing a comprehensive recruitment strategy, overcoming traditional barriers and stigmas in the design of an integrated model of care. Conclusion: Assuming the presence of mental health challenges in young adults living with T1D during recruitment had far‐reaching impacts on the development of a whole‐person and integrated diabetes and mental health care solution. The efficient recruitment of this sample provided invaluable insights into the nuanced challenges experienced by young adults with T1D, the individual skills developed in response to their mental health challenges and the ways that this understanding can shape future programming to support mental health, quality of life and well‐being. The ongoing involvement of the PAC as co‐researchers underscores the enduring impact of patient engagement in developing integrated care solutions. Patient or Public Contribution: The co‐design of the TECC‐T1D3 model was enriched by the invaluable contributions of individuals with lived experience. This included the engagement of a diverse PAC in the recruitment of participants in co‐design interviews and co‐design events. PAC members actively participated in research decision‐making with their insights informing a robust recruitment strategy. Beyond recruitment, PAC members continue to serve as co‐researchers, shaping ongoing research and actively contributing to the TECC‐T1D3 project. Six PAC members are co‐authors on this manuscript. [ABSTRACT FROM AUTHOR]

Background: High‐income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly conditional and stringent in recent decades based on the premise that transitioning people from government support to paid work will improve their circumstances. However, many people end up with low‐paying and precarious jobs that may cause more poverty because they lose benefits such as housing subsidies and health and dental insurance, while incurring job‐related expenses. Conditional assistance programs are also expensive to administer and cause stigma. A guaranteed basic income (GBI) has been proposed as a more effective approach for alleviating poverty, and several experiments have been conducted in high‐income countries to investigate whether GBI leads to improved outcomes compared to existing social programs. Objectives: The aim of this review was to conduct a synthesis of quantitative evidence on GBI interventions in high‐income countries, to compare the effectiveness of various types of GBI versus "usual care" (including existing social assistance programs) in improving poverty‐related outcomes. Search Methods: Searches of 16 academic databases were conducted in May 2022, using both keywords and database‐specific controlled vocabulary, without limits or restrictions on language or date. Sources of gray literature (conference, governmental, and institutional websites) were searched in September 2022. We also searched reference lists of review articles, citations of included articles, and tables of contents of relevant journals in September 2022. Hand searching for recent publications was conducted until December 2022. Selection Criteria: We included all quantitative study designs except cross‐sectional (at one timepoint), with or without control groups. We included studies in high income countries with any population and with interventions meeting our criteria for GBI: unconditional, with regular payments in cash (not in‐kind) that were fixed or predictable in amount. Although two primary outcomes of interest were selected a priori (food insecurity, and poverty level assessed using official, national, or international measures), we did not screen studies on the basis of reported outcomes because it was not possible to define all potentially relevant poverty‐related outcomes in advance. Data Collection and Analysis: We followed the Campbell Collaboration conduct and reporting guidelines to ensure a rigorous methodology. The risk of bias was assessed across seven domains: confounding, selection, attrition, motivation, implementation, measurement, and analysis/reporting. We conducted meta‐analyses where results could be combined; otherwise, we presented the results in tables. We reported effect estimates as standard mean differences (SMDs) if the included studies reported them or provided sufficient data for us to calculate them. To compare the effects of different types of interventions, we developed a GBI typology based on the characteristics of experimental interventions as well as theoretical conceptualizations of GBI. Eligible poverty‐related outcomes were classified into categories and sub‐categories, to facilitate the synthesis of the individual findings. Because most of the included studies analyzed experiments conducted by other researchers, it was necessary to divide our analysis according to the "experiment" stage (i.e. design, recruitment, intervention, data collection) and the "study" stage (data analysis and reporting of results). Main Results: Our searches yielded 24,476 records from databases and 80 from other sources. After screening by title and abstract, the full texts of 294 potentially eligible articles were retrieved and screened, resulting in 27 included studies on 10 experiments. Eight of the experiments were RCTs, one included both an RCT site and a "saturation" site, and one used a repeated cross‐sectional design. The duration ranged from one to 5 years. The control groups in all 10 experiments received "usual care" (i.e. no GBI intervention). The total number of participants was unknown because some of the studies did not report exact sample sizes. Of the studies that did, the smallest had 138 participants and the largest had 8019. The risk of bias assessments found "some concerns" for at least one domain in all 27 studies and "high risk" for at least one domain in 25 studies. The risk of bias was assessed as high in 21 studies due to attrition and in 22 studies due to analysis and reporting bias. To compare the interventions, we developed a classification framework of five GBI types, four of which were implemented in the experiments, and one that is used in new experiments now underway. The included studies reported 176 poverty‐related outcomes, including one pre‐defined primary outcome: food insecurity. The second primary outcome (poverty level assessed using official, national, or international measures) was not reported in any of the included studies. We classified the reported outcomes into seven categories: food insecurity (as a category), economic/material, physical health, psychological/mental health, social, educational, and individual choice/agency. Food insecurity was reported in two studies, both showing improvements (SMD = −0.57, 95% CI: −0.65 to −0.49, and SMD = −0.41, 95% CI: −0.57 to −0.26) which were not pooled because of different study designs. We conducted meta‐analyses on four secondary outcomes that were reported in more than one study: subjective financial well‐being, self‐rated overall physical health, self‐rated life satisfaction, and self‐rated mental distress. Improvements were reported, except for overall physical health or if the intervention was similar to existing social assistance. The results for the remaining 170 outcomes, each reported in only one study, were summarized in tables by category and subcategory. Adverse effects were reported in some studies, but only for specific subgroups of participants, and not consistently, so these results may have been due to chance. Authors' Conclusions: The results of the included studies were difficult to synthesize because of the heterogeneity in the reported outcomes. This was due in part to poverty being multidimensional, so outcomes covered various aspects of life (economic, social, psychological, educational, agency, mental and physical health). Evidence from future studies would be easier to assess if outcomes were measured using more common, validated instruments. Based on our analysis of the included studies, a supplemental type of GBI (provided along with existing programs) may be effective in alleviating poverty‐related outcomes. This approach may also be safer than a wholesale reform of existing social assistance approaches, which could have unintended consequences. [ABSTRACT FROM AUTHOR]

Aim: This study focuses on the fathers of children with chronic illnesses in an effort to clarify how the stressor and the father's sense of coherence (SOC) influence their mental health and how the father's SOC is associated with the social support. Design: Cross‐sectional study. Methods: We conducted a self‐reported questionnaire survey of 137 respondents (51 fathers of children with chronic illnesses, 86 fathers of healthy children) were statistically using ANOVA. Results: The fathers' stressor was significantly related to their SOC. Furthermore, the SOC of the fathers majorly influenced their mental health, while having a buffering effect on the stressor with respect to depression. And their SOC was significantly positively associated with the social support. Our findings underscore that father's SOC has a buffering effect on self‐mental health and is important for maintaining mental health and enhancing SOC to reduce the stressors of these fathers with respect to depression. [ABSTRACT FROM AUTHOR]

Background: Rates of physical activity decline throughout adolescence, and evidence indicates that this has an adverse impact on psychological health. This paper aims to synthesise available evidence for physical activity interventions on the mental health and well‐being of young people (11–19 years) from the general population. Method: Nine databases were searched to identify studies published between January 2005 and June 2020: Web of Science, ProQuest Psychology Journals, PsycINFO, Pub Med, ASSIA, CINHAL PLUS, SPORTDiscus, EMBASE and Wiley Online Library. Key search terms included 'physical activity intervention', 'mental health' and 'adolescen*'. Eligible studies were independently screened by two authors based on inclusion/exclusion criteria. Results: Twenty‐eight interventions were narratively synthesised in four categories: Quality of Life (QOL), self‐esteem, psychological well‐being and psychological ill‐being (e.g. depression, stress). A large proportion (67.9%) of interventions were multicomponent and combined physical activity with other features such as health education (e.g. nutrition). However, only a limited number (N = 5) specifically addressed mental health. Findings suggest that interventions are useful in improving psychological well‐being and QOL, yet evidence for self‐esteem is mixed. Conclusions: Although effectiveness in improving well‐being is evident, evidence for a reduction in the frequency and severity of mental health problems is less clear. A summary of the overall impact of physical activity interventions on the mental health of young people is presented. [ABSTRACT FROM AUTHOR]

Aims: There are sex differences in the excess risk of diabetes‐associated cardiovascular disease. However, it is not clear whether these sex differences exist with regard to other complications like mental health aspects. Therefore, we investigated sex differences in the association of prediabetes and type 2 diabetes (T2D) with cognitive function, depression, and quality of life (QoL). Materials and Methods: In a population‐based cross‐sectional cohort study (n = 7639; age 40–75 years, 50% women, 25% T2D), we estimated sex‐specific associations, and differences therein, of prediabetes and T2D (reference: normal glucose metabolism) with measures of cognitive function, depression, and physical and mental QoL. Sex differences were analysed using multiple regression models with interaction terms. Results: In general, T2D, but not prediabetes, was associated with higher odds of cognitive impairment, major depressive disorder, and poorer QoL. The odds ratio (OR) of cognitive impairment associated with T2D was 1.29 (95% CI: 0.96–1.72) for women and 1.39 (1.10–1.75) for men. The OR of major depressive disorder associated with T2D was 1.19 (0.69–2.04) for women and 1.68 (1.02–2.75) for men. The mean difference of the physical QoL score (ranging from 0 to 100, with 100 indicating the best possible QoL) associated with T2D was −2.09 (−2.92 to −1.25) for women and −1.81 (−2.48 to −1.13) for men. The mean difference of the mental QoL score associated with T2D was −0.90 (−1.79 to −0.02) for women and −0.52 (−1.23 to 0.20) for men. There was no clear pattern of sex differences in the associations of either prediabetes or T2D with measures of cognitive function, depression, or QoL. Conclusions: In general, T2D was associated with worse cognitive function, depression, and poorer QoL. The strength of these associations was similar among women and men. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the mental health of siblings of children with physical illness (PI), with or without co‐occurring mental illness. Methods: The sample included children aged 2 to 16 years with a chronic PI and their aged‐matched healthy siblings (n = 169 dyads). Physical–mental comorbidity (PM) was present if children screened positive for ≥1 mental illness on the Mini International Neuropsychiatric Interview for Children and Adolescents. Parents completed the Strengths and Difficulties Questionnaire (SDQ) to measure child and sibling mental health. Results: Within child–sibling dyads, siblings of children with PI had significantly worse mental health related to conduct problems (d = 0.31), peer problems (d = 0.18) and total difficulties (d = 0.20). Siblings of children with PM had significantly better mental health related to emotional problems (d = 0.42), hyperactivity/inattention (d = 0.23) and total difficulties (d = 0.32). Siblings of children with PI had similar mental health compared with child population norms used in the development of the SDQ. In contrast, siblings of children with PM had significantly worse mental health across all SDQ domains, with the exception of prosocial behaviour. After adjusting for parent psychopathology and family functioning, no statistically significant differences between siblings of children with PM versus siblings of children with PI were found. Conclusions: Differences in mental health exist between children with PI or PM versus their healthy siblings. However, differences between siblings of children with PI versus siblings of children with PM can be explained by parental and family factors (e.g. marital status, education and income). Findings reinforce family‐centred care approaches to address the needs of children with PI or PM and their families. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta‐analysis aimed to synthesize the outcomes of theory‐based nursing interventions for coronary heart disease management. Design and Methods: Web of Science, Scopus, Science Direct, and PubMed databases were electronically searched from January 2013 to August 2021. The Preferred Reporting Item for Systematic Reviews and Meta‐analyses statement guidelines was followed for this meta‐analysis. Randomized controlled trials on patients with coronary heart disease, using a theory‐based nursing intervention were eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p‐values, and fixed or random‐effect models (PROSPERO registration number X). Findings A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta‐analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD = 8.7) years. This meta‐analysis found theory‐based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life. Conclusions: The evidence from this meta‐analysis reveals that theory‐based nursing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well‐designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory‐based nursing interventions on patient outcomes in the CHD population. Clinical relevance: Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta‐analysis provides insights into the implementation of theory‐based nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory‐based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia is a complex pain‐focused syndrome. Previous studies showed that Cannabis is efficacious in promoting sleep, deepening and lengthening the sleep cycle, and good pain relief (compared with the SSRIs and SNRIs). Purpose: This study aimed to use the World Health Organization Quality of Life Bref questionnaire (WhoQoL‐bref) to characterize the impact of Cannabis Treatment initiation on the quality of life in women suffering from treatment‐resistant fibromyalgia. Methods: A prospective cohort study involving 30 women aged 18–70 years old diagnosed with fibromyalgia, exhausted pharmacological fibromyalgia treatment, and started Cannabis treatment. Pregnant women were excluded. WhoQoL‐bref was filled before Cannabis treatment initiation and 1 month following treatment. Results: Women's average age was 46 years (±5), with a poor general quality of life (1.47 ± 0.63), poor general health (1.47 ± 0.78), pain and discomfort, and dependence on medication (3.77 ± 1.3 and 3.07 ± 1.74, respectively) prior to Cannabis intervention. Cannabis treatment for 30 days showed a marked improvement in general quality of life (1.97 scores, p < 0.01), general health (1.83, p < 0.01), physical health (1.5, p < 0.01), and psychological domain (1.3, p < 0.01). Financial resources and home environment were not influenced by cannabis treatment (p = 0.07, p = 0.31, respectively). Conclusion: Results suggest a potentially significant role of Cannabis in treatment‐resistant Fibromyalgia women. Early Cannabis treatment may result in a beneficial short‐term effect on the quality of life through its influence on pain, sleep, and physical and psychological domains. Further studies are still indicated to understand this potential and its long‐term beneficial impact. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effects of urinary symptoms and incontinence on quality of life in postmenopausal women. The sample of the cross‐sectional study consisted of 327 women aged 50–65 who visited primary healthcare centers between 16 April and 30 July 2018. The data were collected using a personal information form, the Urinary Symptom Profile Questionnaire (USP) and the Incontinence Quality of Life Scale (I‐QOL). The mean age of the women participating in the study was 57.89 ± 5.05. It was found that 50.5% of the women had a history of incontinence. While the total mean USP score of all women participating in the study was 4.94 ± 4.81, it was 7.98 ± 4.85 for the women with a history of incontinence. The mean total I‐QOL score was 87.09 ± 16.04 in all women and 76.95 ± 16.93 in the women with a history of incontinence. The women with a history of incontinence were found to have a strong negative correlation between their total USP and total I‐QOL scores. In this study, it was found that the quality of life of women with urinary incontinence, especially their psychosocial health, was found to be significantly affected. [ABSTRACT FROM AUTHOR]

Aim: To explore the unclear association between temporary discharge home from the palliative care unit and achievement of good death, in the background of increases in discharge from the palliative care unit. Association between experiences and circumstances of patient and family and duration of temporary discharge was also examined. Methods: This study was a secondary analysis of data from a nationwide post‐bereavement survey. Results: Among 571 patients, 16% experienced temporary discharge home from the palliative care unit. The total good death inventory score (p <.05) and sum of 10 core attributes (p <.05) were significantly higher in the temporarily discharged and stayed home ≥2 weeks group. Among all attributes, "Independent in daily activities" (p <.001) was significantly better in the temporarily discharged and stayed home ≥2 weeks group. Regarding the experience and circumstance of patient and family, improvement of patient's appetite (p <.05), and sleep (p <.05) and peacefulness (p <.05) of family caregivers, compared to the patient being hospitalized, were associated with longer stay at home after discharge. Conclusions: Patient's achievement of good death was better in the temporarily discharged and stayed home longer group, but this seemed to be affected by high levels of independence of the patient. Temporary discharge from the palliative care unit and staying home longer was associated with improvement of appetite of patients and better sleep and mental health status of family caregivers. Discharging home from palliative care unit is worth being considered even if it is temporary. [ABSTRACT FROM AUTHOR]

The proliferation of mental health research is orienting its efforts towards the exploration of psychological well‐being. One of the main burdens is the measurement challenges reported by the widely used Psychological Well‐Being Scale (PWBS), which has often been criticized for inconsistencies between the theoretical and the empirical model. A potential alternative to understand the structure of psychological well‐being is network models, which conceptualizes psychological phenomena as emerging systems of mutually connected variables. Employing exploratory graph analysis, we examined the network structure of the Spanish 29‐item PWBS in a random sample of 1,404 adults. We estimated a regularized partial correlation network using the graphical LASSO algorithm in the item and dimension level. We tested the stability of both networks and identified the most important variables of the network. The PWBS network model revealed four dimensions, with self‐acceptance, life purpose and environmental mastery clustering together. Node strength centrality suggested that self‐acceptance is the most central dimension in the psychological well‐being structure as measured by the PWBS. Despite the network model of psychological well‐being did not replicate the theoretical structure of Ryff's model, it provides a novel conceptualization of psychological well‐being and proposes target indicators for mental health interventions. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease is the third leading cause of death worldwide. Although there is currently no cure for chronic obstructive pulmonary disease, the available self‐management strategies can result in improving the symptoms, slowing the disease progression, reducing the frequency of acute exacerbations, improving the patients' quality of life and minimising health care utilisation‐associated costs. Patient activation is often considered an essential driver of self‐management; however, there are contradictory evidence about its impact on chronic obstructive pulmonary disease self‐management. Objective: This review aims to fill this gap by collating the available evidence on the effectiveness of patient activation‐driven chronic obstructive pulmonary disease self‐management interventions. Methods: Databases including MEDLINE, Academic Search Complete, CINAHL Plus, Science Citation Index, Social Sciences Citation Index, Scopus, APA PsychInfo, EMBASE and ScienceDirect were searched for randomised controlled trials of patient activation‐driven chronic obstructive pulmonary disease self‐management interventions between 2004 and July 2020. The search terms included chronic obstructive pulmonary disease, self‐management/self‐care and patient activation/patient engagement. Findings: The initial search resulted in 645 articles, and after reviewing, 10 randomised controlled trials met the inclusion and exclusion criteria. Our review found that patient activation level had a positive association with chronic obstructive pulmonary disease self‐management and clinical outcomes, and higher patient activation levels led to better outcomes. The interventions also led to moderate improvements in patient activation level. However, improved patient activation levels did not improve hospitalisation rates, quality of life and mental health. Conclusion: Our findings suggest that patient activation can be used as a reliable tool for improving chronic obstructive pulmonary disease self‐management and clinical outcomes; however, it should encompass all aspects of patient activation, especially the emotional aspect. [ABSTRACT FROM AUTHOR]

Institutional discrimination matters. The purpose of this longitudinal community‐based participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community‐based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = 15 in April and n = 14 in November). Participants reported experiencing significantly less "[when] different cultural ways of doing things were shared, the project did not support my way" from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed‐rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effectiveness of telephone motivational coaching delivered by veteran peers to improve mental health (MH) treatment engagement among veterans. Methods: Veterans receiving primary care from primarily rural VA community‐based outpatient clinics were enrolled. Veterans not engaged in MH treatment screening positive for ≥1 MH problem(s) were randomized to receive veteran peer‐delivered feedback on MH screen results and referrals plus 4 sessions of telephone motivational coaching (intervention) versus veteran peer‐delivered MH results and referrals without motivational coaching (control). Blinded telephone assessments were conducted at baseline, 8, 16, and 32 weeks. Cox proportional hazard models compared MH clinician‐directed treatment initiation between groups; descriptive analyses compared MH treatment retention, changes in MH symptoms, quality of life, and self‐care. Findings: Among 272 veterans screening positive for ≥1 MH problem(s), 45% who received veteran peer telephone motivational coaching versus 46% of control participants initiated MH treatment (primary outcome) (hazard ratio: 1.09, 95% CI: 0.76‐1.57), representing no between‐group differences. In contrast, veterans receiving veteran peer motivational coaching achieved significantly greater improvements in depression, posttraumatic stress disorder and cannabis use scores, quality of life domains, and adoption of some self‐care strategies than controls (secondary outcomes). Qualitative data revealed that veterans who received veteran peer motivational coaching may no longer have perceived a need for MH treatment. Conclusions: Among veterans with MH problems using predominantly rural VA community clinics, telephone peer motivational coaching did not enhance MH treatment engagement, but instead had positive effects on MH symptoms, quality of life indicators, and use of self‐care strategies. [ABSTRACT FROM AUTHOR]

Background: Many neuropsychiatric symptoms in persons of MCI cause negative impacts on their HRQOL. There is limited HRQOL research investigating the effect of Tai Chi on older people with MCI. Objective: To determine the effectiveness of a Tai Chi program in enhancing health‐related quality of life (HRQOL) among community‐dwelling older people with mild cognitive impairment (MCI) in Hong Kong. Methods: This was a quasi‐experimental study using a nonequivalent control group (CG) design. Four social centres for older people participated in the study, of which two centres were randomised for Tai Chi intervention and the other two were treated as control. Participants in the intervention group (IG) were arranged for a 1‐hour Tai Chi class twice weekly for 16 weeks, whereas participants in the CG were advised to join various recreational activities in the social centres as usual. For outcome evaluation, the Chinese version of the Short Form‐12 Health Survey‐Standard 1 (SF‐12) was employed to assess participants' perceived HRQOL. Results: One hundred and sixty participants were recruited (IG = 80, CG = 80). Data were collected at baseline (T0) and 16‐week post‐intervention (T1).The IG reported significant improvement in the physical health component (PCS) (p =.036), the mental health component (MCS) (p =.014), as well as several subscales of SF‐12, namely, the role‐physical (RP) (p =.044), the bodily pain (BP) (p <.001) and the vitality (VT) (p =.004) subscales, in comparison with the CG. Conclusion: The current study results extended our knowledge about Tai Chi of which the mind‐body exercise could enhance the physical and psychosocial well‐being in older people with MCI. Implications for practice: The findings have the potential to inform health and social care professionals to promote Tai Chi in community settings, as it may represent a non‐intensive and age‐fitting strategy to promote HRQOL in older people with MCI. Trial registration: NCT03404765 (Retrospectively registered January 19, 2018). [ABSTRACT FROM AUTHOR]

Background: It is important to develop self‐management behaviours in adolescents to prevent chronic kidney disease progression. Objectives: This study evaluates the effect of a self‐management program that was developed based on individual and family self‐management theory to aid adolescents with chronic kidney disease in the acquisition of competencies in the management of their disease. Design: This is a randomized controlled study. Participants: The study was conducted with 20 intervention and 20 control patients, who were treated at two hospitals in Ankara between December 2018 and May 2019. Measurements: Self‐Management Assessment Form, Paediatric Quality of Life Inventory‐Adolescent Form and clinical parameters. A training program, specific to chronic kidney disease, was administered over three sessions in a group training setting when the patients came to the clinic for follow‐up. After the training program was completed, the patients were monitored for three months through home visits once every two weeks, totalling six visits. Results: Following the application of self‐management training, a statistically significant difference was found self‐management knowledge and behaviours, quality of life and anxiety mean scores of intervention and control group (p <.05), a significant decrease in only blood urea nitrogen among the clinical parameters when compared to the control group. Conclusions: In this study, a self‐management training program was developed based on Individual and Family Self‐Management Theory, aiming to have a positive effect on the self‐management behaviours of adolescents in the cognitive and psychosocial domains. [ABSTRACT FROM AUTHOR]