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Caregivers promote heart failure self-care, yet little is known about how relationship quality and dyad gender influences self-care. The purpose of this study was to evauluate the contribution of dyad gender and relationship quality on heart failure self-care. The study was a secondary analysis from a heart failure self-care intervention. Dyad gender was categorized by patient-caregiver gender as Male-Male (M + M), Female-Female (F + F), Female-Male (Fp + Mc), and Male-Female (Mp + Fc). The Self-Care of Heart Failure Index v.6.2 measured self-care. The Mutuality Scale assessed relationship quality. Univariate linear regression identified determinants of patient self-care maintenance and self-efficacy. The sample (n = 503) was 48% Mp + Fc, 27% F + F, 15% Fp + Mc, and 10% M + M. Better caregiver mutuality in M + M dyads was associated with lower self-care maintenance (b = −7.45, 95% CI [−13.80, −1.11]) and self-efficacy (b = −18.07, 95% CI [−29.11, −7.04]). Better patient mutuality was associated with higher self-efficacy for M + M dyads (b = 12.63, 95% CI [2.18, 23.09]). Mutuality and dyad gender appear important for self-care. Consider the role of gender in the dyad in behavioral interventions. [ABSTRACT FROM AUTHOR]

A retrospective cohort study of hospital-acquired pressure injuries (HAPI) reported an incidence rate of 34.3% based on 582 medical records of adult patients admitted to the intensive care unit (ICU) of a medium-complexity public hospital in 2017 and 2018. Sixty percent of the patients used respirators, 49.3% presented hypotension, and 48.1% used norepinephrine. The main individual predictors of HAPI in the ICU were "days of norepinephrine" with an odds ratio (OR) of 1.625 (95% CI: 1.473–1.792) and concordance statistic (AUC) of 0.818 (95% CI: 0.779–0.857), "days of mechanical ventilation" with an OR of 1.521 (1.416–1.634) and AUC of 0.879 (0.849–0.909), "ICU stay (days)" with an OR of 1.279 (1.218–1.342) and AUC of 0.846 (0.812–0.881), and "Braden's sensory perception" with an OR of 0.345 (95% CI: 0.278–0.429) and AUC of 0.760 (0.722–0.799). The duration of mechanical ventilation, norepinephrine administration, and ICU length of stay presented significant discriminative capacity for HAPI prediction. [ABSTRACT FROM AUTHOR]

The intrinsically adaptive or maladaptive nature of certain activity patterns in fibromyalgia (FM) has been put into question. The role of contextual factors related to their influence on functional limitation is required. Perfectionism complicates the ability to cope of these patients. The aim of the study has been to analyze the moderating role of perfectionism between activity patterns and functional limitation. The sample were 228 women with FM. Moderation analyses were conducted with the PROCESS Macro. Activity avoidance and excessive persistence were associated with poorer functionality, regardless of perfectionism. Pain avoidance and task persistence were more strongly associated with FM impact in women with high or moderate levels of perfectionism. In a clinical setting adapting the recommendations given to patients according to their level of perfectionism would be justified. Pain avoidance might be inadvisable at high levels of perfectionism, and task persistence is recommendable especially when perfectionism is high. [ABSTRACT FROM AUTHOR]

Identifying those at risk of poor outcomes after hospital discharge is a central focus of health care systems. Our purpose was to better understand whether and how patient- and nurse-assessed readiness for discharge (Pt- and RN-RHDS) is related to patient experiences after discharge. We conducted a prospective survey of 70 Veterans and their assigned nurses on the day of, and again with Veterans 2 weeks after, hospital discharge. The predictive model for post-discharge coping difficulty included educational level (p = .05) and an interaction between Pt-RHDS ratings and Pt-RN RHDS discordance (p = .01). The predictive model for patient-reported quality of hospital to home transition experience included Pt-RN RHDS discordance and an interaction between Pt-RHDS and the number of people living with the patient (p = .05). Our findings demonstrate that agreement between Pt -and RN-RHDS may be an important measure in work aiming to improve patient outcomes post-hospitalization. [ABSTRACT FROM AUTHOR]