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Aim: Studies of the effects of COVID‐19, especially post‐acute COVID‐19 syndrome, on psychological health in non‐severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality‐of‐life in three groups of outpatients, hospitalized and intensive care patients. Methods: A total 276 patients, previously confirmed with SARS‐CoV‐2 infection, attending the COVID‐19 follow‐up outpatient clinic from December 2020 to July 2021 were interviewed face‐to‐face. In this cross‐sectional, retrospective study, all participants were asked our self‐designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL‐BREF survey to evaluate quality of life. Results: In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post‐traumatic stress disorder symptoms at a rate of 28.6% and obsessive‐compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID‐19 infection had a higher risk of developing psychological symptoms and decreased quality of life. Conclusion: COVID‐19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness. Summary statement: What is already known about this topic? Post‐intensive care syndrome affects physical, cognitive and psychological health.It is associated with symptoms such as generalized weakness, memory disturbances, cognitive function impairment, depression, anxiety and post‐traumatic stress disorder.Some physical and psychological symptoms persist for over 12 weeks in some patients and have been classified as 'Post‐acute COVID‐19 Condition or Syndrome' (PCS). What this paper adds? At the post‐acute‐COVID‐19 period, a considerable number of outpatients with COVID‐19 infection were at higher risk for psychological distress symptoms than those who had been treated in the hospital or intensive care unit.Depression, anxiety, panic disorder and PTSD symptoms were found to be higher in outpatients and those with these symptoms were also shown to have a lower quality of life.Our findings highlight the significant psychological impact of COVID‐19 on patients, even after their reported recovery from the acute manifestations of this disease. The implications of this paper: Ongoing psychological symptoms in the post‐COVID period are not associated with the severity of the disease in the acute phase.It is important that healthcare professionals are equally concerned not only with physical condition of post‐COVID‐19 patients but also with their psychological state and the patient's psychology‐related quality of life. [ABSTRACT FROM AUTHOR]

Aims: This study aims to examine the prevalence of anxiety symptoms and identify predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners and explore the mediating role of marital satisfaction between maternal and paternal anxiety. Design: A cross‐sectional study was conducted in Guangzhou, China, from July 2021 to May 2022. Methods: A total of 306 dyads of pregnant women with gestational diabetes mellitus and their partners completed the State–Trait Anxiety Inventory, Locke–Wallace Marital Adjustment Test and the socio‐demographic and clinical data sheet. Results: The prevalence of anxiety symptoms was 32.4% and 36.6% in pregnant women with gestational diabetes mellitus and their partners, respectively. The predictors of maternal anxiety were paternal anxiety, maternal marital satisfaction, maternal monthly salary, fasting glucose value and 1‐h glucose value. By contrast, the predictors of paternal anxiety were maternal anxiety, paternal marital satisfaction and paternal monthly salary. Moreover, the relationship between maternal and paternal anxiety was mediated by marital satisfaction. Conclusions: The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other, and this relationship was mediated by marital satisfaction. Every couple should be screened for anxiety symptoms and treated as a team rather than focusing solely on the pregnant woman. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with various short‐ and long‐term adverse maternal and neonatal outcomes.The diagnosis of gestational diabetes mellitus is stressful for pregnant women and their partners.No studies have been conducted to examine and compare the anxiety symptoms among pregnant women with GDM and their partners in mainland China. What this paper adds? The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other.The prevalence of anxiety symptoms was high in both pregnant women with gestational diabetes mellitus and their partners.Marital satisfaction played a mediating role between maternal and paternal anxiety. The implications of this paper: Study findings provide important information to guide future practice for nurses and other health‐care professionals.For the future, routine screening for anxiety symptoms is necessary for both pregnant women with gestational diabetes mellitus and their partners; mental health support should be delivered in a timely fashion for couples.Pregnant women with gestational diabetes mellitus and their partners should be treated as a team rather than focusing solely on pregnant women, with couples given training on enhancing marital satisfaction skills to prevent and reduce their anxiety symptoms. [ABSTRACT FROM AUTHOR]

Aim: This study examined the feasibility of integrating actigraphy devices into orthopaedic surgical settings to assess the concurrent validity between objective actigraphy data and PROMIS measures. Additionally, the association between changes in actigraphy data and longitudinal changes in PROMIS measures was examined. Methods: Data were collected from 17 participants using actigraphy devices the week prior to and after orthopaedic surgery from 02/2019 to 03/2020. Participants completed PROMIS measures (Physical Function, Sleep Disturbance, Pain Interference) preoperatively and up to 6 months postoperatively. Nonparametric correlations (rs) assessed for concurrent validity. Linear mixed‐effects models examined the association between changes in actigraphy data and PROMIS measures. Results: Prolonged wake after sleep onset was associated with increased sleep disturbances (rs = 0.49; p = 0.045) and pain interference (rs = 0.51; p = 0.04). Changes in pain interference were correlated with increased awakenings (rs = 0.54; p = 0.03). Increased wake after sleep onset was associated with worsening sleep disturbance (β = 0.12; p = 0.01) and pain interference scores over the postoperative period (β = 0.12; p = 0.02). Conclusions: This study is among the first to examine changes in objective actigraphy data and longitudinal PROMIS measures following orthopaedic surgery and illustrates the feasibility of incorporating actigraphy into surgical settings to evaluate postoperative recovery. Summary statement: What is already known about this topic? Actigraphy activity and sleep monitoring, paired with robust patient‐reported outcomes, may provide a means by which providers can better understand the patient experience and barriers to recovery after surgery.Often postoperative recovery is only assessed using patient‐reported outcomes (e.g. PROMIS measures), despite consensus groups recommending pairing assessments with objective assessments to better estimate risks for poor postoperative outcomes.Previous studies integrating actigraphy and PROMIS measures together have predominately been limited to paediatric populations or over shorter postoperative periods.What this paper adds? Participants were found to return to preoperative levels of sleep, evident by concurrent changes in both actigraphy and patient outcomes, by 1 week postoperatively.PROMIS Sleep Disturbance and Pain Interference demonstrated concurrent validity with sleep data collected from wrist worn actigraphy devices prior to and after surgery.Prolonged wake after sleep onset was associated with increased PROMIS Sleep Disturbance and Pain Interference scores, while increasing awakenings during sleep were linked to increased PROMIS Pain Interference scores.The implications of this paper: This longitudinal study not only builds upon earlier cross‐sectional investigations with comparable sample sizes that examined the validity of PROMIS measures with actigraphy sleep related data but also uniquely examines how changes in the immediate postoperative period are associated with longitudinal postoperative outcomes.Pairing patient‐reported outcomes with objective actigraphy measures can help improve data collection for nurse scientists and improve nurses' postoperative assessments to help in estimating patient's risks for poor postoperative recovery. [ABSTRACT FROM AUTHOR]

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Aim: This study was conducted to determine the effect of professional values of nurses on their attitudes towards caregiving roles. Methods: This is a cross‐sectional, correlational and descriptive study. The data were collected from 319 nurses working at different units in a public hospital between January and May 2019. The data collection tool included a 10‐question participant information form, the nursing professional values scale and the attitude scale for nurses in caregiving roles. The variables were analysed using the multiple linear regression. Results: The nurses had professional values and attitudes towards caregiving roles at high levels. Significant differences were found in the overall scales and their subscales especially due to nurses loving their profession (P < 0.05). Attitudes of the nurses towards caregiving roles were predicted by human dignity (β = 0.52, P < 0.01), action (β = 0.34, P < 0.01) and autonomy (β = −0.29, P < 0.01). Human dignity, action and autonomy accounted for 30% of the variance in their attitudes towards caregiving roles (∆R2 = 0.30). Conclusion: Scores obtained by the nurses loving their profession from the nursing professional values scale and the attitude scale for nurses in caregiving roles were higher. In addition, nurses' caregiving roles were explained with professional values. SUMMARY STATEMENT: What is already known about this topic? Professional values are the primary source of nursing practices and guide the interaction of nurses with patients, colleagues and society.Acquiring professional values enhances the quality of care.Caregiving is the oldest role of nurses forming the basis of both their traditional practices and modern nursing roles.Effectively performing the caregiving roles by nurses increases the quality of healthcare, job satisfaction and performance. What this paper adds? Total scores obtained by nurses from the nursing professional values scale and the attitude scale for nurses in caregiving roles were found to be above the average.There were significant differences between professional values and caregiving roles of the nurses in terms of their sociodemographic characteristics especially due to those loving their profession.A significant correlation was determined between professional values and caregiving roles of the nurses, and their caregiving roles were explained with professional values. The implications of this paper: Comprehending the importance of professional values directly affecting the caregiving roles of the nurses.Comprehending the importance of professional values forming the basis of professionalization and gaining these values by nurses. [ABSTRACT FROM AUTHOR]

Aim: The awareness for the need for end‐of‐life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end‐of‐life care needs of noncancer patients who were receiving care and wanted to die at home. Methods: A cross‐sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end‐of‐life care needs, in April and May, 2016. Results: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end‐of‐life care needs. Conclusion: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end‐of‐life stages. SUMMARY STATEMENT: What is already known about this topic? Noncancer patients at the end‐of‐life stage have complex needs and problems that are difficult to solve, compared with cancer patients.Noncancer patients need to receive effective symptom management or sufficient support for satisfactory care.End‐of‐life care is still mainly focused on cancer patients and attention to noncancer patients is lacking. What this paper adds? Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives."Duration of home care nursing and an income level were significantly associated with higher end‐of‐life care needs. The implications of this paper: Home care nurses must clearly assess the care needs of noncancer patients at the end‐of‐life stage and subsequently provide comprehensive patient‐centered care based on this assessment.It is important to adjust the care direction between patient, family, and medical staff from early on for patients who want to die at home.The results highlight needs for the development of interventions that focus on the duration of home care nursing of patients. [ABSTRACT FROM AUTHOR]

This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ2(340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ2(335) = 8681.61, P < .05) but the other indices showed improvement (RMSEA = .058 [90% CI, 0.057-0.059], TLI = .891, CFI = .903, and SRMR = .059). The discriminating power of the J-CCCHS was indicated by statistically mean differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence and identify the predictors of breakfast skipping among 14‐ to 16‐year‐old adolescents in Jordan, focusing on mother‐related variables. Background: Breakfast is an essential meal across one's entire lifespan and especially important during the adolescent years. The practice of skipping breakfast has become so prevalent among adolescents that it is now a well‐documented nutritional problem. Design A descriptive cross‐sectional correlational design. Methods: A proportional cluster stratified sampling protocol was used to select 1896 adolescents and their mothers (1013) during the period of March to June 2016. A self‐reported questionnaire was used to collect data on breakfast‐skipping rates, the perceived reasons for this behavior, the perceived importance of consuming breakfast, and maternal encouragement of breakfast consumption. Results: The prevalence of breakfast skipping was 34.3% among adolescents and 21.5% among their mothers. A significant association was found between breakfast skipping among adolescents and their mothers (χ2 [1, n = 998] = 37.90, P =.001). Maternal encouragement of breakfast consumption, gender, and adolescent perception of the importance of this meal were found to be significant predictors of adolescent breakfast skipping. Conclusion: The findings highlight the importance of involving mothers in developing nutritional health plans aimed at promoting regular breakfast consumption among adolescents. SUMMARY STATEMENT: What is known about the topic? Regular breakfast intake has been linked to positive benefits for adolescent health, including lower risk for obesity and fewer biomarkers of chronic illness.The practice of skipping breakfast is highly prevalent among adolescents, both in Jordan and across the globe.Parental eating habits and attitudes influence adolescent eating behaviors and attitudes. What the paper adds? Female adolescents in Jordan skipped breakfast more often than male adolescents and to a significant degree. For both groups, lack of appetite was reported as the main reason (39%) for skipping breakfast.The interrelationships found between maternal and adolescent variables related to breakfast consumption highlight the pivotal role of mothers in promoting this practice. When mothers valued eating breakfast, so did their adolescent children, a relation that translated into lower rates of breakfast skipping among the adolescents.Maternal encouragement of breakfast consumption, the adolescents' perceived value of this practice, and their gender proved significant predictors of breakfast skipping behavior. The implications of this paper: Health interventions to promote breakfast consumption among adolescents are likely to be more effective if based on a better understanding of the role of mothers in this regard.Nurses should involve mothers in developing nutritional health plans to promote regular breakfast consumptions among adolescents.Nurses should educate mothers and adolescents about the health costs for adolescents associated with skipping breakfast. [ABSTRACT FROM AUTHOR]

Aim: The aim of this research was to investigate the effect of urinary incontinence on body image, self‐esteem, and quality of life. Methods: The study was conducted with 218 women with urinary incontinence. The study data were collected using the Socio‐Demographic Characteristics Questionnaire, Body Cathexis Scale, Rosenberg Self‐Esteem Scale, and Incontinence Quality of Life Questionnaire. Results: There was a weak, statistically significant, positive relationship found between the Body Cathexis Scale total average scores and the Rosenberg Self‐Esteem Scale total average scores of the women and a weak, statistically significant, negative relationship with the Incontinence Quality of Life Questionnaire total average scores. In addition, a weak, statistically significant, negative relationship was found between the Rosenberg Self‐Esteem Scale total score averages and Incontinence Quality of Life Questionnaire total score averages. Significant effects were seen for body image score with pad usage; for self‐esteem in relation to number of deliveries, duration, and frequency of urinary incontinence; and for incontinence quality of life and duration and frequency of urinary incontinence and pad usage. Conclusions: It was concluded that most of the women with urinary incontinence had negative body image and that more than half of them had moderate or low self‐esteem and a moderate quality of life. SUMMARY STATEMENT: What is already known about this topic? More than 200 million people in the world have incontinence problems, and the majority are women.Urinary incontinence causes negative psychosocial effects such as continuous leakage of urine and fear of smelling bad, feeling unclean, decreased self‐esteem, deterioration of body image, stigmatization, embarrassment, and decreased sexual desire.There are very few studies in the literature that determine the relationship between body image and self‐esteem in women with urinary incontinence. What this paper adds? Negative effects were demonstrated for urinary incontinence in relation to women's body image, self‐esteem, and quality of life. The implications of this paper: Urinary incontinence does not directly threaten women's lives but can become a problem that physically and psychologically affects the family and social life of a woman significantly; therefore, women with incontinence should be carefully considered and evaluated from a holistic viewpoint.Nurses should assess the emotions, thoughts, and perceptions of body image, self‐esteem, and quality of life of women with urinary incontinence, and as the awareness about urinary incontinence and its treatment increases, the population of patients receiving help will increase, thus increasing the success rate in urinary incontinence management. [ABSTRACT FROM AUTHOR]

Aim: Nurses play an essential role in improving health‐related knowledge and self‐efficacy of patients through health education. This study aimed to investigate the effects of message‐framed informational videos on diabetes management knowledge and self‐efficacy in patients with type 2 diabetes. Methods: A quasi‐experimental pretest and posttest design with two experimental and one standard care comparison groups was carried out to examine the effects of the message‐framed videos. The two message‐framed informational videos were developed to provide health teachings about diabetes self‐care. The knowledge and self‐efficacy of the two video groups and lecture comparison group were measured before and after the intervention using valid and reliable instruments established by the authors. Results: After the intervention, the knowledge and self‐efficacy of the two experimental groups were significantly higher than the comparison group. No significant difference was found in the knowledge scores between the two experimental groups, but a significant difference was noted in the average increase in their self‐efficacy. Conclusion: Message‐framed informational videos can be effective in increasing the diabetes management knowledge and self‐efficacy, and a gain‐framed rather than loss‐framed approach can be superior in increasing self‐efficacy. SUMMARY STATEMENT: What is already known about this topic? The use of an informational video in providing health education to patients improves retention of information.Message framing may be used to provide health‐related information effectively regarding gains and losses of behavioural changes among patients. The majority of the literature has focused on the moderating effects of self‐efficacy on message framing.There is a dearth in message framing research in the nursing literature particularly in a patient setting with high risk for actual health problems like type 2 diabetes. Limited work has reported the magnitude of the effect of message‐framed videos on self‐efficacy. What this paper adds? Gain‐ and loss‐framed informational videos, created to provide health teachings about diabetes self‐care management, significantly increased the diabetes management knowledge of older adults with type 2 diabetes.Both message‐framed informational videos achieved a modest increase in diabetes management self‐efficacy of older adults with type 2 diabetes, but the gain‐framed messages were more effective than the loss‐framed ones. The implications of this paper: Nurses can use message‐framed informational videos to increase the diabetes management knowledge and self‐efficacy in patients with type 2 diabetes during health teaching. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop a simulation-based time-out learning programme targeted to nurses participating in high-risk invasive procedures and to figure out the effects of application of the new programme on acceptance of nurses. This study was performed using a simulation-based learning predesign and postdesign to figure out the effects of implementation of this programme. It was targeted to 48 registered nurses working in the general ward and the emergency department in a tertiary teaching hospital. Difference between acceptance and performance rates has been figured out by using mean, standard deviation, and Wilcoxon-signed rank test. The perception survey and score sheet have been validated through content validation index, and the reliability of evaluator has been verified by using intraclass correlation coefficient. Results showed high level of acceptance of high-risk invasive procedure ( P<.01). Further, improvement was consistent regardless of clinical experience, workplace, or experience in simulation-based learning. The face validity of the programme showed over 4.0 out of 5.0. This simulation-based learning programme was effective in improving the recognition of time-out protocol and has given the participants the opportunity to become proactive in cases of high-risk invasive procedures performed outside of operating room. [ABSTRACT FROM AUTHOR]

The factors affecting influenza vaccine uptake among nurses might vary between different medical facilities. The purpose of the present study was to explore factors that affect the intention of nurses at a facility to receive the influenza vaccine and whether the health belief model predicts this intention. In this cross-sectional quantitative correlational study, a convenience sample of 150 nurses employed at a large facility in central Israel completed a questionnaire based on the health belief model. Data collection took place between January and February of 2016. Forty-two percent of the respondents reported having been vaccinated against influenza in the current year. The health belief model explained 53% of the variance ( p < .01), with perceived (personal) benefits of the vaccine being the most significant factor. The number of times of receiving the influenza vaccine in the past was strongly correlated with the intention to receive the vaccine ( p < .01). To improve nurses' compliance with influenza vaccination at facilities, we find that it is necessary to emphasize the benefits of vaccination and, particularly, the personal benefits. Annual vaccination behavior should be promoted to make it become a routine. [ABSTRACT FROM AUTHOR]

Sleep disorders are a common problem during pregnancy and may affect quality of life. This study aimed to determine the status of sleep quality and its relationship with quality of life in Iranian pregnant women. This cross-sectional study was conducted on 565 women recruited using 2-stage cluster sampling methods. Data were collected using sociodemographic characteristics; quality of life; and Pittsburgh sleep quality questionnaire between March and May 2015. About 6% of the women had a sleep disorder. There were significant correlations between quality of life and total score of sleep quality, subdomains of habitual sleep efficiency, sleep disturbance, and daytime dysfunction. Paying attention to the sleep quality as an effective factor of quality of life can promote sleep quality and hence quality of life of pregnant women. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the lifestyle; examine the relationships among lifestyle, medical factors, and stress status; and determine the predictors of better lifestyle in heart transplant recipients in Taiwan. A prospective design with convenience sampling was used. Data were collected through the Health-Promoting Lifestyle Profile-II and demographic questionnaires, which included personal information, stress status, and medical information. Pearson correlations, 1-way analysis of variance, independent t tests, paired t tests, and hierarchical regression were used to analyze the factors related to better lifestyle. A total of 80 heart transplant recipients participated. The mean score for lifestyle decreased from baseline to 3 months and was even lower at 6 months. Nevertheless, the trend for some participants was the opposite-their lifestyle improved over the 6-month period after baseline. Notably, the trend for each of the 6 subscales was not consistent with the mean of the total score. Stress status accounted for 12.8% of lifestyle. When stress status was combined with family income and creatinine, the 3 factors accounted for 32.2% of lifestyle. This study demonstrated that maintenance of a healthy lifestyle fluctuates after transplantation. Demographic factors and stress status can help to identify people who are more likely to have a poor lifestyle. [ABSTRACT FROM AUTHOR]

We examined the effects of home-based walking on sedentary Japanese women's pregnancy outcomes and mood. A randomized controlled trial was conducted, involving 118 women aged 22-36 years. Participants were randomly assigned to walking intervention ( n = 60) or control ( n = 58) groups. The walking group was instructed to walk briskly for 30 min, three times weekly from 30 weeks' gestation until delivery. Both groups counted their daily steps using pedometers. Pregnancy and delivery outcomes were assessed, participants completed the Profile of Mood States, and we used the intention-to-treat principle. Groups showed no differences regarding pregnancy or delivery outcomes. The walking group exhibited decreased scores on the depression-dejection and confusion subscales of the Profile of Mood States. Five of the 54 women in the intervention group who remained in the study (9.2%) completed 100% of the prescribed walking program; 32 (59.3%) women completed 80% or more. Unsupervised walking improves sedentary pregnant women's mood, indicating that regular walking during pregnancy should be promoted in this group. [ABSTRACT FROM AUTHOR]

A cluster randomized controlled trial showed that the Resident Assessment Instrument ( RAI) could not improve or stabilize the health status of people in need of long-term care or reduce the rate of institutionalization in Germany among clients of home care agencies. The aim of this article is to investigate whether the effect of RAI depends on the degree of implementation. A factor analysis was used to distinguish between those agencies that implemented RAI intensively and those that did not. The clients of home care agencies working intensively with RAI were significantly less hospitalized ( P = 0.0284) and fared slightly better according to activities of daily living ( ADL, instrumental ADL ( IADL)), cognitive skills (Mini-Mental Status Test ( MMST)) and quality of life (EuroQol ( EQ-5 D)) compared with the control group. In contrast, those not working intensively with RAI had worse outcomes ( IADL, MMST, EQ-5 D) than the control group (not significant). It is important to guarantee a successful implementation of RAI. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the cluster dyads of risk factors and symptoms and their impact on the incidence of 12 month major adverse cardiac events ( MACEs) among patients with first-time myocardial infarction ( MI). In a descriptive study, a total of 522 patients completed semi-structured interviews for data on risk factors and symptoms. Patients were followed for 12 months to determine MACEs. Latent class cluster analysis was performed to identify risk factor clusters and symptom clusters. Logistic regression analysis was performed to determine the impact of cluster dyads on 12 month MACEs. There were 436 event-free survivors and 86 patients with MACEs for 12 months. Ten risk factors and 14 symptoms were clustered into two (dyslipidemia/smoking, hypertension/diabetes dominant) and three (typical, multiple, atypical) memberships, respectively. Six cluster dyads which were generated based on the association between risk factors and symptom clusters were a significant predictor of 12 month MACEs, with the incidence occurring three times higher in a dyad of hypertension/diabetes-and-atypical symptoms than a dyad of dyslipidemia/smoking-and-typical symptoms (odds ratio = 3.10, P = 0.01), after adjustment for age, gender and a type of MI diagnosis. The information on cluster dyads suggests that health-care providers need to consider both risk factors and symptoms at hospital presentation for risk stratification to prevent adverse outcomes. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the effects of preoperative fasting and fluid limitation in patients undergoing laparoscopic cholecystectomy. Although traditional long-term fasting is not recommended in current preoperative guidelines, this is still a common intervention. Visual analogue scale was used to assess hunger, thirst, sleepiness, exhaustion, nausea and pain; State and Trait Anxiety Inventory was used to assess the preoperative anxiety of 99 patients undergoing elective laparoscopic cholecystectomy. Mean time of preoperative fasting and fluid limitation were, respectively, 14.70 ± 3.14 and 11.25 ± 3.74 h. Preoperatively, 58.60% of the patients experienced moderate anxiety. Patients fasting 12 h or longer had higher hunger, thirst, nausea and pain scores. The mean trait anxiety score of patients fasting 12 h or longer was statistically significantly higher. Receiving nothing by mouth after midnight preoperatively is a persisted intervention and results in discomfort of patients. Clinical protocols should be revised and nurses should be trained in current fasting protocols. [ABSTRACT FROM AUTHOR]