Empowering educational actions of nurses for patients with long-term health problems: an integrative review

Objective:The mental health of children living in low-income countries remains a neglected research area despite the high burden of disease. This study is one of the first that examines the...

The association between childhood physical disability or long-term health problems and depression among adolescents in China: Mediating effect of childhood maltreatment.

Objective: To examine the characteristics of women with antenatal or postnatal anxiety and to investigate aspects of their care that may be associated with it. Background: Positive outcomes following childbirth are associated with good physical and mental health during pregnancy and following childbirth. Although a degree of anxiety is normal in pregnancy, for some women it can become a serious problem. Methods: This study used data on 5332 women from a 2010 national maternity survey which asked about antenatal and postnatal health and well-being three months after childbirth. Women self-identified as experiencing anxiety and other problems during pregnancy and the postnatal period. Results: Antenatal anxiety was reported by 14% of women and postnatal anxiety by 5% of women. Antenatal anxiety was associated with younger age, Black and Minority Ethnic status, single parenthood, living in a disadvantaged area, having an unwanted pregnancy and long-term health problems. Of these factors, only long-term mental health problems were associated with anxiety in the postnatal period. In the logistic regression models long-term mental health problems dominated the findings. Significant differences in the perceptions of the care experienced were evident in the responses from women with anxiety both antenatally and postnatally. Conclusions: This study shows that antenatal and postnatal anxiety are influenced by health and social factors. Asking women about their current physical and psychological health and past history during pregnancy and following up on their well-being in the postnatal period is an essential element in planning and providing care to meet their needs.

Introduction: Ageing is often associated with multiple long-term health problems influencing older persons’ well-being in daily living. It is not unusual that the point of interest in research is often on the management of the actual health problem instead of being holistic and person-centred. Purpose: To describe the phenomenon of living with long-term health problems that influence daily living, from the older persons’ perspective. Methods: Qualitative individual interviews were conducted with 34 older persons living with long-term health problems. The data were analysed using a Reflected Lifeworld Research (RLR) approach, grounded in phenomenology. Results: Life with long-term health problems entails living in a diminishing world. It entails living in uncertainty, not being able to trust one’s own ability. The freedom to make decisions of your own is deprived by relatives and health-care providers. Living with long-term health problems entails being dependent on support in daily life and a strive to maintain meaningfulness in daily living. Conclusions: The results address a need for extended individual and holistic guidance and support in living with long-term health problems to increase the older person’s sense of well-being and meaning in life.

BackgroundNon-medical use of prescription opioids (NMUPO), defined as taking an opioid in a manner or dose other than prescribed, taking someone else’s, or for the feelings that it produces, has been reported by 5 to 20% of adolescents, and is associated with a two fold increase in suicidal behaviors among adolescents. Adolescents with long-term health problems (LTHP) have poorer mental health and may seek NMUPO for pain relief that is not obtained through standard care. For this study, we measured the association between NMUPO and suicidal behaviors, and further assessed effect modification by LTHP hypothesizing the association between NMUPO and suicidal behaviors was stronger for adolescents with LTHP.FindingsFor students with LTHP, 13.5% reported suicide ideation, while 8.0% of students without LTHP reported suicide ideation. For suicide attempt, 4.4% of students with LTHP reported a suicide attempt, while 2.1% of students without LTHP reported a suicide attempt. The proportion of students who reported suicide ideation and attempts increased with higher occasions of NMUPO. Adjusted logistic regression models found increased odds of suicide ideation (OR (95% CI): 1–5 occasions: 2.3 (2.0–2.6); > 6 occasions: 2.7 (2.2–3.8)) and suicide attempts (OR (95% CI): 1–5 occasions: 3.2 (2.7–3.7); > 6 occasions: 4.1 (3.1–5.3)) for students who reported NMUPO. An interaction term for NMUPO and LTHP was then added to the models. Effect modification was not present on the multiplicative scale. On the additive scale, evidence of effect modification was observed: higher risk was indicated for students with LTHP versus no LTHP for both suicide ideation (Predicted risk (95%CI): > 6 occasions NMUPO, LTHP: 0.24 (0.18–0.29); No LTHP: 0.16 (0.13–0.18)) and attempt (Predicted risk (95%CI): 1–5 occasions NMUPO, LTHP: 0.08 (0.07–0.10); No LTHP: 0.05 (0.05–0.06); > 6 occasions NMUPO, LTHP: 0.11 (0.07–0.15); No LTHP: 0.06 (0.05–0.08)).ConclusionsThe results affirmed that NMUPO is associated with suicidal behaviors among adolescents. A pattern also emerged of higher risk of suicidal behaviors for those with LTHP who reported NMUPO. Areas of further inquiry should explore chronic medical or pain conditions as possible modifying pathways that could exacerbate the effects of NMUPO on suicidal behaviors specific to an adolescent population.

Mental health problems are common among people with rheumatological conditions and other long-term health problems. For example, depression and anxiety are significantly more prevalent among people with arthritis than in...

ObjectivesVarious mechanisms, such as immune dysregulation, viral reservoir, and auto-immunity, are hypothesized to underlie the pathogenesis of long-term health problems after hospitalization for COVID-19. We aimed to assess the effect of in-hospital COVID-19 treatments on prominent long-term health problems. MethodsIn this prospective multicenter cohort study, we enrolled patients (age ≥18 years) who had been hospitalized for COVID-19 in the Netherlands between July 2020 and October 2021. We retrospectively collected data on in-hospital COVID-19 treatments, including steroid, anti-inflammatory, and antiviral treatments. Patients completed questionnaires on self-reported recovery, dyspnea, fatigue, cognitive failures, and health-related quality of life and performed the 6-minute walk test at the 2-year follow-up visit. ResultsFive hundred two patients with COVID-19 were included, all were discharged from the hospital between March 2020 and June 2021. The median age at admission was 60.0 (IQR 53.0-68.0) years and 350 (69.7%) patients were male. At hospital admission, 5/405 (1.2%) of the patients had been vaccinated against SARS-CoV-2. Among all 502 patients, the majority (248 [49.4%]) received steroids only, 57 (11.4%) anti-inflammatory treatment, 78 (15.5%) antiviral treatment, and 119 (23.7%) none during hospitalization. Long-term health problems were common in all groups. We found that in-hospital treatments were not significantly associated with health problems at 2 years after hospital discharge, nor after adjusting for confounders. ConclusionMany patients with COVID-19 suffer from long-term health problems 2 years after hospital discharge. Acute treatment for COVID-19 is not associated with long-term health problems.

Introduction. Health condition is one of the basic factors determining the quality of life of children and adolescents. In early childhood, its poor condition is particularly dangerous as it can interfere with developmental processes and lead to long-term and permanent health problems. Chronic diseases are distinguished among the most common health diseases of children and adolescents. They constitute one of the most serious phenomena and problems of the modern world, resulting from the prevalence in the population, and above all from the consequences it causes in an individual and social sense. The catalog of chronic diseases includes: asthma, allergies, heart diseases, arterial hypertension, stroke, cancer, kidney diseases, multiple sclerosis, degenerative joint diseases and mental diseases. In Poland, the prevalence of chronic diseases in children aged 0-14 is found in 27%, and among adolescents aged 15-19 it is found in 23%. According to the age category of children, chronic disease was diagnosed in 23% of children aged 0-4; 30% – 5-9 years; 29% – 10-14 years. No systematic epidemiological studies are conducted in Poland on the occurrence of chronic diseases in the population of children and adolescents. Aim. The aim of the article is to present the epidemiology of selected chronic diseases among children and adolescents living in several cities of the Silesian Voivodeship. Material and methods. The research material is data from the Silesian Voivodship Office in Katowice – Department of Health. Tables were then drawn up that illustrate the epidemiology of the diseases discussed. Results. The lowest incidence rate of bronchial asthma was recorded in Sosnowiec in 2010 (18.2/10,000) and the highest in Bielsko-Biała in 2014 (91.1/10,000). In Bielsko-Biała and Katowice, the cancer incidence rate is increasing. Conclusions. The general health condition of Polish children (0-14 years) is moderately satisfactory, and children and adolescents from industrial areas, which include the Śląskie Voivodeship, are particularly exposed to more frequent incidence of respiratory diseases and various types of allergies. Currently, every fourth child has long-term health problems (26.1%), and they are more common in older children, among 10-14 year-olds (31.2%).

BackgroundThere is limited evidence about the impact of specific patterns of multi-morbidity on health-related quality of life (HRQoL) from large samples of adult subjects.MethodsWe used data from the English General Practice Patient Survey 2011–2012. We defined multi-morbidity as the presence of two or more of 12 self-reported conditions or another (unspecified) long-term health problem. We investigated differences in HRQoL (EQ-5D scores) associated with combinations of these conditions after adjusting for age, gender, ethnicity, socio-economic deprivation and the presence of a recent illness or injury. Analyses were based on 831,537 responses from patients aged 18 years or older in 8,254 primary care practices in England.ResultsOf respondents, 23 % reported two or more chronic conditions (ranging from 7 % of those under 45 years of age to 51 % of those 65 years or older). Multi-morbidity was more common among women, White individuals and respondents from socio-economically deprived areas. Neurological problems, mental health problems, arthritis and long-term back problem were associated with the greatest HRQoL deficits. The presence of three or more conditions was commonly associated with greater reduction in quality of life than that implied by the sum of the differences associated with the individual conditions. The decline in quality of life associated with an additional condition in people with two and three physical conditions was less for older people than for younger people. Multi-morbidity was associated with a substantially worse HRQoL in diabetes than in other long-term conditions. With the exception of neurological conditions, the presence of a comorbid mental health problem had a more adverse effect on HRQoL than any single comorbid physical condition.ConclusionPatients with multi-morbid diabetes, arthritis, neurological, or long-term mental health problems have significantly lower quality of life than other people. People with long-term health conditions require integrated mental and physical healthcare services.Electronic supplementary materialThe online version of this article (doi:10.1007/s11136-014-0820-7) contains supplementary material, which is available to authorized users.

This study explores the relationship between self-reported physical disabilities or long-term health problems and health risk behaviors or adverse health conditions (self-reported engagement in violent behaviors, attempted suicide, cigarette smoking, alcohol and other drug use, sexual activity, physical activity, dietary behaviors, self-reported overweight [based on height and weight], physical health, and mental health) among US high school students. Data were from the Centers for Disease Control and Prevention's 2005 national Youth Risk Behavior Survey, a cross-sectional paper-and-pencil survey collected from a representative sample of public and private high school students (grades 9 through 12) in the United States. Significantly more students with physical disabilities or long-term health problems than without described their health as fair or poor and reported being in a physical fight, being forced to have sexual intercourse, feeling sad or hopeless, seriously considering and attempting suicide, cigarette smoking, using alcohol and marijuana, engaging in sexual activity, using computers 3 or more hours per day, and being overweight (for all, p < or = .05). For none of the health risk behaviors analyzed were the rates significantly lower among students with physical disabilities or long-term health problems than among other students. Young people who live with physical disabilities or long-term health problems may be at greater risk for poor health outcomes. Public health and school health programs, with guidance from health care providers, need to work with these adolescents and their families to develop and implement appropriate interventions, with particular emphasis on promoting mental health.

This study investigates the impact of obesity, long-term health problems and their interaction on three specific aspects of job satisfaction among Australian adult workers. Exploiting longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey for the years 2006-2017, this study estimates overall job satisfaction, pay satisfaction and job security satisfaction using a common set of explanatory variables. Results from both random effects generalized least squares estimation and random effects ordered probit model confirm that obesity has a significant negative impact on workers' pay and job security satisfaction. The results indicate that overweight workers are dissatisfied about their job security compared to normal weight peers. The study results reveal that long-term health problems significantly reduce all aspects of job satisfaction of the workers. However, the results indicate that the interaction of obesity and long-term health problems positively influences workers' overall job satisfaction. Overall, the study findings are in line with the hypothesis that obese workers with long-term health problems have low expectations about their job.

ObjectiveTo provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low/middle-income countries (LMICs).DesignA phone survey administered between...

Psychiatric care for people in Sweden with long-term mental health problems has shifted from institutional to community and home settings. The aim of this study was to explore and describe mental health nurses' experiences of how structural changes in mental health nursing influence interaction when providing home care to patients with long-term mental health problems. We conducted interviews with 11 mental health nurses who provided home care to people with long-term mental health problems. The constant comparative method of grounded theory was used for data collection and analysis. The process of attempting to reconstruct mental health nursing by entering into the everyday reality of people with long-term mental health problems was identified as the core category. Central to this process was a change in perspective from nurse-controlled to client-centred care. This led to changes in moral values, assessment of client needs, and ways of meeting clients and establishing relationships. However, attempts to reconstruct mental health nursing according to a client-centred perspective became problematic when clients were at risk of harming themselves. In these situations, respondents felt the need to make decisions for clients, and this was experienced as burdensome and lonely. Our study indicates that the process of reconstructing mental health nursing in line with a client-centred perspective is incomplete. Opportunities to interact with people with mental health problems in the home environment may lead to a broader perspective on the daily lives of these people, but also to a realization that home care cannot be modelled on institutional care.

There is a national call for digital health innovations in the provision of health and social care, especially for older adults in the context of home. The Reflective STRENGTH-Giving Dialogue (STRENGTH) method is used to provide individual and holistic care using recurrent dialogues. The SelfSTRENGTH application (app) was developed to support reflection and stimulate activity that enables achievement of meaningful life projects. The objective of the study was to describe how the use of the SelfSTRENGTH app is perceived by older adults living with long-term health problems. A qualitative, descriptive and inductive design. Data, analyzed using a phenomenographic approach, consisted of individual qualitative interviews with older adults (age range = 74–96) conducted before (n = 34) and after (n = 27) participation in the STRENGTH intervention. The results consist of five categories of description: Resistance to use apps and digital tools; Health problems hinder its usefulness; Need of assistance is a prerequisite to be able to use the app; the app supports memory and reflection; and Using the app disperses thoughts and creates motivation. The outcome space thus contains descriptions of both barriers and possibilities regarding how the use of the SelfSTRENGTH app is perceived. The potential of using technology such as applications in health care is immense. However, long-term health problems in older adults, along with care providers’ attitudes and opportunities to support, must be taken into consideration when implementing apps in health and social care.

Childhood obesity: Nursing prevention and intervention approaches are needed