Behavioral Care Research Articles

Ohio Health Care Professionals' Pandemic-Related Help-Seeking Knowledge, Behaviors, and Concerns.

Health care professionals (HCPs) historically exhibit high rates of stress, burnout, and low rates of service utilization from Employee Assistance Programs (EAPs) and Professional Health Programs (PHPs). New and magnified stressors that accompanied COVID-19 exacerbated HCPs' risk of burnout. During the pandemic, this study examined Ohio HCP's utilization of EAPs and PHPs, knowledge of available services, barriers to accessing services, and likelihood of future service utilization. Conditions needing to change to increase likelihood of future utilization were also explored. A one-time survey was administered in July and August of 2021 to HCPs from 13 licensing boards in Ohio. This study used a subset of data to examine the extent of convergence between quantitative results-analyzed using frequency calculations-and results from thematic analysis of corresponding open-ended survey items. Qualitative results supported and elaborated the quantitative findings. Fewer than 25% of respondents (N = 12,807) utilized EAPs or PHPs to address mental health concerns. Obstacles impeding service utilization included issues around awareness, time commitment, and confidentiality-a concern encompassing issues of stigma and fear of employment repercussions. Noting multiple obstacles to accessing EAPs and PHPs, HCPs in Ohio reported low rates of support service utilization and low likeliness to use services in the future despite their experiences of extreme stress and burnout. Addressing the time commitment and confidentiality concerns could increase the likelihood of accessing services. Employers of HCPs should explore additional support mechanisms such as comprehensive wellness programs and innovative, brief intervention strategies to combat burnout, especially during viral outbreaks and other high-stress events.

Reproductive Behavior and Parental Role of Giant Gourami (<i>Osphronemus goramy</i> Lacepède, 1801)

The giant gourami (Osphronemus goramy Lacepede, 1801), a popular aquaculture species in Southeast Asia, exhibits unique cooperative biparental care behaviour. To support captive breeding efforts, this study aimed to visually document the reproductive activity of giant gourami, elucidate each stage in detail, and provide insights into the distinct parenting roles of males and females. Underwater cameras were used to observe a breeding pair of gourami in a pond for five days, conducted three times with different pairs during different spawning periods. The male and female contributions to nest building were quantitatively analysed using the T-test, while their parental care involvement was qualitatively assessed and statistically analysed using the Mann-Whitney U test. The results revealed three main phases of giant gourami reproduction: pre-spawning (including adaptation, nest building, and courtship), spawning and fertilisation, and post-spawning with parental care. Our observation confirmed the biparental tendency, with males being more involved in pre-spawning activities and females taking on a prominent role in post-spawning care. In conclusion, males focused on mating preparations and courtship, while females invested more in parental care.

How washing behaviors influence GHG emissions in textile use phase: a PLS-SEM analysis of household washing behaviors in Shanghai

PurposeThis paper explores what factors influence household textile washing behaviour and how these factors relate to greenhouse gas emissions during the textile use stage.Design/methodology/approachA questionnaire survey related to textile summer washing and care behavior was conducted among households in 16 administrative districts of Shanghai. This study used the modified Consumer Lifestyle Approach framework of the washing and care ecosystem. The research hypotheses were established by selecting related factors from four aspects: household demographic characteristics, economy and consumption characteristics, washing machines and detergents characteristics.FindingsFirst, we have demonstrated how some course factors do not significantly affect greenhouse emissions. None of the demographics, detergent-related activities, economy and consumption constructs significantly affect greenhouse emissions. Second, we have identified that washing machine and related activities has a direct positive effect on GHG emissions. The washing machine is not only the de facto carrier of all washing activities but also the core of washing activities. Washing machine is crucial in reducing greenhouse emissions and adjusting consumer behaviors.Originality/valueThis paper conducts a study related to the washing and care behavior of households in Shanghai. The paper examines the factors influencing household washing behavior and the relationship between these factors and greenhouse gas emissions during the textile use phase.

Improved Chinese Giant Salamander Parental Care Behavior Detection Based on YOLOv8.

Optimizing the breeding techniques and increasing the hatching rate of Andrias davidianus offspring necessitates a thorough understanding of its parental care behaviors. However, A. davidianus' nocturnal and cave-dwelling tendencies pose significant challenges for direct observation. To address this problem, this study constructed a dataset for the parental care behavior of A. davidianus, applied the target detection method to this behavior for the first time, and proposed a detection model for A. davidianus' parental care behavior based on the YOLOv8s algorithm. Firstly, a multi-scale feature fusion convolution (MSConv) is proposed and combined with a C2f module, which significantly enhances the feature extraction capability of the model. Secondly, the large separable kernel attention is introduced into the spatial pyramid pooling fast (SPPF) layer to effectively reduce the interference factors in the complex environment. Thirdly, to address the problem of low quality of captured images, Wise-IoU (WIoU) is used to replace CIoU in the original YOLOv8 to optimize the loss function and improve the model's robustness. The experimental results show that the model achieves 85.7% in the mAP50-95, surpassing the YOLOv8s model by 2.1%. Compared with other mainstream models, the overall performance of our model is much better and can effectively detect the parental care behavior of A. davidianus. Our research method not only offers a reference for the behavior recognition of A. davidianus and other amphibians but also provides a new strategy for the smart breeding of A. davidianus.

CARING NURSES IN THE PREVENTION OF FALL RISK PATIENTS IN THE INPATIENT ROOM

The inpatient treatment room is a room that has the potential to have a risk of falling in patients with heart, lung and nerve diseases such as strokes who experience decreased consciousness, muscle weakness and impaired mobility which are at risk of falling from bed or when going to the bathroom. Nurses who are not Caring for patients can result in the risk of falling for patients. The inability of nurses to carry out fall risk assessments will be detrimental to patients during hospitalization. The purpose of this study was to explore the description of caring for nurses in preventing patients at risk of falling in the inpatient room of Permata Medika Ngaliyan Hospital, Semarang City. The research method uses a qualitative research design with a phenomenological approach. Research informants are implementing nurses. Determination of the sample using purposive sampling. Collecting data by in-depth interviews with informants using a voice recorder. The results of the study identified several themes related to the research objectives, namely the caring behavior of nurses when providing nursing care to patients, the impact of caring for patients on patients, the implementation of patient fall risk assessments in hospitals, and the efforts of nurses to prevent the risk of falling in patients. Conclusion: Nurses' caring behavior is a dynamic approach, where nurses work to increase their concern for patients, especially patients at risk of falling as an effort to prevent unexpected events in maintaining the quality of nursing care services.

Relationship between peer conformity and reproductive health maintenance behaviours among early adolescent girls in Islamic boarding schools

Reproductive health problems are often experienced by early adolescents who live in Islamic boarding schools because Islamic boarding schools have a higher population density and interpersonal contact than other schools. In the early adolescent years, there is a tendency in terms of a solid urge to behave like peers, so conformity quickly occurs when adolescents adopt reproductive health care behaviours. This study aimed to determine the relationship between peer conformity and reproductive health maintenance behaviour of early adolescent girls at Islamic boarding schools. This study used a correlational research design with a cross-sectional approach and a purposive sampling technique conducted on 165 early adolescents. The analytical method used for this study was univariate and bivariate analysis tests, in bivariate tests using the Pearson test processed with the Statistical Package for Social Sciences (SPSS) program. The analysis showed that all early adolescents (100%) had a history of vaginal discharge. The results of the bivariate test showed a value of p=0.0001. The level of reproductive health maintenance behaviour is determined by the extent to which conformity occurs in adolescents. Conformity that occurs can affect and change one's perceptions and behaviour.

Spirituality, Religiosity, Caring Behavior, Spiritual Care, and Personalized Care Among Student Nurses: A Descriptive Correlational Study in the Philippines.

This study sought to determine the student nurses' spirituality, religiosity, caring behavior, spiritual care, and personalized care. Further, it sought to determine the relationship between spirituality, religiosity, and caring behavior in student nurses' spiritual care and personalized care. The study used a descriptive correlational design using convenience sampling to collect data from 1248 student nurses in the Philippines from December 2023 to February 2024. We collected data using the Spirituality and Spiritual Care Scale rating scale and the Caring Behaviors Inventory. The study revealed that the mean scores of the students in their "spirituality" and "religiosity" were 4.08 (SD = 0.98) and 2.99 (SD = 1.26), respectively. Student nurses had sufficient confidence and skills in spiritual care, caring behavior, and personalized care. The students' age had a weak and negative association with the students' spirituality and religiosity. Students from University A had higher levels of spirituality and religiosity than students from University B, University C, and University D. Students in the 4th year level were more religious than 3rd year students. Students who had their last clinical exposure in the Admission and emergency room reported poorer caring behaviors than those who had previous clinical exposure in the Medical-surgical ward, Obstetrics and gynecology, Intensive Care Units, and Community. There is no significant relationship between a student nurse's spiritual care and caring behavior. This trend is similar to caring behavior and personalized care. The students' age predicts their personalized care.

Gambaran Perilaku Caring Perawat pada Pasien Pre Operasi di Ruang Rawat Inap Bedah Rumah Sakit Palembang

Anxiety is a response given by an individual to a threat. The situation of a person who is waiting for an operation schedule shows an event that is full of uncertainty, it can cause fear and anxiety, it is necessary for nurses to apply caring behavior which is the focus of nursing practice. This study aims to determine the description of nurses' caring behavior for pre-operative patients in the surgical inpatient room at a hospital in Palembang. The research design used in this research is descriptive. The data collection technique was purposive sampling with a total of 79 respondents. From the research results, it was found that more nurses had positive caring behavior, namely 70 respondents stated that nurses' caring behavior was positive with a percentage of 88.6% and 9 respondents stated that nurses' caring behavior was negative with a percentage of 11.4%. The conclusion is that more nurses have positive caring behavior for preoperative patients in the Palembang Hospital Surgical Inpatient Room.

Hidradenitis suppurativa as seen by the patient

Background. Hidradenitis suppurativa (HS) is a common disease that significantly reduces the quality of life of patients of reproductive age, while its exact prevalence is unknown in most countries due to untimely and poor-quality diagnosis. Aim. In order to clarify the prevalence of HS, an analysis of the structure of newly identified cases of this disease was carried out in the conditions of the consultative and diagnostic center of the State Research Center of Dermatovenereology and Cosmetology of the Ministry of Health of the Russian Federation for the period 2008–2021 inclusive. In order to study the characteristics of the course of HS, its impact on behavior and receipt of medical care from the patient’s point of view, an anonymous quantitative online survey of patients was conducted. The patient questionnaire “Shin a light on hidradenitis” was used as a basis. Methods. Аnonymous quantitative online survey of patients was conducted. The patient questionnaire “Shin a light on hidradenitis” was used as a basis. Results. For the period 2008–2021 exclusively under the section “L73 Other diseases of the hair follicles”, 765 cases were diagnosed in the State Scientific Center for Disease Control and Prevention (0.36% of the total number of all newly diagnosed cases). The diagnosis of GG (ICD code L73.2) was first established only in 59 cases (about 8% of identified cases using code L73). 1035 respondents took part in the survey. The survey revealed that patients with HS are worried about: 66% — swelling, 55% — pain, 38% — purulent discharge and/or blood, 25% of patients note a disturbing look. Most patients rated the severity of pain as moderate (29%) and low (29%) pain, severe and very severe pain — 12 and 7% respectively. Among the treatments used for HH, patients recommended: antibiotics (34%), opening and drainage (32%), prescription corticosteroid creams/ointments (11%), and biologics (4%). In 44% of patients, a visit to a doctor to provide qualified assistance continues; 18% of patients are observed by one doctor (dermatologist and/or surgeon); 9% of patients visited 2–3 doctors before receiving the necessary help. Conclusion. All over the world, the “search” for a specialist who will correctly diagnose, prescribe adequate treatment and accompany its long process is still a complex and unsolved task. In order to improve the quality of medical care for patients with HH, it is necessary to develop and implement domestic clinical recommendations, as well as the development and implementation of educational programs for interested specialists.

Expectations of Mothers with Infants in The Neonatal Intensive Care Unit for Healing Care Processes: A Qualitative Study

Purpose: The study aimed to describe the expectations of mothers whose infants were hospitalized in the neonatal intensive care unit regarding the healing care environment. Material and Methods: This is a descriptive qualitative study. The study was conducted with mothers whose infants were hospitalized in the neonatal intensive care unit of a private hospital. Data were collected between October and November 2022 by using a purposive sampling method. Semi-structured interviews were conducted with 11 mothers. Data were collected with semi-structured interviews. All interviews were recorded via an audio recorder and transcribed verbatim. The inductive thematic analysis method was used to analyze the data. Results: Three main categories and seven sub-themes emerged from the analysis: “humanistic healing care behaviors, healing physical environment and supports”. Watson's Theory of Human Caring was based on the themes related to mothers' expectations from healing care processes. Conclusion: It has been determined that mothers need humanistic healing behaviors within the healing care processes. At the same time, it has been reported that the design of neonatal intensive care units and noise control are important for the healing environment. It is thought that it will contribute to the institutions in providing a healing care environment.

The relationship between self-compassion and caring behaviour in nurses: A cross-sectional study.

To examine the relationship between self-compassion and caring behaviour in nurses. Self-compassion can influence nurses' ability to cope with stress and their job performance. High levels of self-compassion may play a role in nurses' coping with compassion fatigue and burnout. This may make the concept of self-compassion in nurses an important variable for effective care. This is a cross-sectional study. Study data were collected between March and May 2022 from 331 nurses at a hospital in the city of Antalya, Turkey. A personal information form, the Self-Compassion Scale (SCS), and the Caring Behaviour Inventory-24 (CBI-24) were used to collect data, and the program SPSS 23.0 was used in data evaluation. Descriptive statistical methods, Pearson correlation analysis and multiple linear regression analysis were used in the analysis of data. The STROBE checklist was followed for this cross-sectional study. The nurses' mean scores were 3.50±0.61 on SCS and 5.21±0.56 on CBI-24. A positive correlation was found between the nurses' self-compassion levels and caring behaviour. Also, the SCS sub-dimension of mindfulness, working in intensive care and working willingly in the nursing profession significantly predicted caring behaviour. These variables explain 19.4% of the variance of caring behaviour. The nurses' self-compassion levels were medium and their caring behaviour was at a high level, and caring behaviour was higher in those who worked in intensive care, those who were working willingly in the nursing profession, and in those with high scores on the self-compassion sub-dimension of mindfulness. It is important to strengthen nurses' self-compassion skills to develop their caring behaviour. In particular, giving nurses in clinics mindfulness-based education will help them to increase their awareness concerning their own lives and to develop their caring behaviour.

Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: a path analysis study

IntroductionImproving the quality of life (QOL) is the most important goal of early diagnosis and treatment in patients with type 2 diabetes (T2D). Numerous studies have indicated the positive effects of health literacy, social support and self-care behaviors and the negative effects of diabetes distress and burnout on the QOL of patients with T2D. Understanding these factors is crucial for people with diabetes. However, no study has investigated the simultaneous effects of these variables on QOL. In this study, our goals were to find out how these variables are related to each other, in addition, which variables play the role of mediating variables, and finally, what is the cumulative effect of these variables in predicting the QOL of patients with T2D. So, this study aimed to examine the relationship between diabetes health literacy (DHL), distress, burnout, social support, complications of diabetes, self-care behaviors, and QOL among patients with T2D by application Path analysis method.MethodsIn this study 929 participants were entered to study by cluster sampling method and finally, data were analyzed among 820 participants. Data were gathered by self-report and with seven tools of Demographic section, DHL Scale, Diabetes distress scale, Diabetes Burnout scale, Diabetes Self-Management Questionnaire (DSMQ), Perceived social support, Diabetes Quality of Life (DQOL) Questionnaire. The software’s of SPSS version 24 and AMOS version 24 were used for analysis.ResultsThe variables of DHL, social support, diabetes distress, and complications of diabetes predicted 38% variance in diabetes burnout (R2 = 0.38). Greatest impact on diabetes burnout was related to diabetes distress (estimate total effect = 0.539). The variables of DHL, social support, diabetes distress, complications of diabetes, and diabetes burnout predicted 24% variance in self- care behaviors (R2 = 0.24). Greatest impact on self- care behaviors was related to DHL (estimate total effect = 0.354). The variables of DHL, social support, diabetes distress, diabetes burnout, complications of diabetes, and self- care behaviors predicted 49% variance in DQOL (R2 = 0.49). Greatest impact on DQOL was related to variables of diabetes distress (estimate total effect = -0.613), DHL (estimate total effect = 0.225), diabetes burnout (estimate total effect = -0.202), complications of diabetes (estimate total effect = − 0.173), social support (estimate total effect = 0.149), and self -care (estimate total effect = 0.149), respectively.ConclusionTo improve QOL in patients with T2D, health care providers must develop interventions that increase DHL of diabetic. Because DHL can decrease distress and burnout, enhance self -care skills, create supportive networks, and ultimately improve QOL in patients with type 2 diabetes.

Emergency triage nurses’ perceptions of caring behaviors and the safety of the patient during triage encounters: a grounded theory study

BackgroundTriage is a dynamic process prioritising the patient coming to the emergency department. Caring behaviour and patient safety during the triage process are essential for ensuring a good care experience and treatment outcome.ObjectiveTo describe triage nurses’ perceptions on caring behaviors and patient safety in the triage area.DesignStrauss and Corbin’s Grounded theory method was used to develop the model.MethodsThe study was conducted in the emergency department in northeastern Slovenia. Semi-structured interviews were used for data collection, and 19 triage nurses were selected by theoretical sampling, guided by emerging categories between November 2021 and July 2022. The data analysis was conducted according to Strauss and Corbin’s coding framework.ResultsThe analysis of the interviews generated one category: The process of creating a caring and safe triage encounter for the patient, together with two categories that explain the key phenomenon: (1) Triage caring and (2) Safety in the triage process. Within the category “Triage caring”, four subcategories were developed: (1) Assurance of triage nurses’ presence, (2) Connectedness, (3) Respectful attitude, and (4) Knowledge and skills. The category Safety in the triage process consists of three identified subcategories: (1) Conception and perception of safety, (2) Factors influencing patient safety, and (3) Improving the triage safety.ConclusionsThe triage nurses’ perceptions about caring for the patient and his safety in the triage area show that caring and safety are inseparably linked and coincide when triaging a patient. Namely, caring for the patient means ensuring the patient’s safety at the same time.Implications for the nursing fieldA better understanding of the importance of triage nurses’ caring behavior and patient safety emerges from the findings, highlighting the challenges faced in a busy emergency department where nurses must balance providing care and responding to patients’ needs while ensuring safety. Findings in the study show that patient care and safety are inseparably linked and coincide when triaging a patient. Moreover, applying caring behaviour during triage encounter results in greater patient safety.No patient or public contributionThe study’s design, evaluation of the findings, and execution did not need the involvement of patients or the general public. Participants were triage nurses working in the emergency department. Triage nurses were interviewed about their perceptions of triage nurses on caring behaviors and patient safety during triage encounter.

The knowledge, attitude and behavior on the palliative care among neonatal nurses: what can we do

BackgroundNeonatal nurses should provide timely and high-quality palliative care whenever necessary. It’s necessary to investigate the knowledge, attitude and behavior of palliative care among neonatal nurses, to provide references and evidences for clinical palliative care.MethodsNeonatal intensive care unit (NICU) nurses in a tertiary hospital of China were selected from December 1 to 16, 2022. The palliative care knowledge, attitude and behavior questionnaire was used to evaluate the current situation of palliative nursing knowledge, attitude and behavior of NICU nurses. Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors.Results122 nurses were finally included. The average score of knowledge in neonatal nurses was 7.68 ± 2.93, the average score of attitude was 26.24 ± 7.11, the score of behavior was 40.55 ± 8.98, the average total score was 74.03 ± 10.17. Spearman correlation indicated that score of knowledge, attitude and behavior of palliative care in neonatal nurses were correlated with the age(r = 0.541), year of work experience(r = 0.622) and professional ranks and titles(r = 0.576) (all P < 0.05). Age (OR = 1.515, 95%CI: 1.204 ~ 1.796), year of work experience (OR = 2.488, 95%CI: 2.003 ~ 2.865) and professional ranks and titles (OR = 2.801, 95%CI: 2.434 ~ 3.155) were the influencing factors of score of knowledge, attitude and behavior of palliative care (all P < 0.05).Public contributionNICU nurses have a positive attitude towards palliative care, but the practical behavior of palliative care is less and lack of relevant knowledge. Targeted training should be carried out combined with the current situation of knowledge, attitude and practice of NICU nurses to improve the palliative care ability and quality of NICU nurses.

Developing care behaviors and ethical attitude in nursing education

AimThis study aims to determine the effect of education based on the Theory of Human Caring on nursing students' caring behaviors and ethical attitudes. BackgroundIt is crucial to plan nursing education holistically, addressing cognitive, psychomotor and affective domains for the comprehensive development of caring behaviors and ethical attitudes. DesignThis study employed a convergent mixed-methods approach with randomized pretest-posttest comparisons and qualitative analysis. MethodsThis study was conducted with third-year nursing students at a state university in Ankara, Turkey, in 2021. It comprised a total of 95 participants, with 47 students in the case group and 48 students in the video group. Theoretical education based on the Theory of Human Caring was simultaneously provided to both groups. Following this, one group received practical training using a video-supported teaching method, while the other group received it through a case analysis method. The research used the 'Descriptive Characteristics Form', 'Caring Nurse Patient Interaction Scale (CNPIS)', 'Scale for Attitudes of Ethical Principles (SAEP)' and 'Student Opinion Form on Care Behaviors Education' to collect data. Quantitative data were analyzed using t-tests, Mann-Whitney U tests, Wilcoxon paired two-sample tests and Linear Regression Analysis, with a significance level of p<0.05. Qualitative data were evaluated through document analysis. Permissions were obtained before the research. ResultsAfter the education provided, significant differences were found between the pre-test and post-test scores of both groups (p<0.05). It was determined that there was a statistically significant, positive and generally moderate relationship between the caring behaviors and ethical attitudes of the students. Additionally, participating students reported that they were satisfied with the education provided, stating that the teaching methods increased their motivation and positively influenced their perspectives on caring and its ethical dimensions. ConclusionsThe research findings show significant improvements in nursing students' care behaviors and ethical attitudes following education based on the Human Care Theory, with both case analysis and video-supported teaching methods yielding notable results. Integration of care theories into the nursing undergraduate curriculum, alongside the use of holistic teaching methods, is recommended, along with further randomized controlled trials to assess teaching effectiveness.

Assessment of Health Literacy and Self- Care Behavior with Arteriovenous Fistula among Hemodialysis Patients

Assessment of Health Literacy and Self- Care Behavior with Arteriovenous Fistula among Hemodialysis Patients

Intergenerational care and rural childhood obesity in the digital era: Based on screen exposure perspective

BackgroundRural Chinese children are experiencing increasing obesity rates, yet studies often neglect the impact of IT and screen media growth on obesity risks in the context of intergenerational care, leading to incomplete strategies for the digital era. MethodsBy comprehensively utilizing the data on rural children aged 6–17 from the China Family Panel Studies (CFPS) and the China Health and Nutrition Survey (CHNS), this study aims to test the logical chain and specific mechanisms regarding “intergenerational care - screen exposure - rural childhood obesity”. We employ the Propensity Score Matching (PSM) and Generalized Propensity Score Matching (GPSM) methods to respectively address the self-selection biases associated with inter-generational care and children's screen exposure behaviors. Results1) Intergenerational care significantly increases screen exposure among rural children. 2) Gender bias increases the risk of screen exposure for rural boys under intergenerational care. 3) Children with higher screen exposure levels are more affected by intergenerational care, which further undermines parental supervision. 4) Children's screen exposure leads to increased sedentary time and higher probability of purchasing unhealthy foods, thereby exacerbating obesity. This process is facilitated by enhancing preferences for snacks, fast food, and beverages, and weakening preferences for physical activity. 5) GPSM analysis indicates that children's screen exposure has an inverted “U"-shaped impact on unhealthy dietary preferences and a “U"-shaped impact on activity preferences. It results in a nonlinear positive impact of screen exposure on obesity. This study reveals a positive association between screen exposure and obesity, offering new insights into how intergenerational care in the digital era may elevate obesity prevalence through excessive screen time for rural children.

Incorporating verbal and nonverbal aspects to enhance a model of patient communication in cancer care: A grounded theory study.

High-quality communication is essential to patient-centered care. Existing communication models and research tends to focus on what is said verbally with little attention to nonverbal aspects of communication. In sensitive and emotionally intensive healthcare encounters, such as in cancer care, provider and patient nonverbal behavior may be particularly important for communicating with empathy. Therefore, the aim of this study was to develop a conceptual model of communication that accounts for nonverbal behavior. We followed a systematic grounded theory design that involved semi-structured interviews with 23 providers, including nurse practitioners, physicians, surgeons, and physician's assistants. Using constant comparative analysis, we analyzed transcripts and developed a grounded theory model of communication accounting for nonverbal behavior. The major themes included building rapport, gauging how patients will take bad news, ensuring patients' understanding of their conditions, staying honest but hopeful, centering but guiding patient through cancer care, conveying empathy while managing heightened emotions, and ensuring patient understanding. Throughout the process, providers synthesize both verbal and nonverbal information and apply what they learn to future encounters. The results extend existing models of patient-centered communication and invite communication intervention and research that incorporates nonverbal behavior. The model contributes an understanding of the full process of communication in clinical encounters.

Association between achieving adequate antenatal care and health-seeking behaviors: A study of Demographic and Health Surveys in 47 low- and middle-income countries.

Antenatal care (ANC) is essential for ensuring the well-being of pregnant women and their fetuses. This study models the association between achieving adequate ANC and various health and health-seeking indicators across wealth quintiles in low- and middle-income countries (LMICs). We analyzed data from 638,265 women across 47 LMICs using available Demographic and Health Surveys from 2010 to 2022. Via multilevel logistic regression analyses adjusted for a series of confounding variables and country and wealth quintile fixed effects, we estimated the projected impact of achieving adequate ANC utilization and quality on a series of health and health care indicators: facility birth, postnatal care, childhood immunizations, and childhood stunting and wasting. Achieving adequate levels of ANC utilization and quality (defined as at least 4 visits, blood pressure monitoring, and blood and urine testing) was positively associated with health-seeking behavior across the majority of countries. The strongest association was observed for facility birth, followed by postnatal care and child immunization. The strength of the associations varied across countries and wealth quintiles, with more significant ones observed in countries with lower baseline ANC utilization levels and among the lower wealth quintiles. The associations of ANC with childhood stunting and wasting were notably less statistically significant compared to other indicators. Despite rigorous adjustments for potential confounders, a limitation to the methodology is that it is possible that unobserved variables may still impact outcomes. Strengthening ANC is associated with improved use of other health care in LMICs. ANC could serve as a critical platform for improving health outcomes for mothers and their children, emphasizing its importance beyond direct impact on maternal and neonatal mortality.

Determining the Health Care Behavior Needs of Older Adults Based on the Omaha System

This study aimed to identify the health behavioral needs of older adults based on the Omaha System. This descriptive study was conducted in Northern Cyprus between May and October 2021. The sample comprised 400 older adults who resided in the Gecitkale municipality. The problem-classification scheme of the Omaha system was used for data collection. The main behavioral health problems concerned nutrition (100%), physical activity (87.25%), and medication regimen (87.25%). In addition, all behavioral health problems defined by the Omaha system were evident in participants who were 75 years and older, female, single, childless, educated, and with incomes that did not cover expenses ( p &lt; .05). This study identified the basic healthcare needs of older adults, which increased in parallel with age. The Omaha system may help health professionals deliver services focusing on older people’s needs.