Compliance Behavior Research Articles

Analysis of Effect of Six Sigma Method Combined with CI Strategy on Improving of Nursing Quality in Outpatient Infusion Rooms.

Objective The infusion room is the last part of an outpatient visit, with high patient density, large staff mobility, and a wide variety of conditions. In addition, most patients are accompanied by their families during infusion, and nursing staff in infusion rooms have to face more trivial and miscellaneous tasks than nursing staff in other treatment departments, which are more complex. The purpose of this research is to explore the impact of the Six Sigma method and CI strategy on the quality of nursing management in infusion rooms, so as to provide reference for clinical research. Methods A total of 2142 patients treated in our outpatient infusion rooms from June 2019 to June 2020 was included into this retrospective analysis. Of these, 1105 patients admitted before 2020 received routine care management services and were considered as the control group. Another 1037 patients were admitted after 2020 and received the Six Sigma method combined with CI strategic care management and were considered as the research group. The incidence of adverse events during treatment was counted in both groups, and patients' compliance behavior and psychology were investigated. After treatment, patients' evaluation of the quality of nursing and their satisfaction with the nursing were investigated. Results The incidence of adverse events during infusion in the research group was dramatically lower than that in the control group, while the compliance behavior scores were higher (P < 0.05). In addition, SAS and SDS in the research group were lower than those in the control group, while the quality of nursing were higher (P < 0.05). It was also clear that the research group had 93.39% satisfaction with nursing, which was also higher than the control group (P < 0.05). Conclusion Implementation of infusion room nursing management according to the Six Sigma method with CI strategic plan can avoid adverse events and improve infusion nursing satisfaction. It also helps reduce the incidence of dispute events.

Analisis Perilaku Kepatuhan Penggunaan Alat Pelindung Diri (APD) Pada Tenaga Kesehatan Saat Pandemi Covid-19 (Systematic Review)

Personal protective equipment (PPE) is a device that people use to protect against people who have received a disease that can be spread through contact or by other people. PPE is needed for medical personnel in order to reduce the risk of transmission of the Covid-19 virus because during the Covid-19 pandemic, the risk of increasing cases in health workers is very high because they are in direct contact with patients who have contracted Covid-19 for treatment or who are quarantined. The use of non-standard personal protective equipment is one of the reasons why health workers get Covid-19 infections. This is intended for people who work in the distribution and management of PPE, public and individual health, public health management, and providing PPE information. Before making direct contact with patients infected with the Covid-19 virus, health workers must be required to wear PPE, but the availability of PPE is very limited because it is also used by patients and the community. This condition forces health workers to reduce the use of PPE by providing health services without removing PPE for a long time or by using homemade PPE. This is what motivates academics to conduct a literature review that evaluates the factors that influence the habit of using PPE for health workers. In this study, the method used is Observational Retrospective, specifically with a qualitative approach in Systematic Review to synthesize descriptive qualitative research results using the PRISMA (Preffered Reporting Items for Systematic Review and Meta-Analysis) method, which is carried out systematically by following the steps outlined below. good and right. To get reliable and accurate results from articles that are used as references, the authors search and select scientific publications from database sources (Literature review) using Google Scholar and the search term "Analysis of Compliance Behavior in the Use of Personal Protective Equipment (PPE) in Health Workers During the Covid Pandemic. -19." The data analysis used papers related to research issues, namely the examination of compliance behavior in the use of PPE in health workers during the Covid-19 pandemic, which was then systematically researched by selecting 10 articles to be reviewed and included in the review process. After a literature search was carried out by entering keywords in Google Schoolar with keyword analysis of compliance behavior in the use of PPE in health workers during the Covid-19 pandemic from the 2019-2022 range, at least 1040 articles were obtained, but only 10 articles met the inclusion criteria after articles that were not suitable to be removed.

Perceptions of online shopping and determinants of consumers’ online purchase of food groceries in Polokwane local municipality, South Africa

Online purchase of food groceries is a development in the food retail market that is being driven by recent advances in the Information and Communication Technologies (ICTs). Consumers are, therefore, complying with these emerging trends by testing some of the online shopping platforms to form a behavioural compliance as required by some cashless economic policies being implemented in some African countries. Although considered to be convenient, online shopping is bewildered with a lot of risks. The aim of this study was to analyse the perceptions of consumers on online shopping risks and determine the factors influencing them to purchase food groceries online. The data were collected from 173 respondents selected by simple random sampling. The data were collected using structured questionnaire that was administered by trained enumerators. Descriptive statistics and logit regression were used for data analysis. The analyses were carried out by STATA software. The results showed that 11% of the respondents were using online platforms to purchase food groceries, 57.2% were aware of the existence of online platforms to purchase food groceries, 84.4% perceived online purchase of food groceries as convenient, and 62.4% perceived it as risky. The results of the Logit regression model showed that delivery fee, level of education, employment status, use of phone tablets for internet browsing, use of laptops to browse the internet, perceived online convenience and perceived online risk had statistically significant relationships (p&lt;0.05) with consumers’ decision to purchase food groceries online. It was recommended that in order to encourage active online sales, there is the need to educate consumers on the benefits of purchasing food groceries online, using broadcasting platforms such as radio, television and social media. There is also a need for the South African government to strengthen policies to reduce associated risks of online transactions. Key words: Consumers, food groceries, delivery fee, online purchase, South Africa

A Health Crisis in the Age of Misinformation: How Social Media and Mass Media Influenced Misperceptions about COVID-19 and Compliance Behavior

ABSTRACT The media are important information disseminators in society. Particularly in uncertain times, such as the COVID-19 pandemic, citizens are very “media dependent.” The way in which people are informed about the coronavirus heavily depends on the type of media they use. Especially on social media, the share of misinformation is considerable, which might impact the way in which people comply with preventive measures. Our study investigates how media use affects misperceptions about the coronavirus and whether this influences important behavioral determinants as well as compliance behavior itself. The results of a unique 5-wave panel survey (N = 1,741) conducted between April 2020 and October 2020 show that the use of mass media reduces misperceptions. The same was found for Twitter users, whereas Facebook and Instagram users have more misperceptions about the coronavirus. Misperceptions negatively influence the perceived severity, susceptibility and efficacy of preventive measures taken by governments, which may ultimately result in decreased compliance. Our findings underline the important role of media consumption and misperceptions in shaping citizens’ beliefs and behavior regarding COVID-19. They re-emphasize the importance of mass media, such as newspapers, television broadcasts or reliable news websites, to inform the public about current affairs. They also imply that platform media might be more heterogeneous in their effects than mass media.

The Effect of Providing Health Education on Transmission Prevention Behavior and Treatment Compliance Among Tuberculosis Patients Using the Health Belief Model Approach

Introduction: Public health problems are multicausal and therefore the solution must also be a multidisciplinary approach. Tuberculosis (TB) is an infectious disease caused by infection with Mycobacterium tuberculosis (MTB). Tuberculosis is one of the 10 most common causes of death in the world. However, not all patients have been found, treated, and reported to the national information system. Method: Design used observational analysis with a cross-sectional approach. The population used in this study were all TB patients in health services. The sample size was 37 patients. The sampling was simple random sampling. The analysis used the chi-square test and logistic regression test with a significant value of &lt;0.05. Results: The results showed that there was a correlation between transmission prevention behavior and treatment compliance with perceived susceptibility with a p-value of 0.013, and there was a correlation between transmission prevention behavior and treatment compliance with perceived benefits p=0.005.The logistic regression test result showed that the most related transmission prevention behavior and treatment compliance using the health belief model on perceived susceptibility, perceived benefits, and cues to action. Conclusion: The research results showed that a correlation between transmission prevention behavior and treatment compliance, namely perceived susceptibility, perceived benefits, and cues to action.

Concordance of functional MRI memory task and resting-state functional MRI connectivity used in surgical planning for pediatric temporal lobe epilepsy.

Assessing memory is often critical in surgical evaluation, although difficult to assess in young children and in patients with variable task abilities. While obtaining interpretable data from task-based functional MRI (fMRI) measures is common in compliant and awake patients, it is not known whether functional connectivity MRI (fcMRI) data show equivalent results. If this were the case, it would have substantial clinical and research generalizability. To evaluate this possibility, the authors evaluated the concordance between fMRI and fcMRI data collected in a presurgical epilepsy cohort. Task-based fMRI data for autobiographical memory tasks and resting-state fcMRI data were collected in patients with epilepsy evaluated at Seattle Children's Hospital between 2010 and 2017. To assess memory-related activation and laterality, signal change in task-based measures was computed as a percentage of the average blood oxygen level-dependent signal over the defined regions of interest. An fcMRI data analysis was performed using 1000 Functional Connectomes Project scripts based on Analysis of Functional NeuroImages and FSL (Functional Magnetic Resonance Imaging of the Brain Software Library) software packages. Lateralization indices (LIs) were estimated for activation and connectivity measures. The concordance between these two measures was evaluated using correlation and regression analysis. In this epilepsy cohort studied, the authors observed concordance between fMRI activation and fcMRI connectivity, with an LI regression coefficient of 0.470 (R2 = 0.221, p = 0.00076). Previously published studies have demonstrated fMRI and fcMRI overlap between measures of vision, attention, and language. In the authors' clinical sample, task-based measures of memory and analogous resting-state mapping were similarly linked in pattern and strength. These results support the use of fcMRI methods as a proxy for task-based memory performance in presurgical patients, perhaps including those who are more limited in their behavioral compliance. Future investigations to extend these results will be helpful to explore how the magnitudes of effect are associated with neuropsychological performance and postsurgical behavioral changes.

REFORMING THE MALAYSIAN TAX SYSTEM: THE EFFECTS OF SPECIAL VOLUNTARY DISCLOSURE PROGRAMME (SVDP), ROLE OF INLAND REVENUE BOARD MALAYSIA (IRBM), AND DEMOGRAPHICS OF TAXPAYERS ON MALAYSIAN TAX AWARENESS

A sound tax system improves government revenue by encouraging voluntary tax compliance to ensure good tax awareness among citizens. However, many issues arise with regard to tax collection. As these issues remain unresolved, the government needs to frequently implement a tax amnesty programme which is not sustainable or cost-effective in the longer run. Tax awareness becomes a significant factor in managing tax compliance behaviour within contemporary literature. Hence, this paper aims at ascertaining the effects of Special Voluntary Disclosure Programme (SVDP), the role of Inland Revenue Board Malaysia (IRBM), and demographic factors on tax awareness among Malaysian taxpayers. This paper used Smart PLS version 3 to run the data. The results confirmed that SVDP, IRBM's role, and public/ private sectors’ employment are crucial in influencing tax awareness. These findings have implications for tax policies, such as developing tax knowledge programmes and raising public awareness among individual taxpayers in Malaysia. Keywords: Special voluntary disclosure programme; tax administration; tax awareness; tax reform

The Impact of Covid-19 on Tax Compliance Behaviour Among Malaysian Taxpayers

The unexpected Covid-19 crisis presents major challenges to Malaysian’s revenue administrator due to worsening economic conditions as they anticipated growing in tax arrears, loss reporting by business and increasing in tax non-compliance and tax evasion. Therefore the objective of this study is to investigate the impact of the crisis on tax compliance and look at the willingness of the taxpayer to ensure the survival of the country while they themselves are facing financial uncertainty due to the pandemic. Adopting convenient sampling method, a survey was conducted among taxpayers in the south region of Malaysia. The findings show that 28.6% of respondents have deferred their tax e-filing and tax payment during the Covid-19 crisis. Nevertheless, those who have filed, make an early submission with intention to get tax refund in facing potential income reduction. Interestingly, 59.3% of respondents are still willing to pay tax, during and after the Covid-19 period at same marginal tax rate. In conclusion, this study provides important input to the tax administrator on the likelihood of future shortfalls in tax collection and suggests how to minimize the anticipated negative effects of the pandemic.

Indirect Taxation, Tax Evasion and Profits

In a duopoly with differentiated products under price competition, this paper analyses the frms’ tax compliance behaviour in the presence of tax evasion to challenge the conventional wisdom that indirect taxes penalise profts. In contrast to the preceding literature, it is shown that indirect taxes can increase frms’ profts. The appearance of this unconventional fnding is more likely when there exists a suffcient competitive pressure in the industry and the effort for detecting evasion is not too strong.

Deterrence or conformity?-An analysis of digital economy taxpayer compliance behavior based on prospect theory.

Taking the tax evasion of live streamers as a reference case, this article aims to establish a tax compliance prospect theory model, in which the reference point is determined by the taxpayer's perceived compliance level. The taxpayer compliance behavior is analyzed from two dimensions of the tax authority's audit deterrence and the taxpayer's conformity mentality. We find that both deterrence effect and conformity effect are existing in the taxpayer compliance behavior, which is affected by the tax authority's enforcement effort. When the enforcement effort is low, the deterrence effect and the conformity effect do not exist, and the taxpayer does not comply at all. When the enforcement effort is moderate, the deterrence effect and the conformity effect coexist and the taxpayer complies partially. Besides, the taxpayer compliance level will not exceed the perceived compliance level, and an increase in the perceived compliance level will prompt the taxpayer to comply more. When the enforcement effort is high, there is only a strong deterrence effect, and the taxpayer completely complies. We use the theoretical analysis result to explain the tax compliance behavior of live streamers and find that it is consistent with the predictions of the model. Finally, we propose some policy recommendations on tax administration in digital economy.

The effects of benevolent vs. corrective humor on interpersonal liking and behavioral compliance

This paper reports three studies investigating the effects of benevolent and corrective humor on interpersonal liking and willingness to change problematic behavior. Study 1 (n = 375) found that participants liked corrective-humor-tellers who were socially distant less than those who were socially close, whereas they liked benevolent-humor-tellers equally well regardless of social distance. Study 2 (n = 576) replicated the results of Study 1, showing greater effects of social distance on interpersonal liking and willingness to change behavior when corrective, rather than benevolent, humor was used. Furthermore, Study 2 identified the perceived motive of the humor teller as the mediator for the observed effects. Study 3 (n = 399) manipulated the perceived motive of the humor teller and demonstrated that corrective humor could be more effective on interpersonal liking and willingness to change behavior when the benign motive was made salient. These findings contribute to the humor literature and provide practical implications for using humor in daily life.

The development of compliance behavioral imperatives in public for management of covid-19

ABSTRACT The Covid-19 pandemic, which was declared a public health emergency on 30 January 2020, has made it crucial for humans to learn how to behave to control the pandemic’s spread. Policymakers must assess human behaviour and their responses to pandemic breakouts to develop a strategy for limiting pandemics and their harm to society at large. The present study applying exploratory factor analysis assessed five aspects of human behaviour regarding Covid-19, namely compliance behaviour, avoidance behaviour, protective behaviour, informed behaviour, and risk perception. The study applying hierarchical regression discovered that by combining informed, protective, and avoidance behaviour, people can be convinced to embrace the compliance behaviour required by public authorities. Furthermore, higher risk perception also positively moderates the relationship between information and compliance behaviour.

Behavioral compliance with preventive health measures for students with and without hearing disability during COVID-19 pandemic: A cross-sectional study.

BackgroundHearing loss affects over 1.5 billion individuals worldwide. Their disability and limited access to the coronavirus (COVID-19) pandemic information make them suffer a greater degree than ordinary people. However, the quantitative studies on the implementation of behavior compliance with preventive health measures for vulnerable groups such as people with hearing disability were limited. The purpose of this study was to explore the compliance with pandemic-related protective health measures among people with hearing disability.DesignA cross-sectional survey, population-based cohort study of students aged 12–26 years with and without hearing disability was conducted. Behavioral compliance with preventive health measures was collected from the general education institutions and special education schools using an online questionnaire. Logistic regression and structural equation model were used to determine the associations among the demographic variables, different degrees of mental health status and psychological impacts, and preventive health behaviors.ResultsAmong 1,589 participants, 485 (30.5%) students are with hearing disability (SHD), and 1,104 (69.5%) students with normal hearing (SNH). The SHD has a significantly lower degree of behavioral compliance with the preventive health measures than SNH has. Hearing disability and anxiety [odds ratio (OR) = 1.54–1.76, p < 0.05] are risk factors for avoiding sharing of utensils during mealtime. Hearing disability, male sex, father's education level, mother's profession, bedtime after 11:00 p.m., anxiety, and depression (OR = 1.45–2.95, p < 0.05) are risk factors for hand hygiene. Male sex (OR = 2.13, p < 0.001) is risk factor and being aged below 18 years old (OR = 0.62, p = 0.03) is protective factor for wearing masks. Exercise (OR = 0.32–0.70, p < 0.01) is the most protective factor for preventive health behaviors. Mediating effect of mental health status and psychological impacts between hearing level and the compliance with the preventive health measures was −0.044 (95% CI: −0.068 to −0.027).ConclusionsTo reduce the risk of contraction, update pandemic information, essential communication services, extra assistance, and support should be provided to these disabled persons who are more susceptible to a public health emergency.

Effect of Precision Health Education on Compliance Behavior after Extracorporeal Shock Wave Lithotripsy.

Objective The aim of this study was to investigate the effects of precision health education on patients' compliance behavior and lithotripsy efficacy after extracorporeal shock wave lithotripsy (ESWL). Methods From June 2018 to September 2018, 104 patients with upper urinary tract calculi who underwent ESWL at Anhui No.2 Provincial People's Hospital were randomly divided into two groups. The observation group (n = 53) was given precision health education guidance after ESWL treatment, while the control group (n = 51) was only informed of precautions after lithotripsy. Postoperative compliance behavior, stone expulsion time, and complications were recorded in both groups. Results The clinical baseline data of the two groups were similar in age, gender, number of stones, size of stones, location of stones, complications, number of lithotripsies, and voltage of lithotripsy between the two groups (P > 0.05). However, compared with the control group, the observation group had better compliance behavior of patients. Furthermore, we divided the patients into three groups based on whether they complied with medical advice. Compared with the noncompliance group (n = 17) and the partial compliance group (n = 23), the stone expulsion time in the complete compliance group (n = 64) was significantly shorter. Also, the number of patients with nausea and vomiting, lacrimation, and cold sweat in the complete compliance group was significantly lower than that in the other groups. Conclusion Precision health education for patients treated with ESWL can significantly enhance the compliance behavior of patients, thereby accelerating the expulsion of stones, improving the efficacy and relieving pain. Precision health education and good compliance behavior complement and reinforce each other.

The single and joint effects of health protocol intervention policies and collectivism on people activities during the COVID-19 pandemic

Preventing the spread of COVID-19 does not only require efforts from the government, but also behaviors performed by society in order to prevent the COVID-19 transmission by implementing health protocol called as 6M (Wear Masks, Wash Hands, Keep Your Distance, Avoid Crowds, Limit Mobility, and Avoid Eating Out with Others). Behavior compliance to health protocol is known as obedience, consisting of three dimensions in psychology, including belief, accept, and act. Based on a research conducted on 79 random respondents, the Keep Your Distance protocol had a lower level of obedience compared to Wear Masks and Wash Hands. The collectivist culture of Indonesian people has become a challenge as gathering culture is not only a desire to gather, but also a part of daily need fulfillment, especially for people who rely on their neighbors to survive. The implementation of physical distancing forces people to be individualists in order to break the chain of COVID-19 transmission. This was explained in a further elaboration of the Keep Your Distance as activities to avoid crowds, limit mobility, or avoid eating out with others. Thus, it is necessary to enhance public trust and acceptance of keeping a distance to prevent the spread of COVID-19.

The Application of Focused Care Model in the Management of Hepatitis B Patients in a Tertiary Care Hospital and the Impact on Patients' Quality of Life.

Chronic hepatitis B is one of the common infectious diseases in the world, with a wide epidemic range and strong contagiousness, which is difficult to completely eradicate. From July 2020 to April 2022, 142 patients with hepatitis B who were admitted to tertiary hospitals were selected and randomly divided into 2 cases, with 71 cases per case. The control group adopts a conventional model, and the observation group implements a nursing model based on the control group. The management capacity and quality of life before and after the two groups of care were compared. 94 patients with chronic hepatitis B who were admitted to the hospital from July 2020 to April 2022 were selected, and 47 cases were divided into the control group and observation group according to the admission time. The control group is given a conventional model, and the observation group is given a nursing model on the basis of the control group. Both groups of patients observed anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), short life span scale (SF-36) scores, and treatment conditions before and after the intervention, to explore the application of nursing model in the management of hepatitis B patients in tertiary hospitals and its impact on patient quality of life. Based on study's precare outcomes, there was no statistically significant difference between the self-administered scale (PIH) score and the quality of life measurement summary scale (QOL-BREF) score (P > 0.05) between the two groups. After one month of care, both groups had lower PIH scores than before care, and QOL-BREF scores were higher than before care (P < 0.05). After one month of treatment, the PIH score of the observation group was significantly reduced, and the QOL-BREF score after one month of treatment was significantly higher than that of the control group (P < 0.05). The SAS and SDS scores in the observation group were lower than those in the control group, and the quality of life scores and treatment compliance were higher than those in the control group, and the difference was statistically significant (P < 0.05). Conclusions. The nursing model can effectively improve the management and quality of life of hepatitis B patients. It also had a significant positive effect on the therapeutic capacity and quality of life of patients with hepatitis B and improved patient compliance behavior and quality of life.

Employer safety obligations, safety climate, and safety behaviors in the ready-made garment context in Bangladesh

Purpose: The impact of employer safety obligations on safety climate and safety outcomes has become an important area of research in organizational and safety sciences. Evidence shows that employer safety obligations positively impact safety outcomes, including safety climate and safety behaviors. However, these relationships have not been thoroughly explored within the garment settings. This study is one of the first known studies to examine the relationships between employer safety obligations, safety climate, and safety behavior outcomes in a sample of garment employees. Methods: Two-wave time-lagged data were collected from 347 garment employees and their supervisors in Bangladesh. Hierarchical regression analysis was applied to examine hypothesized relationships using AMOS a SPSS. Results: Employer safety obligations positively influenced safety climate perceptions among garment employees. Safety climate perceptions are positively and significantly associated with safety behaviors, including safety compliance behaviors, prosocial safety behaviors, and proactive safety behaviors. Moreover, the safety climate mediates the influence of employer safety obligations on safety behaviors. Conclusions: These findings provide important evidence of the relationships between employer safety obligations, safety climate, and safety behaviors in the garment industry of Bangladesh. Practical Applications: Ultimately, these findings guide the government, garment manufacturers, and managers to bolster garment employees’ safety outcomes.

Rational medication management mode and its implementation effect for the elderly with multimorbidity: A prospective cohort study in China.

BackgroundAs one of the countries with the most serious degree of aging, the incidence of potentially inappropriate drug use among the elderly is as high as 30. 4% in Chinese communities, and the lack of effective medication management and poor medication compliance at home are the main factors. Given these situations, we constructed a Rational Medication Management Mode based on family physician service, carried out an empirical research and evaluated the implementation effect.MethodsA prospective cohort study was conducted from September to December 2021 to analyze the implementation effect of the Rational Medication Management Mode by comparing the outcome indicators between the intervention group and control group. The primary outcome of this study was medication number and polypharmacy (taking 5 or more medications) at 90 days. The secondary outcomes included the situation for behavioral self-management and knowledge-belief-behavior of rational medication use.ResultsA total of 618 elderly patients (309 in the intervention group and 309 in the control group) with multimorbidity were included in this study, those were all available at follow-up at 90 days. At 90 days, the number of medications was achieved by 3.88 (1.48), and patients with polypharmacy were reduced by 59.55% in the intervention group, having a significant difference compared with the control group (P < 0.001). Patients with medication reminders, intermittent medication and adverse drug reactions were achieved in 294 (95.15%), 47 (15.21%), and 51 (16.51%) respectively in the intervention group (P < 0.001). The knowledge, belief, behavior security and behavior compliance of rational medication use of elderly patients were all greatly improved in the intervention group at 90 days (P < 0.0001).ConclusionThe Rational Medication Management Mode based family physician service, which provides the support of manuals and pillboxes, can decrease the elderly patients' number of drugs with multimorbidity, reduce the incidence of polypharmacy, enhance behavioral self-management, increase the knowledge and belief of rational medication use, and improve the security and compliance of medication usage behavior. In order to provide a practical basis for rational medication management of elderly patients with multimorbidity under the background of long-term prescriptions in China.

Effect of Evidence-Based Diet Nursing on Intestinal Flora and Maternal and Infant Prognosis in Patients with Gestational Diabetes.

Background Gestational diabetes mellitus (GDM) refers to the diabetes first discovered or occurring during pregnancy. The incidence of gestational diabetes in China is about 1%–5%, with an increasing trend in recent years. Objective To observe the effect of evidence-based diet nursing on intestinal flora and maternal and infant prognosis in patients with gestational diabetes. Methods One hundred and thirty patients with GDM admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups according to the intervention method, with 65 cases in each group. The control group was given routine nursing plus diet nursing, while the observation group was given evidence-based nursing plus diet nursing. The changes of blood glucose index and intestinal flora before and after intervention in the two groups were detected, and the compliance behavior, pregnancy outcome, and perinatal outcome in the two groups were statistically analyzed. Results After the intervention, the fasting blood glucose, 2 h postprandial blood glucose, and HbA1c in the two groups gradually decreased (P < 0.05). Further comparison between the groups showed that the fasting blood glucose, 2 h postprandial blood glucose, and HbA1c in the observation group were lower than those in the control group (P < 0.05). After intervention, the ratios of Bifidobacterium, Lactobacillus, and Bifidobacterium to E. coli in the two groups gradually increased (P < 0.05). Furthermore, comparison between the groups showed that the ratios of Bifidobacterium, Lactobacillus, and Bifidobacterium to E. coli in the observation group were higher than those in the control group (P < 0.05). The blood glucose rate, regular prenatal examination rate, and diet control rate of the observation group were 100.00%, 100.00%, and 95.38%, respectively, which were higher than 89.23%, 92.31%, and 84.62% of the control group, and the difference was significant (P < 0.05). The pregnancy infection rate and cesarean section rate in the observation group were 0.00% and 33.85%, respectively, which were lower than 6.15% and 60.00% in the control group, and the difference was significant (P < 0.05).The premature delivery rate and polyhydramnios rate in the observation group were 3.08% and 1.54%, respectively, which were not significantly different from 6.15% to 7.69% in the control group (P > 0.05). The rates of macrosomia, neonatal hypoglycemia, and neonatal hyperbilirubinemia in the observation group were 1.54%, 3.08%, and 9.23%, respectively, which were lower than those in the control group (10.77%, 13.85%, and 23.08%), and the differences were significant (P < 0.05). The fetal malformation rate and neonatal asphyxia rate in the observation group were 0.00% and 1.54%, respectively, which were not significantly different from 1.54% to 7.69% in the control group (P > 0.05). Conclusion The application of evidence-based care combined with dietary care in GDM patients can improve intestinal flora, control blood glucose, improve patient compliance behavior, and improve maternal and infant outcomes.

Portuguese Version of the Stigma Scale: Preliminary Psychometric Characteristics.

Stigma is associated with poor prognosis of illness and reduced help-seeking behavior, self-esteem and treatment compliance. The aims of this study were to study the reliability and construct validity of the King's et al Stigma Scale, and its association with Illness and Help-Seeking Behaviors scale (IHSBS) scores. One hundred and forty mental health patients filled out the Stigma scale and the Illness and Help-Seeking Behaviors scale. The exploratory factor analysis of the stigma scale was performed, and its reliability studied. The correlation analysis was used and mean differences in Stigma Scale scores among IHSBS groups were explored. The exploratory factor analysis indicated four factors (F): F1-Disclosure, F2-Discrimination, F3-Acceptance and F4-Personal Growth, which showed acceptable/good internal consistency (α from 0.70 to 0.91). Help-seeking behaviors were not associated with stigma. The levels of Discrimination were high in the group with global high-IHSB and in patients with medium/high illness behavior (IB) and health-related worries (HW). Additionally, Disclosure and overall stigma levels were higher in groups with high-HW and with medium-IB scores (when compared with the group with low-IB). The group with low-IB also had lower levels of Acceptance and Personal Growth when compared with the groups with medium-IB and high-IB, respectively. The Stigma Scale (27 items) is a valid, reliable instrument and useful tool to assess stigma in mental health patients.