Exclusive breastfeeding intention among pregnant women and associated variables: a cross-sectional study in a Brazilian community / Intenção de amamentar entre gestantes e variáveis associadas: estudo transversal em uma comunidade brasileira

ABSTRACT Objective: To investigate exclusive breastfeeding (EBF) intention and associated variables among women in the third trimester of pregnancy. Methods: The data were collected with a questionnaire for the pregnant women (n=653), from December/2018 to November/2019. They answered the Infant Feeding Intentions (IFI) scale, translated and adapted to Brazilian Portuguese, and a questionnaire on sociodemographic, biological, family, pregnancy, breastfeeding, health care, and habits variables. Descriptive statistics and multiple logistic regression analyses were performed with a 5% significance level, following a multilevel hierarchical model that estimated the association between the dependent and independent variables. The outcome EBF intention measured by the IFI score was dichotomized by the median (<16 or =16). Results: Mean±standard deviation score for the IFI scale was 14.4±2.6 (score 0: very strong intention to not breastfeed at all; score 16: very strong EBF intention up to six months). The results from the regression analysis showed that pregnant women who had no intention to bottle feed (OR=4.33; 95%CI 2.79-6.72) or did not know (OR=1.85; 95%CI 1.21-2.82), those who planned the pregnancy (OR=1.52; 95%CI 1.09-2.12), those who believed they would have help to care for the baby (OR=3.60; 95%CI 1.51-8.56) or did not know (OR=3.97; 95%CI 1.26-12.51), and those who reported knowing the World Health Organization recommendations on breastfeeding (OR=1.73; 95%CI 1.13-2.64) were more likely to show a very strong EBF intention. Conclusions: Pregnant women in the third trimester of pregnancy presented a strong EBF intention. The higher EBF intention score was significantly associated with the structural, setting, and individual determinants.

RESUMO Objetivo: Investigar a intenção materna de amamentar exclusivamente (IMA) e variáveis associadas entre as mulheres no terceiro trimestre de gravidez. Métodos: A coleta de dados foi realizada por meio de entrevista e questionário semiestruturado e autoadministrado, entre dezembro/2018 e novembro/2019. As gestantes (n=653) responderam à escala Infant Feeding Intentions (IFI) testada, traduzida e adaptada para o português do Brasil e ao questionário contendo perguntas sobre variáveis sociodemográficas, biológicas e familiares, bem como relacionadas à gestação, ao aleitamento materno, à assistência à saúde e a hábitos. Foram realizadas análises estatísticas descritivas e de regressão logística múltipla hierarquizada, com nível de significância de 5%, para estimar a associação entre as variáveis independentes e o desfecho. A IMA, medida pela escala IFI, foi dicotomizada pela mediana (<16 ou =16). Resultados: A pontuação média±desvio padrão para a escala IFI foi de 14,4±2,6. Os resultados da análise de regressão mostraram que as gestantes que não tinham intenção de oferecer mamadeira (OR=4,33; IC95% 2,79-6,72) ou não sabiam (OR=1,85; IC95% 1,21-2,82), que planejaram a gestação (OR=1,52; IC95% 1,09-2,12), aquelas que acreditavam que teriam ajuda nos cuidados com o bebê (OR=3,60; IC95% 1,51-8,56) ou que não sabiam (OR=3,97; IC95% 1,26-12,51), bem como aquelas que relataram conhecer as recomendações da Organização Mundial de Saúde sobre amamentação (OR=1,73; IC95% 1.13-2.64) tinham mais chances de mostrar uma IMA muito forte. Conclusões: As gestantes no terceiro trimestre de gestação apresentaram forte IMA. A maior IMA esteve significativamente associada aos determinantes estruturais, contextuais e individuais.

Awareness rate of PCV13 and influencing factors of vaccination intention among parents of infants and young children in Huangpu District , Shanghai / 公共卫生与预防医学

Objective To understand the awareness rate and willingness of parents of school-age infants and young children in Huangpu District, Shanghai to receive the 13 valent pneumococcal conjugate vaccine (PCV13) and its influencing factors, and to provide basic data for formulating community health education policies. Methods A stratified random sampling method was used to conduct a full coverage questionnaire survey on the PVC13 awareness rate and vaccination willingness of 1030 parents of infants and young children in 10 communities. Results A total of 1000 questionnaire surveys were completed, with an accurate response rate of 97.08%. The awareness rate of PCV13 was 85.50%, and the awareness rate of complications was less than 80%. The PCV13 vaccination rate was 55.60%. 38.74% of the reasons for not being vaccinated were concerned about vaccine side effects, and 32.21% were concerned about vaccine quality. The higher the education level of parents and the per capita annual income of the family, the higher the awareness rate of pneumococcal vaccine knowledge and the willingness to receive vaccination. Parents with registered residence in other places had low willingness to vaccinate PCV13. Conclusion The public has a higher awareness of PCV13 and a higher willingness to receive vaccination. It is necessary to strengthen the scientific popularization of complications of pneumococcal pneumonia and vaccine safety, strengthen vaccine safety supervision and disclosure of regulatory results, and strengthen PCV13 science popularization for parents of infants and young children with registered residence outside the city.

Qualitative Study on the Cognition Status of Organ Donors’ Family Members to Advance Care Planning / 中国医学伦理学

Discussing the cognition, attitude and influencing factors of the family members of organ donors towards advance care planning (ACP) to provide a basis for the further promotion of ACP in the field of organ donation. Using qualitative research methods, 8 family members of organ donors were selected purposefully for semi-structured interviews, and the 7-step of Colaizzi was used to analyze and summarize the themes of the interview data. The results showed that the cognition status of the family members of organ donors of ACP could be summarized into 3 themes: problems faced by ACP implementation, positive recognition of the implementation of ACP, factors affecting the promotion of ACP. Organ donors’ family members are unfamiliar with the concept of ACP and have unclear cognition, but think that the implementation of ACP is of positive significance. It is suggested to further strengthen the publicity of ACP, medical autonomy, death education, so as to promote the development of ACP and improve the willing to donate organ.

Psychometric properties of the Entrepreneurial Intention Questionnaire (EIQ) in Dominican Republic adolescents

Introduction: This work represents the first attempt to obtain evidence of the validity of an entrepreneurial intention questionnaire in the adolescent population of a Latin American or Caribbean country. The objectives are to study the factor structure, the reliability, the external validity and to test the gender invariance of the Entrepreneurial Intention Questionnaire, in its adaptation for adolescents. Method: The sample consisted of 708 adolescents from the Dominican Republic with a mean age of 15.49, 65.2% of whom were women and 35.8% were men. Analyses included confirmatory factor analysis, Cronbach's Alpha and Omega scores for reliability, correlations, and a gender invariance routine. Finally, latent means of females and males are compared. Results: The confirmatory factor analysis showed a good fit to the data and the reliability results were adequate. In addition, the correlations with the Entrepreneurial Attitudes Scale for Students were positive and statistically significant. Also, strict gender invariance was successfully verified. Although males presented a higher subjective norm, females showed higher entrepreneurial intentions. Conclusions: The Entrepreneurial Intention Questionnaire shows adequate psychometric properties and proves useful in conducting research on the promotion of entrepreneurship in early stages.

Introducción: Este trabajo supone el primer intento de obtener evidencias de validez de un cuestionario de intención emprendedora en adolescentes en un país de Latinoamérica y el Caribe. Tiene como objetivos reportar la estructura interna, fiabilidad, validez externa y probar la invarianza de género del Cuestionario de Intención Emprendedora en su adaptación para adolescentes. Método: La muestra está formada por 708 adolescentes de República Dominicana con una media edad de 15.49, un 65.2% de mujeres y un 35.8% hombres. Los análisis incluyeron análisis factorial confirmatorio, resultados de Alfa de Cronbach y Omega para la fiabilidad, correlaciones y una rutina de invarianza por género. Finalmente se compararon las medias latentes de hombres y mujeres. Resultados: El análisis factorial mostró un buen ajuste a los datos y los resultados de fiabilidad fueron adecuados. Además, las correlaciones con la Escala de Actitudes Emprendedoras para Estudiantes fueron positivas y estadísticamente significativas. También, se comprobó satisfactoriamente la invarianza estricta por género. Aunque los hombres presentaron mayor norma subjetiva, las mujeres mostraron una mayor intención emprendedora. Conclusiones: El Cuestionario de Intención Emprendedora muestra adecuadas propiedades psicométricas para que sea de utilidad en las investigaciones sobre la promoción del emprendimiento en etapas tempranas.

Resiliencia académica, rendimiento e intención de abandono en estudiantes universitarios de Quito / Academic resilience, performance and intention to drop out in university students in Quito / Resiliência académica, desempenho e intenção de desistir entre os estudantes universitários em Quito

(analítico) La resiliencia académica es la capacidad para responder adaptativamente a las adversidades del proceso educativo y superarlas exitosamente. Este estudio explora los efectos de la resiliencia académica en una muestra de estudiantes de psicología (N = 550) de Quito, Ecuador. Los resultados de los análisis de regresión evidencian que la resiliencia se relaciona positivamente con el rendimiento académico y negativamente con la intención de abandonar los estudios universitarios. Respecto a las dimensiones de resiliencia académica (perseverancia, reflexión y búsqueda adaptativa de ayuda, así como afecto negativo y respuesta emocional), estas presentan un patrón de influencia diferenciado sobre el rendimiento y la intención de abandono. Asimismo, los efectos favorables de la resiliencia son mayores para los estudiantes que cursan niveles iniciales de carrera y se reducen en los estudiantes de niveles superiores.

(analytical) Academic resilience is the individual ability to respond adaptively to the adversities of the educational process and overcome them successfully. This study explores the effects of academic resilience in a sample of Psychology students (N=550) from Quito-Ecuador. The results of regression analyses show that resilience is positively related to academic performance and negatively related to the intention to drop out of university studies. Regarding the dimensions of academic resilience: a) perseverance, b) reflecting and adaptive help-seeking, and c) negative affect and emotional response, these present a pattern of differentiated influence on performance and dropout intention. Likewise, the favorable effects of resilience are greater for students at initial levels of career, and are reduced for students at higher levels.

(analítico) A resiliência acadêmica é a capacidade de responder de forma adaptativa às adversidades do processo educacional e superálas com sucesso. Este estudo explora os efeitos da resiliência acadêmica em uma amostra de estudantes de psicologia (N=550) de Quito-Equador. Os resultados das análises de regressão mostram que a resiliência está positivamente relacionada ao desempenho acadêmico e negativamente relacionada à intenção de abandonar os estudos universitários. Relativamente às dimensões da resiliência académica: a) perseverança, b) reflexão e procura adaptativa de ajuda, e c) afeto negativo e resposta emocional, apresentam um padrão diferenciado de influência no desempenho e na intenção de abandono. Da mesma forma, os efeitos favoráveis da resiliência são maiores para alunos que cursam níveis iniciais do curso e são reduzidos em alunos de níveis superiores.

Impacto de las Creencias Conspirativas en la Intención de Vacunación contra el COVID-19 en Adultos Mexicanos / Impact of Conspiracy beliefs on the Intention to Vaccinate against COVID-19 in Mexican Adults

Resumen Pese a los esfuerzos de las autoridades sanitarias, la presencia de información falsa o poco certera ha provocado que un porcentaje de la población mexicana se encuentra reticente a recibir la vacuna contra el COVID-19. De este modo el objetivo del presente estudio es determinar en adultos mexicanos el rol mediador de las creencias negativas sobre la vacuna y la percepción de riesgo en la relación de las creencias conspirativas y la intención de vacunación contra el COVID-19. Se realizó un estudio transversal en el que se aplicaron las escalas mediante una plataforma en línea. Las hipótesis fueron probadas mediante la técnica multivariada de análisis de senderos. Los resultados indican que las creencias conspirativas predijeron directamente menor intención de vacunación, asimismo, esta relación se encuentra parcialmente mediada por las creencias negativas sobre la vacuna y la percepción de riesgo. Los hallazgos sugieren que la adhesión a creencias conspirativas sobre el origen del CO-VID-19 favorecen el desarrollo de temor a los efectos secundarios de la vacuna y la reducción de la percepción de riesgo, convirtiéndose así, en la principal barrera de la intención de vacunación contra el COVID-19.

Abstract Despite the efforts of the health authorities, the presence of false or inaccurate information has caused a percentage of the Mexican population to be reluctant to receive the COVID-19 vaccine. Thus, the objective of the present study is to determine in Mexican adults the mediating role of negative beliefs about the vaccine and the perception of risk in the relationship between conspiracy beliefs and the intention to vaccinate against COVID-19. A cross-sectional study was carried out in which the scales were applied through an online platform. The hypotheses were tested using the multivariate trail analysis technique. The results indicate that conspiratorial beliefs directly predicted less vaccination intention, likewise, this relationship is partially mediated by negative beliefs about the vaccine and the perception of risk. The findings suggest that adherence to conspiracy beliefs about the origin of COVID-19 favor the development of fear of vaccine side effects and reduced risk perception, thus becoming the main barrier to vaccination intention against the COVID-19.

Actitudes hacia el aborto deseado en estudiantes de ciencias de la salud chilenos / Attitudes towards wanted abortion among Chilean health sciences students

Introducción: La interrupción del embarazo mediando principalmente la voluntad de la mujer, es decir, cuando una mujer desea abortar para terminar su embarazo por cualquier razón, es un procedimiento controversial. Las actitudes individuales de los profesionales de la salud hacia este procedimiento influirían sobre la aceptación o el rechazo de realizarlo y, por ende, afectarían su acceso en el sistema de salud. Objetivo: Relacionar actitudes hacia la interrupción del embarazo con características sociodemográficas y académicas de estudiantes chilenos de enfermería, medicina y obstetricia y puericultura. Método: Estudio cuantitativo con diseño observacional, transversal y descriptivo. Reclutamos estudiantes universitarios con un muestreo no probabilístico. Recolectamos datos mediante cuestionarios virtuales autoadministrados. Preguntamos por la intención de realizar o asistir un aborto médico o quirúrgico frente a 15 escenarios distintos y creamos un índice con estas respuestas. Calculamos estadísticas descriptivas básicas y creamos modelos de regresión lineal. Consideramos significancia estadística si p < 0,05. Resultados: Participaron 229, 306 y 233 estudiantes de enfermería, medicina y obstetricia y puericultura, respectivamente (en total, 768). En el modelo de regresión lineal múltiple, declararse cristiano (β = −0,248) y afirmar que la religión es muy o totalmente importante en la vida (β = −0,269) se asociaron más fuertemente y de manera inversa y significativa con el índice de intención de realizar o asistir un aborto médico o quirúrgico. Conclusiones: La religión es un factor que influiría decisivamente sobre las actitudes hacia la interrupción del embarazo. Los escenarios más positivamente valorados podrían explicarse considerando que las leyes reflejarían los valores predominantes de una sociedad.

Introduction: Termination of pregnancy mediated primarily by the womans will, i.e., when a woman wishes to have an abortion to terminate her pregnancy for any reason, is a controversial procedure. The individual attitudes of health professionals towards this procedure would affect the degree of acceptance or rejection of performing this procedure and, therefore, would affect its accessibility in the health system. Objective: To relate attitudes towards abortion with sociodemographic and academic characteristics of Chilean nursing, medicine and midwifery students. Method: Quantitative study with observational, cross-sectional and descriptive design. We recruited university students with non-probabilistic sampling. We collected data through self-administered virtual questionnaires. We asked about the intention to perform an abortion in 15 different scenarios and created an index with these responses. We calculated basic descriptive statistics and created linear regression models. We considered statistical significance if p < 0.05. Results: 229, 306 and 233 students from nursing, medicine and midwifery participated, respectively (total: 768). In the multiple linear regression model, declaring oneself a Christian (β = −0.248) and stating that religion is very or totally important in life (β = −0.269) were inversely and significantly associated with the index of intention to perform an abortion. Conclusions: Religion is a factor that would decisively influence attitudes toward termination of pregnancy. The more positively valued scenarios could be explained by considering that laws would reflect the predominant values of a society.

Green Products Purchase Intention in Chilean Consumers: Comparing Three Models Using Structural Equations / Intención de Compra de Productos Ecológicos en Consumidores Chilenos: Comparación de Tres Modelos por Ecuaciones Estructurales

Abstract The objective of this study was to compare three models: the theory of reasoned action (TRA), the theory of planned behavior (TPB), and its extended form (ETPB), to predict the intention of Chilean consumers for purchasing green products. Five hundred people were surveyed, establishing an inter-rater reliability analysis, and a discriminant, convergent and construct validity using three structural equation models (SEM). The results showed that the ETPB model is useful to explain the consumption behavior intention for green products based on a triple bottom line, whose main contribution is the indirect effect of EC on the model. The study found that of the three variables, PBC was the strongest predictor of purchase intention, followed by attitude. In conclusion, both the ETPB model and the green products purchase intention instrument contribute to broaden the studies about consumer behavior in sustainable marketing in Chile.

Resumen El objetivo del presente estudio fue comparar los modelos de teoría de acción razonada (TAR), teoría de comportamiento planificado (TCP) y su forma extendida (TCPE), para predecir la intención de compra de productos ecológicos en consumidores chilenos. Se encuestaron 500 personas y se estableció un análisis de fiabilidad interjuez, validez discriminante, convergente y de constructo a través de modelos de ecuaciones estructurales (SEM). Los resultados señalan que el modelo TCPE es útil para explicar la intención de comportamiento de consumo ante productos verdes con base en una triple línea de fondo, cuya principal contribución es el efecto indirecto de PA sobre el modelo. De las tres variables, se evidencia que el CCP era la predictora más fuerte de la intención de compra, seguida de la actitud. En conclusión, tanto el modelo TCPE como el instrumento de intención de compra de productos verdes contribuyen a la ampliación de estudios sobre el comportamiento del consumidor en marketing sustentable en Chile.

Trajetórias afetivo-sexuais de adolescentes em situação de pobreza e suas decisões-ações intencionais para engravidar / Affective-sexual trajectories of adolescents in poverty and their intentional decisions-actions to become pregnant / Trayectorias afectivo-sexuales de adolescentes en situación de pobreza y sus decisiones-acciones intencionales para conseguir embarazar

Objetivo: entender como eventos relacionais, posições sobre métodos contraceptivos e negociações com o parceiro sobre ter o filho encontram-se implicados nos engravidamentos das participantes. Método: participaram dezesseis grávidas entre 15 e 19 anos, que intencionaram o evento, selecionadas em território de vulnerabilidade social de uma capital brasileira. Foram realizadas entrevistas presenciais, orientadas por temas, com o uso adicional dos recursos: autorretrato, mapa relacional, foto-elicitação e WhatsApp, considerando preceitos da Análise de Conteúdo Temática. Resultados: os engravidamentos mostraram-se intrincados à intenção de constituir uma família com filhos, à construção de trajetórias afetivo-sexuais direcionadas a esse desfecho, com contracepção secundária, e à decisão do ter filho pouco refletida e negociada com o par, caracterizada por pressão, imposição e transferência de responsabilidade, exercida por ambos. Conclusão:a abordagem, pelos profissionais de saúde, do engravidar de adolescentes requer considerar a influência nelas imbricada de aspectos de ordem subjetiva, relacional, agencial e social.

Objective: to understand how relational events, contraceptive positions and negotiations with the partner about having a child are implicated in the participants' pregnancies. Method: A total of 16 pregnant young women aged between 15 to 19 years who became pregnant intentionally, selected from a socially vulnerable territory in a Brazilian state capital, participated in the study. Face-to-face interviews guided by themes were conducted, with additional use of the self-portrait, relational map, photo-elicitation, and WhatsApp resources, considering Thematic Content Analysis concepts. Results: the pregnancies were intimately related to the intention of building a family with children, to the construction of affective-sexual trajectories directed at this outcome, with secondary contraception, and to the decision of having a child, little reflected and negotiated, characterized by pressure, imposition and transfer of responsibility, exercised by both. Conclusion:when discussing pregnancy during adolescence, health professionals must consider the subjective, relational, agency and social aspects imbricated in such choice.

Objetivo: entender cómo los hechos relacionales, las posturas sobre los métodos anticonceptivos y las negociaciones con la pareja sobre tener un hijo intervienen en el embarazo de las participantes. Método: participaron 16 embarazadas de entre 15 y 19 años de edad que pretendían el evento, seleccionadas en un territorio de vulnerabilidad social, en una capital brasileña. Se realizaron entrevistas cara a cara, guiadas por temas, con el uso adicional de recursos de autorretrato, mapa relacional, fotoelicitación y WhatsApp; y se consideraron los preceptos del Análisis de Contenido Temático. Resultados: destacan en sus embarazos la intención de constituir una familia con hijos, la construcción de trayectorias afectivo-sexuales encaminadas a ese desenlace, con anticoncepción secundaria, y la decisión de tener un hijo poco discutida y negociada con la pareja, caracterizada por la presión, la imposición y la transferencia de responsabilidad, ejercida por ambos. Conclusión:el abordaje del embarazo en adolescentes por parte de los profesionales de la salud requiere considerar la influencia imbricada de aspectos subjetivos, relacionales, de agencia y sociales

Knowledge, intention, and practice of wearing face mask by common people to ensure protection against COVID-19 during pandemic

Background: Since the outbreak of global pandemic, wearing face mask not only protects the individual but also limits the spread of corona virus infection in the community. However, certain sociocultural and personal factors have created hinderance in wearing face mask by general people against COVID-19 virus. Aims and Objectives: The aim and objective of this study is to assess the knowledge, intension, and practice of wearing face mask among common people. Materials and Methods: It was a cross-sectional study conducted among general people in a part of Western Odisha after ethical approval. A total of 1050 adults above 18 years participated in this study. The data were collected from different locality of the town using a pretested self-administered questionnaire by all authors and research assistants of this project. The period of study was from July 2021 to December 2021. The results were tabulated, processed, and analyzed using SPSS-20. Results: Regarding knowledge score, we observed that 57% had average, 18% had poor, and 25% had good knowledge. Furthermore, we found 42% participants had positive intention and 58% had negative intention. Again we assessed that 35% of participants were practicing face mask appropriately and 65% practicing inappropriately. Conclusion: In this study, the score of knowledge, intention, and also the practice of wearing face mask against COVID-19 was lower than the average as compared to previous researches. Hence, health authorities should promote the people to wear mask and encourage awareness programs for the benefit of the society.

Psychosocial factors related to the behavioral intention of people with type 2 diabetes using insulin / Fatores psicossociais correlacionados com a intenção comportamental das pessoas com diabetes mellitus tipo 2 (DM2) para uso de insulina / Factores psicosociales correlacionados con la intención conductal de personas con diabetes mellitus tipo 2 (DM2) para uso de insulina

ABSTRACT Objectives: to analyze the psychosocial factors correlated with the behavioral intention of people with Type 2 Diabetes Mellitus (T2DM) towards insulin use. Methods: a cross-sectional study; a validated instrument based on the Theory of Planned Behavior was used to identify the direct measures (attitude, subjective norm and perceived control), indirect measures (behavioral, normative and control beliefs) and behavioral intention for the use of insulin. Descriptive analysis and Spearman's correlation were performed for data analysis. Results: a total of 211 individuals participated in the study, with a positive median of behavioral intention. Attitude, normative and behavioral beliefs were the psychosocial factors that presented a significant correlation (r=0.16, r=-0,15 and r=0.25, respectively; p<0.05) with the intention. Conclusions: there is a positive behavioral intention in the use of insulin by people with T2DM. Attitude, normative beliefs and behavioral beliefs have a low magnitude correlation with the intention of people with T2DM to use insulin.

RESUMO Objetivos: analisar os fatores psicossociais correlacionados com a intenção comportamental das pessoas com diabetes mellitus tipo 2 (DM2) para uso de insulina. Métodos: estudo transversal. Instrumento validado com base na Teoria do Comportamento Planejado foi utilizado para identificar as medidas diretas (atitude, norma subjetiva e controle percebido), medidas indiretas (crenças comportamentais, normativas e de controle) e intenção comportamental para uso da insulina. Análise descritiva e correlação de Spearman foram realizadas para a análise dos dados. Resultados: um total de 211 indivíduos participaram do estudo, com uma mediana positiva de intenção comportamental. Atitude, crenças normativas e comportamentais foram os preditores que apresentaram uma correlação significante (r=0,16, r=-0,15 e r=0,25, respectivamente; p<0,05) com a intenção. Conclusões: há uma intenção comportamental positiva no uso da insulina por pessoas com DM2. Atitude, crenças Normativas e crenças comportamentais têm uma correlação de baixa magnitude com a intenção das pessoas com DM2 de usar insulina.

RESUMEN Objetivos: analizar los factores psicosociales correlacionados con la intención conductal de personas con diabetes mellitus tipo 2 (DM2) para uso de insulina. Métodos: estudio transversal. Instrumento validado basado en la Teoría de Conducta Planeada fue utilizada para identificar las medidas directas (actitud, norma subjetiva y control percibido), medidas indirectas (creencias conductuales, normativas y de control) e intención conductal para uso de insulina. Análisis descriptivo y correlación de Spearman fueron realizados para el análisis de datos. Resultados: un total de 211 individuos participaron del estudio, con una mediana positiva de intención conductal. Actitud, creencias normativas y conductuales fueron los predictores que presentaron una correlación significante (r=0,16, r=-0,15 y r=0,25, respectivamente; p<0,05) con la intención. Conclusiones: hay una intención conductal positiva en el uso de insulina por personas con DM2. Actitud, creencias Normativas y creencias conductuales tienen una correlación de baja magnitud con la intención de personas con DM2 de usar insulina.

Intention of breastfeeding and association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women / Intenção de amamentar e associação com características sociodemográficas, obstétricas e experiência com o aleitamento materno entre mulheres grávidas

Abstract Objectives: to estimate the intention of breastfeeding (IBF) duration and its association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women undergoing prenatal care. Methods: cross-sectional study, with pregnant women undergoing prenatal care in public health services in Colombo, Paraná, Brazil. The duration of IBF was questioned to pregnant women. Negative binomial Poisson regression with robust variance adjustment allowed estimating crude and adjusted prevalence ratios (PR), and 95% confidence intervals (CI95%) of the association between IBF duration and exposure variables. Results: among the participating pregnant women (n = 604), 7.9% reported having IBF for less than six months, 28.0% from six to 11 months, 38.3% from 12 to 23 and 25.9% for 24 months or more. The mean IBF time was 13.5 ± 8.4 and median of 12 months. Pregnant women with moderate food insecurity (PR=1.34; CI95%=1.04-1.73), multiparous women (PR=1.13; CI95%=1.00-1.26), and who reported having been breastfed as babies (PR=1.19; CI95%=1.02-1.40) had a longer IBF time. Conclusions: food security situation, primiparity and exposure to breastfeeding in childhood are determinants of IBF during pregnancy.

Resumo Objetivos: estimar o tempo de intenção de amamentar (IA) e sua associação com características sociodemográficas, obstétricas e experiência com amamentação entre gestantes em acompanhamento pré-natal. Métodos: estudo transversal com gestantes em serviços públicos de saúde em Colombo, Paraná. O tempo de IA foi questionado às gestantes. Regressão de Poisson binomial negativa com ajuste robusto da variância permitiu estimar razões de prevalência (RP) brutas e ajustadas, e intervalos de confiança de 95% (IC95%) da associação entre tempo de IA e variáveis de exposição. Resultados: dentre as gestantes (n = 604), 7,9% afirmaram IA por menos de 6 meses, 28,0% de 6 a 11 meses, 38,3% de 12 a 23 e 25,9% por 24 meses ou mais. O tempo médio de IA foi de 13,5 ± 8,4 e mediana de 12 meses. Gestantes em insegurança alimentar moderada (RP=1,34; IC95%=1,04-1,73), multíparas (RP=1,13; IC95%=1,00-1,26), e que referiram terem sido amamentadas quando bebês (RP=1,19; IC95%=1,02-1,40) apresentaram maior tempo de IA. Conclusões: situação de segurança alimentar, primiparidade e exposição ao aleitamento materno na infância são determinantes da IA na gestação.

Adaptación transcultural de instrumentos para el estudio de acoso psicológico y factores relacionados en enfermeras/os

Objetivo: Presentar el proceso de adaptación transcultural de instrumentos utilizados para determinar la relación entre acoso psicológico en el trabajo, ambiente laboral y calidad de vida profesional en la intención de renuncia de profesionales de enfermería en dos países de Sudamérica: Chile y Perú. Material y Método: Estudio de corte transversal, metodológico realizado en los años 2022 y 2023. Para la validez de contenido se consideraron dos etapas: 1) revisión crítica de los instrumentos por parte del equipo investigador; 2) revisión del contenido a través del trabajo con expertas/os con la aplicación del método Delphi en conjunto con el cálculo de índices de validez de contenido. Para la consistencia interna los instrumentos fueron piloteados utilizando la plataforma QuestionPro® aplicando un muestreo por conveniencia a través de un llamado abierto en redes sociales (Facebook®, Twitter®y Linkedin®) a profesionales de enfermería que cumplieran con los criterios de inclusión y exclusión. La fase de pilotaje fue en una muestra de 30 profesionales por país. Como medida de consistencia interna se calculó un Alfa de Cronbach. Resultados: En la validación de contenido participaron entre siete y nueve expertas en las áreas de interés para el problema de investigación. La primera ronda de la técnica Delphi tuvo buenos índices de validez de contenido por ítem y promedio, el índice de contenido universal indicó la necesidad de realizar ajustes lingüísticos. Todos los instrumentos presentaron niveles aceptables de consistencia interna. Conclusiones: Se cuenta con instrumentos adaptados para el análisis del fenómeno en estudio para cada país.

Objective: To present the process of cross-cultural adaptation of instruments used to determine the relationship between psychological harassment at work, work environment and professional quality of life, in relation to the intention to leave the job, of nursing professionals in two South American countries: Chile and Peru. Material and Method: Cross-sectional, methodological study carried out in the years 2022 and 2023. Two stages were considered for content validity: 1) critical review of the instruments by the research team, 2) review of the content by working with experts using the Delphi method, along with the calculation of content validity indices. To ensure internal consistency, the instruments were piloted using the QuestionPro® platform by applying convenience sampling through an open call on social networks (Facebook®, Twitter® and Linkedin®) to nurses who met the inclusion and exclusion criteria. The pilot phase was conducted with a sample of 30 professionals per country. Cronbach's alpha was calculated as a measure of internal consistency. Results: Between seven and nine experts in the areas of interest of the research problem participated in the content validity process. The first round of the Delphi technique showed good content validity indices per item and average, the universal content index indicated the need for linguistic adjustments. All instruments showed acceptable levels of internal consistency. Conclusions: For each country there are instruments adapted to the analysis of the phenomenon under study.

Objetivo: Apresentar o processo de adaptação transcultural de instrumentos utilizados para determinar a relação entre assédio moral no trabalho, ambiente de trabalho e qualidade de vida profissional na intenção de deixar o emprego de profissionais de enfermagem em dois países da América do Sul: Chile e Peru. Material e Método: Estudo transversal e metodológico realizado nos anos 2022 e 2023. Duas etapas foram consideradas para a validade de conteúdo: 1) revisão crítica dos instrumentos pela equipe de pesquisa; 2) revisão do conteúdo por meio do trabalho com especialistas usando o método Delphi, juntamente com o cálculo dos índices de validade de conteúdo. Para garantir a consistência interna, os instrumentos foram testados usando a plataforma QuestionPro®, aplicando amostragem por conveniência por meio de uma chamada aberta nas redes sociais (Facebook®, Twitter® e Linkedin®) para enfermeiros que atendiam aos critérios de inclusão e exclusão. A fase piloto foi realizada com uma amostra de 30 profissionais por país. O alfa de Cronbach foi determinado como uma medida de consistência interna. Resultados: Entre sete e nove especialistas nas áreas de interesse do problema de pesquisa participaram da validação do conteúdo. A primeira rodada da técnica Delphi apresentou bons índices de validade de conteúdo por item e média; o índice de conteúdo universal indicou a necessidade de ajustes linguísticos. Todos os instrumentos apresentaram níveis aceitáveis de consistência interna. Conclusões: Para cada país existem instrumentos adaptados para a análise do fenómeno em estudo.

Association between Pacifier Use, Bottle-Feeding, and Pre-Postnatal Variables: A Cohort Study

ABSTRACT Objective: To determine the prevalence and analyze the variables associated with the use of pacifiers and/or bottles by infants up to 6 months of age. Material and Methods: Data on sociodemographic characteristics, intention to offer pacifier and bottle-feeding, pregnancy and breastfeeding (BF) variables were collected at baseline by interviews and a self-administered questionnaire among pregnant women in the 3rd trimester. After delivery, mother-baby binomials were followed by phone calls at the 1st, 3rd, and 6th months of the baby's life (n=467) to gather information on the type of delivery, baby's gender, BF in the first hour of the newborn's life, baby's weight, mother's return to work, and oral habits. Association analyses were performed using logistic regression models with a 5% significance level with the pacifier/bottle-feeding use as the outcome. Results: Most mothers (52.5%) reported their babies used bottle-feeding, 48.2% used pacifiers and 33.4% used both of them throughout the 6 months. Intention to offer pacifier and bottle-feeding was reported by 45.0% and 54.8% of the mothers at the 3rd trimester of the pregnancy, respectively. Not living in one's own residence (OR=1.53; 95%CI: 1.05-2.24) and having the prenatal intention of offering a pacifier (OR=2.50; 95%CI: 1.63-3.83) to the baby were significantly associated with pacifier use. Variables significantly associated with bottle-feeding were mother's return to work (OR=2.48; 95%CI: 1.54-3.97), baby's lower birth weight (OR=1.58; IC95%: 1.07-2.33), and prenatal intention to offer bottle-feeding (OR=2.51; 95%CI 1.56-4.04). Conclusion: About half of the babies used pacifiers or were bottle-fed, which were associated with the mother's prenatal intention to offer them to their babies and socioeconomic factors.

Analysis on the status and influencing factors of health care intention in transitional children and adolescents with diabetes / 中国实用护理杂志

Objective:To investigate the intention to participate in health care in transitional children and adolescents with diabetes and analyze its influencing factors.Methods:This was a cross-sectional survey study. From March to October 2021, 185 children and adolescents with diabetes were selected as research subjects by convenience sampling method from People′s Hospital Affiliated to Jiangsu University. General data questionnaire, Participation in Health Care Intention Questionnaire, Health Literacy Scale and Diabetes Self-management Scale were used to investigate, and multiple linear regression was used to analyze the influencing factors of the population′s intention to participate in health care.Results:The transitional children and adolescents with diabetes participation in health care intention total score was (124.87 ± 16.31) points, the health literacy total score was (33.70 ± 4.38) points, diabetes self-management total score was (35.11 ± 5.19) points. The regression analysis found that age, course of the disease, diabetes type, family structure modes, health literacy, and self-management ability were the main factors influencing adolescents involved in health care intention ( t values were -1.99-2.66, all P<0.05), including health literacy ability and disease management ability was positively correlated with the disease ( r = 0.250, 0.232, both P<0.01). Conclusions:The transitional children and adolenscents with diabetes have a medium level of intention to participate in health care. The transitional children and adolenscents with older age, longer disease course and nuclear family structure had higher levels of health care intention. The higher the level of health literacy and self-management, the higher the level of intention to participate in health care, medical staff should take targeted measures to improve the intention to participate in health care, promote this group to improve disease management ability and quality of life.

Mechanism of turnover intention of junior nurses as second victims after experiencing adverse events / 中国实用护理杂志

Objective:To explore the mechanism of turnover intention of junior nurses after adverse events from three aspects: work pressure, leadership style and personal characteristics.Methods:This study was a cross-sectional survey, using the convenience sampling method, 289 nurses from Shanxi Bethune Hospital from December 2020 to March 2022 were selected as the research subjects, and the general data questionnaire, the Separation Tendency Scale, the Nurses′ Work Stressor Scale, the Service-oriented Leadership Style Scale, and the Prospective Personality Scale were used to survey them.Results:Structural equation model showed that nurses′ job stressor level positively predicted turnover intention, with a path coefficient of 0.74, P<0.01, while service-oriented leadership style and forward-looking personality negatively predicted turnover intention, with path coefficients of -0.60 and -0.37, respectively, both P<0.01. Hierarchical regression analysis showed that both service-oriented leadership style and forward-looking personality negatively moderated the promotion of job stressors on turnover intention, and the moderating effect regression coefficients were -0.146, -0.215, both P<0.01. Conclusions:Hospitals should improve the prospective personality traits of junior nurses and cultivate the service-oriented leadership style of nursing managers after adverse events, so as to reduce the turnover tendency of junior nurses as the second victim, promote the improvement of nursing quality, and stabilize nursing team development.

Turnover Intention and Influencing Factors of Staffs in Centers for Disease Control and Prevention in the Post-Corvid-19 Era / 中山大学学报(医学科学版)

ObjectiveTo investigate the current situation of turnover intention of staffs in Center for Disease Control and Prevention（CDC） in the post-COVID-19 era and analyze the influencing factors of turnover intention， so as to provide policy suggestions and reference basis for maintaining the stability of the team of CDC and promote the development of health industry in China. MethodsA questionnaire survey on 1，508 staffs in Shenzhen Center for Disease Control and Prevention by means of WenJuanXing electronic questionnaire from January to February 2023 was conducted .Logistic stepwise regression analysis were used to analyze the influencing factors of turnover intention. ResultsAmong the 1，508 respondents， 583 （38.66%） had resignation intention. Logistic stepwise regression analysis showed that the scores of work arrangement， salary level ，professional title promotion system， occupational will，worry about job prospects were related to the generation of turnover intention ［OR 95%CI： 0.783（0.643， 0.952）； 0.531（0.452， 0.623）； 0.738（0.614， 0.887）； 0.605（0.520， 0.703）； 0.614（0.529， 0.714）］. In addition， job title， age and education were also related to generation of turnover intention （P <0.05）. ConclusionDisease prevention and control institutions should reduce the turnover intention of staffs in CDC through reasonable work arrangement， improvement of salary， adjustment of professional title promotion system， strengthening of professional cognition and enhancing confidence of personnel in career prospects.

Development of job characteristics questionnaire for railway employees and test on its reliability and validity / 四川精神卫生

BackgroundThe mental health of employees in railway enterprises is related to the safety and stability of railway transportation. As an important factor affecting occupational mental health， job characteristics have attracted the attention of researchers. However， there exists a lack of job characteristic scales with occupational specificity in current researches relevant to the railway industry. ObjectiveTo develop a job characteristics questionnaire oriented to railway employees that takes both Job Demands-Resources Model （JD-R） and Chinese actual conditions into essential consideration， so as provide guidance for the research on the mental health of railway employees. MethodsPurposive and theoretical samplings were used to select 77 employees across 9 railway units as research objects， and interview method was used to conduct qualitative research in order to determine the structural dimensions and items of the questionnaire. The 612 subjects randomly selected from the railway maintenance system went through the preliminary test， then exploratory factor analysis and confirmatory factor analysis were employed to test the questionnaire. After forming a formal questionnaire on the job characteristics of railway employees， it is extended to the other four main industry systems of railway enterprises， responsible for locomotive maintenance， vehicle depot， signal and communication maintenance， and power supply respectively， to verify the stability and effectiveness. Results①Exploratory factor analysis showed that the questionnaire included two factors， job demands and job resources， with a total of 14 items. The factor loading of each item ranged from 0.761 to 0.916， and the two factors accounted for 71.02% of the total variance. The results of confirmatory factor analysis indicated good fitting of the two-factor model （χ2/df=3.310， RMSEA=0.087， GFI=0.892， CFI=0.932， NFI=0.905， IFI=0.932）. ② Confirmatory factor analysis was carried out in four extended samples of locomotive maintenance， vehicle depot， signal and communication maintenance， and power supply， and each result indicated a satisfactory model fit（χ2/df=2.678， 4.741， 4.868， 3.502， RMSEA=0.109， 0.096， 0.093， 0.084，GFI=0.832， 0.878， 0.894， 0.904，NFI=0.874， 0.935， 0.902， 0.928，IFI=0.917， 0.948， 0.920， 0.947）. ③Job demands in five sub-samples can positively predict job burnout and turnover intention （β=0.564~0.686， 0.425~0.554， P<0.01）. Job resources in five sub-samples can positively predict job performance and job satisfaction （β=0.594~0.752， 0.731~0.807， P<0.01）， and it can also negatively predict job burnout and turnover intention （β=-0.247~-0.186， -0.357~-0.175，P<0.05 or 0.01）.In sub-samples of locomotive maintenance and power supply， job demands can positively predict job performance （β=0.242，0.261， P<0.01）.In sub-samples of railway maintenance and signal and communication maintenance， job demands can negatively predict job satisfaction （β=-0.065， -0.091， P<0.01）. ConclusionThe questionnaire has good reliability and validity， and is applicable for the study of occupational mental health research on railway employees. ［Funded by Major Projects of the National Social Science Foundation of China （number， 19ZDA3580）， Scientific Research and Development Program of China Railway Chengdu Group Co.， Ltd （number， CX21099）］

Behavioral Intention Scale for End-of-life DiscussionsReliability and Validity Using a Web-based Survey

Purpose: The purpose of this study was to examine the reliability and validity of the behavioral intention scale for end-of-life discussions. Methods: The scale items were developed according to the Theory of Planned Behavior. The drafts of the scale were created by Item-Level Content Validity Index (I-CVI) and a preliminary test. In the main study, we administered a cross-sectional questionnaire on the web to the participants 20–79 years of age (n=860), living in Tokyo and six surrounding prefectures, and a retest one week later (n=665). We examined item analysis, calculation of a reliability coefficient (intraclass correlation coefficient, Cronbach's alpha coefficient), construct validity, and concurrent validity of the scale. Results: Six factors identified by an exploratory factor analysis were; outcome evaluation, perceived power, control beliefs, motivation to comply, normative beliefs, and behavioral beliefs. The alpha coefficient of the overall scale was .96. The effect size that was determined based on known-groups validity and the correlation coefficient determined on the basis of concurrent validity were moderate. Conclusions: The reliability and validity of the scale were generally confirmed.

A study of factors influencing the willingness of primary healthcare workers in Qinghai Province to engage in non-discriminatory behaviors towards HBV-infected patients / 上海预防医学

ObjectiveTo understand the current status of primary healthcare workers’ knowledge of hepatitis B and their willingness to engage in non-discriminatory behaviors， to explore the factors influencing their willingness， and to provide a basis for health education on hepatitis B for primary healthcare workers in Qinghai Province. MethodsA questionnaire survey was conducted among primary healthcare institutions in eight cities （prefectures） of Qinghai Province using a combination of random sampling and convenience sampling. The questionnaire included demographic information， knowledge related to hepatitis B， and willingness to engage in non-discriminatory behaviors. ResultsA total of 393 subjects were included in the survey. The accurate awareness rate of hepatitis B transmission route among primary healthcare workers in Qinghai Province was 36.89%. Of the respondents， 46.31% were unwilling to live with family members infected with HBV or carriers， and 50.13% were unwilling to dine with friends infected with HBV or carriers. The willingness of primary healthcare workers to engage in non-discriminatory behaviors related to hepatitis B varied by different places of residence， gender， marital status and per capita household income （P<0.05）. Regarding different dimensions of HBV-related knowledge， there were significant differences in age， education level， and per capita household income for transmission route （P<0.05）. Vaccination showed significant differences based on marital status and per capita family income （P<0.05）. There were significant differences in treatment and outcome among different gender， education level， and per capita family income. Anti-discrimination policies varied significantly by place of residence， age， ethnicity， and per capita income. Multivariate logistic regression analysis showed that primary healthcare workers’ knowledge of hepatitis B transmission route was a significant factor influencing their willingness to engage in non-discriminatory behaviors （OR=0.49， 95%CI：0.29‒0.84）. ConclusionIt is essential to continuously strengthen hepatitis B health education for primary healthcare workers in western China to reduce the willingness to engage in non-discriminatory behaviors towards hepatitis B and protect the rights of HBV-infected individuals.