Retracted: Can the transtheoretical model motivate patients with coronary heart disease to exercise?

Li-Xia Zhu, Shuk-Ching Ho, Janet WH Sit and Hong-Gu He The above article from Nursing & Health Sciences, "Can the transtheoretical model motivate patients with coronary heart disease to exercise?" by Li-Xia Zhu, Shuk-Ching Ho, Janet WH Sit and Hong-Gu He, published online on 4th June 2014 on Wiley Online Library (wileyonlinlibrary.com) DOI: 10.1111/nhs.12150, has been retracted by agreement between the lead author, the journal's Editor in Chief, Teresa Stone, and Wiley Publishing Asia Pty Ltd. The retraction has been agreed due to the main study having been previously published. References to the previously published articles: Zhu L-X, Ho S-C, Sit JWH, He H-G. The effects of a transtheoretical model-based exercise stage-matched intervention on exercise behavior in patients with coronary heart disease: A randomized controlled trial. Patient Educ. Couns. 2014; 95: 384-392. http://www.pec-journal.com/article/S0738-3991(14)00129-3/abstract Zhu L-X, Ho S-C, Sit JWH, He H-G. Effects of a transtheoretical model-based exercise stage-matched intervention on exercise behaviour and quality of life in patients with coronary heart disease: a randomized controlled trial. J. Adv. Nurs. 2014. doi:10.1111/jan.12469 http://onlinelibrary.wiley.com/doi/10.1111/jan.12469/abstract Zhu L-X, Ho S-C, Sit JWH, He H-G. Effect of a transtheoretical model-based stage-matched exercise intervention on exercise behavior and angina in patients with coronary heart disease: a randomized controlled trial. J. Cardiovasc. Nurs. 2014. DOI: 10.1097/JCN.0000000000000162. http://journals.lww.com/jcnjournal/Citation/publishahead/Effect_of_a_Transtheoretical_Model_Based.99700.aspx.

The effects of a transtheoretical model-based exercise stage-matched intervention on exercise behavior in patients with coronary heart disease: a randomized controlled trial.

OBJECTIVE: To determine whether a transtheoretical model-based exercise stage-matched intervention (ESMI) has positive effects on the exercise behavior of sedentary patients with coronary heart disease (CHD). METHODS: The study was a randomized controlled trial with a repeated measures design. Participants (N=196) were randomly allocated to either a conventional (C) group, a patient education (PE) group, or an ESMI group. Exercise behavior was measured by exercise stages of change, exercise self-efficacy, exercise decisional balance, and duration of moderate exercise at baseline, immediate post-intervention, and at 3- and 6-month follow-up. RESULTS: Our results showed that the ESMI group demonstrated a more positive shift in exercise stages of change (p<0.01), higher exercise self-efficacy (p<0.01), greater exercise benefits (p<0.01), fewer exercise barriers (p<0.01), and longer moderate exercise duration (minutes/week) (p<0.01) after completion of the 8-week intervention compared with the C and PE groups. These significantly positive effects were maintained at 3- and 6-month follow-up. CONCLUSION: The transtheoretical model-based ESMI had significantly positive effects on the exercise behavior of sedentary CHD patients. PRACTICE IMPLICATIONS: It is important to provide a structured education program for CHD patients, preferably guided by the transtheoretical model.

Effectiveness of health education programs on exercise behavior among patients with heart disease: a systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Regular exercise has been shown to be beneficial to patients with heart disease. Previous studies have indicated that health education can effectively increase participants' physical activity. However, no systematic review was conducted to evaluate the effectiveness of health education programs on changing exercise behavior among patients with heart disease. The aim of this study was to examine the effectiveness of health education programs on exercise behavior among heart disease patients. METHOD: Potential studies were retrieved in the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMbase, PsycINFO, the British Nursing Index and Archive, Science Direct, and ERIC via EBSCOhost. Meta-analysis was done using the random-effect model. RESULTS: Thirty-seven studies were identified. Only 12 studies delivered health education based on various theories/models. Twenty-eight studies were included in the meta-analyses. The results showed that health education had significantly positive effects on exercise adherence (risk ratio = 1.35 to 1.48), exercise duration (SMD = 0.25 to 0.69), exercise frequency (MD = 0.54 to 1.46 session/week), and exercise level (SMD = 0.25), while no significant effects were found on exercise energy expenditure and cognitive exercise behavior. CONCLUSION: Health education has overall positive effects on changing exercise behavior among heart disease patients. Few theoretical underpinning studies were conducted for changing exercise behavior among heart disease patients. The findings suggest that health education improves exercise behavior for heart disease patients. Health professionals should reinforce health education programs for them.

The effects of caffeine abstinence on sleep: a pilot study.

AIM: The aim of this study was to examine whether caffeine abstinence in the evening could improve the sleep quality of those who habitually consume coffee. DESIGN: A double-blind control group design (caffeine and caffeine-free groups). SETTING: A university. SUBJECTS: A convenience sampling of 10 students (mean age 21.4 years). METHODS: It was a 14-day experiment. For the first 7 days, all participants consumed caffeinated coffee. In the following 7 days, subjects consumed caffeinated or decaffeinated coffee according to their assigned group. MEASURES: Sleep-wake parameters, self-reported sleep quality and level of refreshment. RESULTS: There were no significant differences (p>.05) among the data of the two groups identified. No significant changes (p>.05) were found in the sleep quality of either group during the study. CONCLUSION: This study confirms that caffeine abstinence in the evening might not be helpful in sleep promotion. It highlights the need to implement evidence-based practice in health promotion.

Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong.

BACKGROUND: Although nursing students are at greater risk for needlestick injuries (NSIs) and sharps injuries (SIs) than staff nurses, there is a lack of research on NSIs and SIs in students, especially in different years of study. The purpose of this study was to identify the risk factors for and prevalence of NSIs and SIs among nursing students in different years of study. METHODS: This was a cross-sectional survey study using a questionnaire confirmed to be valid and reliable, with a content validity index of 0.96 and reliability index of 0.82. RESULTS: A total of 878 nursing students (response rate, 76.61%), participated in the study. NSIs/SIs, NSIs, and SIs were significantly increased by year of study (P < .001) in both the study period and 12-month prevalence. Four predictors for NSIs/SIs were final-year study (odds ratio [OR], 11.9; 95% confidence interval [CI], 3.9-36.7), perception of not receiving prevention training (OR, 2.8; 95% CI, 1.1-7.5), perception of not using a kidney dish to contain used needles and sharps (OR, 4.2; 95% CI, 1.7-10.3), and perception of not immediately discarding used needles and syringes into a sharps box (OR, 2.9; 95% CI, 1.2-7.4). CONCLUSIONS: Preclinical training, reinforcement of kidney dish use, immediate discarding of used needles, and adequate clinical supervision are essential elements in reducing the risk of NSIs and SIs.

The experiences of Chinese patients with coronary heart disease.

AIM: To explore the experiences of patients with coronary heart disease in China. BACKGROUND: The morbidity and mortality rates of people with coronary heart disease have been growing rapidly in the past decades in China, yet little is known about the experiences of Chinese patients with the disease. DESIGN: A qualitative descriptive study. METHODS: Face-to-face semi-structured interviews were employed in this study. Using a purposive sample, 11 participants who had been diagnosed with coronary heart disease for at least one month were recruited. A content analysis was used to identify themes. RESULTS: Three themes were identified from the data: experiencing a life-threatening illness, strategies for adapting to living with coronary heart disease and help-seeking behaviour. CONCLUSION: Chinese patients with coronary heart disease experienced the disease as a life-threatening illness related to chest pain. Chinese culture, values and beliefs influenced their adaptation strategies and help-seeking behaviour. Their misconceptions about coronary heart disease and the information needs for lifestyle changes were evident in this study. This study highlights the need for health education to support coronary heart disease patients in China. RELEVANCE TO CLINICAL PRACTICE: The findings provide useful information for Chinese health professionals to develop interventions for Chinese patients with coronary heart disease.

Analysis of needlestick injuries among nursing students in Hong Kong.

BACKGROUND: Research has shown that nursing personnel are exposed to the serious risk of contracting bloodborne diseases from needlestick and sharps injuries (NSIs). Only a few studies have examined the problem among nursing students. In Hong Kong, there is an equal lack of research in this area. METHODS: A review of accident reports in one university was employed to determine the injury rate, causation, and epidemiological profile of NSIs. Descriptive statistics, prevalence, incidence density, cumulative incidence, and Fisher's exact test were used to analyze the data. RESULTS: From January 2002 to December 2006, there were a total of 51 reported cases of NSIs (43 needlestick injuries and 8 sharps injuries). The annual prevalence of NSIs in four academic years from 2002-2003 to 2005-2006 ranged from 0.6 to 1.6 cases while the incidence rate was one new case per 100 nursing students per academic year. The cumulative incidence of NSIs for year-one, year-two and year-three students were 0, 0.03 and 0.004 respectively. The majority of needlestick injuries (n=25; 58.14%) were from contaminated needles. Procedures involved in the needlestick injuries were giving injection (n=22; 51.16%), collecting urine specimen (n=5; 11.63%), removal of urinary catheter (n=4; 9.30%), and checking blood glucose using glucometer (n=3; 6.98%). Giving injection (n=5; 62.50%) also accounted for the highest percentage of sharps injuries. Specific activities that were identified were opening the needle cap, opening ampoules, inserting the needle and mixing dirty and clean material in one kidney dish. CONCLUSIONS: Results showed that nursing students are at high risk of occupational exposure to bloodborne pathogens because of NSIs. A hierarchy control involving engineering, administrative and personal behavioral activities is recommended to reduce the occurrence of NSIs among nursing students.

Nonpharmacologic sleep promotion: bright light exposure.

This paper presents findings on utilizing bright light to entrain the sleep-wake cycle in order to improve the perceived quality of sleep.The feasibility of including bright light as one of the nonpharmacologic nursing interventions for sleep promotion is discussed. A decade ago, nurses relied on sleeping pills to solve patients' sleep problems (Halfens et al. 1991). Reported obstacles to the development of sleep management tools included insufficient knowledge of sleep (Edéll-Gustafasson et al. 1994) and unfamiliarity with effective nursing methods for tackling sleep problems (Halfens et al. 1991). Ten years later, nurses took the initiative in sleep promotion activities. In their book, Morgan and Closs (1999) introduced several sleep management methods in nursing practice. Floyd et al. (2000) summarized that 12 nonpharmacologic interventions used by nurses in the past to promote sleep. These 12 interventions are categorized according to their mechanism of action as relaxation, noise management, circadian repatterning and sleep hygiene. Light is thought to regulate the circadian system (Dawson & Van den Heuvel 1998) as a major synchronizer of endogenous circadian cycles (Dijk et al. 1995).