Unraveling the connections between gut microbiota, stress, and quality of life for holistic care in newly diagnosed breast cancer patients.

There is little research about the stress, quality of life (QOL) and gut microbiota in newly diagnosed breast cancer patients. In this study addressing the dearth of research on stress, quality of life (QOL), and gut microbiota in newly diagnosed breast cancer patients, 82 individuals were prospectively observed. Utilizing the Functional Assessment of Chronic Illness Therapy (FACT)-Breast questionnaire to assess health-related quality of life (HRQOL) and the Distress Thermometer (DT) to gauge distress levels, the findings revealed a mean FACT-B score of 104.5, underscoring HRQOL's varied impact. Significantly, 53.7% reported moderate to severe distress, with a mean DT score of 4.43. Further exploration uncovered compelling links between distress levels, FACT-B domains, and microbial composition. Notably, Alcaligenaceae and Sutterella were more abundant in individuals with higher DT scores at the family and genus levels (p = 0.017), while Streptococcaceae at the family level and Streptococcus at the genus level were prevalent in those with lower DT scores (p = 0.028 and p = 0.023, respectively). This study illuminates the intricate interplay of stress, QOL, and gut microbiota in newly diagnosed breast cancer patients, offering valuable insights for potential interventions of biomarker or probiotics aimed at alleviating stress and enhancing QOL in this patient cohort.

Psychobiotic supplementation of HK-PS23 improves anxiety in highly stressed clinical nurses: a double-blind randomized placebo-controlled study.

Nurses often experience adverse health effects associated with increasing levels of work-related stress. Stress may induce systemic effects through the HPA axis, glucocorticoid responses, and inflammatory cascades. Psychobiotics may help alleviate stress through associations of the microbiota, anti-inflammation factors, and the gut-brain axis. We aimed to investigate whether interventions with a psychobiotic, heat-killed (HK)-PS23 cells, may help improve perceived stress, anxiety, and related biological markers among highly stressed clinical nurses. This double-blind, randomized, placebo-controlled study included seventy clinical nurses from a medical center in Northern Taiwan who scored 27 or higher on the 10-item version of the Perceived Stress Scale (PSS), and participants were randomized into either taking HK-PS23 or a placebo for 8 weeks. Baseline and endpoint results of the PSS, Job Stress Scale, State and Trait Anxiety Index (STAI), emotional questionnaires, gastrointestinal severity questionnaires, Trails Marking Tests, blood biological markers, and sleep data were analyzed. While both groups demonstrated improvements in most measures over time, only the blood cortisol measure demonstrated significant group differences after the 8-week trial. Further analyses of the subgroup with higher anxiety (nurses with STAI ≥ 103) revealed that anxiety states had improved significantly in the HK-PS23 group but not in the placebo group. In summary, this placebo-controlled trial found significant reduction in the level of blood cortisol after 8 weeks of HK-PS23 use. The distinctive anxiolytic effects of HK-PS23 may be beneficial in improving perceived anxiety and stress hormone levels in female nurses under pressure. Clinical trial registration: https://clinicaltrials.gov/, identifier: NCT04452253-sub-project 1.

Development and Evaluation of Psychometric Properties Regarding the Whole Person Health Scale for Employees of Hospital to Emphasize the Importance of Health Awareness of the Workers in the Hospital.

(1) Background: Whole person health (WPH) is important among employees in hospitals. It will affect their performance and attitude toward patient care and organization. This project was designed to develop and assess the validity and reliability of utilizing the Whole Person Health Scale for Employees of a Hospital (WPHS-EH) to determine overall employee health. (2) Methods: A mixed-methods focus group and cross-sectional survey was adopted. Employees held six focus groups, with 62 employees from different departments in medical center in Taiwan. After analyzing the interview content, five experts tested its validity, and the 14-item WPHS-EH scale was analyzed. This was followed by an additional 900 participants questionnaire survey, response rate: 94.9%. Descriptive statistics, Cronbach's alpha, exploratory factor analysis (EFA), and items analysis were used. Additionally, the scale was implemented to conducted confirmatory factor analysis (CFA) test for validity. (3) Results: Three dimensions were extracted from the questionnaires by EFA: "hospital circumstance and system", "professional and interpersonal interaction" and "workload and harm". The Cronbach's alpha of the WPHS-EH scale was 0.82, while the three sub-dimensions were all significantly correlated with total scores. CFA confirmed the scale construct validity, with a good model fit. (4) Conclusions: The WPHS-EH is a reliable measurement tool to assess the effects of hospitals' Whole Person Health among employees. The intent of the WPHS-EH was to provide a reliable scale to analyze the work environment for hospital staff and useful information to healthcare administrators interested in improving the staff's whole person health.

Exploring the factors affecting musculoskeletal disorders risk among hospital nurses.

BACKGROUND: Musculoskeletal disorder (MSD) is currently recognized as one of the most common occupational injuries for which nursing personnel in the medical service industry have been identified as a high-risk group. In this study, we explore the prevalence of MSD in various body parts as well as their risk factors among hospital nurses. METHODS: A cross-sectional descriptive design with stratified cluster sampling was used to collect data from 1,803 nurses. The survey included a demographic questionnaire, and Nordic Musculoskeletal Questionnaire. RESULTS: The results showed that the greatest prevalence of MSD symptoms by body regions were in the right shoulder (85.8%), the left shoulder (80.9%), the neck (62.4%), the right wrist (62.2%) and the lower back (60.4%). Risk factors for shoulder discomfort includes department type, exercise habits, and age (p < .05). Risk factors for neck discomfort includes seniority in the current unit, "job title, and "history of MDS (p < .05). Risk factors for upper back discomfort includes age and seniority in the current unit (p < .05). Risk factors for lower back discomfort including seniority in the current unit, department type, and number of days worked per week (p < .05). CONCLUSIONS: The results of this study can serve as a reference for nursing administration managers and decision-makers for reducing musculoskeletal discomfort among nurses and thereby achieving superior quality in clinical care.

[Reducing the incidence of needlestick injuries due to insulin pen injectors among self-users in the outpatient clinic setting].

BACKGROUND & PROBLEM: The rising number of people practicing insulin self-injection at home has led to increasing numbers of needlestick injuries due to inadequate self-injection skills among these patients. To reduce needlestick injuries at home, patients should not recap needles and should adopt proper needle disposal practices. A random survey of 80 outpatients currently using insulin pen injectors at home conducted between February and April 2012 found that 70% self-reported suffering needlestick incidents. Data analysis indicated the principal causes of these incidents were the lack of standard operating procedures, the absence of educational training, the shortage of educational instruction sheets for patients, and the inadequate skills and tools available to patients for disposing of needles safely at home. PURPOSE: The aim of this project was to decrease the needlestick incidence rate for outpatients that use insulin pen injectors in order to increase overall patient safety. RESOLUTION: The project team established a pen injector standard operation procedure (SOP), conducted an educational training program, developed nursing instruction sheets for patients, designed and distributed needle disposal containers to patients, and taught patients the correct techniques for the disposing of needles at home. RESULTS: The needlestick incidence rate decreased from 70% pretest to 2.6% following implementation of the abovementioned measures. CONCLUSIONS: This project effectively reduced the needlestick rate attributable to insulin pen injectors. The authors hope that other departments will adopt this approach in order to improve patient safety.

[Nursing care experiences of a borderline personality patient with spiritual distress].

Patients with Borderline Personality Disorder (BPD) often question the purpose and value of their life. Understanding the spiritual needs of BPD patients is essential to providing more appropriate care and achieving greater care efficacy. This case report investigated a woman with BPD who had experienced spiritual distress during nursing care. Between February 24th and December 15th, 2010, the authors conducted an assessment of the four dimensions of spiritual care for the patient using observation, interviews and patient medical records. The four dimensions included the relations between the individual and herself, others, religious belief, and the natural environment. After integrating and analyzing data, the authors found the patient questioned the purpose and value of her life and contemplated self-injury / suicide due to inadequate support systems and a lack of effective stress management and coping skills caused by illness-induced depression and the lingering effects of a difficult childhood. In the process of nursing care, the authors employed one-to-one interviews with listening skills to induce the patient to describe her spiritual distress, and then employed dialectical behavior therapy groups and education skills training to enhance the values of positive thinking and reduce suicidal / self-injury tendencies to help the patient foster a more positive outlook toward life. The result increased patient self-respect and quality of life. The authors hope this case may provide a reference for treating similar clinical cases in the future.