Determining Holistic Factors Related to Depressive Symptoms in Patients With Heart Failure.

Identifying modifiable factors associated with depressive symptoms is important to develop corresponding strategies. This study aimed to determine the holistic factors related to depressive symptoms in heart failure (HF) patients. It was a secondary analysis of a cross-sectional study. We recruited 329 hospitalized HF patients from two hospitals in China. It is found that HF patients had a relatively high proportion (28.27%) of depressive symptoms. Red blood cell distribution width (RDW) (ß = .222, p = .011) and physical symptoms (ß = .151, p < .001) were positively associated with depressive symptoms, whereas resilience (ß = -.241, p < .01) and family functioning (ß = -.288, p = .001) were negatively associated with depressive symptoms. Thus, early screening and management of depressive symptoms are warranted. RDW may serve as a marker for screening depressive symptoms. Moreover, interventions focused on relieving physical symptoms and enhancing resilience and family functioning may reduce depressive symptoms.

The Heterogeneity of Physical and Anxiety Symptoms and Quality of Life Among Patients With Heart Failure: A Latent Class Analysis.

BACKGROUND: Patients with heart failure (HF) experience a severe burden of symptoms and reduced quality of life (QoL). However, little is known about the heterogeneity of these symptoms and the association with QoL. OBJECTIVES: The aims of this study were to conduct a latent class analysis on co-occurring physical and anxiety symptoms and to determine whether the underlying subgroups differ regarding the QoL among patients with HF. METHODS: The authors of this cross-sectional study recruited 329 patients with HF from 2 hospitals. Patients' symptoms and QoL were self-reported, and data were analyzed using latent class analysis, χ 2 test, analysis of variance, and hierarchical linear regression analysis. RESULTS: Three latent classes (all low, all high, and high physical-partial anxiety) were identified based on the occurrence of patients' physical and anxiety symptoms. Patients with a lower body mass index, a worse New York Heart Association class, and a longer disease duration were more likely to belong to the all-high class. Hierarchical linear regression analysis showed that distinct subgroups (all low vs all high: ß = -0.299, P < .001; all low vs high physical-partial anxiety: ß = -0.228, P < .001) were significantly associated with the physical summary component score for QoL. Likewise, distinct subgroups (all low vs all high: ß = -0.509, P < .001; all low vs high physical-partial anxiety: ß = -0.128, P = .012) were significantly associated with the mental summary component score for QoL. CONCLUSIONS: Patients with HF showed heterogeneity in physical and anxiety symptoms; the subgroup with severe symptoms exhibited a poor QoL. The associations between symptom subgroups and QoL require targeted symptom-based interventions.

Gender differences in self-care maintenance and its associations among patients with chronic heart failure.

OBJECTIVES: To identify the gender differences in self-care maintenance and its associations among chronic heart failure patients using the Information-Motivation-Behavioral Skills model. METHODS: Two hundred and ten patients (54.0% female) with chronic heart failure participated in this cross-sectional study. Self-care, knowledge of heart failure, social support and illness perception were measured using the Self-Care of Heart Failure Index, the questionnaire of heart failure knowledge, the Perceived Social Support Scale, and the Revised Illness Perception Questionnaire, respectively. RESULTS: Mean scores for self-care maintenance were 51.4 ±â€¯14.8 in men and 55.6 ±â€¯14.1 in women (t = -2.066, P < 0.05). Associated factors of self-care maintenance were social support and self-care confidence in men and the knowledge of heart failure, self-care management and self-care confidence in women. The relationship between social support and self-care maintenance was meditated by self-care confidence in men, whereas the relationship between knowledge of heart failure and self-care maintenance was meditated by self-care management and self-care confidence in women. CONCLUSIONS: Self-care maintenance were inadequate in both genders with chronic heart failure. Interventions for enhancing social support and self-care confidence in men patients, and strengthening knowledge of heart failure, self-care management and self-care confidence in women patients, may facilitate self-care maintenance.

Student nurses' career motivation toward gerontological nursing: A longitudinal study.

BACKGROUND: The intensity of student nurses' motivation toward a certain career can influence their behaviors for career choice and decision making. However, little is known about the career motivation among student nurses toward gerontological nursing and their influencing factors. OBJECTIVES: The objectives of this study were to examine student nurses' career motivation toward gerontological nursing and to explore potential predictors using Bandura's reciprocal determinism. DESIGN: A longitudinal design was used in this study. SETTINGS AND PARTICIPANTS: A total of 305 student nurses were recruited from six hospitals in Shandong province, and they completed the questionnaires over three stages. METHODS: Student nurses' career motivation toward gerontological nursing, geriatrics attitudes, aging anxiety, empathy, and clinical practice environment were measured using the motivation questionnaire, the Geriatrics Attitudes Scale, the Anxiety about Aging Scale, the Interpersonal Reactivity Index, and the clinical practice environment questionnaire, respectively. Measurements were performed at the first month, fourth month, and seventh month of student nurses' clinical practice. A series of Pearson correlation, multiple linear regression, and generalized estimating equations were applied to analyze the data. RESULTS: Among 305 student nurses, the mean scores for career motivation toward gerontological nursing over three stages were 66.11 (SD = 8.98), 67.55 (SD = 8.53) and 66.78 (SD = 9.51), sequentially. There were significant differences in scores for career motivation over time (P < 0.05) and the lowest score was observed at the first month. Geriatric attitudes, aging anxiety, empathy, clinical practice environment and stage of clinical practice were notable predictors of student nurses' career motivation toward gerontological nursing. CONCLUSIONS: Student nurses' career motivation toward gerontological nursing needs to be improved, especially at the first month of clinical practice. Targeted interventions should cultivate positive geriatric attitudes, relieve anxiety about aging, promote empathy, and enrich the clinical practice environment to improve student nurses' career motivation toward gerontological nursing.

Relationships between optimism, educational environment, career adaptability and career motivation in nursing undergraduates: A cross-sectional study.

BACKGROUND: For solving the problem of the abandonment of the career in nursing undergraduates, it is important to understand their motivation to choose nursing as a career and its associated personal and situational factors. OBJECTIVES: To examine the relationships between optimism, educational environment, career adaptability, and career motivation in nursing undergraduates using the career construction model of adaptation. DESIGN: This study adopted a cross-sectional design. PARTICIPANTS AND METHODS: A convenience sample of 1060 nursing undergraduates from three universities completed questionnaires for measuring optimism, educational environment, career adaptability, and career motivation. Confirmatory factor analyses, descriptive analyses, comparison analyses, correlation analyses, and mediation analyses were performed accordingly. RESULTS: Nursing undergraduates' career motivation was positively correlated with their career adaptability (r = 0.41, P < 0.01), the educational environment (r = 0.60, P < 0.01), and optimism (r = 0.26, P < 0.01). In addition, the effects of optimism and educational environment on career motivation were partially mediated by career adaptability in nursing undergraduates. CONCLUSIONS: In nursing undergraduates, the educational environment had a relatively strong positive association with career motivation, while optimism had a weak one. Career adaptability played a mediating role in the relationships. Targeted interventions may improve nursing undergraduates' career motivation.

Self-efficacy for self-regulation and fear of failure as mediators between self-esteem and academic procrastination among undergraduates in health professions.

Academic procrastination has been a widespread problem behavior among undergraduates. This study aimed to examine the prevalence of academic procrastination among undergraduates in health professions, and explore the mediation effects of self-efficacy for self-regulation and fear of failure in the relationship between self-esteem and academic procrastination. A cross-sectional design was used to study 1184 undergraduates in health professions from China. Participants completed measures of academic procrastination, self-esteem, self-efficacy for self-regulation and fear of failure. We used Pearson product-moment correlation to examine the bivariate correlations between study variables, and path analysis to examine mediation. Among the 1184 undergraduates, 877 (74.1%) procrastinated on at least one type of academic task. The total score for academic procrastination was negatively correlated with scores for self-esteem and self-efficacy for self-regulation, and positively correlated with the score for fear of failure. Moreover, the relationship between self-esteem and academic procrastination was fully mediated by self-efficacy for self-regulation (indirect effect: ß = - .15, 95% bootstrap CI - .19 to - .11) and fear of failure (indirect effect: ß = - .06, 95% bootstrap CI - .09 to - .04). These findings suggest that interventions targeting the enhancement of self-efficacy for self-regulation and the conquest of fear of failure may prevent or reduce academic procrastination among undergraduates in health professions, especially for those with lower self-esteem.