Development and validation of gestational diabetes mellitus health literacy scale.

OBJECTIVE: While there are various health literacy scales that exist, none of health literacy scale suitable for pregnant women with gestational diabetes mellitus (GDM). To address this gap, this study aimed to develop GDM health literacy scale and evaluate its psychometric properties. METHODS: Based on the Delphi expert consultation, we developed the initial GDM health literacy scale. Item analysis was taken using a sample (n = 299) recruited in China to form formal scale. Additional participants (n = 395) completed survey to assess the internal consistency reliability, test-retest reliability, content validity, construct validity and criterion correlation validity of scale. RESULTS: The scale performed well in terms of internal consistency reliability, content validity, construct validity and criterion correlation validity. Test-retest reliability indicated that the instrument was effective at measuring health literacy of GDM over time. CONCLUSION: The scale is a reliable and valid measure of six domains of health literacy for GDM. PRACTICE IMPLICATIONS: The scale can be used to effectively evaluate the level of health literacy of pregnant women with GDM. The information can provide targeted health support for pregnant women with GDM to improve their health literacy and self-management ability.

Research progress related to thermosensitive hydrogel dressings in wound healing: a review.

Wound healing is a dynamic and complex process in which the microenvironment at the wound site plays an important role. As a common material for wound healing, dressings accelerate wound healing and prevent external wound infections. Hydrogels have become a hot topic in wound-dressing research because of their high water content, good biocompatibility, and adjustable physical and chemical properties. Intelligent hydrogel dressings have attracted considerable attention because of their excellent environmental responsiveness. As smart polymer hydrogels, thermosensitive hydrogels can respond to small temperature changes in the environment, and their special properties make them superior to other hydrogels. This review mainly focuses on the research progress in thermosensitive intelligent hydrogel dressings for wound healing. Polymers suitable for hydrogel formation and the appropriate molecular design of the hydrogel network to achieve thermosensitive hydrogel properties are discussed, followed by the application of thermosensitive hydrogels as wound dressings. We also discuss the future perspectives of thermosensitive hydrogels as wound dressings and provide systematic theoretical support for wound healing.

Factors influencing kinesiophobia during the "blanking period" after radiofrequency catheter ablation in patients with atrial fibrillation by the fear-avoidance model.

BACKGROUND: The influencing factors of kinesiophobia (fear of movement) in patients with atrial fibrillation(AF)during the post-operative "Blanking Period" are not known. The aims were to investigate the status of kinesiophobia in patients with AF during the post-operative "Blanking Period", then further describe the occurrence and analyze the influencing factors of patients' kinesiophobia by the Fear-Avoidance Model. MATERIALS AND METHODS: In total,400 patients diagnosed with atrial fibrillation, during the post-operative "Blanking Period" from the selected hospital were included in this study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Self-efficacy for Exercise (SEE) scale, and the Geriatric Locomotive Function Scale (GLFS) were used to assess kinesiophobia, exercise self-efficacy, and physical function. The study adopted a cross-sectional design. RESULTS: The score of kinesiophobia during the "Blanking Period" after operation in patients with atrial fibrillation was (44.06 ± 10.77), and the rate of high kinesiophobia was 71.61%.Logistic regression results showed that age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function influenced the kinesiophobia of patients during the post-operative "Blanking Period"(p<0.05， p<0.01). CONCLUSIONS: Kinesiophobia is common in patients with atrial fibrillation during the postoperative "Blanking Period", and the fear of movement is related to age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function. Clinical and nursing staff should pay close attention to the psychological problems in the post-operation "Blanking Period" of exercise rehabilitation in patients with atrial fibrillation, make timely interventions to reduce patients' fear of movement, and improve patients' compliance with exercise rehabilitation.

Work stress in nurses returning to tertiary a general hospitals in China after the delivery of their second child: a cross-sectional study.

OBJECTIVE: To investigate the current situation of work stress in nurses returning to work in Chinese tertiary A general hospitals after giving birth to their second child and to analyze influencing factors. METHODS: From January to April 2021, 448 nurses returning to work after the birth of their second child, working in 23 general hospitals in China, were investigated and completed the postpartum work stress scale and self-rating depression scale. RESULTS: The total work stress score of returning nurses after giving birth to their second child was 90.40 ± 18.29, and the dimension with the highest score was the role commitment of the mother. Multiple linear regression analysis showed that family monthly income, turnover intention, time since returning to work, age of the first child, and depressive symptoms were the influencing factors on work stress. CONCLUSION: It is important to reduce the work stress of the nurses returning to work after the birth of their second child. Nursing managers should pay attention to this group of postpartum nurses and formulate targeted measures to alleviate their work stress.

Sedentary behaviors and gestational diabetes mellitus: A systematic review.

AIM: Sedentary behaviors are activities that expend less energy than 1.5 metabolic equivalents, such as watching TV, sitting. We aim to systematically review the evidence to determine the association of sedentary behavior (SB) with the risk of gestational diabetes mellitus, and the associations of SB with health outcomes in pregnant women with gestational diabetes mellitus (GDM) and women at high risk of gestational diabetes mellitus. METHODS: Two researchers independently performed a literature search using PubMed, Medline, EMBASE, CINAHL, the Cochrane Library, the Rehabilitation and Sports Medicine Source, and the Sedentary Behavior Research Database for studies published up to January 27, 2021. Randomized controlled trials, quasi-experimental studies, and observational studies were screened and selected if SB was assessed in the context of gestational diabetes mellitus. Two reviewers extracted the relevant information and independently assessed the included studies for quality and bias. RESULTS: Eighteen studies were included, involving 60 804 patients, and the timeline of the original study included was from 2006 to 2021. Our review showed that SB before pregnancy was not associated with the risk of gestational diabetes mellitus, while SB during pregnancy was uncertain about the risk of gestational diabetes mellitus. In addition, there were significant associations between SB time and metabolic outcomes. In addition, SB may cause some adverse maternal and fetal outcomes. CONCLUSION: SB is likely to be the intermediary variable between occurrence of GDM and adverse maternal and infant outcome, rather than a direct influencing factor. Limited by the quantity and quality of included studies, the above conclusions need to be verified by more high-quality studies.

A Qualitative Exploration of the Psychological Experience of Patients Hospitalized With COVID-19.

This qualitative study describes the psychological experience of patients hospitalized with COVID-19. These patients went through 3 psychological stages: extremely uncertainties during the initial diagnostic stage, complicated feelings of negativity during the treatment stage, and positive growth in the recovery stage. It is important for nurses to provide holistic care.

An early model to predict the risk of gestational diabetes mellitus in the absence of blood examination indexes: application in primary health care centres.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the critical causes of adverse perinatal outcomes. A reliable estimate of GDM in early pregnancy would facilitate intervention plans for maternal and infant health care to prevent the risk of adverse perinatal outcomes. This study aims to build an early model to predict GDM in the first trimester for the primary health care centre. METHODS: Characteristics of pregnant women in the first trimester were collected from eastern China from 2017 to 2019. The univariate analysis was performed using SPSS 23.0 statistical software. Characteristics comparison was applied with Mann-Whitney U test for continuous variables and chi-square test for categorical variables. All analyses were two-sided with p < 0.05 indicating statistical significance. The train_test_split function in Python was used to split the data set into 70% for training and 30% for test. The Random Forest model and Logistic Regression model in Python were applied to model the training data set. The 10-fold cross-validation was used to assess the model's performance by the areas under the ROC Curve, diagnostic accuracy, sensitivity, and specificity. RESULTS: A total of 1,139 pregnant women (186 with GDM) were included in the final data analysis. Significant differences were observed in age (Z=-2.693, p=0.007), pre-pregnancy BMI (Z=-5.502, p<0.001), abdomen circumference in the first trimester (Z=-6.069, p<0.001), gravidity (Z=-3.210, p=0.001), PCOS (χ2=101.024, p<0.001), irregular menstruation (χ2=6.578, p=0.010), and family history of diabetes (χ2=15.266, p<0.001) between participants with GDM or without GDM. The Random Forest model achieved a higher AUC than the Logistic Regression model (0.777±0.034 vs 0.755±0.032), and had a better discrimination ability of GDM from Non-GDMs (Sensitivity: 0.651±0.087 vs 0.683±0.084, Specificity: 0.813±0.075 vs 0.736±0.087). CONCLUSIONS: This research developed a simple model to predict the risk of GDM using machine learning algorithm based on pre-pregnancy BMI, abdomen circumference in the first trimester, age, PCOS, gravidity, irregular menstruation, and family history of diabetes. The model was easy in operation, and all predictors were easily obtained in the first trimester in primary health care centres.

The Psychological Change Process of Frontline Nurses Caring for Patients with COVID-19 during Its Outbreak.

Aim: To identify the psychological change process of the registered nurses who worked in the epicenter of the COVID-19 outbreak.Background: The pandemic of COVID-19 has continued to pose an unprecedented threat and challenge to people's health around the world. Nurses are at high risk because they work within the closest proximity to patients. Understanding nurses' psychological change process during the care for patients with COVID-19 is imperative for healthcare leaders.Methods: This was a qualitative descriptive study that took place in a hospital in Wuhan, China, the epicenter of the COVID-19 epidemic, from February 9th to March 15th, 2020. Using purposive sampling, we interviewed 23 nurses. Data were analyzed using Colaizzi's method of data analysis to find, understand, and describe nurses' experiences.Results: The psychological change process of frontline nurses included three stages, early, middle, and later stages. The psychological characteristics of each period were ambivalence, emotional exhaustion, and energy renewal, respectively. Nurse leaders were anchors in facilitating frontline nurses' psychological adaptation.Conclusions: In the past month, the psychological characteristics of nurses changed over time. The study indicated the necessity for nurse leaders to implement intervention programs based on nurses' psychological characteristics in different periods to promote nurses' health during this critical time period.

Decreased ALCAM expression and promoter hypermethylation is associated with preeclampsia.

Preeclampsia (PE) is a major obstetrical complication that results in maternal and fetal morbidity and mortality. Aberrant epigenetic modifications are widely involved in the pathogenesis of PE. Previously, the activated leukocyte cell adhesion molecule (ALCAM) was reported to be required for blastocyst implantation but has not been described in the context of pathological pregnancy. This study explored the expression of ALCAM and its methylation levels in the placentas and peripheral venous blood of patients with PE from a Chinese Han population. The mRNA and protein expression levels of ALCAM were downregulated in the PE placentas compared with the control placentas (P < 0.05). The methylation rate of the ALCAM gene promoter was considerably elevated in the placentas (P = 0.003, odds ratio (OR) = 0.264, 95% confidence interval (95% CI) [0.108-0.647], cases n = 47, controls n = 53) and peripheral blood (P = 0.007, OR = 0.455, 95% CI [0.256-0.806], cases n = 100, controls n = 100) of the PE patients compared with those of the normotensive women, suggesting a negative relationship between ALCAM methylation and gene transcription. Moreover, the transcriptional expression of ALCAM was dramatically increased by demethylating treatment in trophoblastic cells. ALCAM is expected to be involved in the pathogenesis of PE through methylation regulation.