Development, Feasibility, and Preliminary Effects of a Hybrid-Mode Multicomponent Music Intervention for Women Undergoing Mastectomy.

BACKGROUND: Music listening interventions have been used to manage preoperative anxiety and postoperative pain in women undergoing breast cancer (BC) using face-to-face mode and music that was relevant to the patients' culture; however, the interventions were not underpinned by any theories. OBJECTIVE: To assess the feasibility and preliminary effects of a theory-driven multicomponent music intervention on preoperative and postoperative patient outcomes in African women with BC undergoing mastectomy. METHODS: This study was a multicenter, single-blind randomized controlled trial with qualitative interview. A total of 36 women scheduled to undergo mastectomy were recruited from Nigeria and Malawi and randomly assigned to either the intervention group or the control group. Quantitative data were analyzed using the Mann-Whitney U and Wilcoxon signed rank tests, whereas qualitative data were analyzed using the inductive approach. RESULTS: The multicomponent music intervention was effective in reducing participants' preoperative anxiety and enhancing satisfaction with care on the day of surgery, reducing postoperative pain at 24 and 48 hours after surgery, and reducing systolic and diastolic blood pressure at 48 hours after surgery. The qualitative data corroborated these findings. CONCLUSION: The study's findings indicated that the theory-driven multicomponent music intervention was feasible, acceptable, and effective in reducing preoperative anxiety and postoperative pain, optimizing vital signs, and enhancing satisfaction with care among African women with BC undergoing mastectomy. IMPLICATION FOR PRACTICE: The study's findings indicate that nurses in clinical settings can integrate the intervention into the plan of care of women with BC beginning with their surgery booking visit.

Genetic/genomic literacy, attitudes and receptivity of nursing students and practising nurses: A cross-sectional online survey.

BACKGROUND: The growing demand for personalised nursing care in the genomic era requires nursing students and practising nurses to be better prepared to apply the knowledge of genetics/genomics to nursing practice. Several studies have shown that, despite having positive attitudes/receptivity towards integrating genetics/genomics into nursing practice, nursing students and professionals report a low level of genetic/genomic literacy. However, little is known about the status in Hong Kong. OBJECTIVES: We assessed and compared the genetic/genomic literacy and attitudes/receptivity towards integrating genetics/genomics into nursing practice among nursing students and practising nurses in Hong Kong. We also explored the relationships between the students' background characteristics, attitudes/receptivity towards integrating genetics/genomics into nursing practice and genetic/genomic literacy. DESIGN: A cross-sectional online survey conducted between March 2020 and January 2022. SETTINGS: A government-funded university in Hong Kong. PARTICIPANTS: We recruited a convenience sample of 234 nursing students, 145 were final-year undergraduate students (median age = 22 years, 84.1 % female) and 89 were practising registered nurses (postgraduate students studying part-time programme, median age = 28 years, 77.5 % female). METHODS: The survey collected the participants' background information, attitudes/receptivity towards integrating genetics/genomics into nursing practice and levels of genetic/genomic literacy. RESULTS: Overall, the participants reported positive attitudes/receptivity towards practice integration but had low levels of genetic/genomic literacy. Practising nurses were more likely to have lower genetic/genomic literacy, but more positive attitudes/receptivity towards practice integration, than undergraduate students. Multiple regression analysis suggested that the level of study (postgraduate/undergraduate programme) and perceptions of the disadvantages of 'needing to re-tool professionally' were significant independent factors associated with the level of genetic/genomic literacy. CONCLUSIONS: Findings from this study call for the strategic integration of genetics/genomics education into all levels of nursing education in Hong Kong and across the globe. In particular, sustained efforts should be made to ensure that practising nurses receive further education in genetics/genomics.

Psychoeducation for psychological issues and birth preparedness in low- and middle-income countries: a systematic review.

BACKGROUND: Psychological issues usually accompany the pregnancy of first-time mothers, and psychoeducational interventions might be effective in addressing these concerns and preparing first-time mothers for childbirth and the postnatal period. OBJECTIVE: This study aimed to identify, analyze, and synthesize the components and determine the effectiveness of psychoeducational interventions that are used for managing psychological issues and enhancing birth preparedness among primigravid women or couples in low- and middle-income countries. STUDY DESIGN: A systematic search of 12 databases (APA PsycINFO, EmCare, Embase, MEDLINE(R), Ovid Nursing, British Nursing Index, Health & Medical Collection, ProQuest, CINAHL, Cochrane, Hinari, and PubMed) was conducted to identify relevant studies published between 1946 and October 2021. The quality of the included studies was appraised by the Joanna and Briggs Institute critical appraisal tool, and a narrative synthesis was performed to analyze data extracted from included articles. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (registration number: CRD42021237896). RESULTS: The initial search yielded 8658 articles. Of note, 16 articles, including 7 randomized controlled trials and 9 nonrandomized trials, met the inclusion criteria and were selected and reviewed for quality. In addition, 31 outcomes were measured in the studies, including psychological outcomes, birth preparedness outcomes, and other outcomes. The design of the interventions included antenatal education that was delivered through lectures, role plays, trainings, and antenatal counseling. All the psychoeducational interventions had a significant effect (P<.05; Cohen's d or Hedges' g=0.2-1.9) on certain psychological outcomes, including childbirth attitude, fear of childbirth, depression, fear, and anxiety, and birth preparedness outcomes. CONCLUSION: Although first-time mothers experience a range of psychological issues during pregnancy, psychoeducational interventions were beneficial in addressing their psychological concerns. It would seem that these interventions are less expensive and could be easily implemented in low- and middle-income countries. However, rigorous research, such as randomized controlled trials, is hereby warranted to standardize the interventions and outcome assessment tools.

Perception of music and its cultural elements on acute post-mastectomy pain management among Nigerian women: an exploratory qualitative study.

PURPOSE: This study aimed to explore the cultural elements of music in relation to pain management among women who have undergone mastectomy. METHOD: An exploratory qualitative study with in-depth interviews. Using the purposive sampling technique, 20 participants were recruited for the study. The interviews were conducted face to face at the surgical out-patient clinic and female surgical ward. Data collection continued until data saturation was reached. The inductive approach was used to analyse the data, and the concepts were organised into themes. The consolidated criteria for reporting qualitative research guidelines (COREQ) were used to report this study. RESULTS: The participants were between 28 and 83 years old and mostly diagnosed with stage III breast cancer. Three main themes emerged from the data analysis, including pain experienced after mastectomy, culture and music, and the perception of music for postoperative pain management after mastectomy. CONCLUSION: In this study, the knowledge of participants and the utilisation of music for pain management remains inadequate, but the participants perceived that music could be useful for pain control after mastectomy when the language and religion of the patient and the meaningfulness of the music were considered when introducing and selecting the music. This study will help open and extend the conversation about the utilisation and cultural elements of music that can be used clinically for pain management after mastectomy.

The effectiveness of self-management programmes for people with type 2 diabetes receiving insulin injection: A systematic review and meta-analysis.

BACKGROUND: People with type 2 diabetes (T2D) receiving insulin injection are reported to encounter challenges to achieve optimal glycaemic control. The evidence on effectiveness of self-management programmes for T2D people receiving insulin injection is far from conclusive. AIM: To examine the effectiveness of self-management programmes for people with T2D receiving insulin injection. METHODS: Twelve databases were searched from dates of inception to June 2021. All randomised controlled trials (RCTs) and controlled clinical trials examining the effectiveness of self-management programmes were included. The methodological quality was appraised using the Joanna Briggs Institute critical appraisal tools by two independent researchers. Data were summarised narratively or pooled statistically where appropriate. RESULTS: Nine RCTs involving 2613 participants were included. At post-intervention, meta-analysis results showed that self-management programmes significantly improved glycated haemoglobin A1c (HbA1c) (mean difference [MD]: -0.21, 95% confidence interval [CI] -0.29 to -0.12, P < .001), self-management behaviours (standardised MD [SMD]: 0.23, 95% CI: 0.12 to 0.33, P < .001) and self-efficacy (SMD: 0.20, 95% CI: 0.09 to 0.31, P = .0002). Only one intensive lifestyle intervention reported significant improvements in body weight and waist circumference. Three RCTs demonstrated significant improvements in body mass index compared with the control group. Only one study demonstrated significant improvements in total cholesterol and triglycerides in favour of the intervention group. At six months post-intervention, pooled results of two studies revealed decreased diabetes-related distress (MD: -2.98, 95% CI: -5.15 to -0.82, P = .007). No significant changes in blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, depression and anxiety were found. CONCLUSIONS: Self-management programmes have the potential to improve glycaemic control, weight management, blood lipids, self-management behaviours, self-efficacy and diabetes-related distress of people with T2D receiving insulin injection. More rigorous experimental trials are warranted to examine the effectiveness of self-management programme and its maintenance.

Effects of non-pharmacological interventions on preoperative anxiety and postoperative pain in patients undergoing breast cancer surgery: A systematic review.

BACKGROUND: Poorly managed preoperative anxiety and pain were reported to slow the postoperative recovery of breast cancer patients. Thus, proactive management using non-pharmacological interventions becomes essential for decreasing opioid or anxiolytics consumption, anxiety level, pain intensity, postoperative complications and improving patients' haemodynamics and satisfaction with care. PURPOSE: To identify, analyse and synthesise the effects of non-pharmacological interventions on preoperative anxiety and acute postoperative pain in women undergoing breast cancer surgery. METHOD: For this systematic review, 12 databases including Ovid Nursing, PsycInfo, British Nursing Index, CINAHL, Cochrane Library were searched to identify relevant studies. A total of 6,012 articles were identified from the search, six RCTs and one quasi-experimental study that met the inclusion criteria were included after eligibility screening. Narrative synthesis was used to analyse data extracted from the included articles. The review adhered to the PRISMA guideline. RESULTS: Twelve outcomes were measured in the included studies, including preoperative anxiety, and acute postoperative pain. Music, massage, aromatherapy and acupuncture were the interventions delivered. Music had a small-to-large effect size and aromatherapy had a small effect size on reducing preoperative anxiety. Also, music had a large effect size whilst acupuncture had a medium effect size on minimising postoperative pain in women undergoing breast cancer surgery. CONCLUSION: Music, aromatherapy and acupuncture appeared to be effective for reducing preoperative anxiety and postoperative pain in women undergoing breast cancer surgery. However, the small number of studies available for each intervention prevents conclusive statements about which the most effective method. IMPLICATION FOR CLINICAL PRACTICE: A nursing care pathway that standardises the use of non-pharmacological interventions for the management of both preoperative anxiety and postoperative pain in breast cancer surgery patients should be developed.