A Meta-Synthesis on Sexuality in Persons with Dementia Mapped Using the Model of Human Occupation.

Dementia affects the individual's functional ability including sexual activity. Limited understanding is available to support sexual health practices. This meta-synthesis review aimed to identify the gaps in the study of sexuality in dementia using the Model of Human Occupation (MOHO). Electronic searches utilizing six databases for existing articles involving persons living with dementia, care partners, and healthcare workers. The result showed that available studies primarily explored sexuality from the viewpoint of spouses of persons living with dementia. The volition domain of MOHO was the most explored provides a deeper understanding of volition on intrinsic perspective on sexuality in people with dementia. The environment domain was the least explored, highlighting healthcare professionals' need for social support and training. The topic of sexuality remains sensitive, limiting the availability of evidence-based interventions in this area.

Development of an Instrument to Assess Health and Social Care Professionals' Knowledge and Attitudes Towards Later-Life Intimacy and Sexuality (HSCP-KALLIS): A Delphi Study.

AIMS: We aimed to ascertain the content validity of an instrument to assess health and social care professionals' knowledge and attitudes towards later-life intimacy and sexuality (HSCP-KALLIS). BACKGROUND: For older adults, intimacy and sexuality are important in maintaining their quality of life and well-being. However, addressing these needs remains challenging for health and social care professionals, particularly for nursing staff providing 24-h direct care to older people with dementia or those identified as lesbian, gay, bisexual, transgender, intersex or queer/questioning individuals. Existing instruments assessing knowledge and attitudes towards later-life intimacy and sexuality are dated and fail to adequately address dementia and sexual diversity. DESIGN: A two-round modified Delphi study was conducted. METHODS: Initially, 79 knowledge and attitude items were generated through an integrative review. Panellists rated each item's clarity and importance using online questionnaires. The content validity index for the individual and overall items was calculated. The panellists' written feedback-along with their knowledge level of later-life intimacy and sexuality-was obtained. RESULTS: Panellists included health and social care professionals (n = 9); healthcare-related educators (n = 2); researchers specialising in later-life intimacy, sexuality, dementia care and sexual diversity support (n = 7); and family carers of older people with dementia (n = 2). The instrument was revised based on the feedback received. The components of dementia, LGBTIQ+ and the provision of sex worker services in healthcare settings were highlighted by the panellists. Notably, 46 knowledge and 40 attitude items fulfilled the consensus criteria for clarity and importance. CONCLUSIONS: Acceptable content validity was established for the knowledge and attitude items. Further research is required to establish the psychometric properties of the HSCP-KALLIS. This instrument has implications for clinical practice-specifically, in nursing care-by addressing issues to improve awareness regarding later-life intimacy and sexuality in healthcare settings. IMPLICATIONS FOR PRACTICE: The HSCP-KALLIS has the potential to inform the educational needs regarding knowledge and attitudes towards later-life intimacy and sexuality for health and social care professionals, specifically nursing staff. The findings of the HSCP-KALLIS can be used for the development of competencies for later-life intimacy and sexuality, establishing policies and guidelines to support older adults' intimacy and sexuality needs in health care settings.

Does Web-Based Relationship Education Improve Sexual Intimacy? Initial Examination, Replication, and Exploration of Moderation in a Low-Income Sample.

Sexual intimacy, characterized as the experience between individuals of sharing general affection and sexual activity with one another within the Personal Assessment of Intimacy in Relationships inventory, is positively related to relationship satisfaction and stability. However, many studies of couple therapy have shown that it only results in small-sized (and often non-significant) improvements in sexual intimacy. Furthermore, there are numerous financial, logistical, and psychological barriers to couple therapy. Thus, the current study sought to examine whether two brief online relationship education programs (OurRelationship and ePREP) could overcome these barriers and yield similar-sized effects to more intensive couple therapy. In two independently collected samples of low-income couples (NSample 1 = 742 Couples; M AgeSample 1 = 33.19; NSample 2 = 671 Couples; M AgeSample 2 = 33.48), the current study found that: OurRelationship (d = 0.24-0.28) and ePREP (d = 0.26-0.34) produced small-sized changes in sexual intimacy relative to a waitlist control condition in both samples, the magnitude of the effect size replicated in a second sample and, with rare exception, these changes were generally not moderated by key variables of interest. Given that web-based relationship education is significantly shorter, less expensive, and more accessible than in-person couple interventions, web-based relationship education could be considered a viable candidate for couples experiencing concerns with sexual intimacy.

Intimacy Promotes Couples' Sexual Well-Being on a Daily Basis and Over One Year: The Role of Positive Sexual Cues.

There is growing interest in identifying factors that promote sexual well-being in romantic relationships. One such factor is intimacy-a process involving self-disclosure and empathic response that is positively associated with sexuality outcomes. However, most work among community couples examined cross-sectional associations in mixed-sex/gender couples using a single sexual outcome, which may not capture daily variations in intimacy and different dimensions of sexual well-being among a diversity of unions over time. Additionally, potential mediating mechanisms of the intimacy-sexual well-being association, such as attention to positive sexual cues (i.e., sexual thoughts and feelings), have been neglected. Adopting daily diary and longitudinal designs, the present study examined whether greater intimacy was associated with higher levels of positive sexual cues and, in turn, higher sexual well-being (sexual desire, satisfaction and distress). A convenience sample of 211 couples (Mage = 30.2 years; SD = 8.3; 75 sexually diverse couples) completed a survey on days of sexual activity with their partner, over a 35-day period and 12 months later. Daily results showed that intimacy was related to greater attention to positive sexual cues for both partners, which in turn was associated with their greater sexual desire and satisfaction and lower sexual distress. Longitudinal results showed that a person's greater daily intimacy was linked to their own greater sexual desire and satisfaction 12 months later via their own higher positive sexual cues, but not to their partner's cues or well-being. Findings extend interpersonal models of sexual well-being and support the role of intimacy and positive sexual cues therein.

Close Intimacy between PtIn Clusters and Zeolite Channels for Ultrastability toward Propane Dehydrogenation.

Propane dehydrogenation (PDH) serves as a pivotal intentional technique to produce propylene. The stability of PDH catalysts is generally restricted by the readsorption of propylene which can subsequently undergo side reactions for coke formation. Herein, we demonstrate an ultrastable PDH catalyst by encapsulating PtIn clusters within silicalite-1 which serves as an efficient promoter for olefin desorption. The mean lifetime of PtIn@S-1 (S-1, silicalite-1) was calculated as 37317 h with high propylene selectivity of >97% at 580 °C with a weight hourly space velocity (WHSV) of 4.7 h-1. With an ultrahigh WHSV of 1128 h-1, which pushed the catalyst away from the equilibrium conversion to 13.3%, PtIn@S-1 substantially outperformed other reported PDH catalysts in terms of mean lifetime (32058 h), reaction rates (3.42 molpropylene gcat-1 h-1 and 341.90 molpropylene gPt-1 h-1), and total turnover number (14387.30 kgpropylene gcat-1). The developed catalyst is likely to lead the way to scalable PDH applications.

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent.

Objective: This study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence. Methods: A total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People's Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed. Results: Family intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group. Conclusion: Family intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.

The Machine Speaks: Conversational AI and the Importance of Effort to Relationships of Meaning.

The focus of debates about conversational artificial intelligence (CAI) has largely been on social and ethical concerns that arise when we speak to machines-what is gained and what is lost when we replace our human interlocutors, including our human therapists, with AI. In this viewpoint, we focus instead on a distinct and growing phenomenon: letting machines speak for us. What is at stake when we replace our own efforts at interpersonal engagement with CAI? The purpose of these technologies is, in part, to remove effort, but effort has enormous value, and in some cases, even intrinsic value. This is true in many realms, but especially in interpersonal relationships. To make an effort for someone, irrespective of what that effort amounts to, often conveys value and meaning in itself. We elaborate on the meaning, worth, and significance that may be lost when we relinquish effort in our interpersonal engagements as well as on the opportunities for self-understanding and growth that we may forsake.

Ethics of a Physiotherapist: Touch, Corporeality, Intimacy-Based on the Experience of Elderly Patients.

This paper presents a qualitative study investigating the application of physiotherapists' professional ethics in practice with respect to touch, intimacy, and corporeality during therapy, based on the experiences of elderly patients. As the relationship in a physiotherapy session is multidimensional, the study considered three levels: physical contact, verbal contact, and the conditions in which the therapy took place. The aim of this study was to find out what values are of importance to older people during a physiotherapy session, with emphasis on the categories of touch, corporeality, and intimacy. The studied group consisted of sixteen male and female physiotherapy patients aged between sixty-six and ninety-two years. The study was conducted according to the grounded theory methodology. The research material consisted of transcriptions of free targeted interviews, which were subjected to a process of coding and analysis. As a result of data analyses, three superior categories have been identified-safety, anxiety, interpersonal relationship-and three a priori categories stemming from the characteristic features of the study area-touch, corporeality, and intimacy. The a priori categories did not appear independently in statements made by the respondents, but instead seemed to be components of superior categories. The most important values indicated by the respondents concerned the interpersonal relationship with their physiotherapist and the feeling of safety and care. In terms of touch, corporeality, and intimacy, the respondents indicated, among others, the importance of predictability, a sense of security, privacy, and acceptance of the body.

Sexual Activity in Adults with Pediatric-Onset Spinal Cord Injury: Injury, Demographic, and Lifestyle Factors.

Background: Sexual development is a complex process of understanding oneself as a sexual being. Youth with spinal cord injury (SCI) navigate the typical phases of sexual development along with the physical and psychological sequelae of an SCI. As youth with SCI progress from adolescence to emerging adulthood, sexual activity-physical intimacy and sexual intercourse-is an important milestone. Objectives: The aims of the study were to (1) describe frequency of physical intimacy among adults with pediatric-onset SCI and (2) identify injury, demographic, and lifestyle factors that predict frequency of physical intimacy. Methods: Adults with pediatric-onset SCI who were former patients within a North American pediatric hospital system (N = 277) completed a structured telephone interview that included medical and sociodemographic information and standardized measures of psychological functioning. Participants rated physical intimacy and sexual intercourse frequency on a 5-point Likert scale, with a response of monthly, weekly, or daily classified as regular frequency and never or yearly as irregular frequency. Bivariate and multivariate analyses were conducted with physical intimacy frequency as the primary outcome. Results: Of the participants, 55% engaged in physical intimacy and 49% engaged in sexual intercourse with regular frequency. In logistic regression analyses, living independently of parents, being married, and higher perceived social integration increased likelihood of regular frequency of physical intimacy. Injury severity and secondary medical complications were not significant independent predictors of frequency of physical intimacy. Conclusion: Half of adults with pediatric-onset SCI engage in regular physical intimacy; this is below the estimates for the general population. Psychosocial factors are stronger contributors to physical intimacy frequency than SCI-related factors. Health care providers and researchers should focus on barriers to social integration and development of social relationships as factors that influence physical intimacy in this population.

Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study.

Background: Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority. Objectives: This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI. Methods: Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning. Results: Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity. Conclusion: By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.

The experiences of Chinese colorectal cancer survivors in marital intimacy after ostomy creation: A qualitative study.

Background: Colorectal cancer (CRC) ranks as the third most prevalent cancer globally. The disease and its treatment significantly impact marital intimacy, particularly among individuals who have undergone ostomy creation. Therefore, it is necessary to explore their experiences. Objective: This study aimed to explore the experiences of colorectal cancer survivors in marital intimacy after ostomy creation and clarify the domain and sub-domain of marital intimacy in CRC survivors with ostomy. Method: This study used a qualitative descriptive design, and participants were selected by purposive sampling from two hospitals in Henan province, China. Sixteen patients participated in this research, and the data were collected through an in-depth interview from June 27 to September 27, 2023. Colaizzi's method was used to analyze the data. Results: Five themes emerged from data analysis, including physical intimacy, psychological intimacy, social intimacy, spiritual intimacy, and operational intimacy. Conclusion: By profiling the experiences of CRC survivors in marital intimacy after ostomy creation, the domain and sub-domain of marital intimacy were clarified in this cohort and revealed that ostomy had a severe effect on marital intimacy among colorectal cancer survivors. The results from this study could be used by nurses, midwives, and other healthcare professionals to design specific interventions covering all aspects of marital intimacy. Also, the findings will guide the development of a particular instrument for marital intimacy in CRC survivors with ostomy.

Maternal caregiving stress and metabolic health: Sexual activity as a potential buffer.

Chronic stress lead to dysregulation of metabolic hormones, creating risk for obesity and type 2 diabetes. Based on previous work suggesting the potential for sexual activity to relieve psychological stress and reduce stress-related neuroendocrine activity, the present research explored sexual activity as a protective factor. We focused on chronic stress in the form of caregiving stress, comparing premenopausal mothers of a child with an autism spectrum disorder vs. a neurotypical child, in relation to metabolic hormones - insulin (and insulin resistance as assessed by HOMA), leptin, and ghrelin. Then, we explored the moderating role of sexual activity. Our results showed that high-stress mothers showed higher levels of insulin, insulin resistance, and lower levels of ghrelin compared to low-stress mothers. However, sexual activity modulated these associations such that among mothers who were sexually active (as coded from their daily diaries), no significant differences in these outcomes were observed between groups. This buffering effect of sexual activity was distinguishable from the buffering effect of physical activity and independent of global relationship satisfaction. Together, our findings provide novel evidence supporting the potential protective effects of sexual activity from chronic stress-related metabolic disease risk.

Identifying the Unmet Needs of People Living With Amyotrophic Lateral Sclerosis: A National Survey to Inform Interdisciplinary Palliative Care.

Introduction/Aims: This national survey builds on previous qualitative research examining potential palliative care needs among people living with ALS (pALS) by quantifying and investigating relationships among pALS' stage of illness progression; physical, emotional, social, spiritual, and intimacy-related concerns; advance care planning behaviors; perceptions of feeling heard and understood by healthcare providers; and overall quality of life. Methods: Researchers partnered with national organizations to recruit pALS to participate in a one-time survey comprising items from validated instruments (eg, the ALS Specific Quality of Life Instrument-Revised) and researcher-generated measures. Data were analyzed using logistic and linear regression. Results: Among pALS (n = 112), many respondents indicated they had discussed their wishes for end-of-life care with family or friends, shared their wishes with providers, and documented their wishes in writing (79.5%, 49.1%, and 63.4%, respectively). Mean (M) quality of life scores were moderate (M ≈ 6 of 10). Illness stage was associated with documentation of end-of-life care wishes but not with having discussed these wishes with others or with overall quality of life. Reported emotional intimacy received was comparable to that desired (difference = .01 of 10); however, a greater desire for physical intimacy relative to that received was indicated (difference = 1.75 of 10). Discussion: Interdisciplinary palliative care teams may enhance ALS care by promoting advance care planning behaviors (particularly discussing one's wishes with healthcare providers), providing interventions to improve quality of life, and supporting pALS in navigating challenges related to physical intimacy.

Vocation as tragedy: Love and knowledge in the lives of the Mills, the Webers, and the Russells.

Can love affect knowledge and knowledge affect love? John Stuart Mill and Harriet Taylor-Mill, Max and Marianne Weber, and Bertrand and Dora Russell had a definite vocation: they wanted to change the world. They questioned traditional gender arrangements through publications on equality, marriage, and education. They were liberal thinkers, advocating individual freedom and autonomy, vis à vis the constraints of state and society. Their partnership inspired their work, a living experiment conducted through their own unconventional relationship. Over time, their increasingly radical, avant-garde ideas on marriage complicated the ongoing negotiation over power and intimacy which typified their marriages. Building on the historiography of social science couples, and by means of an analysis of the micro-social dynamics of marriage as documented in the life writings of the Mills, the Webers, and the Russells, I analyse the connections between gender, intimacy, and creativity. These couples' experiences highlight the non-rational dimension of a most rational endeavour.

Do perfectionism, body image concerns, and intimacy predict genitopelvic pain in the postpartum? A prospective study of new mothers.

BACKGROUND: Genitopelvic pain following childbirth is common and likely to challenge the psychological, relational, and sexual well-being of new mothers. While genitopelvic pain generally decreases during the postpartum period, personal and interpersonal characteristics may explain why genitopelvic pain persists beyond the period of physical recovery in some mothers. Body image concerns, increased stress, and relationship challenges would be particularly salient during pregnancy and the postpartum period, which could put new mothers at greater risk of sexual difficulties. Also, mothers may display a negative appraisal regarding genitopelvic pain and doubt their ability to cope with it, which may contribute to the pain. AIM: The current study aimed to examine the role of perfectionism, body image concerns, and perceived intimacy in the occurrence and change in genitopelvic pain in new mothers in postpartum. METHODS: A total of 211 new mothers and their partners were recruited for a larger prospective dyadic study on the transition to parenthood. OUTCOMES: Mothers completed a single item assessing genitopelvic pain, in addition to brief validated questionnaires measuring perfectionism, body image concerns, and perceived couple intimacy during pregnancy and at 4, 8, and 12 months postpartum. RESULTS: Five multilevel modeling analyses revealed that adaptive perfectionism, maladaptive perfectionism, and body image concerns were associated with a higher occurrence of genitopelvic pain from 4 to 12 months postpartum. Mothers' and partners' perceived intimacy was not significantly related to new mothers' genitopelvic pain. None of the predictors modified the trajectory of genitopelvic pain over time. CLINICAL IMPLICATIONS: Raising awareness among health care professionals regarding the role of perfectionism and body image concerns in genitopelvic pain may help them identify new mothers at risk of chronic genitopelvic pain, while offering a new avenue of intervention. STRENGTHS AND LIMITATIONS: There has been little research examining the role of perfectionism, body image concerns, and intimacy in postpartum genitopelvic pain. Based on a longitudinal prospective approach, this study identified perfectionism and body image concerns as significant predictors of postpartum genitopelvic pain. However, prepregnancy genitopelvic pain, genitopelvic pain intensity, and sexual distress were not measured. CONCLUSION: Adaptive and maladaptive perfectionism and body image concerns are associated with new mothers' genitopelvic pain up to 12 months postpartum.

Differences in proximal and intimacy-related defense mechanisms among patients with cancer in different psychological stages of dying.

Purpose: This study measured three of the psychological stages of dying in patients with cancer and explored the differences in proximal and intimacy-related defense mechanisms at each stage. Patients and methods: A total of 220 cancer patients were recruited for this study; 168 patients met the inclusion criteria and were included in the data analysis. The participants were divided into three groups using the "Death Attitudes Questionnaire Revised" (1994) and then completed the Death-Thought Accessibility Test, Self-Control Questionnaire, Rumination Reflection Questionnaire, Attachment Type Test, Intimacy Test, External Control Test, and Positive and Negative Affect Scale. Results: In the death avoidance stage, which represents a defense stage without cognitive processes, patients are in an irrational state with the highest level of self-control and the lowest level of external control; they tend to prefer close relationships with many people while experiencing high levels of fear and depression. In the bargaining stage, which represents a biased cognitive defense stage, the level of rationality increases, the level of fear and depression decreases, and patients tend to prefer relationships with many people that do not involve intimacy. In the neutral death acceptance stage, which represents a defense stage without cognitive bias, self-control is lowest, external control is highest, patients tend to prefer intimate relationships with a few people, and experience the lowest levels of fear and depression. Conclusion: Three psychological stages of death exist in cancer patients, with differences in proximal and intimacy-related defense mechanisms in each stage. The findings have theoretical and practical implications for psychological interventions for cancer patients.

Family intimacy and adaptability and non-suicidal self-injury: a mediation analysis.

BACKGROUND: Current research has been focusing on non-suicidal self-injury (NSSI) behaviors among adolescents with depression. Although family intimacy and adaptability are considered protective factors for NSSI, evidence supporting this relationship is lacking. OBJECTIVE: This study aims to examine the mechanisms operating in the relationship between family intimacy and adaptability and NSSI behaviors among adolescents. METHODS: A self-administered general demographic information questionnaire, the Behavioral Functional Assessment Scale for Non-Suicidal Self-Injury, the Family Intimacy and Adaptability Scale, the Connor-Davidson Resilience Scale, and the Self-Assessment of Depression Scale were distributed among adolescents with depression in three tertiary hospitals in Jiangsu Province. RESULTS: The relationship between family intimacy and adaptability and NSSI was assessed among 596 adolescents with depression. The results revealed the following: (1) Family intimacy and adaptability were negatively correlated with NSSI behavior. (2) Psychological resilience and depression levels acted as chain mediators in the relationship between family intimacy and adaptability and NSSI behavior. CONCLUSIONS: Enhancing psychological resilience, controlling depressive symptoms, and reducing depression severity among adolescents by improving their family intimacy and adaptability are conducive to preventing and mitigating their NSSI behaviors.

Influences of communication ability, organizational intimacy, and trust among colleagues on job satisfaction of nurses in comprehensive nursing care service units.

Background: Communication abilities, organizational intimacy, trust among colleagues, and job satisfaction of nurses in comprehensive nursing care service units are emphasized more than any other ward, and research on this is necessary. Objective: The study was to examine the influences of communication ability, organizational intimacy, and trust among colleagues on the job satisfaction of nurses in the comprehensive nursing care service units. Methods: This study used a cross-sectional descriptive design. The participants were 155 nurses caring for patients in the comprehensive nursing care service units in Seoul. Measures included the general characteristics of study participants, communication ability, organizational intimacy, trust among colleagues, and job satisfaction. The data were analyzed using the SPSS/WIN version 27.0 program. The data collection period was from August to September 2022. Results: Factors influencing the job satisfaction of nurses at the comprehensive nursing care service units were organizational intimacy (ß = 0.36), communication abilities (ß = 0.26), trust among colleagues (ß = 0.22), and the average number of patients assigned to a nurse (ß = -0.19), which explained 67% of the variance. Conclusions: Organizational intimacy was the greatest factor influencing the job satisfaction of nurses in the comprehensive nursing care service units. To increase the job satisfaction of ward nurses working in the comprehensive nursing care service, securing manpower is required, and it is necessary to provide effective nursing care with an average number of patients of 5 or less. In particular, a systematic job training program is needed to increase organizational intimacy among team nurses.

The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis.

BACKGROUND: Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS: To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS: From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS: The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

The Influence of Mindful Parenting on Children's Creative Tendencies: The Chain Mediating Effect of Parent-Child Intimacy and Connectedness to Nature.

(1) Objectives: The aim of this study was to examine the relationship between mindful parenting and children's creative tendencies and to investigate the mediating role of parent-child intimacy and connectedness to nature in the relationship between mindful parenting and children's creative tendencies. (2) Methods: In this cross-sectional study, nearly 800 mothers of children aged 3-6 were enrolled. General sociodemographic data, the Mindfulness in Parenting Questionnaire (MIPQ), the Creativity Assessment Packet (CAP), the Child-Parent Relationship Scale-Short Form (CPRS-SF), and the Connectedness to Nature Index-Parents of Preschool Children (CNI-PPC) were all included in the questionnaire survey. (3) Results: There were significant positive correlations among mindful parenting, parent-child intimacy, connectedness to nature, and children's creative tendencies. Mindful parenting had a positive predictive effect on children's creative tendencies. Parent-child intimacy played a mediating role between mindful parenting and children's creative tendencies. Connectedness to nature played a mediating role between mindful parenting and children's creative tendencies. The correlation between mindful parenting and children's creative tendencies may be impacted by the chain mediation effects of parent-child intimacy and connectedness to nature. (4) Conclusions: By promoting parent-child intimacy and connectedness to nature, and by utilizing the chain mediating effects of both, mindful parenting positively impacted children's creative tendencies.