Mothers' intentions and behaviours regarding providing risk communication to their daughters about their possibility of being haemophilia carriers: A qualitative study.

INTRODUCTION: Prophylactic replacement therapy has enabled improvements in the quality of life of patients with haemophilia. However, these patients and their families continue to report psychosocial problems regarding pregnancy and childbirth. In a situation where there is little medical support for haemophilia carriers (HCs), parents must inform their children regarding their possibility of being HCs. AIM: This study aimed to elucidate intentions and challenges among mothers with daughters who may be HCs, regarding providing them with carrier risk communication (RC). METHODS: Study participants were mothers with daughters who have the possibility of being HCs. Semi-structured interviews were conducted with 20 mothers and were fully transcribed. The analysis was undertaken using a grounded theory-informed approach, through a process of repeated inductive and deductive qualitative coding. RESULTS: The study included 14 mothers who had already provided RC to their daughters, five who had not yet provided RC but who intended to do so, and one with no intention of providing RC. Mothers who had already provided RC included those who were not troubled and those who experienced psychological difficulties regarding the RC. Participants who had not provided RC experienced difficulties with 'not knowing what to do' and feelings of 'anxiety due to uncertainty' and reported not knowing the best RC method or timing. CONCLUSION: The study revealed a need for support for persons experiencing difficulties with informing their daughters of their possibility of being HCs. Healthcare professionals can advise parents to reduce the burden of providing carrier RC to their daughters.

The effects of a 120-minute nap on sleepiness, fatigue, and performance during 16-hour night shifts: A pilot study.

OBJECTIVE: To investigate sleepiness, fatigue, and performance following a 120-minute nap during simulated 16-hour night shifts based on subjective and objective assessments. METHODS: Fourteen females participated in this crossover comparative study. Three experimental nap conditions were used: naps from 22:00 to 00:00 (22-NAP), 00:00 to 02:00 (00-NAP), and 02:00 to 04:00 (02-NAP), respectively. Measurement items were sleep parameters, sublingual temperature, a Visual Analog Scale for sleepiness and fatigue, a single-digit mental arithmetic task (for 10 minutes), and heart rate variability. Participants wore an ActiGraph to estimate their sleep state. RESULTS: There was no difference in the sleep parameters at the time of naps among the three conditions. Immediately following a 120-minute nap, sleepiness and fatigue increased, and the number of calculations performed in the single-digit mental arithmetic task decreased in any of the conditions. In particular, immediately after the 02-NAP, fatigue and high-frequency power (HF) were higher than after the 22-NAP. In the early morning (from 05:00 to 09:00), in the 22-NAP, sleepiness and fatigue increased, and performance and sublingual temperature decreased more than in the 00-NAP and 02-NAP. Furthermore, the ratio of errors was significantly lower in the 00-NAP than in the 22-NAP in the early morning. CONCLUSIONS: A 120-minute nap taken from 22:00 to 02:00 may cause temporary sleepiness after waking, increase fatigue and reduce performance. Greater attention should be given to naps taken at a later time (ie, 02-NAP). In addition, taking a nap starting at 00:00 might decrease the risks of errors in the morning.

The effects of nighttime napping on sleep, sleep inertia, and performance during simulated 16 h night work: a pilot study.

OBJECTIVES: This study aimed to elucidate the effects of two naps taken at night on morning waking state and performance. METHODS: The participants were 12 women. The experiment was performed in a laboratory over 2 days (16:00-09:00). In this crossover comparative study, three experimental nap conditions were used (naps from 22:30 to 00:00 and from 02:30 to 03:00 (22:30-NAP), 00:30 to 02:00 and 04:30 to 05:00 (00:30-NAP), and no naps (NO-NAP), respectively). Measurement items were a Visual Analog Scale for sleepiness and fatigue, the Psychomotor Vigilance Test (PVT), and single-digit addition calculations (10 min) every hour for 18 h from 16:00 to 09:00, excluding nap times. RESULTS: Sleep inertia and sleepiness were noted directly after napping. Less sleepiness and fatigue were noted in the nap groups between 06:00 and 09:00 in the morning than in the NO-NAP condition and PVT response times were faster. Since participants in the nap groups were able to conduct more single-digit addition calculations, the performance of these groups appeared to be superior to that of the NO-NAP condition. Furthermore, the performance of calculations was significantly better in the 00:30-NAP than in the 22:30-NAP. CONCLUSIONS: Taking two naps during a simulated night shift helps improve sleepiness and fatigue and maintain performance. Taking a nap in the early morning appears to be promising for improving the waking state.

Positive appraisal of in-home family caregivers of dementia patients as an influence on the continuation of caregiving.

BACKGROUND: We attempted to determine the factors that influence the continuation of in-home caregiving for patients with dementia. METHODS: The participants were family caregivers of dementia patients who received home care services. Data were collected via a questionnaire completed by caregivers and then returned in the mail. Of the 705 caregivers who received the questionnaire, 405 completed and returned it (response rate: 57.4%). RESULTS: The average age of the caregivers was 63.9 ± 11.5 years, and they had been providing care for an average of 5.1 ± 4.1 years. The average age of the patients was 84.7 ± 7.4 years. We analyzed the path model. Caregivers' current feelings about continuing caregiving were directly affected by a positive appraisal of caregiving (ß = 0.20, P < 0.001) and by the burden they experienced (ß = -0.39, P < 0.001). The continuation of caregiving of patients with worsening symptoms was directly affected by a positive appraisal of caregiving (ß = 0.15, P < 0.01) and by the burden experienced by the caregivers (ß = -0.46, P < 0.001). The continuation of caregiving was indirectly affected by the patients' cognitive impairment and by the behavioral and psychological symptoms of dementia score. CONCLUSIONS: The continuation of in-home caregiving among caregivers of patients with dementia was affected by both positive appraisal and caregiver burden. In addition, the present study revealed that behavioral and psychological symptoms of dementia score indirectly affects the continuation of caregiving by directly affecting caregiver burden.

Effects of two 15-min naps on the subjective sleepiness, fatigue and heart rate variability of night shift nurses.

The purpose of this study was to examine the effects of two 15-min naps on nurses who work at night in a three-shift system. Of the 15 nurses who were included as study subjects on a night shift, eight took two short naps (the Nap condition), and seven worked without taking a nap (the No-nap condition) during the night shift. We measured sublingual temperature and the bispectral index (BIS), obtained heart rate and heart rate variability measures from an electrocardiogram (ECG), and evaluated sleepiness and fatigue levels every hour using the Visual Analog Scale (VAS). Both subjective sleepiness and fatigue increased between 4:00 and 5:00, with no significant differences observed between the two groups. However, the low- to high-frequency ratio (LF/HF) in the Nap condition group was found to be significantly lower than in the No-nap condition group. Furthermore, a sudden, brief increase in HF values was observed in the No-nap condition group in the morning. The results of this study suggest that taking two short naps may effectively reduce tension and prevent a brief increase in HF values by suppressing sympathetic nervous activity in the morning.

Physiological characteristics of the body fluid in lymphedematous patients postbreast cancer surgery, focusing on the intracellular/extracellular fluid ratio of the upper limb.

AIM: The aim of this research was to determine the physiological characteristics of patients with lymphedema following breast cancer surgery, based on differences between the quantity of body water in the right and left fingertips, with a view to establishing whether or not this simple measurement could serve as a predictive index for the onset of lymphedema. METHOD: The research was conducted at a hospital in Hiroshima, Japan (August 2004 to December 2004). Observations were made on 39 female breast cancer patients who had undergone surgery and 45 healthy female participants. Additional information was collected via interviews with the individual participants. The quantity of body water in all the participants was measured by using a bioimpedance spectrum analysis system. Comparisons of the intracellular/extracellular fluid ratios (I/Es) were made between the edema patients and the non-edema patients, with further testing being done between the affected and unaffected sides of the upper limb in the edema patients. RESULTS: In the edema patients, significant differences were recognized between the affected side's upper limb I/E and the unaffected side's upper limb I/E. In relation to the affected side's upper limb I/E of the edema patients, even when the mean value and standard deviation were included, the value did not exceed 1.0 and the mean - 3 SD value of the affected side's upper limb I/E in the non-edema patients was 1.04. CONCLUSIONS: The results suggest that measurements of the affected and unaffected sides' upper limb I/E showed a potential for use as a reliable predictive index for lymphedema.