Publications by authors named "Jinbing Bai"

72 Publications

Skin Microbiome and Treatment-Related Skin Toxicities in Patients With Cancer: A Mini-Review.

Front Oncol 2022 15;12:924849. Epub 2022 Jul 15.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States.

The human skin hosts millions of bacteria, fungi, archaea, and viruses. These skin microbes play a crucial role in human immunological and physiological functions, as well as the development of skin diseases, including cancer when the balance between skin commensals and pathogens is interrupted. Due to the linkages between inflammation processes and skin microbes, and viral links to skin cancer, new theories have supported the role a dysbiotic skin microbiome plays in the development of cancer and cancer treatment-related skin toxicities. This review focuses on the skin microbiome and its role in cancer treatment-related skin toxicities, particularly from chemotherapy, radiation therapy, and immunotherapy. The current literature found changes in the diversity and abundance of the skin microbiome during cancer treatments such as radiation therapy, including lower diversity of the skin microbiome, an increased ratio, and a higher abundance of pathogenic . These changes may be associated with the development and severity of treatment-related skin toxicities, such as acute radiation dermatitis, hand-foot syndrome in chemotherapy, and immunotherapy-induced rash. Several clinical guidelines have issued potential interventions (e.g., use of topical corticosteroids, phototherapy, and non-pharmaceutical skin care products) to prevent and treat skin toxicities. The effectiveness of these promising interventions in alleviating treatment-related skin toxicities should be further tested among cancer patients.
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http://dx.doi.org/10.3389/fonc.2022.924849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9334917PMC
July 2022

Associations between the Gut Microbiome and Migraines in Children Aged 7-18 Years: An Analysis of the American Gut Project Cohort.

Pain Manag Nurs 2022 Jul 27. Epub 2022 Jul 27.

School of Nursing, Wuhan University, Wuhan, China.

Background: The gut microbiome seems to play a role in migraines through increasing intestinal epithelial permeability and pro-inflammatory processes. The associations between the gut microbiome and migraines are uncertain in children.

Aim: The purpose of this quantitative study was to examine the associations between the gut microbiome and migraines in children aged 7-18 years from the American Gut Project (AGP).

Method: A cohort of children aged 7-18 years from the AGP was analyzed. 16S rRNA V4 gene sequences for the gut microbiome, migraines, and demographics were obtained from the AGP Public Repository. After quality control of 16S rRNA gene sequences, α-diversity (Shannon, Faith's_PD, and evenness) and β-diversity metrics (Bray-Curtis and weighted-UniFrac distances), taxonomy, and abundance analyses were implemented using QIIME 2.

Results: In total, 381 children (341 without migraines; 40 with professional or self-diagnosed migraines) were analyzed with a mean age of 11.5 years. Compared with those without migraines, children with migraines showed lower estimates in Shannon and Faith's_PD (p < .01). Both Bray-Curtis and weighted-UniFrac distances displayed the gut microbial dissimilarities between these two groups (p = .001). Children with migraines had higher abundances in genus of phylum Bacteroidetes (Bacteroides, Parabacteroides, Odoribacter), Actinobacteria (Eggerthella, Varibaculum), Firmicutes (SMB53, Lachnospira, Dorea, Veillonella, Anaerotruncus, Butyricicoccus, Coprobacillus, Eubacterium), and Proteobacteria (Sutterella) than children without migraines.

Conclusions: Associations of the gut microbiome diversity and abundances with migraines in children indicated potential biological mechanisms of migraines. Future work needs to confirm our findings in children.
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http://dx.doi.org/10.1016/j.pmn.2022.06.002DOI Listing
July 2022

Psychometric evaluation of the pregnancy-related anxiety questionnaire-revised 2 for Chinese pregnant women.

Midwifery 2022 Jun 25;112:103411. Epub 2022 Jun 25.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, United States.

Introduction: Pregnancy related anxiety (PrA) is a unique type of anxiety during pregnancy. PrA can affect both maternal and infant health, as well as pregnancy outcomes. The purpose of this study was to culturally translate the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) into Chinese and evaluate its psychometric properties in Chinese women during pregnancy irrespective of parity.

Methods: There were 411 Chinese pregnant women recruited from September 2020 to June 2021. The Cronbach's alpha, split-half reliability, and test-retest reliability were used to evaluate the reliability of PRAQ-R2 Chinese version. Validity was analyzed through content validity, convergent validity, discriminant validity and construct validity.

Results: The Chinese version of PRAQ-R2 showed good reliability and validity. The Cronbach's alpha coefficients of the total scale and subscales were all greater than 0.7. The median score (interquartile range, IQR) of PRAQ-R2 was 27 (32, 22). The correlation coefficient between item and hypothesis subscale were all greater than 0.40, indicating good convergence validity. Our findings revealed three dimensions of this scale by exploratory factor analysis and confirmed the original version of PRAQ-R2: worries about bearing a handicapped child, concern about own appearance, and fear of giving birth, with a total variance of 72.84% explained. The confirmatory factor analysis showed accepted model fit indexes.

Limitations: All pregnant women were recruited from one region in China, and the study lacked the longitudinal design. Future longitudinal multi-central studies are needed.

Conclusion: The Chinese version of PRAQ-R2 can be used as a promising tool to measure PrA in Chinese pregnant women without comorbidities and complications.
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http://dx.doi.org/10.1016/j.midw.2022.103411DOI Listing
June 2022

Psychometric evaluation of the body understanding measure pregnancy scale Chinese version for pregnant Chinese women.

Midwifery 2022 Jun 2;112:103394. Epub 2022 Jun 2.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA.

Objectives: At present, there is limited research on pregnancy body image and no valid tool to measure body image in pregnant Chinese women. The purpose of this study was to translate the Body Understanding Measure Pregnancy Scale into Chinese to determine its reliability and validity in measuring body image in pregnant women.

Methods: The translation of the Body Understanding Measure Pregnancy Scale (BUMPs) was carried out with a standardized procedure. This study was conducted from July to December 2020 in the outpatient department of three tertiary hospitals in China. There were 1069 pregnant women completed the questionnaire and 1057 of those women were included in the analysis. Internal consistency, test-retest reliability, content validity, and construct validity of the translation version were examined.

Results: The final Chinese version of the BUMPs (BUMPs-C) had four dimensions with 16 items. Exploratory factor analysis obtained a three-factor solution, which explained 50.26% of the total variances. Confirmatory factor analysis showed that the model fit of the four-factor model was better than the three-factor model, and the four-factor model also reached a satisfactory model fit after modifying: Minimum Discrepancy was 2.82; Comparative Fit Index was 0.939, and Tucker-Lewis Index was 0.92; Root Mean Square Error of Approximation was 0.059. The content validity index of the scale was 1.0; the Cronbach's alpha (α) coefficient was 0.82 for the total scale, the McDonald's omega (ω) coefficient was 0.829; the test-retest reliability was 0.796.

Conclusions: The BUMPs-C showed good reliability and validity among pregnant Chinese women, which can be used as a simple and valid measurement tool to assess the feelings of pregnant Chinese women on body changes during pregnancy.
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http://dx.doi.org/10.1016/j.midw.2022.103394DOI Listing
June 2022

Associations of readiness for hospital discharge with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home: A prospective study.

J Oncol Pharm Pract 2022 May 12:10781552221100720. Epub 2022 May 12.

15792Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.

Background: Readiness for hospital discharge is associated with patients' health outcomes after they return home. However, little is known about this association among cancer patients receiving oral chemotherapy at home. This study aimed to examine whether patients' reported readiness for hospital discharge was associated with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home.

Methods: A prospective study was conducted, and 151 cancer patients receiving oral chemotherapy were recruited from a provincial level hospital in South China between October 2018 and December 2019. The primary outcome was readiness for hospital discharge assessed by the Readiness for Hospital Discharge Scale-Short Form on the day of discharge. The secondary endpoints were symptoms assessed by MD Anderson Symptom Inventory and non-routine utilization of post-discharge services within one cycle of chemotherapy at home (21 days).

Results: Among these 151 participants, 74.2% of them reported as ready for discharge. Patients who were employed, lived in suburban area or villages, had a higher Eastern Cooperative Oncology Group score, took Tegafur as oral chemotherapy, and took oral chemotherapy for the first time reported lower readiness for hospital discharge. These five factors explained 28.1% of variance in readiness for hospital discharge. Patients who were not ready for discharge were prone to report higher symptom severity (  0.038). No differences in non-routine utilization of post-discharge services were found between the readiness versus non-readiness for discharge groups (  0.891).

Conclusions: Most cancer patients receiving oral chemotherapy at home were ready for discharge, which was influenced by employment status, residence status, Eastern Cooperative Oncology Group score, type of oral chemotherapy drug, and the experience of taking oral chemotherapy at home. Patients with lower readiness reported worse symptom severity at home. Routine assessment was suggested to recognize unready patients, and more extensive preparations for discharge were recommended to help them manage symptoms at home.
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http://dx.doi.org/10.1177/10781552221100720DOI Listing
May 2022

Metabolic Pathways Associated With Psychoneurological Symptoms in Children With Cancer Receiving Chemotherapy.

Biol Res Nurs 2022 07 12;24(3):281-293. Epub 2022 Mar 12.

Nell Hodgson Woodruff School of Nursing, 1371Emory University, Atlanta, GA, USA.

Context: Children with cancer undergoing chemotherapy experience a cluster of psychoneurological symptoms (PNS), including pain, fatigue, anxiety, and depressive symptoms. Metabolomics is promising to differentiate metabolic pathways associated with the PNS cluster.

Objectives: Identify metabolic pathways associated with the PNS cluster in children with cancer before and after chemotherapy.

Methods: Pain, fatigue, anxiety, and depressive symptoms were assessed using the Pediatric PROMIS scales. T-scores were computed and divided dichotomously by a cutoff point of 50; the PNS cluster was a sum of the four symptoms ranging from 0 (all T-scores <50) to 4 (all T-scores ≥50). Serum metabolites were processed using liquid chromatography mass-spectrometry untargeted metabolomics approach. Linear regression models examined metabolites associated with the PNS cluster. Metabolic pathway enrichment analysis was performed.

Results: Participant demographics ( = 40) were 55% female, 60% white, 62.5% aged 13-19 years, and 62.5% diagnoses of Hodgkin's lymphoma and B-cell acute lymphocytic leukemia. Among 9276 unique metabolic features, 454 were associated with pain, 281 with fatigue, 596 with anxiety, 551 with depressive symptoms, and 300 with the PNS cluster across one chemotherapy cycle. Fatty acids pathways were associated with pain: de novo fatty acid biosynthesis ( < .001), fatty acid metabolism ( = .001), fatty acid activation ( = .004), and omega-3 fatty acid metabolism ( = .009). Tryptophan amino acid pathway was associated with fatigue ( < .001), anxiety ( = .015), and the PNS cluster ( = .037). Carnitine shuttle was associated with the PNS cluster ( = .015).

Conclusion: Fatty acids and amino acids pathways were associated with PNS in children undergoing chemotherapy. These findings require further investigation in a larger sample.
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http://dx.doi.org/10.1177/10998004211069619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9343884PMC
July 2022

How to Maintain a Healthy Gut Microbiome in Children with Cancer? Gut Microbiome Association with Diet in Children with Solid Tumors Postchemotherapy.

OMICS 2022 04 25;26(4):236-245. Epub 2022 Feb 25.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.

Malnutrition is a common complication in children with cancer. Cancer treatment and malnutrition can disrupt gut microbiome diversity and composition. The gut microbiome is of broad interest to better understand the mechanisms of malnutrition in cancer therapy. This study aimed to compare the gut microbiome between children with solid tumors postchemotherapy and healthy controls, and investigated the association of the putative microbiome differences with diet. Study participants were 27 children (7-18 years) with solid tumors within the first year after the completion of chemotherapy and 22 healthy controls. The study groups did not have a statistically significant difference in age, race, sex, and body mass index. At study intake, the participants completed the Block Kids Food Screener for dietary intakes in the past week. Fecal specimens were collected and analyzed for the gut microbiome. The cancer and control groups differed in gut microbial β-diversity and abundance analyses. The macronutrient intakes such as carbohydrates, fiber, beta-carotene, and vitamin B6 were positively associated with α-diversity. Children with adequate vitamin B6 had a higher Chao1 diversity index than children with inadequate or excessive intake ( = 0.0004). Children with excessive selenium intake had a trend for higher Pielou's_e index than children with inadequate intake ( = 0.091). Maintaining a healthy gut microbiome is critical among children with cancer. This study provides new insights on the linkages between dietary intakes and the gut microbiome in children with solid tumors postchemotherapy. These findings, if replicated in future independent studies, may help anticipate malnutrition and plan for personalized nutrition approaches during chemotherapy in pediatric cancers.
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http://dx.doi.org/10.1089/omi.2022.0002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9051874PMC
April 2022

Effects of thalassemia on pregnancy outcomes of women with gestational diabetes mellitus.

J Obstet Gynaecol Res 2022 May 24;48(5):1132-1140. Epub 2022 Feb 24.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.

Aim: To explore the effect of thalassemia on pregnancy outcomes of women with gestational diabetes mellitus (GDM).

Methods: This retrospective study reviewed the medical records of women with GDM delivered at the Chongqing Maternal and Child Health Hospital in China between July 2017 and December 2020. The live singleton pregnancies with α or β-thalassemia were identified as the thalassemia group, included α-thalassemia subgroup and β-thalassemia subgroup, whereas pregnant women without thalassemia were randomly selected as the non-thalassemia group according to a control-to-case ratio of 10:1 by computerized randomization. Logistic regression analyses were used to explore the potential association between thalassemia and pregnancy outcomes.

Results: A total of 223 pregnant women with GDM and thalassemia were analyzed, including women with α-thalassemia (n = 143) and β-thalassemia (n = 80). There were no significant differences in the incidence of adverse neonatal outcomes such as preterm birth and low-birth weight among groups. However, among pregnancy complications, significant differences were detected in the incidence of placenta increta, polyhydramnios, and postpartum anemia between the thalassemia group and the non-thalassemia group. Logistic regression results indicated that β-thalassemia increased the risk of polyhydramnios (odds ratio [OR] = 3.95, 95% confidence interval [CI]: 1.14-13.65, p = 0.030) and chorioamnionitis (OR = 3.61, 95%CI: 1.04-12.49, p = 0.043) compared with the non-thalassemia group.

Conclusion: In our study, thalassemia did not increase adverse neonatal outcomes, but β-thalassemia increased the risk of pregnancy complications, including polyhydramnios and chorioamnionitis.
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http://dx.doi.org/10.1111/jog.15206DOI Listing
May 2022

Relationship between the gut microbiota and temperament in children 1-2 years old in Chinese birth cohort.

J Psychiatr Res 2022 04 24;148:52-60. Epub 2022 Jan 24.

Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, USA. Electronic address:

Background: Understanding the relationship between the gut microbiota and temperament can provide new insights for the regulation of behavioral intervention in children, which is still lacking research. This study aimed to examine the relationship between the gut microbiota and temperament in a cohort of children in 1 year and 2 years old.

Methods: This study included a total of 37 children with completed information, in which 51 samples at age 1 and 41 samples at age 2 were received respectively. We collected birth and demographic information. Parents reported their child's temperament characteristics using the Infant Behavior Questionnaire-revised (IBQ-R) and Early Childhood Behavior Questionnaire (ECBQ). Fecal samples were collected from each child at 1 and 2 years old and sequenced with MiSeq sequencer. Multiple linear regressions and linear mixed effect models were used to analyze the relationship between the temperament and their microbiota composition as well as the diversity and effect of gender or age on this relationship.

Results: At age of year 2, Faecalibacterium was negatively associated with high-intensity pleasure and surgency. Bifidobacterium was negatively correlated with Perceptual sensitivity. Results showed no difference about three domains between year 1 and year 2, while gut microbiota showed diversity difference and genera difference. There was no gender and age difference on the relationship between temperament and the gut microbiota.

Conclusions: Temperament was associated with the gut microbiota over time. The temperament remained stable and the relationship between the gut microbiota and temperament wasn't associated with age and gender.
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http://dx.doi.org/10.1016/j.jpsychires.2022.01.041DOI Listing
April 2022

Exploring the Anal Microbiome in HIV Positive and High-Risk HIV Negative Women.

AIDS Res Hum Retroviruses 2022 03;38(3):228-236

Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

This exploratory study sought to characterize the anal microbiome and explore associations among the anal microbiome, risk factors for anal cancer, and clinical factors. A pilot sample of 50 HIV infected and high-risk HIV negative women were recruited from the former Women's Interagency HIV Study. Microbiome characterization by 16S rRNA gene sequencing and datasets were analyzed using QIIME 2™. Composition of the anal microbiome and its associations with anal cancer risk factors and clinical factors were analyzed using linear decomposition model and permutational multivariate analysis of variance. Composition of the anal microbiome among HIV positive and high-risk negative women was dominated by , , and . The overall taxonomic composition and microbial diversity of the anal microbiome did not significantly differ by HIV status. However, the abundance of belonging to the family was associated with HIV status ( = .05). No anal cancer risk factors were associated with the anal microbiome composition. Clinical factors marginally associated with the anal microbiome composition included body mass index (BMI;  = .05) and hepatitis C virus (HCV;  = .05). Although HIV and risk factors for anal cancer were not associated with the composition of the anal microbiome in this pilot sample, other clinical factors such as BMI and HCV, may be worth further investigation in a larger study. Future research can build on these findings to explore the role of the microbiome and HIV comorbidities in women.
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http://dx.doi.org/10.1089/AID.2020.0245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968844PMC
March 2022

Barriers to Pain Management: Incongruence in Black Cancer Caregiving Dyads.

J Pain Symptom Manage 2022 05 4;63(5):711-720. Epub 2022 Jan 4.

Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.; Winship Cancer Institute (J.B., K.A.Y.),, Emory University, Atlanta, Georgia, USA.

Context: To effectively manage cancer pain, there is a need to understand how caregiving dyads appraise symptoms. Dyadic appraisal of symptoms influences whether the dyad perceives the patient's pain is managed well and whether they are on the same page with their appraisal. Beliefs can act as barriers to the dyadic appraisal.

Objectives: This secondary data analysis examined incongruence within Black cancer caregiving dyads regarding beliefs about pain management and potential medication side effects using the Barriers Questionnaire-13. Associated factors were also examined.

Methods: Guided by the Theory of Dyadic Illness Management, dyadic multilevel modeling was conducted with data from 60 Black cancer caregiving dyads to determine the dyadic appraisal of beliefs about pain management and potential medication side effects, which includes the average perception of barriers within the dyad (i.e., dyadic average) and the dyadic incongruence (i.e., gap between patient and caregiver).

Results: On average, Black cancer caregiving dyads reported moderate barriers regarding pain management (2.262 (SE=0.102, P<0.001) and medication side effects (2.223 (SE=0.144, P<0.001). There was significant variability across dyads regarding barriers to pain management and medication side effects. Lower patient education and higher patient-reported pain interference were significantly associated with more perceived barriers to pain management and potential medication side effects. Incongruence within dyads regarding barriers to pain management and medication side effects were significantly associated with the caregiver's report of patient's pain interference.

Conclusion: Findings suggest the importance of appraisal that includes both members of Black cancer caregiving dyads regarding pain management.
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http://dx.doi.org/10.1016/j.jpainsymman.2021.12.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9018523PMC
May 2022

Gut Microbiome and Its Associations With Acute and Chronic Gastrointestinal Toxicities in Cancer Patients With Pelvic Radiation Therapy: A Systematic Review.

Front Oncol 2021 6;11:745262. Epub 2021 Dec 6.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States.

Aim: Pelvic radiation therapy (RT) can impact the gut microbiome in patients with cancer and result in gastrointestinal (GI) toxicities. The purpose of this systematic review was to describe the effects of RT on the gut microbiome and the associations between the gut microbiome and GI toxicities in patients treated with pelvic RT.

Methods: PubMed, Embase, and Web of Science databases were searched from their earliest records to August 2020. The articles screening process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Mixed Method Assessment Tool was used to assess the methodological quality for each included study. All study findings were synthesized and presented in narrative format. Thirteen studies were included. The gut microbiome of fecal samples was analyzed using 16S rRNA sequencing approaches.

Results: There were disparities in alpha and beta diversities that existed across the studies. Divergent results were found among various phyla, including , , and . Moreover, alteration in the gut microbiome diversity and abundance related to cancer treatment was associated with pelvic toxicities, specifically diarrhea. Following treatment, increases in the abundance of was associated with diarrhea and radiation enteritis.

Conclusions: Pelvic RT can disrupt the diversity and abundance of commensal gut microorganisms. A dysbiotic gut microbiome showed a promising association with radiation enteritis through alterations of the intestinal barrier function, innate immunity, and intestinal repair mechanisms; however, confounders, such as diet, were not thoroughly addressed.
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http://dx.doi.org/10.3389/fonc.2021.745262DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8685326PMC
December 2021

Predictors of oral chemotherapy adherence at home among Chinese cancer patients: An observational prospective study.

J Clin Nurs 2021 Dec 15. Epub 2021 Dec 15.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.

Aims And Objectives: To explore whether medication non-adherence experience, readiness for hospital discharge, financial toxicity and symptoms predicted oral chemotherapy adherence at home for Chinese cancer patients.

Background: Oral chemotherapy adherence is critical to determine the treatment efficacy among cancer patients. Identifying predictors before discharge from hospital based on transition theory could assist healthcare providers to improve oral chemotherapy adherence at home.

Design: An observational prospective study.

Methods: Between October 2018 and December 2019, self-reported questionnaires were used to collect data among 151 cancer patients with oral chemotherapy at home. At discharge, baseline data of patient-perceived readiness for hospital discharge, financial toxicity and non-adherence experience were collected, while symptoms and adherence of oral chemotherapy at home were collected after finishing one cycle of oral chemotherapy at home (21 days, the first 14 days received oral chemotherapy). Regression analyses were performed for the predictors' explorations. The STROBE guidelines were followed.

Results: Among 151 participants with oral chemotherapy at home, 30.46% of patients reported medication non-adherence experience at discharge and 82.12% of patients reported adherence to oral chemotherapy at home. Patients with non-adherence experience at discharge were 5.4 times more likely to being non-adhered to oral chemotherapy at home. Numbness were the most frequent and severe symptoms during at home, patients with numbness were 6.6 times more likely to being non-adhered to oral chemotherapy. Although patients reported high level of readiness for discharge and financial toxicity at discharge, which did not predicted oral chemotherapy adherence at home.

Conclusions: Patients with medication non-adherence experience at discharge and symptom of numbness from oral chemotherapy suggested a higher risk of oral chemotherapy non-adherence at home.

Relevance To Clinical Practice: Preventive interventions should focus on patients with previous medication non-adherence experience at discharge and experiencing numbness to promote oral chemotherapy adherence.
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http://dx.doi.org/10.1111/jocn.16170DOI Listing
December 2021

Pain Management Nurses' Roles During the COVID-19 Pandemic.

Pain Manag Nurs 2022 02 2;23(1):9-16. Epub 2021 Oct 2.

The University of Iowa College of Nursing, Iowa City, Iowa.

Background: Millions of people globally have been affected by the Covid-19 pandemic. It's impact on pain management nurses roles' remains unknown.

Aims: To explore role changes among pain management nurses performing patient care during the Covid-19 pandemic.

Design: Qualitative descriptive research study.

Settings: The American Society for Pain Management Nursing's listserv, E-News Brief postings, and snowball sampling.

Participants/subjects: English-speaking registered nurses or advanced practice registered nurses who provided direct patient care since 2020 were eligible.

Method: Data were collected through individual, semi-structured telephone interviews. An interview guide was used and included questions about participants' characteristics and the effect of the Covid-19 pandemic on their roles in clinical work. Data were analyzed using qualitative content analysis.

Results: A homogenous sample of eighteen nurses from the United States was interviewed. Their normal roles, roles during the pandemic, and surges in patients with Covid-19 as the condition for role changes emerged from their descriptions. Most participants did not experience significant changes in their normal roles, but all described how their normal functions were impacted by the pandemic.

Conclusions: As the infectious variants of this disease evolve or other disastrous conditions occur, further changes to roles may occur. The skill sets of pain management nurses, including understanding assessment of pain across the lifespan, administration of opioids and multimodal analgesia, monitoring of patients, and communicating by educating and consultations, reinforce the significant contribution pain management nurses have as valued team members in times of crisis.
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http://dx.doi.org/10.1016/j.pmn.2021.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486647PMC
February 2022

Pain and Self-Management Status Among Chinese Patients With Cancer During the COVID-19 Pandemic.

Pain Manag Nurs 2022 02 4;23(1):26-30. Epub 2021 Oct 4.

School of Nursing, Wuhan University, Wuhan, China.

Background: To investigate the pain and self-management status of patients with cancer and the influencing factors of pain and self-management status during the COVID-19 pandemic.

Methods: A cross-sectional design was used. Eighty-one Chinese patients with cancer were recruited in December 2020. The Brief Pain Inventory, the Pain Management Inventory, and the Pain Self-efficacy Questionnaire were used to evaluate patients' pain and self-management status. Descriptive statistical analysis and multiple linear regression models were conducted for the research aims.

Results: Two thirds of the participants experienced moderate to severe pain. Cancer pain had moderate to severe interference on 90.12% of patients' lives. Self-management of pain in these participants was low. The most commonly used methods of pain management included adjusting activity intensity to avoid fatigue, using distraction techniques, and massaging the sore area. The most effective methods to manage pain included taking analgesics prescribed by doctor, taking over-the-counter analgesics, and massaging the sore area. Fifteen patients (18.5%) believed that the COVID-19 pandemic had an impact on pain management and 26 patients (32.1%) needed support. Pain education, pain interference on sleep, chemotherapy, and payment status were significantly associated with cancer patients 'pain self-management.

Conclusions: During the COVID-19 pandemic, patients with cancer had moderate to severe pain intensity with low levels of self-management and self-efficacy towards that pain.
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http://dx.doi.org/10.1016/j.pmn.2021.09.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487793PMC
February 2022

Grant Writing Doesn't Have to Be a Pain: Tips for Preparation, Writing and Dissemination.

Pain Manag Nurs 2021 10;22(5):561-564

College of Nursing, The University of Arizona, Tucson, AZ.

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http://dx.doi.org/10.1016/j.pmn.2021.08.009DOI Listing
October 2021

Exploring the experience of nursing undergraduates in using gamification teaching mode based on the flow theory in nursing research: A qualitative study.

Nurse Educ Today 2021 Dec 29;107:105158. Epub 2021 Sep 29.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA. Electronic address:

Background: With the development of evidence-based nursing practice, nursing research courses are important in undergraduate programs. However, nursing research courses are highly theoretical, which is difficult for students to understand. Improving the teaching quality of nursing research courses is a challenge for educators.

Objectives: To understand the learning experience and the effect of gamification teaching on nursing undergraduates, and to provide new ideas for nurse educators.

Design: A qualitative research design using individual semi-structured interviews.

Settings: Gamification teaching was applied in an undergraduate nursing research course over one semester at a university in Central China.

Participants: Purposive sampling was adopted to select nine undergraduate nursing students who had recently completed gamification teaching in a nursing research course.

Methods: Data were collected through semi-structured interviews and analyzed using Colaizzi's phenomenological method.

Results: Three major themes and seven subthemes emerged from the interviewees' experience: (1) positive attitude (e.g., acceptance with pleasure and flow experience); (2) self-perceived competence improvement (e.g., creative thinking, collaboration, and knowledge internalization and application); and (3) challenges of gamification teaching (e.g., learning pressure and rationality of game design).

Conclusions: The gamification teaching mode based on the flow theory had a positive effect on the students' learning experience in the nursing research course. It is recommended to improve the game design model and to enhance its effectiveness for classrooms in the future.
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http://dx.doi.org/10.1016/j.nedt.2021.105158DOI Listing
December 2021

Self-Care Efficacy-Mediated Associations Between Healthcare Provider-Patient Communication and Psychological Distress Among Patients With Gastrointestinal Cancers.

Cancer Nurs 2022 Mar-Apr 01;45(2):E594-E603

Author Affiliations: Guangxi Academy of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region (Mrs Chen, Mrs Chen, Mrs Zhang, and Mrs Li), Nanning, China; and Nell Hodgson Woodruff School of Nursing, Emory University (Dr. Bai), Atlanta, Georgia.

Background: Both healthcare provider-patient communication and self-care efficacy affect psychological distress, which is prevalent among patients with gastrointestinal (GI) cancers. It is essential to explore the underlying mechanism among them to relieve psychological distress.

Objective: The aim of this study was to examine whether self-care efficacy mediated the association between healthcare provider-patient communication and psychological distress among patients with GI cancers.

Methods: A cross-sectional study was conducted between March 2018 and May 2019 in China. In total, 219 patients with GI cancers were recruited before discharge from chemotherapy. Healthcare provider-patient communication was assessed by the revised Physician-Patient Communication Scale; patient self-care efficacy was assessed by the Strategies Used by People to Promote Health; and psychological distress was assessed by the Distress Thermometer and the Hospital Anxiety and Depression Scale. Mediation analyses were conducted to examine the mediating effect of self-care efficacy on the association between healthcare provider-patient communication and psychological distress.

Results: A total of 54.34% of patients experienced psychological distress. Patients reported a mean score of 89.93 (SD, 13.81) for healthcare provider-patient communication and 93.91 (SD, 23.39) for self-care efficacy. Self-care efficacy completely mediated the association between healthcare provider-patient communication and psychological distress, and communication outcome was the only domain that significantly influenced self-care efficacy.

Conclusion: Psychological distress is prevalent among patients with GI cancers. Healthcare provider-patient communication, especially communication outcome, promoted patients' self-care efficacy to reduce psychological distress.

Implications For Practice: Healthcare providers should design interventions to improve communication outcomes and eventually increase self-care efficacy to relieve psychological distress among patients with GI cancers.
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http://dx.doi.org/10.1097/NCC.0000000000001009DOI Listing
April 2022

Congruence of pain perceptions between Black cancer patients and their family caregivers.

Support Care Cancer 2022 Jan 2;30(1):543-553. Epub 2021 Aug 2.

Nell Hodgson Woodruff School of Nursing, Emory University, Room 228, 1520 Clifton Road, Atlanta, GA, 30322, USA.

Purpose: This cross-sectional study evaluated congruence in pain assessment among Black cancer patients taking opioids for pain and their family caregivers and the effects of patient-reported depressive symptoms and cognitive complaints on the congruence.

Methods: Patient-reported pain scores (current, average, and worst pain severity and pain interference) and caregiver proxy scores were independently assessed (Brief Pain Inventory). Patient-reported depressive symptoms (Patient Health Questionnaire-8) and cognitive complaints (Cognitive Difficulties Scale) were also assessed. Paired t-test, intraclass correlation coefficient (ICC), and Bland-Altman (BA) plots were used to evaluate group and dyad level congruence in pain assessment. The influence of patient depressive symptoms and cognitive complaints on congruence was examined using bivariate analyses and BA plots.

Results: Among 50 dyads, 62% of patients and 56% of caregivers were female. Patients were older than caregivers (57 vs. 50 years, p = .008). Neither statistically significant (t-test) nor clinically relevant mean differences in pain severity and interference were found at a group level. At the dyad level, congruence was poor in pain now (ICC = 0.343) and average pain severity (ICC = 0.435), but moderate in worst pain severity (ICC = 0.694) and pain interference (ICC = 0.603). Results indicated better congruence in pain severity between patients with depressive symptoms and their caregivers, compared to patients without depressive symptoms. Patient CDS scores had no significant correlations with score differences between patients and caregivers in any pain variables.

Conclusion: Congruence varied depending on how the analysis was done. More information is needed to understand pain assessment between patients and caregivers.
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http://dx.doi.org/10.1007/s00520-021-06448-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332883PMC
January 2022

How stress, discrimination, acculturation and the gut microbiome affect depression, anxiety and sleep among Chinese and Korean immigrants in the USA: a cross-sectional pilot study protocol.

BMJ Open 2021 07 21;11(7):e047281. Epub 2021 Jul 21.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA

Introduction: Although a considerable proportion of Asians in the USA experience depression, anxiety and poor sleep, these health issues have been underestimated due to the model minority myth about Asians, the stigma associated with mental illness, lower rates of treatment seeking and a shortage of culturally tailored mental health services. Indeed, despite emerging evidence of links between psychosocial risk factors, the gut microbiome and depression, anxiety and sleep quality, very few studies have examined how these factors are related in Chinese and Korean immigrants in the USA. The purpose of this pilot study was to address this issue by (a) testing the usability and feasibility of the study's multilingual survey measures and biospecimen collection procedure among Chinese and Korean immigrants in the USA and (b) examining how stress, discrimination, acculturation and the gut microbiome are associated with depression, anxiety and sleep quality in this population.

Method And Analysis: This is a cross-sectional pilot study among first and second generations of adult Chinese and Korean immigrants in the greater Atlanta area (Georgia, USA). We collected (a) gut microbiome samples and (b) data on psychosocial risk factors, depression, anxiety and sleep disturbance using validated, online surveys in English, Chinese and Korean. We aim to recruit 60 participants (30 Chinese, 30 Korean). We will profile participants' gut microbiome using 16S rRNA V3-V4 sequencing data, which will be analysed by QIIME 2. Associations of the gut microbiome and psychosocial factors with depression, anxiety and sleep disturbance will be analysed using descriptive and inferential statistics, including linear regression.

Ethics And Dissemination: This study has been approved by the Institutional Review Board at Emory University (IRB ID: STUDY00000935). Results will be made available to Chinese and Korean community members, the funder and other researchers and the broader scientific community.
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http://dx.doi.org/10.1136/bmjopen-2020-047281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296781PMC
July 2021

Human Microbiome: Understanding the Role of the Gut Microbiome and Implications for Oncology Nursing Care.

Clin J Oncol Nurs 2021 Aug;25(4):383-387

Emory University.

By understanding the human microbiome and its influencing factors, oncology nurses in clinical practice can educate, screen, and monitor patients with cancer who have a higher risk of gut microbiome dysbiosis. Knowledge of the gut microbiome and its impact on cancer outcomes can help oncology nurses interpret associations between the gut microbiome and treatment- related toxicities and symptoms. Oncology nurses can guide patients to build a healthy gut microbiome across the trajectory of cancer treatment and survivorship.
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http://dx.doi.org/10.1188/21.CJON.383-387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197758PMC
August 2021

Exploring the Vaginal Microbiome and Intravaginal Practices in Postmenopausal Women.

Nurs Res 2021 Set/Oct 01;70(5):405-411

Background: Evidence suggests that intravaginal practices (IVPs) women use to cleanse their vagina or enhance sexual pleasure may be associated with unhealthy changes in the vaginal microbiome (VM). However, the effects of these practices in postmenopausal women are unknown.

Objectives: The objective of this pilot study was to characterize the VM communities of postmenopausal women, identify types and frequency of IVPs, and explore associations between the VM and IVPs in postmenopausal women.

Methods: We analyzed the VM data of 21 postmenopausal women in Atlanta, Georgia, from vaginal swabs collected at a routine gynecological visit. 16S rRNA gene sequencing in the V3-V4 region was used to characterize the VM. In addition, we described the IVPs of these women, identified by using our newly developed instrument: the Vaginal Cleansing Practices Questionnaire. The associations between the VM and IVPs were explored by comparing the alpha diversities, beta diversities, and the relative abundances at both the community level and individual genus level.

Results: The most abundant known bacterial genus found in the VM samples was Lactobacillus (35.7%), followed by Prevotella (21.4%). Eleven women (52%) reported using at least one type of IVP since menopause. The most common type of IVP was soap and water to clean inside the vagina. The use of IVPs was not associated with any alpha diversity metric, including Shannon index, inverse Simpson index, and Chao1 index; beta diversity metric, including Bray-Curtis and Jaccard distances; nor relative abundances at the community and individual genus level. Sociodemographic factors were also not associated with any alpha diversity metric.

Discussion: Clinicians must assess IVPs and other vaginal and sexual hygiene practices of women of all ages to educate and promote healthy behaviors. More than half of the postmenopausal women in this pilot study use IVPs. Understanding the reasoning behind participants' use of IVPs and their perceptions of the possible effects of these practices will require further research. Although the small sample did not show associations with the VM, more extensive studies are warranted.
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http://dx.doi.org/10.1097/NNR.0000000000000538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462522PMC
September 2021

Effectiveness of the CenteringPregnancy program on maternal and birth outcomes: A systematic review and meta-analysis.

Int J Nurs Stud 2021 Aug 20;120:103981. Epub 2021 May 20.

Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA. Electronic address:

Background: The World Health Organization has emphasized the critical role of prenatal care in achieving the Millennium Development Goals to reduce child and maternal mortality. The CenteringPregnancy program is a widely recognized model of prenatal care. Several countries have attempted to implement the program in prenatal care practice; however, its effectiveness on maternal and birth outcomes has not been systematically evaluated and analyzed.

Objectives: To determine the effect of the CenteringPregnancy program on improving maternal and birth outcomes, including low birth weight, preterm birth, and postpartum depression.

Design: This study evaluated and analyzed randomized controlled trials by comparing the CenteringPregnancy program with o0bstetric led prenatal care. Maternal and birth outcomes of interest included low birthweight, preterm birth, and postpartum depressive symptoms.

Data Sources: Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were utilized in this systematic review. Additionally, a supplemental Google Scholar search was performed to capture all relevant articles.

Methods: All data were extracted independently by two trained researchers, who evaluated the quality of the study by examining the risk of bias. The biases of selection, allocation, measurement, reporting, and loss of follow-up were assessed using the Cochrane risk of bias for these included randomized controlled trials. A meta-analysis of eligible randomized controlled trials was conducted using Review Manager. Heterogeneity of studies was assessed using the I statistic.

Results: Out of 591 articles reviewed, seven randomized controlled trials were included in this study. Findings showed that the CenteringPregnancy program was not associated with lower rates of preterm birth (0.88 [0.71-1.07], p = 0.20, I = 0%), low birth weight (0.87 [0.68-1.12], p =0.29, I = 0%), or 12-month postpartum depressive symptoms (0.07 [-0.12-0.26], p =0.46, I = 69%). However, the CenteringPregnancy program was associated with reduced rates of 6-month postpartum depressive symptoms (0.49 [0.40-0.59], p < 0.01, I = 40%).

Conclusions: Existing evidence suggests that the CenteringPregnancy program and obstetric led care have similar effects on reducing the rates of preterm birth and low birth weight but different effects on postpartum depressive symptoms. More studies are needed to examine the effect of the CenteringPregnancy program on the improvement of postpartum depressive symptoms. PROSPERO Registration number: CRD42020171831. Tweetable abstract: We conducted a systematic review and meta-analysis of randomized controlled trials to determine the effects of the CenteringPregnancy program on improving maternal and birth outcomes, including low birth weight, preterm birth, and postpartum depressive symptoms. Seven randomized controlled trials were included in this study. The findings suggested that the CenteringPregnancy program and obstetric led care had similar effects in reducing the rates of preterm birth and low birth weight. More studies are needed to examine the effect of the CenteringPregnancy program on the improvement of postpartum depressive symptoms.
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http://dx.doi.org/10.1016/j.ijnurstu.2021.103981DOI Listing
August 2021

Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study.

Nurs Health Sci 2021 Jun 3;23(2):538-546. Epub 2021 May 3.

Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia, USA.

Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.
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http://dx.doi.org/10.1111/nhs.12842DOI Listing
June 2021

Impacts of Maternal Diet and Alcohol Consumption during Pregnancy on Maternal and Infant Gut Microbiota.

Biomolecules 2021 03 1;11(3). Epub 2021 Mar 1.

Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA 30322, USA.

(1) Background: Maternal diet and alcohol consumption can influence both maternal and infant's gut microbiota. These relationships are still not examined in the Chinese population. The purpose of this study was to explore the effect of alcohol consumption and maternal diet during pregnancy on maternal and infant's gut microbiota. (2) Methods: Twenty-nine mother-child dyads were enrolled in central China. Fecal samples of mothers during late pregnancy and of newborns within 48 h were collected. The V3-V4 regions of 16S rRNA sequences were analyzed. A self-administrated questionnaire about simple diet frequency in the past week was completed by mothers before childbirth. The demographic information was finished by mothers at 24 h after childbirth. (3) Results: Among these 29 mothers, 10 mothers reported alcohol consumption during pregnancy. The PCoA (β-diversity) showed significant difference in maternal gut microbiota between the alcohol consumption group vs. the non-alcohol consumption group (abund-Jaccard, r = 0.2, = 0.006). The same phenomenon was observed in newborns (unweighted-UniFrac full tree, r = 0.174, = 0.031). Maternal alcohol consumption frequency showed positive associations with maternal ( = 0.032) and ( = 0.019); maternal ( = 0.013) was negatively correlated with frequency of alcohol consumption. As for newborns, a positive relationship showed between ( = 0.035) and newborns with maternal alcohol consumption. The diet was not associated with both maternal and infant's gut microbiota. (4) Conclusions: Maternal alcohol consumption during pregnancy influenced the gut microbiota on both mothers and the newborns. Future research is needed to explore these relationships in a lager birth cohort. Understanding the long-term effect of alcohol consumption on maternal and newborns' gut microbiota is needed.
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http://dx.doi.org/10.3390/biom11030369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001387PMC
March 2021

Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey.

BMJ Open 2021 03 4;11(3):e041578. Epub 2021 Mar 4.

School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Objectives: To assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.

Design: A cross-sectional design.

Setting: Two community health centres in central China.

Participants: 291 community-dwelling older adults aged ≥65 years with type 2 diabetes.

Main Outcome Measures: Data were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.

Results: The prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).

Conclusions: A high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.
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http://dx.doi.org/10.1136/bmjopen-2020-041578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934736PMC
March 2021

Cultural adaptation and psychometric evaluation of the Chinese version of the nurse-specific end-of-life professional caregiver survey: a cross-sectional study.

BMC Palliat Care 2021 Feb 16;20(1):32. Epub 2021 Feb 16.

Yale University School of Nursing, 400 west Campus Drive, Orange, CT, USA.

Background: Nurses' palliative and hospice care-specific education is associated with the quality of palliative and hospice care that influences health outcomes of patients with life-limiting illnesses and their caregivers. However, China lacks measures available to assess nurses' educational needs in palliative and hospice care. The End-of-Life Professional Caregiver Survey (EPCS) is a psychometrically reliable self-reporting scale to measure multidisciplinary professionals' palliative and hospice care educational needs. This study was performed to explore the psychometric properties of the Chinese version of the EPCS (EPCS-C) among Chinese nurses.

Methods: We translated and culturally adapted the EPCS into Chinese based on Beaton and colleagues' instrument adaptation process. A cross-sectional study design was used. We recruited 312 nurses from 1482 nurses in a tertiary hospital in central China using convenience sampling to complete the study. Participants completed the EPCS-C and a demographic questionnaire. Exploratory and confirmatory factor analysis was carried out to test and verify the construct validity of the nurse-specific EPCS-C. Cronbach's alpha coefficient was used to appraise the reliability of the nurse-specific EPCS-C.

Results: A three-factor structure of EPCS-C was determined, including cultural, ethical, and national values; patient- and family-centered communication; and effective care delivery. The exploratory factor analysis explained 70.82% of the total variances. The 3-factor solution of the nurse-specific EPCS-C had a satisfactory model fit: χ2 = 537.96, χ2/df = 2.96, CFI = 0.94, RMSEA = 0.079, IFI = 0.94, and GFI = 0.86. Cronbach's alpha coefficient of the overall questionnaire was 0.96.

Conclusions: The nurse-specific EPCS-C showed satisfactory reliability and validity to assess nurses' palliative and hospice care educational need. Further research is required to verify the reliability and validity of the EPCS-C in a larger sample, especially the criterion-related validity.
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http://dx.doi.org/10.1186/s12904-021-00725-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885229PMC
February 2021

The experiences of nurses infected with COVID-19 in Wuhan, China: A qualitative study.

J Nurs Manag 2021 Jul 24;29(5):1180-1188. Epub 2021 Mar 24.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.

Aim: To understand about the experiences and feelings of the nurses infected with COVID-19 when caring for patients with COVID-19.

Background: With the sudden outbreak of coronavirus disease 2019 (COVID-19), nurses take care of patients with COVID-19 and have a very high risk of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) themselves.

Methods: This study adopted a qualitative design of hermeneutic phenomenology. A purposeful sampling was used, and all data were collected through in-depth semi-structured telephone interviews then analysed using interpretative phenomenological analysis.

Results: The interview data generated 4 topics and 14 secondary topics. Four major themes were identified from this study, including 'experiences of infection', 'health belief', 'social support' and 'the pursuit of self-worth'.

Conclusions: Nurses infected by COVID-19 experienced a physical and psychological shock. They had a strong sense of responsibility and willingness to take risks. Providing professional psychological counselling and physical rehabilitation services are crucial.

Implications For Nursing Management: This manuscript provides nursing managers an understanding of the personal experiences and needs of clinical nurses in their work, especially during COVID-19. It is helpful for nursing managers to explore the greater driving force of nurses and prepare nursing human resources for greater challenges.
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http://dx.doi.org/10.1111/jonm.13256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013478PMC
July 2021

Environmental Tobacco Smoke Exposure and Breastfeeding Duration Influence the Composition and Dynamics of Gut Microbiota in Young Children Aged 0-2 Years.

Biol Res Nurs 2021 07 3;23(3):382-393. Epub 2020 Dec 3.

Nell Hodgson Woodruff School of Nursing, 1371Emory University, Atlanta, GA, USA.

The colonization characteristics of infant gut microbiota are influenced by many factors at various stages, but few studies have explored the longitudinal effects of environmental tobacco smoke exposure and quantitative breastfeeding duration on young children' gut microbiota. We explored the effects of smoke exposure and breastfeeding duration on gut microbiota by following 37 maternal and children pairs in China for 2 years. We collected the demographic information, frequency of smoke exposure, breastfeeding duration, and fecal samples (mothers in the late pregnancy and infants at 6, 12, and 24 months), and analyzed the microbiota results using the V3-V4 gene sequence of 16S rRNA. The diversity of gut microbiota in children was the highest at 24 months and most similar to that in mothers. Breastfeeding duration was positively correlated with and negatively correlated with The α diversity of microbiota and the relative abundance of was higher in the non-smoke exposed group. The higher the smoke exposure, the higher the relative abundance of Prolonged breastfeeding and reduced smoke exposure are beneficial to the diversity and composition of gut microbiota in young children.
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http://dx.doi.org/10.1177/1099800420975129DOI Listing
July 2021

The experiences of pregnant women with gestational diabetes mellitus: a systematic review of qualitative evidence.

Rev Endocr Metab Disord 2021 12 12;22(4):777-787. Epub 2020 Nov 12.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA.

Gestational diabetes mellitus (GDM) can have serious adverse effects on pregnant women and their fetuses. The purpose of this systematic review is to explore responses from women diagnosed with GDM and to describe their real-life experiences with self-management during pregnancy. The review provides insight into the physical, psychological, and social experiences of women with GDM; exploring these factors can help identify the challenges of glucose control and may provide targeted care and interventions to improve maternal and child health. Twelve databases were included in the initial article search, which was conducted on February 27, 2019. Two independent reviewers used the JBI Critical Appraisal Checklist for Qualitative Research for methodological validity to assess articles for study inclusion. The final synthesized findings were graded according to the ConQual approach for establishing confidence. Ten studies (totaling 223 pregnant women with GDM), originating from 6 different countries, were included in the review. Of the 223 women, 171 had one pregnancy affected by GDM and 52 had two or more pregnancies affected by GDM. Based on the findings from these studies, three main themes emerged, which were synthesized from 10 separate categories and 46 individual findings: beliefs about illness and health; life-changing experiences and healthy expectations; and difficulties and needs. Both positive and negative experiences of pregnant women with GDM can be understood as a process of "continuous struggle and change". Understanding the experiences of women diagnosed with GDM can provide health care professionals with more knowledge of how women experience GDM and develop feasible interventions to reduce the risk of developing type II diabetes.PROSPERO registration number CRD42019132065.
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http://dx.doi.org/10.1007/s11154-020-09610-4DOI Listing
December 2021
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