Nursing Research最新文献

{"title":"Qualitative Evaluation of Financial Toxicity and Supportive Care Needs of Women with Metastatic Breast Cancer.","authors":"Victoria K Marshall, Cindy Tofthagen, Pooja Advani, Dawn Mussallem, Cheryl Zambroski, Constance Visovsky","doi":"10.1097/NNR.0000000000000831","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000831","url":null,"abstract":"<p><strong>Background: </strong>The cost of cancer treatment is higher for breast cancer than any other cancer diagnosis, leaving women with metastatic breast cancer vulnerable to challenges given the extended length of cancer treatment, including financial, physical, and psychological burdens.</p><p><strong>Objective: </strong>The purpose of this study was to examine the lived experiences of women diagnosed with MBC in the realm of financial concerns and unmet support needs specific to their cancer treatment.</p><p><strong>Methods: </strong>This qualitative, phenomenological study included individual interviews that were audio-recorded and transcribed verbatim. Applied thematic analysis was completed using Atlas.ti. Inter-rater reliability using Cohen's Kappa was established at .80. Participants were recruited from a National Cancer Institute-designated cancer center in the United States.</p><p><strong>Results: </strong>Sixteen participants were interviewed. A majority were white, non-Hispanic, married, unemployed, had obtained at least a bachelor's degree level of education. Nearly 19% of participants reported a gross household income of below $50,000. The mean age of participants was 55.6 years. Two major themes were identified, with each having three corresponding subthemes, including: 1) financial toxicities (cost of cancer treatments and medications, limitations of health insurance, and effect on employment); and 2) unmet support needs (managing usual responsibilities, emotional support, community, and organizational support).</p><p><strong>Discussion: </strong>The results highlight the financial and psychosocial needs of women with MBC. Treatment costs take a huge financial toll on patients and their families, including insured women with higher household incomes. Participants expressed a desire for specific metastatic breast cancer resources and support.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to Stroke Awareness and Severity in an Underserved Urban Community.","authors":"Joanna M Marmo, Benjamin Bass, Vincenza Coughlin, Kathleen Evanovich Zavotsky","doi":"10.1097/NNR.0000000000000829","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000829","url":null,"abstract":"<p><strong>Background: </strong>Despite experiencing an increased incidence in stroke, minority groups have the lowest reported knowledge of stroke signs and symptoms and are less likely to receive time-sensitive interventions. There is a need to explore the relationship between social determinants of health and stroke awareness and severity within at-risk communities.</p><p><strong>Objectives: </strong>The aim of this study was to explore relationships between social determinants of health and stroke awareness and severity in an underserved area located in a city borough in Northeastern United States.</p><p><strong>Methods: </strong>We used an exploratory descriptive retrospective design and existing data. Data from 1162 patients discharged with a principal diagnosis of stroke (ischemic stroke, subarachnoid hemorrhage, or intracerebral hemorrhage) were analyzed to explore the relationship between social determinants of health (age, sex, race, ethnicity, payer status, zip code) and stroke awareness and severity.</p><p><strong>Results: </strong>Age group, race, and hospital arrival method were all significant indicators of time to arrival at the hospital. When holding all other factors in the model constant, being 65 years of age or older was associated with a decrease in time to reach the hospital compared to those under 65 years of age. Those who travelled by private transport had longer discovery to arrival times when holding all other factors constant, as compared to those who arrived by emergency medical services. Compared to persons who were White, persons who were Black and Asian saw increased times to hospital arrival.</p><p><strong>Discussion: </strong>This study found that social determinants of health including age, race, sex, and insurance type significantly influenced stroke awareness and/or severity. Study findings of this can be used by stroke program leadership and community nurses to direct community-centered stroke awareness outreach.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Health Behaviors and Symptom Status Mediated by Digital Health Literacy in Persons With Heart Failure.","authors":"Esra Nur Dibek, Merve Gulbahar Eren, Havva Sert, İbrahim Kocayİgİt","doi":"10.1097/NNR.0000000000000828","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000828","url":null,"abstract":"<p><strong>Background: </strong>In a digitalized world, accessing disease information through online platforms has become essential in influencing health-promoting behaviors among patients with heart failure. Patients must possess sufficient digital health literacy to obtain accurate and reliable information from digital platforms; however, there is no known data about the mediating role of digital health literacy in the relationship between health behaviors and symptom burden among persons with heart failure.</p><p><strong>Objective: </strong>To examine the relationship between digital health literacy, health behaviors, and symptom status (frequency, severity, and level of discomfort) in persons with heart failure and the mediating role of digital health literacy in the relationship between health behaviors and symptom status.</p><p><strong>Methods: </strong>This cross-sectional, correlational study was conducted between November 2023 and June 2024 with 250 persons diagnosed with heart failure. Data were collected using the Heart Failure Health Behavior Scale, e-Health Literacy Scale, and Heart Failure Symptom Status Scale. Pearson correlation analysis, linear regression, and hierarchical regression analysis with PROCESS Model 4 were used to analyze the continuous variables.</p><p><strong>Results: </strong>Digital health literacy was positively but weakly correlated with health behavior and negatively correlated with symptom status. The mediation analysis revealed that part of the effect of health behaviors on symptom status was mediated by digital health literacy.</p><p><strong>Discussion: </strong>Health behaviors directly affected symptom status and indirectly affected symptom status through digital health literacy. Strategies developed by nurses to enhance digital health literacy could play a critical role in improving the health of persons with heart failure by reducing symptom burden and promoting health behaviors. Research is needed on the influence of various predictors on symptom burden and assessing whether interventions to enhance digital health literacy can improve health outcomes among those with heart failure.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Females With Late Diagnosis of Autism: Descriptive Qualitative Study.","authors":"Maria Inmaculada Garcia-Simon, Eva Del Mar Navarro-Jimenez, Adrian Martinez-Ortigosa, Carmen Ropero-Padilla, Pablo Roman, Miguel Rodriguez-Arrastia","doi":"10.1097/NNR.0000000000000825","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000825","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Females with autism often receive late diagnoses-especially those with average or above-average intellectual abilities-highlighting the need to explore the unique experiences of this population for better health care support.Objective: To explore the experiences and perceptions of females who received a late diagnosis on the autism spectrum in terms of coping and managing their diagnosis.Methods: A descriptive qualitative study was conducted from December 2022 to March 2023 using semistructured interviews with 14 late-diagnosed autistic female subjects. Purposive and snowball sampling were employed, and thematic analysis of the interview data was performed using ATLAS.ti v.9 software. Findings were reported following standards for reporting qualitative research guidelines.Results: Two main themes emerged: (a) getting a diagnosis: fitting into the norm, and (b) navigating the distinct significance for autistic females. The findings indicated that masking strategies contribute to delayed diagnoses, and social and health care stigma surrounding autism in females was evident. Areas for improving access to resources and support programs were identified.Discussion: The results show that masking and camouflaging are predominant strategies among autistic females, contributing to delayed diagnoses and exposing them to additional risks. Enhancing resources and training for health care professionals is necessary to address the specific needs of this population.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine Metabolites as Indicators of Chronic Pain and Related Symptoms in Active-Duty Service Members.","authors":"Dahee Wi, Hannah Choi, Nathan Tintle, Nicholas Ieronimakis, Diane M Flynn, Jeffrey C Ransom, Kira P Orr, Honor M McQuinn, Tyler J Snow, Ardith Z Doorenbos","doi":"10.1097/NNR.0000000000000827","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000827","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Chronic pain is a major cause of distress and disability, and biomarkers may aid in the assessment and treatment of it. Urine metabolites may be valuable bioindicators that can provide biological insight regarding chronic pain.Objectives: To investigate the relationship between a multimarker composite measure of metabolites and patient-reported outcomes scores in adults with chronic pain, using data from a pragmatic clinical trial with a sequential, multiple-assignment randomized trial design.Methods: Self-reported measures and urine samples from 169 active-duty service members with chronic pain were collected. Urine was analyzed using a preestablished panel of metabolites, including four previously identified biomarkers of pain: kynurenic acid, pyroglutamic acid, ethylmalonic acid, and methylmalonate. Multivariable linear regression models-adjusted for participant characteristics such as age and sex-were used to cross-sectionally examine the relationship between 11 patient-reported outcomes (fatigue, sleep-related impairment, anxiety, depression, anger, pain catastrophizing, physical function, pain interference, satisfaction with participation with social roles, pain intensity, and pain impact score) and the four urine metabolites both individually and as a composite (urine metabolite pain indicator, or UMPI). Given the study's small sample size and exploratory nature, a significance threshold of p ≤ .10 was used for all analyses.Results: The UMPI showed statistically significant associations with five self-reported measures (fatigue, anxiety, depression, physical functioning, and pain impact score); adjusted Pearson correlations ranged from .18 to .25. Individual metabolite analyses supported these findings, with all relationships between individual metabolites and self-reported measures showing positive associations. Kynurenic acid and ethylmalonic acid showed the strongest associations, each having statistically significant relationships with four individual self-reported measures, while pyroglutamic acid had statistically significant relationships with three self-reported measures and methylmalonate with none. The UMPI demonstrated feasible reliability.Discussion: Our finding of associations between the UMPI and components of the self-reported measures supports the development of the UMPI and these four urine metabolites as biomarkers for chronic pain outcomes. Further research is planned and will be essential for establishing mechanistic insight and guiding biomarker development within the context of pain management.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations in Launching an International Multisite Clinical Trial.","authors":"Laura Beth Kalvas, Mallory A Perry-Eaddy, Amy Cassidy, Onella S Dawkins-Henry, Laurie Lee, Lisa A Asaro, David Wypij, Martha A Q Curley","doi":"10.1097/NNR.0000000000000826","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000826","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Adequately powered randomized controlled clinical trials (RCTs) provide the highest level of evidence to support nursing interventions that are thought to improve clinical outcomes. To ensure adequate power, recruitment at multiple study sites is often required. Complexity is exponentiated when RCTs are conducted in multiple settings, especially on an international level. Regardless of logistical challenges, funders typically expect subjects to be enrolled within the first year of funding.Objective: To describe essential elements that must be considered when launching a multisite RCT.Methods: Step-by-step review of essential multisite RCT start-up activities using PROSpect, a nurse-led 50+ site international pediatric critical care RCT, as an exemplar. Essential pre- and post-award activities and organizational structure are discussed. The PROSpect launch timeline, with comparisons between United States (U.S.) and international study site initiation, is presented.Results: In the first two years of PROSpect funding (6/15/18-6/14/20), 54 sites in 13 countries spanning five continents initiated study launch activities and subsequently went on to begin subject screening. Of these, 15 sites (28%) began screening within the first funding year and 29 (54%) within the second year. PROSpect enrolled its first subject prior to the end of the first year of funding. Sites completed launch activities within a median of 295 days of receiving an instructional email delineating study launch steps (IQR: 202, 379; range = 151-1,046). International sites (n = 19) required more time to launch than U.S. sites (n = 35; 448 [360, 785] vs 219 [201, 299] days; p < .001).Discussion: Nurses must provide care that is supported by the best available evidence. Multisite RCTs are complex but provide high-quality evidence and can be managed with prospective systematic organization. In PROSpect, international sites took approximately twice as long to activate as U.S. sites. When developing a study start-up timeline, it is important to adjust milestones to accommodate the complexities of launching international sites and maintain momentum throughout the process, as start-up delays can increase risk of trial failure. This paper contributes to recent efforts to demystify and streamline the multisite RCT start-up process for nurse investigators transitioning from conducting single-site to multisite trials.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Effects of Medication Dispenser Use by Home-Dwelling Older Adults.","authors":"Olli Salmensuu, Virva Hyttinen-Huotari, Jenni Isotalo, Mieke Rijken, Ismo Linnosmaa, Minna Kaarakainen","doi":"10.1097/NNR.0000000000000824","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000824","url":null,"abstract":"<p><strong>Background: </strong>Population aging has increased the need for solutions that help older adults live independently in their own homes, where medication management is a major challenge.</p><p><strong>Objectives: </strong>In this systematic review, we assessed the effects of medication dispensers among home-dwelling older adults on outcomes within the five domains of the Quintuple Aim framework: user experiences, health and well-being outcomes, health service utilization and costs, care professional experiences, and equity.</p><p><strong>Methods: </strong>We identified relevant studies by searching databases (Scopus, CENTRAL, PubMed, Web of Science, CINAHL, PsycINFO, and Cochrane Reviews) from January 2017 to April 2022 with a predefined search strategy and two-person abstract and full-text screening. Two authors extracted the most relevant data and assessed quality for each included study. We assessed the evidence using a four-level quality rating measure: strong, moderate, limited, or no evidence.</p><p><strong>Results: </strong>We included five original studies and three systematic reviews, which provided information on 20 additional original studies. Data were extracted from these 25 original studies. We found significant results in 16 of them, mostly pointing to beneficial effects of dispenser devices. Significant results for health and well-being outcomes were found in 13 out of 21 studies in which these were assessed, for service utilization in two out of five studies, for costs in two out of three studies, and for patient/carer experiences in one out of five studies. No study evaluated professional experiences or equity outcomes. Overall, strong evidence of a beneficial effect of dispenser devices in any outcome is lacking, but they can improve health outcomes (moderate evidence of beneficial effects of using dispenser devices on systolic and diastolic blood pressure, and hemoglobin A1c levels). For other outcome domains, there is no or only limited evidence for beneficial effects of dispenser devices.Discussion: We found that the use of dispenser devices by home-dwelling older adults can improve clinical health outcomes and may reduce health service utilization and costs. More high-quality research is needed to get a better insight into their effects on service utilization and costs. Future studies should also examine the effects on care professionals' experiences and equity.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and Functional Adaptation to Chronic Stress in Older Adults.","authors":"Wan-Chin Kuo, Karl P Hummel, Roger L Brown, Katherine Mead, Daniel J Liebzeit","doi":"10.1097/NNR.0000000000000823","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000823","url":null,"abstract":"<p><strong>Background: </strong>The wear and tear from chronic stress exposure has been linked to premature aging through allostatic load; however, it is unclear how chronic stress exposure affects physical functioning and physical activity in older adults.</p><p><strong>Objectives: </strong>The study aims were to examine the behavioral and functional adaptation to chronic stress in older adults and its mediational pathways.</p><p><strong>Methods: </strong>Data from the Health and Retirement Study 2016 and 2020 (N = 3075, mean age 66 years) was analyzed. Chronic and perceived stress exposure was quantified using Troxel's chronic stressors scale and Cohen's perceived stress scale. Physical activity was quantified using self-reported questionnaires, including light, moderate, and vigorous physical activity. Physical functioning was operated as a latent construct with four perceived physical limitations (i.e., difficulty in movement, hand strength, shortness of breath, and balance). The cross-sectional data were analyzed using latent regression analysis. The longitudinal data were analyzed using serial mediation based on MacKinnon's bias-corrected bootstrap confidence intervals.</p><p><strong>Results: </strong>Cross-sectionally, psychological stress, as a latent construct indicated by stress exposure and stress perception, explained more variances in perceived physical limitation than physical activity. Longitudinally, perceived stress and physical activity mediated the relationship between chronic stress exposure and perceived physical limitation with significant indirect effects. Furthermore, perceived physical limitation suppressed the effect of chronic stress exposure on physical activity levels. The effects of mediation and suppression remained significant after the adjustment of age, gender, years of education, race, number of comorbidities, working status, and marital status.</p><p><strong>Discussion: </strong>The promotion of physical activity and physical functioning in older adults might not achieve the optimal outcome if the program design overlooks the target population's chronic stress process and functional limitations.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited English Proficient Patient and Nurses Experiences with Language Access Services.","authors":"Julie McCulloh Nair, Alex Waad, Brenda Hollingsworth","doi":"10.1097/NNR.0000000000000822","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000822","url":null,"abstract":"<p><strong>Background: </strong>Persons with limited English proficiency may receive inequitable care due to the absence of language services. Despite health equity initiatives, knowledge gaps exist regarding how and when language access needs are identified, acted upon, and which methods are being used.</p><p><strong>Objective: </strong>The purpose of this study was to explore limited English proficient and deaf obstetrical patient and nurses' experiences with language services to improve delivery of culturally competent care.</p><p><strong>Methods: </strong>This mixed-methods study occurred in two phases. In phase 1, demographic and language service data were collected via surveys that were deployed to obstetric patients with limited English proficiency. In phase 2, nurses' experiences with interpretive services were explored via three focus groups to identify facilitators and barriers to care. Quantitative data were analyzed using descriptive analysis methods, while qualitative data were analyzed using grounded theory methods.</p><p><strong>Results: </strong>Fifty participants receiving obstetric services who had limited English proficiency participated in phase I. Language services were positively rated with a noted preference for in-person interpreters. Participants identified unique barriers, but felt comfortable discussing concerns, stating nurses listened to them, treated them with courtesy, kindness, and respect. In phase II, 16 nurse participants identified two major themes: evidence of barriers to accessibility, convenience, and consistency of language access services; and increased need for cultural and linguistic competence.</p><p><strong>Discussion: </strong>Findings indicate in-person interpreters are most effective and capture cultural nuances often missed when using a phone/iPad during patient encounters. Language service delivery at various points of care requires further consideration to ensure consistent use during patient encounters. Future research should explore digital health language interventions, while nurses' suggestions to decrease language service barriers should be used to develop policies and programs designed to better meet linguistic needs.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Care, Perceived Social Support, and Health-Related Quality of Life in Persons With Heart Failure.","authors":"Ashmita Thapa, JungHee Kang, Misook Lee Chung, Jia-Rong Wu, Martha J Biddle, Geunyeong Cha, Debra K Moser","doi":"10.1097/NNR.0000000000000820","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000820","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Depressive symptoms, anxiety, and inadequate social support are predictors of health-related quality of life (HRQoL) in persons with heart failure, but the prediction of HRQoL is multifaceted, and mechanisms underlying association are unknown. Self-care maintenance may moderate associations among these predictors, which is essential to better heart failure outcomes.Objectives: To determine whether self-care maintenance moderates the direct and indirect effects of social support on HRQoL through psychological status (i.e., depressive symptoms and anxiety) in persons with heart failure.Methods: We conducted a secondary analysis using cross-sectional data collected from 167 participants. Participants completed Patient Health Questionnaire-9, Brief Symptom Inventory, Multidimensional Scale of Perceived Social Support, Self-Care of Heart Failure Index version 6.2, and Minnesota Living with Heart Failure Questionnaire for depressive symptoms, anxiety, social support, self-care maintenance, and HRQoL, respectively. PROCESS macro was used for the analysis.Results: Self-care maintenance did not moderate the direct effect of social support on HRQoL. However, self-care maintenance moderated the indirect effect of social support on HRQoL through depressive symptoms and anxiety. The beneficial effect of social support on depressive symptoms and anxiety varied with self-care maintenance, suggesting a dose-response moderation effect.Discussion: Findings suggest that an increment in social support reduces depressive symptoms and anxiety, which further improves HRQoL. This relationship was more profound when the self-care maintenance was at a higher level. Our study emphasizes the need to focus on improving HRQoL by promoting positive social support that can decrease depressive symptoms and anxiety in persons with heart failure-particularly in those with low or moderate levels of self-care maintenance.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}