Investigation of adaptation after liver transplantation using Roy's Adaptation Model

Effects of a Virtual Reality-Based Nursing Intervention Using the Roy Adaptation Model on Social Anxiety in Young Adults

PURPOSE

To determine the effects of an innovative nursing practice approach based on the Roy Adaptation Model (RAM) integrated with virtual reality (VR) on social anxiety levels among young adults.

METHOD

A single-blind, randomized controlled trial was conducted with 55 young adults aged 18 to 25 years. The intervention, based on the RAM, comprised six sessions focusing on psychoeducation, relaxation, and cognitive restructuring. VR was integrated into four of the sessions, aiming to simulate social situations and provide real-time feedback. Data were collected using the Liebowitz Social Anxiety Scale (LSAS), Life Satisfaction Scale (LSS), and an individual introduction form, with pretest, posttest, and follow-up measurements.

RESULTS

LSAS scores indicated that the intervention had a significant positive impact on the experimental group regarding anxiety (F = 24.005, p < 0.001) and avoidance (F = 44.915, p < 0.001), as well as total scale scores. However, LSS scores revealed no significant differences between experimental and control groups (F = 0.429, p = 0.654).

CONCLUSION

Nursing interventions based on the VR-integrated RAM significantly reduced social anxiety among young adults. VR should be incorporated into nursing interventions to provide innovative, cost-effective therapy for patients, especially those with anxiety disorders. In addition, VR-focused training programs for nurses and inclusion of VR in nursing curricula could enhance nurses' skills in modern therapeutic approaches from the undergraduate level. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Assessment of the Difficulties Experienced by Individuals with Intestinal Stomas: A Qualitative Study

OBJECTIVE

The aim of this study was to assess the difficulties faced by individuals with intestinal stomas.

METHODS

The authors used a qualitative descriptive phenomenologic design. The study population comprised individuals with intestinal stoma living in Eskişehir who were 18 years or older and did not have any mental, physical, and communication disorders. Criterion sampling and snowball sampling methods were used. Data were collected from June to September 2019 through a questionnaire of personal characteristics as well as a semistructured interview. Data on personal characteristics were analyzed in numbers and percentages, and qualitative data were analyzed using the MAXQDA 2020 program (VERBI Software, Berlin, Germany).

RESULTS

The study data were evaluated under two headings: (1) themes created using the Roy's Adaptation Model and (2) other themes. In the themes created using the Roy's Adaptation Model, difficulties related to the physiologic adaptation mode and interdependence adaptation mode were observed, whereas among other themes, difficulties due to lack of information and economic worries were commonly reported.

CONCLUSIONS

Most individuals experienced sleep pattern disturbances; faced issues in their relationships with family and friends due to physiologic and psychological distress; received no training for stoma care, diet, or sexual life; could not cope with issues related to the stoma; and faced financial difficulties in procuring stoma bags and care products.

Women's interdependence after hysterectomy: a qualitative study based on Roy adaptation model

Background

Hysterectomy is a difficult process that some women encounter that can affect their interdependence, but its impact on women’s Interdependence has received less attention. Therefore, this study aimed to explain women’s Interdependence after hysterectomy.

Methods

This qualitative study was performed using a directed content analysis approach in Mashhad (Iran). Thirty women with a history of hysterectomy were included in the study by purposive sampling method. Data were collected from August 2018 to November 2019 using semi-structured interviews based on the interdependence mod of the Roy adaptation model until data saturation. Data analysis was performed using MAXQDA software and the deductive approach of Elo and Kingas (J Adv Nurs 62(1):107–115, 2008. 10.1111/j.1365-2648.2007.04569.x).

Results

Data analysis led to the production of 537 initial codes from participants’ experiences. By merging and categorizing them, the theme of “increasing interdependence” emerged, which consists of 2 categories: “Evolution independence and interaction with important people in life” and “Reinforced support system”, that include six subcategories.

Conclusion

After hysterectomy, women not only feel a strong need for support from family members, especially their husbands, they are also seeking support from health care providers and their colleagues. Before the hysterectomy, it is recommended that family members be consulted to ensure the emotional support and care of women after the hysterectomy. It can help the adaptation to hysterectomy.

Perspectives of solid organ transplant recipients on medicine-taking: Systematic review of qualitative studies

Medicine-taking among transplant recipients is a complex and ubiquitous task with significant impacts on outcomes. This study aimed to describe the perspectives and experiences of medicine-taking in adult solid organ transplant recipients. Electronic databases were searched to July 2020, and thematic synthesis was used to analyze the data. From 119 studies (n = 2901), we identified six themes: threats to identity and ambitions (impaired self-image, restricting goals and roles, loss of financial independence); navigating through uncertainty and distrust (lacking tangible/perceptible benefits, unprepared for side effects, isolation in decision-making); alleviating treatment burdens (establishing and mastering routines, counteracting side effects, preparing for the unexpected); gaining and seeking confidence (clarity with knowledge, reassurance through collective experiences, focusing on the future outlook); recalibrating to a new normal posttransplant (adjusting to ongoing dependence on medications, in both states of illness and health, unfulfilled expectations); and preserving graft survival (maintaining the ability to participate in life, avoiding rejection, enacting a social responsibility of giving back). Transplant recipients take medications to preserve graft function, but dependence on medications jeopardizes their sense of normality. Interventions supporting the adaptation to medicine-taking and addressing treatment burdens may improve patient satisfaction and capacities to take medications for improved outcomes.

Pathways to psychological wellbeing for patients with bladder cancer and their partners-in-care

PURPOSE

The goal of the current analyses was to describe pathways through which Psychological Wellbeing might be better understood for clinical participants with bladder cancer and their partners. This was achieved by applying Roy's Adaptation Model that provides a framework with which to understand responses to challenging circumstances that has proved useful in the study of a range of chronic conditions.

METHODS

The sample comprised 119 patients with a diagnosis of bladder cancer, and 103 supportive partners. Participants completed a self-report questionnaire comprising the Bladder Cancer Index, Mini-Mental Adjustment to Cancer Scale, Psychosocial Adjustment to Illness Scale, and sociodemographic details. For each sample, structural equation modelling was used to determine goodness of fit, guided by Roy's Adaptation Model.

RESULTS

For patients, increasing age and disease duration, the negative appraisal of health care, perceived poor functioning and elevated burden of disease provided pathways to Psychological Wellbeing. For partners, increasing age, being male, a negative health care experience, and perceived burden of disease were significant. However, for both groups a positive evaluation of family and social support was the key indicator of lower Psychological Wellbeing.

CONCLUSIONS

The models presented describe a suite of issues that could inform a nursing model of care to enhance the experience of living with bladder cancer for both patients and their supportive partners.

Informational needs of liver transplant recipients during a two-year posttransplant period

OBJECTIVES

To describe the informational needs of liver transplant (LTx) recipients, examine potential differences in informational needs by sociodemographic and clinical variables, and examine informational needs at various time points posttransplant.

METHODS

A descriptive, cross-sectional design was used. Informational needs were assessed by the Informational Needs Questionnaire-liver, a new questionnaire developed to include LTx recipients' perspectives. To examine informational needs at different posttransplant time points, participants were classified into four groups (0-1, 2-4, 5-9, and 10-24 months).

RESULTS

Participants (159) who were married, single, had higher education, or higher monthly incomes had significantly greater informational needs. Informational needs regarding disease and physical and emotional management remained high after transplant. Four subscales (medication, wound management, diet, and daily and social activities) indicated informational needs were different across time. Participants 2-4 months posttransplant had higher informational needs regarding wound management and daily and social activities. Participants 5-9 months posttransplant had the highest informational needs regarding medication and diet.

DISCUSSION

Findings indicate informational needs vary among LTx recipients at different posttransplant time points. Marital status, education, and monthly income can influence informational needs.

CONCLUSION

Healthcare providers should tailor information given to LTx recipients based on informational needs. Longitudinal studies are needed to confirm changing patterns of informational needs.

Psychosocial adaptation: an evolutionary concept analysis exploring a common multidisciplinary language

AIMS

To provide the first known concept analysis of psychosocial adaptation, exploring its evolution from the concept adaptation. We also determine how psychosocial adaptation is conceptualized across nursing, health, sociobehavioural and education disciplines.

BACKGROUND

Psychosocial adaptation is an important conceptual term that is poorly defined in nursing and other health, sociobehavioural and education disciplines. A thorough understanding of the concept's application in nursing and across disciplines can help to clarify its meaning, facilitate a more effective common language between disciplines and inform future psychosocial adaptation research.

DESIGN

Rodger's evolutionary view guided this concept analysis.

DATA SOURCES

Peer-reviewed English and Spanish manuscripts published between 2011-2013 were retrieved from the following databases: CINAHL, Psych INFO, PubMed, Scopus and LILACS.

REVIEW METHODS

Eighty-nine articles related to psychosocial adaptation were included in the analysis. Findings identify key attributes, antecedents and consequences associated with the use of the concept. Findings were compared vis-a-vis reported characteristics of adaptation.

RESULTS

The attributes characterizing psychosocial adaptation are: change, process, continuity, interaction and influence. In psychosocial adaptation, new life conditions serve as antecedents, while consequences are good or bad outcomes. Important features of the evolution of this concept include its broad appropriation across the reviewed disciplines. The attributes of psychosocial adaptation, have some similarities to those of general adaptation. Both concepts include an aspect of change, but unlike adaptation, psychosocial adaptation has branched away from biological descriptors, such as homeostasis and tends to focus on relational characteristics, such as interaction and influences.

Effects of a Support Group Intervention on Physical, Psychological, and Social Adaptation of Liver Transplant Recipients

OBJECTIVES

Liver transplant recipients must adapt to a new life after transplant. We report the effects of a support group on physical and psychosocial adaptation of liver transplant recipients.

MATERIALS AND METHODS

The study used a quasi-experimental design, comparing an intervention group and a control group. Data were collected between January 2011 and May 2012 with 73 liver transplant recipients. A patient identification form, Modified Transplant Symptom Occurrence and Symptom Distress Scale - 58, and SF-36 were used for data collection. The intervention group attended support group meetings, while the control group received a routine follow-up. Data were analyzed with t test and The Repeated Measures ANOVA with 1 between-group factor.

RESULTS

The results indicated that the support group intervention increases physical, psychological, and social adaptation of liver transplant recipients. Specifically, this effect of the support group was accrued after support group intervention and decreased 3 months after intervention.

CONCLUSIONS

A support group intervention can have a positive effect on liver transplant recipients' physical, psychological, and social adaptations.

Nursing Approach Based on Roy Adaptation Model in a Patient Undergoing Breast Conserving Surgery for Breast Cancer

The use of models in nursing provides nurses to focus on the role of nursing and its applications rather than medical practice. In addition, it helps patient care to be systematic, purposeful, controlled and effective. One of the commonly used models in nursing is Roy Adaptation Model. According to Roy adaptation model, the aim of nursing is to increase compliance and life expectancy. Roy Adaptation Model evaluates the patient in physiologic mode, self-concept mode, role function mode and interdependence mode aiming to provide holistic care. This article describes the use of Roy Adaptation Model in the care of a patient who has been diagnosed with breast cancer and had breast-conserving surgery. Patient data was evaluated in the four modes of Roy adaptation model (physiologic, self-concept, role function, and interdependence modes) and the nursing process was applied.