Partner Notification, Treatment, and Subsequent Condom Use After Pelvic Inflammatory Disease: Implications for Dyadic Intervention With Urban Youth

Management of Pelvic Inflammatory Disease in Clinical Practice

Pelvic inflammatory disease (PID) is a common reproductive health disorder among women of reproductive age. The treatment of PID has slowly evolved, reflecting changing antibiotic susceptibility and advancements in therapeutics and research; however, it has been largely unchanged over the last several decades. The most recent treatment recommendations consider the severity of infection, clinical presentation, and the polymicrobial nature of the disease. In addition, the role of novel organisms like Mycoplasma genitalium in PID is of emerging significance. PID treatment guidance offers oral and parenteral treatment options based on the patient's clinical status; however, deviations from the published guidelines are a general concern. Point of care (POC) testing for precision care, provision of adherence support, optimizing self-management and prevention strategies, and other alternative or synergistic approaches that maximize treatment outcomes will be instrumental for addressing the current challenges in PID diagnosis and management.

Clinical Efficacy Analysis of Fast Rehabilitation Nursing on Pain Mitigation after Lumbar Discectomy and Bone Graft Fusion and Internal Fixation

Objective

To investigate clinical efficacy analysis of fast rehabilitation nursing on pain mitigation after lumbar discectomy and bone graft fusion and internal fixation.

Methods

A total of 60 patients with lumbar disc herniation who underwent lumbar discectomy and bone graft fusion and internal fixation in our hospital from January 2021 to December 2021 were randomized either into routine group (n = 30) or rehabilitation group (n = 30) via the random number table method. The patients in the routine group were intervened with the routine postoperative nursing mode, and the patients in the rehabilitation group were intervened with the fast rehabilitation nursing mode on the basis of the nursing of the patients in the routine group. The rehabilitation effect, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores, postoperative pain improvement, and nursing satisfaction were compared between the two groups.

Results

The postoperative rehabilitation effect of the rehabilitation group was significantly better than that of the routine group (P < 0.05). The fast rehabilitation nursing resulted in a notably lower postoperative SAS and SDS scores versus the routine nursing (P < 0.001). The postoperative pain was significantly mitigated in the rehabilitation group when compared with the routine group (P < 0.001). The fast rehabilitation nursing implemented in the rehabilitation group led to a remarkably higher nursing satisfaction of the patients (P < 0.001).

Conclusion

The fast rehabilitation nursing mode intervention for lumbar disc herniation patients undergoing lumbar discectomy and bone graft fusion and internal fixation is a promising approach to improve the postoperative rehabilitation, mitigate postoperative pain, and relieve anxiety, depression, and other negative emotions, with higher clinical nursing satisfaction.

Dyadic Intervention for Sexually Transmitted Infection Prevention in Urban Adolescents and Young Adults (The SEXPERIENCE Study): Protocol for a Randomized Controlled Trial (Preprint)

Background

Adolescents and young adults (AYA) aged younger than 25 years have the highest rates of sexually transmitted infections (STIs) in the United States. Current STI prevention strategies for AYA rely primarily on individual approaches, leaving sexual partners with significant unmet sexual and reproductive health care and health education needs. Dyadic interventions may hold promise for harnessing the power of communal coping within relationship dynamics to enhance sexual decision making, communication, and behavior changes that reduce the future risk of STIs.

Objective

This paper describes the protocol and research methods of a dyad-based behavioral intervention that augments individual evidence-based interventions with joint health education counseling for heterosexual AYA dyads within a primary care setting. The trial aims to improve partner communication and collaborative sexual decision making and promote the adoption of sexual behaviors such as consistent condom use. The primary objective of this study is to assess the feasibility, acceptability, and effectiveness of a dyadic intervention targeted at preventing STIs in heterosexual couples in an urban setting.

Methods

A total of 100 AYA (50 dyads) aged 16 to 25 years, engaged in heterosexual intercourse, who reside in the city and are willing to recruit their main sexual partner for the study will be recruited and randomized into 2 groups, an intervention arm and a control arm. Participants will be recruited from an AYA medicine clinic and by using social media (Facebook and Instagram). The index participant and partner will complete a single individual session separately (Sister to Sister or Focus on the Future) with a gender-matched health educator. Dyads will then be randomized to receive an additional joint debriefing session together to discuss relationship dynamics, condom negotiation, etc. Participants will separately complete a telephone interview 6 weeks postintervention to determine the feasibility, acceptability, and impact of the intervention on mutual sexual negotiation, consistency of condom use, and communal coping skills, etc.

Results

So far, 25.4% (44/173) of eligible participants have been enrolled and randomized. Participants are mostly female (20/22, 91%), with at least a high school diploma (19/22, 86%), and 9 average lifetime sexual partners. Acceptability is high, with 98% (43/44) of participants expressing satisfaction with their study experience; 100% of dyads recruited were still together at 6-week follow-up.

Conclusions

Findings from this study will add to the current literature on the approaches to STI prevention, and its success will inform its application in risk reduction counseling for youth who are most at risk.

Trial Registration

Clinical Trials.gov NCT03275168; https://www.clinicaltrials.gov/ct2/history/NCT03275168

International Registered Report Identifier (IRRID)

DERR1-10.2196/29389