Critical illness and subsequent hospitalisation of a relative to an intensive care unit (ICU) can result in many physiological and psychosocial problems for patients and their family members. Caring for the anxiety and frustration of these families is an integral part of critical care nursing. The purpose of this study was to examine the effect of a needs-based education programme provided within the first 3 days of patients' hospitalisation, on the anxiety levels and satisfaction of psychosocial needs of their families. This was a quasi-experimental study with pre- and post-test design. A convenience sample was recruited over a period of three months, consisting of one primary family carer of each critically ill patient who had been admitted to an ICU in Hong Kong. Conducted by an ICU nurse specially assigned for the purpose, family carers in the experimental group (n=34) received an individual education programme based on the results of a literature review and an individual family needs assessment carried out at the time of patient admission, using the Critical Care Family Needs Inventory. The subjects in the control group (n=32) received the usual orientation and explanation given by the ICU nurses. Anxiety and need satisfaction were measured in the two groups at pre- and post-test and their mean scores were compared. Of the ten most important statements identified by the family carers in the two groups, the statements regarding the needs for information and assurance were found to predominate. After the needs-based intervention, the experimental group reported significantly lower levels of anxiety and higher levels of satisfaction of family needs than the control group at the post-test. The findings support the effectiveness of providing families of newly admitted critically ill patients, with a needs-based educational intervention to allay anxiety and satisfy immediate psychosocial needs. The formulation of a family education programme should be based on the results of a needs assessment, in order to meet family carers' individual needs.

This study focuses on the use of bio-nanocomposite microspheres, consisting of carbonated hydroxyapatite (CHAp) nanospheres within a poly(L: -lactide) (PLLA) matrix, to produce tissue engineering (TE) scaffolds using a modified selective laser sintering (SLS) machine. PLLA microspheres and PLLA/CHAp nanocomposite microspheres were prepared by emulsion techniques. The resultant microspheres had a size range of 5-30 microm, suitable for the SLS process. Microstructural analyses revealed that the CHAp nanospheres were embedded throughout the PLLA microsphere, forming a nanocomposite structure. A custom-made miniature sintering platform was installed in a commercial Sinterstation((R)) 2000 SLS machine. This platform allowed the use of small quantities of biomaterials for TE scaffold production. The effects of laser power; scan spacing and part bed temperature were investigated and optimized. Finally, porous scaffolds were successfully fabricated from the PLLA microspheres and PLLA/CHAp nanocomposite microspheres. In particular, the PLLA/CHAp nanocomposite microspheres appeared to be promising for porous bone TE scaffold production using the SLS technique.

Aim and objective. To test the effectiveness of an efficacy-enhancing educational intervention to promote women's self-efficacy for childbirth and coping ability in reducing anxiety and pain during labour. Background. The evidence of the effective application of the self-efficacy theory in health-promoting interventions has been well established. Little effort has been made by health professionals to integrate self-efficacy theory into childbirth care. Design. Randomised controlled trial.Methods. An efficacy-enhancing educational intervention based on Bandura's self-efficacy theory was evaluated. The eligible Chinese first-time pregnant women were randomly assigned to either an experimental group (n = 60) or a control group (n = 73). The experimental group received two 90-minute sessions of the educational programme in between the 33rd-35th weeks of pregnancy. Follow-up assessments on outcome measures were conducted within 48 hours after delivery. The short form of the Chinese Childbirth Self-Efficacy Inventory was used to measure maternal self-efficacy prior to labour. Evaluation of pain and anxiety during the three stages of labour and performance of coping behaviour during labour were measured by the Visual Analogue Scale and Childbirth Coping Behaviour Scale respectively. Results. The experimental group was significantly more likely than the control group to demonstrate higher levels of self-efficacy for childbirth (p < 0AE0001), lower perceived anxiety (p < 0AE001, early stage and p = 0AE02, middle stage) and pain (p < 0AE01, early stage and p = 0AE01, middle stage) and greater performance of coping behaviour during labour (p < 0AE01). Conclusions. The educational intervention based on Bandura's self-efficacy theory is effective in promoting pregnant women's self-efficacy for childbirth and reducing their perceived pain and anxiety in the first two stages of labour. Relevance to clinical practice. Relief of pain and anxiety is an important issue for both women and childbirth health professionals. The efficacy-enhancing educational intervention should be further developed and integrated into childbirth educational interventions for promoting women's coping ability during childbirth.