METHODS: A qualitative, phenomenological design was employed to explore the experiences of 12 gynecological nurses working in early pregnancy units. Semi-structured interviews investigated nurses' perceptions of emotional labor, the coping strategies they utilized, and the influence of organizational factors on their well-being. Thematic analysis guided by Braun and Clarke's framework illuminated emerging patterns, with member checking and peer debriefing ensuring analytical rigor.
RESULTS: Four key themes emerged. First, The Emotional Burden of Recurrent Loss highlighted nurses' cumulative grief and sense of "compounding sorrow" as they supported patients through multiple losses. Second, Balancing Empathy and Professional Boundaries underscored the tension between offering genuine compassion and guarding personal emotional reserves. Third, Coping Strategies and Resilience-Building revealed a multilayered approach comprising reflective practices, peer debriefing, and self-care. Finally, Organizational Support and Gaps emphasized how institutional resources, staffing levels, and specialized training significantly shaped nurses' capacity to sustain empathetic care.
CONCLUSION: Nurses caring for RPL patients experience heightened emotional labor due to repetitive, distressing encounters with loss. While individual and peer-based coping mechanisms foster resilience, organizational support-such as formal debriefing sessions and RPL-focused training-amplifies nurses' well-being and ensures sustainable, high-quality care. These findings underscore the need for targeted interventions that address both the individual and systemic dimensions of emotional labor in RPL settings.
PATIENTS AND METHODS: Fourteen patients with normal ejection fraction and 16 patients with reduced ejection fraction were compared with 20 healthy individuals. Phase-contrast MRI was used to assess intraventricular flow variables and speckle-tracking echocardiography to assess myocardial strain and left ventricular (LV) dyssynchrony. Infarct size was acquired using delayed-enhancement MRI.
RESULTS: The results obtained showed no significant differences in intraventricular flow variables between the healthy group and the patients with normal ejection fraction group, whereas considerable reductions in kinetic energy (KE) fluctuation index, E' (P<0.001) and vortex KE (P=0.003) were found in the patients with reduced ejection fraction group. In multivariate analysis, only vortex KE and infarct size were significantly related to LV ejection fraction (P<0.001); furthermore, vortex KE was correlated negatively with energy dissipation, energy dissipation index (r=-0.44, P=0.021).
CONCLUSION: This study highlights that flow energetic indices have limited applicability as early predictors of LV progressive dysfunction, whereas vortex KE could be an alternative to LV performance.
METHODS AND ANALYSIS: Initially, during Phase I of the study, the serum level of IL-1β, IL-6 and TNF-α; ERP changes in the EEG and fecal microbiota content will be compared between 120 AUD patients and 120 healthy controls. Subsequently in Phase II of the study, 120 AUD patients will be randomized by stratified permuted block randomization into the probiotic, ACT and placebo groups in a 1:1:1 ratio. Participants in the probiotic and placebo groups will be administered one sachet per day of Lactobacillus spp. probiotic and placebo, respectively for 12 weeks. While those in the ACT group will receive one session per week of ACT for 8 weeks. Outcome measures will be administered at four timepoints, such as t0 = baseline assessment prior to intervention, t1 = 8 weeks after intervention began, t2 = 12 weeks after intervention and t3 = 24 weeks after intervention. Primary outcomes are the degrees of alcohol craving, alcohol withdrawal during abstinence and AUD. Secondary outcomes to be assessed are the severity of co-morbid depression and anxiety symptoms; the serum levels of IL-1β, IL-6 and TNF-α; changes in ERP and fecal microbiota content.
TRIAL REGISTRATION NUMBER: NCT05830708 (ClinicalTrials.gov). Registered on April 25, 2023.