Relationship between job demands, work engagement, emotional workload and job performance among nurses: A moderated mediation model.

AIM: To explore the mediating effect of work engagement and the moderated mediating effect of emotional workload on the relationship between job demands and job performance among nurses. BACKGROUND: Nurses work in a high-demand situation that could affect their job performance. However, previous studies have reported an inconsistent relationship between job demands and job performance. The underlying mechanism of how job demands influence job performance remains unclear. METHODS: An online cross-sectional survey was conducted with a convenience sample of 893 nurses from 14 cities in Sichuan Province between November and December 2021. Data were collected using the Job Demands Scale, Job Performance Scale, Utrecht Work Engagement Scale, and emotional workload subscale of the Questionnaire on the Experience and Evaluation of Work. Bootstrap and simple slope methods were used to test a moderated mediation model using Hayes' PROCESS macro. The STROBE reporting guidelines were utilized. RESULTS: Job demands had a positive effect on job performance, and this effect was mediated by work engagement. Emotional workload moderated the indirect relationship between job demands and job performance. Specifically, the positive effect of job demands on job performance via work engagement was attenuated in nurses with a high emotional workload. CONCLUSION: This study sheds light on the complex relationship between job demands and job performance. Work engagement and emotional workload deserve more attention to improve nurses' performance. IMPLICATIONS FOR NURSING AND NURSING POLICY: Policymakers and nurse managers should make efforts to develop and implement strategies to foster nurses' work engagement, reduce their emotional workload, and further help nurses efficiently deal with job demands.

Analysis and comparison of the trends in burden of rheumatic heart disease in China and worldwide from 1990 to 2019.

OBJECTIVES: This study aimed to describe the temporal trends in age and gender burdens of rheumatic heart disease (RHD) in China from 1990 to 2019, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare them with the global burden of the disease. METHODS: Using open data from the Global Burden of Disease (GBD) database from 1990 to 2019, this study analyzed the characteristics of RHD burden in China and worldwide, including changes in incidence, prevalence, mortality, and DALYs. Joinpoint was used to calculate the average annual percentage change (AAPC) and the corresponding 95% confidence interval (95% CI) to reflect the trends in the burden of RHD. A comprehensive comparative analysis of the differences in RHD burden between China and the rest of the world was conducted from multiple dimensions, including age, gender, and time periods. RESULTS: From 1990 to 2019, the age-standardized incidence rate (ASIR) of RHD in China decreased from 29.62/100,000 to 23.95/100,000, while the global ASIR increased from 32.69/100,000 to 37.40/100,000. The age-standardized prevalence rate (ASPR) in China decreased from 446.15/100,000 to 390.24/100,000, while the global ASPR increased from 451.56/100,000 to 513.68/100,000. The age-standardized rates of mortality (ASMR) in China decreased from 18.11/100,000 to 4.04/100,000, while the global ASMR decreased from 8.94/100,000 to 3.85/100,000. The age-standardized DALY rate (ASDR) in China decreased from 431.45/100,000 to 93.73/100,000, while the global ASDR decreased from 283.30/100,000 to 132.88/100,000. The AAPC of ASIR, ASPR, ASMR, and ASDR in China was - 0.73%, -0.47%, -5.10%, and - 5.21%, respectively, while the AAPC of the global burden of RHD was 0.48%, 0.45%, -2.87%, and - 2.58%, respectively. The effects of age and gender on the burden of RHD were different. ASIR generally decreased with increasing age, while ASPR increased first and then decreased. ASMR and ASDR increased with increasing age. Women had higher incidence and mortality rates of RHD than men. CONCLUSION: From 1990 to 2019, the incidence, prevalence, mortality, and DALYs of RHD in China decreased, indicating a relative reduction in the burden of RHD in China. The burden of RHD is age-related, with a higher prevalence observed in the younger population, a peak incidence among young adults, and a higher mortality rate among the elderly population. Women are more susceptible to RHD and have a higher risk of mortality than men. Given China's large population and aging population, RHD remains a significant public health challenge in China.

The mediating role of psychological needs on the relationship between perceived organizational support and work engagement.

AIM: To examine the mediating effect of basic psychological needs on the relationship between perceived organizational support and work engagement among nurses. BACKGROUND: The satisfaction of basic psychological needs is crucial for breeding and sustaining individuals' intrinsic motivation. Little is known about the underlying motivational mechanisms that explain the relationship among perceived organizational support, basic psychological needs, and work engagement in a nursing context. METHODS: This was a cross-sectional online survey. A sample of 858 nurses from 12 hospitals was surveyed on their perceived organizational support, basic psychological needs, and work engagement. Structural equation models and bootstrapping methods were used to examine the hypotheses. STROBE reporting guidelines were utilized. RESULTS: Perceived organizational support was positively associated with basic psychological needs and work engagement. Basic psychological needs were positively associated with work engagement. Basic psychological needs mediated the relationship between perceived organizational and work engagement. CONCLUSION: Perceived organizational support may enhance work engagement by fulfilling the basic psychological needs of nurses. IMPLICATIONS FOR NURSING AND NURSING POLICY: Basic psychological needs deserve more attention in nursing organizations. Managers should seek optimal strategies to fulfill nurses' needs for autonomy, competence, and relatedness to stimulate their intrinsic motivation to enhance work engagement.

Nurses' perceptions of career growth: A qualitative descriptive study.

AIMS: To explore nurses' experiences and perceptions of career growth and its influencing factors, as career growth is more closely associated with individual attitudes and behaviours in the new career era. DESIGN: A qualitative descriptive design was used. METHODS: Thirty-one nurses from 10 secondary and 8 tertiary hospitals in Sichuan Province of China were purposively selected to participate in this study. The data were collected using individual semi-structured face-to-face interviews. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis. FINDINGS: The nurses' perceptions of career growth fully described the nurses' experience and occurred in five dimensions: career promotion, career goal progress, professional ability and quality improvement, professional identity development and increase in personal prestige. The factors influencing career growth were identified at the organizational, individual and social levels. Career growth in nursing was complex, changed over time and showed several specific characteristics compared with other careers. The nurse-specific symbol of career growth was professional identity development, which reflected career progression characteristics. CONCLUSIONS: Career growth is a multi-dimensional concept with varying influencing factors. The meaning of career growth for nurses is distinct from that for employees in other careers. IMPACT: Nursing managers should guide nurses to comprehensively assess their career growth from multiple perspectives, and professional identity development deserves more attention. Both organizations and individuals should take responsibility for career management to pursue career growth.

Caregiving burden and depression in paid caregivers of hospitalized patients: a pilot study in China.

BACKGROUND: Caregiving burden and depression in family caregivers have been investigated, but little is known about how they affect paid caregivers. The aim of this study was to investigate caregiving burden and depression in paid caregivers of hospitalized patients. METHODS: A cross-sectional survey study was conducted in a tertiary referral hospital (Chengdu, China) that enrolled 108 paid caregivers who worked in the inpatient department. The Caregiver Burden Inventory (CBI) and the Center for Epidemiologic Studies Depression (CES-D) scale were incorporated into a self-developed questionnaire to gather demographic information on the following four aspects: general, work, income, and family. RESULTS: The mean total CBI score was 29.7 ± 12.5. The time-dependence burden had the highest score of 15.3 ± 4.0, which was followed by the physical burden score of 6.5 ± 4.6, developmental burden score of 3.7 ± 4.0, social burden score of 3.2 ± 4.0, and emotional burden score of 2.4 ± 3.1. Multiple linear regression analysis showed that a higher CBI was associated with a longer time as a paid caregiver [ß=7.041, 95% Confidence Interval (CI):1.935 to 12.974, p = 0.009], lower income satisfaction (ß= - 6.573, 95% CI: -11.248 to -3.020, p = 0.001), and higher frequency of meeting with their relatives (ß=7.125, 95% CI: 2.019 to 12.456, p = 0.006). The mean CES-D score was 11.9 ± 8.7, and significant depression was found in 28 (25.9%) paid caregivers according to the CES-D score ≥ 16 cut-off. There was a moderate positive correlation between the CBI and CES-D scores (Pearson's r = 0.452, p < 0.001). CONCLUSIONS: A high caregiving burden was commonly observed in paid caregivers of hospitalized patients in China, as was a high prevalence of depression symptoms. Several associated factors were identified that could be areas for future interventions.

Perceptions and Acceptability of Receiving SMS Self-care Messages in Chinese Patients With Heart Failure: An Inpatient Survey.

BACKGROUND: Self-care is critical for postdischarge heart failure (HF) patients. Short message service (SMS) is a promising way to promote HF self-care. OBJECTIVE: The aim of this study is to investigate knowledge status in Chinese HF patients, as well as the acceptance of SMS as a way to improve self-care. METHODS: A survey using a self-developed questionnaire was conducted in patients with decompensated HF 2 days before discharge. RESULTS: A total of 540 patients completed the survey. Among them, only 69.8% and 63.3% of patients were aware of their HF status and medication regimen, respectively. A total of 95.6% patients were willing to receive SMS. Patient himself/herself, caregiver, or both patient and caregiver were almost equally selected as the preferred receiver of SMS. Educational and/or reminder SMS was considered "very helpful" by 50.2% of the patients as a way of promoting self-care, similar to that of telephone education and brochure education. "Take your medicine", "avoid getting flu," and "keep follow-up" were regarded as the most important self-care contents, whereas "weigh yourself every day" and "restrict fluid intake" were considered the least important. CONCLUSION: As a way of promoting HF self-care, SMS intervention combining educational and reminder function might be well accepted by HF patients in China. The status of HF, medication, weight control, and fluid restriction should be emphasized during the practice. Caution should be drawn as the survey was not tested elsewhere. Further clinical trials would be conducted to examine the effect of SMS intervention on self-care behaviors and outcomes of HF patients.

Significance of Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography.

BACKGROUND Contrast-induced nephropathy is acute kidney injury caused by contrast medium exposure. Serum creatinine is the clinical diagnostic standard, but it does not yield quick results. The serum level of cystatin C is stable and it can reflect renal function sensitively. The study aimed to assess the usefulness of cystatin C for early diagnosis of contrast-induced nephropathy in patients undergoing coronary angiography. MATERIAL AND METHODS We included 300 patients who underwent CAG. According to the sCr at 48 h, patients were divided into 2 groups: CIN group and non-CIN group. Their demographics and basal renal function were recorded. Changes in sCr, Cys C, and e GFR were compared at the same time. ROC analysis was used to assess the sensitivity and specificity of Cys C in the early diagnosis of CIN. RESULTS Comparison of basal renal function and serum level of Cys C showed no significant differences between the 2 groups. Serum level of Cys C increased significantly at 24 h (p<0.001), and sCr increased significantly at 48 h. ROC analysis showed that the AUC of the change in Cys C between baseline and 24 h was 0.936 (95% CI: 0.879-0.992, p=0.000) and the optimum cut-off level was 0.26 mg/L (sensitivity=89.7% and specificity=95.6%). CONCLUSIONS The concentration change of Cys C is better than sCr as a biomarker in the early detection of CIN.

Higher blood pressure control rate in a real life management program provided by the community health service center in China.

BACKGROUND: Community health service center (CHSC) in China is always regarded as a good facility of primary care, which plays an important role in chronic non-communicable disease management. This study aimed to investigate the blood pressure (BP) control rate in a real life CHSC-based management program and its determinants. METHODS: The study enrolled 3191 patients (mean age of 70 ± 10 years, 43% males) in a hypertension management program provided by the Yulin CHSC (Chengdu, China), which had been running for 9 years. Uncontrolled BP was defined as the systolic BP of ≥140 mmHg and/or the diastolic BP of ≥90 mmHg, and its associated factors were analyzed by using logistic regression. RESULTS: The duration of stay in the program was 33 ± 25 months. When compared with the BP at entry, the recent BP was significantly lowered (147 ± 17 vs. 133 ± 8 mmHg; 83 ± 11 vs. 75 ± 6 mmHg) and the BP control rate was dramatically increased (32 vs. 85%) (all p < 0.001). The age of >70 years [1.40 (odds ratio), 1.15-1.71 (95% confidence interval)], female gender (0.76, 0.63-0.93), longer stay of >33 months (0.77, 0.63-0.94), doctor in charge (0.97, 0.95-0.99), and the use of calcium channel blocker (1.35, 1.09-1.67) were significantly related to uncontrolled BP at the recent follow up (all p < 0.05). CONCLUSIONS: This CHSC-run hypertension program provides an ideal platform of multi-intervention management, which is effective in achieving higher BP control rate in community patient population. However, the BP control status could be affected by age, gender and adherence of the patients, as well as practice behavior of the doctors.

Learning needs of Chinese patients before undergoing elective percutaneous coronary intervention.

Abstract This study aimed to determine the learning needs of Chinese patients going for elective percutaneous coronary intervention (PCI), in order to design nurse-led education programs. A self-administered survey was completed by a total of 395 patients prior to the procedure. Face-to-face communication was chosen by 343 (86.8%) patients as the most preferred way of education. Doctor-in-charge was ranked as the most wanted educator by 372 (94.2%) patients, including 191 (45.4%) patients who chose both doctor-in-charge and nurse-in-charge. Interventional cardiologist was preferred by patients with higher education more than those with lower education (63.6 vs. 48.1%, P < 0.05). Learning items such as self-rescue on heart attack, efficiency of PCI and post-procedural medication were regarded as the most important, which could be affected by age, gender and educational level. These findings would help to develop patient preferred programs that involve brief communications with doctors and more structured education activities led by nurses.

Relationship between perceived organisational support, self-efficacy, proactive personality and career self-management among nurses: a moderated mediation analysis.

OBJECTIVES: Career self-management is believed to be a critical behaviour in the new career era. However, the underlying mechanisms that stimulate nurses' career self-management are unclear. The aim of this study was to examine the mediating effect of self-efficacy and the moderating effect of proactive personality on the relationship between perceived organisational support and career self-management among nurses. DESIGN: This was a cross-sectional survey. SETTING AND PARTICIPANTS: A total of 1866 nurses from 15 hospitals across 15 cities in China were recruited for this study. PRIMARY AND SECONDARY OUTCOME MEASURES: The Perceived Organizational Support Scale, General Self-efficacy Scale, Proactive Personality Scale and Individual Career Management Questionnaire were used. Data were analysed using moderated mediation regressions with Hayes' PROCESS macro in SPSS version 26.0. RESULTS: General self-efficacy mediated the relationship between perceived organisational support and career self-management. Proactive personality moderated the direct (B=0.043, p<0.001, 95% CI 0.026 to 0.060) and indirect relationship (B=0.098, p<0.001, 95% CI 0.074 to 0.123) between perceived organisational support and career self-management. Further, the positive effects of perceived organisational support on general self-efficacy and career self-management were stronger for nurses with a high level of proactive personality. The model explained 47.2% of the variance in career self-management. CONCLUSION: The findings highlight the crucial benefits of self-efficacy and important conditional effects of perceived organisational support on nurses' career self-management.

Emission factors and source profiles of volatile organic compounds in container manufacturing industry.

The container manufacturing industry is the key contributor of industrial volatile organic compounds (VOCs). Emission factors (EFs) and source profiles of container manufacturing industry were comprehensively investigated basing on multiple VOCs discharge links. 17 samples were collected from a typical container manufacturing enterprise based on field measurements. The material balance method and weighted average method were applied to estimate EFs and establish VOCs source profiles. It is found that diluent use (DU) was the largest contributor (39.96 %), followed by intermediate painting spaying (IMPS), primer painting (PP), chassis painting (CP), exterior paint spaying (EPS), and interior paint spaying (IPS). EF of the container manufacturing industry (2.90 kg VOCs/ Twenty-foot Equivalent Units, TEU) was firstly estimated. EFs of six processes were further estimated. The EFs of DU, IMPS, PP, CP, EPS, and IPS were 1.22, 0.74, 0.42, 0.33, 0.20, and 0.00045 kg VOCs/TEU, respectively. EFs of six materials were further estimated. The EF of the diluent was largest (382.74 kg VOCs/t material), followed by water-based epoxy intermediate paint (132.09 kg VOCs/t material), organic-based epoxy zinc-rich priming paint (91.31 kg VOCs/t material). EFs of other paints ranged from 0.0047 to 43.01 kg VOCs/t material. These results suggest that the replacement of lower- VOCs- contained diluent and effective control from diluent consumption are dramatically conducive to VOCs reduction. Source profiles were established at the industry and individual process levels. Aromatics (77.05-98.38 %) were dominant components in all processes, followed by alkane and OVOCs. m/p-Xylene, o-xylene, and ethylbenzene were the key active species that should be prioritized for control. Overall, EFs and source profiles of the container manufacturing industry were firstly proposed, conducing to the systematic formulation of VOCs control strategies.

Trends in the Incidence and Mortality Rates of Myocarditis in the Chinese Population During 1990-2019: Joinpoint Regression and Age-Period-Cohort Analysis.

BACKGROUND: This study aimed to analyze trends in the burden of myocarditis in the Chinese population during 1990-2019. METHODS: The Global Burden of Disease (GBD) database aims to assess the burden of various diseases and injuries on a global scale, and the contribution of relevant risk factors to the burden of disease was also included. In this study, we collected age-standardized incidence and mortality rates for myocarditis in China from 1990 to 2019 using GBD 2019. The age-period-cohort model was utilized to calculate local drift, longitudinal age patterns, as well as the ratios of period and cohort. RESULTS: The age-standardized incidence and mortality rates of myocarditis in both men and women presented a decreasing trend during 1990-2019 [average annual percentage change (AAPC) of men = -0.202 (95% CI: -0.213 to -0.191); AAPC of women = -0.263 (95% CI: -0.27 to -0.256) for incidence; AAPC of men = -0.233 (95% CI: -0.371 to -0.094); AAPC of women = -0.872 (95% CI: -1.112 to -0.631) for mortality]. Longitudinal age curves showed that myocarditis incidence and mortality rates elevated with age among individuals aged 15-95+ years, with a higher growth rate in men than in women. The period and cohort ratios for both men and women showed similar decreasing trends. Local drift values for the incidence and mortality rates of myocarditis showed an increasing trend among individuals aged 70-75 years and above. CONCLUSION: Although the overall burden of myocarditis in China presented a decreasing trend during 1990-2019, the male and elderly populations still have a higher risk of incidence and mortality. Therefore, it is essential for the health-care system to introduce effective prevention and treatment measures for myocarditis.

Emission factors and source profiles of volatile organic compounds from the automobile manufacturing industry.

Controlling volatile organic compounds (VOCs) emitted from the automobile manufacturing industry requires establishing VOCs emission factors (EFs) and source profiles refinedly. In this study, 41 samples involved 32 VOCs discharge links were collected from three factories. The EFs and VOCs source profiles were estimated by the material balance method and weighted average method, respectively. The ozone formation potential (OFP) of the 110 VOCs species were calculated by the maximum incremental reactivity (MIR). According to estimations, the ranges of EFs were 0.23-1.66 kg VOCs/SUV car and 2.14-14.86 g VOCs/m2 painted area. EFs of six materials were firstly estimated, which are electrophoretic primer (152.31 ± 97.39 g VOCs/SUV car, 0.97 ± 0.38 g VOCs/m2 painted area), sealant (48.39 ± 26.20 g VOCs/SUV car, 0.46 ± 0.25 g VOCs/m2 painted area), floating coat (87.40 ± 75.63 g VOCs/SUV car, 0.86 ± 0.74 g VOCs/m2 painted area), colored paint (127.24 ± 168.24 g VOCs/SUV car, 1.25 ± 1.66 g VOCs/m2 painted area), varnish (205.46 ± 218.14 g VOCs/SUV car, 2.01 ± 2.15 g VOCs/m2 painted area), and cleaning solvent (328.54 ± 404.94 g VOCs/SUV car, 3.23 ± 3.98 g VOCs/m2 painted area). OVOCs (37.40-51.60 %) and aromatics (36.40-37.00 %) were the dominant components. n-Butyl acetate, 1,2,4-trimethylbenzene, undecane, n-hexanal, acetone, 1,2,3-trimethylbenzene, 1,3,5 -trimethylbenzene, m/p/o-xylene, 3-ethylbenzene, and 4-ethylbenzene were the major VOCs species, accounting for 68 % of total VOCs in the automobile manufacturing industry. Considering the OFP values of species, 1,2,4-trimethylbenzene, 1,3,5-trimethylbenzene, 1,2,3-trimethylbenzene, m/p-xylene, acetaldehyde, methyl ethyl ketone are the key active species that should be prioritized for control.

A model for predicting acute and chronic fatigue in Chinese nurses.

AIM: To explore a model designed to examine direct and indirect effects of variables on acute and chronic fatigue. BACKGROUND: Although influencing factors for fatigue have been studied extensively, direct and indirect effects of predictors for acute and chronic fatigue remain poorly understood. Therefore, we proposed an original prediction model for acute and chronic fatigue in Chinese nurses based on previous studies. DESIGN: Cross-sectional, descriptive, correlational design. METHODS: We used a multi-stage sampling process to finally include 581 nurses working in the general hospitals in Chengdu, China. Data were collected between November 2007-March 2008 by using questionnaires. A path analysis was applied to test the fit of the hypothesized model and analysis of variance. RESULTS: The final model fits the data well. A total of 44·8% of variance in acute fatigue was directly and indirectly explained by job demand, job control, support at work, exposure to hazards in work environments and sleep quality, and only indirectly influenced by intershift recovery and shift work. Moreover, 61·5% of total chronic fatigue was directly and indirectly accounted for by anxiety, depression, job dissatisfaction, intershift recovery, and acute fatigue, and only indirectly influenced by job control, support at work, exposure to hazards in work environments, shift work, and sleep quality. CONCLUSION: Acute and chronic fatigue is affected by different factors and nurse managers should generate specific interventions to decrease them.

The relationship between work practice environment and work engagement among nurses: The multiple mediation of basic psychological needs and organizational commitment a cross-sectional survey.

Background: Previous researchers have demonstrated that the work practice environment influences nurses' engagement; however, few studies have explored the mechanisms that explain the links between them. Objectives: To examine whether basic psychological needs and organizational commitment mediate the relationship between the work practice environment and work engagement. Methods: A cross-sectional survey was conducted with a sample of 893 nurses from 14 cities in Sichuan Province of China between November 2021 and December 2021. Data were collected online using the Chinese version of the Practice Environment Scale of the Nursing Work Index, Basic Needs Satisfaction in General Scale, Organizational Commitment Scale, and Utrecht Work Engagement Scale. The Pearson correlation analysis and multiple mediation model were used to analyze the data. Results: The Pearson correlation analysis showed that work practice environment, basic psychological needs, and organizational commitment were positively associated with work engagement. The positive relationship between work practice environment and work engagement was mediated by basic psychological needs and organizational commitment [B = 0.505, SE = 0.032, 95% CI (0.442, 0.566)]. Conclusions: The study substantially contributes to the existing knowledge by revealing the mechanisms of fostering work engagement among nurses and explaining why the work practice environment influences work engagement.

VOC species controlling O3 formation in ambient air and their sources in Kaifeng, China.

The concentration of ozone has been in a rising crescendo in the last decade while the fine particles (PM2.5) is gradually decreasing but still at a high level in central China. Volatile organic compounds (VOCs) are the vital precursors of ozone and PM2.5. A total of 101 VOC species were measured in four seasons at five sites from 2019 to 2021 in Kaifeng. VOC sources and geographic origin of sources were identified by the positive matrix factorization (PMF) model and the hybrid single-particle Lagrangian integrated trajectory transport model. The source-specific OH loss rates (LOH) and ozone formation potential (OFP) were calculated to estimate the effects of each VOC source. The average mixing ratios of total VOCs (TVOC) were 43.15 parts per billion (ppb), of which the alkanes, alkenes, aromatics, halocarbons, and oxygenated VOCs respectively accounted for 49%, 12%, 11%, 14%, and 14%. Although the mixing ratios of alkenes were comparatively low, they played a dominant role in the LOH and OFP, especially ethene (0.55 s-1, 7%; 27.11 µg/m3, 10%) and 1,3-butadiene (0.74 s-1, 10%; 12.52 µg/m3, 5%). The vehicle-related source which emitted considerable alkenes ranked as the foremost contributing factor (21%). Biomass burning was probably influenced by other cities in the western and southern Henan and other provinces, Shandong and Hebei.

Nurses' perspectives on the barriers to and facilitators of the implementation of secondary prevention for people with coronary heart disease: a qualitative descriptive study.

OBJECTIVES: To identify the barriers to and facilitators of secondary prevention among people with coronary heart disease from the perspectives of nurses. DESIGN: A qualitative descriptive design using face-to-face semistructured interviews. SETTING: This study was conducted in China from October to November 2021. PARTICIPANTS: Registered nurses who had experience conducting secondary prevention for coronary heart disease were purposively recruited. Twelve nurses from 10 hospitals participated in this study. The data were analysed using content analysis based on the Theoretical Domains Framework. RESULTS: Based on the Theoretical Domains Framework, barriers to and facilitators of secondary prevention were identified within four key themes: nurse attributes (eg, knowledge and skills, motivation), patient characteristics (eg, age, education and economic conditions), the environmental context and resources (eg, organisational support, including financial support, clarity of responsibilities) and social influence (eg, economic development level, patient feedback). CONCLUSIONS: This research highlights the importance of nurses' motivation for delivering preventive care. Organisations should provide adequate support and establish a quality management system to maintain the quality of secondary prevention.

[Detection of visfatin level of plasma in patients with coronary artery diseases].

OBJECTIVE: To study the plasma visfatin level in patients with coronary artery disease (CAD) and evaluate the correlation between plasma visfatin level and coronary lesion severity. METHODS: The level of plasma visfatin of 48 patients with CAD (proved by angiography) and 41 normal controls were detected and compared. Plasma visfatin was determined by an enzyme immunoassay. The lesion severity of coronary arteries was assessed by Gensini coronary scoring system, and the correlation between plasma visfatin level and coronary lesion severity was evaluated. RESULTS: Plasma visfatin level in the CAD group was significantly higher than that in the control group [(28.58 +/- 14.53) ng/mL vs. [16.01 +/- 6.09) ng/mL, P < 0.01]. A significant positive correlation was found between coronary lesion severity score and Plasma visfatin level (r = 0.906, P < 0.01). CONCLUSION: Plasma visfatin level may be related to the pathogenesis of CAD. Detection of plasma visfatin might be helpful for early diagnosis of CAD, and patients with higher Plasma visfatin level may have more severe coronary lesion.

Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure.

AIMS: In addition to giving optimal medical and device therapy, promoting self-care of chronic heart failure (CHF) patients also plays an important role in comprehensive disease management for better outcomes. The study was aimed to investigate whether short message service (SMS) would help to improve death or readmission-free survival and self-care behaviour in CHF patients. METHODS AND RESULTS: This was a randomized controlled trial. Between December 2011 and September 2015, patients admitted with decompensated CHF in a tertiary referral hospital who fulfilled the inclusion criteria were enrolled and randomized to receive SMS, structured telephone support (STS), or usual care after discharge. All patients were followed up to 180 days after discharge by phone call or clinic visit. Primary endpoint was the 180 day composite event, defined as all-cause mortality or readmission. Secondary endpoints included self-care behaviour and quality of life. Seven hundred sixty-seven patients (61 ± 15 years, 56.5% male) were finally randomized to receive SMS (n = 252), STS (n = 255), or usual care (n = 260). Baseline characteristics were similar among the three groups. Five hundred twenty-five (68.4%) patients were in New York Heart Association Class III or IV, and 472 (61.5%) patients had an ejection fraction of <50%. During a 180 day follow-up, 76 (9.9%) patients died and 274 (35.7%) patients experienced at least one readmission. In a short-term follow-up of 30 days, there was no difference in mortality and the composite endpoint among the three groups (SMS vs. STS vs. usual care: 2.8% vs. 3.1% vs. 3.8% for mortality, P = 0.786; 12.3% vs. 14.5% vs. 15.4% for the composite endpoint, P = 0.588). The 180 day composite event rate was significantly lower in the SMS and STS groups (50.4% vs. 41.3% and 36.5%, both P < 0.05) than in the usual care group, but no difference was observed between the two phone-based intervention groups (P = 0.268). Although there was no difference between the two groups, better self-care behaviour was reported in the SMS and STS groups than in the control group (medication compliance, 78.9% vs. 81.4% vs. 69.5%, P = 0.011; water restriction, 70.8% vs. 74.5% vs. 61.5%, P = 0.013). Quality-of-life score was similar among the three groups at 180 days (P = 0.526). CONCLUSIONS: In CHF patients, post-discharge SMS, which appeared as efficient as STS, reduced the 180 day composite event and improved self-care behaviour. SMS intervention could be integrated into CHF management.

To tell or not to tell: attitudes of Chinese oncology nurses towards truth telling of cancer diagnosis.

AIMS AND OBJECTIVES: To investigate the attitude of oncology nurses towards whether and how to disclose diagnoses to patients with early-stage cancer or terminal illness. BACKGROUND: The attitudes of patients and doctors towards the disclosure of cancer diagnosis differed from culture to culture. However, little research has focused on the attitudes of Chinese oncology nurses. DESIGN: Survey. METHODS: A questionnaire investigating nurses' attitudes towards truth telling was delivered to 243 Chinese oncology nurses. RESULTS: One hundred and ninety-nine (819%) nurses completed the questionnaire. 814% of the nurses reported that patients with early-stage cancer should be informed of the diagnosis, while only 442% believed that patients with terminal illnesses should know the truth (p < 0001). Nurses who preferred truth telling reported that patients with early or terminal stages of cancer should be informed by the doctor in charge (765% vs. 739%, respectively; p > 005), immediately after the diagnosis (759% vs. 795%, respectively) and in a quiet and undisturbed room (809% vs. 705%, respectively; p > 005). Nurses' attitudes towards truth telling of terminal cancer were influenced by their educational level and work experience. CONCLUSION: Oncology nurses differed in their attitudes towards truth telling of different stages of cancer. Nurses who preferred disclosure reported that cancer patients should be informed by the doctor in charge immediately after the diagnosis and in a quiet and undisturbed room. RELEVANCE TO CLINICAL PRACTICE: Many Chinese doctors, patients and their relatives believed that patients with terminal illness should not know their diagnosis. Thus, oncology nurses need additional training to deal with these situations.