Understanding Family Caregivers' Needs in Coping with the Behavioral and Psychological Symptoms of People with Dementia: A Hermeneutic-Phenomenological Study.

Background: Alzheimer's disease and related dementias (ADRD) are progressive conditions. Family caregivers of patients, especially those caring for patients with ADRD exhibiting behavioral and psychological symptoms of dementia (BPSD), undergo significant physical and mental changes during long-term care. While most researchers have focused on the specific needs of family caregivers, the comprehensive understanding of these needs is limited. In this study, Alderfer's existence, relatedness, and growth theory was used to develop an interview framework to systematically and comprehensively understand the needs of family caregivers of individuals with ADRD. Objective: The objective of this study was to understand family caregivers' needs in coping with BPSD in individuals with ADRD, aiming to alleviate caregivers' stress and promote their overall well-being. Methods: This study used a hermeneutic-phenomenological interview research design. Data were collected via remote conferences involving interviews with 17 participants selected via maximum variation sampling. The Colaizzi seven-step method was utilized, and the interview contents were analyzed using NVivo 12.0 software. Results: The needs of family caregivers in coping with the BPSD of individuals with ADRD could be summarized into three themes, namely existence needs, relatedness needs, and growth needs, and 10 sub-themes. Conclusions: The study findings provide new insights into the needs of family caregivers in coping with patients exhibiting BPSD. Family caregivers experience significant negative emotions, poor caregiving experiences, heavy caregiving burdens, and a desire for professional assistance and policy support.

Perceived professional benefits and associated factors among nurses during the COVID-19 pandemic: A cross-sectional study.

AIMS: To examine the perceived professional benefits (PPB) and associated factors among nurses during the coronavirus disease 2019 (COVID-19) pandemic in China. DESIGN: Cross-sectional study. METHODS: Using the snowball sampling method, 492 nurses (478 females, 14 males) were recruited. Data were collected using an online survey, including participants' socio-demographic and working characteristics, psychological distress related to the COVID-19 pandemic, dealing with professional frustration, professional self-reflection and PPB from 1-30 April 2020. RESULTS: Nurses experienced high levels of PPB. In linear regression analysis, self-perceived concerns about COVID-19, emotional shock caused by it, risk perception towards their occupations, dealing with professional frustration and professional self-reflection were positively associated with PPB among nurses. These factors explained 84% variance in PPB. CONCLUSIONS: This study highlighted that although the nurses experienced psychological distress, they gained high PPB during the COVID-19 pandemic. Additionally, to facilitate nurses' efforts to achieve professional growth, more educational resources and opportunities for engaging in reflective practices could be provided.

Effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression: A mixed methods study.

AIMS: To determine the effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression. BACKGROUND: Nursing work in clinical settings is highly stressful and may result in an increase in nurses' turnover rate, which threatens the quality of nursing care and patient safety. METHODS: We used a mixed methods design and a three-month intervention (January to April, 2019) involving a convenience sample of 176 nurses working at a Chinese tertiary hospital. We conducted 12 semi-structured interviews and performed a content analysis. The pre- and post-intervention comparisons of nurses' stress, self-perceived anxiety and depression were performed using a paired t test. RESULTS: The 3-month leisure activities programme significantly decreased nurses' job stress (t = 3.80, p < .01), perceived personal stress (t = 3.30, p < .01), self-perceived anxiety (t = 3.76, p < .01) and depression (t = 2.73, p < .01). The qualitative findings revealed five mechanisms linking leisure activities to subjective well-being: detachment recovery, autonomy, mastery, meaning and affiliation. CONCLUSIONS: A hospital-based leisure activities programme had a positive effect on job stress, self-perceived anxiety and depression, thus improving nurses' well-being. IMPLICATIONS FOR NURSING MANAGEMENT: A hospital-based leisure activities programme provides a beneficial strategy for ameliorating nurses' psychosocial issues. Interventions aimed at facilitating or increasing nurses' participation in leisure activities are greatly needed.

Dispatched nurses' experience of wearing full gear personal protective equipment to care for COVID-19 patients in China-A descriptive qualitative study.

AIMS AND OBJECTIVES: We explored dispatched nurses' experiences of wearing full gear personal protective equipment to care for patients with coronavirus disease-2019 (COVID-19) in Wuhan, China. BACKGROUND: Full gear personal protective equipment is the primary and foremost measure to prevent the contact and transmission of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2); however, working in full gear personal protective equipment may hinder nursing care activities and thus negatively affect patients' and nurses' health. DESIGN: This descriptive qualitative inquiry followed the COREQ guidelines. METHODS: Individual semi-structured telephone interviews were conducted in a purposive sample of 15 frontline nurses who were dispatched to the outbreak epicentre from March to April 2020. Verbatim transcripts were content analysed. RESULTS: Four themes emerged from the data: inadequate preparedness for working with full gear personal protective equipment, full gear personal protective equipment stimulated stress responses, coping strategies and professional growth. Participants learned a great deal from problem-focussed and emotion-focussed strategies to tackle challenges related to the prolonged wearing of full gear personal protective equipment for quality nursing care and reduced risk of exposure. They became more vigilant to the adherence to evolving protocols and appropriate training concerning full gear personal protective equipment use. CONCLUSIONS: Frontline nurses confronted various but diminishing challenges related to the use of full gear personal protective equipment when caring for patients with COVID-19 across the approximate 40-day period. Consistent use of coverall personal protective equipment to protect from SARS-CoV-2 in high exposure settings would be feasible if nurses were better prepared; therefore, scenario-based skill training concerning the prolonged use of full gear personal protective equipment should be offered regularly and intensively. RELEVANCE TO CLINICAL PRACTICE: This study informs future decisions concerning improved full gear personal protective equipment-related psychomotor training and promoting ways for nurses to cope with the stress that comes from working in highly contiguous environments.

Emergency preparedness for heat illness in China: A cross-sectional observational study.

BACKGROUND: The morbidity and mortality rates from heat illness have increased due to a higher number of heatwaves. Effective urgent care of heat illness is crucial for optimizing patient outcomes. However, few studies have examined the emergency preparedness measures required for treating such patients. METHODS: From December 23, 2019, to January 23, 2020, a content-validated instrument containing the Perceived Emergency Preparedness Scale for heat illness (heatPEPS) was administered to emergency nurses in China through WeChat. Some of these nurses were retested two weeks later. SPSS 26, IRTPRO 4.2, and NVivo 12 Plus were used for data analysis. RESULTS: In total, 46.4% (200/431) of the participants returned valid responses. With dichotomous scoring, a high score for heatPEPS (mean 7.29; SD 1.667) was elicited. The reduced 9-item heatPEPS had a perfect fit with the 2PL model (M2 = 27.24, p > 0.05; RMSEA = 0.01) and acceptable internal (α = 0.68) and test-rest reliability (intraclass correlation = 0.56). Many participants (74%) were dissatisfied with their heat illness-related knowledge and skills, suggesting an area that could be improved for better emergency preparedness. CONCLUSION: Emergency departments appear to be well-prepared; however, this is subject to social desirability bias. The 9-item heatPEPS is a reliable and valid tool to measure emergency preparedness for heat illness.

Serotonin control of thermotaxis memory behavior in nematode Caenorhabditis elegans.

Caenorhabditis elegans is as an ideal model system for the study of mechanisms underlying learning and memory. In the present study, we employed C. elegans assay system of thermotaxis memory to investigate the possible role of serotonin neurotransmitter in memory control. Our data showed that both mutations of tph-1, bas-1, and cat-4 genes, required for serotonin synthesis, and mutations of mod-5 gene, encoding a serotonin reuptake transporter, resulted in deficits in thermotaxis memory behavior. Exogenous treatment with serotonin effectively recovered the deficits in thermotaxis memory of tph-1 and bas-1 mutants to the level of wild-type N2. Neuron-specific activity assay of TPH-1 suggests that serotonin might regulate the thermotaxis memory behavior by release from the ADF sensory neurons. Ablation of ADF sensory neurons by expressing a cell-death activator gene egl-1 decreased the thermotaxis memory, whereas activation of ADF neurons by expression of a constitutively active protein kinase C homologue (pkc-1(gf)) increased the thermotaxis memory and rescued the deficits in thermotaxis memory in tph-1 mutants. Moreover, serotonin released from the ADF sensory neurons might act through the G-protein-coupled serotonin receptors of SER-4 and SER-7 to regulate the thermotaxis memory behavior. Genetic analysis implies that serotonin might further target the insulin signaling pathway to regulate the thermotaxis memory behavior. Thus, our results suggest the possible crucial role of serotonin and ADF sensory neurons in thermotaxis memory control in C. elegans.

Regulation of longevity by genes required for the functions of AIY interneuron in nematode Caenorhabditis elegans.

In Caenorhabditis elegans, functional ttx-3, sra-11, ceh-10, and ceh-23 genes are required for the functions of AIY interneuron. Compared to wild-type N2, mutations in ttx-3 and ceh-10 significantly decreased lifespan, whereas mutations in sra-11 and ceh-23 did not obviously influence nematode lifespan. Mutations in ttx-3 and ceh-10 were associated closely with lower pumping rates at adult day 8 and caused a more rapid accumulated intestinal autofluorescence than wild-type N2. Mutations in ceh-10 remarkably affected fertility and egg number in the uterus. The regulation of ttx-3 and ceh-10 on longevity was not temperature-dependent, and ttx-3, and ceh-10 mutants all formed very few dauers at 27°C. The shortened lifespan of the ttx-3 or ceh-10 mutants was completely or largely rescued by expression of TTX-3 or CEH-10 in AIY interneurons. Moreover, the long-lived phenotype of the daf-2 mutant could be suppressed by both the ttx-3 and the ceh-10 mutations. Furthermore, ablation of AIY interneurons shortened the longevity of wild-type and the daf-2 mutant. Therefore, ttx-3 and ceh-10 regulate the longevity through influencing the insulin/IGF signaling pathway in C. elegans.

Genes required for the functions of olfactory AWA neuron regulate the longevity of Caenorhabditis elegans in an insulin/IGF signaling-dependent fashion.

OBJECTIVE: To investigate the interaction between the genes required for the functions of AWA olfactory neuron and insulin/IGF signaling in regulating the longevity of nematode Caenorhabditis elegans (C. elegans). METHODS: The mutants that had loss-of-function mutation of the genes required for AWA, AWC, ASE, and AFD sensory neurons were employed. Lifespan, the speed of pharynx pumping, the intestinal autofluorescence, the dauer formation, and the brood size were examined. Rescue experiments were performed to confirm the role of the genes required for the functions of AWA neuron in regulating lifespan. Moreover, genetic interactions between genes required for the functions of AWA neuron and insulin/IGF signaling were investigated. RESULTS: Mutations of odr-7, odr-2, and odr-3 genes required for the functions of AWA neuron significantly increased the mean lifespan of nematodes and slowed the accumulation of intestinal autofluorescence. Besides, these mutations were closely associated with higher pumping rates during aging. However, mutation of odr-7, odr-2, or odr-3 did not obviously affect the brood size or the dauer formation, and the regulation of longevity by odr-7, odr-2, and odr-3 was temperature-independent. In contrast, mutations of genes required for the functions of ASE, AWC, and AFD sensory neurons did not influence the nematode lifespan. Moreover, expression of odr-7, odr-2 and odr-3 in AWA neuron could completely or largely restore the altered lifespan in odr-7, odr-2 and odr-3 mutants. Furthermore, genetic interaction assay demonstrated that the extended lifespan in odr-7 mutant could be suppressed by daf-16 mutation and enhanced by daf-2 or age-1 mutation, whereas mev-1 and pha-4 were not required for the long lifespan of odr-7 mutant. CONCLUSION: The genes required for the function of AWA sensory neuron could regulate the nematode longevity in an insulin/IGF signaling-dependent fashion in C. elegans.