Caregivers' experiences of caring for non-COVID-19 patients during the pandemic: A qualitative systematic review.

OBJECTIVE: To investigate caregivers' experiences of caring for non-coronavirus disease (COVID-19) patients to determine their challenges and needs. METHODS: Five electronic databases (PubMed, Web of Science, Ovid, CINAHL, and ClinicalKey) were searched from January 2020 to June 2022. Two authors independently reviewed all studies for eligibility and extracted information on the study aim, sample characteristics, study design, data collection, analysis methods, and so on. RESULTS: Finally, 13 studies were included. Four themes were determined: impacts on physical and psychosocial well-being of caregivers, perceived risk of the virus, negative impacts on employment and financial statuses, and changes in support networks. CONCLUSION: This is the first qualitative systematic review to describe caregivers' experiences of caring for non-COVID-19 patients during the pandemic. The four themes should be focused on to ease caregivers' physical, psychological, and financial burdens; to provide them with better assistance in terms of formal and informal supports to cope with the epidemic more effectively; and to ensure that their loved ones are much healthier. PRACTICE IMPLICATIONS: The findings can be used by healthcare policymakers, social policymakers, and governments to better support caregivers of non-COVID-19 patients. Additionally, it provides suggestions for related medical institutions to pay more attention to caregivers' experiences.

Application of network teaching in nursing undergraduate education during the coronavirus disease 2019 epidemic.

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 (COVID-19) is currently raging all over the world. COVID-19 can be transmitted among humans. To control the spread of the epidemic and meet the learning needs of students, Chinese universities have used a variety of multimedia forms to conduct online teaching. However, the influence of different teaching methods on the learning effects of nursing students has not been conclusive, and few studies have directly compared the differences in the effects of different teaching methods. Therefore, it is necessary to evaluate the impact of different teaching methods on students' learning effects. METHODS: A total of 119 participants from the graduating class of 2022 performed 4 validated classes (fundamental nursing, medical nursing, surgical nursing, and paediatric nursing) through network teaching. A total of 126 participants from the graduating class of 2021 used the traditional teaching method and were enrolled as a control group. All participants completed a questionnaire, which was designed by the school for teaching evaluation, and took a test after the courses. RESULTS: A total of 245 nursing undergraduates were ultimately enrolled. The analysis of the academic performance and the student evaluations from the four courses showed no significant difference between the network teaching group and the traditional teaching group for nursing undergraduates (all P > 0.05). CONCLUSION: Through the convenience of network teaching, teachers and students can choose the time and place of both their teaching and learning independently. Moreover, such use effectively prevents the spread of the epidemic. After the epidemic concludes, the continued use of the network teaching method can help improve teaching efficiency by being combined with the traditional teaching method.

Status and associations of nursing practice environments in intensive care units: A cross-sectional study in China.

OBJECTIVE: The objective of this study is to investigate the status and associations of nursing practice environments in intensive care units of tertiary hospitals and provide suggestions for improvement. BACKGROUND: Nursing shortage is an urgent global problem and a concern in China. Intensive care unit nurses have been reported to have one of the highest rates of burnout; however, their comprehensive perceptions of nursing practice environments have not yet been examined. METHODS: The Nursing Practice Environment Scale was used to conduct a questionnaire-based survey of 1,523 intensive care unit nurses from 22 tertiary hospitals in China. The data collection was conducted in 2020. RESULTS: The overall score for the nursing practice environment was 77.042 ± 19.682 (where 100 was the highest possible score). The three highest scoring dimensions were quality management, clinical nursing professionalism and professional improvement, whereas the three lowest-scoring dimensions were hospital management participation, remuneration package and social status. Educational background, position, gender and hospital type were significantly associated with nurses' satisfaction with the working environment. CONCLUSION: Chinese nurses in the intensive care units of tertiary hospitals reported relatively satisfactory nursing practice environments, but the scale scores in dimensions such as hospital management participation, remuneration package and social status remained low. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding the status and associations of the nursing practice environment in intensive care units provides evidence that new policies are needed. Furthermore, managers are responsible for supervising and ensuring that nursing practice environments meet the criteria necessary to improve job satisfaction.

Impact of Pain and Psychosocial Factors on Frailty Among Older Adults With Physical Functional Limitations: A Cross-Sectional Study.

AIMS: The objective of this study was to determine the prevalence of frailty and pain among older adults with physical functional limitations in China. We also assessed the impact of pain and psychosocial determinants on frailty among this vulnerable population. DESIGN: This study was a cross-sectional study. SETTING AND PARTICIPANTS: Totally, 2,323 Chinese elders with physical functional limitation were enrolled. METHODS: Physical functioning was assessed by the Barthel Index, participants who reported "often troubled with pain" were further asked about the intensity of their pain using a 1-10 numeric rating scale, and frailty was assessed by the Assessment of frailty FRAIL scale. The impact of pain and psychosocial factors on frailty was assessed by multivariable binary logistic regression. RESULTS: The prevalence of frailty and pain were 30.9% and 46.1%, respectively. Compared with subjects who reported no pain, those who reported mild (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.21-2.31), moderate (OR = 2.10, 95% CI = 1.53-2.82), or severe pain (OR = 2.31, 95% CI = 1.56-3.40) tended to be more vulnerable to frailty. Furthermore, compared with participants with positive psychosocial determinants, those with negative psychosocial determinants seemed more likely to be frail. CONCLUSIONS: These findings suggest that the incidence of pain, negative psychosocial status, and frailty were prevalent, and the presence of pain and negative psychosocial factors increased the risk of frailty among older adults with physical functional limitation.

Retrospective Study on the Application of Enhanced Recovery After Surgery Measures to Promote Postoperative Rehabilitation in 50 Patients With Brain Tumor Undergoing Craniotomy.

OBJECTIVE: To investigate whether enhanced recovery after surgery (ERAS) can promote rehabilitation of patients after neurosurgical craniotomy. METHODS: The clinical data of 100 patients with brain tumor undergoing craniotomy in the Department of Neurosurgery, Xiangya Hospital, Central South University, from January 2018 to August 2020 were collected, including 50 patients in the ERAS group and 50 patients in the control group. t-Test, Wilcoxon's rank sum test, and chi-square analysis were used to compare the clinical characteristics, prognosis, and hospitalization time between the two groups. RESULTS: There was no significant difference in gender, age, and other general clinical data between the two groups (p > 0.05). The days of antiemetic drugs applied in the ERAS group were less than those in the control group (1.00 vs. 2.00 days, p = 0.003), and the proportion of patients requiring analgesics was lower than that of the control group (30% vs. 52%, OR = 0.41, 95% CI 0.18-0.93, p = 0.031). The time of urinary catheter removal and that of patients starting ambulation in the ERAS group were shorter than those in the control group (16.00 vs. 24.00 h, and 1.00 vs. 2.00 days, p < 0.001, respectively); and the hospital length of stay (LOS) in the ERAS group was shorter than that in the control group (Total LOS, 13.00 vs. 15.50 days; Postoperative LOS, 7.00 vs. 10.00 days, p < 0.001). By analyzing the prognosis of patients in the ERAS group and control group, we found that there was no significant difference in postoperative complications and Karnofsky Performance Status (KPS) score 1 month after operation between the two groups. CONCLUSION: The application of ERAS in craniotomy can accelerate the postoperative recovery of patients without increasing the perioperative risk, which is worthy of wide application. However, whether the ERAS measures can reduce the postoperative complications and improve the prognosis of patients still needs more large-scale case validation and multicenter collaborative study.

MicroRNA-183 attenuates osteoarthritic pain by inhibiting the TGFα-mediated CCL2/CCR2 signalling axis.

AIMS: MicroRNA-183 (miR-183) is known to play important roles in osteoarthritis (OA) pain. The aims of this study were to explore the specific functions of miR-183 in OA pain and to investigate the underlying mechanisms. METHODS: Clinical samples were collected from patients with OA, and a mouse model of OA pain was constructed by surgically induced destabilization of the medial meniscus (DMM). Reverse transcription quantitative polymerase chain reaction was employed to measure the expression of miR-183, transforming growth factor α (TGFα), C-C motif chemokine ligand 2 (CCL2), proinflammatory cytokines (interleukin (IL)-6, IL-1ß, and tumour necrosis factor-α (TNF-α)), and pain-related factors (transient receptor potential vanilloid subtype-1 (TRPV1), voltage-gated sodium 1.3, 1.7, and 1.8 (Nav1.3, Nav1.7, and Nav1.8)). Expression of miR-183 in the dorsal root ganglia (DRG) of mice was evaluated by in situ hybridization. TGFα, CCL2, and C-C chemokine receptor type 2 (CCR2) levels were examined by immunoblot analysis and interaction between miR-183 and TGFα, determined by luciferase reporter assay. The extent of pain in mice was measured using a behavioural assay, and OA severity assessed by Safranin O and Fast Green staining. Immunofluorescent staining was conducted to examine the infiltration of macrophages in mouse DRG. RESULTS: miR-183 was downregulated in tissue samples from patients and mice with OA. In DMM mice, overexpression of miR-183 inhibited the expression of proinflammatory cytokines (IL-6, IL-1ß, TNF-α) and pain-related factors (TRPV1, Nav1.3, Nav1.7, Nav1.8) in DRG. OA pain was relieved by miR-183-mediated inhibition of macrophage infiltration, and dual luciferase reporter assay demonstrated that miR-183 directly targeted TGFα. CONCLUSION: Our data demonstrate that miR-183 can ameliorate OA pain by inhibiting the TGFα-CCL2/CCR2 signalling axis, providing an excellent therapeutic target for OA treatment. Cite this article: Bone Joint Res 2021;10(8):548-557.

Selection of PICC catheter location in neonates via evidence-based ACE Star model. / 基于ACE Star循证模式选择新生儿经外周静脉穿刺的中心静脉导管置管部位.

OBJECTIVES: To explore the most suitable insertion site for neonatal placement of peripherally inserted central venous catheter (PICC) according to the evidence-based ACE Star model. METHODS: This study was carried out according to the evidence-based ACE Star model in 5 steps, including discovery research, evidence summary, guidelines translation, practice integration, and outcome evaluation. Based on the results of Meta-analysis, relevant guidelines, expert recommendations, clinical experience of nurses, and characteristics of neonates, the final recommendation was formed. A total of 87 neonates in a tertiary neonatal intensive care unit in Hunan Province were integrated into practice of PICC to evaluate the incidence of catheter-related complications and one-attempt success rate of puncture. RESULTS: The results of Meta-analysis showed that the incidence of complications of PICC in neonates via lower limb veins was significantly lower than that of upper limb veins (OR=0.83, 95% CI 0.75 to 0.92, P<0.05). The final result of guideline translation was that PICC should be performed first through lower limb veins if the lower limb vein before PICC catheterization was not damaged.The results of integrated practice showed that the incidence of complications of PICC via lower extremity vein was 17.24%. Compared with the left lower limb catheterization, the incidence of complications and the incidence of catheter blockage of the right lower limb catheterization were significantly lower (both P<0.05). Compared with femoral vein catheterization, one-attempt success rate of puncture via the saphenous vein catheterization was higher and the incidence of complications, the incidence of catheter blockage, and the incidence of infection were lower, with significant difference (all P<0.05). CONCLUSIONS: Saphenous vein in right lower limb could be the most suitable insertion site for neonatal PICC.

Psychometric properties of the Chinese Version of the Readiness for Hospital Discharge Scale for people living with HIV.

OBJECTIVE: The study was conducted to validate the reliability and factor structure of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS-CH) for people living with HIV (PLWH). METHODS: From May 2017 to November 2017, a cross-sectional survey was performed in two AIDS inpatient departments located in two cities in Hunan, China. Reliability was evaluated by examining the internal consistency and split-half reliability of the items. A confirmatory factor analysis was performed to assess the factor structure of the RHDS-CH, and the model was revised according to the modification index. RESULTS: Cronbach's α for the RHDS-CH was 0.912, and the split-half reliability of the total scale was 0.831. Initially, the results of the confirmatory factor analysis indicated that the sample did not fit this four-factor model and its 23 items well (χ 2/df = 3, GFI =0.772, TLI = 0.823, CFI = 0.844, RMSEA = 0.100). To improve the model fit indices, we performed model modification with the guidance of modification indices. Finally, the model fit indices showed an acceptable fit to the data (χ 2/df = 2.141, GFI = 0.844, TLI = 0.899, CFI = 0.915, RMSEA = 0.075). Coefficients of corrected item-total correlation of the RHDS-CH ranged from 0.435 to 0.726. CONCLUSION: This study is the first to examine the psychometric properties of the RHDS-CH for PLWH. Our findings showed good reliability and confirmed the four-factor structure model for PLWH.

[Effect of placement of peripherally inserted central catheter via the upper versus lower extremity veins: a Meta analysis].

OBJECTIVE: To investigate the effect of placement of peripherally inserted central catheter (PICC) via the upper versus lower extremity veins in neonates through a Meta analysis. METHODS: CNKI, Wanfang Data, VIP Data, CBMdisc, PubMed, Web of Knowledge, Embase, Medline, Cochrane Library and Google Scholar were searched for control studies on the effect of PICC placement via the upper versus lower extremity veins in neonates. RevMan 5.3 was used to perform a Meta analysis of the studies which met the inclusion criteria. RESULTS: A total of 18 studies were included, among which there were 8 randomized controlled trials and 10 cohort studies, with 4 890 subjects in total. Compared with those undergoing PICC placement via the upper extremity veins, the neonates undergoing PICC placement via the lower extremity veins had significantly lower incidence rates of complications (RR=0.83, 95%CI: 0.75-0.92, P<0.05), catheter-related infections (RR=0.77, 95%CI: 0.60-0.99, P<0.05), catheter malposition (RR=0.28, 95%CI: 0.18-0.42, P<0.05), extravasation of the infusate (RR=0.52, 95%CI: 0.40-0.70, P<0.05), and unplanned extubation (RR=0.82, 95%CI: 0.69-0.98, P<0.05). They also had a significantly higher first-attempt success rate of puncture (RR=1.17, 95%CI: 1.05-1.30, P<0.05) and a significantly shorter PICC indwelling time (MD=-0.93, 95%CI: -1.26-0.60, P<0.05). CONCLUSIONS: The above evidence shows that PICC placement via the lower extremity veins has a better effect than PICC placement via the upper extremity veins in neonates.

Prevalence of hypochondriac symptoms among health science students in China: A systematic review and meta-analysis.

BACKGROUND: Hypochondriac symptoms are commonly reported in health science students. With their incomplete medical knowledge, they may compare their own bodily symptoms with disease symptoms during the process of learning, which can lead to mental distress and the need for repeated medical reassurance. OBJECTIVE: To estimate the prevalence of hypochondriac symptoms in Chinese health science students. METHODS: A systematic literature search was conducted on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Data on July 1, 2018. Additionally, the references of the retrieved papers were searched. Cross-sectional studies published in either English or Chinese that reported the prevalence of hypochondriac symptoms in health science students were included. The selection process was executed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and study quality was assessed with the checklist recommended by the Agency for Healthcare Research and Quality for cross-sectional studies. A random-effects model according to the DerSimonian-Laird method was used to calculate the pooled prevalence. RESULTS: Seven cross-sectional studies involving 6,217 Chinese health science students were included. The pooled prevalence of hypochondriac symptoms among health science students was 28.0% (95% CI = 19.0%-38.0%). The symptoms were a little more common in females (30.0%, 95% CI = 19.0%-42.0%) than in males (29.0%, 95% CI = 16.0%-42.0%), but the difference was not significant. No significant differences were found between participants grouped by study year. Only three studies explored the coping styles of students with hypochondriasis, and these revealed a high tendency toward help-seeking behaviors. CONCLUSION: Our systematic review and meta-analysis showed a high prevalence of hypochondriac symptoms among health science students, indicating that it is a noteworthy phenomenon. We suggest that counseling and other support services are necessary for health science students.