Investigation and Analysis of Perceived Stress Levels in Pediatric Nurses During the 2019-20 SARS-CoV-2 Outbreak.

This study investigated perceived stress levels of pediatric nurses during the 2019-20 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. From February 9 to 13, 2020, 250 pediatric nurses were selected from 4 grade III children's hospitals and 5 grade III general hospitals in Jiangsu Province, China. A general information questionnaire and a stress perception scale were used to investigate and analyze the influencing factors of perceived stress among participants. Perceived stress was at the intermediate level or above for 54.1% (133) of the sample. Multiple linear regression analysis showed that hospital department, living styles, physical conditions, and the proportion of negative (eg, increased deaths and infections) information received about the epidemic (eg, via media and/or face-to-face) influenced perceived stress. Thus, the overall level of perceived stress among clinical pediatric nurses was medium. Nursing managers should pay more attention to and conduct timely assessment interventions for staff to reduce stress levels and promote physical and mental health.

Effects of home-based lower limb resistance training on muscle strength and functional status in stable Chronic obstructive pulmonary disease patients.

AIMS AND OBJECTIVES: This study aimed to determine the effect of home-based lower limb resistance training (LLRT) in patients with stable COPD. BACKGROUND: Pulmonary rehabilitation (PR) in COPD patients has been substantially investigated, but the rehabilitation components differ among studies. Few works have focused on home-based LLRT. Furthermore, few studies have assessed muscle strength and functional status by isokinetic/isometric extensor muscle peak torque (PT) and five-repetition sit-to-stand test (FTSST), respectively. DESIGN: A randomised controlled design was adopted. METHODS: (i) The home-based LLRT consisted of six sets of lower limb training cycles by self-gravity resistance and Thera-band resistance at 8-12RM, 20-30 min/session and 3 sessions/week for 12 weeks. (ii) The intervention group (n = 25) received routine PR guidance and home-based LLRT, whereas the control group (n = 22) received routine PR guidance only. The muscle strengths, FTSST durations, 6-min walking distances (6MWDs) and COPD assessment test results at enrolment and week 12 were compared. RESULTS: Relative to the baseline findings, all the indexes of muscle strength (isometric extensor muscle PT, isometric extensor muscle PT to body weight ratio [PT/BW], isokinetic extensor muscle PT and isokinetic extensor muscle PT/BW) did not significantly change in the intervention group. Meanwhile, no significant intragroup difference was noted among the indexes of muscle strength (except for isometric extensor muscle PT) in the control group. The FTSST decrease was significant between and within groups. By contrast, the 6MWD significantly increased within both groups, but not between the groups. The COPD assessment tool score decreased significantly within the intervention group. CONCLUSIONS: Compared with routine PR guidance, home-based LLRT can improve not only the muscle strength and exercise endurance but also the lower limb functional status. RELEVANCE TO CLINICAL PRACTICE: Our developed home-based LLRT intervention is simple, safe and feasible in stable COPD patients and could hence be promoted in clinical practice.

Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

PURPOSE: Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. METHODS: A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. RESULTS: The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001). CONCLUSION: The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

Experience and nursing needs of school-age children undergoing lumbar puncture during the treatment of acute lymphoblastic leukaemia: a descriptive and qualitative study.

AIMS AND OBJECTIVES: To describe experiences and nursing needs of school-age Chinese children undergoing lumbar puncture for the treatment of acute lymphoblastic leukaemia. BACKGROUND: Lumbar puncture is an invasive procedure, causing psychological changes and physical discomfort in patients. In a previous study, it was proved that distraction intervention, such as music therapy, relieves pain and anxiety. There is limited evidence regarding the experience and needs of school-age children during lumbar puncture after being diagnosed with acute lymphoblastic leukaemia. To minimise their anxiety and pain during the procedure, it is important to collect information directly from these children. DESIGN: A descriptive qualitative research. METHODS: Twenty-one school-age children with acute lymphoblastic leukaemia participated in semi-structured interviews at a Children's Hospital in China. Data were collected by an experienced and trained interviewer. Qualitative content analysis was chosen to describe experiences of children undergoing lumbar puncture. RESULTS: While undergoing lumbar puncture for the treatment of acute lymphoblastic leukaemia, school-age Chinese children experienced complex psychological feelings (fear, tension, helplessness, sadness and anxiety). They also experienced physical discomfort. They had multipolar needs, such as information, communication, respect, self-actualisation, environment and equipment. CONCLUSIONS: This study identified important areas that must be closely monitored by healthcare staff, performing lumbar puncture on acute lymphoblastic leukaemia children. Thus, a successful and smooth procedure can be performed on these patients, and their quality of life can be improved. RELEVANCE TO CLINICAL PRACTICE: The experiences described in this study contribute to a better understanding of the needs of acute lymphoblastic leukaemia children undergoing lumbar puncture. They also provide valuable information to professional medical care staff that develops future nursing assessments.

A Phenomenological Study of Nurses' Experiences in a Pediatric Fever Clinic During the COVID-19 Epidemic.

BACKGROUND AND PURPOSE: In the initial COVID-19 outbreak, nursing staff reportedly experienced high levels of psychological stress. The purpose of this study was to explore the real experience of the first cohort of pediatric fever clinic nurses during the COVID-19 epidemic. METHODS: Semi-structured interviews were conducted with eight nurses who worked in a fever clinic at a children's hospital in China. The interviews were conducted by an experienced and trained interviewer. Qualitative content analysis was used to describe the experiences of the nurses. RESULTS: Three themes were distilled from the interviews: 1) complex psychological experiences including positive experiences (increased sense of responsibility and honor, gaining the respect and recognition of parents, having a sense of achievement in personal growth) and negative experiences (panic and compulsion, guilt towards their family, antipathy, and dissatisfaction); 2) extreme physical discomfort; and 3) a lack of relevant knowledge. IMPLICATIONS FOR PRACTICE: The nurses in the pediatric fever clinic experienced various psychological impacts and physiological discomfort. Nursing managers should improve the management of hospital emergency nursing, strengthen the psychological guidance and logistics support of frontline nurses, and provide nurses with the relevant knowledge and skills training. These improvements would support frontline nurses in their work to provide effective patient treatment during the COVID-19 epidemic.

Anxiety in Chinese pediatric medical staff during the outbreak of Coronavirus Disease 2019: a cross-sectional study.

BACKGROUND: Our study aimed to explore the anxiety levels and possible associated factors in the pediatric medical staff in Jiangsu province during an outbreak of Coronavirus Disease 2019 (COVID-19). METHODS: Pediatric medical staff (n=534) from nine hospitals in Jiangsu province were enrolled. Their anxiety levels and quality of sleep were assessed using the online SAS and PSQI questionnaires. RESULTS: The prevalence of anxiety was 14.0% among the medical staff. In children's hospital staff, anxiety levels in outpatient and emergency departments were significantly higher than those in inpatient departments, except for the intensive care unit. The SAS scores were significantly associated with educational background, professional title, lifestyle, and physical condition. Stepwise multiple linear regression showed that physical condition, lifestyle, attention to the epidemic, professional title, and educational background all had a linear relationship with the individual's anxiety levels. Pearson correlation analysis showed that sleep quality was moderately associated with anxiety levels. CONCLUSIONS: The prevalence of anxiety was 14.0% in pediatric medical staff in Jiangsu province during an outbreak of COVID-19. Department, professional title, and educational background were associated with anxiety levels in these workers. More attention should be paid to staff who are in poor health, and this anxiety can also be accompanied by poor sleep quality. Peer support can assist with anxiety relief.

Multimedia Appendix Correction: mHealth Supportive Care Intervention for Parents of Children With Acute Lymphoblastic Leukemia: Quasi-Experimental Pre- and Postdesign Study.

[This corrects the article DOI: 10.2196/mhealth.9981.].

mHealth Supportive Care Intervention for Parents of Children With Acute Lymphoblastic Leukemia: Quasi-Experimental Pre- and Postdesign Study.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Caring for children with ALL is challenging for parents. A mobile health (mHealth) supportive care intervention was developed to meet parents' needs. OBJECTIVE: This study aims to evaluate the potential effectiveness of this mHealth supportive care intervention on emotional distress, social support, care burden, uncertainty in illness, quality of life, and knowledge. METHODS: We conducted a quasi-experimental pre- and postdesign study from June 2015 to January 2016. In total, 101 parents were enrolled in the study, with 50 in the observation group and 51 in the intervention group. Parents in the observation group received the standard health education and were observed for 3 months. Parents in the intervention group received the mHealth supportive care intervention, in addition to the standard health education. The intervention consisted of 2 parts-an Android smartphone app "Care Assistant (CA)" and a WeChat Official Account. The CA with 8 modules (Personal Information, Treatment Tracking, Family Care, Financial and Social Assistance, Knowledge Center, Self- Assessment Questionnaires, Interactive Platform, and Reminders) was the main intervention tool, whereas the WeChat Official Account was supplementary to update information and realize interaction between parents and health care providers. Data of parents' social support, anxiety, depression, care burden, uncertainty in illness, quality of life, their existing knowledge of ALL and care, and knowledge need were collected before and after the 3-month study period in both groups. For the intervention group, parents' experience of receiving the intervention was also collected through individual interviews. RESULTS: Overall, 43 parents in the observation group and 49 in the intervention group completed the study. Results found that the intervention reduced parents' anxiety (Dint(Post-Pre)=-7.0 [SD 13.1], Dobs(Post-Pre)=-0.4 [SD 15.8], t90=-2.200, P=.03) and uncertainty in illness (Dint(Post-Pre)=-25.0 [SD 8.2], Dobs(Post-Pre)=-19.8 [SD 10.1], t90=-2.761, P=.01), improved parents' social function (Dint(Post-Pre)=9.0 [SD 32.8], Dobs(Post-Pre)=-7.5 [SD 30.3], t90=2.494, P=.01), increased parents' knowledge of ALL and care (Dint(Post-Pre)=28.4 [SD 12.4], Dobs(Post-Pre)=17.2 [SD 11.9], t90=4.407, P<.001), and decreased their need for knowledge (Dint(Post-Pre)=-9.9 [SD 11.6], Dobs(Post-Pre)=-1.9 [SD 6.4], t90=-4.112, P<.001). Qualitative results showed that parents were satisfied with the intervention and their role in the caregiving process. CONCLUSIONS: The mHealth intervention in supporting parents of children with ALL is effective. This study is informative for other future studies on providing mHealth supportive care for parents of children with cancer.