The effects of the-optimal-lymph-flow health IT system application on treatment-related high risk lymphedema in breast cancer patients: a randomized controlled trial.

PURPOSE: To evaluate the application effects of The-Optimal-Lymph-Flow IT System in Chinese patients at high risk of developing breast cancer-related lymphedema. METHODS: A total of 104 breast cancer patients were randomly assigned to either the control group or the intervention group. The intervention group was provided with the The-Optimal-Lymph-Flow program, while the control group received the usual care. Trial outcomes including symptom experience, quality of life, and limb volume were evaluated at baseline, and at end of the 1- and 3-month trials. RESULTS: After controlling for covariates, the incidence of eight symptoms was significantly higher in the control group than in the intervention group. There were significant differences in the changes in the severity of symptoms and arm volume between the two groups from baseline to 3 months after the intervention. CONCLUSIONS: The application of TOLF in patients at high risk of developing lymphedema following breast cancer treatment significantly improved the lymphedema-related symptoms experienced in the early stage after surgery. Trial registration ChiCTR1800016713.

Public risk perceptions, emotions and behaviours under a major epidemic: A structural equation model analysis.

AIM: To explore the relationships between public risk perceptions, emotions and behaviours during a major epidemic. DESIGN: Exploratory cross-sectional design. METHODS: The 701 subjects were surveyed using self-administered questionnaires, including the General Information Questionnaire, Public Risk Perceptions Questionnaire, Public Emotions Questionnaire and Public Behaviours Questionnaire. The results were analysed using structural equation modelling, and mediated effects were probed at the same time. RESULTS: The median of the total scores of the Public Risk Perceptions Questionnaire was 70, the median of the total scores of the Public Emotions Questionnaire was 65 and the median of the total scores of the Public Behaviours Questionnaire was 83. Spearman's correlation analysis showed that the correlation coefficient ρ between public risk perceptions and emotions was 0.26 (p < 0.01); the correlation coefficient ρ between risk perceptions and behaviours was 0.36 (p < 0.01); and the correlation coefficient ρ between emotions and behaviours was 0.37 (p < 0.01). After many rounds of correction, the final model was established, the fit was good, and the results of the mediating effect analysis showed that the level of public risk perceptions under a major epidemic had a direct positive effect on public emotions (ß = 0.41, p < 0.01) and public behaviours (ß = 0.51, p < 0.01). The level of public risk perceptions also had an indirect positive effect on behaviours by affecting public emotions (ß = 0.11), while public emotions had a direct positive effect on public behaviours (ß = 0.27, p < 0.01). CONCLUSIONS: Our findings revealed that public perceptions and public emotions directly influenced public behaviours. Additionally, public perceptions can indirectly influence public behaviours through public emotions.

Experience of clinical nurses engaged in caring for patients with COVID-19: A qualitative systematic review and meta-synthesis.

AIMS AND OBJECTIVE: This qualitative review summarises and synthesises the available evidence on subjective experiences of clinical nurses who cared for patients with COVID-19. BACKGROUND: Nurses are first responders and play a vital role in emerging infectious disease epidemics such as the COVID-19 pandemic. In this context, they also face many difficulties and challenges related, for example to the imbalance between extensive demands and low control over work tasks. DESIGN AND METHOD: A systematic review of qualitative studies and meta-synthesis focused on the experiences of clinical nurses caring for patients with COVID-19 during the pandemic was carried out. RESULTS: A total of 279 findings were extracted, aggregated into 21 categories and combined into seven synthesised findings, namely (1) professional nursing practice during the pandemic, (2) support systems, (3) somatic sensations and psychological experiences, (4) difficulties and challenges, (5) coping strategies and behaviour, (6) impact on life, profession and values, and (7) needs and expectations for the future. CONCLUSION: Nurses encountered considerable difficulties and challenges in caring for patients with COVID-19. Nurses caring for patients with COVID-19 need more support from organisations, families and society. It is essential to explore positive coping strategies suitable for working in different cultural backgrounds. Policymakers and decision-makers should pay attention to the experiences and voices of nurses. RELEVANCE TO CLINICAL PRACTICE: It is critical for nurse managers to consider how to enhance the support system and help nurses develop adaptive coping strategies in response to COVID-19. Nurses' experiences and voices are valuable in improving health emergency response systems. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution.

Understanding early experiences of Chinese frontline nurses during the COVID-19 pandemic: A text mining and thematic analysis of social media information.

This study aims to explore the early experiences of frontline nurses at the beginning of the COVID-19 pandemic in China as expressed through social media posts. This study used an explanatory sequential mixed-method design. Text mining was used for sentiment analysis. The chi-square test was used to compare the differences in the composition ratio of sentiment classification of posts in different months. Word frequency was statistically analyzed. Further thematic analysis was also performed. The primary sentiments of the posts were discovered to be positive and neutral. The number of posts containing positive emotions was the lowest in January, peaked in March, and gradually declined in April 2020. The following nurse-oriented narrative themes were developed: "To see and be seen," "Moving forward amid adversity and support," and "Returning to everyday life and constructing meaning." The sentiments of Chinese nurses in response to the pandemic fluctuated, with positive emotions in the early stage, but it could not be sustained. This study recommends nurses could be encouraged to engage in expressive writing while adhering to ethical guidelines.

Relationships between cataract surgery patient-perceived discharge teaching quality, discharge readiness, and post-discharge outcomes: a cross-sectional study based on regression modeling analysis.

INTRODUCTION: A short hospital stay makes discharge planning services especially critical for patients undergoing cataract surgery. Studies on discharge teaching quality, discharge readiness, and post-discharge outcomes for patients are lacking with cataracts. Our study aimed to explore the relationships between the perceived discharge teaching quality, discharge readiness, and post-discharge outcomes of cataract surgery patients and to conduct a differential analysis between inpatient and day ward patients. METHODS: We recruited 387 patients from the ophthalmology ward of a top-tier hospital in western China through convenience sampling. Data were collected on the day of discharge and at 2 weeks post-discharge. Statistical methods included multiple linear regression analysis, chi-square test, and the Mann-Whitney U test. RESULTS: Regression models indicated that discharge teaching quality was the key factor of discharge readiness, while post-discharge outcomes were influenced by discharge readiness and discharge teaching quality. Further, inpatients' discharge teaching quality, discharge readiness, and post-discharge subjective feelings were better than those of day ward patients. CONCLUSIONS: The effect of discharge planning services on patients undergoing cataract surgery was generally satisfactory. High-quality discharge teaching can enhance patients' discharge readiness, further improving their post-discharge outcomes. When conducting discharge teaching, day ward medical staff should pay more attention to patients' demands and explore a more effective teaching delivery method.

Discharge teaching, readiness for hospital discharge and post-discharge outcomes in cataract patients: A structural equation model analysis.

AIM: To explore the interaction mechanism of cataract patients' quality of discharge teaching, discharge readiness and post-discharge outcomes using structural equation model analysis. BACKGROUND: The quality of discharge teaching and discharge readiness are two indicators used to evaluate the quality of hospital discharge services. Little research has been done on the quality of discharge teaching, discharge readiness and post-discharge outcomes in cataract patients, especially in China. METHODS: Four questionnaires were administered to 192 patients, and the results were analysed using Spearman's correlation and structural equation model. RESULTS: The statistical analysis showed low-to-moderate correlations among the quality of discharge teaching, discharge readiness and post-discharge outcome variables; discharge readiness played an intermediary role in the interaction mechanism of the three variables. CONCLUSION: The cataract patients demonstrated satisfactory quality of discharge teaching, discharge readiness and post-discharge outcomes. Quality of discharge teaching affected post-discharge outcomes through the intermediary role of discharge readiness. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should recognize the importance of discharge services, pay more attention to improve the quality of discharge teaching and strengthen discharge readiness to prevent the risks of post-discharge complications and readmission.

Willingness to participate in front-line work during the COVID-19 pandemic: A cross-sectional study of nurses from a province in South-West China.

AIM: To explore the current status of Chinese nurses' willingness to work during the COVID-19 pandemic and the factors that influence them. BACKGROUND: The demand for front-line nurses continues to grow during the COVID-19 pandemic, but their willingness varies significantly. Therefore, it is crucial to explore nurses' willingness to report for front-line work. METHODS: A cross-sectional study of 1,310 nurses from six tertiary hospitals was conducted. The participants completed self-administered online questionnaires. RESULTS: A total of 90.5% of nurses reported that they would like to voluntarily participate in front-line work. Those with previous training, higher self-efficacy scores, and lower perceived risk and self-worth scores were more likely to participate in front-line work, while nurses, who had 11-15 years of work experience and were worried about their family and the lack of family support, were less likely to be involved in front-line work. CONCLUSION: This study found that the vast majority of nurses were willing to participate in front-line work and affirmed the positive effects of previous infection prevention training, self-efficacy and self-worth. IMPLICATIONS FOR NURSING MANAGEMENT: This research emphasizes the necessity of infection prevention training and provides evidence for further emergency workforce deployment and incentives.

Nursing interruptions in emergency room in China: An observational study.

AIM: To analyse the frequency and core elements of nursing work interruptions in Chinese emergency nursing settings. BACKGROUND: Little is known about nursing interruptions, which affect the quality of services in Chinese emergency nursing setting. METHOD(S): A cross-sectional observational study was conducted in three units of an emergency department in a Chinese tertiary hospital. Participants comprised 60 nurses. Data were collected using a questionnaire developed by the researchers specifically for this study. RESULTS: In total, 25,965 min of work was observed and 2333 interruptions were identified. Most interruptions were from patients, their families and nurses. Therapeutic nursing and patient observation and documentation were the most frequently interrupted procedures. Most interruptions were negative, and a majority of the nurses immediately responded to interruptions. Significant differences existed in the overall distribution of the core elements among the three nursing units. CONCLUSIONS: The frequency of emergency nursing interruptions was moderate. Most interruptions tend to lead to negative treatment outcomes for patients. IMPLICATIONS FOR NURSING MANAGEMENT: Emergency nursing managers should recognize the importance of interruptions, understand work situations better and develop ways to reduce the incidence of interruptions. Thus, nursing risks can be avoided by reducing the adverse outcomes caused by work interruptions.

Physical function, post-traumatic stress disorder, and quality of life in persons with spinal cord injury caused by the Wenchuan earthquake versus nondisaster trauma: a cross-sectional modeling study.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To compare physical function, post-traumatic stress disorder (PTSD) and quality of life (QOL) between individuals with spinal cord injury (SCI) caused by the Wenchuan earthquake and individuals with SCI caused by nondisaster trauma and to explore the relationship between physical function, PTSD and QOL. SETTING: Community, Sichuan, China. METHODS: Two hundred individuals with SCI (39 caused by the Wenchuan earthquake, 161 with other traumatic etiology) were surveyed. Physical function was assessed with the Spinal Cord Independence Measure-SR, PTSD with the PTSD Checklist-C, and QOL with the World Health Organization QOL-BREF. Independent sample t-tests and rank-sum tests were used to compare the two groups. Structural equation modeling (SEM) was used to analyze the relationship between physical function, PTSD and QOL. RESULTS: QOL of the study participants was at a moderate to low level, physical function was at a medium level. The prevalence of PTSD in the group injured due to the Wenchuan earthquake was 64.1% as opposed to 10.0% in individuals with other traumatic etiology. In the SEM, earthquake-related etiology was strongly related to increased PTSD symptoms which negatively affected QOL. Earthquake-related etiology was however also associated with slightly increased physical function which was associated with better QOL and less PTSD symptoms CONCLUSIONS: Prevalence of PTSD in earthquake survivors with SCI was largely increased as compared with people with SCI of other traumatic etiology. In spite of this, the groups did not differ in QOL because of better physical function of earthquake survivors. Effective intervention for PTSD is still needed in earthquake survivors with SCI. Continuous rehabilitative measures to improve physical function and QOL in both groups are also recommended.

Factors influencing readiness for hospital discharge among patients undergoing laryngectomy.

AIM: To identify factors influencing readiness for hospital discharge among Chinese patients having undergone a laryngectomy and to provide evidence for developing future processes. BACKGROUND: Laryngectomy changes the functional and psychological state of laryngeal cancer patients considerably. However, influencing factors for discharge readiness among laryngectomy patients have hardly been investigated. METHODS: A descriptive, cross-sectional design was used with Meleis' transitions theory as a guiding framework. This survey-based study was performed with 212 laryngeal cancer patients undergoing laryngectomy at a regional tertiary medical centre between August 2012 and September 2013. RESULTS: Quality of discharge teaching and having a designated caregiver after discharge were found to influence patients' readiness for discharge. CONCLUSION: Clinical interventions such as nursing assessment on discharge readiness, assistance to coordinate postdischarge support and individualized follow-up planning should be integrated into future clinical processes in China. However, further investigations are needed to systematically align relevant results before clinical practices in Chinese settings are eventually changed.

[Translation and Development of the Chinese-Version Patient Privacy Scale].

BACKGROUND: The unauthorized releasing of confidential patient information is a serious problem worldwide. Nurses, the healthcare professionals who are in most frequent contact with patients, have access to a significant amount of confidential patient information and play a key role in protecting patient privacy. However, currently, there is no proper tool to measure the level to which clinical nurses protect the privacy of their patients in China. PURPOSE: To translate the patient privacy scale (PPS) into Chinese and to test the reliability and validity of this Chinese version. METHODS: The original scale was developed by Özturk, Bahcecik, and Özçelik (2014) to identify whether nurses protect or violate patient privacy in the workplace. This study used the "back translation" method to translate the scale. A total of 616 nurses in two tertiary hospitals in the Western region of China were enrolled to test the internal consistency, test-retest reliability, and construct validity of the translated scale. RESULTS: The Cronbach's coefficients of the total scale and its 5 factors ranged from .84 to .94; the split half reliability was .91; the test-retest reliability was .82; and the content validity index was .95. Explanatory factor analysis revealed that the 5 factors explained 64.98% of the total variance. CONCLUSIONS: The Chinese version of the PPS is reliable and valid, and may be used to reliably assess the behaviors of nurses with regard to protecting the privacy of their patients. The scale may also be used to evaluate the effects of training on patient privacy protection.

An Investigation on Self-Rated Health of Adolescent Students and Influencing Factors From Sichuan, China.

To investigate adolescent students' self-rated health status and to identify the influencing factors that affect students' health status. A stratified cluster sampling method and the Self-assessed General Health Questionnaires were used to enroll 503 adolescent students from Sichuan Province, Southwest part of China. Most adolescent students perceived their self-rated health as "Fair" (29.4%), "Good" (52.1%), or "Very Good" (16.3%). Regarding the sleep quality, most of them rated them as "Fair" (24.9%), "Good" (43.1%), or "Very Good" (19.7%), but 59.7% students reported to sleep less than 8 hours a day, even a few reported to sleep less than 6 hours (4.4%) or more than 9 hours (9.7%). A considerable number of students (41.1%) reported that they "Never" or just "Occasionally" participated in appropriate sports or exercises. As to the dietary habit, a significant number of students (15.7%) reported that they "Never" or "Occasionally" have breakfast. Students from different administrative levels of schools (municipal level, county level, and township level) rated differently (P < 0.05) in terms of their self-rated health, Health Behaviors, Sleeping, Dietary behaviors, Safety Awareness, and Drinking and Smoking behaviors. In general, Chinese teenage students perceived their own health status as fairly good. However, attention needs to be paid to health problems of some of the students, such as lack of sleep and exercise and inadequate dietary habits, etc. More concerns need to be addressed to students from different administrative levels of schools, and strategies should be put forward accordingly.

Public image of nursing in modern society: An evolving concept analysis.

AIMS: This study aimed to analyse the evolution of the public image of nursing in the context of the constantly developing nursing profession. DESIGN: The Rodger's evolving concept analysis was applied. METHODS: PubMed, CINAHL, Web of Science, Scopus, and ProQuest databases were searched for articles published between 1 January 2001, and 30 April 2022, using the search terms; "NURS * AND image". The selected literature was screened using Rodgers' evolutionary method to explore the attributes, antecedents and consequences of the concept. RESULTS: The defining attributes were identified as nursing (nursing as the collective object), public (public as the collective subject) and information (the medium of interaction between the collective subject and the collective object). Nursing elements were classified into intrinsic elements (professional spirit, professional knowledge and professional skills) and extrinsic (appearance, language and behaviour) elements. Public elements were further subcategorized into public categories (internal organizational public and external organizational public) and public perceptions (cognition, emotion and behavioural intention). The information elements are mainly classified as information generation, dissemination, identification, processing and judgement. The antecedents and consequences of the public perception of nursing were also identified. CONCLUSIONS: The public image of nursing is dynamic and has evolved over time. Its dynamism and malleability imply that the traditional public image of nursing can be improved through targeted interventions in nursing practice, management and education. IMPLICATIONS FOR THE PROFESSION: Identifying the antecedents and consequences associated with the public image of nursing will help the healthcare organizations adopt effective strategies to alleviate the shortage of the nursing workforce and promote the development of the nursing profession. No Patient or Public Contribution.

Correlation between symptom experience and fear of cancer recurrence in postoperative breast cancer patients undergoing chemotherapy in China: A cross-sectional study.

OBJECTIVE: To analyze the relationship between experience of symptoms (e.g., pain, fatigue) and fear of cancer recurrence (FCR) in Chinese postoperative patients with breast cancer undergoing chemotherapy. METHODS: A total of 225 patients were recruited using convenience sampling. The Fear of Cancer Recurrence Inventory-Chinese Version and the Symptom Experience Index were used to collect data. The Mann-Whitney U test, Spearman's correlation, and multivariate analysis were employed to explore the relationships between symptom experience and FCR. RESULTS: The total Fear of Cancer Recurrence Inventory score in postoperative patients with breast cancer undergoing chemotherapy was 43.19±22.83, and >64.0% of participants exhibited significant fear of cancer recurrence. The total score of symptom experience was 27.41±16.77, including scores of symptom severity (16.91±8.70) and symptom distress (10.50±8.89). Participants' symptom experience was positively correlated with fear of cancer recurrence (r = 0.353, P < 0.001). Patients with clinically relevant FCR had higher scores for total symptom experience (Z = -3.911, P<0.001), symptom severity (Z = -3.245, P = 0.001), and symptom distress (Z = -4.185, P<0.001), compared to patients without clinically relevant FCR. Symptom experience (b = 0.511, t = 6.474, P<0.001), age (b = -0.591, t = -4.201, P<0.001), and educational level (b = 4.147, t = 3.955, P<0.001) were statistically correlated with FCR, accounting for 27.0% of the variance. Among these variables, symptom experience demonstrated the strongest correlation, with a beta value of 0.371. CONCLUSION: This study followed others in identifying a cross-sectional relationship between symptom experience and FCR. Further prospective research is required to better understand the nature of this relationship.

Correlation between quality of discharge teaching, readiness for hospital discharge and health outcomes of hysterectomy patients: A structural equation model analysis.

AIM: To explore the relationship between the quality of discharge teaching, readiness for hospital discharge and postdischarge health outcomes in hysterectomy patients. DESIGN: Cross-sectional online survey. METHODS: A cross-sectional survey design was used to investigate 331 hysterectomy patients in a hospital in Chengdu. The results were analysed using Spearman's correlation and structural equation model. RESULTS: Spearman's correlation analysis revealed moderate-to-strong correlations among the quality of discharge teaching, readiness for hospital discharge and postdischarge health outcomes. The total and direct effects of the quality of discharge teaching on patients' readiness for hospital discharge were both 0.70 and readiness for hospital discharge on patients' postdischarge health outcomes were both 0.49. The total, direct and indirect effects of the quality of discharge teaching on patients' postdischarge health outcomes were 0.58, 0.24 and 0.34, respectively. Readiness for hospital discharge mediated the interaction mechanism.

Relationship between information literacy and innovative behavior of emergency specialist nurses: A cross-sectional study in southwest China.

BACKGROUND: Emergency specialist nurses play a vital role in providing high-quality care to patients. This study investigated the innovative behavior and information literacy of emergency specialist nurses and analyzed the influence of information literacy on innovative behavior to promote the latter. METHODS: In total, 484 emergency specialist nurses in Sichuan Province, China, completed the Innovative Behavior and Information Literacy Scales. Univariate analysis, Pearson's analysis, and multiple linear regression were performed. RESULTS: The emergency specialist nurses' innovative behavior and information literacy scores were 32.34 ± 6.27 and 74.32 ± 7.38, respectively. Scores for information awareness, ability, knowledge, and ethics were 3.90 ± 0.53, 2.95 ± 0.45, 3.32 ± 0.19, and 3.28 ± 0.30, respectively. The correlation analysis demonstrated that information literacy positively correlated with innovative behavior. The multivariate linear regression analysis revealed that experience in publishing academic papers influenced innovative behavior. CONCLUSIONS: Emergency specialist nurses demonstrated a moderate level of innovative behavior. Higher information literacy was associated with higher innovative behavior. Therefore, enhancing emergency specialist nurses' information literacy could stimulate innovative behavior and improve innovation ability. Nursing managers should develop corresponding information literacy training programs according to the characteristics of information literacy and evidence-based practice of emergency specialist nurses to improve their innovation level and quality of specialized nursing services.

Data on the effects of The-Optimal-Lymph-Flow program on lymphedema symptoms in breast cancer survivors.

A substantial proportion of more than 50% of breast cancer survivors, who remain undiagnosed with lymphedema, encounter a daily struggle with the presence of multiple and concomitant lymphedema associated symptoms (i.e., lymphedema symptoms). The-Optimal-Lymph-Flow (TOLF) program was developed based on physiological-cognitive-behavioral principles to educate breast cancer survivors on effective self-care strategies. Physiologically, TOLF program was designed to stimulate lymphatic system to enhance lymph flow, thereby alleviating lymphedema symptoms and mitigating the risk and severity of lymphedema. The dataset presented in this article was obtained from a randomized clinical trial (RCT) that assessed the preventive effects of the TOLF program in improving lymphedema symptom experience and optimizing lymph fluid status among breast cancer survivors who were at higher risk for lymphedema. Between January 2019 and June 2020, a RCT was conducted to recruit 92 eligible participants who were assigned randomly to either the TOLF group (intervention) or the arm mobility group (control). Demographic and clinical data were collected at baseline and updated over the study period. Outcome data were collected at baseline and three months after intervention. Study outcomes included lymphedema symptom experience (i.e., number, severity, distress of lymphedema symptoms, and impact on daily activities) and lymph fluid status. The Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was utilized to assess lymphedema symptoms and circumferential arm measurement was utilized to estimate limb volume differences (a surrogate for lymph fluid status). The dataset based on the RCT allowed confirmation of positive effects of the TOLF intervention during early postoperative period. The dataset can be further utilized as a benchmark reference in clinical settings or experimental research to determine the effects of optimal lymphatic exercise dosage on lymphedema risk reduction and symptom alleviation as well as provide a basis for future research related to this topic.

The concept analysis of smart teaching.

OBJECTIVE: To explore the defining attributes, antecedents, and consequences and identify the approximate concepts of smart teaching. DESIGN: A concept analysis of smart teaching informed by Walker and Avant's classical concept analysis method. DATA SOURCES: Major databases: China National Knowledge Infrastructure, Wangfang Data, VIP Database, Web of Science, PubMed, Institute of Electrical and Electronics Engineers Xplore Digital Library, Association for Computing Machinery Digital Library, Educational Resources Information Center, Scopus, and Science Direct were searched. REVIEW METHODS: The search strategy yielded 5407 papers. Screening for inclusion resulted in a review of 32 articles. RESULTS: Five attributes of smart teaching were identified as the participating groups, teaching process, teaching forms, components, and characteristics. Additionally, two antecedents were clarified: smart education philosophy and smart teaching environments. Finally, the consequences of smart teaching were identified as the generation and development of the wisdom of teachers and learners. CONCLUSION: The conceptual attributes of smart teaching align with the characteristics of current teaching practice, which can provide conceptual support for theoretical and practical research on smart teaching and are of great significance for clarifying concepts, constructing theories, and promoting education and teaching reform.

The relationship between disaster preparedness, psychological capital, and coping style among nurses: A cross-sectional study from China.

PURPOSE: To find the relationship between psychological capital, coping style, and disaster preparedness in public hospital nurses. DESIGN AND METHODS: A cross-sectional study of 515 registered nurses from a public hospital in northeast Sichuan Province, China who were enrolled to complete self-reported questionnaires sent through the WeChat app. RESULTS: Disaster preparedness and psychology capital (r = 0.73, p < 0.01), disaster preparedness and coping style (r = 0.55, p < 0.01), and psychological capital and coping style (r = 0.56, p < 0.01) were positively correlated. Psychological capital (B = 1.81, p < 0.01) and coping style (B = 0.87, p < 0.01) accounted for 50% of disaster preparedness. Coping style partly mediated the effect of psychological capital on disaster preparedness (ab: 0.33, 95% confidence interval [CI]: 0.21-0.45). PRACTICAL IMPLICATIONS: The level of psychological capital of nurses can provide an objective reference for administrators to establish intervention strategies and to promote positive psychological resources among nurses.

Strategies in activating lymphatic system to promote lymph flow on lymphedema symptoms in breast cancer survivors: A randomized controlled trial.

Background: Many breast cancer survivors face long-term postoperative challenges as a result of developing lymphedema symptoms and chronic lymphedema. The-Optimal-Lymph-Flow (TOLF) program is an intervention based on physiological-cognitive-behavioral principles that teaches patients self-management strategies to activate lymphatic system and promote lymph flow to decrease lymphatic pain, reduce the risk and severity of lymphedema. Objective: The purpose of this pilot clinical trial was to evaluate the use of TOLF program as an early intervention on improving lymphedema symptom experience (i.e., symptom number, symptom severity, symptom distress, and the impact of symptoms on patients' activities of daily living) and optimizing lymph fluid levels (measured by the arm volume differences) among breast cancer survivors. Methods: This study is a parallel, randomized clinical trial. A total of 92 breast cancer patients were randomly assigned to either the TOLF intervention group or the control group focusing on promoting arm mobility. Data were collected at baseline and end of the trial at the 3-month post intervention. The Breast Cancer and Lymphedema Symptom Experience Index was used to measure lymphedema symptom experience. Anthropometric measurements were used for circumferential arm measurements. Generalized linear mixed-effects models were used to evaluate the trial outcomes. Results: Significant improvements of lymphedema symptom experience were found in patients in the TOLF intervention group in comparison with patients in control group: the number of lymphedema symptoms (P<0.001) and the severity of lymphedema symptoms (P<0.001) as well as the impact of symptoms on patients' daily living function (P<0.001). Patients in both groups showed improvements in all study outcomes over the 3 months, whereas those in the TOLF group gained greater benefits in reducing the number and severity of lymphedema symptoms. Moreover, the TOLF group had significantly fewer patients with ≥5% arm volume differences ([5/45] vs [13/43], P=0.035) at the study endpoint. Conclusions: Findings of the study demonstrated positive outcomes of relieving lymphedema symptom experience, optimizing arm circumference and halting the progression of lymphedema status in breast cancer survivors receiving TOLF intervention during early postoperative time. Given its feasibility, acceptability, and effectiveness, this program may be incorporated in routine breast cancer care. Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, identifier ChiCTR1800016713.