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BACKGROUND: At the onset of their professional journey, novice nurses often undergo a multifaceted psychological experience as they transition from theoretical knowledge to clinical practice, potentially impacting their development of professional identity. However, limited research has been conducted on the psychological aspects pertaining to newly graduated nurses in stomatological hospitals in our country. METHODS: The phenomenological method and semi-structured interviews were used in this study, and the sample size of the interview was purposive sampling method. A semi-structured virtual interview was conducted with 21 new nurses in the department of stomatology. Colaizzi's analysis method was used to analyse the interview data. RESULTS: Based on Kramer's reality shock theoretical framework and analyzing interview data, this study extracted the psychological experiences of novice nurses during their first year of employment across four distinct stages. The four stages include: cheerful period, frustration period, adjustment period and competency period. Six themes and nine sub-themes were derived from the four period. CONCLUSION: Due to the lack of professional knowledge, novice oral nurses will experience a series of complex positive and negative emotions at the beginning of their career. Through the research, the training of oral specialty theory, good psychological counseling and peer support can improve their participation in oral outpatient nursing. At the same time, the establishment of oral care quality assurance system and the improvement of oral care higher education in our country will become the focus of future research.
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BACKGROUND: Compared to other healthcare workers, nurses are more vulnerable to the potentially devastating effects of pandemic-related stressors. Studies have not yet investigated the deeper characteristics of the relationship between team resilience and team performance among nurses during the COVID-19 pandemic. This study aimed to elucidate the characteristics of team resilience and performance networks among nurses during the pandemic. METHODS: A cross-sectional study involving 118 nursing teams comprising 1627 practice nurses from four tertiary-A and secondary-A hospitals in Shandong Province, China, was conducted. Analyzing and Developing Adaptability and Performance in Teams to Enhance Resilience Scale and the Team Effectiveness Scale were used to measure team resilience and performance, respectively. The estimation of the network model and calculation of related metrics, network stability and accuracy, and network comparison tests were performed using R 4.0.2. RESULTS: Node monitoring had the highest centralities in the team resilience and performance network model, followed by node anticipation, cooperation satisfaction, and cooperation with other departments. Moreover, node cooperation satisfaction and learning had the highest levels of bridge centrality in the entire network. CONCLUSION: Monitoring, anticipation, cooperation satisfaction, cooperation with other departments, and learning constituted core variables maintaining the team resilience-performance network structure of nurses during the pandemic. Clinical interventions targeting core variables may be effective in maintaining or promoting both team resilience and performance in this population.
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BACKGROUND: Healthcare reform in China has attracted worldwide interest and reached a new juncture. In an attempt to improve healthcare quality and patient satisfaction, the government of Beijing introduced comprehensive reform of urban public hospitals in 2016 and implemented new policies on personnel, compensation, management, and diagnosis and treatment. As the agents of healthcare service, and a target of reform measures, healthcare workers were greatly affected by these reforms but have not been carefully studied. METHODS: This study used mean value analysis, variance analysis, and qualitative content analysis to investigate the status of healthcare workers after comprehensive reform of urban public hospitals in Beijing. RESULTS: We found a gradual but constant increase in the number of healthcare workers in poor health in Beijing public hospitals. After the reforms, this population reported high challenge stress, public service motivation, job satisfaction, job performance and quality of healthcare, moderate presenteeism, and low hindrance stress and turnover intention. The status of healthcare workers differed by subgroup and changed during the reform process. CONCLUSIONS: Our study provides data useful for policy recommendations regarding the implementation and extension of future reforms and offers important lessons for developing and developed countries that are reforming public hospitals to improve efficiency and reduce costs.
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Actitud del Personal de Salud , Reforma de la Atención de Salud/métodos , Personal de Salud/psicología , Hospitales Públicos/organización & administración , Reorganización del Personal/estadística & datos numéricos , Rendimiento Laboral/estadística & datos numéricos , Adulto , Beijing , Femenino , Personal de Salud/estadística & datos numéricos , Hospitales Urbanos/organización & administración , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Motivación , Presentismo/estadística & datos numéricosRESUMEN
OBJECTIVE: A comparative analysis was performed to investigate the potential risk factors of Adverse Events Following Immunization (AEFI) after receiving different booster vaccines. METHODS: From 18 January 2021 to 21 January 2022, the Health Care Workers (HCWs) of Guizhou Provincial Staff Hospital (Guizhou Province, China) who received a third Booster vaccine, that was either homologous (i.e., (i) a total of three doses of Vero cell vaccine or (ii) three doses of CHO cell vaccine) or (iii) heterologous with two first doses of Vero cell vaccine, being either CHO cell vaccine or adenovirus type-5 (Ad5) vectored COVID-19 vaccine, were asked to complete a self-report questionnaire form to provide information on any AEFI that may have occurred in the first 3 days after vaccination with the booster. The frequency of AEFI corresponding to the three different booster vaccines was compared, and the risk factors for predicting AEFI were determined by multivariate logistic regression analysis. RESULTS: Of the 904 HCWs who completed the survey, 792 met the inclusion criteria. The rates of AEFI were 9.8% (62/635) in the homologous Vero cell booster group, 17.3% (13/75) in the homologous CHO cell booster group, and 20.7% (17/82) in the heterologous mixed vaccines booster group, and the rates were significantly different (c2 = 11.5, p = 0.004) between the three groups of vaccines. Multivariate logistic regression analysis showed that: (1) compared to the homologous Vero cell booster group, the risk of AEFI was about 2.1 times higher (OR = 2.095, 95% CI: 1.056-4.157, p = 0.034) in the CHO cell booster group and 2.5 times higher (OR = 2.476, 95% CI: 1.352-4.533, p = 0.003) in the mixed vaccines group; (2) the odds for women experiencing AEFI were about 2.8 times higher (OR = 2.792, 95% CI: 1.407-5.543, p = 0.003) than men; and (3) compared to the non-frontline HCWs, the risk of AEFI was about 2.6 times higher (OR = 2.648, 95% CI: 1.473-4.760, p = 0.001) in the doctors. CONCLUSION: The AEFI in all three booster groups are acceptable, and serious adverse events are rare. The risk of AEFI was higher in doctors, which may be related to the high stress during the COVID-19 epidemic. Support from government and non-governmental agencies is important for ensuring the physical and mental health of HCWs.
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Objective: To investigate the factors associated with the treatment of breast cancer with biosimilars from the perspectives of physicians and patients, and to generate evidence for promoting the uptake of biosimilars. Methods: This study targeted trastuzumab and its indicated human epidermal growth factor receptor 2 (HER2) positive breast cancer and included female HER2 positive breast cancer patients under treatment of trastuzumab at a provincial oncology medical center in southern China from 1 January 2021, to 31 December 2021. The study extracted patients' demographic, socioeconomic and clinical information and the basic information of their attending physicians from the hospital information system. We performed a bivariate multiple logistic regression analysis of predictive factors of the use of trastuzumab biosimilar. Results: A total of 446 patients (aged ranging between 26 and 74, 51.4 ± 9.06) were included in the analysis, and 19.1% chose biosimilar trastuzumab. Older patients, patients enrolled in the urban and rural resident health insurance program compared with those enrolled in the urban employee health insurance program, patients who initiated treatment after January 2021 when biosimilar entered clinical use compared with those who initiated treatment before, patients with female attending physicians, younger attending physicians and with chief attending physicians compared with deputy chief attending physicians were more likely to adopt biosimilar trastuzumab for treatment (p < 05). Controlling the other factors unchanged, when the patient's attending physician was deputy chief physician, increasing 1 year age of the patient was associated with an increased probability of adopting biosimilar by .8% (dy/dx = .008, 95%CI: .002-.01, p = .01). When the patient was aged between 26 and 60, the probability of adopting biosimilar for the patient whose attending physician was a chief physician was higher than for those whose attending physician was a deputy chief physician, and the gap was the largest when the patient was at the age of 45 (dy/dx = .20, 95%CI: .13-.27, p < .01). Conclusion: The uptake rate of biosimilars is still low at its initial development stage in China. Educational policies and physicians making recommendations to the indicated patients at the initiation stage of treatment are helpful to avoid reduced willingness to switch to biosimilars due to non-clinical reasons. Patients with lower ability-to-pay will have better accessibility to biologic regimens through the uptake of biosimilars. Official guidelines and professional training are critical to enhancing physicians' willingness and confidence in adopting biosimilars.
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Objectives: The corona virus disease-2019 (COVID-19) pandemic spread globally, and we aimed to investigate the psychosocial impact on healthcare workers (HWs) in China during the pandemic. Methods: In this systematic review and meta-analysis, we searched seven electronic databases for cross-sectional studies on psychosocial impact on HWs in relation to COVID-19 from January 1, 2020 to October 7, 2020. We included primary studies involving Chinese HWs during the pandemic, and data were extracted from the published articles. Our primary outcome was prevalence of anxiety, depression, and stress disorders. We pooled prevalence value with their 95% confidence interval using random effect models and assessed study quality on the basis of an 11-item checklist recommended by the Agency for Healthcare Research and Quality. The study protocol was registered in PROSPERO (CRD42020195843). Results: We identified 25 articles comprising a total of 30,841 completed questionnaires and 22 studies for meta-analysis. The prevalence of anxiety, depression, and stress disorders was 34.4% (29.5-39.4%), 31.1% (24.5-37.7%), and 29.1% (24.3-33.8%) for HWs. The pooled prevalence of anxiety disorders for HWs from late January to early February was 46.4% (42.9-49.9%), significantly higher than those in mid-term February (28.0%, 23.9-32.1%) and after late February (27.6%, 16.0-39.2%). The pooled prevalence of depression disorders for HWs from late January to early February was 46.5% (38.8-54.2%), significantly higher than those in mid-term February (27.1%, 19.8-34.5%) and after late February (32.9%, 16.2-49.5%). HWs working in Hubei Province had a higher prevalence of anxiety (37.9 vs. 30.8%) and a lower prevalence of depression (27.5 vs. 34.7%) than those working in other regions. Nurses had a higher prevalence of anxiety (44.1 vs. 29.0%) and depression (34.1 vs. 29.2%) than other HWs. Conclusions: About one-third of HWs in China suffered anxiety, depression, and stress at the early epidemic of COVID-19. HWs in Hubei Province, especially nurses, had a higher prevalence of psychological disorders. During the pandemic, a negative psychological state may persist in a proportion of Chinese HWs, fluctuating with the control of the pandemic. The long-term impact should continue to be observed. Attention should be paid to HWs for their psychological impact due to the pandemic. Systematic Review Registration: The study protocol was registered with PROSPERO (CRD42020195843).
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BACKGROUND: Vaccination is an effective strategy to mitigate the spread of COVID-19. This study aimed to compare predictors of vaccination intention between healthcare workers (HCWs) and non-healthcare workers (non-HCWs) in China. METHODS: A web-based cross-sectional survey was conducted among HCWs and non-HCWs. Several bivariate analysis techniques, eg, crosstab with Chi-square, independent t-test and single factor ANOVA, were performed to analyze the correlation. After that, a series of multivariate binary regressions were employed to determine predictors of vaccination intention. RESULTS: Intention was closely and significantly related with gender, perceived vaccination knowledge, perceived importance and effectiveness of vaccine to prevent COVID-19. HCWs and non-HCWs were heterogeneous, since vaccination intention, perceived knowledge, and attitudes (eg, importance, severity, risk) toward COVID-19 or vaccine had statistically significant difference between the two groups. With comparison of predictors of vaccination intention, for HCWs, demographic factors were the major predictors of COVID-19 vaccination intention. Female HCWs and HCWs with a Master's or higher degree were more hesitant about vaccination (P = 0.01 and P < 0.001, respectively), while HCWs had greater vaccination intention as their age increased (P = 0.02). For non-HCWs, perceived vaccination knowledge was the major predictor of COVID-19 vaccination intention (P < 0.001). Additionally, perceived importance and effectiveness of vaccine were predictors for both HCWs and non-HCWs. CONCLUSION: Vaccination intention of HCWs was greater than that of non-HCWs in China. Measures should be taken to improve the vaccination rate based on the predictors of vaccination intention identified in this study. For HCWs, especially those with a high level of education or who were females, the safety and effectiveness of vaccines in use may reinforce their vaccination intention. For non-HCWs, popularization of general medical knowledge, including of vaccine-preventable diseases, may increase their vaccination intention.