Efficacy of Community Health Worker-Delivered Family Health History-Based Breast Cancer Education and Services Among Chinese Americans.

Family health history (FHH) is an evidence-based genomics tool used in cancer prevention and education. Chinese Americans, the largest Asian American group, face unique barriers in FHH collection and communication. This study aimed to evaluate the efficacy of culturally and linguistically appropriate community health worker (CHW)-delivered FHH-based breast cancer (BC) education and services to Chinese Americans. A total of 1129 Chinese Americans received FHH-based BC education and service delivered by our trained Chinese American CHWs. Participants responded to evaluation surveys before, immediately after, and 3 months after the education and service. Participating Chinese Americans showed significant increases in rates of collecting FHH of BC, discussing FHH of BC with family members, informing their primary care physicians of their FHH of BC, and discussing their FHH of BC with their primary care physicians at 3 months post-education and service compared to the baseline data (all Ps < 0.01). Attitudes, intention, and self-efficacy related to FHH of BC communication and collection and FHH of BC knowledge were improved both immediately after and 3 months after the delivery of the education and services (all Ps < 0.01). Within 3 months, ~ 14.3% of participants who had a high risk of BC based on FHH reported visiting geneticists for genetic evaluation. Our Chinese American CHW-delivered FHH-based BC education and services showed initial success in increasing knowledge, collection and communication of BC-related FHH, and genetic service utilization among Chinese American participants. This study can serve as a starting point for conducting more robust studies, such as randomized controlled trials, in the future.

Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China.

Background: With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recognition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health consequences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associated factors among nurses in China. Methods: We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom. Findings: A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial proportion of nurses reported symptoms of burnout (34%), depression (55·5%), and anxiety (41·8%). In line with the disproportionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression. Interpretation: Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating countermeasures to safeguard nurses' health. Funding: The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17].

Difference of Physical Restraint Knowledge, Attitudes and Practice Between Nurses and Nursing Assistants in Long-Term Care Facilities: A Cross-Sectional Study.

BACKGROUND: Physical restraint (PR) is widespread use among older adults in long-term care (LTC) facilities, which has negative effects on older adults' health and quality of care. Considering that research on PR use in Chinese LTC facilities is rare, assessment of nursing staff's knowledge, attitude, and practice (KAP) is a prerequisite before minimized PR program and staff training project development. PURPOSE: This study aimed at determining the differentiation of levels and factors of KAP toward PR use between nurses and nursing assistants in LTC facilities. METHODS: A cross-sectional study was conducted in six Chinese LTC facilities from November to December in 2019 and May to June in 2020. A total of 316 nursing staff, comprising 69 nurses and 247 nursing assistants were investigated using the Chinese version of the Staff Knowledge, Attitudes and Practices Questionnaire regarding PR. One-way analysis of variance, chi-squared test, Welch test, the Mann-Whitney U-test, and multiple linear regression were performed for data analysis. RESULTS: Mean scores of overall knowledge, attitude, and practice were 5.90±2.27, 31.97±3.01, 30.89±4.82, respectively. PR knowledge and practice of nurses were significantly higher than that of nursing assistants (all P<0.001), whereas PR attitude with no significant difference (P=0.084). In-school training, in-job training, and knowledge on PR significantly affected PR practice of nurses and nursing assistants. Further, nursing assistants' practice was also significantly predicted by education (ß=0.131, P=0.019), age (ß=-0.140, P=0.034), monthly income (ß=-0.184, P=0.002), and attitude (ß=0.130, P=0.030). In-job training (ß=0.283, P<0.001), age (ß=-0.164, P=0.021), and knowledge (ß=0.292, P<0.001) significantly affected nursing assistants' attitude, while their knowledge was influenced by monthly income (ß=0.153, P=0.019) and work years in LTC (ß=0.343, P<0.001). CONCLUSION: Specific knowledge deficits, negative fields of attitude, and practice were dissimilar between nurses and nursing assistants. The targeted and stratified PR education approaches were suggested to prompt their KAP.

An Application of the Theory of Planned Behavior to Predict the Intention and Practice of Nursing Staff Toward Physical Restraint Use in Long-Term Care Facilities: Structural Equation Modeling.

PURPOSE: Understanding the factors that affect nursing staffs' intention and practice of physical restraint (PR) on older adults help develop restraint-reduction programs. This study aimed to identify the relationship between the Theory of Planned Behavior (TPB) constructs and nursing staffs' practice to use PR in long-term care (LTC) facilities. PATIENTS AND METHODS: A cross-sectional survey was conducted via convenience sampling among 316 nursing staff in six Chinese LTC facilities. PR-TPB questionnaire and the practice subscale of the Chinese version of the Staff Knowledge, Attitudes and Practices Questionnaire regarding PR were used to collect the data. Structural equation modeling (SEM) was used to examine the relationship between variables. RESULTS: The SEM fit well with the data (χ2/df =1.639, RMSEA = 0.045, CFI= 0.955, GFI=0.945). Attitude (ß=0.536, P<0.001) and perceived behavioral control (PBC) (ß=0.139, P<0.05) predicted intention (R2 =0.359). PBC was a significant predictor of practice, with R2 accounting for 0.151. CONCLUSION: TPB provided useful insight into better understanding nursing staffs' PR practices, although it did not support all the TPB principles significantly. Prospective studies may be conducted to design and implement multi-component interventions based on TPB and explore the effectiveness of PR reduction in LTC facilities in-depth.

Mental health risks among nurses under abusive supervision: the moderating roles of job role ambiguity and patients' lack of reciprocity.

BACKGROUND: While the nursing profession has been associated with mental health problems and the research into the antecedents of mental health has steadily grown, the relationship between abusive supervision and mental health issues of anxiety and depression remains largely unknown. AIM: This study aims to examine the relationship between abusive supervision and mental health problems. And we also aim to investigate whether this relationship is moderated by role ambiguity and the patients' lack of reciprocity. METHODS: A total of 227 frontline nurses from two public hospitals completed the survey questionnaire. RESULTS: (1) Abusive supervision was positively associated with poor mental health; (2) the positive relationship was moderated by nurses' perceived role ambiguity in such a way that the relationship was stronger when the perceived role ambiguity is high; (3) the positive relationship was moderated by the patients' lack of reciprocity in such a way that the relationship was stronger when patients' lack of reciprocity was high. CONCLUSIONS: To conclude, the present study showed that abusive supervision was positively associated with mental health problems of anxiety and depression among samples of Chinese nurses. Findings of this study also highlighted that this relationship was contingent upon perceived role ambiguity and patients' reciprocity.