Summary of the best evidence on self-management support schemes for patients with inflammatory bowel disease based on mobile health systems.

Objective: Self-management support services can improve patients' self-management ability. This study summarized the best evidence on a self-management support scheme for patients with inflammatory bowel disease based on a mobile health system to accurately describe the current status of the field and provide recommendations for healthcare workers. Methods: Two researchers retrieved studies from computer decision support systems, guideline websites, official association websites, and databases from the establishment of the database until October 2023. The quality of the included studies was independently evaluated by two authors using the Appraisal of Guidelines for Research and Evaluation Instrument II and the 2016 version of the corresponding evaluation standards of the Australian Joanna Briggs Institute Evidence-based Health Care Center. The classification of evidence and recommendation level adopted the 2014 version of the Australian Joanna Briggs Institute evidence pregrading and recommending level system. Results: Fifteen studies were included, comprising one guideline, two expert consensuses, four systematic reviews, four quasi-experimental studies, and four qualitative studies. The overall quality of the included studies was moderate to high. Thirty-six pieces of best evidence were compiled for seven elements, namely, mobile health system type and functional support; mobile health system application preparation; health information recording, uploading, and presentation; zoning management of diseases and early warning of the active period; support related to health education; healthcare support team formation and services; and virtual communities. Conclusions: Our study evaluated the quality of the included studies and summarized a self-management support scheme for patients with inflammatory bowel disease based on a mobile health system. The main scheme was divided into 7 parts and 36 items, which can be used as a reference for healthcare workers so that they can provide more comprehensive and scientific self-management support services for patients with inflammatory bowel disease through mobile health systems.

Constructing and Preliminary Testing a Narrative Therapy Programme for Posttraumatic Growth in Chinese Patients With Inflammatory Bowel Disease-A Pilot Study.

BACKGROUND: The research on posttraumatic growth (PTG) promotion programmes, particularly narrative therapy (NT), for patients with inflammatory bowel disease (IBD) remains limited. This pilot study aims to develop an NT programme to promote PTG and evaluate its feasibility, preliminary effectiveness, participants' experiences and improvement suggestions. METHODS: The NT programme was initially developed through literature review, interviews with IBD patients and expert panel discussions. A randomized controlled pilot trial was conducted to assess the feasibility and preliminary effectiveness of the programme. Participants in the NT group received five consecutive weekly sessions of the programme, while the control group received standard care. Outcomes including PTG, anxiety, depression and quality of life were measured. Qualitative interviews were conducted to explore participants' experiences and suggestions for programme modifications. RESULTS: The NT programme was developed with scientific rigour. The recruitment rate and retention rate were 62.5% and 96.7%, respectively. A significant reduction in anxiety levels was observed, and manifestations of PTG were reported in the NT group. Suggestions for improvement of the NT programme were received from the participants. CONCLUSION: The NT programme was constructed to promote PTG in IBD patients in this study, further offering preliminary evidence for its feasibility and potential positive psychological change. However, large-scale research is needed to validate its effectiveness for broader applications.

Symptom management experiences of Chinese individuals with Crohn's disease: A longitudinal descriptive qualitative study.

Individuals diagnosed with Crohn's disease, a chronic lifelong condition, experience a dynamic or fluctuating process of developing symptom management behavior. However, less clear is how these individuals respond to and manage their symptoms over time. The aim of this study was to longitudinally explore the symptom management experiences of individuals with Crohn's disease in China. A longitudinal qualitative design was used. Eighteen individuals with newly diagnosed Crohn's disease were purposely selected. Semi-structured interviews were conducted on four occasions over a 12-month period. Interviews at each time point were transcribed and coded using conventional content analysis. Afterward, data analyses of each time point were compared longitudinally to form a holistic understanding. Three themes and eight subthemes emerged from the analysis: (1) disclosing symptoms strategically: voluntary disclosure, reluctance to disclose, no need to disclose; (2) decreasing vigilance in symptom prevention: preventing symptoms stringently, preventing symptoms discriminatively, preventing symptoms with decreased diligence; and (3) increasing autonomy in symptom treatment: actively seeking medical advice, self-treatment and self-observation. The participants were inclined to keep symptoms hidden from relatives and friends and showed a downward trend in actively disclosing physical discomfort to medical staff within the course of 1 year. The participants' attention to symptom prevention declined, but the enthusiasm and independence to eliminate symptoms on their own increased over time. Nurses could implement targeted interventions according to the characteristics of different periods to assist individuals with Crohn's disease in managing symptoms effectively, reducing symptom burden and improving their quality of life.

Factors influencing the healthcare transition in Chinese adolescents with inflammatory bowel disease: a multi-perspective qualitative study.

BACKGROUND: The development and implementation of the transition from pediatric to adult healthcare systems for adolescents with inflammatory bowel disease (IBD) should consider stakeholders' perceptions. This study aimed to explore the factors influencing the transition of Chinese adolescents with IBD from the perspectives of patients, parents, and healthcare providers. METHODS: A descriptive qualitative research was conducted. Purposive sampling was used to recruit 36 participants, including 13 patients, 13 parents, and 10 providers, from a tertiary pediatric IBD center, a tertiary adult IBD center, and the China Crohn's & Colitis Foundation in Zhejiang Province, China. Individual semi-structured interviews were used to collect data on facilitators and barriers to the transition process. Conventional content analysis was used to analyze the interview transcripts. RESULTS: Nine primary themes were identified. Patients with young age, prolonged disease duration, severe disease, academic pressures such as the Gaokao, low level of disease acceptance, limited transition consciousness, low self-efficacy, poor transition communication, and inadequate medical transition system serve as barriers. While patients with the mentality of guilt towards their parents; parents with low education levels and intensive work schedules, high levels of disease acceptance, and situations of parent-child separation; stakeholders with high transition consciousness, high transition self-efficacy, and effective transition communication act as facilitators. Furthermore, community support and hospital guide services were also contributing factors during the transition. CONCLUSIONS: This study offers comprehensive insights into the factors affecting the transition of Chinese adolescent IBD patients. The process is continuously influenced by stakeholders, community, and healthcare environments and policies. Identifying these factors provides healthcare providers with a reference for developing and implementing targeted transition interventions.

Experience of Disease Acceptance in Chinese Patients with Newly Diagnosed Crohn's Disease: A Descriptive Qualitative Study.

Background: High levels of disease acceptance are important predictors of improved psychological well-being, treatment outcomes, and enhanced quality of life. Relatively few studies have focused on the process of disease acceptance in patients with Crohn's disease (CD), particularly those who are newly diagnosed. Purpose: To explore the disease acceptance process in newly diagnosed CD patients. Patients and Methods: A descriptive qualitative approach was employed. Sixteen CD patients from 2 tertiary hospitals in Hangzhou, Zhejiang were recruited through purposive sampling using a maximum variation strategy. Semi-structured interviews were conducted. The interviews were transcribed verbatim and analysed using conventional content analysis. Results: Five phases of the psychosocial process of the "acceptance journey" of newly diagnosed CD patients emerged from the data analysis: (1) praying for the illness to not be CD; (2) not being able to accept CD; (3) having to accept CD; (4) knowing that CD should be acceptable; and (5) starting to accept CD. Patients at the stage of "starting to accept CD" are more proactive and motivated to face the disease, and their overall acceptance of the disease is higher than that of the previous stages. However, by the end of the interview, 2 patients remained at the stage of "having to accept CD", and 3 patients remained at the stage of "knowing that CD should be acceptable". Two patients entered the stage of "starting to accept CD" and then reverted back to one of the previous stages. Conclusion: The "acceptance journey" of newly diagnosed CD patients is dynamic, individual and reversible. Traditional Chinese cultural values such as respect for authority, the philosophy of wu-wei and family responsibility contribute to the acceptance of CD in Chinese patients. Hence, there is a need to provide early and culturally tailored psychological support or interventions according to the stages of acceptance.

Reconstructing self from the illness: a constructivist grounded theory study of posttraumatic growth in patients with Crohn's disease.

BACKGROUND: Some patients with Crohn's disease report posttraumatic growth, which can promote reductions in anxiety and depression, and improve the patient's quality of life. However, the process of posttraumatic growth remains unclear. The objectives of this study were to explore the social-psychological process of posttraumatic growth in patients with Crohn's disease in the context of Chinese culture and construct an interpretive understanding based on the perspectives of patients. METHODS: This research adopted Charmaz's constructivist grounded theory. Nineteen participants with Crohn's disease were selected by purposive and theoretical sampling from three hospitals in Hangzhou, Zhejiang Province, as well as from the China Crohn's & Colitis Foundation. In-depth interviews were conducted. Data analysis was based on initial, focused and theoretical coding strategies, and methods such as constant comparison and memo writing were adopted. The Consolidated Criteria for Reporting Qualitative Research, a 32-item checklist for interviews and focus groups, was utilised. RESULTS: An interpretive understanding of posttraumatic growth in patients with Crohn's disease was constructed. The core category was "reconstructing self from the illness", which included the following four categories: "suffering from the illness", "accepting the illness", "dancing with the illness" and "enriching life beyond the illness". However, not every patient reached the last phase. Before patients enter the next stage, they might begin a new cycle by experiencing new suffering or discovering new unacceptable facts about the illness. CONCLUSIONS: This interpretive understanding reveals a growth process centred on "reconstructing self from the illness". These findings provide knowledge on the process of posttraumatic growth in patients with Crohn's disease within the wider sociocultural context.

The symptom experience of newly diagnosed Chinese patients with Crohn's disease: A longitudinal qualitative study.

AIMS: To longitudinally explore the symptom experience of Chinese patients with Crohn's disease within the first year following their diagnosis. DESIGN: A longitudinal qualitative study. METHOD: Eighteen newly diagnosed Chinese patients with Crohn's disease were recruited through purposive sampling. Semi-structured interviews were conducted at four time points: soon after diagnosis, 3, 6 and 12 months post-diagnosis. Data were collected between January 2021 and February 2022. Conventional content analysis was used for data analysis of each time point. Afterwards, the data of each time point were compared longitudinally. COREQ checklist was followed. RESULTS: Three themes and eight sub-themes were formed through analysis: feelings towards symptoms (symptoms make me feel uneasy, symptoms make me feel inferior and symptoms make me feel helpless); acceptability of symptoms (difficult to accept, have to accept, be able to accept); functions of symptoms (assessing disease conditions and treatment effects, warning of disease management). CONCLUSIONS: Overall, the negative emotions related to symptoms gradually decreased over time, and the patient's acceptance of symptoms increased within the first year following diagnosis. In addition, when the disease was in remission after treatment, the warning function of symptoms gradually weakened. IMPACT: The process of how patients accept their symptoms found in this study provides a basis for nurses to improve patients' acceptance of symptoms and reduce their symptom-related negative emotions. This study also emphasizes the phenomenon that patients gradually ignore some symptoms with their increased acceptance level, which warrants additional health education to strengthen their awareness of self-management. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was required to design or undertake this study. Patients contributed only to the data collection and member checking.

The Illness Experiences of Chinese Adolescent Patients Living with Crohn Disease: A Descriptive Qualitative Study.

The purpose of this qualitative study was to explore the illness experience of adolescent patients with Crohn disease and describe the impact of the disease on the everyday lives of these individuals within the Chinese social and cultural context to provide references for targeted interventions for the healthcare team. A descriptive qualitative design was adopted. Purposive sampling was used to select Chinese adolescent patients with Crohn disease to participate in face-to-face in-depth interviews. Data analysis was performed using the conventional content analysis method. Through the analysis of data from 14 adolescent patients with Crohn disease, four themes were formed: (1) I am different from others, (2) I am a burden to my parents, (3) I want to be the master of my own body, and (4) I grow up suffering from illness. Healthcare providers should offer more psychological support to adolescent Crohn disease patients and advise parents to shift more attention to the mental health of their children.

Medication Adherence and Its Influencing Factors Among Inflammatory Bowel Disease Patients in China.

Purpose: To investigate the current state of medication adherence among patients with inflammatory bowel disease (IBD) in China and analyze the influencing factors. Patients and Methods: We recruited as many eligible subjects as possible and a total of 105 patients with IBD finished this cross-sectional survey. The General Information Questionnaire and Morisky Medication Adherence Scale were used as measurement instruments. The factors influencing the Morisky score were studied by multiple linear regression analysis. Results: The average Morisky score was 6.11 ± 1.93. Univariate analysis showed that there were statistically significant differences in Morisky scores among patients with different ages, education levels, disease types, medication administration methods, medication frequencies, disease understanding and knowledge learning frequencies (P < 0.05). Multiple stepwise linear regression analyses showed that medication frequency, medication administration method and disease understanding were important factors influencing the Morisky score (P < 0.001). Conclusion: Our data confirmed that the medication adherence of IBD patients was poor, especially among patients taking oral medication, those taking medications with a high frequency and those with a low understanding of the disease. To reduce symptom recurrence and control the disease, medical staff should pay attention to the individual patient factors, simplify the medication regimens, formulate effective coping strategies for drug management support.

Development of mobile health-based self-management support for patients with lung cancer: A stepwise approach.

AIM: To develop self-management support platform on mobile for Chinese patients with lung cancer. DESIGN: A stepwise approach with combination of methods. METHODS: Literature review was carried out to construct preliminary framework and develop detailed content for self-management modules. A semistructured interview was conducted to elicit preference in the content and platform of self-management modules with 15 patients with lung cancer. Delphi study was performed to evaluate and improve the content of modules with 13 experts. A pilot study was conducted to test the mobile health-based self-management support modules with 13 patients with lung cancer. RESULTS: A social network software-based WeChat public account "Symptom Self-Management" for patients with lung cancer was developed and preliminarily tested with positive feedback. Three modules were designed and presented, including symptom management (cancer-related fatigue, cough, dyspnoea, pain, nausea and vomiting), emotion management and role management. CONCLUSION: This study showed that patients with lung cancer have diversified supportive care needs after discharge. A bottom-up and stepwise approach to develop mobile health-based self-management support tool has shown to be feasible and valuable. Theory guidance, user requirement exploration, evidence-based information and expert evaluation are key elements of the process. IMPLICATIONS FOR PRACTICE: The WeChat Public Account "Symptom Self-Management" could be used as sustainable platform to support patients with lung cancer in dealing with common challenges. It provides professional information, self-assessment tools, self-management skills and peer-support platform. Information presented in both text and audio forms enables patients' easy access to the platform.

Coping and growing in dilemma: Clinical work experience of front-line nurses in Wuhan during the early stage of COVID-19 epidemic.

AIM: To deeply explore the experience of front-line nurses who participated in rescuing Wuhan during the early stage of coronavirus disease 2019 (COVID-19) epidemic. METHODS: Using a descriptive qualitative design, individual semi-structured interviews were conducted between February 25 and March 5, 2020. A conventional content analysis method was used in data analysis to extract themes and sub-themes. RESULTS: Six themes emerged after data analysis: (a) worries and stress during rescue; (b) difficulties encountered during rescue; (c) experience of team work; (d) experience of interaction with COVID-19 patients; (e) experience of logistic support and widespread concern; and (f) value and significance of the experience. CONCLUSIONS: Nurses took on difficult missions in the rescue and played an irreplaceable role. They experienced remarkable psychological changes over the intensive work. It was necessary to understand the feelings and problems of the nurses so as to establish a healthcare system that can protect medical staff effectively in future disasters.

Experiences of Body Image Changes in Chinese Patients Living with Inflammatory Bowel Disease: A Descriptive Qualitative Study.

PURPOSE: Body image changes are common among patients living with inflammatory bowel disease (IBD) because of the illness and related treatments. Currently, there is little known about how those patients experience and perceive their altered body image in the literature. The aim of this study was to explore the experiences of body image changes in patients with IBD in China and to describe how those changes influence patients' perception of body and self. METHODS: This study used a descriptive qualitative approach. A total of 16 participants from three tertiary hospitals in southeast China were recruited through purposive sampling combined with maximum variation strategy. Data were collected through semistructured interviews and analyzed using conventional content analysis method. RESULTS: The following six themes were extracted: (1) "being a constrained person," (2) "being a flawed person," (3) "being a disliked person," (4) "being an alienated person," (5) "being a reconciled person," and (6) "being a blessed person." CONCLUSION: With the diagnosis of IBD and its side effects of treatments, patients' life changed significantly and they were struggling to reinterpret their body and self. As a result, negative self-evaluations and/or positive self-evaluations towards themselves generated. Further studies are required to explore the underlying mechanism and related influencing factors about how those different images were produced.

Experiences With Traditional Chinese Medicine Among Patients With Inflammatory Bowel Disease: A Qualitative Study.

Despite the increasing number of inflammatory bowel disease (IBD) patients using traditional Chinese medicine (TCM), relatively few studies have examined their experiences with TCM in the Chinese healthcare context. The aim of this study was to explore these experiences from the perspective of IBD patients. Adopting a qualitative descriptive method, IBD patients from several comprehensive hospitals in Hangzhou, Zhejiang were recruited through purposive sampling. Data were collected using semistructured interviews and analyzed by a conventional content analysis method. The results are presented thematically. Fourteen IBD patients participated in the study. They often used TCM, such as Chinese herbal medicine, retention enemas of Chinese medicine, and acupuncture, as a complementary therapy instead of as an alternative to conventional therapies. Three themes emerged from the analysis: triggers for initiating TCM, the experienced efficacies of TCM, and disturbances caused by TCM use. The IBD patients initiate TCM treatment due to the unsatisfactory effects of conventional therapies and TCM culture. However, the efficacies of TCM are subjective and slow acting and vary across individuals. There are communication gaps between physicians and patients concerning TCM. Thus, healthcare professionals are encouraged to gain more knowledge on these therapies and employ a participatory decision-making style based on this understanding.

The Illness Experiences of Chinese Patients Living With Lymphoma: A Qualitative Study.

BACKGROUND: Lymphoma patients encounter many problems. Studies investigating the illness experiences of Chinese patients with lymphoma are limited. OBJECTIVE: The objectives of this study were to explore the illness experiences of lymphoma patients in China and describe the impacts of this disease on the everyday lives of these individuals. METHODS: A descriptive qualitative design was used. The data were collected through face-to-face semistructured interviews and analyzed using the conventional content analysis method. RESULTS: Nine men and 7 women participated in this study. The following 6 themes emerged: (1) cancer diagnosis reactions, (2) self-image altered, (3) interpersonal relationships influenced, (4) career development hindered, (5) life philosophy changed, and (6) personal growth achieved. CONCLUSIONS: This study contributes new knowledge to the understanding of the illness experiences of lymphoma patients within the Chinese social and cultural context. This study also reveals how these individuals cope with the complex problems they face. IMPLICATIONS FOR PRACTICE: Nurses could help Chinese patients with lymphoma accept the disease and its treatments by emphasizing the importance of family integrity. Information, such as how to act in response to workplace discrimination, should be provided to patients by oncology nurses.

Regaining normality: A grounded theory study of the illness experiences of Chinese patients living with Crohn's disease.

BACKGROUND: Crohn's disease is a chronic condition causing inflammation of the lining of the digestive system. Individuals suffering from this illness encounter various challenges and problems, but studies investigating the illness experiences of patients with Crohn's disease in East Asian countries are scarce. OBJECTIVES: The objective of this study was to explore the illness experiences of patients with Crohn's disease in China and construct an interpretive understanding of these experiences from the perspective of the patients. DESIGN: A constructivist grounded theory approach was used to develop a theoretical understanding of illness experiences. SETTINGS: This study included participants from the following four provincial capital cities in China: Hangzhou, Nanjing, Guangzhou, and Wuhan. PARTICIPANTS: Purposive sampling and theoretical sampling were used to select Chinese patients living with Crohn's disease. METHOD: Between February 2015 and January 2018, audio-recorded interviews were conducted. The data analysis included initial coding, focused coding, and theoretical coding using the constant comparative method and memo writing. RESULTS: Thirty-one participants were included in the study. "Regaining normality" was identified as the core category. The following four categories were conceptualized: comparing, struggling, reflecting, and realizing. Comparing refers to distinguishing the similarities and differences or evaluating the superiority and inferiority of similar things. Comparisons could occur between patients with Crohn's disease and healthy individuals or between patients and people in similar or more unfortunate situations. Struggling reflects the dilemmas experienced by patients with Crohn's disease in acknowledging their patient identity and informing others of this identity. Reflecting refers to the consideration of the values and life attitudes held by patients before and after the diagnosis of Crohn's disease. Realizing involves patients gaining a deeper understanding of the suffering associated with Crohn's disease after experiencing the illness. CONCLUSION: This study offers an interpretive understanding of the illness experiences of patients with Crohn's disease. Regaining normality represents the basic social psychological process. Regaining normality is related to reassessing and reconstructing the self after receiving a Crohn's disease diagnosis. This paper provides new insight into patients' lives and describes the strategies patients use to cope with the challenges and problems caused by the illness. These study findings can be used to develop future complex interventions and studies.

An evaluation of adult critical result policies in haematology in a teaching hospital in China.

BACKGROUND: Critical result (CR) reporting is one of the core policies in China, yet it varies in different hospitals. In addition, few reports of the evaluation of CR policies have been published. This study aimed to evaluate the adult CR policies for haematology in a teaching hospital. METHODS: The consistency was compared between CR policies in a tertiary hospital in China and the current standards, consensuses and literature. The incidences for the alert thresholds of white blood cells (WBC), haemoglobin (HgB), and platelets (PLT) and the turn-around time (TAT) for different phases of CR reporting in 2017 were investigated. On-site observation of the staff was used to assess CR implementation and compliance with CR policies. RESULTS: The clauses of adult CR policies in haematology were consistent with the requirements in the standards, consensuses and literature, and the CR items and alert thresholds were within the range reported in the literature. CRs in haematology were dominated by lower thresholds. The incidences of alerts due to WBC, HgB, and PLT levels were 37.5, 18.0 and 37.0 times/day, respectively. A total of 150 cases of CR implementation were observed on-site, and the procedures followed by the staff were consistent with the requirements of the polices. The TAT medians for CR verification in the outpatient, emergency and inpatient departments were ≤6 min. CONCLUSIONS: The consistency and implementation of CR policies were both good, which ensures patient safety.

Experiences of Chinese patients with Crohn's disease in the self-administration of nasogastric feeding: A descriptive qualitative study.

BACKGROUND: Despite the increasing number of Crohn's disease patients self-administering nasogastric feeding as enteral nutrition support therapy, no studies have reported the experiences of self-administering nasogastric feeding from the perspective of these patients. OBJECTIVES: To explore the initial trigger factors for the self-administration of nasogastric feeding by Crohn's disease patients and to understand the experiences of self-administration of nasogastric feeding, its effects on various aspects of life and work, and relevant challenges and coping mechanisms encountered during this therapy in order to improve the understanding of this group of patients among medical staff and the public. DESIGN: This study adopted a descriptive qualitative method. Crohn's disease patients from several tertiary hospitals in Hangzhou, Zhejiang, were recruited to participate through purposive sampling combined with maximum variation and the snowballing technique. Data were collected using semi-structured interviews and analyzed using the conventional content analysis method. RESULTS: A total of 11 Crohn's disease patients were interviewed. Four themes and eight subthemes emerged from the analysis: rejecting the self-administration of nasogastric feeding (being afraid of inserting the nasogastric tube, having concerns about nasogastric feeding), accepting the reality of nasogastric feeding (health being the most important, followed by having sources of support), nasogastric feeding as a double-edged sword (the disturbances and efficacies of nasogastric feeding), and nasogastric feeding as a part of life (becoming accustomed to tube insertion and taking nasogastric feeding for granted). CONCLUSIONS: Apart from suffering from physical discomfort, diet and body image disturbances, and inconveniences in daily life, Crohn's disease patients who self-administered nasogastric feeding faced many psychological challenges. Many of these patients eventually adjusted to a life with nasogastric feeding, but not everyone achieved this state. Therefore, health care providers, including physicians and nurses, and the general public should collaborate to help these patients adapt to their "new lives" as soon as possible.

Postprandial Lipid Concentrations and Daytime Biological Variation of Lipids in a Healthy Chinese Population.

BACKGROUND: Several latest guidelines and consensus statements from Europe and the United States specify that there is no need for fasting prior to routine lipid tests. However, the latest Chinese guidelines still recommend fasting tests owing to a lack of local evidence. This study aimed to investigate postprandial lipid concentrations and daytime biological variation of lipids in a healthy Chinese population. METHODS: Venous blood samples were collected from 41 ostensibly healthy Chinese volunteers at five time points during the day (06:30, 09:00, 12:00, 15:00, and 18:30). The same batch of reagents was used to determine lipid concentrations. A nested ANOVA was performed to calculate within-subject biological variation (CV(I)) and between-subject biological variation (CV(G)). RESULTS: Postprandial concentrations of triglyceride were higher than fasting concentrations, with the maximum change occurring at 12:00 (0.5 hours after lunch, 0.21±0.65 mmol/L difference). The daytime biological variation of triglycerides was relatively high (CV(I)=25%, CV(G)=35.9%). The postprandial concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A1, and apolipoprotein B were mostly lower than the fasting concentrations, and their daytime biological variations were relatively low (CV(I)=2.4-4.4%, CV(G)=11.8-18.7%). CONCLUSIONS: As most daytime lipid concentrations changed only slightly, non-fasting samples could be used for routine lipid tests. However, in cases of abnormal postprandial triglyceride concentrations, dietary factors and fasting time should be considered when interpreting the results.

Corrigendum to: Nurses' knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey.

[This corrects the article DOI: 10.11613/BM.2018.010703.].

Nurses' knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey.

INTRODUCTION: In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses' knowledge on phlebotomy to provide reference for improving blood sampling practice in China. MATERIALS AND METHODS: A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. RESULTS: A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). CONCLUSIONS: The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse's knowledge level on phlebotomy.