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BACKGROUND: Psychological stress and anxiety have seriously affected the ability of new clinicians to adapt and coordinate their clinical work. Traditional pre-job training is often not very good at assisting new recruits to regulate their emotional problems. METHODS: This study is a randomized controlled study. A total of 435 newly recruited clinicians participated in the study. 428 clinicians were randomized into a control group (n = 214) and an intervention group (n = 214). The control group conducted regular pre-job training. Doctors of the intervention group attend a themed course every two weeks on the basis of regular induction training. Their physiological status was evaluated by Perceived Stress Scale (PPS-10), Generalized Anxiety Scale (GAD-7) and Psychological Resilience Scale (CD-RISC-10) 3 months later. Participants in the intervention group received a training satisfaction questionnaire. RESULTS: After entering the clinic for 3 months, the PSS-10 and GAD-7 scores of the intervention group were significantly lower than that of the control group. Consistently, the CD-RISC-10 score of new clinicians who received proof-of-concept pre-job training was significantly higher than that of new doctors in the control group. CONCLUSION: New doctors received the proof-of-concept group experienced alleviation in stress and anxiety.
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OBJECTIVE: To explore the occurrence and dynamic trends of psychological stress responses of medical staff experiencing workplace violence at different time points. METHODS: A longitudinal study of 23 medical workers who experienced workplace violence was conducted. The perceived stress scale (PSS-4), posttraumatic stress disorder checklist for DSM-5 (PCL-5), and hospital anxiety and depression scale (HADS) were used to measure the medical workers' psychological perception of pressure, posttraumatic stress symptoms, anxiety, and depression at the time of exposure to violence, at 1 month, 2 months, and 4 months after exposure in the workplace, respectively. Repeated measures analysis of variance was applied to analyze psychological stress response and temporal effect. Factors influencing psychological stress responses were analyzed. RESULTS: The scores of PSS-4, PCL-5, HADS-anxiety, and HADS-depression of medical staff exposed to violence began to increase at the time of exposure, peaked 1 month after exposure, and gradually decreased 2 months and 4 months after exposure (all P<0.05). The main influencing factors were being nurses, physical violence, working years ≤5, and being female. CONCLUSION: Effective interventions for medical staff should be made up to 1 month after exposure to workplace violence when the psychological stress responses are the highest.
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OBJECTIVE: To explore the effect of fast-track surgery (FTS) based high quality nursing on orthopedic trauma. METHODS: In this retrospective study, 94 patients who received orthopedic trauma surgery in our hospital from December 2018 to November 2020 were included. The patients were assigned to a research group (n=47) or a control group (n=47) according to which nursing method they received. The control group received routine nursing, while the research group also received FTS-based high-quality nursing. Perioperative situation, quality of life score (SF-36) before and after operation, incidence of complications, pain score (VAS) at different time periods after operation, and nursing satisfaction were compared between the two groups. RESULTS: There was no significant difference in operation time or blood loss between groups (P>0.05). The time to getting out of bed for the first time, time to drainage tube removal, and length of hospital stay in the research group were shorter than those in the control group (P<0.001). Repeated measurement analysis of variance revealed that the VAS score of the research group was lower than that of the control group at 1 h, 3 h, 6 h, 24 h and 48 h after operation (P<0.05). Intra-group comparison manifested that the VAS scores of both groups decreased at 1 h, 3 h, 6 h, 24 h and 48 h after operation (P<0.05). Comparison at different time points revealed that the difference was statistically significant (P<0.05). The incidence of complications in the research group (4.26%) was lower than that in the control group (17.02%; P<0.05). The satisfaction rate of nursing in the research group (93.62%) was higher than that in the control group (78.72%; P<0.05). After intervention, the level of superoxide dismutase (SOD) and glutathione (GSH) in both groups decreased with a lesser decrease in the research group. The contents of reactive oxygen species (ROS) and malondialdehyde (MDA) in groups after intervention were higher than those before intervention with a milder increase in the research group. CONCLUSION: FTS mode can shorten the recovery time, reduce the degree of pain and the reduce the time of analgesia. It also promotes the recovery and shortens the hospital stay of patients, and improves their quality of life, with high satisfaction. This may be related to an expeditedd surgical process and reduced oxidative stress response of patients undergoing surgery under the rapid recovery surgical model.
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OBJECTIVE: Gestational diabetes mellitus (GDM) is one of the common complications of pregnant women, with serious threatening to pregnant women and newborns. The pathogenesis of GDM remains unclear now. This study aims to explore the effects of miR-22-3p targeted regulation of suppressors of cytokine signaling 3 (Socs3) on the hepatic insulin resistance (HIR) in mice with GDM. METHODS: Healthy SPF C57BL/6J mice were selected to establish GDM model and divided into 7 groups: Normal group, Model group, NC-(negative control) mimic group, miR-22-3p mimic group, NC-pcDNA3.0 group, pcDNA3.0-Socs3 group, and miR-22-3p mimic + pcDNA3.0-Socs3 group. The islet morphology, and the expressions of miR-22-3p, Socs3 mRNA and Socs3 protein in the islet tissues were detected by HE staining, qRT-PCR and Western blot. Fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were measured. Oral glucose tolerance test (OGTT) was performed to detect FBG and fasting insulin (FINS) contents, and insulin resistance (HOMA-IR) was calculated. RESULTS: Compared with the Normal group, the model group had decreased levels of miR-22-3p and HDL-C, while increased levels of Socs3 mRNA and protein expressions, OGTT, FBG, FINS, and HOMA-IR, TG and TC (all P < 0.05). Compared with the Model group, the above indicators (OGTT, FBG, FINS, HOMA-IR, TG, TC and HDL-C) were improved in the miR-22-3p mimic group, but worsened in the pcDNA3.0-Socs3 group (all P < 0.05). CONCLUSION: miR-22-3p can down-regulate the expression of Socs3, thereby inhibiting HIR in GDM mice.
