The effect of sense of security on job performance of medical staff: the mediating effect of psychological capital.

Objective: To investigate the current situation of sense of security, psychological capital and job performance of medical staff in Guangdong Province, and to explore the mediating role of psychological capital on the relationship between sense of security and job performance of medical staff. Methods: In this study, 969 health care workers were selected from February 2023 to April 2023 from 37 hospitals in Guangdong Province, China, using purposive sampling method. The Sense of Security Scale for Medical Staff (SSS-MS), psychological capital scale (PCS) in Chinese version and the Chinese version of job performance scale (JPS) were used in this study. We use SPSS 26.0 for statistical analysis and Amos 24.0 for structural equation modeling (SEM). The control variables entering SEM were selected by regression analysis. SEM analysis confirmed psychological capital scale's mediating function in the link between work performance scale and Sense of Security. Results: The overall SSS-MS, PCS, and JPS scores were 67.42 ± 16.136, 87.06 ± 15.04, and 77.87 ± 10.50, respectively. The results of Pearson's correlation analysis showed that there was a positive relationship between PCS and JPS (r = 0.722, P < 0.01), SSS-MS and JPS (r = 0.312, P < 0.01), and SSS-MS and PCS (r = 0.424, P < 0.01). PCS demonstrated a fully mediating influence on the link between medical workers' SSS-MS and JPS, according to structural equation modeling. Conclusion: The JPS of medical personnel in Guangdong Province is at a medium level, with much room for improvement. PCS is positively impacted by a sense of security. There is a supportive correlation between PCS, JPS, and SSS-MS. Furthermore, PCS fully mediates the relationship between medical staff members' JPS and their SSS-MS. The Job Diamond-Resource model and Conservation of Resource theory are further validated and supplemented by the findings of this study, which also gives managers a theoretical foundation for enhancing medical staff performance.

The mediating role of resilience between perceived social support and sense of security in medical staff following the COVID-19 pandemic: A cross-sectional study.

Background: The COVID-19 pandemic not only posed a serious threat to public life and health but also had a serious impact on people's mental health, especially that of medical staff. Perceived social support is an important factor in one's sense of security. Objective: Following the COVID-19 pandemic, the goal is to explore the potential mediating role of resilience in the relationship between perceived social support and the sense of security of Chinese medical personnel. Methods: The multi-stage proportionally stratified convenience sampling method was adopted to select 4,076 medical professionals from 29 hospitals in Guangdong Province between September 2020 and October 2020. The Sense of Security Scale for Medical Staff, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale were employed in this study. For statistical analysis and structural equation modeling (SEM), the SPSS 23.0 and Amos 24.0 software packages were used. Regression analysis was used to select the control variables to be included in the SEM. SEM analysis was conducted to verify the mediating effect of resilience on the relationship between perceived social support and a sense of security. Results: Pearson's correlation analysis showed that perceived social support and resilience were positively associated with a sense of security (correlation coefficients range from 0.350 to 0.607, P < 0.01), and perceived social support (correlation coefficients range from 0.398 to 0.589, P < 0.01) was positively associated with resilience. Structural equation modeling revealed that resilience played a partial mediating role in the association between perceived social support and a sense of security (60.3% of the effect of perceived social support on security was direct, and 39.7% of the effect was mediated by resilience). Conclusions: Hospital managers should make efforts to develop resilience. Interventions based on resilience should be developed to enhance the perception of social support and strengthen one's sense of security.

Job security among healthcare workers in Guangdong, China.

Objective: The objective of this study was to explore the sense of job security and its influencing factors among healthcare workers in Guangdong, China. Methods: This cross-sectional study used stratified random sampling to enroll healthcare workers employed by hospitals across Guangdong province between September 2020 and October 2020. Results: A total of 4,173 questionnaires were distributed, and 4,076 were returned for an effective recovery rate of 97.68%. The overall score for the sense of security was 64.85 ± 20.09, and the item means score was 2.95 ± 0.91. Multiple-linear regression analysis showed that work experience (years), education level, job position, specialty unit, employment type, marital status, job satisfaction, WPV frequency, daily sleep duration, weekly overtime hours, average monthly earnings (RMB), hospital level, and region were significantly associated with senses of poor security among healthcare workers (all P < 0.05). Conclusions: Hospital workers in Guangdong reported relatively low levels of job security. Levels of job security were significantly associated with multiple factors which could be addressed by hospital practices to improve the sense of job security among healthcare workers.

The impact of nurses' sense of security on turnover intention during the normalization of COVID-19 epidemic: The mediating role of work engagement.

Background: COVID-19 pandemic has entered a normal stage in China. During this phase, nurses have an increased workload and mental health issues that threaten the sense of security. Poor sense of security may have a considerable impact on turnover intention through low work engagement. It was challenging to maintain the nurse workforce. Fewer studies have been conducted on the effect of nurses' sense of security on their turnover intention in that phase. This study aimed to investigate the interrelationship between nurses' sense of security, work engagement, and turnover intention during the normalization phase of the epidemic in China and to explore the impact of sense of security on turnover intention. Methods: A cross-sectional survey was conducted from September 2020 to May 2021 in Guangdong Province, China. Data were collected online using Sense of Security Scale for Medical Staff (SSS-MS), Utrecht Work Engagement Scale (UWES), and Turnover Intention Scale. Pearson's correlation analysis was used to assess the correlation between sense of security, work engagement, and turnover intention. The hypothesis model used multiple linear regression models and the bootstrapping procedure to analyze the relationship between these variables. Results: Data were collected from 2,480 nurses who met the inclusion criteria. Over half(64.5%) of nurses had a high and very high turnover intention. After controlling the demographic and working variables, sense of security (ß = 0.291, P < 0.001) had a direct positive effect on work engagement. Sense of security (ß = -0.447, P < 0.001) and work engagement (ß = -0.484, P < 0.001) had a direct negative effect on turnover intention. Sense of security and all of its components were associated with turnover intention through the partially mediating effects of work engagement. Conclusions: Nurses' turnover intention was at a high level during the normalization phase of the epidemic. Sense of security and its components act as positive resources to reduce turnover intention by improving work engagement. Policy makers and managers may pay attention to the needs of nurses' sense of security, which may be a new perspective to help managers reduce their turnover intention and stabilize the nurse team.

Factors associated with poor mental health outcomes in nurses in COVID-19-designated hospitals in the postepidemic period in Guangdong Province: a cross-sectional study.

OBJECTIVE: The early days of the COVID-19 pandemic placed enormous pressure and subsequent negative psychological problems on nurses, but at this stage of the year-long COVID-19 outbreak, the level of stress and negative emotions that nurses experience is unclear. Our study attempted to assess the factors influencing mental health status in nurses during the postepidemic period of COVID-19. DESIGN: Cross-sectional study. SETTING: COVID-19 designated hospitals. PARTICIPANTS: 1284 Chinese nurses. MAIN OUTCOME MEASURES: Electronic questionnaires, including the Chinese version of the Perceived Stress Scale (CPSS) and Symptom Checklist-90 (SCL-90), were distributed for self-evaluation. Regression analysis was used to analyse the associated factors of psychological stress among variables such as age, years of nursing experience, weekly working hours, anxiety symptoms, somatisation symptoms and compulsive symptoms. RESULTS: A total of 1284 respondents from COVID-19-designated hospitals in Guangdong Province were studied. The average CPSS score for all respondents was 22.91±7.12. A total of 38.5% of respondents scored ≥26 on the CPSS, indicating a significant degree of psychological stress. Nurses with high psychological stress had higher levels of anxiety symptoms (41.7% vs 8.0%), somatisation symptoms (31.4% vs 7.7%) and compulsion symptoms (62.3% vs 27.0%) than nurses with low psychological stress. Stepwise multiple linear regression revealed that weekly working hours, years of nursing experience, anxiety symptoms, somatisation symptoms and compulsion symptoms had a linear relationship with the participants' psychological stress scores. CONCLUSION: Nurses experienced significant physical and psychological risk while working in the postepidemic period. Our findings suggest that nurses still need support to protect their physical and mental health.

The psychological impact of COVID-19 pandemic on medical staff in Guangdong, China: a cross-sectional study.

BACKGROUND: During previous pandemic outbreaks, medical staff have reported high levels of psychological distress. The aim of the current study was to report a snapshot of the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic and its correlated factors on medical staff in Guangdong, China. METHODS: On the 2nd and 3rd February 2020, soon after the start of the COVID-19 pandemic, we surveyed medical staff at four hospitals in Guangdong, China, to collect demographic characteristics, Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-14), and Insomnia Severity Index (ISI) scores. RESULTS: Complete responses were received from 1045 medical staff. Respondents were divided into high- and low-risk groups according to their working environment of contacting with potential or confirmed COVID-19 cases. The proportion of staff with anxiety (55.4% v. 43.0%, p < 0.001) or depression (43.6% v. 36.8%, p = 0.028) was significantly higher in the high-risk group than the low-risk group. The percentage of staff with severe anxiety was similar in the two groups. Doctors were more susceptible to moderate-to-severe depressive symptoms. The high-risk group had higher levels of clinical insomnia (13.5% v. 8.5%, p = 0.011) and were more likely to be in the upper quartile for stress symptoms (24.7% v. 19.3%, p = 0.037) than the low-risk group. Additionally, work experience negatively correlated with insomnia symptoms. CONCLUSIONS: It is important for hospitals and authorities to protect both the physical and psychological health of medical staff during times of pandemic, even those with a low exposure risk.

Detection of deteriorating patients after Whipple surgery by a modified early warning score (MEWS).

BACKGROUND: The modified early warning score (MEWS) was set up to supply prompt recognition of clinically deteriorating patients before they undergo a severe and life-threatening event. The study aimed to describe the probable usefulness of the MEWS in identifying deteriorating post-Whipple patients in hospital wards. METHODS: We performed a study to analyze the relationship between the vital parameters and postoperative severe adverse events of patients after Whipple surgery in Guangdong Provincial People's Hospital from 2000 to 2017. In the retrospective study, a total of 13,651 sets of vital parameters in 236 Whipple postoperative patients were included. Subsequently, we applied a MEWS scoring system and explored the accuracy of the MEWS in evaluating the patients' final events versus advanced mathematical models. We then put the MEWS into the ward warning system and confirmed the accuracy of the MEWS based on the results of prospective studies again. RESULTS: We assessed the ability of the MEWS to predict postoperative complications with an accuracy rate of 90.86-91.23%, a sensitivity of 83.04-90.88%, and a specificity of 90.85-95.73%. CONCLUSIONS: The MEWS model was applied to identify post-Whipple patients at risk of complication. Once the MEWS ≥2, interventions were needed to minimize the adverse events. Our data suggest that the MEWS is comparable to the advanced mathematical models, but MEWS is more accessible to perform and more generally applicable.

Validation of the Chinese version of the Quality of Nursing Work Life scale.

Quality of Nursing Work Life (QNWL) serves as a predictor of a nurse's intent to leave and hospital nurse turnover. However, QNWL measurement tools that have been validated for use in China are lacking. The present study evaluated the construct validity of the QNWL scale in China. A cross-sectional study was conducted conveniently from June 2012 to January 2013 at five hospitals in Guangzhou, which employ 1938 nurses. The participants were asked to complete the QNWL scale and the World Health Organization Quality of Life abbreviated version (WHOQOL-BREF). A total of 1922 nurses provided the final data used for analyses. Sixty-five nurses from the first investigated division were re-measured two weeks later to assess the test-retest reliability of the scale. The internal consistency reliability of the QNWL scale was assessed using Cronbach's α. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC). Criterion-relation validity was assessed using the correlation of the total scores of the QNWL and the WHOQOL-BREF. Construct validity was assessed with the following indices: χ2 statistics and degrees of freedom; relative mean square error of approximation (RMSEA); the Akaike information criterion (AIC); the consistent Akaike information criterion (CAIC); the goodness-of-fit index (GFI); the adjusted goodness of fit index; and the comparative fit index (CFI). The findings demonstrated high internal consistency (Cronbach's α = 0.912) and test-retest reliability (interclass correlation coefficient = 0.74) for the QNWL scale. The chi-square test (χ2 = 13879.60, df [degree of freedom] = 813 P = 0.0001) was significant. The RMSEA value was 0.091, and AIC = 1806.00, CAIC = 7730.69, CFI = 0.93, and GFI = 0.74. The correlation coefficient between the QNWL total scores and the WHOQOL-BREF total scores was 0.605 (p<0.01). The QNWL scale was reliable and valid in Chinese-speaking nurses and could be used as a clinical and research instrument for measuring work-related factors among nurses in China.

Perceived stigma, medical social support and quality of life among people living with HIV/AIDS in Hunan, China.

PURPOSE: The present study aimed at examining the relationships among perceived stigma, social support, and quality of life (QOL) in people living with HIV (PLWH). METHODS: We recruited 190 participants meeting the inclusion criteria from two HIV clinics in Hunan, China. HIV-related Stigma Scale, the Chinese Version of the Medical Outcomes Study - Social Support Survey (MOS-SSS-C), and the Medical Outcomes Study-HIV (MOS-HIV) were used to measure the perceived stigma, social support and QOL in PLWH. RESULTS: The mean scores of the perceived stigma, social support, and QOL were 104.32, 53.63, and 61.97 respectively, which were in moderate range. Stepwise multivariate regression analysis showed (R(2)=.49, p<.01) a low score of internalized stigma and family stigma, a high score of tangible support for non-drug use and antiretroviral treatment, and high CD4 count predicted better QOL. CONCLUSION: Perceived stigma and social support are correlated with the QOL in PLWH. Interventions designed to decrease perceived stigma and strengthen social support from family are necessary to improve the QOL in PLWH.

Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy.

PURPOSE: To develop a predictive model for circuit clotting in patients with continuous renal replacement therapy (CRRT). METHODS: A total of 425 cases were selected. 302 cases were used to develop a predictive model of extracorporeal circuit life span during CRRT without citrate anticoagulation in 24 h, and 123 cases were used to validate the model. The prediction formula was developed using multivariate Cox proportional-hazards regression analysis, from which a risk score was assigned. RESULTS: The mean survival time of the circuit was 15.0 ± 1.3 h, and the rate of circuit clotting was 66.6 % during 24 h of CRRT. Five significant variables were assigned a predicting score according to the regression coefficient: insufficient blood flow, no anticoagulation, hematocrit ≥0.37, lactic acid of arterial blood gas analysis ≤3 mmol/L and APTT < 44.2 s. The Hosmer-Lemeshow test showed no significant difference between the predicted and actual circuit clotting (R (2) = 0.232; P = 0.301). CONCLUSIONS: A risk score that includes the five above-mentioned variables can be used to predict the likelihood of extracorporeal circuit clotting in patients undergoing CRRT.