Research of Arithmetic and Drawing Writing in Improving Communication and Cognitive Function in Patients with Mild-to-Moderate Dementia: A Cluster Randomized Controlled Trial.

Objective: The aim of the study was to investigate the effectiveness of arithmetic and drawing writing on communication skills, quality of life, and cognitive impairment among people with mild and moderate dementia. Methods: We recruited 45 patients diagnosed with mild-to-moderate dementia into this study. The participants were randomly divided into arithmetic group (n = 14), drawing writing group (n = 16), and control group (n = 15). The arithmetic group was educated to understand the addition and subtraction formulas, then wrote down the correct answers between the number of 20 and 100. The drawing writing group was guided to name, draw, and write a given object. Both were trained by therapist for 12 weeks (40 minutes per week). Blinded assessors measured global cognitive function, communication skills, and quality of life using Mini-Mental State Examination (MMSE) scale, the subscales of Functional Assessment of Communication Skills scale and Quality of Life-Alzheimer's Disease scale at baseline and after 12 weeks' intervention. Results: After the 12-week intervention, the participants with mild-to-moderate dementia of the arithmetic writing group and the drawing writing group showed statistically significant improvement in communication skills and quality of life compared with the control group (social communication: 6.00 ± 0.69 vs. 6.06 ± 0.92 vs. 3.98 ± 1.33; basic needs communication: 6.32 ± 0.48 vs. 6.42 ± 0.53 vs. 4.25 ± 1.49; quality of life: 33.23 ± 5.34 vs. 34.07 ± 3.49 vs. 25.07 ± 2.60). In addition, MMSE scores of the arithmetic group tended to improve after the 12-week intervention (14.77 ± 3.06 vs. 17.31 ± 4.80, P < .01), but stabled in drawing writing group (14.27 ± 4.28 vs. 14.53 ± 5.26, P > .05) and significant decreased in the control group (13.73 ± 2.58 vs. 10.13 ± 3.23, P < .01). Conclusion: Arithmetic, drawing, and writing are effective in improving communication skills and quality of life; arithmetic also could delay the decline of cognitive function in people with mild-to-moderate dementia.

Latent profiles of academic resilience in undergraduate nursing students and their association with resilience and self-efficacy.

AIM: This study aimed to investigate the heterogeneity of academic resilience among nursing students using latent profile analysis and its associated influencing factors. BACKGROUND: Nursing students experience higher levels of stress compared to their peers in other professions, and the cultivation of academic resilience plays a pivotal role in their ability to effectively cope with this stress. Academic resilience not only facilitates success in the face of academic adversity but also contributes to the promotion of mental well-being among nursing students. However, the current research on the academic resilience of nursing students has predominantly focused on a scale-centered total score approach, disregarding individual variability, and hindering the development to inform personalized interventions for enhancing academic resilience. DESIGN: A cross-sectional study. METHODS: A convenience sampling method was used to collect a total of 644 nursing students from two medical schools in Guangzhou City. The participants were recruited through an online survey conducted from January to March 2023. The questionnaires consisted of a general information form, the Chinese version of the Academic Resilience Scale-30 (C-ARS-30), the 10-item Connor Davidson Resilience Scale (CD-RISC-10), and the General Self-Efficacy Scale (GSES). Latent profile analysis was used to identify distinct categories of academic resilience among nursing students, and influencing factors were examined through ordinal logistic regression analysis. RESULTS: The academic resilience levels of nursing students can be divided into three potential categories: 'low academic resilience' (13.0%), 'moderate academic resilience' (70.0%), and 'high academic resilience' (17.0%). Level of grade, GPA, self-reported physical health level, resilience and self-efficacy were significantly influenced the different categories of academic resilience of nursing students (P<0.05). CONCLUSIONS: The majority of undergraduate nursing students were placed in the moderate academic resilience group, however, educational institutions should pay special attention to nursing students demonstrating low levels. Regular assessments of academic resilience are recommended, and personalized interventions should be tailored to address specific academic resilience characteristics across different grades of nursing students. Strategies aimed at enhancing academic resilience among nursing students may include improvements in GPA performance, attention to physical health, and the reinforcement of resilience and self-efficacy.

Chinese cross-cultural adaptation and validation of the Well-being Numerical Rating Scales.

Introduction: Well-being is a multi-domain concept that involves measuring physical, psychological, social, and spiritual domains. However, there are currently few multi-domain and comprehensive well-being instruments available. In addition, measures that do exist customarily contain a vast number of items that may lead to boredom or fatigue in participants. The Well-being Numerical Rating Scales (WB-NRSs) offer a concise, multi-domain well-being scale. This study aimed to perform the translation, adaptation, and validation of the Chinese version of WB-NRSs (WBNRSs-CV). Methods: A total of 639 clinical participants and 542 community participants completed the WB-NRSs-CV, the Single-item Self-report Subjective Well-being Scale (SISRSWBS), the World Health Organization Five-item Well-Being Index (WHO-5), the 10-item Perceived Stress Scale (PSS-10), and the Kessler Psychological Distress Scale (K10). Results: High internal consistency and test-retest reliability were obtained for both samples. Additionally, WB-NRSs-CV was positively associated with SISRSWBS and WHO-5 and negatively associated with PSS-10 and K10. In the item response theory analysis, the model fit was adequate with the discrimination parameters ranging from 2.73 to 3.56. The diffculty parameters ranged from -3.40 to 1.71 and were evenly spaced along the trait, attesting to the appropriateness of the response categories. The invariance tests demonstrated that there was no difference in WB-NRSs-CV across groups by gender or age. Discussion: The WB-NRSs-CV was translated appropriately and cross-culturally adapted in China. It can be used as a rapid and relevant instrument to assess well-being in both clinical and non-clinical settings, with its utility for well-being measurement and management among the Chinese people.

The impact of COVID-19 on stress and resilience in undergraduate nursing students: A scoping review.

BACKGROUND: Being a nursing student can be a stressful experience, faced with considerable academic and clinical demands. It has been suggested that the Coronavirus Disease 2019 (COVID-19) may have further exacerbated the pressure nursing students face. It has been posited that resilience, a complex psychological concept, may help nursing students overcome stressful situations. AIMS: The aim of this scoping review was to examine the relationship between resilience and stress in nursing students during the COVID-19 pandemic. METHODS: Relevant publications were identified by a comprehensive search of the literature from January 2019 to September 2022 to capture relevant publications during the COVID-19 global pandemic period from the following databases: CINAHL, Medline Complete, APA PsycInfo, Ovid EmCare and Web of Science. Fifteen studies met our inclusion criteria and were included in the review using Arskey & O'Malley's (2005) methodological framework for scoping reviews. RESULTS: Our findings suggest that nursing students from all around the world have experienced high levels of stress during the COVID-19 pandemic. Almost unanimously, resilience was identified as a key protective factor against stress and the development of psychological morbidity. Those nursing students with higher levels of resilience were deemed more likely to stay on track with their studies, despite COVID-related challenges. CONCLUSION: In conclusion, this scoping review adds to the well-established argument to incorporate resilience-building activities in undergraduate nursing curricula. Developing levels of resilience has the potential to empower nursing students for academic and clinical success, whilst facing the challenges of an ever-changing world.

Translation, cross-cultural adaptation, and validation of the Chinese version of the COVID-19 health literacy scale in nursing students.

BACKGROUND: Effective communication is an essential component of high-quality nursing care. Health literacy, the ability to access, describe, evaluate and apply health information to make informed decisions, is an important component of effective communication in nursing. Nurses, including student nurses, with good levels of health literacy (HL) are well positioned to communicate reliable public health-related information effectively, at times like the COVID-19 global pandemic. At this time, many nursing students have been at the frontline of patient education, as such, it would be expected that they have high levels of HL. However, it has been suggested that there is the need to improve HL levels in nursing students. AIMS: The aim of this study was to analyse the structure of item response of a back translated Chinese version of the COVID-HLS-Q22 questionnaire and to assess the coronavirus-related HLof Chinese speaking nursing students in Hong Kong using the COVID-HLS-Q22-CN. METHODS: A cross-sectional study of 97 undergraduate nursing students was conducted using two self-reported questionnaires. The HLS-EU-16 scale, with face validity already established, was used to assess scale equivalence Using a cross-over study approach, student participants were randomly assigned in sequential order. The validation process was performed in five phases: direct translation, translation synthesis, back translation, consolidation with experts, and testing with the students. The intended outcome of this study will be a formally tested model of the Chinese version of the COVID-HLS-Q22-CN, that can be replicated in Chinese population. RESULTS: Factorial equivalence was present across language versions in both questionnaires. Internal consistency was excellent for COVID-HLS-Q22-CN (coefficient alpha for Chinese version of questionnaire, 0.957 and English version, 0.953). This suggested that the four subscale are stable across the two questionnaires. CONCLUSION: The COVID-HLS-Q22-CN has proven to be a feasible and reliable tool in the assessment of Hong Kong based Chinese speaking nursing students. The emergence of issues around COVID-related HL further highlights the need to include the teaching of critical health literacy skills within nurse education, preparing the healthcare professionals of the future for public health emergencies.

The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Mindfulness yoga is a type of exercise that emphasizes the integration of mindfulness or meditation into yoga. The aim of this study was to determine the effectiveness of mindfulness yoga intervention on major depressive disorder (MDD) patients. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching nine databases, including PubMed, EMBASE, Web of Science, The Cochrane Library, MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang Data knowledge service platform, Chinese Biomedical Literature Database (CBM), and China Science and Technology Journal Database (VIP) from inception to April 2023. Primary outcomes included the severity of depression. Secondary outcomes included anxiety and rumination. RESULTS: Nine RCTs met our inclusion criteria (n = 581). The meta-analysis showed that mindfulness yoga significantly has a significant effect on depression (SMD = -0.53; 95%CI = -0.96 to -0.11; P < 0.05) among MDD patients. The only two RCTs involved also showed that mindfulness yoga could alleviate the anxiety level of MDD patients after intervention (SMD = -1.08; 95%CI = -1.64 to -0.52; P < 0.05). Meta-analysis did not reveal positive effects of the mindfulness yoga groups on rumination after intervention based on three RCTs (SMD = -0.33; 95%CI = -0.89 to 0.23; P > 0.05), but found a significant difference in the follow-up period based on two RCTs (MD = -7.42; 95%CI = -11.27 to -3.56; P < 0.05), compared with the control groups. CONCLUSION: Although we were unable to provide conclusive evidence to support the effectiveness of mindfulness yoga in improving symptoms in MDD patients, we found the literature included in this study indicated that mindfulness yoga might have a potential benefit for MDD patients and should be a feasible, acceptable, and promising intervention.

Psychometric properties of the Indonesian version of the nursing home survey on patient safety culture.

INTRODUCTION: The development of resident safety culture in nursing homes (NH) represents a major challenge for governments and NH owners, with a requirement for suitable tools to assess safety culture. Indonesia currently lacks suitable safety cultures scales for NH. OBJECTIVES: To evaluate the psychometric properties of the translated Indonesian version of the Nursing Home Survey on Patient Safety Culture (NHSOPSC-INA). METHODS: This study was a cross-sectional survey conducted using NHSOPSC-INA. A total of 258 participants from 20 NH in Indonesia were engaged. Participants included NH managers, caregivers, administrative staff, nurses and support staff with at least junior high school education. The SPSS 23.0 was used for descriptive data analysis and internal consistency (Cronbach's alpha) estimation. The AMOS (version 22) was used to perform confirmatory factor analysis (CFA) on the questionnaire's dimensional structure. RESULTS: The NHSOPSC CFA test originally had 12 dimensions with 42 items and was modified to eight dimensions with 26 items in the Indonesian version. The deleted dimensions were 'Staffing' (4 items), 'Compliance with procedure' (3 items), 'Training and skills' (3 items), 'non-punitive response to mistakes' (4 items) and 'Organisational learning' (2 items). The subsequent analysis revealed an accepted model with 26 NHSOPSC-INA items (root mean square error of approximation = 0.091, comparative fit index = 0.815, Tucker-Lewis index = 0.793, CMIN = 798.488, df = 291, CMIN/Df = 2.74, GFI = 0.782, AGFI = 0.737, p < 0.0001) and a factor loading value of 0.538-0.981. Expert feedback confirmed the relevance of the instrument items (content validity index [CVI] = 0.942). CONCLUSION: The modified NHSPOSC-INA model with eight dimensions (26 items) fits the data set in the context of Indonesian NH services. IMPLICATIONS FOR PRACTICE: The NHSPOSC-INA is a valid and reliable instrument for assessing staff perceptions of NH resident safety culture in Indonesia. The questionnaire can now be used to evaluate interventions for resident safety in Indonesian NH.

Resilience to depression: Implication for psychological vaccination.

From the vulnerability perspective, we often ask the question "why someone suffers from depression?" Despite outstanding achievements along this line, we still face high occurrence or recurrence and unsatisfied therapeutic efficacy of depression, suggesting that solely focusing on vulnerability perspective is insufficient to prevent and cure depression. Importantly, although experiencing same adversity, most people do not suffer from depression but manifest certain resilience, which could be used to prevent and cure depression, however, the systematic review is still lack. Here, we propose the concept "resilience to depression" to emphasize resilient diathesis against depression, by asking the question "why someone is exempted from depression?" Research evidence of resilience to depression has been reviewed systematically: positive cognitive style (clear purpose in life, hopefulness, et al.), positive emotion (emotional stability, et al.), adaptive behavior (extraversion, internal self-control, et al.), strong social interaction (gratitude and love, et al.), and neural foundation (dopamine circuit, et al.). Inspired by these evidence, "psychological vaccination" could be achieved by well-known real-world natural-stress vaccination (mild, controllable, and adaptive of stress, with help from parents or leaders) or newly developed "clinical vaccination" (positive activity intervention for current depression, preventive cognitive therapy for remitted depression, et al.), both of which aim to enhance the resilient psychological diathesis against depression, through events or training. Potential neural circuit vaccination was further discussed. This review calls for directing attention to resilient diathesis against depression, which offers a new thinking "psychological vaccination" in both prevention and therapy of depression.

Overlooked by nurses: A scoping review on health stressors, problems and coping of migrant domestic workers.

AIM: The first scoping review is to map and synthesize the stressors, problems and coping strategies surrounding the health issues of migrant domestic workers. DESIGN: Scoping review using Arksey and O'Malley's five-stage framework. METHODS: Ten electronic databases were systematically searched by keywords for literature published between January 1995 and December 2019. Data were extracted into tables and collated and summarized into themes for presentation. RESULTS: Twenty-seven reports were included in the final review. Analysis revealed that stressors to health included abuse, poor health service accessibility, ongoing financial hardship despite demanding working conditions and social isolation. Physical and mental health problems were identified for which migrant domestic workers largely depended on social networks and religion to cope with stressors and health problems. Training para-professional peer leaders of migrant domestic workers by community nurses and including them in interprofessional teams is a possible way for nurses to promote their health and well-being.

Development and validation of a brief version of the traditional Chinese Stressors in Nursing Students scale among college nursing students in Taiwan.

Objective: The 43-item Stressors in Nursing Students (SINS) scale has been evaluated among nursing students in several countries, including China, Hong Kong, Japan, Pakistan, and Spain. However, the original four-factor structure has not been consistently replicated in all of these populations. The aim of this study was to develop a brief version of the traditional Chinese SINS (TC-SINS) scale and to validate it in Taiwanese nursing students. Materials and Methods: Data obtained from a cross-sectional survey study of 814 nursing students in a nursing college and a university in Taiwan were randomly divided into two parts. The first part was used to conduct an exploratory factor analysis using principal axis factoring with oblique rotation. After the removal of cross-loading items, the resulting scale was validated with the data from the second part using confirmatory factor analysis. Results: A three-factor solution (social, clinical, and education) with 23 items accounting for 54.5% of variance was obtained in the exploratory factor analysis. The confirmatory factor analysis further reduced the number of items to 20. The goodness-of-fit indexes were good (Root Mean Square Error of Approximation = 0.075 and Comparative Fit Index = 0.90). Conclusions: The number of items in the TC-SINS could be reduced from 43 to 20, without sacrificing its psychometric properties. The brief version of TC-SINS might be able to reduce respondent burden.

Inpatient Dignity Scale: Mandarin translation and psychometric characteristics evaluation.

AIM: The aim of this paper was to translate the English version of the Inpatient Dignity Scale into Mandarin and to test the psychometric properties of the Mandarin version of the Inpatient Dignity Scale. DESIGN: This research is a cross-sectional survey, using convenience sampling. METHODS: The English version of the Inpatient Dignity Scale was translated into Mandarin Chinese. From June-August 2020, 736 inpatients from 50 tertiary hospitals in Guangzhou were recruited to assess the psychometric attributes of the Inpatient Dignity Scale. RESULTS: The Mandarin version of the Inpatient Dignity Scale consists of expectation and satisfaction subscales. It differs from the English language version, as the expectation subscale includes three dimensions and the satisfaction subscale includes two dimensions. The total Cronbach alpha coefficient of the expectation subscale and the satisfaction subscale were .820 and .965, respectively, and the split-half reliability of the expectation subscale and the satisfaction subscale were 0.740 and 0.928, respectively, indicating good internal consistency and effectiveness. Known-groups validity was established, as 70% of the hypotheses were supported.

Psychological distress experienced by nurses amid the fifth wave of the COVID-19 pandemic in Hong Kong: A qualitative study.

Introduction: The fifth wave of COVID-19 has significantly overburdened the health care system in Hong Kong. Health care professionals, particularly nurses continue to experience significant levels of psychological distress when tackling this ongoing outbreak. Yet, no study has explored the psychological experiences of nurses during the most recent outbreak of the highly transmissible Omicron variant in Hong Kong. The aim of this qualitative study was to explore the psychological distress experienced by nurses during the fifth wave of the COVID-19 pandemic in Hong Kong. Methods: Twenty-two nurses (14 female and 8 male nurses; average age, 36.7 ± 8.5 years) were recruited to attend the one-to-one semi-structured telephone interviews from June to July, 2022. Data were analyzed using thematic analysis. Results: Four main themes emerged from the interview: (1) Intense fear, worry, and anxiety; (2) Feeling worn out and psychologically distress; (3) Impact on psychosocial and physical health; and (4) Limited options to cope with psychological distress during the difficult times. Discussion: Our study findings may provide concerned stakeholders with useful insights into reducing the psychological distress experienced by nurses in Hong Kong. Offering psychological support is of paramount importance to address the unmet psychological needs of nurses and reduce their psychological distress during the pandemic, particularly when they are working under high levels of workplace stress.