A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China.

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

Development and validation of the Nurse Team Resilience Scale (NTRS) in the context of public health emergencies.

BACKGROUND: Team resilience can help nurse to respond positively to adversity at work and maintain normal team function in complex and unstable environments. However, much less research attention has been paid to team resilience than to individual resilience, and nurses lack reliable and valid tools to measure team resilience. This study aimed to develop and evaluate the psychometric properties of a scale that measures the nursing team resilience in the context of a public health emergency. METHODS: The study was conducted in three stages that item development, scale development, and scale evaluation. This scale was based on that of Morgan and Sharma et al. proposed four-factor team resilience model, and the draft scale was generated based on the literature review, existing scales, experts' validations, and cognitive interviews. During July 2022 to August 2022, the construct validity and the internal consistency reliability of the NTRS were evaluated through an online survey of 421 nurses. RESULTS: The 8-item NTRS scale has good reliability and validity and is suitable for measuring the nurse team resilience. The EFA found a common factor solution and explained 72.33% of the common varianc and the CFA score showed construct validity. Reliability of the internal consistency of the scale with a good Cronbach alpha of 0.94. CONCLUSION: This scale can assess team resilience in nurses that nursing education and management resources can be allocated to improve policies and training programs to provide effective positive support to nurses in challenging workplace situations and to enable greater health systems resilience in the future.

Empowered But Isolated: A Qualitative Research on Experiences of Family Caregivers of Patients With Acute Heart Failure in China.

BACKGROUND: Family caregivers play crucial roles in the self-management of patients with heart failure (HF). However, little is known about caregiving experiences of Chinese family caregivers during acute HF. OBJECTIVE: The aim of this study was to describe Chinese family caregivers' experiences in symptom management and care-seeking during acute HF. METHODS: This is an exploratory, qualitative study using the Consolidated Criteria for Reporting Qualitative Research guidelines. Data were collected through semistructured interviews and analyzed with thematic analysis. FINDINGS: A total of 21 family caregivers of patients with acute HF were enrolled in this study. "Empowered but isolated" was identified as the overarching theme during data analysis, including 3 themes and 6 subthemes: (1) "Responsible symptom managers: leading the home-based symptom management," including 2 subthemes, "Proxy in symptom management" and "Only knowing the surface, instead of the truth"; (2) "Powerless anchors: care-seeking is a torturous journey," including 2 subthemes, "Facing discrepancies in care-seeking" and "Seeing a doctor is the last choice"; (3) "Carrying the weight forward: responsibility combing with emotional burnout," including 2 subthemes, "Living on tenterhooks" and "Submitting to fate." CONCLUSIONS: In this study, we described Chinese family caregivers' experiences in symptom management and care-seeking during acute HF. Although empowered as proxy, they were also isolated bearing a great burden, receiving insufficient support from patients, family, and the medical system.

Effects of heated humidification on positive airway pressure side effects in patients with obstructive sleep apnoea: a meta-analysis.

PURPOSE: An earlier study found that heated humidification reduced the side effects of positive airway pressure (PAP) in patients with obstructive sleep apnoea (OSA). However, other studies disagreed with this finding. Therefore, we evaluated the relationship between heated humidification and the side effects of PAP in patients with OSA. METHODS: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, six databases were searched for relevant randomised controlled trials (RCTs) performed from January 1999 to June 2021. RESULTS: From 1012 retrieved articles, we identified 9 eligible RCTs. Compared to the control group, the heated humidification group reported improvements in dry nose (pooled standardised mean difference [SMD] = - 0.70, 95% confidence interval [CI] = - 0.96 to - 0.45, I2 = 0%, p < 0.00001), blocked nose (SMD = - 0.47, 95%CI - 0.69 to - 0.25, I2 = 36%, p < 0.0001), runny nose (SMD = - 0.22, 95%CI - 0.44 to 0, I2 = 0%, p = 0.05), dry mouth (SMD = - 0.62, 95%CI - 0.87 to - 0.37, I2 = 0%, p < 0.00001), and dry throat (SMD = - 0.61, 95%CI - 0.90 to - 0.33, I2 = 41%, p < 0.0001), but did not enhance positive airway pressure adherence (pooled mean difference [MD] = 0.24, 95% CI - 0.10 to 0.58, I2 = 0%, p = 0.17). CONCLUSIONS: Heated humidification improved some PAP side effects in patients with OSA but did not increase PAP adherence. Additional large-scale multi-centre RCTs are needed to verify the long-term effects.

The Prevalence and Influencing Factors of Postpartum Depression Between Primiparous and Secundiparous.

ABSTRACT: Since the implementation of "two-child policy" in China, the prevalence and influencing factors of postpartum depression (PPD) between women at first childbirth and second childbirth remains unclear. We aimed to compare the prevalence and the influencing factors of PPD between the two groups. Postpartum women were recruited at their 6-week postpartum checkups and invited to complete questionnaires. The prevalence rate of PPD was 42.1%. There was no statistical difference found regarding the prevalence of PPD and the total score on the Edinburgh Postnatal Depression Scale between the two groups. The median of the item "self-injury" was significantly higher among women at first childbirth. Women with gestational diabetes in pregnancy, antenatal anxiety and depression, abortion, having babies getting sick occasionally, and deteriorated relationships with partner in pregnancy had much higher risks for PPD. Both primiparous and secundiparous had a high prevalence of PPD. It provides scientific evidence for clinical preventive and nursing care for PPD.

Characteristics of workplace violence, responses and their relationship with the professional identity among nursing students in China: a multicenter cross-sectional study.

BACKGROUND: Nursing students are one of the most vulnerable groups suffering from workplace violence. This study aimed to investigate the workplace violence incidence of Chinese nursing students during clinical practice, to describe the characteristics of violence and students' responses and to analyse the relationship between the experience of workplace violence and professional identity. METHODS: A cross-sectional study was conducted among 954 nursing students in ten universities in China through convenience sampling. Workplace violence was surveyed through Hospital Workplace Violence Questionnaire for Nursing Students. Students' professional identity was measured by Professional Identity Questionnaire for Nursing Students. Statistical methods included descriptive statistics, chi-square test, independent-samples t-test, analysis of variance and linear regression analysis. RESULTS: It was found that the incidence of workplace violence among nursing students was 42.98%. The violent incidents ranking from high to low were: verbal abuse, threat, physical attack, sexual harassment, and gathering disturbance. The majority of the nursing students chose to avoid the conflict during the incident. 86.34% of the students didn't report the incidents. More than half of the victims developed post-traumatic stress disorder after the incidents. Regression analysis results showed that workplace violence experience (ß = - 0.076, P < 0.05) was a significantly negative predictor of professional identity. CONCLUSIONS: Chinese nursing students were exposed to physical and psychological violence during clinical practice with insufficient coping solutions and psychological adjustment. The professional identity of the nursing students was significantly associated with the experience of workplace violence.

The Effects of the Solution-Focused Model on Anxiety and Postpartum Depression in Nulliparous Pregnant Women.

Background: Solution-focused model (SFM) is an intervention method that fully mobilizes patients' initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression (PPD) in nulliparous pregnant women compared with routine care services. Methods: We chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale (EPDS) at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group took the regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire. Results: Compared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group (p = 0.0046). Conclusion: In conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women.

Thirst and factors associated with thirst in hospitalized patients with heart failure in China.

BACKGROUND: Thirst is a distressing symptom and increases burden of the patients with heart failure (HF). Knowledge about thirst in HF patients is still not clear in China. OBJECTIVE: To describe thirst intensity, distress, frequency, and duration and to identify factors associated with thirst intensity in hospitalized HF patients in China. METHODS: A cross-sectional descriptive study was conducted in two public hospitals in Shanghai, China. Patients were recruited in cardiology wards. Sociodemographic and clinical data were collected by the social-demographic and disease-related questionnaire. Thirst was assessed by Visual Analog Scale (VAS, 0-100 mm), Thirst Distress Scale for HF patients (scores 8 to 40) and three questions about thirst frequency and duration. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. RESULTS: Four hundred and thirty-one patients participated in this study. Their mean (SD) thirst intensity was 47 (±22) mm, and the thirst distress was 21(±4). It was found that 75% patients had moderate to severe feeling in thirst intensity and 73% in distress. Most patients experienced thirst several times a week (33%) or several times a month (38%). Most patients (88%) felt thirst for one hour or less. The most intense thirst occurred in the morning (26%), afternoon (19%) and before sleeping (16%). Factors associated with thirst were omeprazole, renal insufficiency, coronary heart disease, high NYHA class and low room humidity. No links were found between physiological indicators of HF (ProBNP) and thirst. CONCLUSIONS: HF patients have strong sense of thirst. However, it is rarely identified by healthcare professionals. It is crucial for healthcare providers to keep an eye on patients' thirst symptoms. More attention should be paid to patients with thirst risk factors to minimize the discomfort of thirst.

Effects of telemedicine interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials.

PURPOSE: This meta-analysis was conducted to assess the effects of telemedicine interventions on continuous positive airway pressure (CPAP) adherence in patients with obstructive sleep apnoea (OSA). METHODS: The PubMed, Cochrane Library, OVID, Web of Science and EBSCO host databases were searched from January 2004 to February 2020 for randomised controlled trials (RCTs) that assessed the effects of telemedicine interventions on CPAP adherence in patients with OSA. The study inclusion criteria were RCTs that compared patients who received telemedicine interventions with a control group and reported a change in CPAP adherence. The primary outcome was the improvement in CPAP adherence. RESULTS: In total, there were 11 RCTs (n = 1358) with quantitative analyses. Intervention times ranged from 1 to 6 months. Compared to controls, the telemedicine group exhibited better adherence to CPAP therapy (pooled mean difference (MD) = 0.57, 95% CI = 0.33 to 0.80, I2 = 7%, p < 0.00001). We performed sensitivity analyses by the type of telemedicine intervention, comorbidity burden, and OSA severity to explore whether or not their effect sizes may have affected the time of CPAP application. We performed subgroup analyses by follow-up duration, age, and OSA Epworth sleepiness scale (ESS) symptoms to determine if their effect sizes may have affected the time of CPAP application. However, these analyses did not change the statistical significance of the pooled estimate. CONCLUSIONS: The use of telemedicine for up to 6 months may enhance CPAP adherence in patients with OSA, when compared to no intervention. Our study was searched from January 2004 to February 2020 for randomised controlled trials (RCTs) that assessed the effects of telemedicine interventions on CPAP adherence in patients with OSA. Future studies can continue to search for articles after February 2020.

Facility-Level Case Report of Nursing Care Processes for Patients With Suspected 2019 Novel Coronavirus Disease in Shanghai, China.

INTRODUCTION: Coronavirus disease emerged in Wuhan, China, on December 31, 2019, and spread rapidly worldwide. Few studies have described the nursing care provided to patients in isolation between suspicion of having the disease and a confirmed diagnosis. The purpose of this study was to describe the treatment of, and nursing care processes for, patients suspected, but not yet confirmed, of having coronavirus disease at 1 facility in Shanghai, China. METHODS: For this retrospective facility case review and patient health record study, data were collected on all patients with suspected coronavirus disease who were treated between January 22, 2020, and February 29, 2020, at 1 hospital. The facility's nursing care processes were described in detail. RESULTS: A total of 119 patients were suspected of having coronavirus disease on the basis of the screening criteria. Nine (7.6%) patients had confirmed coronavirus disease and were transferred to a higher level of care. The remaining 110 (92.4%) were treated and discharged. No cross-infection between patients and hospital staff or other patients was detected. The patients' symptoms included fever (n = 98, 82.4%), cough (n = 79, 66.4%), dizziness (n = 28, 23.5%), headache (n = 26, 21.8%), fatigue (n = 26, 21.8%), myalgia (n = 16, 13.4%), rhinorrhea (n = 6, 5.0%), diarrhea (n = 5, 4.2%), severe nasal congestion (n = 4, 3.4%), and dyspnea (n = 1, 0.8%). DISCUSSION: Coronavirus disease is very contagious. Nurses need to understand the symptoms and treatment of the disease as well as nursing procedures, and learn how to cut off transmission routes, control transmission sources, and use protective equipment correctly to prevent transmission of the disease within the hospital.

[Evaluation of multimodal analgesia in treatment of avascular necrosis of femoral head with free vascularized fibular grafting].

OBJECTIVE: To prospective study the effectiveness and safety of multimodal analgesia (MA) in treatment of avascular necrosis of the femoral head with free vascularized fibular grafting (FVFG). METHODS: Sixty patients with avascular necrosis of the femoral head, who were scheduled to unilateral primary FVFG between February 2016 and December 2016 and met the selection criteria, were included in the study. All patients were allocated to two groups according to the method of random number table: MA group ( n=30) and control group ( n=30). There was no significant difference in gender, age, body mass index, side, duration and stage of avascular necrosis of the femoral head, preoperative visual analogue scale (VAS) scores under quiescent and active states, and range of motion (ROM) of hip flexion and abduction before operation ( P>0.05). The patients in the MA group were treated with MA therapy, including oral administration of celecoxib before operation, local anesthetic wound infiltration during operation, and ice compression and oral administration of celecoxib after operation. The patients in control group were only treated with patient-controlled intravenous analgesia pump. The postoperative VAS scores under quiescent and active states, ROM of hip flexion and abduction, prescription of Tramadol and adverse reaction were recorded and compared. RESULTS: The operations were completed successfully in both groups without obvious complications and adverse reaction. The Tramadol was used in 4 cases (13.3%) of MA group and in 11 cases (36.7%) of control group, but no significant difference was found between the two groups ( χ 2=4.356, P=0.072). The VAS scores under quiescent state at 6 and 24 hours postoperatively were significantly lower in MA group than in control group ( P<0.05), while VAS scores under active state at 48 hours postoperatively and on the day of discharge were significantly lower in MA group than in control group ( P<0.05). There was no significant difference in VAS score between two groups at other time points ( P>0.05). The ROM of hip flexion in MA group was better than that in control group at 1 day postoperatively and the day of discharge ( P<0.05), while no significant difference was found at 2 and 3 days postoperatively ( P>0.05). The ROM of hip abduction in MA group was superior to the control group at 1, 2, and 3 days postoperatively and the day of discharge ( P<0.05). CONCLUSION: The MA can effectively relieve the pain following FVFG and facilitate early functional exercises of the hip. The usage of opioids was also relatively fewer for MA protocol.

Fondaparinux vs. enoxaparin for the prevention of venous thromboembolism after total hip replacement: A meta-analysis.

The aim of the study was to compare the efficacy and safety profiles of fondaparinux and enoxaparin in preventing the venous thromboembolism (VTE) after total hip replacement. A systematic literature search in the PubMed, EMBASE and Cochrane library databases was performed to identify relevant articles published in English since inception up to November 16, 2014. The efficacy outcomes were all VTE, total deep vein thrombosis (DVT) and symptomatic VTE, while the safety outcome was major bleeding. Four eligible studies were included in the meta-analysis. The incidences of total VTEs and DVTs were significantly decreased with the use of fondaparinux when compared to enoxaparin [total VTE: risk ratio (RR)=0.59, 95% confidence interval (CI): 0.46-0.74, P<0.01; total DVT: RR=0.58, 95% CI: 0.46-0.74, P<0.01]. Significantly fewer symptomatic VTEs and major bleeding cases were observed for the enoxaparin group (symptomatic VTE: RR=2.62, 95% CI: 1.07-6.45, P=0.04; major bleeding: RR=1.75, 95% CI: 1.20-2.53, P<0.01). In conclusion, the pooled analysis revealed that, compared to enoxaparin, fondaparinux was significantly more effective in preventing VTE after total hip replacements in terms of total VTEs and DVTs, although this was accompanied with an increased risk of major bleeding. However, the pooled analysis of two small sample trials from Japan failed to demonstrate any significant advantage for fondaparinux compared to enoxaparin.