The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave.

The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.

Nurse staffing levels make a difference on patient outcomes: a multisite study in Chinese hospitals.

PURPOSE: The purpose of this study is to examine the relationship between nurse staffing and patient outcomes in hospitals in mainland China. METHODS: The study was conducted in 181 hospitals across all of the eight economic zones in mainland China using a four-stage sampling design. Two instruments, the China Nurse Survey and the patient satisfaction measurement from the Hospital Consumer Assessment of Healthcare Providers and Systems, were employed in data collection. In this article, 7,802 nurse surveys and 5,430 patient surveys from 600 medical and surgical units were analyzed. RESULTS: The adjusted joint effects of nurse staffing on patient outcomes from logistic regression analyses showed that more nursing staff per patient had statistically significant positive effects on all necessary nursing care, nurses' reports of quality of care, their confidence on patients' self-care ability on discharge from the hospital, patient adverse events, as well as patients' report of satisfaction. When the nurse-to-patient ratio (total number of nurses on all shifts on the unit divided by total number of patients who stay on the unit) increased to the 0.5-<0.6 category, most patient outcomes were significantly improved, considering hospital and patient factors and nurse skill mix in the logistic regression models. CONCLUSIONS: The findings provide evidence on how inadequate nurse staffing might result in missed but needed nursing care and negative patient outcomes, while better staffing levels could be an effective strategy for improving patient outcomes. CLINICAL RELEVANCE: We recommend that the nurse-to-patient ratio on medical and surgical units in Chinese hospitals be increased to at least 0.5-0.6 so as to secure patient safety and the quality of health services.

[Transmission disequilibrium test for 15 short tandem repeat loci in Kashin-Beck disease and their interaction with low selenium].

OBJECTIVE: To identify the genetic susceptibility to Kashin-Beck disease (KBD) and explore the interaction between low selenium (Se) and the susceptibility gene loci in KBD. METHODS: The DNA samples collected from 23 KBD nuclear families were analyzed using PCR and GeneScan Analysis 3.7 and Genotyper3.7 software. The haplotype relative risk (HRR) and transmission disequilibrium test (TDT) were used to test the data of the genotypes. The serum selenium (Se) concentration was measured by atomic fluorescence spectrometry, and the interaction between low Se and the susceptibility loci was calculated using a binary logistic regression. RESULTS: In the 23 nuclear families, the alleles of D2S151 (248 bp), D2S305 (320 bp), and D11S4094 (194 bp) showed significant correlation to KBD (P<0.05). Serum Se concentrations in the studied individuals was 0.037 µg/ml. No significant statistical interaction was observed between low Se exposure and the susceptibility loci (P>0.05). CONCLUSION: The polymorphisms in the STR loci D2S305, D2S151, and D11S4094 or the polymorphism loci near them might been related to KBD susceptibility. Low Se exposure shows no significant interaction with the susceptibility loci.