[Risk Factors for Returning of Pediatric Liver Transplant Recipients to the Intensive Care Unit].

Objective To explore the risk factors for the returning of pediatric liver transplant recipients to the intensive care unit (ICU) and provide reference for the clinical decision-making after surgery. Methods A retrospective analysis was conducted with the information of all the pediatric patients who underwent liver transplantation in Ren Ji Hospital,Shanghai Jiao Tong University School of Medicine and were returned to the ICU from 2019 to 2021.The patients returned to the ICU during hospitalization and the reasons for the return were recorded.Each patient of ICU return was matched with three pediatric patients who did not return to the ICU during hospitalization.The basic information,the vital signs and laboratory indicators on the day of transfer from ICU,immunosuppressants and drug concentrations were compared between the two groups.Multivariate Logistic regression analysis was performed to explore the risk factors for the returning of pediatric liver transplant recipients to the ICU. Results The returning rate of pediatric liver transplant recipients to the ICU was 4.36%,and it was 16.00% within 48 h.The main reasons for the return included respiratory complications,abdominal infections,and hepatic vascular occlusion.Multivariate Logistic regression analysis showed that post-operative red blood cell transfusion (OR=4.554,95%CI=1.743-11.901,P=0.002) and high serum level of uric acid (OR=1.005,95%CI=1.001-1.009,P=0.014) were the risk factors for returning to the ICU.High diastolic blood pressure (OR=0.922,95%CI=0.885-0.960,P<0.001) and high total protein level (OR=0.937,95%CI=0.891-0.986,P=0.012) were the protective factors for returning to the ICU. Conclusion Post-operative red blood cell transfusion and high serum level of uric acid are independent risk factors for the returning of pediatric liver transplant recipients to the ICU.

The moderating effect of cultural intelligence between nurses' relationship conflict and teamwork.

AIMS: To determine if there is a moderating effect of cultural intelligence between the conflict of nursing relationships and teamwork. BACKGROUND: Relationship conflicts that exist in the nursing teamwork cannot be ignored. It would lead to poor teamwork and impact on patients' poor outcomes. In the meantime, cultural intelligence has been proven that people who have a higher cultural intelligence can do better at the work. METHODS: The sample included 550 clinic nurses from five different hospitals in Shanghai. The Cultural Intelligence Scale, the Relationship Conflict Scale, and the Nursing Teamwork Survey Scale were used to investigate. Through the Johnson-Neyman method and SPSS Process Macro, the moderating effect of cultural intelligence was analysed. RESULTS: The findings showed that cultural intelligence was founded to be significant (b = 2.03, p < 0.01). When the cultural intelligence score is greater than or equal to 90.8, the relationship conflict between nurses will not affect teamwork. CONCLUSIONS: The findings of this study may provide data to improve nurses' performance in team cooperation. IMPLICATION FOR NURSING MANAGEMENT: Nursing managers should pay attention to the construction of the nurse's cultural intelligence. Nursing managers should guide nurses in daily work to continuously develop their own cultural intelligence. Enable nurses to effectively transfer social skills from one culture to another, and improve teamwork skills.

Correlation between patients' power distance and their willingness to participate in patients' safety: A cross-sectional study.

AIMS: This study aimed to explore the correlation between patient power distance and their willingness to participate in patient safety. BACKGROUND: The positive significance of patient participation in patient safety has been widely recognized worldwide, but in clinical practice, patients' willingness to participate is uneven and lack of initiative. METHODS: This study is a cross-sectional survey of hospitalized patients (n = 660) from six tertiary hospitals in Shanghai. Pearson's correlation analysis analyzed data. RESULTS: Patients have a higher power distance (4.08 ± 0.59). The willingness of patients to participate in patient safety was moderate (3.50 ± 1.03). Pearson's correlation analysis shows that patients' power distance negatively and slightly affected their willingness of participation (r = -.134, p < .001). The perceived authority dimension of patients' power distance has no significant correlation with patients' willingness of participation (p > .05). The emotional communication dimension of patients' power distance negatively affects patients' disease-related willingness (r = -.077, p < .001). The decision-making participation dimension of patients' power distance negatively affects patients' willingness (R = -.201, p < .001). CONCLUSIONS: Medical staff should focus on patients' power distance in medical activities. In addition, appropriate communication methods should be selected according to patients' power distance, so as to help them improve their willingness of participation. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should educate nurses on the knowledge of power distance and its importance. By evaluating patients' power distance, humanistic care and meticulous communication are implemented to encourage patients to actively participate in patient safety.

Validity of Chinese Version of Attitudes Toward Interprofessional Health Care Teams Scale.

OBJECTIVE: Effective teamwork can provide safe and effective care in various medical systems. Thus, there is increasing recognition of the value of interprofessional collaborative practice. The Attitudes Toward Interprofessional Health Care Teams Scale (ATIHCTS) has been applied to a wide variety of health professions for evaluating attitudes toward health care teams. The ATIHCTS has been widely used internationally, but no Chinese version has been developed. The aim of this study was to adapt a Chinese version of the ATIHCTS among Chinese health care professionals and to test its validity. METHODS: The English version of the ATIHCTS was translated into Chinese, back-translated, and modified for cultural adaptation according to Brislin's guideline. A total of 306 health professionals in a Shanghai tertiary hospital were investigated using the Chinese version of the ATIHCTS to test its validity. RESULTS: The Chinese version of the ATIHCTS was adjusted based on expert review and pilot testing. According to expert opinions, the text that did not conform to the Chinese language habits and the Chinese medical environment was adjusted. A total of five adjustments were made. After the pilot testing, minor corrections were made to improve the sentence structure of the scale instructions to make it easier to understand. Factor analysis was subsequently conducted with 306 respondents. The Chinese version of the ATIHCTS had 14 items. Exploratory factor analysis extracted two common factors, quality of care and time constraints, with the cumulative variance contribution rate reaching 70.011% and the load value of each entry on its common factor > 0.4. In addition, for scale confirmatory factor analysis (CFA), the chi-square/degrees of freedom ratio (X2/df) was 1.46, the normed fit index (NFI) was 0.97, the Tucker-Lewis index (TLI) was 0.99, the incremental fit index (IFI) was 0.99, the comparative fit index (CFI) was 0.99, and the root mean square error of approximation (RMSEA) was 0.04. The fitting values all met the judgment criteria, and the scale had good structural validity. Cronbach's α of the Chinese version of the ATIHCTS was 0.861, and the Cronbach's α values of each factor were 0.949 and 0.838, respectively. The split-half reliability was 0.644, and the Guttman split-half coefficients of each factor were 0.904 and 0.779, respectively. CONCLUSION: The Chinese version of the ATIHCTS has good validity. It is a valuable tool for evaluating attitudes toward interprofessional health care teams among the health care professionals in China.