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1.
Front Psychiatry ; 12: 692485, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603098

RESUMO

Objectives: This study aimed to explore the association between hospitalized cardiovascular patients' life events and adaptive coping approaches to self-management. Methods: The study was a qualitative study that was conducted in a cardiology department of one affiliated university hospital in Hangzhou, China. Twenty-eight participants with cardiovascular diseases were recruited through a purposive sampling procedure. Semi-structured interviews were used to gain insights into adaptive coping approaches to self-management when living with different life events. Interviews were audio-recorded and transcribed, and the data were analyzed by thematic analysis. Results: Life events reported by hospitalized cardiovascular participants could be summarized in four categories: daily routines, life changes, life-threatening experiences, and emotional sufferings. The adaptive coping approaches were also summarized in four themes: decision-making, avoidance, consistent responses, and episodic responses. Conclusion: This study described essential insights into the mutual influences between various life events and adaptive coping approaches to self-management by a group of hospitalized cardiovascular patients. Participants coped with their problems flexibly by processing comprehensive information from various and unpredictable life events regarding the situations and contexts. While inequity was cumulated, psychological resilience was a vital mediator between stressful events and their responses. The study illuminated the importance of understanding context, situations, and experiences on how cardiovascular patients adapted to their self-management regimens.

2.
BMJ Open ; 11(9): e048875, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493514

RESUMO

OBJECTIVE: Caregiver contribution (CC) is important for the self-care behaviors of chronic disease individuals, as it could enhance patient outcomes. Therefore, it is necessary to assess this CC by using a good validity and reliability instrument. The Caregiver Contribution to Self-Care Chronic Illness Inventory (CC-SC-CII) was designed to assess CC to self-care behaviors of patients with chronic illness in Italy. However, it was unclear whether this tool had sound psychometrics properties in the context of Chinese culture. Therefore, we performed the cross-cultural adaption of the CC-SC-CII and we tested its psychometric properties among Chinese caregivers of patients with chronic disease. DESIGN: A cross-sectional observational design. SETTINGS: Participants were recruited from communities and institutions in Pingdingshan, Henan Province, China. PARTICIPANTS: 301 caregivers of care recipients with chronic disease completed the Chinese version of the CC-SC-CII (C-CC-SC-CII). PRIMARY AND SECONDARY OUTCOME MEASURES: The content validity index of items (I-CVI), the scale content validity index-average (S-CVI/Ave), exploratory factor analysis, confirmatory factor analysis (CFA), internal consistency and item analysis were tested. RESULTS: The range of I-CVI was between 0.833 and 1.00, and the score of S-CVI was 0.991. In CFA, the C-CC to self-care monitoring scale had satisfactory fit indices. However, the C-CC to self-care maintenance and management scales had unsupported fit indices. The reliability coefficients of C-CC-SC-CII were 0.792, 0.880 and 0.870 for its three scales. Item-total correlations were all over 0.590. Test-retest reliability showed that the range of intraclass correlation coefficients was from 0.728 to 0.783. CONCLUSION: The C-CC-SC-CII has sound psychometrics characteristics and is a culturally appropriate and reliable instrument for assessing CC to the self-care behaviours of patients with chronic disease in China.


Assuntos
Cuidadores , Autocuidado , China , Doença Crônica , Comparação Transcultural , Estudos Transversais , Análise Fatorial , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
3.
Diabetes Metab Syndr Obes ; 14: 3027-3034, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34234498

RESUMO

Purpose: A prediction model for 4-year risk of metabolic syndrome in adults was previously developed and internally validated. However, external validity or generalizability for this model was not assessed so it is not appropriate for clinical application. We aimed to externally validate this model based on a retrospective cohort. Patients and Methods: A retrospective cohort design and a temporal validation strategy were used in this study based on a dataset from 1 January 2015 to 31 December 2018. Multiple imputation was used for missing values. Model performance was evaluated by using discrimination, calibration (calibration plot, calibration slope, and calibration intercept), overall performance (Brier score), and decision curve analysis. Results: In external validation, the C-statistic was 0.782 (95% CI, 0.771-0.793). The calibration plot shows good calibration, calibration slope was 1.006 (95% CI, -0.011-1.063), and calibration intercept was -0.045 (95% CI, -0.113-0.022). Brier score was 0.164.The discrimination and calibration of the prediction model were good in temporal external validation. Conclusion: The discrimination and calibration of the prediction model were satisfactory in the temporal external validation. However, clinicians should be aware that this prediction model was developed and validated in a tertiary setting. It is strongly recommended that further studies validate this model in international cohorts and large, prospective cohorts in different institutions.

4.
Diabetes Metab Syndr Obes ; 14: 2229-2237, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34040408

RESUMO

Purpose: A prognostic prediction model for metabolic syndrome can help nurses or physicians evaluate the future individual absolute risk of MetS in order to develop personalized care strategies. We aimed to derive and internally validate a prognostic prediction model for 4-year risk of metabolic syndrome in adults. Patients and Methods: This was a retrospective cohort study conducted in a tertiary care setting, and the dataset was obtained from the Healthcare Information and Management Systems of a tertiary hospital. The cohort included Chinese adults attending health examination from 1 January 2011 to 31 December 2014. A total of 6793 participants without metabolic syndrome were included in the cohort and were followed up for 4 years. Available candidate predictors in the dataset were weight, MCV, MCH, AST, ALT, BMI, NGC, TC, serum uric acid, gender, smoking, WBC, LC, Hb, HCT, and age. A logistic regression model was adopted to build the risk equation, and bootstrapping was used when considering internal validation. Calibration, discrimination, and the clinical utility were calculated for the model's performance. Results: Of the 6793 participants, 1750 participants were diagnosed with metabolic syndrome within 4 years. The developed prediction model contained 5 predictors (body mass index, age, total cholesterol, alanine transaminase, and serum uric acid). After internal validation, the C-statistic was 0.783 (95% CI, 0.772-0.795). Additionally, the current model had good calibration. Calibration slope was 0.995 (95% CI, 0.934-1.058), and calibration intercept was -0.008 (95% CI, -0.088-0.073). The Brier score was 0.156. The decision-curve analysis indicated that the prediction model provided greater net benefit than the default strategies of providing treatment or not providing treatment for all patients. Conclusion: A prognostic risk prediction model for determining 4-year risk of metabolic syndrome onset in adults was developed and internally validated. This model was based on routine clinical measurements that quantified individual future risk of metabolic syndrome.

6.
Int J Health Plann Manage ; 36(4): 1260-1275, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33864295

RESUMO

OBJECTIVES: Patients living with cardiovascular diseases use different strategies to solve various problems. This study aimed to identify the category, type and specific self-management strategies reported by hospitalized patients with cardiovascular diseases. METHODS: This is a qualitative descriptive study. Twenty-eight individuals with cardiovascular diseases from a Cardiology Department affiliated with a school in China were recruited by purposive sampling. Face-to-face semi-structured interviews were used. The interviews were audio-recorded, transcribed, translated and analysed by using content analysis. RESULTS: Five self-management strategy categories (medical and alternative therapy uptake, risk assessment and avoidance, resource seeking and utilization, maintaining normality, and optional management), and seventeen self-management strategy types, encompassing one hundred and ten specific strategies were identified. The most commonly used self-management strategy types were lifestyle adjustment (eleven strategies), self-maintenance (nine strategies) and problem-solving (nine strategies). Additionally, the most described explicit self-management strategies were receiving family/colleague support, maintaining daily routines, monitoring symptoms and managing side effects, discussing with professionals, using medicines, and improving awareness. CONCLUSION: This study identified diverse strategies reported by some Chinese cardiovascular patients. It may inform the design and development of personalized self-management interventions for health practitioners and policymakers, helping cardiovascular patients in Chinese communities worldwide receive culture-tailored services.


Assuntos
Doenças Cardiovasculares , Autogestão , Doenças Cardiovasculares/terapia , China , Humanos , Pesquisa Qualitativa
7.
Int J Gen Med ; 14: 709-720, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33688242

RESUMO

Introduction: With the effective treatments of novel coronavirus disease 2019 (COVID-19), thousands of patients have recovered from COVID-19 globally. The public perceptions and views are vital to facilitate recovered COVID-19 patients reintegrate into society. In China, the rural population accounts for nearly 70% of the total population. Therefore, we chose to evaluate perceptions and views of rural residents towards COVID-19 recovered patients in China. Methods: Fifteen participants were sampled from a village with the severe COVID-19 epidemic in Zibo city, Shandong Province. The fifteen participants who lived in the village with COVID-19 recovered patients were included. They were over 18 years of age and were voluntary to participant in the study. A descriptive qualitative design using semi-structured telephone interviews was undertaken. Thematic analysis was undertaken. Results: Five main themes emerged from the data: (1) Perceived personal characteristics of COVID-19 recovered patients; (2) Perceived difficulties faced by COVID-19 recovered patients; (3) Perceptions on the social relationship with COVID-19 recovered patients; (4) Views on COVID-19 recovered patients going to public venues; (5) Views on helping COVID-19 recovered patients. Each theme was supported by several subthemes. Conclusion: Our study showed that discrimination and reduced social intimacy exist among rural residents. To improve their views or the situation, relevant departments could lead health educational programs and encourage supportive social connections. Through these strategic messaging, rural residents are expected to recognize that COVID-19 recovered patients need more social support, rather than discrimination and resistance, which helps recovered patients better return to society.

8.
Eur J Cardiovasc Nurs ; 20(6): 556-564, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-33580782

RESUMO

AIMS : Lifestyle factors have been well-established as essential targets for fighting individual chronic diseases, but little research has concentrated on multimorbidity from the perspective of multiple lifestyle factors in the Chinese population. Thus, this study aimed to explore the associations of lifestyle factors with the occurrence of multimorbidity. METHODS AND RESULTS : Cross-sectional data retrieved from the China Health and Retirement Longitudinal Study were used for analysis. Multimorbidity was calculated on a simple count of self-reported chronic conditions. Lifestyle factors included sleep duration, physical activity, alcohol intake, smoking status, and body mass index. Logistic regression analysis was used to examine the independent and accumulating effects of lifestyle factors on multimorbidity. Latent class analysis was performed to explore the lifestyle patterns. Six thousand, five hundred, and ninety-one valid subjects were included for analysis. Overall, the community dweller's median number of chronic conditions was 1 (range 1-11) and median number of high-risk lifestyle factors was 2 (range 0-5). All lifestyle factors were associated with the occurrence of multimorbidity but varied between genders. We also identified that participants who accumulated more unhealthy lifestyle factors having a higher likelihood of multimorbidity. 'Physical activity and weight', 'smoke and drink', and 'sleep and weight' dominated high-risk lifestyles were the most common lifestyle patterns. CONCLUSION : This study revealed the associations of unhealthy lifestyle factors and their accumulating effect with multimorbidity in Chinese community dwellers. Three common lifestyle patterns indicated that a holistic approach focused on engaging and changing multiple modifiable lifestyle behaviours within an individual might be more effective in managing multimorbidity.

9.
Diabetes Metab Syndr Obes ; 13: 4981-4992, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33364802

RESUMO

Purpose: A prognostic prediction model for metabolic syndrome can calculate the probability of risk of experiencing metabolic syndrome within a specific period for individualized treatment decisions. We aimed to provide a systematic review and critical appraisal on prognostic models for metabolic syndrome. Materials and Methods: Studies were identified through searching in English databases (PubMed, EMBASE, CINAHL, and Web of Science) and Chinese databases (Sinomed, WANFANG, CNKI, and CQVIP). A checklist for critical appraisal and data extraction for systematic reviews of prediction modeling studies (CHARMS) and the prediction model risk of bias assessment tool (PROBAST) were used for the data extraction process and critical appraisal. Results: From the 29,668 retrieved articles, eleven studies meeting the selection criteria were included in this review. Forty-eight predictors were identified from prognostic prediction models. The c-statistic ranged from 0.67 to 0.95. Critical appraisal has shown that all modeling studies were subject to a high risk of bias in methodological quality mainly driven by outcome and statistical analysis, and six modeling studies were subject to a high risk of bias in applicability. Conclusion: Future model development and validation studies should adhere to the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) statement to improve methodological quality and applicability, thus increasing the transparency of the reporting of a prediction model study. It is not appropriate to adopt any of the identified models in this study for clinical practice since all models are prone to optimism and overfitting.

10.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(5): 614-617, 2020 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-33210489

RESUMO

OBJECTIVE: To evaluate the effect of standardized health education on the sputum specimen collection rate for nucleic acid detection of coronavirus disease 2019 (COVID-19). METHODS: Two hundred and twenty-seven patients in fever clinics and isolation wards of Sir Run Run Shaw Hospital of Zhejiang University and 307 migrant workers returning to 5 enterprises in Shanghai from February 3 to March 14, 2020 were enrolled in the study. Through clarifying the procedures of collecting sputum specimens, making graphic/video health education materials, standardizing the contents and methods of health education, we conducted education to the subjects. The subject expectorated spontaneously or with medical assistance. For patients, the number of sampling attempts and sputum acquisition times were documented before and after the implementation of the standardized expectoration method; for the returning migrant employees in the enterprises, only the number of collected samples after the implementation of the standardized expectoration method were recorded. RESULTS: A total of 378 sputum samples were collected from 227 patients. The sputum sampling rates before and after the implementation of health education were 40.9%and 58.4%, respectively (P<0.01). A total of 304 sputum samples were obtained from 307 enterprise returnees, with a sample collection rate of 99.0%. CONCLUSIONS: The education for standardized sputum sample collection method can effectively increase the sputum collection rate.


Assuntos
Infecções por Coronavirus , Técnicas de Amplificação de Ácido Nucleico , Pandemias , Pneumonia Viral , Manejo de Espécimes , Escarro , Betacoronavirus/genética , COVID-19 , China , Infecções por Coronavirus/diagnóstico , Eficiência , Humanos , Técnicas de Amplificação de Ácido Nucleico/métodos , Pneumonia Viral/diagnóstico , SARS-CoV-2 , Manejo de Espécimes/métodos , Fatores de Tempo
11.
Int J Nurs Sci ; 7(4): 391-400, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-33195750

RESUMO

Objectives: To examine the effects of the Roy Adaptation Model-based interventions on adaptation in persons with heart failure. Methods: A quasi-experimental study was conducted in Hangzhou, China, from March 2018 to November 2019. A convenience sample of 112 participants with heart failure from a multi-campus hospital was enrolled. Participants were allocated into an intervention group (n = 55) and a control group (n = 57) according to their hospitalized campus. A culturally-tailored care plan intervention based on the Roy Adaptation Model was performed in the intervention group. The control group received bedside patient education and a regular booklet for HF home care before discharge. Heart ultrasound, Minnesota Living with Heart Failure Questionnaire (MLHFQ), a knowledge survey, Self-care Heart failure Index (SCHFI), and Coping and Adaptation Processing Scale-Short Form (CAPS-SF) were used to measure patients' levels of adaptation of physical function, self-concept, role function, and interdependence at baseline and six months after discharge. Results: Ninety-one participants with complete data, 43 in the intervention group and 48 in the control group, were included in the analysis for the primary endpoints and showed adaptive improvement trends. Most patients in the intervention group completed 60% or more of the given interventions. At the sixth month after discharge, compared with the control group, the intervention group had improved adaptive behaviors showing higher scores of the MLHFQ (70.90 ± 22.45 vs. 54.78 ± 18.04), heart failure-related knowledge (13.79 ± 2.45 vs. 10.73 ± 4.28), SCHFI maintenance (57.67 ± 13.22 vs. 50.35 ± 10.88), and CAPS-SF (40.23 ± 4.36 vs. 38.27 ± 2.60) at the six-month follow-up (P < 0.05). There were no significant differences between the two groups in the scores of left ventricular ejection fraction, scores of SCHFI management and SCHFI confidence subscales (P > 0.05). Conclusions: The findings reported evidence of positive adaptation in patients with heart failure, indicating that the Roy Adaptation Model is an effective guide for developing an implemented framework for the nursing practice of the patients. The culturally-tailored care plan intervention is helpful to improve adaptation of patients with heart failure.

12.
BMJ Open ; 10(10): e036927, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33033085

RESUMO

OBJECTIVE: We aimed to examine whether eHealth interventions can effectively improve anthropometric and biochemical indicators of patients with metabolic syndrome (MetS). DESIGN: Systematic review and meta-analysis. METHODS: PubMed, the Web of Science, Embase, Medline, CINAHL, PsycINFO, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang and Weipu databases were comprehensively searched for papers that were published from database inception to May 2019. Articles were included if the participants were metabolic syndrome (MetS) patients, the participants received eHealth interventions, the participants in the control group received usual care or were wait listed, the outcomes included anthropometric and biochemical indicators of MetS, and the study was a randomised controlled trial (RCT) or a controlled clinical trial (CCT). The Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included articles. The meta-analysis was conducted using Review Manager V.5.3 software. RESULTS: In our review, seven RCTs and two CCTs comprising 935 MetS participants met the inclusion criteria. The results of the meta-analysis revealed that eHealth interventions resulted in significant improvements in body mass index (standardised mean difference (SMD)=-0.36, 95% CI (-0.61 to -0.10), p<0.01), waist circumference (SMD=-0.47, 95% CI (-0.84 to -0.09), p=0.01) and systolic blood pressure(SMD=-0.35, 95% CI (-0.66 to -0.04), p=0.03) compared with the respective outcomes associated with the usual care or wait-listed groups. Based on the included studies, we found significant effects of the eHealth interventions on body weight. However, we did not find significant positive effects of the eHealth interventions on other metabolic parameters. CONCLUSIONS: The results indicated that eHealth interventions were beneficial for improving specific anthropometric outcomes, but did not affect biochemical indicators of MetS. Therefore, whether researchers adopt eHealth interventions should be based on the purpose of the study. More rigorous studies are needed to confirm these findings.


Assuntos
Síndrome Metabólica , Telemedicina , Pressão Sanguínea , Eletrônica , Humanos , Síndrome Metabólica/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
BMJ Open ; 10(9): e039711, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928867

RESUMO

OBJECTIVES: High levels of organisational citizenship behaviour can enable nurses to cooperate with coworkers effectively to provide a high quality of nursing care during the outbreak of COVID-19. However, the association between autonomy, optimism, work engagement and organisational citizenship behaviour remains largely unexplored. This study aimed to test if the effect of autonomy on organisational citizenship behaviour through the mediating effects of optimism and work engagement. STUDY DESIGN: This was a cross-sectional study. SETTING: The study was conducted in the Wuhan Jinyintan Hospital in China. PARTICIPANTS: In total, 242 nurses who came from multiple areas of China to work at the Wuhan Jinyintan hospital during the COVID-19 epidemic participated in this study. METHODS: A serial mediation model (model 6) of the PROCESS macro in SPSS was adopted to test the hypotheses, and a 95% CI for the indirect effects was constructed by using Bootstrapping. RESULTS: The autonomy-organisational citizenship behaviour relationship was mediated by optimism and work engagement, respectively. In addition, optimism and work engagement mediated this relationship serially. CONCLUSION: The findings of this study may have implications for improving organisational citizenship behaviour. The effects of optimism and work engagement suggest a potential mechanism of action for the autonomy-organisational citizenship behaviour linkage. A multifaceted intervention targeting organisational citizenship behaviour through optimism and work engagement may help improve the quality of nursing care among nurses supporting patients with COVID-19.


Assuntos
Comportamento Cooperativo , Infecções por Coronavirus/enfermagem , Enfermeiras e Enfermeiros/psicologia , Otimismo/psicologia , Pneumonia Viral/enfermagem , Autonomia Profissional , Engajamento no Trabalho , Atitude do Pessoal de Saúde , Betacoronavirus , COVID-19 , China , Humanos , Pandemias , SARS-CoV-2 , Comportamento Social , Inquéritos e Questionários
14.
Gen Hosp Psychiatry ; 66: 81-88, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32736195

RESUMO

OBJECTIVE: Close contacts of novel coronavirus disease 2019 (COVID-19) patients may suffer from physical and psychological problems. Few studies have investigated the quarantine experiences of close contacts of COVID-19 patients. The objective of this study was to best capture participants' quarantine experiences during the COVID-19 outbreak in China. METHODS: A descriptive, qualitative design was used. All interviews were recorded and coded using thematic analysis. RESULTS: Fifteen participants took part in this study. The following five themes emerged: (1) experience in the early stage of quarantine; (2) experience in the middle stage of quarantine; (3) experience in the late stage of quarantine; (4) self-coping persisted throughout the quarantine period; and (5) external support was evident throughout the quarantine period. CONCLUSION: Our study highlights the need to assess the psychological state of close contacts in the early stage of quarantine and to provide psychological support for them, especially for the older and the less educated. Although close contacts had physical symptoms and psychological issues, they adopted positive coping strategies, which indicated that they were vulnerable but strong. Furthermore, external support from the Chinese government helped them cope with the quarantine effectively. Learning from the quarantine experience is expected to help the Chinese government and institutions from other parts of the world to better care for close contacts.


Assuntos
Adaptação Psicológica , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Quarentena/psicologia , Adulto , COVID-19 , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
15.
Front Psychol ; 11: 1642, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32849006

RESUMO

Background: Adaptive capacity may serve as an indicator of the individuals' coping behaviors toward illness management and may contribute to day-to-day living with chronic illness and improved quality of life. Practical and well-constructed instruments for measuring adaptation have not been adequately explored. An English 15-item Coping and Adaptation Processing-Short Form (CAPS-SF) for assessing adaptation has been created and validated in line with the underlying tenets of Coping and Adaptation Processing theory, but there is no applicable Chinese version. Methods: The CAPS-SF was translated and culturally adapted into simplified Chinese. Among Chinese adults with chronic illness, 81 patients were selected for cultural adaptation and 288 patients were approached for psychometric testing. Content validity was evaluated by an expert panel. Construct validity was tested by confirmatory factor analysis. Concurrent validity and predictive validity were analyzed by Spearman correlation coefficient. Reliability was assessed by internal consistency and test-retest coefficients. Floor/ceiling effect was calculated. Results: Adequate content validity was ensured by the expert panel. A four-factor structure (resourceful and focused, self-initiated and knowing-based, physical and fixed, and positive and systematic) describing individuals' coping strategies was identified and verified. Concurrent validity and predictive validity were demonstrated by strong correlations with the confrontation of coping mode (r = 0.46) and a quality-of-life measure (r = 0.58). The McDonald's omega coefficient of total scale was 0.82. Split-half reliability and test-retest reliability were 0.87 and 0.87. No floor/ceiling effect was present. Conclusion: The Chinese version CAPS-SF is a theoretically based and culturally acceptable instrument with sound psychometric properties. Further studies are advocated to refine its four-factor structure.

16.
BMC Psychiatry ; 20(1): 266, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32471440

RESUMO

BACKGROUND: Limited work has been done to explain how work-family conflict is related to anxiety symptoms and the roles of emotional exhaustion and social support may play. METHODS: Based on a sample of 764 female nurses and physicians, a model was tested in which emotional exhaustion served as a mediator and social support was regarded as a moderator between work-family conflict and anxiety symptoms. RESULTS: This current study supported a moderated mediation model where the relationship between work-family conflict and anxiety symptoms via emotional exhaustion was weakest for female medical staff who reported high levels of social support. CONCLUSIONS: This study contribute to providing an understanding of how and when work-family conflict affects anxiety symptoms. The results implicate a wide range of interventions aimed at promoting mental wellbeing among female medical staff for policymakers and individuals.


Assuntos
Ansiedade/psicologia , Esgotamento Profissional/psicologia , Conflito Familiar , Enfermeiras e Enfermeiros/psicologia , Médicos/psicologia , Apoio Social , Equilíbrio Trabalho-Vida , Ansiedade/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Corpo Clínico , Inquéritos e Questionários
17.
BMC Psychiatry ; 20(1): 197, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32357865

RESUMO

BACKGROUND: Social support can be a critical resource to help medical staff cope with stressful events; however, the moderating effect of social support on the relationship between burnout and anxiety symptoms has not yet been explored. METHODS: The final sample was comprised of 514 intensive care unit physicians and nurses in this cross-sectional study. Questionnaires were used to collect data. A moderated model was used to test the effect of social support. RESULTS: The moderating effect of social support was found to be significant (b = - 0.06, p = 0.04, 95%CI [- 0.12, - 0.01]). The Johnson-Neyman technique indicated that when social support scores were above 4.26 among intensive care unit medical staff, burnout was not related to anxiety symptoms. CONCLUSIONS: This is the first study to test the moderating effect of social support on the relationship between burnout and anxiety symptoms among intensive care unit staff.


Assuntos
Esgotamento Profissional/psicologia , Corpo Clínico/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Apoio Social , Adulto , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/psicologia , Esgotamento Profissional/etnologia , China/epidemiologia , Enfermagem de Cuidados Críticos , Estudos Transversais , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
BMJ Open ; 10(4): e035216, 2020 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-32265245

RESUMO

OBJECTIVES: In this study, we aimed to estimate the prevalence of metabolic syndrome (MetS) among Chinese adults, describe the disease components and compare utility of the existing international criteria and Chinese diagnostic criteria. DESIGN, SETTING AND PARTICIPANTS: A retrospective database analysis was conducted for one hospital in Zhejiang province, China. We analysed data (collected in 2017) from a total of 64 902 participants (37 500 males and 27 402 females), aged between 18 and 97 years, and who met the eligibility criteria. MAIN OUTCOME MEASURES: We employed three criteria for MetS proposed by the International Diabetes Federation (IDF) in 2005, the 2009 Joint Scientific Statement (harmonising criteria) and the China Diabetes Society (CDS) in 2013 to detect prevalence of MetS. Specifically, we analysed waist circumference, blood pressure, fasting plasma glucose, plasma triglycerides and plasma high-density lipoprotein cholesterol. RESULTS: We found an estimated age-adjusted MetS prevalence of 20.4% using IDF 2005, 30.0% based on harmonising criteria 2009 and 16.3% under the CDS 2013. This prevalence was higher in males, older adults and increased body mass index. Analysis of agreements among the criteria were 87.2% (IDF and CDS), 87.1% (IDF and harmonising criteria) and 81.6% (CDS and harmonising criteria), while their kappa coefficients were 0.641, 0.708 and 0.572 for IDF versus CDS, IDF versus harmonising criteria and CDS versus harmonising criteria, respectively. The most prevalent MetS component was abdominal obesity (50.1%), followed by dyslipidaemia (49.5%) and hypertension (46.8%) using harmonising criteria. CONCLUSION: These findings revealed moderate agreement among the three criteria with utility in Chinese clinical settings. The harmonising criteria 2009 performed better in early identification of MetS in the Chinese population.


Assuntos
Síndrome Metabólica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
19.
Patient Prefer Adherence ; 14: 287-300, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32109995

RESUMO

Purpose: This study is aiming to investigate cardiovascular patients' attitudes towards self-management during hospitalization in China. Patients and Methods: Twenty-nine individuals living with cardiovascular disease from one designated Cardiology Department in Hangzhou, China, were recruited through a purposive sampling procedure. A qualitative descriptive methodology was used. Semi-structured interviews were also used to gain attitudes toward self-management. The interviews were audio-recorded, transcribed and analyzed by thematic analysis to develop the results. Results: Four themes were identified from the qualitative data: (1): Responsibilities of self-management; (2): Reflections on self-management; (3): Acknowledgement of self-management support; (4): Challenges in implementing and adherence to self-management. Additionally, interview data were also given to illustrate these main themes emerging during the analysis. Patients gradually took their responsibilities to manage chronic symptoms. During their self-management process, they did reflections to help correct their regiments through supportive interactions. Health system responsiveness, health disparities, social capital, and cultural setting were the main external factors influencing better self-management implementation and adherence. Conclusion: This study revealed the hospitalized cardiovascular patients' attitudes towards self-management in China. These findings emphasized the importance of patients' responsibility, reflections, and various social support receiving and pointed out specific external factors influencing the health outcomes and their quality of life. This study also proves the guide for the policymakers and health system better instructions to develop individually and culturally tailored advanced self-management interventions and programs.

20.
Patient Prefer Adherence ; 13: 923-931, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31239650

RESUMO

Background: Recently, cancer pain management has come increasingly to be provided in outpatient settings, requiring health-care providers and outpatients to take on responsibilities. Pain is among the most distressing symptoms of cancer. Objectives: To compare the effectiveness of nurse-led telephone calls plus WeChat versus telephone calls only for the pain management of outpatients with cancer. Methods: 231 outpatients with cancer pain were classified into two groups (group 1, N=125; group 2, N=106). Group 1 was followed up with weekly telephone calls for eight weeks, and group 2 with weekly telephone calls combined with the booklets through WeChat for eight weeks. Differences between groups in pain level, side effects, medication adherence, and satisfaction with pain management were analyzed, and statistical differences were tested usingan independent-sample t-test and a chi-squared test. Results: Group 2 had a significantly lower rest pain (p<0.01), and lower move pain but there was no statistical difference between the two groups. Among patients in group 2, constipation, nausea and vomiting, and dizziness were less (p<0.01), while medication adherence (p<0.05) and pain management satisfaction were higher (p<0.01) than patients in group 1. Conclusion: Nurse-led follow-up telephone calls combined with WeChat significantly reduced opioid-related health problems, such as pain intensity, side effects and medication adherence.

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