Hospitals In Shandong Province Research Articles

Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China.

Hypertension is a leading cause of death worldwide. Hypertension is associated with poor sleep quality, which adversely affects physical and mental health, and can increase the incidence rate and mortality of cardiovascular disease, cancer, and depression. This study aimed to investigate the prevalence of the factors related to poor sleep quality in hypertensive patients in Shandong Province, China. This cross-sectional study of adult patients with hypertension from August 2020 to February 2021was conducted in 10 cooperative hospitals in Shandong Province, China. Information was collected in the form of a questionnaire. In this study, Pittsburgh sleep quality index was used to evaluate sleep quality. A multivariate logistic regression model was used to analyze the risk of poor sleep quality. Variables with a P value < 0.05 and a 95% confidence interval (CI) were considered statistically significant. A total of 528 patients with hypertension were included, ranging in age from 31 to 90 years old. The prevalence of poor sleep quality among study participants with hypertension was 319 (60.4%) (95% CI: 0.562-0.646). Female gender (adjusted odds ratios [AOR] = 3.231; 95% CI: 2.194-4.757), stage III blood pressure (AOR = 2.142; 95% CI: 1.108-4.141), mental labor, and labor both physical and mental (AOR = 1.639; 95% CI:1.03-2.611 and AOR = 1.632; 95% CI: 1.030-2.584), unstable marriage (AOR = 3.203; 95% CI: 1.026-9.997) and the very Low-density Lipoprotein (odds ratios = 0.776; 95% CI: 0.649-0.928) were significantly associated with poor sleep quality. This study preliminarily showed that poor sleep quality was a common problem in hypertensive patients, and more than half of the hypertensive patients had poor sleep quality. Poor sleep quality was significantly correlated with gender, hypertension level, occupation, marital status, and the very Low-density Lipoprotein. Considering the negative impact of sleep quality, appropriate strategies should be developed to prevent and treat poor sleep quality in hypertensive patients.

Reactivation of Epstein-Barr virus in SFTSV infected patients

BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever caused by a tick-borne bunyavirus SFTSV with case fatality up to 30%. The reactivation of Epstein-Barr virus (EBV) has been proven to occur in individuals with various immune suppression conditions. MethodsHere, we diagnosed 22 SFTSV infected patients with PCR in a hospital in Shandong Province, China in 2020. To understand the consequences of SFTSV infection leading to EBV reactivation, we examined EBV reactivation in SFTSV-infected patients with PCR and RT-PCR. ResultsWe found that EBV was reactivated in 18.2% (4/22) of SFTS patients, suggesting that EBV reactivation is common in SFTS patients. Compared with SFTS patients without EBV reactivation, SFTS patients with EBV-reactivation had a significantly lower median level of serum albumin (32.45 g/L vs. 26.95 g/L, p = 0.03) and a significantly higher median number of urine red blood cells (0 cells/μL vs. 9 cells/μL, p = 0.04). ConclusionSFTS infection can reactivate EBV in patients, which may make the clinical condition of patients worsen.

Negative association between workplace violence and patient safety behaviour in male, but not female, nursing interns: A cross-section study.

The aim of the study was to compare the associations between workplace violence and patient safety behaviour between male and female nursing interns. A cross-sectional survey. A cross-sectional survey was carried out at three general hospitals in Shandong Province in China to collect data from 466 nursing interns. We evaluated the associations between workplace violence and patient safety behaviours in men and women using multiple linear regressions. Sex moderated the association between workplace violence and patient safety behaviour (B = 1.046, [SE = 0.477]; p = 0.029). Among male nursing interns, there was a significant association between workplace violence and patient safety (B = -1.353, 95% CI [-2.556, -0.151]; p = 0.028). In male nursing interns, verbal violence and sexual violence were significantly negatively associated with patient safety (B = -1.569, SE = 0.492, p = 0.002; B = -45.663, SE = 5.554, p < 0.001). No significant association was found in female nursing interns. This study did not have a patient or public contribution.

The association between fear of future workplace violence and depressive symptoms among nurses based on different experiences of workplace violence: a cross-sectional study

BackgroundFear of future workplace violence (FFWV) has a negative impact on individuals’ health. However, no study has investigated the association between FFWV and depressive symptoms. Nurses with different experiences of workplace violence may have different levels of FFWV and differences in mental health. This study explored the association between FFWV and depressive symptoms among Chinese nurses with different experiences of workplace violence.MethodsA cross-sectional study was conducted involving 1888 Chinese nurses from 12 tertiary hospitals in Shandong Province. The Fear of Future Violence at Work scale was used to measure FFWV. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression scale. Multiple logistic regression analysis was used to examine the association between FFWV and depressive symptoms.ResultsThe prevalence of depressive symptoms was 45.9% (no aggression group: 24.3%; non-physical violence group: 46.1%; physical violence group: 63.7%), and 72.8% of nurses had high levels of fear of future workplace violence (no aggression group: 60.2%; non-physical violence group: 75.6%; physical violence group: 70.8%). Compared with low levels of FFWV, high levels of FFWV were associated with more depressive symptoms among nurses in the no aggression group (odds ratio [OR] = 3.269, 95% confidence interval [CI]: 1.102–9.695) and in the non-physical violence group (OR = 2.338, 95% CI: 1.385–3.945).ConclusionNurses who had experienced physical violence had the most depressive symptoms and nurses with experience of non-physical violence had the greatest FFWV. Our findings suggested that there was a significant association between FFWV and depressive symptoms among Chinese nurses in the no aggression and non-physical violence groups. Hospital administrators need to address FFWV needs when developing strategies to reduce depressive symptoms among nurses.

Current situation and influencing factors for suicidal intent in patients with intentional acute pesticide poisoning.

Since pesticides have been widely used in agricultural production, acute pesticide poisoning (APP) has gradually become a worldwide public health problem. Recently, the number of APP cases has been high in China, and the intentional self-administration of pesticides is the main cause of APP. However, there is a lack of relevant studies on the factors influencing suicidal intent in patients with intentional APP. This study aimed to explore the current situation and influencing factors for suicidal intent among patients with intentional APP. In this cross-sectional study, we enrolled a total of 225 patients with intentional APP admitted to the emergency department of our Grade A comprehensive hospital in Shandong Province between June 2019 and January 2021. Patients were investigated using a health status interview questionnaire, Beck Suicidal Intent Scale, Duke Social Support Index, psychological stress scale, Dickman Impulsivity Inventory, Trait Anxiety Inventory, Center for Epidemiologic Studies Depression Scale, and Beck Hopelessness Scale. Descriptive statistics, single-factor analysis, and multiple linear regression were used for data analysis. Suicidal intent scores were collected and averaged (14.23 ± 6.22). Multiple linear regression analysis revealed that marital status, residential area, impulsivity, hopelessness, depression, psychological strain, and social support impact suicidal intent. Patients with intentional APP have high suicidal intent. Therefore, different interventions should be tailored to different patients.

Mediating role of psychological resilience in the relationship between self-efficacy and professional identity among nurses

ABSTRACT To explore the mediating role of resilience in the relationship between general self-efficacy and professional identity of nurses during the COVID-19 pandemic. A cross-sectional design was employed. A total of 982 nurses from four Grade III, class A hospitals in Shandong Province were investigated using general information questionnaire, nurses’ professional identity rating scale, general self-efficacy scale (GSES), and Connor-Davidson flexibility scale (CD-RISC). SPSS22.0 and Amos21.0 were used for data analysis and structural equation modeling. p % counseling The nurses had a score of （27.038±5.933） for general self-efficacy score, 38.290±6.234 for psychological resilience, and （114.99±16.209） for professional identity. A positive correlation between general self-efficacy, professional identity, and psychological resilience (<0.01) was found. The SEM analysis shows that psychological resilience plays a mediating role between general self-efficacy and professional identity. The ratio of the effect is 75.155. During the COVID-19 pandemic, the levels of general self-efficacy and professional identity of nurses was medium, while psychological resilience was high. Nurses’ general self-efficacy can affect their professional identity through psychological resilience. During the pandemic, the psychological status of nurses should not be ignored. Nursing managers should fully utilize of group and cognitive therapy based on mindfulness to improve nurses’ psychological resilience and general self-efficacy, and to promote nurses’ professional identity, so as to ensure the lower turnover rate.

Abstract P1-14-03: Efficacy and safety of pyrotinib-based therapy in the treatment of HER2-positive breast cancer patients with brain metastases:a multi-center real-world study

Abstract Background: An estimated 30-50% of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) will develop brain metastases (BMs), and there are few effective treatment options. Pyrotinib has shown good efficacy in HER2-positive breast cancer patients with BMs in a single-arm phase II trial, but there is a lack of data from randomized controlled trial and real-world study. The purpose of this multi-center real-world study was to evaluate the efficacy and safety of pyrotinib-based therapy in HER2-positive breast cancer patients with BMs in real world. Methods: We reviewed the data of HER2-positive breast cancer patients with BMs who were treated with pyrotinib-based therapy from January 2018 to September 2021 at Shandong Cancer Hospital and Institute and other hospitals in Shandong Province in China. The initial dose of pyrotinib in most patients (n=92, 85.2%) was 400 mg once a day for every 21 days as a cycle. All patients were evaluated for tumor response every two cycles according to RECIST 1.1. The primary endpoint was progression free survival (PFS) and secondary endpoints were compounded objective response rate (ORR) and CNS-ORR (the ORR of central nervous system), compounded disease control rate (DCR) and CNS-DCR (the DCR of central nervous system) and overall survival (OS). The safety profile has also been assessed. The updated graded prognostic assessment for breast cancer patients with brain metastases (Breast GPA) includes age, Karnofsky performance status (KPS), extracranial metastases, number of brain metastases, and tumor subtype. It is divided into four subgroups (0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0) with different prognosis (the median survival: 6 months, 12.9 months, 23.5 months, and 36.3 months). Results: 101 patients were assessed for efficacy and toxicity. The median PFS is 10.0 months (95% CI, 6.9 to 13.1 months), and OS data were not available at the time of analysis. In overall patients, patients with GPA of 0-2.0 achieved shorter PFS (4.8 months vs 12.4 months, P=0.003). Trastuzumab (neo and adjuvant) (P=0.021), local therapy for BMs (P﹤0.001) and pyrotinib treatment (P=0.022) had significant positive correlation with PFS. In patients with GPA of 0-2.0, the median PFS of different local treatment methods was significantly different (P﹤0.001), stereotactic radiotherapy alone (13.6 months) was better than whole-brain radiotherapy alone (4.8 months) and combined local therapy (6.7 months); patients who received pyrotinib first in the BMs stage had longer PFS than those who did not (6.7 months vs 2.7 months, P=0.009) and radiotherapy for BMs (P=0.036) had correlation with longer PFS. Cox multivariate analysis indicated that GPA (0-2.0 vs 2.5-4.0) was independent predictor of PFS. For overall patients, the ORR was 42.6% and DCR was 88.1%. The CNS-ORR was 45.5% and CNS-DCR was 90.1%. Diarrhea (71.3%) was the most common adverse events (AEs), 47 patients (46.5%) reported grade 1-2 diarrhea, 25 patients (24.8%) reported grade 3 diarrhea. In addition, the more common AEs of grade 3 were loss of appetite (7.9%), hand-foot syndrome (6.9%), nausea (5.9%) and vomiting (5.0%). No grade 4 and 5 AEs occurred. Conclusions: Pyrotinib-based therapy is effective and tolerable in HER2-positive breast cancer patients with BMs. In the subgroup with Breast GPA 0-2.0, patients treated with radiotherapy had a better prognosis, and stereotactic radiosurgery alone was a viable option. Clinical trial information: ChiCTR2000037995. Citation Format: Huihui Li, Jie Huang, Qiaorui Tan, Xiaochu Man, Sha Yin, Shujuan Sun, Yu Hu, Wenhuan Li, Dongdong Zhou, Lihua Song, Baoxuan Zhang, Liang Xu, Xinzhao Wang, Xuemei Xie. Efficacy and safety of pyrotinib-based therapy in the treatment of HER2-positive breast cancer patients with brain metastases:a multi-center real-world study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-14-03.

Association between social support and depressive symptoms among Chinese nurses with formal employment versus contract-based employment.

Inequalities may exist in social and health status among nurses with different employment types. Few studies have investigated the relationship between social support and depressive symptoms among formally employed nurses compared with those in contract-based employment. This study aimed to examine the associations between social support and depressive symptoms among Chinese nurses with different forms of employment. The present cross-sectional study was performed with 1,892 nurses from 12 tertiary hospitals in Shandong Province, China. The Social Support Rating Scale and the 10-item Center for Epidemiologic Studies Depression Scale were used to measure social support and depressive symptoms, respectively. The association between social support and depressive symptoms among participants was explored using multiple linear regression analysis. The prevalence of depressive symptoms was 45.7%. The mean score for total social support was 40.16 (SD = 7.47), which was lower than the norms in the general Chinese population. Formally employed participants' total social support scores were statistically significantly higher than those of contract-based employees (p ≤ 0.05). After controlling for confounding factors, the multiple linear regression analysis showed that subjective support and support utilization scores were inversely associated with depressive symptoms. Objective support scores were negatively associated with depressive symptoms only among contract-employment nurses. Chinese nurses have a higher prevalence of depressive symptoms and lower social support than the Chinese general population. Compared with contract-employment nurses, formally employed nurses had higher social support. Inverse associations exist between social support and depressive symptoms among nurses with different types of employment. It is suggested that improving Chinese nurses' social support levels and reducing their depressive symptoms, especially for nurses employed through contracts, are critical.

The association between team resilience and team performance in nurses during COVID-19 pandemic: a network analysis

BackgroundCompared to other healthcare workers, nurses are more vulnerable to the potentially devastating effects of pandemic-related stressors. Studies have not yet investigated the deeper characteristics of the relationship between team resilience and team performance among nurses during the COVID-19 pandemic. This study aimed to elucidate the characteristics of team resilience and performance networks among nurses during the pandemic.MethodsA cross-sectional study involving 118 nursing teams comprising 1627 practice nurses from four tertiary-A and secondary-A hospitals in Shandong Province, China, was conducted. Analyzing and Developing Adaptability and Performance in Teams to Enhance Resilience Scale and the Team Effectiveness Scale were used to measure team resilience and performance, respectively. The estimation of the network model and calculation of related metrics, network stability and accuracy, and network comparison tests were performed using R 4.0.2.ResultsNode monitoring had the highest centralities in the team resilience and performance network model, followed by node anticipation, cooperation satisfaction, and cooperation with other departments. Moreover, node cooperation satisfaction and learning had the highest levels of bridge centrality in the entire network.ConclusionMonitoring, anticipation, cooperation satisfaction, cooperation with other departments, and learning constituted core variables maintaining the team resilience-performance network structure of nurses during the pandemic. Clinical interventions targeting core variables may be effective in maintaining or promoting both team resilience and performance in this population.

Investigation of predictors for invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome

Patients with severe fever with thrombocytopenia syndrome (SFTS) had been confirmed to have immune dysfunction and were prone to invasive pulmonary aspergillosis (IPA), which was directly related to the increased mortality. The aim of this study was to investigate the predictors for IPA in SFTS patients, and the results were expected to be helpful for early identification of IPA and initiation of anti-fungal therapy. The study was performed to review laboratory confirmed SFTS patients in two tertiary hospitals in Shandong province (Qilu Hospital of Shandong University and Shandong Public Health Clinical Center) from April 2021 to August 2022. The enrolled patients were further divided into IPA group and non-IPA group. Demographic characteristics, clinical manifestations and laboratory parameters between IPA group and non-IPA group patients were analyzed and compared to identify the independent predictors for IPA by univariate analysis and multivariable logistic regression analysis. Sensitivity and specificity of independent predictors were evaluated by receiver operating characteristic (ROC) curve analysis. In total, 67 SFTS patients were enrolled with an average age of 64.7 (± 8.4) years old. The incidence of IPA was 32.8% (22/67). Mortality of patients in IPA group was 27.3% (6/22), which was significantly higher than that in non-IPA group. Results of univariate analysis showed that uncontrolled diabetes, central nervous system symptoms, platelet < 40 × 109/L, CD4+ T cell < 300/μL and CD8+ T cell < 400/μL were risk factors for development of IPA. These factors were further analyzed by multivariable logistic regression analysis and the results indicated that uncontrolled diabetes, platelet < 40 × 109/L, CD4+ T cell < 300/μL and CD8+ T cell < 400/μL could be recognized as independent predictors for IPA in SFTS patients. In conclusion, IPA is a serious complication for SFTS patients and increases mortality. It is necessary to early identify predictors of IPA for improving survival of SFTS patients.

Analysis of factors influencing the use of child restraint system by parents of children aged 0–6 years: an information, motivation, behavioral skills model-based cross-sectional study

BackgroundChildren's injuries from traffic accidents have been identified as a global public health issue. Child restraint system (CRS) is a useful tool for lowering the risk of injury to children. Nevertheless, CRS usage is really low in China. The goal of the current study was to investigate the use of CRS after the legislation revised in China and to explore the influencing factors based on Information, Motivation, and Behavioral Skills model (IMB).MethodsThe study is a cross-sectional survey of parents who took their 0 to 6-year-old children for seeking primary care services at the Children Preventive Health Care Clinic of a tertiary hospital in Shandong Province, China. Parents were invited to complete the self-administered questionnaire between March and June 2022, including their knowledge, motivation, and behavioral skills, use behavior of CRS and socio-demographics. Ordinal logistic regression was used to explore the factors associated with CRS use by using SPSS software (version 26.0).ResultsIn total, 442 parents participated in the study; 56.1% (n = 201) of the parents utilized CRS for their child passengers, however only 29.0% used CRS frequently. The result of logistic regression analysis show that parents with junior college (OR = 0.398, 95%CI: 0.185 ~ 0.857), possessing a high family economic status(OR = 0.225, 95%CI: 0.088 ~ 0.578), being trained on children’s unintentional injuries(OR = 0.435,95%CI: 0.272 ~ 0.695), and having high scores on CRS riding mode cognition(OR = 0.476, 95%CI: 0.368 ~ 0.616), CRS type cognition(OR = 0.519, 95%CI: 0.392 ~ 0.689), CRS use motivation(OR = 0.392, 95%CI: 0.295 ~ 0.520) and installation skills(OR = 0.559, 95%CI:0.411 ~ 0.761) were the main factors promoting the usage of CRS.ConclusionsThis study found that the use of CRS can be increased by improving parents' knowledge, motivation and behavior skills and hence related educational programs is necessary for increasing CRS use in China.

Safety monitoring of oral iron supplements in pregnant women with anemia: a multi-center observational clinical study.

To investigate the safety of oral iron therapy in pregnant women with iron-deficiency anemia (IDA) in the real world. A retrospective analysis was performed on 1792 pregnant patients with IDA who received oral iron supplements from 12 hospitals in Shandong Province from 1 April to 31 June 2021; follow-up and adverse reactions were recorded. They were divided into six groups according to the treatment drugs. The overall adverse reaction rate was 15.4%, and the main adverse reaction site was the digestive system. The incidence of all kinds of oral iron adverse reactions from high to low in order: compound ferrous sulfate and folic acid tablets (21.88%); iron proteinsuccinylate oral solution (20.90%); ferrous succinate tablets (19.76%); ferrous succinate sustained-release tablets (18.00%); iron polysaccharide complex capsule (12.06%); and iron dextran oral solution (6.94%). It was found that there was a significant difference in the incidence of adverse reactions among the six drugs (p < 0.05). Pairwise comparison showed that the incidence of adverse reactions was higher in the iron proteinsuccinylate oral solution than that in the iron polysaccharide complex capsule (p < 0.05). There was no significant difference in the incidence of adverse reactions in different ages (p > 0.05), but there was a significant difference in the incidence of adverse reactions in different gestational ages (p < 0.05). In Adverse Drug Reaction (ADR) patients, the adverse reaction result of most patients is recovery or improvement, and there was no serious adverse reaction outcome such as sequela and death. All the adverse reactions of oral iron were mainly gastrointestinal adverse reactions, and no heavy adverse reactions were found. Iron proteinsuccinylate oral solution has a higher incidence of adverse reactions than iron polysaccharide complex capsule. The results showed that oral iron was safer for anemia patients during pregnancy.

Dyadic communication quality and family resilience in gynecologic cancer survivors: a study on the mediating role of perceived spousal support.

To analyze the level of family resilience in Chinese gynecological cancer survivors and determine whether perceived spousal support plays a mediating role in the relationship between dyadic communication quality and family resilience, enhance the confidence of families in coping with the disease together, and thus promote psychosocial adaptation to cancer. A total of 348 gynecologic cancer survivors were selected from a gynecologic ward in a public hospital in Shandong Province, China. All participants completed the Sociodemographic and Clinical Characteristics Questionnaire, Couples' Communication Quality Scale (CCQS), Perceived Social Support Scale (PSSS), and Family Hardiness Index (FHI). The mediating effect of perceived spousal support was estimated using the bootstrap method via IBM SPSS AMOS 21.0. The mean FHI score was 53.03 ± 9.34 points, showing moderate levels of family resilience. Family resilience was shown to be significantly positively associated with both perceived spousal support and dyadic communication quality (both p < 0.01). Furthermore, perceived spousal support was shown to partially mediate the relationship between communication quality and family resilience (β = 0.141; 95% confidence interval: 0.063-0.243). The level of family resilience in survivors of gynecologic cancer needs to be further improved, and perceived spousal support partially mediates the relationship between dyadic communication quality and family resilience within this population. Therefore, dyadic communication quality and subjective perceived spousal support should be enhanced for gynecologic cancer survivors to increase their family resilience.

The relationship between perceived organizational support and insomnia in Chinese nurses: The Serial multiple mediation analysis.

Nurses are in high-pressure, high-load, and high-risk environment for a long time, and their insomnia cannot be ignored. Insomnia not only has a negative impact on the physical and mental health of nurses, but also on the efficiency and quality of nursing work. The purpose of this study was to investigate the multiple mediating effect of psychological capital, effort-reward ratio, and overcommitment in the relationship between perceived organizational support and insomnia among Chinese nurses. A cross-sectional study has been carried out in a tertiary grade A hospital in Shandong Province, China from March 2021 to May 2021. The demographic questionnaire, Perceived Organization Support Questionnaire, Psychological Capital Questionnaire, Chinese version Effort-Reward Imbalance, Questionnaire and Athens Insomnia Scale were used for data collection. SPSS PROCESS 3.4 macro program developed by Hayes was used to test the serial multiple mediation. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson's correlation analyses, ordinary least-squares regression, and the bootstrap method were used for data analysis. 658 valid questionnaires were collected (81.2%). Nurses' perceived organizational support was positively correlated with psychological capital (r = 0.455, p < 0.001), and was significantly negatively correlated with effort-reward ratio (r = -0.318, p < 0.001), overcommitment (r = -0.328, p < 0.001), and insomnia (r = -0.358, p < 0.001); Psychological capital was negatively correlated with effort-reward ratio (r = -0.275, p < 0.001), overcommitment (r = -0.339, p < 0.001), and insomnia (r = -0.402, p < 0.001), respectively; effort-reward ratio and overcommitment were significantly positively correlated with insomnia (r = 0.379, p < 0.001; r = 0.466, p < 0.001), respectively. In the model of perceived organizational support-psychological capital-effort-reward ratio-insomnia, the overall mediating effect was -0.080 (95%CI: -0.109 ~ -0.058), and the mediating effect of psychological capital was -0.050, accounting for 34.30% of the total effect; the mediating effect of effort-reward ratio was -0.024, accounting for 16.49% of the total effect; the chain mediating effect of psychological capital and effort-reward ratio was -0.007, accounting for 4.49% of the total effect. In the model of perceived organizational support-psychological capital-overcommitment-insomnia, the overall mediating effect was -0.085 (95%CI: -0.109 ~ -0.064), and the mediating effect of psychological capital was -0.042, accounting for 28.64% of the total effect; the mediating effect of overcommitment was -0.029, accounting for 19.81% of the total effect; the chain mediating effect of psychological capital and overcommitment was -0.015, accounting for 10.14% of the total effect. Perceived organizational support had direct negative influence on insomnia. Psychological capital and effort-reward ratio/overcommitment acted as chained mediating factor could partially relieve insomnia symptoms related to perceived organizational support. It is suggested to improve the level of organizational support and psychological capital of nurses, and reduce the effort-reward imbalance and overcommitment of nurses, so as to effectively decline and deal with nurses' insomnia.

Comparing the application of three thrombosis risk assessment models in patients with acute poisoning: A cross-sectional survey.

Patients with acute toxic hemoperfusion are prone to deep vein thrombosis. However, there is no risk assessment model for thrombosis in patients with acute toxic hemoperfusion. Therefore, we compared three commonly used risk assessment models for deep vein thrombosis to determine the model most suitable for assessment of deep vein thrombosis in patients with acute toxic hemoperfusion. Caprini, Autar, and Padua thrombosis risk assessment models were used to assess the risk of deep vein thrombosis in patients with acute poisoning and hemoperfusion admitted to a grade A hospital in Shandong province from October 2017 to February 2019. The predictive values of the three models were compared using receiver operating characteristic (ROC) curve analysis. The risk assessment model scores of Caprini, Autar, and Padua were 7.55 ± 1.76, 8.63 ± 2.36, and 3.92 ± 0.55, respectively. The Caprini risk assessment model was significantly different (p < 0.05) in high-risk patients in the thrombus and non-thrombotic groups; the difference between the other two models was not significant (p > 0.05). The areas under the ROC curve of the Caprini, Autar, and Padua risk assessment models were 0.673, 0.585, and 0.535, respectively. The difference in areas under the ROC curve between the Caprini risk assessment model and the Autar risk assessment model as well as the Padua risk assessment model was significant (p < 0.05), but the areas under the ROC curve of the Autar risk assessment model and the Padua risk assessment model were not statistically significant (p > 0.05). The Caprini risk assessment model had a sensitivity of 91.9%, specificity of 33.1%, and a Youden index of 0.249. The sensitivity and specificity of Autar's risk assessment model were 37.0 and 77.2%, respectively, and the Youden index was 0.141. The Padua risk assessment model had a sensitivity of 91.3%, specificity of 15.0%, and a Youden index of 0.063. The three thrombosis risk assessment models were not suitable for patients with acute poisoning and hemoperfusion.

Disease perception and experience in people with diabetic retinopathy: A qualitative study.

The aim of this study was to investigate the lived experience of people with diabetic retinopathy and to understand the impact of the disease on them including the practical problems faced in the day-to-day life. Descriptive qualitative research. A convenience sample of 11 patients with diabetic retinopathy who were hospitalized in a tertiary hospitals in Shandong province of China were enrolled. Data were collected using semi-structured in-depth interviews. The six-stage thematic analysis of Braun and Clarke was used for data analysis. Three themes and 12 sub-themes were extracted, namely: countdown to darkness (lack of disease knowledge, bystander's perspective, distrust of grassroots hospitals); Endless abyss (action restrictions, social isolation, stigma, lost of meaning in life, catastrophizing explanations, a heavy burden); Light chaser (craving for light, turning points in behaviour, self-adjustment).

Effects of air pollution on cardiovascular health in patients with type 2 diabetes mellitus: Evidence from a large tertiary hospital in Shandong Province, China.

Air pollution has posed serious threats to human health. Based on the microdata of a large tertiary hospital in Shandong Province from 2016 to 2021, combined with the macro data such as air quality monitoring data, meteorological data, and city-level regional socio-economic data, this paper empirically tests the impact of air pollution instrumented by thermal inversions on the cardiovascular health of patients with type 2 diabetes mellitus (T2DM) and its group differences. The results show that: (1) Air pollution has a negative impact on the cardiovascular health of patients with T2DM, that is, the cardiovascular health of patients with T2DM will decline in regions with high air pollution; (2) The impact of air pollution on cardiovascular health in T2DM patients is heterogeneous, with males and older patients bearing greater air pollution health losses; (3) From the perspective of the external environment, the negative effects of environmental pollution on patients' health were significantly reduced in areas with higher environmental regulation intensity and better public health conditions, indicating the necessity of strengthening environmental governance and increasing public health expenditure.

Investigation and analysis of carbapenem-resistant gram-negative bacterial infection rates across hospitals in Shandong Province in China.

The increasing incidence of carbapenem-resistant bacterial infections has become a serious public health threat. This study aimed to investigate and analyze the current regional differences in carbapenem-resistant gram-negative bacteria (CRGN) in a major Province of China, and provide suggestions for preventing hospital infections. A questionnaire survey was used to obtain the current data on CRGN from 36 hospitals in Shandong Province, China, from 2019 to 2020. The association between the detection rates and discovery rates of CRGN and the use of antibacterial drugs was analyzed using Spearman's correlation coefficient. In addition, we compared the detection rates of CRGN and antibacterial drugs using hospitals categorized according to different levels and economic areas using the Kruskal-Wallis test. The average detection rates of CRGN across the 36 hospitals varied from 1.91% to 66.04%. The discovery rate of carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant Acinetobacter baumannii (CRAB) remained below 5‰, and that of carbapenem-resistant Pseudomonas aeruginosa (CRPA) was below 10‰. Except for CRAB, the correlations between the detection rate and antimicrobial drug use intensity and carbapenem drug use percentage were 0.11-0.29 and 0.31-0.47, respectively. Carbapenem drug use was higher in the provincial hospital group than in the prefecture-level hospitals (P < 0.05), and that in the high-economic regional hospital group was higher than in the low-economic regional hospital group (P < 0.05). The detection and discovery rates of CRE were low, and those of CRAB were high in Shandong Province. Larger hospitals have higher carbapenem drug use. These results can be used as a reference for preventing CRGN infections in developing countries and provide a basis for regional carbapenem resistance prevention and control strategies.

Acute coronary syndrome screening in patients presenting with arteriosclerosis in health check-ups: a case–control study

ObjectivesThis research aimed to develop a simple and effective acute coronary syndrome (ACS) screening model in order to intervene early and focus on prevention in patients presenting with arteriosclerosis.DesignA case–control...

Association of Workplace Bullying with Suicide Ideation and Attempt Among Chinese Nurses During the COVID-19 Pandemic.

Nurses experience a high incidence of workplace bullying and are at a higher risk of suicide than the general population. However, there is no empirical evidence on how exposure to workplace bullying is associated with suicide ideation and attempts among nurses. Nurses were recruited from tertiary hospitals in Shandong Province, China, using stratified cluster sampling. Suicide ideation and attempts were assessed using two items, and the Workplace Psychologically Violent Behaviors Instrument was used to measure subtypes of workplace bullying. The prevalence of workplace bullying, suicide ideation, and suicide attempts was 30.6%, 16.8%, and 10.8%, respectively. After adjusting for covariates, victims of workplace bullying were at a high risk of suicide ideation and attempts. Among workplace bullying subtypes, individuals’ isolation from work and direct negative behaviors were predictors of both suicide ideation and attempts; attack on personality only predicted suicide attempts. The more bullying subtypes experienced by nurses, the greater their likelihood of suicide ideation and attempts. These findings suggested that workplace bullying was associated with an increased risk of suicide ideation and attempts in nurses, with both independent and cumulative risks. Interventions should focus on prevention and managing the effects of workplace bullying among nurses.