Public Hospital In China Research Articles

Self-efficacy with Pelvic floor muscle training mediates the effect of an App-based intervention on improving postpartum urinary incontinence severity among pregnant women: A causal mediation analysis from a randomised controlled trial

BackgroundA pragmatic randomised controlled trial has confirmed the effectiveness of Urinary Incontinence for Women (UIW) app-based intervention in improving postpartum urinary incontinence (UI) severity among pregnant women. However, the causal mechanisms underlying this intervention effect remain unclear. ObjectiveTo examine the mediating role of self-efficacy with pelvic floor muscle training (PFMT) on the effect of the UIW app-based intervention in improving postpartum UI severity. MethodsThis was a secondary causal mediation analysis of a single-center, 2-arm, unblinded pragmatic randomised controlled trial. Singleton pregnant women without UI before pregnancy aged ≥18 years and between 24 and 28 weeks of gestation were recruited from a tertiary public hospital in China and randomised to receive the UIW app intervention plus oral PFMT instructions (n = 63) or oral PFMT instructions alone (n = 63). The primary outcome was postpartum changes in UI severity at 6 weeks. Changes in self-efficacy with PFMT 2 months after randomisation were a hypothesised mediator. Causal mediation analysis was used to estimate the average causal mediation effect (ACME), average direct effect (ADE), average total effect (ATE), and proportion mediated. A sensitivity analysis was conducted to examine the robustness of the ACME in relation to potential unmeasured confounding. ResultsData from 103 participants were analyzed. The ATE of UIW app-based intervention on postpartum UI severity was 2.91 points (95 % confidence intervals [CI] 1.69 to 4.12), with ADE of 1.97 points (95 % CI 0.63 to 3.41) and the ACME 0.94 points (95 % CI 0.27 to 1.72). The proportion of ATE mediated by self-efficacy with PFMT was 0.32 (95 % CI 0.08 to 0.67). Sensitivity analysis revealed the robust ACME with respect to the potential effects of unmeasured confounding. ConclusionAn increase in self-efficacy with PFMT partially mediated the effect of the UIW app intervention on improvements in postpartum UI severity. Trial registrationThe original trial was prospectively registered in the Chinese Clinical Trial Registry under the reference number ChiCTR1800016171 on 16/05/2018. Further details can be accessed at: http://www.chictr.org.cn/showproj.aspx?proj=27455.

Daily leader humor and healthcare workers’ next-day helping behaviors: the roles of positive affect and difficulty in maintaining display rules

PurposeThe main purpose of our study is to investigate the impact of daily leader humor behaviors on healthcare workers’ daily psychological state and behavioral outcomes.Design/methodology/approachBased on the conservation of resources (COR) theory, this study proposes that daily leader humor behaviors are positively related to healthcare workers’ daily positive affect, which in turn affects their next-day helping behaviors towards patients. These predictions hinge on healthcare workers’ difficulty in maintaining display rules. We conducted a lagged experience sampling methodology (ESM) survey of 621 complete daily observations from 93 healthcare workers who work in direct contact with patients at a large public hospital in China across consecutive 10 working days.FindingsResults of multilevel path analysis demonstrate that daily leader humor behaviors are positively related to healthcare workers’ same-day positive affect, and this positive affect enhances their next-day helping behaviors towards patients. Furthermore, healthcare workers’ higher difficulty in maintaining display rules attenuates the benefits of daily leader humor behaviors.Originality/valueBuilding on the COR theory and adopting a diary research design, this study shows daily fluctuations in leader humor behaviors and proposes a mechanism through which daily leader humor behaviors indirectly affect healthcare workers’ next-day helping behaviors. Thus, our study disclosed possible means for healthcare organizations to improve service quality.

Relationship Between Mindfulness and Affiliate Stigma in Parents of Children with Autism Spectrum Disorder in China: The Mediating Role of Coping Styles

PurposeThis study aims to investigate the current status of affiliate stigma among parents of autistic children, analyze the influencing factors, explore the relationship among mindfulness, coping styles, and affiliate stigma, and verify the mediating role of coping styles between mindfulness and affiliate stigma in parents of children with autism in China. MethodBetween February and April 2023, the Child Development Behaviour Centre of a public hospital in China recruited 345 parents of children with autism. These parents completed the general information questionnaire, the Mindful Attention Awareness Scale, the Affiliate Stigma Scale, and the Simple Coping Style Questionnaire. We then adapted the Hayes Process Macro and Bootstrap methods to examine the mediating effects of coping styles between mindfulness and affiliate stigma. Results(1) The total affiliate stigma score of parents of children with autism was 48.53 (standard deviation:: 10.74). Parents' age, monthly family income, duration of care, mindfulness, and coping styles were the influencing factors of parental affiliate stigma. (2) Mindfulness was positively correlated with positive coping style (r = 0.33, p < .01) and negatively correlated with negative coping style, affiliate stigma (r = −0.38, −0.39, p < .01), whereas affiliate stigma was negatively correlated with positive coping style (r = −0.34, p < .01) and positively correlated with negative coping style (r = 0.41, p < .01). (3) Positive coping style and negative coping style play a parallel mediating role between mindfulness and affiliate stigma of parents of autistic children. ConclusionsParents of children with autism experience significant levels of affiliate stigma. Mindfulness has a direct impact on associated stigma in parents of children with autism and also indirectly predicts associated stigma through the intermediary influence of positive and negative coping styles. Healthcare professionals could perform mindfulness interventions from an optimistic psychology viewpoint to boost parents' mindfulness and coping abilities, thereby accomplishing the objective of mitigating affiliate stigma.

The mediating effect of family resilience between coping styles and caregiver burden in maintenance hemodialysis patients: a cross-sectional study

BackgroundPrimary caregivers of hemodialysis patients suffer from varying degrees of stress from their patients. Caring for hemodialysis patients can expose caregivers to many problems, leading to an increased burden of care and even impacting the quality of care. The purpose of our study was to examine whether family resilience could be a mediating variable moderating the relationship between patient coping styles and caregiver burden.MethodsThe study was a cross-sectional and descriptive-analytical study that interviewed 173 pairs of hemodialysis patients and their caregivers at a blood purification center in a public hospital in China. The Brief Coping Styles Scale (Chinese version) was used to assess individuals’ coping styles for disease and treatment. From the caregiver’s perspective, the Family Resilience Assessment Scale (Chinese version) was used to understand the resilience of families, and the Zarit Caregiver Burden Scale was used to capture the caregiver’s subjective experience of burden. Statistical analyses were conducted using SPSS version 23 and Amos version 26 to analyze the relationships between variables to examine for correlation and construct mediated effects models.ResultsCoping styles showed a significant positive correlation with family resilience (r = 0.347, P < 0.01) and a negative correlation with caregiver burden (r = -0.379, P < 0.01). A significant negative correlation was found between family resilience and caregiver burden (r = -0.503, P < 0.01). In the mediation model, patient coping styles directly impacted caregiver burden significantly (95% CI [-0.372, -0.058]), and coping styles indirectly impacted caregiver burden by family resilience in a significant way (95% CI [-0.275, -0.098]).ConclusionsPatient coping styles directly affect caregiver burden. Family resilience is a mediating variable between patients’ coping styles and the burden on caregivers.

Substandard feeding in children undergoing mechanical ventilation in pediatric intensive care unit: A retrospective cohort study in China.

Enteral nutrition is a common yet vital practice in the pediatric intensive care unit (PICU). However, the status of substandard feeding of enteral nutrition in PICU children undergoing mechanical ventilation remains unclear and can be detrimental to the children's prognosis. This study aimed to evaluate the incidence, nursing care status, and influencing factors of substandard feeding in children undergoing mechanical ventilation in the PICU. This study employed a retrospective cohort design. Children undergoing mechanical ventilation and enteral nutrition in the PICU of a public hospital in China from 1 June 2021 to 31 December 2022 were selected using convenience sampling, and their characteristics were collected and evaluated. Pearson correlation analysis and multivariate logistic regression analysis were conducted to assess the influencing factors of substandard feeding in PICU children with mechanical ventilation. A total of 156 PICU children undergoing mechanical ventilation were included for analysis in this study. The rate of substandard feeding in PICU children was 65.38%. Statistically significant differences were observed in diarrhea, vomiting, the use of sedatives, and average infusion speed between the substandard feeding group and the standard group (p <0.05). Pearson correlation results indicated that diarrhea (r = 0.595), vomiting (r = 0.602), and average infusion speed (r = 0.562) were correlated with substandard feeding and characteristics of included ICU children undergoing mechanical ventilation (p <0.05). Logistic regression results found that diarrhea (OR = 2.183, 95%CI: 1.855~2.742), vomiting (OR = 3.021, 95%CI: 2.256~4.294), and average infusion speed ≤40 mL/h (OR = 2.605, 95%CI: 1.921~3.357) were independent risk factors for substandard feeding in mechanically ventilated children in the ICU (p <0.05). The rate of substandard feeding in children with mechanical ventilation in the PICU was high. Diarrhea, vomiting, and slow infusion speed are important influencing factors for substandard feeding. It is suggested that nurses and other healthcare professionals take targeted measures, including the prevention and care of diarrhea and vomiting, as well as monitoring and adjusting the infusion speed of enteral nutrition, to reduce the occurrence of substandard feeding.

Identifying patient perceived values during outpatient encounters: an empirical study from Chinese public hospitals

BackgroundFocusing on patients’ perceived values is essential for patient-centered health care. Only by identifying the patient’s preferred values can we better meet their needs and provide them with valuable medical services. This study aimed to construct and validate a research model to obtain an overall quantification of patient value during outpatient encounters.MethodsThe development of the research model was based on the reviewed literature, and an initial theoretical framework was formed by an expert panel discussion. A scale questionnaire for all the items was adapted from previous research related to patient value, verified using a presurvey, and thus used for data collection for this study. The structural equation model was used to determine and evaluate the research model of the values patients perceived during outpatient encounters.Results572 eligible respondents who completed outpatient visits from a typical public hospital in China participated in this study from November 2020 to February 2021. We constructed the patient perceived value (PPV) model to identify core values, which includes eight dimensions and 29 items in terms of functional value (installation, efficiency, price, service quality), emotional value (interactive, control), and social value (accessibility, image) from two subgroups of patient value outside and in the outpatient visit process. Cronbach’s alpha for the whole model was 0.950. The confirmatory factor analysis showed that the PPV model fits well, with a correlation of 0.83 between the two subgroups.ConclusionIt is essential to recognize the values based on patients’ perceptions and experiences throughout the entire visit process. Our findings offer targeted insights for healthcare administrators, enabling them to holistically optimize outpatient service processes and continually enhance the quality of outpatient medical services from the patient’s perspective.

Assessing resource allocation based on workload: a data envelopment analysis study on clinical departments in a class a tertiary public hospital in China

ObjectiveToday, the development mode of public hospitals in China is turning from expansion to efficiency, and the management mode is turning from extensive to refined. This study aims to evaluate the efficiency of clinical departments in a Chinese class A tertiary public hospital (Hospital M) to analyze the allocation of hospital resources among these departments providing a reference for the hospital management.MethodsThe hospitalization data of inpatients from 32 clinical departments of Hospital M in 2021 are extracted from the hospital information system (HIS), and a dataset containing 38,147 inpatients is got using stratified sampling. Considering the non-homogeneity of clinical departments, the 38,147 patients are clustered using the K-means algorithm based on workload-related data labels including inpatient days, intensive care workload index, nursing workload index, and operation workload index, so that the medical resource consumption of inpatients from non-homogeneous clinical departments can be transformed into the homogeneous workload of medical staff. Taking the numbers of doctors, nurses, and beds as input indicators, and the numbers of inpatients assigned to certain clusters as output indicators, an input-oriented BCC model is built named the workload-based DEA model. Meanwhile, a control DEA model with the number of inpatients and medical revenue as output indicators is built, and the outputs of the two models are compared and analyzed.ResultsClustering of 38,147 patients into 3 categories is of better interpretability. 14 departments reach DEA efficient in the workload-based DEA model, 10 reach DEA efficient in the control DEA model, and 8 reach DEA efficient in both models. The workload-based DEA model gives a relatively rational judge on the increase of income brought by scale expansion, and evaluates some special departments like Critical Care Medicine Dept., Geriatrics Dept. and Rehabilitation Medicine Dept. more properly, which better adapts to the functional orientation of public hospitals in China.ConclusionThe design of evaluating the efficiency of non-homogeneous clinical departments with the workload as output proposed in this study is feasible, and provides a new idea to quantify professional medical human resources, which is of practical significance for public hospitals to optimize the layout of resources, to provide real-time guidance on manpower grouping strategies, and to estimate the expected output reasonably.

Study on Sustainable Development Oriented Community Public Hospital in China Based on Optimal Decision Making Model for Environment Renovation

Community public hospital provides public health and basic medical services, and their construction environment has an important impact on the health and well-being of the residents. Due to the long construction period of most community hospitals, the population expansion and the change in age structure have led to a mismatch between the needs of patients and the current situation, which is in urgent need of renovation. This paper aims to support the government and hospitals in making decisions by eliminating the blind spots in capital investment and benefit evaluation. In this study, environmental modification design variables are first established, and on this basis, the fuzzy Delphi method is used to understand the willingness for renovation on the part of patients, accompanying personnel, staff, healthcare workers as well as hospital administrators. Besides, the I-S model is used to identify the renovation projects that would maximize user satisfaction. Furthermore, the differences between patients and medical staff are compared. The ODM (Optimal Decision-making) model is used to evaluate the cost investment and benefits, which provides support for the decision-making of government and hospitals. The results clarify the key renovation design variables that can significantly improve user satisfaction and extend them into renovation strategies that can be landed, and identify renovation strategies with larger improvement scores and the range of renovation funds that maximize benefits to promote the sustainable development of community public hospitals. It can be seen that the ODM model can also be well applied to the renovation of community healthcare services. In addition, the reference classification and design variables should be adjusted according to the characteristics of China, taking into consideration the specificity of individual hospitals.

Couple communication quality and family resilience among Chinese gynecologic cancer patients and their spouses: a dyadic study

The purpose of this study was to explore the couple communication process for gynecologic cancer (GC) patients and their spouses. Particular attention was given to examining the relationship between couple communication quality and family resilience for GC dyads. In this cross-sectional study, 354 dyads were recruited from a gynecology ward of a public hospital in China. The patients and their spouses completed the Couples' Communication Quality Scale and the Family Hardiness Index. This study used the actor-partner interdependence model (APIM) to examine the effect of couple communication quality on family resilience in distinguishable GC dyads. Both GC patients and their spouses reported a moderate level of couple communication quality and family resilience, but spouses reported better couple communication and family resilience than patients. With the exception of perceived response, for which only a patient actor effect was observed, the factors of couple communication quality had significant actor effects on family resilience for both patients and spouses. Additionally, four significant partner effects were found: spouse self-disclosure, stress coping, and productive action positively predicted patients' family resilience, while patient normalcy crafting positively predicted spouses' family resilience. This study not only highlights the need for couple-based communication strategies for developing family resilience but also identifies differences in the experiences of patients and their partners, which provides a direction for future intervention research. Through the development of interventions at a dyadic level, spouses can be encouraged to actively engage in communication, which may promote mutual family resilience in a larger sense.

The Moderating Effects of Social Responsibility Climate and Safety Climate in Keeping Healthcare Workers' Engagement during COVID-19.

The outbreak of COVID-19 brings an overload of physical and mental demands to healthcare professionals. Keeping healthcare professionals sustainable, engaged, and performing at their highest levels becomes critical and nonetheless difficult. The objective of this research is to link the literature on organizational climates, corporate social responsibility, safety science, and work engagement, and propose a research framework that investigates the factors influencing healthcare professionals' engagement during COVID-19. We propose that when healthcare workers' career callings are triggered by COVID-19, it influences their perceptions of the work's meaningfulness, which ultimately enhances their work engagement. We argue that creating a social responsibility climate and a safety climate inside the hospital facilitates the process of turning healthcare workers' perceived work meaningfulness into work engagement. We collected data from 112 healthcare professionals, including nurses, doctors, and executive staff, from 16 wards in a public hospital in China to test our hypotheses. Hierarchical linear regression analysis provided empirical support for our research model. We find that healthcare professionals' career callings during COVID-19 enhanced their perceived work meaningfulness, which results in increased work engagement. Moreover, a social responsibility climate and a safety climate strengthens the link between work meaningfulness and work engagement among participants. Creating a social responsibility climate and a safety climate in the workplace are effective management approaches to realize healthcare workers' feelings of work meaningfulness and turn them into work engagement.

Group citizenship behaviour in healthcare organization, doctor-patient relationship, work engagement and turnover intention: A moderated mediation model.

The effective functioning of health care organisations depends on the inter-professional collaboration among healthcare professionals from diverse backgrounds, representing different work units, to provide quality services. This study aims to understand how group citizenship behaviour (GCB) that supports other work groups may moderate the relationship between doctor-patient relationship (DPR), Work Engagement (WE) and Turnover Intention (TI). The data for this study were collected through two waves of questionnaire survey at a tertiary public hospital in China. The hypothesised model was tested by Hayes' PROCESS macro. There were significant differences of perceived GCB across different professional units with work units practicing a multidisciplinary working approach and working in the high-stake working environment reported higher levels of GCB. The results show that WE mediates the relationships between DPR and TI and GCB accentuates the positive relationship between DPR and WE. Specifically, the path between DPR and WE was stronger for individuals with high perceived GCB than those with low perceived GCB. The study contributes to the development of Job Demands-Resources model with integrating GCB into the model and enriching the challenge job demand conceptualisation by focussing on DPR in Chinese health care setting. In practice, the hospital administrators should encourage GCB to improve organizational effectiveness and doctors' attitudes.

The mediating effects of adversity quotient and self-efficacy on ICU nurses' organizational climate and work engagement.

This study aimed to explore the mediating effects of adversity quotient and the moderating effect of self-efficacy on the relationship between the organizational climate and the work engagement of intensive care unit nurses. A good organizational climate can contribute to a high level of work engagement. Adversity quotient and self-efficacy are the key factors affecting nurses' work engagement, while the mechanism of these factors in the organizational climate and work engagement remains unclear. This study was conducted to contribute to the relevant field research. The study used a cross-sectional research design and surveyed 323 intensive care unit nurses working in a public hospital in China. The data were analysed using descriptive statistical methods: Pearson correlation analysis and PROCESS macro Model 7 in the regression analysis. Organizational climate was positively correlated with work engagement and adversity quotient. The indirect effect of organizational climate on work engagement through adversity quotient was positive. Furthermore, self-efficacy moderated the relationship between the two factors. Cultivating organizational climate and adversity quotients is an important strategy to improve the work engagement of intensive care unit nurses, particularly for nurses with high self-efficacy. Administrators should make efforts to create a good organizational climate and cultivate nurses' adversity quotients and self-efficacy to decrease their intent to leave.

An investigation of the incidence of post-traumatic stress disorder, turnover intention and psychological resilience among medical staff in a public hospital in China during the outbreak of the omicron variant in the COVID-19 pandemic in 2022.

ObjectiveTo investigate the incidence of post-traumatic stress disorder (PTSD), turnover intention and psychological resilience of medical staff during the Outbreak of the Omicron Variant in the COVID-19 pandemic in 2022 and to provide a basis for adopting relevant psychological interventions to reduce medical staff turnover.MethodsUsing the PTSD Checklist-Civilian Version (PCL-C) and a total score ranging from 17 to 85 points, a total score ≥ 38 indicates significant PTSD symptoms and a diagnosis of PTSD. The Chinese version of the Turnover Intention Scale (TIS) has a total score of 6 to 24 points; the higher the score, the stronger the turnover intention. The Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) has a total score of 0 to 100 points, with higher scores indicating a better level of psychological resilience. A total of 443 front-line medical staff working in Chinese public hospitals and still treating all patients normally during COVID-19 were invited via the internet to complete a survey from 15 May to 30 May 2022 in China.ResultsThe incidence of PTSD was 14.4%, the total turnover intention score was 13.38 ± 4.08, and the total psychological resilience score was 87.16 ± 18.42. The prevalence of PTSD was higher among medical staff who were married, had children, and were worried about being infected; in addition, the PTSD group had a higher level of education, higher turnover intention, and lower psychological resilience than the non-PTSD group. The total scores for turnover intention and fear of being infected were risk factors for PTSD, while a high total psychological resilience score and high education level were protective factors for PTSD; the differences were statistically significant (all P < 0.05).ConclusionPost-traumatic stress disorder among Chinese medical personnel was associated with the marital status, childbirth, education level, turnover intention, and psychological resilience. Among these factors, psychological resilience might be exploited as a protective factor.

Maternal knowledge, attitudes and practices related to neonatal jaundice and associated factors in Shenzhen, China: a facility-based cross-sectional study

ObjectiveThis study aimed to assess knowledge, attitudes and practices related to neonatal jaundice among mothers in Shenzhen, China, and analyse associated factors.DesignA cross-sectional study.SettingThis study was conducted in Shenzhen Hospital,...

Assessment and nonpharmacological management for patients with cancer anorexia-cachexia syndrome: a best practice implementation project.

Cancer anorexia-cachexia syndrome (CACS) is a common multifactorial syndrome, which affects up to 80% patients with advanced cancer. At present, evidence to support the benefit of pharmacological intervention in the management of CACS is limited. Patients would benefit from standard procedures for early assessment and identification of cancer anorexia-cachexia, and using nonpharmacological strategies to manage patients with CACS. This best practice implementation project aimed to implement an evidence-based practice in assessing and managing patients with CACS, thereby improving the compliance of clinical practice with the best evidence and the quality of life of patients with CACS. This was an evidence-based audit and feedback project that used a three-phase approach at a public hospital in China. Phase 1 included the development of seven evidence-based audit criteria and carrying out a baseline audit on 30 patients using the JBI's Practical Application of Clinical Evidence System in the Department of Radiation Oncology of Nanfang Hospital. Phase 2 utilized the Getting Research into Practice component of the Practical Application of Clinical Evidence System to identify barriers to compliance with best practice principles and developed strategies and resources to improve compliance. Phase 3 involved conducting a follow-up audit using the same sample size and audit criteria to assess the results of interventions implemented to improve practice and identify issues that would be addressed in future audit. The compliance rates of audit criteria 1, 2 and 6 were 100% at both baseline and follow-up audit. After the application of evidence, the compliance rate increased from 0 to 100% for audit criterion 3, from 0 to 76.6% for audit criterion 4, from 23 to 70% for audit criterion 5, and from 0 to 40% for audit criterion 5. The best evidence for the assessment and nonpharmacological management of cancer patients with CACS can improve clinical practice, the quality of clinical nursing, and patient satisfaction. The application of electronic informatization promotes the implementation and maintenance of best practice.

Assessing Workplace Stress Among Nurses Using Heart Rate Variability Analysis With Wearable ECG Device-A Pilot Study.

This study aims to measure workplace stress of nurses using heart rate variability (HRV) analysis based on data derived from wearable ECG heart rate monitors. The study population consists of 17 nurses at a major public hospital in China. Data was collected from 7 DON nurses (department of neurosurgery; all females; mean age: 31.43 ± 4.50), and 9 ICU nurses (intensive care unit; 8 females and 1 male; mean age: 31.33 ± 5.43). Each participant was asked to wear a wireless ECG heart rate monitor to measure stress level during work, and to complete the Chinese Nurses Stress Response Scale (CNSRS) after work as subjective response criteria. Demographic information, body posture, heart rate, R-R intervals (RRI), low frequency components (LF) and high frequency components (HF) were collected. LF%, LnHF and the squared root of the mean squared differences of successive NN intervals (RMSSD) based on HRV analysis were used to estimate the stress level of nurses. DON nurses reported a higher LF%, lower LnHF and lower RMSSD than ICU nurses. Work shifts were shown to have significant effects on LF%, LnHF and RMSSD respectively, with nurses in long shifts and night shifts reported high stress levels. Higher LF%, lower LnHF and lower RMSSD were found during work shift. Posture analysis revealed negative correlations with LnHF and RMSSD in walking and standing/sitting positions, and a significant negative correlation with LF% in lying-down position. Nurses with higher LF% reported higher CNSRS scores in all subscales, whereas nurses with lower LnHF or RMSSD reported higher CNSRS scores in social phobia and fatigue subscales. The results of this study support the idea that HRV can be used to investigate workplace stress among nurses under real work condition, and can serve as a preventive measure for identifying stress-related illnesses among nurses.

The Impact of Chronic Illness on the Patient Experience: Results From a Cross-Sectional Comparative Study in a Comprehensive Tertiary Hospital in China.

Objective:Improving the satisfaction and medical experience of patients is a basic goal of the comprehensive reform of public hospitals in China. This study aimed to investigate the patient experience and its influencing factors, and to compare medical experiences between patients with and without chronic disease, with a view to providing suggestions for improving the quality of public hospitals in China.Methods:A cross-sectional comparative study involving 102 patients discharged from Taizhou Hospital of Zhejiang Province, a tertiary public hospital in China, was conducted. The patients were invited to participate in a survey comprising the Picker Patient Experience Questionnaire (PPE-15), and an overall satisfaction evaluation (on a scale of 1-10). The patients were divided into two groups according to whether or not they had a chronic disease, and the medical experience and overall satisfaction of the groups were compared. Descriptive statistics (frequency, median, mean), chi-square analysis, and Mann–Whitney U tests were used to analyze the data.Results:No statistical significance was found in overall satisfaction between patients with and without chronic diseases, but there were differences in the patient experience score. Chronic illness had negative impacts on the experience of care coordination for patients and respect for patient preferences. Of the seven dimensions of the PPE-15, the scores for emotional support and respect for patient preferences were the lowest in both groups, and the item “want to be more involved in decisions made about care and treatment” scored the lowest among all items.Conclusions:Hospital managers and staff members should pay more attention to the emotional support and preferences of patients. For patients with chronic diseases, the standardization of medical care and patient participation in the medical process should be strengthened. Hospitals should also subdivide patient groups, ascertain the demands and expectations of patients, and carry out targeted evaluation and intervention measures.

Implementation of strategies to improve nutritional intervention for patients with cancer treatment-related oral mucositis: a best practice implementation project.

Oral mucositis is a common complication after radiotherapy or chemotherapy in cancer patients. Oral mucositis can affect the patient's food intake and their confidence in treatment as patients are more likely to suffer severe pain, experience weight loss, encounter an interruption or change of cancer treatment plan, and are reported to have a reduced survival from the disease. Nutritional intervention is the primary nursing focus in patients with oral mucositis treated by chemoradiotherapy. The current best practice implementation project aimed to establish best practice principles in nutritional interventions for patients with cancer treatment-related oral mucositis. This was an evidence-based audit and feedback project that used a three-phase approach at a public hospital in China. Phase 1 involved developing five evidence-based audit criteria informed by current best available evidence, and undertaking a clinical audit of current practice on 50 patients in the Department of Radiation Oncology of Nanfang Hospital using the JBI's Practical Application of Clinical Evidence System. Phase 2 utilized the Getting Research into Practice component of the Practical Application of Clinical Evidence System to identify barriers to compliance with best practice principles and developed strategies and resources to improve compliance. Phase 3 involved conducting a postaudit using the same sample size and audit criteria to re-evaluate compliance with best practice. Baseline results showed that compliance rates were 0% for criteria 1 and 2, 76% for criteria 3 and 5, and 82% for criterion 4. The implementation of strategies, including establishing a multidisciplinary team with a dietitian, creating training and education programs for all staff and patients, utilizing a scale regarding diet to assess patients' current diet, and establishing a nutrition intervention nursing procedure to supervise implementation of the nutritional intervention for patients with cancer treatment-related oral mucositis, increased compliance with best practice, achieving compliance rates of at least 82% for all five audit criteria. The implementation of context-specific strategies improved compliance with evidence-based practice in the nutritional intervention for patients with cancer treatment-related oral mucositis. Sustainability of best practice is important, with further audits planned to evaluate the sustainability of these practice changes.

New Graduate Nurses’ Professional Identification Awakened During COVID-19

Although the COVID-19 pandemic has put health-care employees, especially nurses, under tremendous pressure, it may provide these workers with a chance to reassess their professional identification and break the “hangover” effect in socialization. Drawing on an identity construction process perspective, we explore the trajectory of professional identification among new graduate nurses, and propose that since the COVID-19 outbreak, new graduate nurses’ professional identification increases. Furthermore, the increased professional identification is positively related to both sensegiving, as a top-down process, and moral elevation, as a bottom-up process of identity construction via work meaningfulness. Using nine-wave longitudinal data (five waves before and four after the COVID-19 outbreak) from 322 new graduate nurses at a public hospital in China, we conducted discontinuous growth modeling (DGM) analyses to test our hypotheses. We found that new graduate nurses’ professional identification gradually fell during the initial months into professional practice (hangover effect), but rose significantly after the onset of COVID-19. Sensegiving and moral elevation, mediated by work meaningfulness, were positively associated with this increase in professional identification. Our findings shed light on professional identification dynamics in the crisis context and the disruptive socialization processes to overcome the hangover effect.

Dyadic effects of family resilience on post-traumatic stress symptoms among breast cancer patients and their primary family caregivers: A cross-sectional study.

The aims of this study were to verify actor and partner effects, by examining the effects of family resilience on post-traumatic stress symptoms (PTSS) among Chinese breast cancer patients and their primary family caregivers. In this cross-sectional study, 104 breast cancer patients (age range 20-75, Mean=47, Standard Deviation=10), and their principal caregivers (n=104), were recruited from a comprehensive cancer center of a public hospital in China. The patients and their caregivers self-reported sociodemographic, family resilience, and PTSS factors. The actor-partner interdependence model were adopted to examine whether the patients and caregivers' perceived family resilience could contribute to their own ("actor effect") and each other's ("partner effect") PTSS. There were significant correlations between patients' and caregivers' shortened Chinese version of Family Resilience Assessment Scale scores (r=0.58, p<0.01) and Post-traumatic Stress Disorder Checklist-Civilian Version scores (r=0.69, p<0.01). Caregivers' perceived family resilience was negatively related to their PTSS (actor effect), and the patients' PTSS (partner effect). However, the patients' perceived family resilience was not significantly related to their or the caregivers' PTSS. The primary caregivers' perceived family resilience had both actor and partner effects on patient/caregiver PTSS within the first year of breast cancer diagnosis. Family-based interventions should be designed to enhance family resilience to decrease PTSS within families dealing with cancer patients. Supportive care should focus on the primary family caregivers within the first year of breast cancer diagnosis.