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Background: The condition and correlation of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. This survey aimed to evaluate the current status and influencing factors of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas. Methods: Patients undergoing pituitary adenoma resection in two tertiary hospitals from November 2019 to November 2021 were included. The general data questionnaire, Multidimensional Fatigue Inventory (MFI‐20), Pittsburgh Sleep Quality Index (PSQI) and international physical activity questionnaire were used for data analysis. Results: In total, 184 patients with pituitary adenomas were included. The postoperative patients with pituitary adenomas had a high level of fatigue. In total, 34 (18.5%) patients had low level of physical activity, 76(41.3%) patients had medium level of physical activity and 74 (40.2%) had high level of physical activity. Postoperative time, PSQI, physical activity level and gender were the influencing factors of fatigue in patients with pituitary adenomas (all P < 0.05). Conclusions: Postoperative patients with pituitary adenomas have a higher level of fatigue, and it is related to reduced sleep quality and activity. Relevant nursing measures should be taken according to the influencing factors of fatigue to reduce the fatigue of postoperative patients with pituitary adenomas. Summary statement: What is already known about this topic? The postoperative nursing care of patients is very important to the quality of life in patients with pituitary adenomas.Fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. What this paper adds? There is a high level of fatigue in patients with pituitary adenomas within 1 year after operation.The degree of fatigue is negatively correlated with the course of disease and the level of physical activity. The implications of this paper: Interventions and nursing care strategies targeted on the factors affecting postoperative fatigue of patients with pituitary adenomas are needed. [ABSTRACT FROM AUTHOR]

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Aims: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. Methods: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random‐effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). Results: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06–0.41). Notable reductions were observed in anxiety (MD: −8.96, 95% CI: −11.52 to −6.40) and depression (MD: −9.47, 95% CI: −11.79 to −7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15–2.25), social (SMD: 1.65, 95% CI: 1.14–2.16) and activity scores (SMD: 1.94, 95% CI: 1.49–2.39), alongside a decrease in post‐treatment complications (OR: 0.28, 95% CI: 0.21–0.37), demonstrating the multifaceted benefits of comprehensive care. Conclusion: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy. Summary statement: What is already known about this topic? Liver cancer patients undergoing interventional therapy often experience significant physical and psychological challenges.Comprehensive nursing care has been hypothesized to offer potential benefits in addressing these challenges.There is limited evidence on the exact impacts of comprehensive nursing care on these patients, leading to knowledge gaps in its applicability and efficacy. What this paper adds? This review demonstrates that comprehensive nursing care can lead to significant improvements in the quality of life for liver cancer patients in China.This review provides evidence that comprehensive care reduces levels of anxiety and depression in these patients.This review shows that this approach boosts physical, social function and activity scores while also reducing post‐treatment complications. The implications of this paper: This paper suggests integrating comprehensive nursing care as a standard practice, given its potential to significantly improve patient outcomes and quality of life.This research emphasizes the importance of equipping oncology nurses with comprehensive care skills and expanding their roles to ensure optimal patient outcomes.Despite promising results, there is a need for further high‐quality, randomized controlled trials to confirm these findings and delve deeper into other potential benefits and best practices of comprehensive nursing care for liver cancer patients. [ABSTRACT FROM AUTHOR]

Background: Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other. Aims: The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure. Methods: A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors. Results: The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression–anxiety, subjective social support–objective social support, and subjective social support–social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA–dyspnea, depression–difficulty sleeping, and social support availability–dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes. Conclusions: Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health. Summary statement: What is already known about this topic? Limited studies have explored core somatic symptoms in patients with chronic heart failure using network analysis.There is a lack of a holistic perspective when studying symptoms in patients with chronic heart failure and their association with various factors. What this paper adds? This study identifies daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping as the four core symptoms of chronic heart failure.Targeting these core symptoms in treatments and management can potentially lead to improvements in patients' overall health.The network analysis highlights the importance of psychological and environmental factors, suggesting that interventions targeting these factors may contribute to overall health improvement. The implications of this paper: It provides evidence of core symptoms of chronic heart failure.It provides evidence of the complex interconnections among symptoms and related factors in chronic heart failure.It provides implications for future interventions and strategies in managing chronic heart failure. [ABSTRACT FROM AUTHOR]

Aims: To test the psychometric properties of the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory on a sample of patients with chronic obstructive pulmonary disease in China. Background: Measuring the self‐care of patients with chronic obstructive pulmonary disease is vital to promote the performance of effective self‐care behaviours. However, few instruments have been developed to measure self‐care in chronic obstructive pulmonary disease, and the existing instruments lack theoretical support and satisfactory psychometrics properties. The Self‐Care in Chronic Obstructive Pulmonary Disease Inventory based on Middle‐Range Theory of Self‐Care of Chronic Illness has been developed and tested previously in Italian and US population. Design: A cross‐sectional instrument development study. Methods: Construct validity was tested by confirmatory factor analysis and hypothesis testing, and reliability internal consistency using factor score determinacy coefficients. Results: A convenience sample of 185 patients with chronic obstructive pulmonary disease was recruited from September 2020 to January 2022. The instrument consists of three scales: self‐care maintenance, self‐care monitoring and self‐care management. Confirmatory factor analysis performed on the three scales produced good fit indices. The internal consistency was adequate with factor score determinacy coefficients ranging from 0.891 to 0.953 in Self‐Care Maintenance Scale, 0.990 to 0.993 in Self‐Care Monitoring Scale and 0.750 to 0.976 in Self‐Care Management Scale. Conclusions: The Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has acceptable reliability and validity. Some differences from the original instrument were identified. Further validation studies should be conducted to confirm the psychometric properties of the instrument in Chinese population. Summary statement: What is already known about this topic? The Middle‐Range Theory of Self‐care of Chronic Illness has been used to direct clinical nursing practice for coronary heart disease, heart failure, hypertension, chronic obstructive pulmonary disease and other chronic illnesses and has been shown to have good guiding significance for clinical nursing practice for the self‐care of clinical chronic illness.In patients with chronic obstructive pulmonary disease, self‐care has a significant positive effect on preserving disease stability and enhancing health‐related quality of life.There is a shortage of moderate length evaluation instruments for chronic obstructive pulmonary disease self‐care with comprehensive theoretical assessment content, but the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory, based on the Middle‐Range Theory of Self‐care of Chronic Illness, has been demonstrated to have positive application effects in Italy and the United States. However, its applicability in China is unclear. What this paper adds? This paper indicates that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has good reliability and validity and can reflect the self‐care ability of patients with chronic obstructive pulmonary disease in China. The implications of this paper: The results show that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory is simple and accessible, and nurses can use it to assess patients' capacity for self‐care regularly.The Chinese version of the Self‐Care Scale has different dimensions from the original scale, indicating that different medical backgrounds and varying understanding of concept of self‐care in various nations may result in various self‐care behaviours.To ensure its wider application, the development of this scale necessitates cross‐cultural adaptation of populations in more countries. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the influence of Chinese culture and customs on the beliefs and health‐related behaviours of Chinese women with gestational diabetes mellitus (GDM). Methods: This descriptive qualitative study conducted semi‐structured interviews with 15 Chinese women between November 2022 and January 2023. The interview data were analysed using thematic analysis. Results: Three major themes are found: (1) beliefs in health, (2) beliefs in illness and GDM and (3) beliefs in health‐related behaviours. They worried about the negative effects of GDM on the infant and family, so they actively sought medical advice to maintain health. However, it is challenging for them to balance adhering to healthcare professionals' advice and avoiding practical difficulties in the impact of the Chinese sociocultural context. Conclusion: This study emphasizes the influence of Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM. Healthcare providers should recognize the influence of Chinese culture, customs and beliefs on women with GDM and their families, in order to provide individualized education to help them maintain health‐related behaviours. Summary statement: What is already known about this topic? The prevalence of gestational diabetes mellitus (GDM) is increasing in China and affects 14.8% of pregnant women.Some personal beliefs about illness and health can lead to inadequate self‐care behaviours and thus failure to achieve optimal self‐management and health goals.Factors of Chinese sociocultural content and Chinese traditional culture and customs may have different influences on Chinese married women's beliefs in health, illness and health‐related behaviours. What this paper adds? Influenced by Chinese culture and customs, Chinese women's perspectives on gestational diabetes are bidirectional. They fear the negative effects of the disease on infants' and families' health and actively seek help, while some try to balance following professional advice and practical difficulties, such as diet control and self‐glucose monitoring.The low‐risk self‐management awareness, lack of adequate healthcare knowledge, and self‐care practice in Chinese women with GDM are one of the factors that lead to practical difficulties in GDM management.Understanding the impact of traditional Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM, well‐trained healthcare professionals can disseminate personalized health education to individuals, families and communities to improve GDM management in these women. The implications of this paper: Health providers need to constantly update the GDM guidelines with Chinese cultural characteristics based on the cultural acceptance and customs of Chinese women with GDM in order to offer them individualized care and scientific advice.The findings of this study could act as a clinical resource for health professionals to investigate the impact of differences in culture and customs across countries or regions on individual beliefs and health‐related behaviours in different populations. [ABSTRACT FROM AUTHOR]

Aims: This study aims to examine the prevalence of anxiety symptoms and identify predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners and explore the mediating role of marital satisfaction between maternal and paternal anxiety. Design: A cross‐sectional study was conducted in Guangzhou, China, from July 2021 to May 2022. Methods: A total of 306 dyads of pregnant women with gestational diabetes mellitus and their partners completed the State–Trait Anxiety Inventory, Locke–Wallace Marital Adjustment Test and the socio‐demographic and clinical data sheet. Results: The prevalence of anxiety symptoms was 32.4% and 36.6% in pregnant women with gestational diabetes mellitus and their partners, respectively. The predictors of maternal anxiety were paternal anxiety, maternal marital satisfaction, maternal monthly salary, fasting glucose value and 1‐h glucose value. By contrast, the predictors of paternal anxiety were maternal anxiety, paternal marital satisfaction and paternal monthly salary. Moreover, the relationship between maternal and paternal anxiety was mediated by marital satisfaction. Conclusions: The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other, and this relationship was mediated by marital satisfaction. Every couple should be screened for anxiety symptoms and treated as a team rather than focusing solely on the pregnant woman. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with various short‐ and long‐term adverse maternal and neonatal outcomes.The diagnosis of gestational diabetes mellitus is stressful for pregnant women and their partners.No studies have been conducted to examine and compare the anxiety symptoms among pregnant women with GDM and their partners in mainland China. What this paper adds? The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other.The prevalence of anxiety symptoms was high in both pregnant women with gestational diabetes mellitus and their partners.Marital satisfaction played a mediating role between maternal and paternal anxiety. The implications of this paper: Study findings provide important information to guide future practice for nurses and other health‐care professionals.For the future, routine screening for anxiety symptoms is necessary for both pregnant women with gestational diabetes mellitus and their partners; mental health support should be delivered in a timely fashion for couples.Pregnant women with gestational diabetes mellitus and their partners should be treated as a team rather than focusing solely on pregnant women, with couples given training on enhancing marital satisfaction skills to prevent and reduce their anxiety symptoms. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to synthesize the available evidence on the effectiveness of nurse‐led multidisciplinary interventions in primary health care. Methods: The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM), from the establishment of the databases until the last updating search 1 April 2022. Two researchers screened the studies independently and extracted the data. Meta‐analysis was performed using the RevMan 5.3 software. Results: A total of 12 studies were included in this review. It was found that nurse‐led multidisciplinary interventions significantly shortened patients' length of stay in hospital (standardized mean differences [SMD] = −1.28, 95%CI: −2.03 to −0.54; P<0.001) and decreased incidences of complications (RR = 0.24, 95%CI:0.10 to 0.54; P = 0.0006) compared to the control group, and lowered patients' anxiety levels (SMD = −1.21, 95%CI: −1.99 to −0.44; P<0.01) and depression levels (SMD = −1.85, 95%CI: −3.42 to −0.28; P<0.0001). Furthermore, the results of subgroup analysis indicated that nurse‐led multidisciplinary interventions had significant effects on patients' self‐management ability (SMD = 4.45, 95%CI:2.45 to 6.44; P<0.0001) and quality of life (SMD = 1.01, 95%CI: 0.63 to 1.40; P<0.0001) compared to the control group. Conclusions: Nurse‐led multidisciplinary interventions had strong effects in primary health care, contributing to shorten patients' length of stay in hospital, decrease incidences of complications and reduce the levels of anxiety and depression. Moreover, nurse‐led multidisciplinary interventions also improved patients' self‐management ability and quality of life. Summary statement: What is already known about this topic? Chronic diseases with long duration and slow recovery are one of the priorities for management in primary health care.In China and other countries around the world, primary health care is highly regarded for its efforts for the health of all.Several randomized controlled trials have explored the effectiveness of nurse‐led multidisciplinary interventions in primary health care, but the findings of these studies are contradictory. What this paper adds? The review demonstrates that nurse‐led multidisciplinary interventions could shorten patients' length of stay in hospital, decrease the incidence of complications and reduce the levels of anxiety and depression.Nurse‐led multidisciplinary interventions also improve patients' self‐management ability and quality of life.Nurse‐led multidisciplinary interventions are beneficial for promoting health and preventing disease in primary health care. The implications of this paper: Community primary health‐care personnel should be aware of the importance of nurse‐led multidisciplinary interventions in preventing disease and safeguarding health.For people with chronic diseases, community health‐care personnel should adopt multidisciplinary care methods to improve outcomes for patients.High‐quality studies are needed to verify the effects of interventions for patients. [ABSTRACT FROM AUTHOR]

Aim: Smoking is harmful to human health. However, the relationship between smoking and blood pressure (BP) has not been consistent. This study aimed to analyse nurses' smoking behaviours and their relationship with BP. Methods: This cross‐sectional study recruited 128 009 nurses in 11 cities in China. They were surveyed with questionnaires including BP measurements. The main contents of the questionnaire included smoking status and other factors that might be associated with hypertension. Multiple linear regression analyses and binary logistic regression analyses were used to analyse the data. Results: The results showed there was a significant difference in the smoking rate among nurses with different characteristics (P < 0.05). For both male and female nurses, smoking was associated with increased diastolic BP and mean arterial pressure, but only with increased systolic BP of male nurses. The prevalence of hypertension among male and female nurses was not related to smoking. Conclusion: Despite a relatively low overall smoking rate, rates among some groups are high. Different cities, hospitals, and departments can combine local data and conditions to formulate targeted tobacco control measures to improve nurses' physical and mental health. Summary statement: What is already known about this topic?: The number of tobacco‐related diseases has been steadily increasing worldwide over the past few decades.A decrease in the smoking rate of medical staff can lead to a decrease in the smoking rate of the general population.The association between smoking and blood pressure remains controversial, and further clarification is required. What this paper adds?: There was a significant difference between the smoking rates of nurses with different characteristics.The smoking rates were relatively high for nurses in emergency departments and operating rooms and those with >10 night shifts per month within the last 6 months.Among nurses, smoking is related to increase in diastolic blood pressure and mean arterial pressure in both men and women but only to increased systolic blood pressure in men; however, there was no association with hypertension risk. The implications of this paper: This study can support nursing managers to take targeted interventions to target smoking populations to reduce their smoking rates.For nurses who smoke due to high pressure, it is suggested that the working hours and cycles should be adjusted appropriately, the proportion of nurses should be increased, and the work intensity should be reduced to alleviate the work pressure.Nurses with high blood pressure should especially be dissuaded from smoking. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the utility of latent profile analysis of illness perception, in comparison to treating illness perception as several dimensions, to predict breast cancer‐related lymphedema risk management behaviours among Chinese breast cancer patients. Methods: This is a 3‐month longitudinal study. From August 2019 to January 2021, patients who recently underwent breast cancer surgery including axillary lymphadenectomy were recruited. Illness perception and risk management behaviours were measured by breast cancer‐related lymphedema specific questionnaires before discharge following surgery (n = 268) and at 3 months postsurgery (n = 213), respectively. Results: Treating illness perception as several dimensions, 'illness coherence' and 'timeline (cyclical)' dimensions were found to be significantly associated with breast cancer‐related lymphedema risk management behaviours. Using the latent profile analysis, two illness perception profiles were identified and significant differences were revealed in breast cancer‐related lymphedema risk management behaviours between them. Overall, illness perception profiles explained smaller amounts of variability in breast cancer‐related lymphedema risk management behaviours than illness perception dimensions. Conclusion: Future studies could combine these two different perspectives of illness perception regarding breast cancer‐related lymphedema into the design of interventions to improve breast cancer‐related lymphedema risk management behaviours. Summary statement: What is already known about this topic? Risk management behaviours are essential to reduce the risk and severity of breast cancer‐related lymphedema (BCRL).Illness perception is a modifiable predictor of BCRL risk management behaviours.Traditional correlation or regression analysis treat illness perceptions as several isolated elements and make it difficult to synthesize our understanding of it. What this paper adds Treating illness perceptions as several isolated elements, illness coherence and timeline (cyclical) were main components predicting BCRL risk management behaviours.Treating illness perception as a whole, latent profile analysis assigned breast cancer patients into two distinct profiles with similar illness perception.Illness perception dimensions and illness perception profiles showed certain effects on predicting BCRL risk management behaviours. The implications of this paper This study adds our knowledge of illness perception regarding BCRL and its effect on predicting BCRL risk management behaviours.The two analysis approaches provided different perspectives on the design and implementation of future intervention. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to identify risk factors for cognitive impairment in advanced cancer patients and to develop predictive models based on these risk factors. Background: Cancer‐related cognitive impairment seriously affects the quality of life of advanced cancer patients. However, neural network models of cognitive impairment in patients with advanced cancer have not yet been identified. Design: A cross‐sectional design was used. Methods: This study collected 494 questionnaires between January and June 2022. Statistically significant clinical indicators were selected by univariate analysis, and the artificial neural network model and logistic regression model were used for multivariate analysis. The predicted value of the model was estimated using the area under the subject's working characteristic curve. Result: The artificial neural network and the logistic regression models suggested that cancer course, anxiety and age were the major risk factors for cognitive impairment in advanced cancer patients. All the indexes of artificial neural network model constructed in this study are better than those of the logistic model. Conclusion: The artificial neural network model can better predict the risk factors of cognitive impairment in patients with advanced cancer. Better prediction will enable nurses and other healthcare professionals to provide better targeted and timely support. Summary statement: What is already known about this topic?: Cancer‐related cognitive impairment has significantly affected the quality of life of patients with advanced cancer.Risk factors associated with cognitive impairment in patients with advanced cancer have not been adequately documented, and neural network models have not been identified. What this paper adds?: This study found that long a cancer course, anxiety and ageing were the most important risk factors for cognitive impairment in patients with advanced cancer.The artificial neural network showed good predictive indicators, indicating that it can be used to predict cognitive impairment in patients with advanced cancer. The implications of this paper: Neural network models can help nurses and other clinicians predict cognitive impairment in advanced cancer patients early which will allow provision of timely intervention. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to test the effects of a novel diabetes self‐management education (DSME) programme focused on multilevel social resources utilization on improving self‐management behaviour, social resources utilization and haemoglobin Alc (HbA1c) in patients with type 2 diabetes mellitus (T2DM). Methods: A randomized controlled design was used. A total of 118 participants with T2DM from two communities were recruited through randomized sampling, and randomly assigned to the novel DSME group or the traditional DSME group. DSME focusing on multilevel social resources utilization was implemented in the novel DSME group. Data were collected at baseline (T0), at the end of the intervention (T1) and 3 months after the end of intervention (T2) from 3 March to 16 November 2014. Results: Comparing these two groups, the participants in the novel DSME group reported significantly better improvement in self‐management behaviour and social resources utilization at T1 and T2 (all p < 0.01). A significant difference was found in the mean improvement of HbA1c level between the two groups at T2 (p < 0.05). Conclusions: The novel DSME programme focused on multilevel social resources utilization can effectively enhance T2DM patients' self‐management behaviour and social resource utilization and lower HbA1c levels. More importantly, the effects could last longer. Summary statement: What is already known about this topic? Traditional diabetes self‐management education does not guarantee lifelong effective diabetes self‐management behaviour.The utilization of multilevel social resources has been found to be positively associated with self‐management behaviour and health outcomes of patients with chronic diseases. What this paper adds? The novel diabetes self‐management education programme is beneficial to community patients with type 2 diabetes mellitus as it shows significantly better effects in improving diabetes self‐management behaviour, social resources utilization and HbA1c level, and the effects last longer.Due to the large diabetes patient population and the relative shortage of medical resources in China, focusing on inspiring patients' initiative to actively tap and utilize existing and potential social resources for self‐management is indicated when developing education protocols for diabetes patients. The implications of this paper In addition to traditional self‐management education, community health‐care professionals should pay attention to the education of social resources utilization to further improve and solidify diabetes patients' self‐management behaviour.Especially in places with large population and limited medical resources, it is economical and effective to inspire patients to actively tap and utilize existing and potential social resources for self‐management. [ABSTRACT FROM AUTHOR]

Background: It has been reported that the knowledge, attitudes and practices of nurses play a significant role in preventing incontinence‐associated dermatitis (IAD), and these three factors influence and interact with each other. This study aimed to translate the English version of the Knowledge, Attitudes and Practices of Incontinence‐Associated Dermatitis Questionnaire (KAP‐IAD‐Q) into Chinese and assess the validity and reliability of the Chinese KAP‐IAD‐Q (C‐ KAP‐IAD‐Q) used with Chinese nurses. Methods: The KAP‐IAD‐Q was translated into Chinese strictly in accordance with the Brislin translation model, and a Chinese version of IAD was formed after discussion by experts. From October to November 2021, a total of 259 Chinese nurses were recruited through a convenience sampling method and investigated using the Chinese version of the knowledge, attitudes and practices of the incontinence‐associated dermatitis questionnaire (C‐KAP‐IAD‐Q) and the general self‐efficacy scale to assess its reliability and validity. Results: Three factors were extracted by exploratory factor analysis comprised of 22 items. The Cronbach's α coefficients were 0.961, 0.929 and 0.833, and the intraclass correlation coefficient was 0.98 totally. The scale‐level content validity index (S‐CVI) was 0.95, and the item‐level content validity (I‐CVI) was 0.83–1.00. The correlation coefficient between the general self‐efficacy scale and the C‐KAP‐IAD‐Q was 0.561 (P < 0.01). Conclusion: The 22‐item C‐KAP‐IAD‐Q seems to be culturally well adapted and has good psychometric properties used by Chinese nurses. Summary statement: What is already known about this topic? There is a knowledge gap among nurses, and the attitudes of nurses to prevent incontinence‐associated dermatitis (IAD) have a significant impact on the final implementation of preventive interventions.The Knowledge, Attitudes and Practices of the Incontinence‐associated Dermatitis Questionnaire (KAP‐IAD‐Q) was developed and assessed as a valid and reliable tool in Singapore.China does not currently have such a tool.What this paper adds? This study translated the KAP‐IAD‐Q into Chinese and formed the Chinese version of the KAP‐IAD‐Q (C‐ KAP‐IAD‐Q).The C‐KAP‐IAD‐Q comprises 22 items and three factors, including knowledge, attitudes and practices towards IAD prevention with proper psychometric properties.The implications of this paper: The C‐KAP‐IAD‐Q could be used in clinical practice and research to provide a reference for improving the knowledge, attitudes and practices towards IAD prevention in China.The C‐KAP‐IAD‐Q can make a great contribution to supporting the education and management of IAD. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the incidence of facial pressure injuries in health‐care professionals during the COVID‐19 pandemic in a meta‐analysis. Methods: Related studies were obtained through electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) Chinese Scientific Journal (VIP) China Biomedical Literature service systems (CBM) and Wanfang Data (from inception to 27 November 2021). The pooled incidence and the 95% confidence interval of facial pressure injuries were calculated with Review Manager v5.4 software. Results: Overall, 16 studies with 14 430 health‐care professionals were included. Pooled results showed that the pooled incidence of facial pressure injury in health‐care professionals was 58.8% (95% CI: 49.0%–68.7%; p < 0.01). The results of the subgroup analysis showed that the incidence of facial pressure injury in these staff was high, and predominantly stage I pressure injury, in the following cases: in health‐care professionals who wore personal protective equipment for longer than 4 h, in those without any training experience, and on the nose. Conclusion: Administrators and researchers should pay attention to preventing facial pressure injury related to the wearing of personal protective equipment (PPE) by ensuring all health‐care professionals receive training and by limiting prolonged periods of use. Summary statement: What is already known about this topic? Facial pressure injury was one of the most common effects experiencedby health‐care professionals wearing facial PPE during COVID‐19, which seriously affected their facial comfort and self‐image.A number of studies have reported the incidence of facial pressure injury in health‐care professionals, but the evidence is inconsistent.Medical staff are the main force during the COVID‐19. What this paper adds? This study showed that the pooled incidence of facial pressure injury in health‐care professionals was 56.8% during COVID‐19.This study showed that there was a higher incidence of facial pressure injury in staff who wore PPE for longer than 4 h and in those without any training experience.This study showed that the nose was the most common part of the face with pressure injury, and Stage I pressure injury was the most prevalent injury type in health‐care professionals. The implications of this paper: This study may provide evidence for managers about the development of guidelines for health‐care professionals to prevent and manage facial pressure injuries and promote the health of health‐care professionals. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and confirm the factor structure and item distribution of the Chinese version of Self‐care Ability Scale for the Elderly among older Chinese people. Methods: A cluster random sampling method was used to collect 2856 older people from five different cities of China from July 2018 to July 2019. A questionnaire comprised of socio‐demographic information and the Chinese version of the Self‐care Ability Scale for the Elderly was administered, and SPSS 21.0 and Mplus 7.4 were used for analyses. Results: Participants were aged 60 to 92 years, with a mean age of 71.52 (SD = 7.68) years. In the Exploratory Factor Analysis, the three‐factor structure and item distribution of the Chinese version of the Self‐care Ability Scale for the Elderly were verified to be better than other options. The factor loadings varied from 0.428 to 0.800, and the communality values ranged from 0.426 to 0.792. The modified model showed a good fit in the Confirmatory Factor Analysis. Conclusion: The Chinese version of the Self‐care Ability Scale for the Elderly has a clear three‐factor structure and a good item distribution. It serves as a convenient and accurate assessment tool to assess the self‐care ability of older Chinese people. Summary statement: What is already known about this topic? Assessing self‐care ability plays a significant role in the care of older people.The Chinese version of the Self‐care Ability Scale for the Elderly is often used to assess the self‐care ability of older people in China but whilst it has good reliability and content validity, its factor structure and item distribution are not clearly explained in recent literature.Solid evidence on the factor analysis of the Chinese version of the Self‐care Ability Scale for the Elderly is needed to maintain a high standard of health care assessment for the older Chinese people. What this paper adds? We confirmed that the Chinese version of the Self‐care Ability Scale for the Elderly has a clear three‐factor structure and item distribution.The Chinese version of the Self‐care Ability Scale for the Elderly can now be used as the study confirmed its validity and reliability. The implications of this paper: The instrument can be effective in older Chinese people to identify their self‐care support needs and thereby to enable provision of opportunities to implement appropriate nursing care.Health care professionals can use this instrument to assess the alterations in self‐care ability of older Chinese people after particular interventions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

Background: Ulcer area is a critical parameter in diabetic foot ulcer assessment but existing methods have deficiencies for routine measurement. Aim: We hypothesized that the Image J‐based Computer Analysis method has a high level of agreement with the commonly used Maximum Length and Width and the Transparent Dressing‐based Square Grid methods and aimed to test the consistency and verify the feasibility of the Image J‐based Computer Analysis method in the routine assessment of ulcers. Methods: Outpatient attendees with diabetic foot ulcers at the Department of Endocrinology of Sun Yat‐sen Memorial Hospital were enrolled between October 2020 and October 2021. The three methods sequentially assessed the area of 65 included ulcers. Results were analysed using one‐way analysis of variance and Bland–Altman plots to perform consistency analysis. Results: The mean ± standard deviation ulcer area measured using the three methods were 14.79 ± 5.39, 14.35 ± 5.26, and 14.30 ± 5.26 cm2, respectively. The measurement differences among the three groups or between any two were not statistically significant. Bland–Altman plots showed good consistency between the Image J‐based Computer Analysis and the other two methods. Conclusion: The Image J‐based Computer Analysis method can be interchanged with the other methods to assess ulcer areas. It is freely accessible, accurate and home‐operable, thus worth consideration by nurses for routine ulcer area assessment. Summary statement: What is already known about this topic? Ulcer area is a critical parameter in diabetic foot ulcer assessment, monitoring and for predicting the outcome of treatment efficacy.The Maximum Length and Width and the Transparent Dressing‐based Square Grid methods bear some deficiencies in daily ulcer area monitoring. What this paper adds? This study measured the area of diabetic foot ulcers using the Image J‐based Computer Analysis method and verified its consistency of measurement compared to current common methods, and its feasibility for routine assessment of ulcers. The implications of this paper: The Image J‐based Computer Analysis method is freely accessible, accurate and feasible for routine area assessment of diabetic foot wounds; the home measurable feature is especially applicable for patients with diabetic foot who need plantar decompression, rendering it a practical tool for home wound monitoring. [ABSTRACT FROM AUTHOR]

Background: Case management has been regarded as the front line of necessary change for fragmented healthcare system. Aim: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12‐month follow‐up. Methods: A quasi‐experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured. Results: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate. Conclusion: Nurse‐led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized. Summary statement: What is already known about this topic?: Current evidence of the effectiveness of case management is limited due to mixed results and single settings.Case management is rarely tested in single‐type cancer patients and in countries with underdeveloped primary care. What this paper adds?: Nurse‐led hospital‐based case management can effectively improve quality of life, anxiety, depression, symptom distress, treatment adherence and unplanned readmission rates.In countries with underdeveloped primary care, case management is a feasible way to provide continuous care to cancer patients and to improve healthcare utilization. The implications of this paper: Nurse case managers can serve as a pivot in multidisciplinary management of cancer patients to promote interdisciplinary cooperation and resource integration.A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized.Future studies and nursing practice should develop an online case management platform and set up posts for full‐time case managers. [ABSTRACT FROM AUTHOR]

Aims: To explore how family functioning and family resilience mediate the relationship between disability severity and quality of home‐based care among families with disabled older adults. Methods: A cross‐sectional survey was conducted with 431 families with Uygur and Kazakh disabled older adults in Xinjiang, China, in 2020. The data were collected using the Katz Activity of Daily Living Scale; Mini‐Mental State Examination; Family Adaptation, Partnership, Growth, Affection and Resolve Index Scale; Family Resilience Assessment Scale; and Family Caregiving Consequences Inventory Scale. All mediation effects were estimated in SPSS26.0. Results: Disability severity, family functioning and family resilience were all significantly correlated with home‐based care quality. Disability severity had a 46.16% direct effect on home‐based care quality and a 53.84% indirect effect on home‐based care quality independently and in series through family functioning and family resilience. Conclusions: Disability severity directly affected home‐based care quality and had an indirect influence via family functioning and family resilience. Multidisciplinary care teams should focus on families with disabled older adults and help them improve family functioning and family resilience by implementing targeted interventions, so as to improve home‐based care quality. Summary statement: What is already known about the topic? Literature has clarified that social support and caregiver competence mediate the path relationship between disability severity and home‐based care quality from the perspective of individuals.Long‐term care for disabled older adults affects not only informal caregivers but also the whole family.The role of the family, such as family functioning and family resilience, in the whole process remains unclear. What this paper adds? Findings indicated relationships between disability severity, family functioning, family resilience and home‐based care quality.Disability severity can indirectly influence home‐based care quality not only through family functioning or family resilience but also through family functioning affecting family resilience. The implications of this paper Findings indicate that community nurses should not only pay attention to disabled older adults and their informal caregivers but also consider the impact of family functioning and family resilience when formulating interventions to improve the quality of home‐based care.When disabled older adults are transferred from hospitals to home, community rehabilitation nurses should intervene as early as possible, providing guidance on rehabilitation training and daily living skills for disabled older adults to restore and maintain function and prevent complications.Community nurses can conduct case counselling services for family members to understand and satisfy their care needs, enhancing their confidence, cohesion and problem‐solving abilities to improve the quality of home‐based care. [ABSTRACT FROM AUTHOR]

Aims: This meta‐analysis aimed to synthesize the available evidence on the effectiveness of psychoeducational interventions on family function among families after stroke. Background: Family function may be improved by psychoeducational intervention, but findings about the effect of psychoeducation on family function among families after stroke have been mixed. Methods: This was a meta‐analysis carried out by searching five international electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science and CINAHL, as well as four national electronic databases, including Chinese Biological Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP and Wanfang. Two groups of researchers screened the studies independently, assessed the quality of the studies and extracted data. Meta‐analysis was performed by using the RevMan 5.3 software. Results: Five studies on psychoeducational interventions were included. Pooled analysis of these studies showed a small effect of the interventions on improving family function (WMD: −0.13, 95% CI: −0.24 to −0.01, P < 0.05). Subgroup analysis showed significant differences between the psychoeducation and control groups at 1 month postintervention (WMD: −0.12, 95% CI: −0.18 to −0.05, P < 0.05) and more than 6 months postintervention (WMD: −0.14, 95% CI: −0.24 to −0.04, P < 0.05). The psychoeducational interventions also had positive effect on improving the problem solving (WMD: −0.22, 95% CI: −0.14 to −0.03, P < 0.05) and communication (WMD: −0.23, 95% CI: −0.41 to −0.05, P < 0.05) functions of the family. There were significant differences in the group of dyad intervention (WMD: −0.14, 95% CI: −0.25 to −0.02, P < 0.05) and the group using face to face method (WMD: −0.58, 95% CI: −0.84 to −0.32, P < 0.05). Conclusions: Synthesized results demonstrated the favourable effect of psychoeducational interventions on the improvement of the family function among families after stroke, especially in terms of family problem solving and family communication. Future psychoeducational intervention research design should consider the combination of multiple intervention methods and the applicable population of intervention. Summary statement: What is already known about this topic? Good family function can promote the physical and mental health of family caregivers, improve the life quality of stroke survivors and lighten a heavy burden on the whole family.Family function may be improved by psychoeducational intervention, but findings about the effect of psychoeducation on family function among families after stroke have been mixed.What this paper adds? The psychoeducational intervention has a positive effect on family function among families after stroke, especially in terms of family problem solving and family communication.The implications of this paper: The psychoeducational intervention can be an acceptable method to improve family function among families after stroke. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China. Methods: The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China. Results: A 49‐item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four‐factor structure of the 49‐item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four‐factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001). Conclusions: The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer. Summary Statement: What is already known about this topic? Nurses generally provide supportive care services and play imperative roles in supporting patients in cancer.Using a valid and reliable instrument to assess supportive care needs for patients with cancer is a critical step for the improvement of clinical practice and research. What this paper adds? Mixed methods were beneficial for developing the new self‐report and culturally appropriate instrument for Chinese patients with cancer.The Professional Nursing Support Scale (PNSS) is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the needs. The implications of this paper: The PNSS is expected to a reliable needs evaluation tool. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the effectiveness of an instant message‐based lifestyle and stress management intervention delivered by nurses on cardiovascular disease risk reduction. Methods: In this nonrandomized concurrent controlled trial conducted from March 2013 to September 2013, 164 eligible employees in two companies were assigned to the intervention (n = 83) and control (n = 81) groups based on their worksites. Only participants were blinded to group assignment. All participants received two education sessions during 1 month, and the intervention group also received an instant message‐based lifestyle and stress management intervention for 5 months. The primary outcome was the Framingham Risk Score, and the data were collected at the first month and the sixth month. Results: The final analysis included 80 participants in the intervention group and 76 in the control group. After the intervention, significant intervention effects were found for the mean value and the changes of the Framingham Risk Score and the proportion of participants who improved their diet and exercise (P < 0.05). There were trends for improvement in the proportion of smoking and levels of stress, but statistically significant levels (P > 0.05) were not met. Conclusion: An instant message‐based lifestyle and stress management intervention can reduce cardiovascular disease risk in high‐risk individuals. Summary statement: What is already known about this topic? Cardiovascular disease is the leading cause of death globally and causes a heavy economic burden, while lifestyle changes and stress management are modifiable and cost‐effective ways to reduce the risk of cardiovascular disease in high‐risk individuals.The widespread use of mobile phones facilitates the implementation of health education to improve lifestyle and is well adapted for use in the developing world.Instant messaging tools are widely used for daily and work communication because of convenience and free access. These tools have also been used to improve health knowledge and self‐management. What this paper adds? More than half of participants had unhealthy diets and insufficient exercise, which contributed to abnormal body mass index and cholesterol levels.Lifestyle‐related health education that provided tailored strategies for improving lifestyle and stress reduction, as well as timely feedback and peer support, can reduce cardiovascular disease risk in high‐risk individual.Instant messaging tools provide a cost‐effective and feasible platform for health education on prevention of cardiovascular disease. The implications of this paper: Improving unhealthy diet and levels of exercise, which can decrease the prevalence of obesity and dyslipidemia, are two main aspects for prevention of cardiovascular disease that require continued focus.Using instant messaging tools as a platform to deliver health education, nurses can more easily manage high CVD risk individuals and provide guidance on healthy lifestyle. These tools should be used more widely, especially in developing countries with limited resources and heavy economic burdens. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID‐19. Background: At the end of 2019, COVID‐19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored. Methods: During February 2020, we recruited 114 patients with mild or common type COVID‐19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors. Results: The fear of disease progression scores of patients with mild or common COVID‐19 was at the low‐to‐moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID‐19 were factors potentially associated with fear of progression. Conclusion: With a high prevalence of fear of disease progression in patients with COVID‐19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning. Summary statement: What is already known about this topic? Fear of progression is a common bio‐socio‐psychological consequence that widespread in cancer patients as well as chronic diseases.Very few studies focus on fear of progression in patients with major infectious disease, not to mention coronavirus disease (COVID‐19). What this paper adds? The present study surveys fear of progression in patients with mild or common type COVID‐19 and revealed a low‐to‐moderate level overall.Being unemployed, having no spouse diagnosed with COVID‐19, and a disease duration of 28 days or more are potential factors associated to patients' fear of the disease progression. The implications of this paper: The COVID‐19 outbreak has been declared as a public health emergency of international concern. Mental health problems such as fear of disease progression might need more attention beyond medical treatment.Future mental health nursing practice and research need to focus on those potential factors or patients with specific characteristics. [ABSTRACT FROM AUTHOR]

Aim: We aim to investigate the prevalence and associated factors for compassion fatigue among nurses in Fangcang Shelter Hospitals in Wuhan. Studies have shown that compassion fatigue was more common among nurses than other health‐care providers, and its predictors were also different. In recent years, most studies have investigated compassion fatigue in emergency and oncology nurses, whereas there is little information on compassion fatigue among nurses from the frontline of Fangcang Shelter Hospitals during the COVID‐19 pandemic. Methods: A descriptive, cross‐sectional design was used in this study. An online survey was conducted among nurses (n = 972) of five Fangcang Shelter Hospitals in Wuhan, Hubei province, China, from 6 March to 10 March 2020. A self‐administered questionnaire including demographic information, work‐related information, General Health Questionnaire, Perceived Stress Scale and Compassion Fatigue Scale was used. Results: The prevalence of compassion fatigue among nurses in Fangcang Shelter Hospitals was moderate, and most cases were mild. There was a significant relationship between compassion fatigue and work‐related factors, mental health and perceived stress among nurses working in Fangcang Shelter Hospitals. Conclusions: Various factors contribute to compassion fatigue, including lower job satisfaction and job adaptability, less praise from patients, more fear of infection and more perceived stress. A good working atmosphere, organizational support and psychological consultation are essential to alleviate nurses' compassion fatigue during the anti‐epidemic period. Summary statement: What is already known about this topic? Nurses are particularly vulnerable to compassion fatigue among health‐care providers, and it causes billions of dollars in productivity losses to economies in different countries every year.Personal factors (professional cognition, health condition, gender etc.), working environment (working hours, working load, working system problems, professional roles etc.), mental health and stress may affect nurses' compassion fatigue. What this paper adds? Both extrinsic and intrinsic factors played a crucial role in nurses in Fangcang Shelter Hospitals who are exposed to adverse events, leading to compassion fatigue. The implications of this paper: This paper reveals a new perspective on the factors influencing compassion fatigue of nurses working in Fangcang Shelter Hospitals.We suggest that compassion fatigue among nurses in Fangcang Shelter Hospitals could be reduced by maintaining a good working atmosphere, providing organizational support, helping nurses keep a healthy mental state and reducing stress levels. [ABSTRACT FROM AUTHOR]

Aim This study aimed to determine the moderating effect of work‐related social support on the relationship between work–family–school role conflicts and job satisfaction among female registered nurses pursuing further degrees in China. Methods: The study had a cross‐sectional correlational design. Convenience sampling was applied to recruit participants from eight hospitals in China from January to August 2017. SPSS software and the PROCESS macro were used to conduct the data analyses in the present study. Results: A total of 320 nurses were included in the present study. Work–family–school role conflicts were negatively correlated with job satisfaction (r = −0.21, P < 0.001). Work‐related social support was a significant moderator (interaction effect: β = 0.22, P = 0.039) on the relationship between work–family–school role conflicts and job satisfaction. Conclusions: The study revealed that when nurses perceived that they received a low or moderate level of social support in the workplace that strengthened the relationship between work–family–school role conflicts and job satisfaction. Hospital administrators should implement school‐ and family‐friendly policies that increase the social support provided to nurses pursuing further degrees to balance their responsibilities of work, family and school and to improve their job satisfaction. Summary statement: What is already known to the topic? Registered nurses pursuing further degree perform multiple roles in their lives at work, at home and at school, leading to work–family–school role conflicts.Work–family conflict was significant related with job satisfaction among registered nurses.Social support played a role as a moderator in the relationship between work–family conflict and mental health. What this paper adds? Work–family–school role conflicts were negatively correlated with job satisfaction among the registered nurses pursuing a further degree in China.Work‐related social support significantly moderated the relationship between work–family–school role conflicts and job satisfaction among registered nurses pursuing a further degree. The implication of this paper: Certain policies such as work flexibility, shift work and part‐time work that are family‐ and school‐friendly could be instituted by hospital administrators to mitigate the effect of work–family–school role conflicts on job satisfaction among RNs pursuing further degrees.When facing work–family–school role conflicts, registered nurses pursuing further degrees should ask for help from department managers or coworkers in order to alleviate their work–family–school role conflicts and improve their job satisfaction. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to translate the Stoma‐quality of life into Chinese and evaluate its psychometric properties in Chinese patients. Background: Quality of life is an important issue for patients with colostomy, and its appropriate and precise measurement is beneficial to promoting better care. The Stoma‐quality of life questionnaire has been widely used; however, the validity and reliability of its Chinese version has not been determined. Design A cross‐sectional validation study was conducted. Methods: We translated the Stoma‐quality of life into Chinese using standardized methods. Then it was psychometrically tested on a convenience sample of 513 patients with colostomy. Construct validity was evaluated via exploratory factor analysis and confirmatory factor analysis. Reliability was measured with Cronbach's alpha and the split‐half Spearman–Brown coefficient. Results: The content validity, the Cronbach's α coefficient and the Spearman–Brown split‐half reliability coefficient indicated adequate validity and reliability. The exploratory factor analysis yielded four common factors, and the cumulative variance contribution rate was 67.5%. Moreover, the confirmatory factor analysis showed a good model fit. Conclusion: This study confirmed that the Chinese version of Stoma‐quality of life is an effective and reliable measurement for evaluating the quality of life of patients with colostomy. Summary statement: What is already known about this topic? Quality of life (QOL) is an important issue for patients with colostomy, and it is conducive to evaluate the effect of specific treatment and nursing interventions. However, a tailored instrument measuring QOL in Chinese patients with colostomy is lacking.The Stoma‐QOL is a widely used stoma‐specific instrument based on Hunt and McKennal's basic QOL demand model and has shown acceptable psychometric properties. What this paper adds? This study provides evidence of the construct validity and internal consistency reliability of the Stoma‐QOL‐C.The four‐factor structure of the scale shows the aspects and complexity of QOL of patients with colostomy.The study proves the Stoma‐QOL‐C a valid and reliable measure of assessing QOL of patients with colostomy. The implication of this paper: The Stoma‐QOL‐C could be used as a disease‐specific scale to evaluate the QOL of patients with colostomy.This study adds the knowledge of the psychometric properties regarding the inventory in diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Background: Trait emotional intelligence and fear of cancer recurrence could predict quality of life, but the mechanism between the three is poorly understood. Methods: The aim of this study was to investigate the associations between trait emotional intelligence, fear of cancer recurrence and quality of life in patients with breast cancer. A cross‐sectional study was conducted with 215 breast cancer patients recruited from two hospitals in China. Data were collected from December 2018 to April 2019. Questionnaires measured demographic and medical characteristics, trait emotional intelligence, fear of cancer recurrence and quality of life. Pearson correlation analysis and structural equation modelling were conducted to analyse the data. Results: As expected, trait emotional intelligence was positively related to quality of life and negatively correlated with fear of cancer recurrence. Fear of cancer recurrence was negatively associated with quality of life. This relationship between trait emotional intelligence and quality of life was mediated by fear of cancer recurrence. Conclusions: These results shed light on underlying mechanisms by which trait emotional intelligence affects quality of life. Trait emotional intelligence training could reduce fear of cancer recurrence to improve quality of life for cancer patients. Summary statement: What is already known about this topic? Trait emotional intelligence is a predictor of quality of life and can manage emotion.Fear of cancer recurrence in breast cancer patients is an important factor that impairs their quality of life.There is a lack of research on the mediating role of fear of cancer recurrence on the path from trait emotional intelligence to quality of life. What this paper adds? Trait emotional intelligence is associated with fear of cancer recurrence.Fear of cancer recurrence of breast cancer patients mediates the effect of trait emotional intelligence on their quality of life. The implications of this paper: Nurses can consider implementing trait emotional intelligence training, which may be a new type of psychological intervention for cancer patients to reduce fear of cancer recurrence and improve quality of life. [ABSTRACT FROM AUTHOR]

Aims: To explore loneliness, in association with frailty, in explaining the quality of life (QOL) of empty‐nest older adults in rural China. Design A cross‐sectional questionnaire survey was conducted. Methods: Data collection was performed from June to August 2017 in Changchun, the capital city of Jilin province, which consists of seven districts and three counties. In total, 304 older adults aged 60 years and above participated. The characteristics of older adults were evaluated in terms of frailty status, loneliness and the QOL. One‐way and two‐way analyses of covariance and the area under the receiver operating characteristic curves were used to explore the relationships of frailty, loneliness and the QOL. Results: The one‐way ANCOVA showed a significant difference among robust, prefrail and frail participants for loneliness. Moreover, an interaction effect of frailty with loneliness in determining the QOL was found. The receiver operating characteristic curves showed that loneliness and QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. Conclusion: This study demonstrates a close relationship between frailty and loneliness, suggesting the need to simultaneously consider the two with regard to the QOL of empty‐nest older adults in rural China. Summary statement: What is already known about this topic? There were no studies examining the associations of frailty and loneliness with QOL or the cut‐point of the loneliness and QOL scores to reflect frailty.Few studies have revealed an association between loneliness and frailty. These studies focus mainly on older adults living in the community, and none consider the relationship between mental status and the frailty of empty nesters. What this paper adds? This study determined that frailty, loneliness and the QOL had a close relationship in empty nesters. There was a significant interaction among frailty, loneliness and the quality of life.Loneliness and the QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. The implications of this paper? This study can enable governments and communities to pay attention to the psychological status of empty‐nest individuals while paying attention to their psychological problems, such as loneliness, to help them improve their quality of life. [ABSTRACT FROM AUTHOR]

Background: Elders' disability severity and caregiver health could predict elders' informal care time, but the mechanism by which the degree of disability in the elderly affects informal care time is unclear. Aim: The aim of this works is to explore the mediating roles of caregiver health and home‐based care quality between disability severity of elders and informal care time in far north‐western low‐income areas in China. Method: From September 2017 to February 2018, three hundred fifty‐two dyads of Kazakh disabled elders and informal caregivers in Xinjiang were interviewed. Structural equation modelling analyses were applied. Results: Significant positive correlations were observed between elders' disability severity and informal care time, caregiver health and informal care time, elders' disability severity and caregiver health. Significant negative correlations were observed between home‐based care quality and informal care time, elders' disability severity and home‐based care quality, caregiver health and home‐based care quality. Elders' disability severity had 71.94% direct effect on informal care time, 28.06% indirect effect on informal care time mediated by home‐based care quality and caregiver health. Conclusion: Caregiver health and home‐based care quality play mediating roles on the path relationship between the elders' disability severity and informal care time. Summary statement: What is already known about this topic? Elders' disability severity and caregiver health are critical factors that affect informal care time.The mechanism by which the degree of disability in the elderly affects informal care time is unclear. What this paper adds? Elders' disability severity is positively associated with caregiver health and negatively associated with home‐based care quality.The better home‐based care quality, the shorter the informal care time.Disabled elders' severity degree had a direct effect on informal care time and indirect effects on informal care time mediated by caregiver health and home‐based care quality. The implications of this paper: Community nurses, doctors and health care teams should provide medical services, nursing skills and knowledge for the dyads of disabled elders and informal caregivers and should provide emotional support for other family members to enable growth of the entire family in the process of long‐term care and to reduce informal care time.The government should attach great importance to the informal care time for disabled elders and propose specific informal care time cost compensation policies based on path relationships that influence informal care time. [ABSTRACT FROM AUTHOR]

Background: Multiple chronic conditions (MCCs) are highly prevalent in primary care. Coping is an important psychological factor that influences patients' ability to adapt physically and mentally to MCCs. Testing a reliable and valid psychometric inventory is necessary to identify coping strategies before developing coping‐oriented interventions. Purpose The purpose of this study is to examine the psychometric properties of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE‐CN) inventory in patients with MCCs. Method: This study adopted a cross‐sectional design. A convenience sample of 290 Chinese patients with MCCs was recruited from a tertiary hospital in East China. The Brief COPE‐CN, sociodemographic characteristics and clinical data were collected using a self‐reported questionnaire from November 2017 to May 2018. Factor analysis and reliability analysis were performed. Results: The mean age of the participants was 58.5 years (range from 23 to 95 years), and approximately half of the participants were female (49.3%). Most participants had two chronic conditions (82.1%) and reported having had MCCs for more than 2 years. The explanatory factor analysis (EFA) identified five factors in the Brief COPE‐CN that explained 58.4% of the total variance. The Cronbach's α coefficients ranged from.65 to.85 for the five subscales. Conclusions: The psychometric properties of the Brief COPE‐CN were acceptable for use with Chinese patients with MCCs. With further evaluation, this instrument may help health‐care professionals understand patients' coping and develop coping‐based interventions to promote coping in this population. Summary statement: What is already known about this topic? There is a growing predominance of chronic diseases in China, with many Chinese patients living with multiple chronic conditions (MCCs) that can adversely impact physical and psychological health.Coping‐oriented interventions that address and enhance patients' coping strategies are beneficial in terms of improving their health.There is no valid and reliable Chinese tool to measure coping strategies among patients with MCCs. What this paper adds? This study reports a five‐factor structure of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE‐CN) established by explanatory factor analysis.The five‐factor structure of the Brief COPE‐CN has good internal consistency. The implications of this paper: The five‐factor Brief COPE‐CN has the potential to measure coping strategies effectively in Chinese patients with MCCs.With further evaluation, this instrument may be a useful tool for developing specific interventions to promote coping in Chinese patients with MCCs. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis. Methods: This cross‐sectional study was conducted in 243 patients with rheumatoid arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi‐Dimensional Questionnaire, Arthritis Self‐Efficacy Scale‐8, Visual Analogue Scale for pain, physical function subscale of Short Form 36‐Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self‐designed demographic and disease‐related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one‐way ANOVA and correlation analysis on the level of fatigue. Results: Stepwise linear multiple regression analyses showed that disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance. Conclusion: Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue. Summary statement: What is already known about this topic? Fatigue is a common problem in patients with rheumatoid arthritis (RA).Little research has investigated what factors are associated with fatigue in patients with RA.Nurses need to understand the factors that potentially influence fatigue in patients with RA, in order to improve the quality of life. What this paper adds? Fatigue is moderate in Chinese patients with RA, which is lower than the results of western countries.Disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety are important factors affecting fatigue in patients with RA. The implications of this paper: Special attention should be paid to the RA patients with high level of fatigue.The findings of this study highlight the need to develop effective strategies to alleviate fatigue and eventually improve the quality of life in patients with RA. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe levels of social support and explore the factors predictive of social support for Chinese family caregivers of patients with dementia. Background: Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented, which need to be further clarified to provide a basis for creating effective social support strategies. Methods: This was a cross‐sectional study with 91 participants who completed a demographic questionnaire and the Social Support Rating Scale from 2015 to 2016. Results: Chinese family caregivers of patients with dementia received moderate social support. Caregivers' subjective support domain scores and support utilization domain scores were significantly lower than those of the normal Chinese population, whereas caregivers' total social support scores were higher than those of the normal Chinese population. Family caregivers' monthly household income, educational level and place of residence were predictors of their own social support. Conclusion: Social support in Chinese caregivers of patients with dementia needs to be improved, especially the subjective support and support utilization. Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. Summary statement: What is already known about this topic? Social support is important for family caregivers of patients with dementia.Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented. What this paper adds? Caregivers' subjective support and support utilization were significantly lower than the normal Chinese population; caregivers' total social support was significantly higher than the normal Chinese population.The best predictors of caregivers' social support were the monthly household income, educational level and place of residence of the caregivers. The implications of this paper: Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area.Future research is needed to create effective nursing regimes, paying attention to caregivers with a lower educational level and caregivers who lived in the suburban area. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether a novel decision support tool would effectively minimize physical restraint use in critically ill adult patients. Design A nonequivalent quasi‐experimental design combined with a descriptive qualitative approach was used. Methods: A Restraint Decision Tree was developed based on a qualitative study that explored the barriers to employ the Restraint Decision Wheel. During the quasi‐experimental study, patients admitted to the unit between October 2017 and March 2018 were enrolled as the control group receiving the Restraint Decision Wheel (n = 528), whereas patients between April 2018 and September 2018 were enrolled as the intervention group receiving the Restraint Decision Tree (n = 564). The physical restraint rate, accidental catheter removal rate and nurses' satisfaction were compared. Results: The Restraint Decision Tree significantly decreased physical restraint use. No significant difference in the rate of accidental catheter removal was found. Nurses reported increased satisfaction with the restraint decision‐making. Conclusions: The Restraint Decision Tree could minimize physical restraint use. Physicians' involvement in the restraint decision‐making and nurses' competence in delirium assessment may be essential for successful implementation of the Restraint Decision Tree. Summary statement: What is already known about this topic? Physical restraint is a common practice in the intensive care unit.Minimizing physical restraint use does not increase the risk of catheter self‐removal.Nurses equipped with clinical decision‐making skills could promote the appropriateness of restraint application. What this paper adds? The Restraint Decision Tree could help nurses make appropriate restraint decisions for critically ill adult patients, thus decreasing the use of physical restraint.Multidisciplinary decision‐making improves nurses' satisfaction with the restraint decision process. The implications of this paper: This study suggests that the Restraint Decision Tree can be implemented in the intensive care unit as an effective decision‐making tool to decrease physical restraint use while maintaining patient safety.A strong culture of multidisciplinary collaboration and delirium screening is called for prior to utilizing the Restraint Decision Tree. [ABSTRACT FROM AUTHOR]

Aim: We aimed to identify the risk factors for delayed discharge in a day surgery centre in west China. Background: Delayed discharge affected by various factors is a key indicator for healthcare quality of day surgery. However, few studies have focused on this issue in developing countries where the day surgery started much later. Design A retrospective case–control design. Method: A random sample of 169 delayed discharge cases and 514 normal discharge cases was randomly selected from 38,021 day surgery cases from May 2011 to May 2019 in a tertiary teaching hospital in west China. Socio‐demographic and clinical characteristics of patients were collected through the hospital electronic database and a chart review. A multivariate logistic regression was conducted to identify the risk factors for delayed discharge. Results: The urban employee basic medical insurance, comorbidity, general anaesthesia, pain, fever, bleeding and metabolic disorder were identified as the risk factors for delayed discharge. Living in the city where the hospital located was a protective factor for delayed discharge. Conclusion: Post‐operative complications including fever, pain, bleeding and metabolic disorder were the most important risk factors for delayed discharge. The pre‐operative prevention, careful monitoring and rapid reactions to post‐operative complications may reduce delayed discharge. Summary statement: What is already known about this topic? Day surgery is conducted worldwide due to its time‐saving, cost‐effectiveness and low risk for post‐operative infection.Delayed discharge is considered as one of the most important indicators for healthcare quality of a day surgery centre.Most of the identified risk factors for delayed discharge are from the developed countries' experience of day surgery and remain controversial. What this paper adds? The insurance reimbursement rate influenced patients' willingness for discharge.Living in the same city where the hospital is located was a protective factor for delayed discharge.Post‐operative metabolic disorder was a risk factor for delayed discharge. The implications of this paper: Reducing the insurance reimbursement rate of patients who meet discharge criteria but ask for longer hospital stays may be helpful to reduce delayed discharge.Careful monitoring and rapid response to post‐operative complications may be simple but useful measures to reduce the risk of delayed discharge. [ABSTRACT FROM AUTHOR]

Aims: To investigate the efficacy of pre‐emptive remifentanil in alleviating pain during tracheal suctioning in patients under mechanical ventilation. Background: Goal‐directed sedation is recommended for patients under mechanical ventilation by the current guidelines. Whether goal‐directed sedation can prevent pain during tracheal suctioning in these patients is unknown. Design: This was a two‐centre, randomized, crossover, single‐blind trial conducted between August and October 2019. Methods: Patients under mechanical ventilation received low‐dose remifentanil, high‐dose remifentanil or placebo prior to each tracheal suctioning in a random order. The primary outcomes were evaluated using the critical‐care pain observation tool and Richmond agitation–sedation scale after tracheal suctioning. Adverse events were also documented. Results: A total of 39 patients who underwent 117 tracheal suctions were enrolled. After the tracheal suction, changes in the critical‐care pain observation tool and Richmond agitation–sedation scale scores were significantly lower in the low‐dose and high‐dose groups than in the placebo group (P < 0.001). A non‐significant increase in the absence of spontaneous breathing was observed in the high‐dose group compared to that in the placebo group. Conclusion: A pre‐emptive remifentanil bolus of 0.5 μg/kg can mitigate the pain associated with tracheal suctioning. SUMMARY STATEMENT: What is already known about this topic? Pre‐emptive analgesia is recommended by several guidelines to alleviate the pain associated with invasive and potentially painful procedures in ICU patients.Goal‐directed sedation can shorten the length of hospital stay and is recommended for patients in the ICU by several clinical practice guidelines.Literature regarding whether goal‐directed sedation management or pre‐emptive remifentanil can prevent the pain associated with tracheal suctioning in patients under mechanical ventilation is scarce. What this paper adds? A pre‐emptive remifentanil bolus of 0.5 μg/kg can mitigate the pain associated with tracheal suctioning. The implications of this paper: Normal opioid doses administered for goal‐directed sedation management might be insufficient to prevent the pain associated with tracheal suctioningPre‐emptive analgesia can alleviate the pain without increasing the risk of opioid‐related adverse events in ICU patients under mechanical ventilation. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe the experiences of nurses and other health care workers who were infected with coronavirus disease 2019. Methods: An empirical phenomenological approach was used. Sixteen participants were recruited in Wuhan using purposive and snowball sampling. Semistructured, in‐depth interviews were conducted by telephone in February 2020. Interviews were transcribed verbatim and analysed following Colaizzi's method. Results: Two themes emerged: (1) Intense emotional distress since becoming infected. Participants were fearful of spreading the virus to family and overwhelmed by a lack of information, experienced uncertainty and worried about treatment, felt lonely during isolation and reported moral distress about inadequate health care staffing. (2) Coping strategies were needed. They tried their best to address negative psychological reactions using their professional knowledge and gaining support from others and community resources. Conclusions: Preparedness for catastrophic events and providing timely and accurate information are major considerations in government policy development, related to pandemics and adequacy of health care personnel. Mental health resources and support, both short‐ and long‐term should be anticipated for health care providers to alleviate their fear and anxiety. Summary statement: What is already known about this topic? Health care workers, including nurses, are at the frontlines of the COVID‐19 outbreak and at high risk of infection.Experts have called for infection prevention for health care providers.Limited research has reported the experiences of health care workers infected by COVID‐19 using an empirical phenomenological approach. What this paper adds? Upon diagnosis, nurses and other health care workers experienced fear, uncertainty and distress like general patients.Health care workers reported moral distress about inadequate health care staffing issues.Health care workers could cope with their negative psychological reactions using professional knowledge and support from significant others and the community. The implications of this paper: Preparedness for large‐scale pandemics and a system that can provide openness and timely information needs consideration in policy development.Accurate information and good communication are vital to support infected health care workers and enhance their sense of safety and belonging.Long‐term support should be available when these health care workers return to work. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics. Methods: A descriptive study was conducted using a self‐designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018. Results: The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant. Conclusion: Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals. Summary Statement: What is already known about this topic? Nurses are susceptible to developing compassion fatigue (CF) due to multiple challenges and harsh environments in practice.Although previous studies have highlighted that haemodialysis nurses across the globe face issues with the work environment, stress and burnout, there are few reports of CF among haemodialysis nurses.At present, many countries have both publicly and privately funded hospitals, and it is not known whether the CF of haemodialysis nurses differs by hospital type. What this paper adds? Haemodialysis nurses have high levels of CF, and haemodialysis nurses in public hospitals have higher CF and lower job satisfaction than those in private hospitals.The main factors associated with CF among haemodialysis nurses in public hospitals were years worked, type of employment, and intrinsic and extrinsic satisfaction.The main factors associated with CF in haemodialysis nurses in private hospitals were education level, years worked, and intrinsic and extrinsic satisfaction. The implications of this paper: There is a need to raise awareness among both nurses and nursing management staff of haemodialysis units regarding the existence of CF among haemodialysis nurses, especially in public hospitals.Different targeted interventions or solutions should be considered according to various factors associated with CF in different types of hospitals (public and private). [ABSTRACT FROM AUTHOR]

Aims: To evaluate whether a nurse‐supervised rehabilitation programmes could improve respiratory functions and systematic inflammation in children with asthma. Background: Children with asthma always suffer from poor life quality, and physical training and pulmonary rehabilitation could be beneficial to asthma. Design A retrospective, observational, single‐centre cohort analysis. Method: Baseline characteristics between the nurse‐supervised rehabilitation programme and usual‐care groups were matched by propensity‐score matching (PSM) in a 1:1 ratio. We compared the lung function and inflammatory markers between groups. Results: Among 52 pairs of children, differences in lung function were improved in the nurse‐supervised rehabilitation group compared with those in usual‐care group, including the oxygen saturation, forced expiratory volume in 1 second, forced expiratory flow of 25%–75% and peak expiratory flow (all P < 0.05). Two asthma‐related inflammatory markers (hypersensitive C‐reactive protein and immunoglobulin E) also significantly decreased in the nurse‐supervised rehabilitation group (both P < 0.001). Conclusions: The results indicate that the nurse‐supervised rehabilitation programme might be effective in improving symptom control, respiratory functions and systemic inflammation in children with asthma. The study suggests that the NSR for asthma merits further research. Summary Statement: What is already known about this topic? Children with asthma generally suffer a poor quality of life, as their daily life activities are limited by worsening respiratory symptoms.As a non‐pharmacological therapy, the pulmonary rehabilitation has been widely applied to manage individuals with chronic respiratory diseases.Physical training has been confirmed to be beneficial to the paediatric asthma.What this paper adds? Trained nurses could safely prescribe pulmonary rehabilitation programme for children with asthma.The nurse‐supervised rehabilitation programme could improve the lung function indexes in asthma children.The lower levels of inflammatory markers were seen in the NSR group, compared with the usual‐care group.Implications of this paper: Our findings highlight the applicability of the nurse‐supervised rehabilitation programme that could improve lung function in children with asthma.The beneficial effects of the nurse‐supervised rehabilitation programme in children with asthma might be partly ascribe to the resolution of elevated inflammatory markers.Ongoing nurse‐supervised rehabilitation programme support by nurses developed in our study might be effective in establishing non‐pharmacological therapies for asthma children. [ABSTRACT FROM AUTHOR]

Aims: This study investigated self‐care activities and identified their related factors in Chinese patients with type 2 diabetes mellitus. Methods: A cross‐sectional study was conducted in Guangzhou, China, between September 2016 and February 2017, involving 202 Chinese patients with type 2 diabetes mellitus. Measures included the Summary of Diabetes Self‐Care Activities Questionnaire and Revised Illness Perception Questionnaire. Results: Self‐care activities in Chinese patients with type 2 diabetes mellitus were suboptimal overall. Foot care and blood sugar testing were the self‐care activities that were performed the least. One fifth of patients smoked. Some subscales of illness perceptions, receiving health education on diabetes, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self‐care activities in patients with type 2 diabetes mellitus. Conclusion: Health‐care providers and nurses should encourage greater engagement in self‐care activities in patients with type 2 diabetes mellitus, especially foot care and blood sugar testing. Illness perceptions may be used as a framework to guide interventions. Summary statement: What is already known about this topic? Diabetes is a global epidemic, and China has the largest number of patients with type 2 diabetes mellitus.Self‐care activities are a key factor in preventing complications and maintaining long‐term health in patients with type 2 diabetes mellitus.Illness perceptions are amendable to change by health‐care providers. What this paper adds? Self‐care activities in Chinese patients with type 2 diabetes mellitus were suboptimal; the least frequently performed self‐care activities were foot care and blood sugar testing, and one in five patients smoked.Some subscales of illness perceptions, receiving diabetes education, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self‐care activities in Chinese patients with type 2 diabetes mellitus. The implications of this paper: Illness perceptions may be used as a framework to guide interventions aimed at promoting self‐care activities in Chinese patients with type 2 diabetes mellitus.Interventions aimed at promoting self‐care activities should be tailored to the sociodemographic and clinical profiles of individual patients. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the overall status of burnout in nurses in China on a national scale and investigate the demographic characteristics related to burnout and the relationships between demographics, job satisfaction and burnout. Methods: This was a national cross‐sectional study conducted by the Chinese Nursing Association between July 2016 and July 2017. Data were collected using a structured, self‐administered questionnaire. Results: A total of 51 406 registered nurses in 311 Chinese cities completed the questionnaire. Fifty per cent of the participants suffered burnout, and 33.8% of nurses had high scores on emotional exhaustion, 66.6% had high scores on depersonalization and 93.5% had low scores on personal accomplishment; 16.2% reported a high level of job satisfaction, only 0.4% was satisfied with their jobs and 70.7% intended to leave their jobs. Marital status, educational level, income and years of working experience affected job burnout. Nurses with a high level of burnout were more likely to have a high degree of job dissatisfaction and intend to leave their jobs. Conclusion: We found a high prevalence of burnout among nurses in China. Nursing managers need to pay more attention to job burnout and its influencing factors. Interventions to reduce nurse burnout should be implemented. SUMMARY STATEMENT: What is already known about this topic? Burnout is a prolonged response to chronic job‐related stress and it has a negative effect on job satisfaction and quality of nursing care. What this paper adds? The prevalence of burnout among nurses working in China is high.Marital status, educational level, income and years of working experience affect job burnout.Nurses with a high level of burnout have high job dissatisfaction and intend to leave. The implications of this paper: Nursing supervisors and managers need to be more aware of the high prevalence of job burnout among nurses in China.Interventions should be undertaken to prevent or reduce nurse burnout. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to test the mediator role of patient safety behaviour between safety culture and safety performance among nurses. Methods: This cross‐sectional study was carried out between September and December 2017 in the nursing units of 10 primary hospitals, two secondary hospitals and two tertiary hospitals in Anhui Province, China. Results: The study participants comprised 79 RNs from primary hospitals, 147 RNs from secondary hospitals and 242 RNs from tertiary hospitals. Most were female (97.6%) and married (73.1%), and their ages ranged from less than 25 years to retirement age. The sample included nurses working in several departments, including medicine (27.1%), surgery (14.3%), emergency (11.5%) and ICU (9%). Structural equation model analysis results showed that espoused values directly affected safety performance, and practised values affected safety performance through safety behaviour. Conclusion: Our hypothetical model noted that safety behaviour is a positive mediating factor of practised safety values affecting safety performance, suggesting that Chinese nursing managers should construct a patient safety culture that is guided and driven by appropriate values, which will ultimately be externalized as nurses' daily behaviour. Summary statement: What is already known about this topic? Nurse‐based patient safety culture evaluation is the primary step towards building a patient safety culture.The investigation of patient safety culture in nursing has revealed that although considerable work has been accomplished towards building a patient safety culture by hospital administrators and nursing administrators, the expected results of patient safety management remain unrealized.Research on the correlation between patient safety culture and safety performance is currently lacking in China. What this paper adds? Nurses had positive self‐reported culture, behaviour and outcomes.Safety behaviour of nurses is a positive mediating factor of practised values and safety performance. The implications of this paper: The core of patient safety culture change is a fundamental shift in values. Chinese nursing managers should construct a patient safety culture that is guided and driven by appropriate values.Safety behaviour of nurses is a positive mediating factor of practised values. In management practice, we should first focus on refining espoused values and then promoting change among nurses by encouraging the adoption of specific management strategies. These strategies will then be internalized by nurses and become practised values, which will ultimately be externalized as nurses' daily habits. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the experiences of family caregivers interacting with people with dementia. Background: A majority of people with mild‐to‐moderate dementia live at home with family caregivers. This interaction creates positive experiences and challenges for these caregivers. Design Descriptive phenomenological qualitative inquiry guided this study. Methods: This qualitative study involved semi‐structured interviews with the caregivers of people with mild‐to‐moderate dementia (n = 10). Data were collected from June to September 2018, and then data were thematically analysed. Results: Six categories of themes were identified from the interviews: (1) unexpected things often happen; (2) positive coping strategies; (3) sense of accomplishment because people with dementia actively participate in activities; (4) sense of frustration because of the reluctance of people with dementia to participate in activities; (5) hope for the happiness of people with dementia; and (6) want to have their own life. Conclusions: This study reveals that caregivers could positively interact with people with dementia through creating opportunities and arranging meaningful activities. Future research should focus on family management and training on how to help caregivers interact effectively with people with dementia. SUMMARY STATEMENT: What is already known about this topic? A majority of people with mild‐to‐moderate dementia live at home with family caregivers.Many caregivers suffer from depression, anxiety, fatigue, insomnia, family conflicts and low levels of life satisfaction.How caregivers interact with people with dementia at home remains unclear. What this paper adds? Caregivers experience various feelings, such as a sense of accomplishment and occasionally frustration, when interacting with people with dementia.Caregivers stated that they wanted people with dementia to be happy and live their life. Thus, the caregivers changed their attitude, accepted the situation and organized meaningful activities for people with dementia.Caregivers employed various strategies for handling situations involving people with dementia and shared how they interacted with such individuals. The implications of this paper: Care organizations that can offer certain services for people with dementia should be developed to lessen caregivers' burden.Community nurses should develop caregivers' strengths and enhance their abilities to improve interaction with people with dementia.Future research should focus on family management and training on how to help caregivers interact effectively with people with dementia. [ABSTRACT FROM AUTHOR]

Aim: To assess the attitudes of newly graduated nurses in China toward their work environment and identify the factors affecting their perception. Background: Newly graduated nurses are the primary supply to cover the nursing shortage, but their stressful transition into clinical work has contributed to high turnover for decades. Although serving as a source of stress, the work environment can also be a source of support for new nurses. Methods: A total of 2361 new nurses at 31 tertiary hospitals in 20 provinces were surveyed from June to November 2018, using the Chinese version of the Practice Environment Scale‐Nursing Work Index. Basic information and their perception about work environment were collected. Results: New nurses rated their work environment with an overall score of 84.67 (12.85). Multiple linear regression identified that education level, monthly income, hospital type and location, participation (or not) in standardized training programmes and having (or not) a mentor/preceptor were factors significantly associated with their perception of the work environment. Conclusion: The perception of newly graduated nurses in China was mainly positive overall. Nursing managers may take full advantage of factors affecting the perception of work environment to support newly graduated nurses better, to help their retention and transition. Summary statement: What is already known about the topic? Newly graduated nurses experience transition shock at the beginning of their work.Supportive work environments can help successful transition. What this paper adds? Newly graduated nurses are not fully supported in their work environment.Staffing and resource inadequacy were the poorest environmental factors.Residency programmes had the most impact on the perceptions of newly graduated nurses about their work environment. Implications for nursing practice: These results can guide nursing managers to support the newly graduated nurses better in their transition process, thus helping retention of nursing human resource. [ABSTRACT FROM AUTHOR]