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Aims: To evaluate the prevalence of sleep disturbance in older adults with or without mild cognitive impairment (MCI) and associated factors among residents in rural central China. Methods: A cross-sectional survey was conducted in adults in rural areas of the Hunan province aged≥60 years. Study participants (N = 1213) included 479 individuals meeting the criteria for MCI and 734 with normal cognitive abilities. The participants completed the Athens Insomnia Scale, Stress Resilience Quotient Scale, Affect Balance Scale and Activities of Daily Living (ADL) Scale. Chi-square test, Wilcoxon rank sum analyses and multiple logistic regression were used in this study. Results: A total of 60.33% of participants with MCI demonstrated sleep disturbance (60.33%, 95% CI: 0.559-0.649), which was significantly higher than in the non-MCI group (43.73%, 95% CI: 0.759-0.838). Multiple logistic regression conducted separately in the populations of older adults with or without MCI showed that age, drinking habits, affect balance and activities of daily life were correlates of self-reported sleep disturbance in rural older adults with MCI (B = −5.469), whereas age, ADL, living arrangement and resilience were the main influencing factors in older adults without MCI (B = 2.991). Conclusion: Sleep disturbance is more common in older adults with MCI than without MCI in rural areas of China. The factors influencing sleep disturbances vary between older adults with or without MCI, with age and ADL representing common factors influencing sleep disturbance in both groups. Interventions focusing on the age, drinking habits, affect balance and ADL may improve sleep quality in MCI older adults. [ABSTRACT FROM AUTHOR]

Aims: To investigate the eHealth literacy and the psychological status of Chinese residents during the COVID‐19 pandemic and explore their interrelationship. Background: The COVID‐19 outbreak has placed intense psychological pressure on community residents. Their psychological status may be affected by eHealth literacy due to home isolation during this rampant pandemic. Methods: This is a Web‐based cross‐sectional survey conducted on the JD Health platform, which resulted in 15,000 respondents having participated in this survey. The eHealth Literacy Questionnaire (EHLQ), Patient Health Questionnaire‐9 (PHQ‐9), Insomnia Severity Index (ISI) and Impact of Event Scale‐Revised (IES‐R) were used. The Pearson correlation was used to analyse the relationship between eHealth literacy and depression, insomnia and post‐traumatic stress disorder. Results: The score of eHealth literacy was 48.88 ± 8.46, and 11.4%, 6.8% and 20.1% of respondents experienced moderate to severe depression, insomnia and post‐traumatic stress disorder. eHealth literacy negatively correlated with depression (r = −0.331), insomnia (r = −0.366) and post‐traumatic stress disorder (r = −0.320). Conclusion: eHealth literacy is closely related to psychological status. Improving eHealth literacy may contribute to maintaining good psychological well‐being. Implications for Nursing Management: It is necessary to strengthen the education of primary health care providers to enhance their ability to help community residents effectively use eHealth information. [ABSTRACT FROM AUTHOR]

The article informs that COVID-19 disease has resulted in an unprecedented shutdown in many cities and regions in China, and concerns raised about the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), health care providers are also subject to isolation in and deployment to infection is epidemic. It mentions that evaluate measures of depression, anxiety, insomnia, and distress among health care providers providing care for individuals affected by SARS-CoV-2.

Aims Patients with acute coronary syndrome (ACS) often experience reduced health-related quality of life (HRQOL), which may be attributable to the disease severity and psychological stress. While illness perception is speculated to be a potential pathway underlying these relationships, evidence supporting this mechanism remains limited. This study aimed to investigate the relationships between disease severity, psychological stress, and HRQOL and whether these relationships are mediated by illness perception in patients with ACS. Methods and results Data were collected from June to July 2019 and June to September 2020 in the cardiology departments of four public hospitals in China. Eligible patients completed measures of disease severity, psychological stress, illness perception, HRQOL, and socio-demographic and clinical characteristics. Data were analysed employing hierarchical multiple regression and structural equation modelling. This study included 405 participants (mean age 60.63 years, 67.4% male). After controlling for socio-demographic and clinical covariates, higher levels of disease severity (β = 0.115 , P = 0.024) and psychological stress (β = −0.209, P ＜0.001) were associated with poorer HRQOL; however, the relationships became non-significant after adding illness perception into the regression model. Structural equation modelling analysis suggested that illness perception played a mediating role between disease severity, psychological stress, and HRQOL, accounting for 45.95% and 65.79% of the total effects, respectively. Conclusion This study found that illness perception mediated the relationships between disease severity, psychological stress, and HRQOL among patients with ACS. Improving patients' HRQOL should consider its important influencing factors with a focus on promoting positive illness perception. [ABSTRACT FROM AUTHOR]

This study aimed to understand the current state of adolescent mental health, explore the mediating effect of bullying victimization and resilience in the relationship between adolescent family functioning and mental health, and investigate gender differences in this association. A total of 4319 students (2347 boys and 1972 girls) completed the questionnaire. Mediating effects were analyzed using the framework of structural equation modeling and bootstrapping. The results revealed that family functioning is significantly associated with adolescent mental health, and that bullying victimization and resilience have significant independent and chain mediating effects on this relationship. Multiple group analysis revealed that the independent mediating role of resilience was more significant for male adolescents. Furthermore, the chain-mediated effects of bullying victimization and resilience were observed only in the relationship between family functioning and mental health in male adolescents. To improve the mental health of adolescents, special attention should be given to the impact of family life on adolescents' school life. Early detection and intervention for adolescents with poor family functioning are also important to effectively prevent bullying victimization and reduce the emergence of mental health problems. [ABSTRACT FROM AUTHOR]

Background: Mental illness is a major burden of disease worldwide. Community Mental Health Services (CMHS) are key to achieving community-based recovery for people with mental illness. In China, even though the community management of patients with mental illness is improving, the barriers faced by Community Mental Health Workers (CMHWs) are unclear. This study explores the difficulties and challenges in CMHS from the perspective of CMHWs. The results of this study may provide a practical basis for the training of CMHWs. Methods: We carried out a qualitative study using an empirical phenomenological approach. Nine CMHWs were recruited from nine communities in Wuhan, Hubei Province, using purposive and snowball sampling. Face to face semi-structured in-depth interviews were conducted with them from December 27 to 28, 2019. Interview recordings were converted to text content by Nvivo 11.0 software and analyzed using Colaizzi's phenomenological method. Results: Three main themes were identified in this study: 1) Lack of role orientation leads to role ambiguity, 2) Failure to establish a therapeutic trust relationship with patients, and 3) Lack of communication and collaboration with various departments and peers. Seven sub themes were also identified. In these themes, CMHWs emphasized the importance of role clarity, therapeutic trusting relationships, and effective communication and coordination mechanisms. Conclusion: Although China has made great efforts on the road to improving the quality of CMHS, several salient issues regarding CMHWs must be addressed to optimize the quality of services provided by CMHWs. Community mental health institutions should help CMHWs overcome these difficulties, by maximizing its value and promoting the development of CMHS. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate eHealth literacy about coronavirus disease 2019 (COVID‐19) among older adults during the pandemic. Background: The COVID‐19 pandemic promoted the development of online health care. Higher demand for accessing information from the Internet was seen. Methods: This was a sequential explanatory mixed‐method study, involving a survey of older adults to explore the status and influencing factors of eHealth literacy regarding COVID‐19. Semi‐structured interviews were used to understand experiences and challenges regarding information retrieval, judgment and utilization. Results: A total of 337 older adults participated in the online questionnaire survey. Overall, older adults had slightly higher scores on eHealth literacy during the COVID‐19 pandemic. Participants' location in the past month and current health issues were associated with eHealth literacy. Qualitative data were collected from nine older adults and included that some older adults retrieved health‐related information during the pandemic. However, those who used non‐smartphones described difficulties in information retrieval. A glut of misinformation has resulted in an 'infodemic', which has not only increased the difficulty of judging information but also posed challenges in information utilization for older adults. Conclusion: Improving older adults' eHealth literacy is essential in promoting an improved response to major public health events and in providing better health care for this group in the future. It is essential that government health agencies and health care providers provide evidence‐based health information via social media platforms. Further efforts are needed to combine aspects of traditional and online health care services and provide reliable and updated online information and resources for older adults. Implications for Nursing Management: Providing evidence to eHealth literacy improvement and health management of older adults in the context of public health events. [ABSTRACT FROM AUTHOR]

Trials to assess the efficacy of psychological interventions for personal stigma in patients with schizophrenia are controversial, inconclusive, and limited. Using a systematic review and network meta-analysis, this study aimed to compare the effect of different psychological interventions for reducing personal stigma in patients with schizophrenia both direct and indirect. Relevant randomized controlled trials (RCTs) were obtained from Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, PsycINFO, Embase, Ovid Medline, CNKI, Wanfang, CBM, and Weipu. The focus of this network meta-analysis was on comparing the effects of various psychological interventions for reducing personal stigma in patients with schizophrenia. Standardized mean differences (SMDs) of personal stigma outcomes and 95% confidence intervals (CIs) were used to determine the efficacy. Inconsistency test, network map, surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, and sensitivity analysis was performed. Twenty-one RCTs involving 1,749 participants and nine psychological interventions were included. In terms of short-term efficacy, group self-assertiveness training ranked as most likely to reduce personal stigma (SUCRA: 97.0%, SMD: 2.15, 95% CI: 1.07 to 3.23), followed by group psychoeducation programs (SUCRA: 60.1%, SMD: 0.90, 95% CI: 0.24 to 1.55). These two interventions were significantly more effective than the treatment as usual. Group self-assertiveness training and psychoeducation programs with higher ranks in short-term efficacy might be favorable to reduce personal stigma in patients with schizophrenia. However, the quality of evidence for pairwise comparison was rated as "very low" to "low" according to the Confidence in Network Meta-Analysis (CINeMA) approach. Further longitudinal studies with larger well-designed multicentric RCTs are needed to verify the efficacy of long-term outcomes. • Stigma is pervasive in patients with schizophrenia, which may lead to physical or mental changes as well as patients' quality of life. • This study provides updated evidence to identify the most effective psychological intervention to reduce personal stigma in patients with schizophrenia. • Group self-assertiveness training and group psychoeducation programs might be favorable to reduce personal stigma in patients with schizophrenia in the short term. [ABSTRACT FROM AUTHOR]

Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention. • The most important familial predictor within the random forest algorithm was family function. • The logistic regression model found family history of mental illness as the foremost familial risk predictor for NSSI. • Help-seeking behaviors of mental distress from parents or others in the family were protective predictors of NSSI. • Maternal education less than high school was a protective predictor of NSSI. • Both models resulted in an overall positive ability to predict family-related factors of NSSI. [ABSTRACT FROM AUTHOR]

Objective: Many people with mental disorders are cared for by informed caregivers, but they usually have limited care-related training and lack caregiving capacity and support networks. In order to provide professional training and social support for informed caregivers, we designed the Caregivers-to-Caregivers Training Programme (C2C) and performed a pilot study to assess its effect. Methods: Caregivers of persons with mental disorders who participated in the C2C were asked to participate in a quasi-experimental study to assess their knowledge and skills development, self-care ability, trainer engagement, and training content. A total of 800 participants completed self-designed evaluation questionnaires and two open-ended questions to gather suggestions and feedback. Assessments were carried out at pretest (baseline), post-test, and at 2-month follow-up. Results were analyzed using one-way repeated measures analysis of variance (ANOVA) and pairwise comparison method. Results: At post-test, 667 assessments were considered valid and 515 were deemed valid at 2-month follow-up. One-way repeated-measures ANOVA showed that the main effect of the scores on knowledge and skills development and self-care ability from baseline to 2-month follow-up was significant (p <.001). Results of pairwise comparison method showed that the scores on each item of knowledge and skills development and self-care ability at post-test and at 2-month follow up were higher than those at baseline (p <.001). The scores on items of trainer engagement and training content were all above average (4/5). The open-ended questions resulted in 678 comments indicating that participants gained significant support from other caregivers and healthcare professionals in the alliance and wanted more and continuously updated material. Conclusion: This study demonstrated that C2C effectively improved the development of caregivers' knowledge, skills, and their self-care ability. Available social support for caregivers was better than average, including professional support and peer support. [ABSTRACT FROM AUTHOR]

Understanding the intention of community residents to seek help from mental health professionals (MHPs) is essential in targeting interventions that promote the prevention and treatment of depression. This study aimed to investigate the current status of Chinese community populations' depression help-seeking intentions from MHPs and explore factors influencing the intentions. Data were used from a survey conducted in a city in central China (n = 919 aged 38.68 ± 17.34, 72.1% female). Help-seeking intentions, help-seeking attitude, depression stigma, family function and depressive symptoms were measured. The total mean score on the intent to seek help from MHPs was 11.01 ± 7.78 and most of respondents were unwilling to seek professional help. Multiple linear regression showed that participants who were students, held a positive help-seeking attitude and had low personal stigma were more likely to have the intention to seek help from MHPs. It is necessary to utilize effective interventions to improve community residents' intention to seek professional help. These include promoting the importance of seeking professional assistance, optimizing the quality of mental health services and altering residents' prejudice to seeking professional help. [ABSTRACT FROM AUTHOR]

Background: Due to the increasing burden of life-limiting illnesses, the need for palliative care has increased. Nurses' palliative care competence is a vital factor in improving its accessibility. A reliable instrument is needed to measure nurses' competence in providing palliative care. Objective: Our aim was to translate and culturally adapt the Palliative Care Nursing Self-Competence Scale (PCNSC) into the Palliative Care Nursing Self-Competence Scale–Simplified Chinese (PCNSC-SC). Methods: Two cross-sectional studies were conducted after content validity had been confirmed during the instrument's translation and adaption. The convergent validity, construct validity, internal consistency, and homogeneity were evaluated in both the first and second studies. Test-retest reliability was assessed only in the first study. Clinical nurses who had a registered nurse qualification certificate and at least 12 months of work experience from a tertiary hospital in Hubei, China participated in the 2 studies. Results: The PCNSC-SC contains 8 dimensions and 34 items, based on goodness-of-fit indices and confirmatory factor analysis. The Cronbach's alpha of the PCNSC-SC was.984 and.990 in the 2 studies, respectively. The test-retest reliability of the PCNSC-SC after 2 weeks was.717. Conclusion: The PCNSC-SC can be used to evaluate perceived self-competence in palliative care of Chinese nurses with good reliability and validity. [ABSTRACT FROM AUTHOR]

aimei Zhu,1 Zhongxiang Cai11Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; 2School of Medicine, Yangtze University, Jingzhou, People's Republic of China; 3Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; 4School of Nursing, Wuhan University, Wuhan, People's Republic of China*These authors contributed equally to this workCorrespondence: Zhongxiang Cai; Lili Zhang, Department of Nursing, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, Hubei Province, 430060, People's Republic of China, Tel +86-18627932929 ; +86-13971907706, Email [email protected] ; [email protected] Purpose: Nonsuicidal self-injury (NSSI) is related to childhood trauma, negative life events, and coping style, but the interaction among these factors and the mechanism by which they interact in adolescents with depressive disorder remain unclear. This paper explores how these factors interact to influence NSSI and provides evidence to develop prevention efforts and interventions for adolescents with depressive disorder with NSSI.Patients and Methods: A cross-sectional design and convenient sampling method were used in this study. The Childhood Trauma Questionnaire, Adolescent Self-Rating Life Events Checklist, Trait Coping Style Questionnaire, and Adolescent Nonsuicidal Self-injury Assessment Questionnaire were completed by 540 adolescents with depressive disorder. Descriptive analysis, chi-square tests, t-tests, Pearson correlations, and serial mediation analyses were used in the data analysis.Results: A total of 398 (79.442%) adolescents with depressive disorders reported experiences of NSSI. The results of serial mediation analyses determined that childhood trauma has a direct (estimate = 0.209, 95% CI: 0.063, 0.334) and indirect (estimate = 0.271, 95% CI: 0.199, 0.371) impact on NSSI. The indirect impact of childhood trauma on NSSI through negative life events alone (estimate = 0.096, 95% CI: 0.007, 0.169), coping styles alone (estimate = 0.088, 95% CI: 0.034, 0.183), and negative life events on coping styles (estimate = 0.086, 95% CI: 0.042, 0.162) was significant.Conclusion: This study demonstrates that screening for childhood trauma should be considered when preventing and treating NSSI behavior in adolescents with depressive disorder. Managing negative life events and coping style may mitigate the negative impact of childhood trauma on NSSI behavior in adolescents with depressive disorder. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a chronic and severe mental disorder. People with schizophrenia have transferred from hospital-based care to community-based care with the support of mental health legal policies. Challenges faced in the community should be emphasized. Limited qualitative studies have explored the challenges of living with schizophrenia. Aims: To explore the challenges of people living with schizophrenia in the community. Methods: A narrative method was used, including semi-structured, face-to-face interviews. Thematic analysis approach was used to analyze data. Results: Ten clients and their family members participated in the study. Analysis revealed three main themes related to their challenges in the community: deficits in self-management of illness; insufficient community mental health care; and the influence of policy. These challenges prevent those with schizophrenia from effectively managing their illness, returning to a productive role in society, and improving their quality of life. Conclusions: There are challenges in mental health rehabilitation and social reintegration of individuals with schizophrenia. There is a need for continuous community mental rehabilitation services, appropriate policy support, and the need to educate the public to reduce social bias and discrimination which allows individuals with schizophrenia to assume a productive role in the community. [ABSTRACT FROM AUTHOR]

Background: Various populations have experienced significant increases in depression and decreased quality of life (QOL) during the coronavirus disease 2019 (COVID-19) pandemic. This network analysis study was designed to elucidate interconnections between particular depressive symptoms and different aspects of QOL and identify the most clinically important symptoms in this network among adults in Wuhan China, the initial epicenter of the COVID-19 pandemic.Methods: This cross-sectional, convenience-sampling study (N = 2459) was conducted between May 25 to June 18, 2020, after the lockdown policy had been lifted in Wuhan. Depressive symptoms and QOL were measured with the Patient Health Questionnaire-9 (PHQ-9) and first two items of the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. A network structure was constructed from the extended Bayesian Information Criterion (EBIC) model. Network centrality strength and bridge strength were evaluated along with the stability of the derived network model.Results: Loss of energy (DEP-4) and Guilt feelings (DEP-6) were the two central symptoms with the highest strength as well as the two most prominent bridge symptoms connecting the clusters of depression and quality of life (QOL) in tandem with the two nodes from the QOL cluster. Network structure and bridge strengths remained stable after randomly dropping 75 % of the sample.Conclusion: Interventions targeting "Loss of energy" and "Guilt feelings" should be evaluated as strategies for reducing depressive symptoms and promoting improved QOL in COVID-19-affected populations. [ABSTRACT FROM AUTHOR]

Objectives: The Coronavirus Disease 2019 (COVID-19) outbreak may have a long-term impact on mental health in the general population. This study examined inter-relationships between post-traumatic stress disorder symptoms (PTSS) and quality of life (QOL) in Wuhan residents after the COVID-19 outbreak using network approach.Methods: A cross-sectional survey was conducted between May 25 and June 18, 2020. PTSS and QOL were measured using Chinese versions of the Post -Traumatic Stress Disorder Checklist - Civilian Version and the World Health Organization Quality of Life Questionnaire - brief version, respectively.Results: A total of 2598 participants were included. A network analysis revealed "Avoiding reminders", "Feeling emotionally numb", "Avoiding thoughts", "Hypervigilance", and "Reliving experiences" as the most central (influential) nodes in PTSS network models both before and after controlling for covariates. The connection between "Avoiding thoughts" and "Avoiding reminders" had the strongest edge. Three symptom communities were detected and can be summarized as "re-experiencing and avoidance", "negative changes in thinking and mood", and "hyperarousal". The bridge symptoms connecting PTSS and QOL were "Sleep disturbances", "Irritability", and "Loss of interest".Limitations: Limitations included the cross-sectional study design, self-report measures in data collection, and lack of follow-ups beyond the initial phase of the pandemic.Conclusions: PTSS were common among Wuhan residents even after the initial COVID-19 outbreak had passed. Attention should be paid to lingering symptoms of avoiding reminders, emotional numbness, avoiding thoughts, hypervigilance, and reliving experiences in treating PTSS related to the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

Background: Suicide in college students is a major public health concern. Suicidal ideation (SI) is associated with childhood trauma, personality, dysfunctional attitudes and depressive symptoms, but how they interact to predict SI remains unclear.Methods: Using cross-sectional design and convenience sampling method, a survey was conducted among 565 college students having major depressive disorder (MDD). The Childhood Trauma Questionnaire, Eysenck Personality Questionnaire, Dysfunctional Attitudes Scale and Hamilton Depression Scale assessed participants' psychosocial factors. Chi-square test, t-test, Pearson correlation, and Structural Equation Model were used in data analysis.Results: Overall, 66.02% of participants with MDD had SI. Those with SI showed significant differences in physical abuse, emotional abuse, physical neglect, emotional neglect, psychoticism, neuroticism, extroversion, dysfunctional attitudes and depressive symptoms compared with those without SI. Childhood trauma, psychoticism, neuroticism, extroversion and dysfunctional attitudes affected SI through chain mediation. In addition, depressive symptoms, psychoticism, neuroticism and extroversion directly affected SI.Limitations: The convenience sampling method may limit the generalizability of the findings. Results may be biased due to the self-report nature of the data collection procedure, the number of research subjects and differences in suicide risk assessment. The cross-sectional study cannot be used to infer causality.Conclusions: The factors of childhood trauma, personality and dysfunctional attitudes affect SI through chain mediation. In addition, depressive symptoms and personality independently predict the occurrence of SI. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe the prevalence of perceived self‐competence in palliative care among emergency care nurses and explore its predictors. Background: Emergency care nurses have a responsibility to develop palliative care competence to enhance the quality of life of dying patients and their families in the emergency department. Methods: With a convenience sample, a cross‐sectional study was conducted among 415 emergency care nurses from 22 hospitals in China. Descriptive analysis, Spearman correlation analysis and multivariate linear stepwise regression were performed. Results: Variables including marital status (single), emergency department not implementing palliative care, no palliative care training and true cooperation dimension were selected as independent predictors and explained 19.9% of variation in the regression model. Conclusions: Interventions to improve healthy work environments, offering palliative care training, advocating for policies in palliative care and offering support to unmarried nurses can advance nurses' palliative care competence. Implications for nursing management: This is the first study of emergency care nurses in China aimed at identifying predictors associated with palliative care self‐competence. It is significant in that palliative care training and a cooperative work environment are required to encourage the development of palliative care. [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]

Background: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and well-being of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic.Method: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure.Results: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights.Limitations: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic.Conclusions: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population. [ABSTRACT FROM AUTHOR]

Background and Objectives: The prevalence of problematic Internet use (PIU) in the post‐COVID‐19 pandemic era is not known. This cross‐sectional study aimed to determine the prevalence of PIU among baccalaureate nursing students (hereafter: nursing students) in the post‐COVID‐19 era. Methods: A total of 1070 nursing students were consecutively invited to participate in this study from the nursing schools of five universities. PIU and quality of life (QOL) were assessed using the Internet Addiction Test (IAT) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL‐BREF), respectively. t Tests, χ2, tests, and Kruskal–Wallis tests were used to compare basic demographic and clinical characteristics between participants with and without PIU. Binary logistic regression analysis was used to examine independent correlates. Results: The prevalence of PIU was 23.3% (95% confidence interval [CI]: 20.7%–25.8%). Multiple logistic regression analysis revealed that second‐ (p =.024) and third‐year (p =.012) students were more likely to suffer from PIU compared with first year students. Students with more severe depressive (p =.014) and anxiety symptoms (p =.011) were independently and significantly associated with more severe PIU. After controlling for covariates, nursing students with PIU had a lower overall QOL score (p =.002). Conclusion and Scientific Significance: Problematic Internet use (PIU) was common among nursing students in the post‐COVID‐19 era. Considering the negative impact of PIU on QOL and academic performance, regular screening should be conducted and effective interventions implemented for nursing students with PIU. This was the first study on the prevalence of PIU among nursing students in the post‐COVID‐19 era. The findings of this study could help health professionals and education authorities to understand the patterns of PIU and its influence on QOL among nursing students and to allocate health resources and develop effective measures to reduce the risk of PIU in this population. [ABSTRACT FROM AUTHOR]

Background: Nonsuicidal self-injury (NSSI) is related to childhood abuse, family relationships, interpersonal relationships, personality, but the interaction between them is still unclear, and how they interact in major depressive disorder (MDD).Methods: Collected data from 444 undergraduate degree students with MDD participated. Used the Eysenck Personality Questionnaire, Childhood Trauma Questionnaire, Interpersonal Relationship Comprehensive Diagnostic Scale, and Family Assessment Device to assess the patients' psychosocial factors. NSSI behavior was assessed through interviews. Use the Chi-square test, Wilcoxon rank-sum test, Kruskal-Wallis H-test, Distance Correlation, Structural Equation Mode for data analysis.Results: Overall, 34.2% of patients with MDD had a history of NSSI. MDD patients with a history of NSSI had significant differences in psychoticism, neuroticism, emotional abuse, physical abuse, sexual abuse, emotional neglect, troubles in conversation, ability to make friends and family roles. Among these factors, psychoticism was most related to NSSI, and child abuse, interpersonal relationships and family roles played a variety of roles in mediating the relationship with NSSI.Conclusions: Psychosocial factors affect the occurrence of NSSI through chain intermediary effects. [ABSTRACT FROM AUTHOR]

The aim of this assessment was to determine the information needs, resources, and resource preferences and self/family-management challenges of parents caring for a child with asthma in China. The acceptance of asthma and consolidated framework for implementation research guided the study. A cross-sectional, descriptive design was used. Seventy-one parents of a child receiving care in an outpatient respiratory clinic completed a three-part, pragmatic, self-report survey. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. Parents, who needed more knowledge about asthma, sought information from internet sources. However, most parents preferred receiving information during in-person consultation with trained specialists. Management challenges revolved around understanding asthma information, formulating beliefs about asthma, experiencing distressing thoughts and feelings, forming supportive networks, and meeting their child's emotional needs. Evidence supports expanding nursing roles in China to include extended time for initial in-person parental interactions and follow-up using reliable clinic-based internet counseling. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effect of Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) intervention on the rehabilitation of preschool children having autism spectrum disorder (ASD) in China. Sixty children with ASD were randomly assigned to the intervention group (n = 30) or the control group (n = 30). The intervention group received TEACCH training plus Discrete Trial Teaching (DTT) for six months, while the control group received only DTT. The Chinese version of the Psycho-educational Profile (3rd ed.) (CPEP-3) was used to assess participants at baseline, posttest and at six-month follow-up. The results were analyzed using descriptive statistics, t test, χ 2 or Fisher's exact test, and repeated-measures analysis of variance (ANOVA). No significant difference was found between the two groups at baseline (p > 0.05). Repeated-measures ANOVA showed that the CPEP-3 subscales had a significant time effect (p < 0.001). The two groups significantly differed in expressive language, affective expression, social reciprocity, problem behavior, and personal self-care at posttest and six-month follow-up (p < 0.05). They also significantly differed in receptive language, fine motor at posttest (p < 0.05), but not at follow-up. This study demonstrated that TEACCH-based group rehabilitation training effectively improved the development of children having ASD. It provided enhanced rehabilitation strategies that assisted children with ASD to learn, function, and reach their goals. [ABSTRACT FROM AUTHOR]

Millions of people older than 60 years are affected by arthritis. Unrelieved chronic pain of arthritis is associated with increased healthcare needs and decreased quality of life in older adults. Understanding older adults' perceptions and experiences of living with arthritis pain can benefit healthcare experts in designing and implementing clinical, education, and research programs to better care for this population. This meta-synthesis of qualitative studies aimed to explore older adults' experiences of living with arthritis pain. A narrative meta-synthesis. Journal articles published in English were identified by conducting electronic searches in CINAHL, PubMed, PsycINFO, Scopus, and ISI Web of Science to June 2019. Unpublished studies were searched in Google Scholar, ProQuest Dissertations and Theses Database. Four groups of keywords were combined in the search strategy: (1) research methods/qualitative researches; (2) older adults; (3) arthritis/arthritis pain; (4) experience. Studies were included if they (a) used qualitative research designs, qualitative data collection and analysis; (b) included participants aged 60 years and older regardless of the study context; (c) reported on older adults' experiences of living with arthritis pain; and (d) were published in English. Studies were excluded if: (a) they used mixed methods where qualitative data could not be extracted or (b) the data analysis lacked the necessary qualitative depth. Noblit and Hare's methodology of synthesizing qualitative studies was used. Eleven studies were included. Among the 11 included studies published in 2003–2018, the sample size ranged from 3 to 551 participants. Older adults aged 62 to 95 years, and the majority were female. The ethnicity of the older adults was reported in 7 studies, including Caucasians, African Americans, Hispanics, Korean Americans, Australian, European, and South Korean. Through meta-synthesis, four themes were identified. The lived experiences of pain among older adults with arthritis include the center of daily living, a lonely path, an inevitable and endless process, and surviving through pain management. These themes may reflect older adults' experiences of living with arthritis pain across diverse ethnicities and cultures. Health care providers must be sensitive to older adults' experience of arthritis pain, realize the importance of providers' support on patients' adaptation, and provide comprehensive and individualized patient-centered interventions for managing arthritis pain for older adults. The study protocol had been registered in PROSPERO (International prospective register of systematic reviews). The registration number is CRD42019129716. Link: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019129716. [ABSTRACT FROM AUTHOR]