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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]

Aims: To explore predictors of lymphedema self‐management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables. Design: Further analysis of a multicentre cross‐sectional and survey‐based study. Methods: A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self‐reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed. Results: The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self‐management behaviours. The final structural model showed good model fit. Social support, self‐efficacy and lymphedema knowledge positively affected lymphedema self‐management behaviours, directly and indirectly. Self‐regulation acted as a crucial mediator between these variables and self‐management. The direct path between social support and self‐regulation was not significant. Lymphedema knowledge and social support also influenced self‐management via illness perception, self‐efficacy and self‐regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self‐management behaviours. Conclusions: The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self‐management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self‐efficacy, social support and self‐regulation directly and indirectly influenced lymphedema self‐management behaviours. Impact: This study provides a theoretical basis for the assessment and interventions of lymphedema self‐management behaviours in breast cancer patients. Lymphedema self‐management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors. Reporting Method: This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Patient or Public Contribution: No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. What Does This Paper Contribute to the Wider Global Clinical Community?: This study focused on identifying and predicting mechanism of self‐management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high‐risk populations, and inspire the assessment and interventions facilitating self‐management behaviours. Study Registration: This study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084). Implications for the Profession and/or Patient Care: For breast cancer patients with poor lymphedema self‐management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self‐management is multi‐faced. Strategies targeted at improving social support, self‐regulation, knowledge, self‐efficacy and illness perception should be also addressed in lymphedema self‐management programs, to facilitate more effective improvement of lymphedema self‐management behaviours. [ABSTRACT FROM AUTHOR]

Objective: Health literacy is an important predictor of health outcomes. The Health Literacy Questionnaire has been widely adopted to measure health literacy and has been translated into multiple languages including Chinese. This study aims to evaluate the psychometric properties of the simplified Chinese Health Literacy Questionnaire. Methods: Data were obtained from a sample of 362 Chinese immigrants from Chinese community organizations in New South Wales, Australia. Statistical analyses include descriptive and exploratory factor analyses. Results: A seven‐factor solution was derived from 39 of the original 44 items, all with acceptable to excellent internal consistency but differing from the original construction. The health literacy subscale scores were negatively associated with age and with age at immigration, but positively associated with duration of stay (years) in Australia, better English proficiency and current employment. Differing interpretations of the questions based on Chinese culture could possibly explain the variations between the two versions. Conclusion: The simplified Chinese Health Literacy Questionnaire measures some central concepts of health literacy well. However, the questionnaire may require further development, especially in linguistic and cultural aspects. SUMMARY STATEMENT: What is already known about this topic? The Health Literacy Questionnaire has been translated and validated in multiple languages with good reliability and validity. What this paper adds? The study addresses issues that may be related to cultural adaptation and language interpretation of the simplified Chinese version of the Health Literacy Questionnaire. The implications of this paper: It is important for researchers and clinicians to evaluate the cultural sensitivity of translated questionnaires within the specific context before application. [ABSTRACT FROM AUTHOR]

Aim: To psychometrically test the Chinese version of Self‐Care of Coronary Heart Disease Inventory. Background: Self‐care is a significant step to impede the progression of coronary heart disease and serves as the primary outcome in self‐care interventions. In China, however, no instrument is available to measure self‐care in patients with coronary heart disease. To address this gap, we introduce the Self‐Care of Coronary Heart Disease Inventory into China. Design A cross‐sectional design. Methods: We translated the inventory into Chinese using standardized methods. Then, it was psychometrically tested on a convenience sample of 301 patients with coronary heart disease (October 2017 to May 2018). Construct validity was evaluated via exploratory factor analysis and testing hypotheses. Internal consistency reliability was measured with Cronbach's alpha or composite reliability. Results: Both self‐care maintenance and management subscales showed a two‐factor structure, whereas self‐care confidence subscale showed a one‐dimension structure. All subscales were significantly correlated with associated variables (disease‐related knowledge and perceived control). The internal consistency reliability for all three subscales was acceptable. Conclusion: The Chinese version showed acceptable psychometric properties when applied to the sample group of this study. It is recommended for use in self‐care interventions targeting coronary heart disease. SUMMARY STATEMENT: What is already known about this topic? Self‐care is important for patients with coronary heart disease to control risk factors, reduce recurrence and improve the prognosis.Self‐Care of Coronary Heart Disease Inventory is developed based on the middle‐range theory of self‐care of chronic illnesses and shown acceptable psychometric properties.Self‐care of CHD is a growing focus of research and clinical practice; however, a tailored instrument to measure self‐care in Chinese patients with CHD is lacking. What this paper adds? This study provides the evidence of the construct validity and internal consistency reliability of the Chinese version of Self‐Care of Coronary Heart Disease Inventory.The Chinese version is a reliable and valid measure to assess the self‐care in patients with coronary heart disease. The implications of this paper: This study fills an important gap concerning measures of self‐care related to CHD in China.The Chinese version of Self‐Care of Coronary Heart Disease Inventory has the potential to be an ideal outcome measure in self‐care interventions and promote the research focusing on self‐care of CHD.This study adds the knowledge of the psychometric properties regarding the inventory in diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Aims and objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Results: Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Relevance to clinical practice: Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Readiness for hospital discharge (RHD) has been an important topic for nurses.RHD can be measured by the Readiness for Hospital Discharge Scale (RHDS), including 4 subscales: personal status, knowledge, coping ability and expected support.There are few studies that focus on RHD in patients diagnosed with mental disorders. What does the paper add to existing knowledge?: Improving patient‐reported RHD can decrease the risks of unscheduled post‐discharge clinic visits, readmission and poor quality of life (QOL) in patients diagnosed with anxiety disorders.Improving patient‐reported personal status can decrease the risk of poor QOL in patients diagnosed with anxiety disorders.Improving patient‐reported knowledge can decrease the risks of unscheduled post‐discharge clinic visits and readmission in patients diagnosed with anxiety disorders.Improving patient‐reported expected support can decrease the risk of unscheduled post‐discharge clinic visits in patients diagnosed with anxiety disorders.Improving the methods of discharge teaching and anxiety severity can enhance RHD in patients diagnosed with anxiety disorders. What are the implications for practice?: Nurses could enhance patient‐reported RHD to reduce unscheduled post‐discharge medical resource utilization or improve QOL by facilitating knowledge acquisition and skill development and improving social support systems.Nurse managers could add RHD assessment to patients' discharge process and train nurses in the methods of discharge education.Nurses could advance their methods of discharge education, such as listening to and answering patients' questions, choosing a convenient time and engaging in online education. Introduction: The association between readiness for hospital discharge (RHD) and post‐discharge outcomes remains unclear in individuals with anxiety disorders. Aim: To explore the factors of RHD and the effect of patient‐reported RHD on post‐discharge outcomes. Method: In the observational study, 373 patients diagnosed with anxiety disorders completed the self‐administered Readiness for Hospital Discharge Scale (RHDS) on discharge. After 30 days, phone interviews were conducted to collect data on post‐discharge outcomes, including self‐reported unscheduled medical service utilization, symptom severity and quality of life (QOL). Multiple logistic regression models were built to explore the relationships among sociodemographic characteristics, the RHDS and its subscales, and post‐discharge outcomes. Results: The unscheduled clinic visits were significantly associated with low RHD, knowledge and expected support. Readmission was significantly associated with low RHD and knowledge. Poor QOL was significantly associated with low RHD and personal status. Delivery, received content and anxiety severity were the predictors of RHD. Discussion: Improved RHD is associated with fewer unscheduled clinic visits and readmissions and better QOL. Enhancing discharge education can improve RHD. Implications for practice: Nurses should enhance patient‐reported RHD to improve post‐discharge outcomes by advancing the quality of discharge education in patients diagnosed with anxiety disorders. [ABSTRACT FROM AUTHOR]

Aims and objectives This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Background Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Design Systematic review using integrative methods. Methods Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: 'patient', 'healthcare provider', 'task', 'work environment', 'organisation & management'. Results We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Conclusions Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Relevance to clinical practice Patients have a significant role to play in enhancing their own safety while receiving hospital care. This review offers a framework for clinicians to develop comprehensive practical guidelines to support patient involvement in patient safety. [ABSTRACT FROM AUTHOR]

Aim: To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps. Design: A scoping review. Methods: Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross‐checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries. Results: Ninety‐eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects. Conclusions: International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels. Relevance to Clinical Practice: Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions. Reporting Method: PRISMA‐ScR Checklist. [ABSTRACT FROM AUTHOR]

Aims: To identify health literacy profiles in individuals receiving haemodialysis and to explore how these profiles interact with individuals' self‐efficacy, engagement with traditional dietary habits, self‐reported fluid restriction and relative‐interdialytic weight gain. Design: A cross‐sectional study engaging nephrology departments from four hospitals in Guangdong Province, China. Methods: A sample of 433 individuals receiving haemodialysis participated between December 2018 and July 2019. We assessed health literacy, self‐efficacy and self‐reported fluid restriction using the Health Literacy Questionnaire, the Fluid Self‐efficacy Scale and the Fluid Adherence Subscale, respectively. Traditional dietary habits, including daily tea drinking, soup drinking and preserved food consumption, were measured using three yes/no questions. Relative‐interdialytic weight gain was calculated by dividing the mean interdialytic weight gain (from three recent intervals) by dry weight. Latent profile analysis and structural equation modelling were performed. Results: Three health literacy profiles were identified: low, moderate and high. Compared to those in the low health literacy profile, individuals in high and moderate health literacy profiles demonstrated an indirect association with reduced relative‐interdialytic weight gain. This reduction can be attributed to their higher self‐efficacy levels, decreased reliance on dietary habits and higher self‐reported fluid restrictions. Conclusions: Most participants exhibited either low or moderate levels of health literacy. Improving health literacy has the potential to promote self‐efficacy and foster effective fluid restriction, ultimately leading to a reduction in relative‐interdialytic weight gain in individuals receiving haemodialysis. Impact: This study reveals heterogeneity in health literacy levels among individuals receiving haemodialysis and illuminates the connections between an individual's entire spectrum of health literacy and fluid management. These findings provide valuable insights for developing person‐centred fluid management interventions, especially for individuals with diverse cultural dietary backgrounds within the haemodialysis population. Reporting Method: We adhered to the STROBE guideline. Patient or Public Contribution: Patients were included only for collecting their data. [ABSTRACT FROM AUTHOR]

Aims: To establish a cognitive appraisal path model that examines the impact of stroke knowledge on stigma with the parallel mediating effects of negative and positive coping traits, as well as the moderating effects of family functioning. Background: Stroke‐related stigma, a 'mixture' of negative emotions involving internal criticism and external judgement, has been shown to impair patients' health outcomes. However, the specific factors underlying cognitive appraisals and their pathways remain unknown. Design: A cross‐sectional design. Methods: The cross‐sectional sample was from two stroke centres in China. Questionnaires were administered to collect sociodemographic data, stroke knowledge, coping traits, family functioning and stigma. Hierarchical regression models and the moderated parallel mediation model were constructed to analyse influencing pathways. The study adhered to the strengthening the reporting of observational studies in epidemiology guideline. Results: All 144 samples reported stigma symptoms with a moderate‐to‐high standardising score. The best hierarchical regression model explains 55.5% of the variance in stigma. The parallel mediation model indicated that negative and positive coping traits co‐mediating the association of stroke knowledge and stigma. After adding the family functioning as a moderator, the moderated parallel mediation model was confirmed with adequate fit indices. Conclusion: Among the cognitive appraisal factors affecting stroke‐related stigma, stroke knowledge reduces stigma by modifying coping traits, while poor family functioning may serve as an opposing moderator. Notably, when family support is insufficient, enhanced stroke knowledge might paradoxically exacerbate the stigma. Relevance to Clinical Practice: This study contributes knowledge on transforming health education and emphasises the pivotal roles of clinical nursing practitioners. In similar global contexts, the study highlights integrating health education, psychological counselling and family support to advance systematic nursing practices. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to explore the experiences of women with gestational diabetes mellitus (GDM) and their partners and examine the factors influencing partner involvement in GDM management, seeking to inform a targeted couple‐based intervention. Design: A descriptive qualitative study. Methods: We conducted semi‐structured interviews with 14 women with GDM and their partners. Participants were recruited through convenience sampling from a tertiary hospital in Xi'an, China. Data were analysed using thematic analysis. Results: Three themes and 12 subthemes were identified. Theme I: Women's expectations of their partner's involvement in GDM management—practical support and emotional support. Theme II: Partner involvement in GDM management—constructive involvement, unhelpful involvement with good intentions and insufficient involvement. Theme III: Factors that influence partner involvement in GDM—knowledge of GDM, GDM risk perception, health consciousness, attitudes towards the treatment plan, couple communication regarding GDM management, family roles and appraisal of GDM management responsibility. Conclusion: Women desired practical and emotional support from partners. The types of partner involvement in GDM management varied. Some partners provided constructive support, while some partners' involvement was limited, non‐existent or actively unhelpful. By combining these results with the factors influencing partner involvement, our findings may help healthcare professionals develop strategies to involve partners in GDM care and enhance women's ability to manage GDM. Implications for the Profession and Patient Care: Partner involvement in GDM care may help them understand and better attend to women's needs, thus improving their experience and potential outcomes. This study highlights novel factors that need to be considered in developing couple‐based interventions for this population. Reporting Method: The reporting follows the COREQ checklist. Patient or Public Contribution: Some patients were involved in data interpretation. There is no public contribution. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Several studies have measured the general public's knowledge and attitudes towards Alzheimer's disease; however, much of this work is based on western samples. Due to cultural differences, the western findings may be difficult to generalize to the Chinese general public. In addition, the few studies conducted in China were often restricted to a relatively narrow range of knowledge and attitudes., What this paper adds to existing knowledge? The general public had little knowledge of Alzheimer's disease, especially on the causes, symptoms and risk factors. In terms of attitudes, although the general public held positive attitudes towards persons with Alzheimer's disease, most of them were not sure whether or not to share a diagnosis of Alzheimer's disease with the patient. In daily life, only a low proportion of people kept mentally active., What are the implications for practice? A popularization of a wide range of knowledge about Alzheimer's disease needs to be undertaken, especially focusing on persons with low educational level and emphasizing the causes, symptoms and risk factors. Besides, there is a significant need to draw up evidence-based dietary and lifestyle guidelines for Alzheimer's disease risk reduction. Moreover, health promotion agencies should identify priority groups for Alzheimer's disease risk reduction initiatives, especially those with lower income, a lower level of knowledge on Alzheimer's disease and with chronic diseases., Abstract Aim The purpose of this descriptive correlational cross-sectional study was to assess the current level of knowledge, attitudes and health behaviours regarding Alzheimer's disease among community residents in Tianjin, China and to identify factors related to these attributes. Method A convenience sample of 140 community-dwelling adults aged 20-75 years was selected to complete a researcher-designed questionnaire about Alzheimer's disease-related knowledge, attitudes and health behaviours. Results The findings revealed that 15.7% of the participants knew the risk factors for Alzheimer's disease. With regard to attitude, 138 participants (98.6%) believed that people with Alzheimer's disease should not be discriminated against, and 55.7% were not sure whether to share a diagnosis of Alzheimer's disease with the patient. In daily life, 28.6% of the participants pursued their interests and hobbies. A lower level of health behaviours was associated with lower income, presence of chronic diseases and a lower level of knowledge about Alzheimer's disease. Discussion These findings provide a strong case for population-level risk reduction initiatives to be undertaken, especially among people with lower income, a lower level of knowledge on Alzheimer's disease and with chronic diseases. [ABSTRACT FROM AUTHOR]

Aim: To assess the feasibility, acceptability, and preliminary efficacy of a culturally sensitive nurse‐led structured education programme for patients with type 2 diabetes. Background: A nurse‐led satisfactory diabetes education programme might be feasible. The structured education programme is considered a potential model that helps patients manage diabetes. Design A mixed‐method design. Methods: A convenience sample of 44 participants received the programme. Feasibility was assessed using the recruitment rate and the retention rate. Acceptability was assessed by interviews to obtain the perception and experience of participants. Also, preliminary efficacy on diabetes knowledge, self‐efficacy, self‐management behaviours, and clinical outcomes was assessed. Finally, data were collected from April to December 2015. Results: The recruitment rate and the retention rate were acceptable. Participants thought that the programme contributed to their positive changes. They enjoyed and accepted the programme, and they wanted to gain the ongoing support. Significant improvements in diabetes knowledge, self‐efficacy, self‐management behaviours, A1C, fasting blood glucose, low‐density lipoprotein cholesterol, weight, body mass index, and waist circumference were reported in 12‐week follow‐up. Conclusions: This programme is feasible and acceptable, and its preliminary efficacy is promising. Ongoing support, a control group, and long‐term follow‐up are required in future studies to assess its effectiveness. SUMMARY STATEMENT: What is already known about this topic? Unsatisfactory diabetes education and a shortage of general practitioners may promote the poor management of patients with type 2 diabetes.Structured education programmes for patients with type 2 diabetes could improve biomedical, psychological, and lifestyle outcomes.A structured education programme for patients with type 2 diabetes without receiving insulin therapy was developed in mainland China. What this paper adds? The structured education programme is feasible and exhibits high preliminary efficacy.Participants received the structured education programme and experienced positive change.Participants hope to gain the ongoing support to maintain self‐management behaviours. The implications of this paper: The study indicates that nurses can use this programme to help patients manage diabetes.The programme can be applied in regular clinic care and generalized to other community health service centres.The results can provide some guidance for the further assessment of the effectiveness of the programme. [ABSTRACT FROM AUTHOR]

The aims of this paper were to determine the level of knowledge and attitude of contraception and their relationships among Chinese migrant woman workers. Studies on psychosocial variables that lead to reproductive health behaviours among Chinese migrant woman workers in China remain limited. A cross-sectional, descriptive and correlational design. One hundred and ninety young woman workers of a factory in Guangdong, a representative city of factory base in mainland China, voluntarily participated in the study with a response rate of 63%. Data were collected through self-administered questionnaires consisting of a socio-demographic sheet, the Contraceptive Knowledge Scale and the Contraceptive Attitude Scale. Pearson product moment correlation coefficient test was employed to examine the relationships between the contraceptive knowledge and attitude, with level of significance set at p < 0·05. The Chinese migrant woman workers demonstrated lower contraceptive knowledge and less favourable contraceptive attitude compared with previous studies of adolescents in Taiwan and women seeking abortion in Hong Kong. Although it was a weak correlation, contraceptive knowledge was statistically associated with contraceptive attitudes among the respondents ( r = 0·276, p < 0·001). Respondents' age, education level and working experience were significantly positively correlated with the contraceptive knowledge. Young Chinese migrant workers reported in the current study are found to be at higher sexual risk, when compared to the adolescents in Taiwan and Hong Kong women seeking abortion. Early educational intervention for reproductive health in particular contraception and its usage to these young women is indicated. Migrant woman workers in mainland demonstrated poor knowledge and unfavourable attitudes towards contraception, especially for the younger, single and less educated group. Greater effort is necessary to promote young migrant women's knowledge and attitude towards contraception and sexual health. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. Background: OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. Design: A cross‐sectional design following the STROBE guideline. Methods: A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health‐related quality of life. OHL was measured using the validated Chinese version of the short‐form Health Literacy of Dentistry (HeLD‐14) scale. Descriptive statistics, the Mann–Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. Results: The median HeLD‐14 score (p25–p75) was 50.0 (44.0–54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self‐reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. Conclusions: The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. Relevance to clinical practice: The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. Patient or public contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore hospital healthcare professionals' knowledge and attitudes towards dementia care in China. Background: Hospital healthcare professionals deliver most diagnosis and treatment for people with dementia in China. Literature shows that healthcare professionals' knowledge and attitudes are of great importance in providing optimum dementia care. However, there is limited research of healthcare professionals' dementia knowledge and attitudes within hospital contexts in China. Design: A cross‐sectional survey was conducted between April and December 2019. Methods: A self‐report questionnaire composed of demographics and knowledge and attitude scales related to dementia was used for doctors and registered nurses working in settings where people with dementia are cared for in eleven public tertiary hospitals in Hebei Province, China. The STROBE checklist was adhered to in this study. Results: In total, 603 healthcare professionals completed the study. The majority of respondents were registered nurses (71.3%). The overall mean knowledge score was 20.7 (SD = 2.9) out of a maximum possible score of 30. The overall mean score for attitudes was 91.3 (SD = 15.9) out of a maximum possible score of 140. Standard multiple linear regression analysis revealed that the highest level of education, the experience of searching for dementia‐related information and willingness to receive dementia training or education were significant predictors of knowledge scores. The department, the experience of working with people with dementia, length of dementia care, interest in dementia care and training type were significant predictors of attitude scores. Conclusions: Deficits in the knowledge of dementia and a low level of positive attitude were identified among the healthcare professionals who work in hospital settings where people with dementia are cared for in China. Relevance to clinical practice: Education and training in dementia care should be integrated into undergraduate nursing and medical programmes and provided for healthcare professionals after commencing employment. [ABSTRACT FROM AUTHOR]

Aims: To translate 25‐item Dementia Knowledge Assessment Scale into Chinese and evaluate its psychometric properties amongst Chinese healthcare providers. Background: The prevalence of dementia is increasing in China, but development of relevant training for healthcare providers is still in its infancy stage. A comprehensive, valid and reliable Chinese knowledge‐of‐dementia measure is needed to identify training needs and evaluate the effect of educational interventions. Design: A cross‐sectional survey. Methods: The Dementia Knowledge Assessment Scale was translated into Chinese following the modified Brislin's translation model. Content and face validity were established by an expert panel in dementia care and healthcare providers. A convenience sample of 290 healthcare providers in care homes and hospitals was recruited. Construct validity was evaluated through confirmatory factor analysis, concurrent validity and known groups' comparisons method. Reliability was evaluated through internal consistency reliability and 2‐week test–retest reliability. This study used the STROBE checklist for reporting. Results: The content validity index was 0.98. The confirmatory factor analysis model revealed that the four‐factor model was partly supported in the present study. The moderate correlation between Chinese version of Dementia Knowledge Assessment Scale and Alzheimer's Disease Knowledge Scale indicated acceptable concurrent validity. The mean score of the scale and subscale scores showed significant differences between health professionals and care assistants, except for the subscale of "Care Considerations." The reliability was demonstrated with Cronbach's alpha of.77 and intra‐class correlation coefficients of each subscale between.74 and.92 among 56 respondents. Conclusions: The Chinese version of Dementia Knowledge Assessment Scale demonstrated acceptable concurrent validity but marginal factorial validity and satisfactory reliability amongst Chinese healthcare providers. Therefore, applying the four‐factor structure of Chinese version scale should be considered. Relevance to clinical practice: Chinese version of Dementia Knowledge Assessment Scale can be used to understand the training needs of healthcare providers in dementia. [ABSTRACT FROM AUTHOR]

Aims: This study explored how adult children perceived family resilience, barriers to develop family resilience and how cultural values influence their experience of parents with bipolar disorder in Chinese society. Design: A qualitative design with an interpretive phenomenological analysis of data was employed. Methods: Twenty adults who had lived with parents with bipolar disorder during childhood were recruited from the acute psychiatric ward when their parents were admitted to the hospital. They described their experiences of perceived family resilience and barriers to resilience (October 2013–September 2015). Semi‐structured interviews were conducted in the hospital meeting room or at a convenient location. Findings: Six themes were identified in family resilience: ill parents try to be good parents, parents' personal strengths, parents' positive attitudes towards mental illness, flexibility of family role, cohesive relationships between family members, and families' social connections. Three themes were identified in the barriers to develop family resilience: poor parenting/family function, conflict between parents and poor mental health literacy. Conclusion: Children's views of family resilience could transform their suffering from lived experiences with a mentally ill parent to a positive growth experience. Family resilience includes well and ill parents' efforts and social network's help to maintain family function. However, the conflicts between well and ill parents and poor family function result in a traumatic growth experience. Impact: To enhance a positive growth experience, family resilience programs for a parent with bipolar disorder aiming to cultivate both the ill and well parents' inner strength and their competence of parenting skills with connecting their social network to maintain family function is needed. Moreover, early stress‐reduction intervention needs to be developed for children who did not experience family resilience. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To explore the effectiveness of a health education programme by telephone follow‐up on the self‐efficacy of patients with rheumatoid arthritis (RA). Background: Self‐efficacy is increasingly perceived to be a cornerstone in improving the capacity of self‐management. However, a paucity of research has demonstrated the effectiveness of health education by the use of a telephone follow‐up for RA patients in China. Design: This study was a randomised control trial. Methods: Recruited patients were randomly divided into control and intervention groups. The intervention group accepted health education by telephone follow‐up four times after the patients were discharged. The patients in the control group only accepted telephone follow‐up once after they were discharged. Self‐efficacy was measured by the use of the Rheumatoid Arthritis Self‐Efficacy Questionnaire (RASE), and data were collected at the day before the discharge, the 12th week and the 24th week after patients were discharged. The CONSORT checklist was used to check the procedure. Results: A total of 92 discharged patients with rheumatoid arthritis were enrolled. The sociodemographic indexes of the control and intervention groups had no significant differences at baseline (p > .05). The RASE score of the intervention group was higher than that of the control group (p < .05) at the 12th week and the 24th week. Conclusion: The HET improved the self‐efficacy of the discharged patients with RA in the 12th week and the 24th week after discharge. This study demonstrated that our HET can improve the short‐term and long‐term effects of self‐efficacy, which implies that the clinical nursing staff should increase the frequency of HET to improve the patients' knowledge and abilities of self‐management. Relevance to clinical practice: Patients with RA will benefit from a health education programme by telephone follow‐up; thus, it is necessary for nursing managers to implement this programme. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the effectiveness of a self‐efficacy‐focused structured education programme on outcomes in adults with type 2 diabetes (T2DM) without insulin therapy. Background: Structured education regarding metabolic control in T2DM adults without insulin therapy has not always been effective, and this lack of effectiveness might be due to overlooking self‐efficacy. Whether a self‐efficacy‐focused structured education programme could improve metabolic and psychosocial outcomes for T2DM adults more effectively remains unknown. Design: A multicentre parallel randomised controlled concealed label trial. Methods: The study conducted in outpatients of four hospitals in China. A total of 265 T2DM adults without insulin therapy were randomly assigned to an intervention group of a self‐efficacy‐focused structured education programme (n = 133), or to a control group of routine education (n = 132). The differences in metabolic and psychosocial outcomes were investigated at baseline, three‐ and 6‐month follow‐ups. Results: The primary outcome of A1C and the secondary outcomes of weight, body mass index, waist circumference, diastolic pressure, self‐efficacy, self‐management behaviours and knowledge improved significantly in the intervention group compared with the control group at 6‐month follow‐up. The differences in A1C between groups for patients with a low educational background at 6‐month follow‐up were significant. No significant differences were found in other secondary outcomes of systolic pressure, the blood lipid profile and diabetes distress between groups at 6‐month follow‐up. Conclusions: This programme can improve glycaemic control, weight control, diastolic pressure, self‐efficacy, self‐management behaviours and diabetes knowledge for T2DM adults. Relevance to clinical practice: This self‐efficacy‐focused structured education programme is effective and can be incorporated into regular clinical care and led by trained staff (e.g. nurses), and it can be implemented in patients with low educational backgrounds. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine the relationship between health literacy (HL) and adherence to secondary coronary heart disease (CHD) prevention behaviours in patients in China. Background: Adherence of patients to secondary CHD prevention behaviours is important in order to slow or reverse disease progression. The relationship between HL and adherence is varied across populations and warrants further research in order to inform nurses caring for such patients how to direct their teaching. Design: A descriptive cross‐sectional design. Methods: A total of 598 patients with CHD were recruited during hospitalisation for a myocardial revascularization procedure at either of two tertiary hospitals in China. Data were collected by self‐report on demographics, HL and adherence to secondary CHD prevention behaviours (medication‐taking and heart‐healthy lifestyle) prior to this admission. HL was measured by the short version of European Health Literacy Survey Questionnaire (HLS‐EU‐Q16), while adherence was measured with the Medical Outcomes Study Specific Adherence Scale (MOS‐SAS). Descriptive, chi‐square test and regression analyses were conducted. The study was reported based on STROBE checklist. Results: Overall, 74.5% of the patients had limited HL. Adherence rates to medication‐taking and heart‐healthy lifestyle were 84.7% and 53.2%, respectively. HL was not significantly associated with medication adherence, but in regression models patients with limited HL demonstrated significantly increased odds for nonadherence to heart‐healthy lifestyle (OR 1.69). Conclusion: HL was not significantly associated with medication adherence but was related to heart‐healthy lifestyle adherence. Relevance to clinical practice: Nurses should assess the health literacy of discharging patients with CHD and focus on patients with limited health literacy to improve heart‐healthy lifestyle behaviours, and not just taking medications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To identify factors that influence the engagement of Chinese Australians with advance care planning. Background: Despite the benefits of advance care planning, there is a low prevalence of advance care planning in the Chinese Australian community. Reasons for this are often cited as cultural considerations and taboos surrounding future medical planning and death; however, other logistical factors may also be important. Design: This qualitative study used a thematic analysis grounded theory approach to explore facilitators and barriers to engagement in advance care planning. Methods: Semistructured interviews were conducted in‐language (Mandarin or Cantonese) exploring the views of a purposive sample of 30 community‐dwelling older Chinese Australians within Victoria, Australia. Results: Three key themes were identified: knowledge of, attitudes towards and needs for undertaking advance care planning amongst the Chinese Australians. There was a low awareness of advance care planning amongst the participants and some confusion regarding the concept. Most participants reported positive attitudes towards advance care planning but acknowledged that others may be uncomfortable discussing death‐related topics. Participants would want to know the true status of their health and plan ahead in consultation with family members to reduce the burden on the family and suffering for themselves. Language was identified as the largest barrier to overcome to increase advance care planning awareness. In‐language materials and key support networks including GPs, family and Chinese community groups were identified as ideal forums for the promotion of advance care planning. Conclusions: The participants of this study were open to conversations regarding future medical planning and end‐of‐life care, suggesting the low uptake of advance care planning amongst Chinese Australians is not culturally motivated but may be due a lack of knowledge relating to advance care planning. Relevance to clinical practice: The results highlight the need to provide access to appropriate in‐language advance care planning resources and promotion of advance care planning across the Chinese community. [ABSTRACT FROM AUTHOR]

The purpose of the study was to explore the individual, social and environmental factors influencing regular exercise on the basis of the theoretical framework of social ecological model among adults with type 2 diabetes and peripheral neuropathy. A total of 122 participants were chosen from Tianjin Metabolic Disease Hospital from November 2013 to May 2014. Information on exercise status and influencing factors was collected. Most participants took walking as the mode of exercise and exercised alone. Only 59.8% of participants were reported to carry out regular exercise. Logistic regression analysis suggested that being male, longer duration with diabetic peripheral neuropathy, higher self-efficacy for exercise and higher objective support were associated with regular exercise. Exercise status was clearly not ideal among adults with type 2 diabetes and peripheral neuropathy. The study highlighted the need to take measures to improve self-efficacy for exercise and social support in order to promote exercise participation among adults with type 2 diabetes and peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore the relationships of demographic and clinical variables and attendance at diabetes educational programmes with diabetes knowledge among a community sample of older Chinese adults with type 2 diabetes residing in Beijing. Background. Knowledge of diabetes is an important component of diabetes self-management. Level of education, duration of diabetes, visits to a dietician and diabetes self-management are associated with diabetes knowledge. A few studies have examined these relationships in older Chinese with diabetes. Design. A descriptive correlational study. Methods. The study was conducted in face-to-face interviews with 108 older adults with type 2 diabetes and an average age of 68 (SD = 8·41) years residing in six residential apartment complexes in Beijing. Along with the assessment of diabetes knowledge and diabetes self-management, assessments of glucose, blood pressure, body mass index (BMI) and waist circumference were obtained. Results. Age and systolic blood pressure were negatively associated with diabetes knowledge. Diabetes knowledge was not related to diabetes self-care activities or glucose level. A regression model with age, education and clinical variables significantly predicted diabetes knowledge, explaining 29% of the variance in knowledge. Participants who had a family history of diabetes, visited traditional Chinese medicine (TCM) doctors and ophthalmologists and attended diabetes educational programmes were more likely to have high scores on diabetes knowledge. Conclusions. Age, education, a family history of diabetes, visits to TCM providers and ophthalmologists and attending diabetes class are factors associated with increased levels of diabetes knowledge. Relevance to clinical practice. Healthcare providers need to provide age-specific, low literacy and family-focused diabetes education programmes and consider integrating principles and holistic perspectives of TCM in diabetes educational programmes for older Chinese with diabetes. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of this study was to describe knowledge about stroke warning signs and risk factors in patients with previous stroke or transient ischaemic attacks in China and to investigate the relationship between socio-demographic characteristics & health status and patients' knowledge about stroke. Background. Stroke is the leading cause of death and functional impairment in China. Survivors are at high risk of new vascular events. Secondary prevention after stroke or transient ischaemic attacks is not satisfactory. Previous research suggests that awareness of stroke plays an important role in facilitating secondary prevention. However, little is known about knowledge of stroke warning signs and risk factors among patients with previous stroke/transient ischaemic attacks. Design. A cross-sectional questionnaire study. Methods. This study was conducted in Hunan Province, China, between July and December in 2010. Subjects were recruited using a cluster sampling method. A questionnaire was administered to 1600 patients with stroke/transient ischaemic attacks diagnose from eight hospitals, and 1200 patients (75%) responded. Patients' knowledge about stroke warning signs and risk factors were collected and analysed. Results. Patients' knowledge about stroke warning signs was very poor (only 3·3% identified all warning signs and 28·3% identified three). Patients' knowledge about important risk factors (e.g. atrial fibrillation, diabetes, metabolic syndrome, etc.) was also very poor (<30%). Patients' action in emergency was extremely poor (only 9·2% reported to call emergency service). The age, education, stroke-related diagnoses and family history of cardiovascular disease were significantly associated with patients' knowledge about stroke. Conclusions. Knowledge about stroke warning signs and risk factors was very poor in patients with previous stroke or transient ischaemic attacks in China. Relevance to clinical practice. Dissemination of stroke knowledge should be a core responsibility for Chinese clinical nurse. Future clinical education to improve patient's knowledge about stroke and further intervention to manage cardiovascular risk factors are indicated. [ABSTRACT FROM AUTHOR]

Aims. To describe and compare the lifestyle behaviours and psychosocial well-being of Chinese adolescents aged 10-19 in the two cities of Hong Kong and Guangzhou and to identify the factors that most influence adolescents' lifestyle patterns in these two cities. Background. Health-promoting lifestyle behaviours of adolescents are influenced by economic growth and societal changes. Design. A cross-sectional comparative survey. Methods. The Chinese version of the Adolescent Lifestyle Questionnaire was used to measure the adolescents' lifestyle behaviours and psychosocial well-being in the primary and secondary schools. Results. A total of 2014 adolescents aged 10-19 responded to the survey in Hong Kong ( n = 1008) and Guangzhou ( n = 1006). Adolescents in Guangzhou practised healthier lifestyle behaviours and psychosocial well-being than adolescents in Hong Kong, with statistically significant differences in all the seven dimensions. Adolescents in Guangzhou, when compared with those in Hong Kong, obtained higher mean scores in 'physical participation' (9·6 vs. 8·9, p < 0·001), 'nutrition' (20·2 vs. 17·6, p < 0·001), 'social support' (19·6 vs. 18·9, p = 0·001), 'stress management' (9·6 vs. 9·3, p = 0·022), 'identity awareness' (25·7 vs. 23·5, p < 0·001), 'health practices awareness' (9·2 vs. 8·3, p < 0·001) and 'safety' (21·6 vs. 20·6, p < 0·001). Demographic factors that contributed to adolescents' lifestyle behaviours were living in Guangzhou (OR = 1·92, 95% CI 1·56, 2·44), being in the younger age group (10-14 years old) (OR = 2·44, 95% CI 2·00, 3·03) and living with both parents (OR = 1·92, 95% CI 1·12, 3·27). Conclusions. Socio-economic disparities, family composition and age group are the key factors associated with adolescents' healthy lifestyle behaviours. Further research is needed to understand the complex causal pathways between ethnicity, social environment and health behaviours. Relevance to clinical practice. Parental lifestyles inevitably influence the lifestyles of their young. Therefore, nurses should emphasise the health education of both parents and youth as future parents and support parents in modelling health-promoting lifestyles. [ABSTRACT FROM AUTHOR]

The article presents a study to translate the heart disease fact questionnaire (HDFQ) from English to Chinese (C-HDFQ) and to determine its reliability and validity among Hong Kong Chinese people. The study showed that the Chinese heart disease fact questionnaire (C-HDFQ) demonstrated acceptable reliability and validity and also indicated that the heart disease risk knowledge in people with diabetes deserves both clinical and research attention in Hong Kong.