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Objective The elderly population has proliferated worldwide. The empty-nest family pattern has become predominant among the aging people, and they are more vulnerable to the development of cognitive disorders. However, there is no standardized service in the community nursing care that includes procedures on how to improve the cognitive function of the elderly. Meanwhile, the booming number of empty-nest elderly stimulates the community nurses to assume the responsibility for their care. All of these bring more difficulties and opportunities for community nurses who are dedicated to the prevention of geriatric cognitive disorders. Methods The authors reviewed the literature related to “empty-nest elderly”, “cognitive function”, “mahjong”, and “Chinese square dance” in the Elsevier, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), Springer and PubMed databases. The study illustrates the utility possibility of an efficient and straightforward method for improving the cognitive function among the elderly in the context of community nursing care in China and even in the rest of the world. Results Mental and physical activity contributes to cognitive fitness and may be beneficial in delaying cognitive decline. Mental activities, such as playing mahjong, and physical activities, such as the Chinese square dance, are common Chinese activities. Both of them can affect cognitive function in some way. Conclusions China is experiencing one of its most severe aging problems. Community health personnel and related professionals may consider using mahjong and Chinese square dance to promote psychological health in empty-nest elderly individuals in the community.

Aim To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks. Background The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID-19, but there appear to be differences in health beliefs of nurses within and between countries regarding these. Methods This qualitative descriptive study used content analysis with a framework approach. Findings There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts. Conclusion Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level. Implications for nursing policy and health policy The COVID-19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence-based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide-reaching education campaign.

Objective Clinical reasoning is an essential feature of health care practice; it is also a crucial ability for providing patient care of high quality. It has been identified that graduate nurses may lack the clinical reasoning skills to deliver safe and effective patient care. It is therefore of paramount importance to enhance nursing students' clinical reasoning ability. High-fidelity simulation (HFS) is proved to be an effective teaching and learning method, which may also have some advantages over other teaching methods. Methods The authors retrospectively reviewed the related literature, illustrated the application of high-fidelity simulation teaching method in nursing education, putting the focus on the use of it in teaching with clinical reasoning. Results The application of high-fidelity simulation to nursing education can simulate the clinical situation, thus to create a safe, continuous and efficient learning environment for students, and it can effectively improve students' clinical reasoning ability. Conclusions high-fidelity simulation is effective for clinical reasoning teaching in nursing education. The extension of its application in China should be of great value. The relevant further study is suggested focusing on how to overcome its own limitations and have it better applied in nursing education in China.

Introduction: Teenage pregnancy is a public health concern. Maternal and neonatal health outcomesare negatively impacted in teenage pregnancy. The objective of the study is to find the prevalence ofteenage pregnancy in a community hospital of rural Nepal. Methods: A descriptive cross-sectional study was conducted at Okhaldhunga Community Hospital,Okhaldhunga, Nepal. Ethical approval was taken from the Institutional Review Committee of thehospital. Data were retrieved from July 2007 to July 2017 from the hospital record books. The total of7054 records of deliveries were reviewed from the hospital records and whole sampling was done.Subgroup analysis was done on basis of age, ethnicity, gravida, para, period of gestation, mode ofdelivery, maternal or neonatal complications and birth weight. Datas were entered and analyzedusing Microsoft Excel. Results: The total of 7054 deliveries were conducted in ten years among which 2050 (29.06%) wereteenage deliveries at the confidence interval of 95% (28.52% - 29.06%). The highest percentage ofteenage delivery was found among Janajati ethnicity of 1056 (53.3%). Amongst teenage delivery, asignificant tear was found in 157 (7.9%) as a maternal complication. Perinatal deaths were found in27 (1.4%). The cesarean section rate was 839 (11.9%) among all deliveries. Conclusions: The trend of teenage pregnancy remains almost same over ten years in theOkhaldhunga Community Hospital. The overall prevalence of teenage delivery is higher than thenational figure. Low birth weight babies, premature delivery, perineal and cervical tears were thecommon complications. Further health education and awareness programs might help to reduce theteenage pregnancy rate.

This study was designed to investigate the association of quality of life, perceived stigma, and medication adherence among Chinese patients with schizophrenia, and to ascertain the predictors of quality of life. A cross-sectional correlation study was conducted with 146 participants. All participants completed self-report scales: the Schizophrenia Quality of Life Scale, Link's Stigma Scale, and the Morisky Medication Adherence Scale. Pearson parametric correlations and stepwise multiple regressions were performed. The total quality of life score and psychosocial subscale was significantly positively correlated with perceived stigma, coping orientation of withdrawal, and feelings of stigma, and negatively correlated with age and medication adherence. The means of all subscale scores except perceived devaluation-discrimination and different/guilty feelings were significantly higher than the midpoint of 2.5. The best predictors of quality of life and psychosocial domains were stigma-related feelings: feeling misunderstood, feeling different/shame, and age. Our findings suggest that an individual's negative emotional response may strengthen internalized stigma and decrease quality of life. As the best predictor, age indicated that adaptation to mental illness may relieve perceived stigma and achieve favorable quality of life.

We aimed to assess the quality of life (QOL) of the patients with cervical cancer after initial treatment, the factors affecting QOL and their clinical relevance. A total of 256 patients with cervical cancer who visited Zhongnan Hospital of Wuhan University from January 2017 to December 2017 were enrolled in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) was used to assess the QOL of patients. More than half of the patients with cervical cancer reported an excellent QOL. Symptoms mostly experienced were insomnia, constipation, financial difficulties, and menopausal symptoms. Global QOL and social functioning were statistically associated with education level, occupation, the area of living, family income and treatment modality. Similarly, role functioning showed significant association with the stage of cancer, treatment modality and time since diagnosis. The rural area of living and poor economic status of the patients with cervical cancer has a negative impact on overall quality of life. Younger and educated patients are more worried about sexuality. Patients treated with multiple therapies had more problems with their QOL scales than patients treated with surgery only.

Introduction: Worldwide breast cancer is the common invasive cancer among the females. The quality of life of women after treatment, which is often a mastectomy, is frequently decreased. Objective: To determine the life quality of Nepalese women post mastectomy. Materials and Methods: One hundred seven women after a mastectomy were selected and interviewed by using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire and its Breast Specific Module to assess women’s quality of life. Result: The study findings revealed a good score on global health status/quality of life. The respondents performed well on functional and symptom scales. In the Breast Specific Module, all respondents performed poor regarding sexual function and sexual enjoyment. Global Health Status was found useful among the women involved in service/business/agriculture and the survivors using breast prosthesis. In Breast Specific Module, systemic therapy side effects showed strong statistical associations with age, marital status, occupation, education, use of breast prosthesis and co-morbidity. Body image was highly significant with age, occupation, education, use of breast prosthesis and co-morbidity. Conclusion: Based on the study findings, counseling, and a structured educational programme is recommended to improve the QOL of women after a mastectomy.

There are few studies about how healthcare decisions are made for women with breast cancer in China and this knowledge is vital, both to further develop person-centered health care and to ensure that women have a voice in their healthcare decisions. This phenomenological study explored the meaning of women's lived experiences of making healthcare decisions about their breast cancer in China. Semistructured, in-depth interviews were conducted with a purposive sample of eight women with breast cancer. Data were analyzed using Colaizzi's phenomenological analytic method. The results of this study identified four themes: authority and expertise, lack of knowledge, family support, and Chinese cultural and social influences. Women were deferential to medical authority and perceived expertise, but they wanted to be involved to a greater degree in healthcare decisions. It is important for health professionals to optimize women's participation in decision-making by removing barriers and advocating on their behalf.

© 2015 Elsevier Ltd. Healthcare is dynamic and complex, and against this background, nursing students must negotiate the transition from lay person to healthcare professional. Diverse life experiences and learning styles can further complicate this journey of transformation. The contemporary role of the nurse includes caring for and making clinical decisions about patients based on ethical principles. Learning about and integrating ethical comportment as part of the transformative journey requires nurse educators to create and implement learning experiences that challenge nursing students to think deeply and broadly about the experiences they encounter, to question their previous assumptions and prejudices, to consider the world of healthcare through a new lens, and to reflect on and learn from the process. The judicious use of film has the potential to assist students to recognize and develop ethical comportment as they prepare for real-world clinical practice experiences. In this paper, we present three film exemplars and related teaching strategies designed to facilitate transformative learning and development of ethical comportment.

Objective To examine the effectiveness of music listening on pain, anxiety, and vital signs among patients after thoracic surgery in China. Design and setting A randomized controlled clinical trial was conducted in the thoracic surgery department of two tertiary hospitals in Wuhan, China. 112 patients were recruited and randomly assigned to either experimental ( n =56) or control ( n =56) group respectively. Intervention The experimental group received standard care and a 30-min soft music intervention for 3 days, while the control group received only standard care. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate), patient controlled analgesia, and diclofenac sodium suppository use. Results The experimental group showed statistically significant decrease in pain, anxiety, systolic blood pressure and heart rate over time compared to the control group, but no significant difference were identified in diastolic blood pressure, respiratory rate, patient controlled analgesia and diclofenac sodium suppository use. Conclusion The findings provide further evidence to support the practice of music therapy to reduce postoperative pain and anxiety, and lower systolic blood pressure and heart rate in patients after thoracic surgery in China.

Objective: To find out the knowledge, attitude, practice, and barriers of cervical cancer screening in mid-western rural, Nepal. Methods: A hospital-based cross-sectional study was conducted. Women aged 20 or more were interviewed using a structured questionnaire regarding the socio-demographic information, knowledge, attitude, practice, and barriers to the cervical cancer screening. Results: Total of 360 participants were recruited for this study, mean age was 30.13±10.4 years. More than 87% of participants had inadequate knowledge, but around 72% had a favorable attitude towards cervical cancer screening. There was a significant portion of women (86.4%) had never done any cervical cancer screening test. Despite being higher literacy rate of Brahmin and Chhetri ethnic group, they were less likely to attend the cervical cancer screening than Dalit and Janajati (p

Background: Prevalence of osteoporosis (OP) is high among Chinese adults with diabetes. Assessment of OP and fracture risk as well as patient education should be included as part of the management of diabetes. Purpose: The purpose of this pilot study was to test the effectiveness of an educational self-efficacy intervention on knowledge about OP, dietary calcium intake, the importance of physical activity (PA), and glycemic control among Chinese adults with type 2 diabetes residing in Wuhan, China. Method: A quasi-experimental design with repeated measures was employed. Participants were assigned to either the intervention ( n = 23) or the control group ( n = 23). Intervention participants attended 6 weekly 1-hr educational sessions comprising presentations, demonstration, and discussions. Control participants received standard care. Data were collected via questionnaires at pre- and postintervention and at 3-month follow-up, and blood was drawn at preintervention and 3-month follow-up. Results: Participants in the intervention group had significant improvement in OP knowledge, F(2, 43) = 11.504, p < .001; OP self-efficacy, F(2, 43) = 6.915, p = .003; dietary calcium intake, F(2, 43) = 7.856, p = .002; level of PA, F(2, 43) = 4.787, p = .011; diabetes self-care activities, F(2, 43) = 14.009, p < .001; diabetes self-efficacy, F(2, 43) = 19.722, p < .001; and glycemic control (A1C level; t = 2.809, p = .010) compared to the control group at the 3-month follow-up. Conclusion: The results demonstrate the effectiveness of OP prevention education based on self-efficacy theory among Chinese adults with type 2 diabetes.

Objective: Nurses, who are indispensable constituents of first responders, should be equipped to respond in a disaster. This study evaluated the effectiveness of a course to prepare undergraduate nursing students for disaster response. Methods: The course included three-hour overviews, one-hour case studies, and a three-hour disaster drill with six simulation skill stations among 120 junior nursing students. To measure education practice, simulation design, and outcomes embedded in the Jeffries’ framework, three Chinese-version self-evaluation scales designed by the National League for Nursing (NLN) were used. In addition, facilitators’ observation of student performance skills, two group interviews and one feedback questionnaire were utilized. Results: Of the three self-evaluation scales, the Simulation Design Scale and Educational Practices Questionnaire indicated that the simulation design was effective and promoted students’ learning practices. The Satisfaction and Self-Confidence Scale demonstrated satisfaction with current learning (4.39±0.46) and self-confidence in learning (4.27±0.53). Facilitator observation and group interviews revealed that most students need more time to prepare and practice for the disaster nursing drills. Conclusions: The study indicated that students were interested in the disaster nursing drill and satisfied with the diverse teaching methods and the motivating teaching materials used in the simulation. Simulation as a teaching strategy was an effective approach to improve team-work, active learning, problem-solving, satisfaction level and self-confidence during the disaster nursing drill. It is essential for nurse educators to provide disaster training programs for nursing students to prepare them for an active role in disaster response.