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The health beliefs and practices regarding cervical cancer screening among women in the mountainous and Terai region of Nepal were investigated and examined for the differences. A descriptive cross-sectional study was conducted with a purposive sample of 216 in mountainous and 294 in Terai. The interview tools were a socio-demographic scale, a Nepalese Health Belief Model Scale for Cervical Cancer followed by the Screening Test. Chi-square test, binary logistic regression, Mann-Whitney U, and Kruskal-Wallis were used to analyze the data. The results showed that the screening rate was low for both regions with a significant difference in the benefit of screening and health motivation. Being older and having a positive family history of cervical cancer were shown to be predictors screening practice. Women from both groups preferred female doctors for screening. Culturally appropriate educational interventions focused on the benefits and obstacles of screening is needed to improve the beliefs of cervical cancer and screening and increase the screening rate. Nurses need to be aware of health beliefs regarding cervical cancer during cervical screening and education.

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.

Purpose The purpose of this study was to explore the effect of a home-based resistance exercise program for people living with physical disability. Design A quasiexperimental study. Method Forty participants enrolled, and 24 completed the 12-week study with 13 in the intervention group and 11 in the control group. Outcomes were measured by pretests and posttests, including Six-Minute Walk Test, Five Times Sit-to-Stand Test, 10-Meter Walk Test, Timed Up and Go, One Repetition Maximum, World Health Organization Disability Assessment Schedule 2.0, and Self-administered Short Form Health Survey. Findings Outcomes of participants within intervention group improved significantly after the training. Conclusions This home-based resistance exercise demonstrated impact on improving the functioning of the participants. Clinical relevance A well-developed home-based resistance exercise for people with disability will improve their physical functioning. The trainers for the home-based program should have frequent interaction with the group to determine how to improve the outcome of physical abilities. Community health nurses could be taught how to conduct resistance exercise so that it will become routine care in the community health centers for people with disability.

Objectives The study aim was to identify the perceived perspectives of baccalaureate nursing students toward the peer tutoring in the simulation laboratory. Insight into the nursing students' experiences and baseline data related to their perception of peer tutoring will assist to improve nursing education. Design Q methodology was applied to explore the students' perspectives of peer tutoring in the simulation laboratory. Participants A convenience P-sample of 40 baccalaureate nursing students was used. Method Fifty-eight selected Q statements from each participant were classified into the shape of a normal distribution using an 11-point bipolar scale form with a range from − 5 to + 5. PQ Method software analyzed the collected data. Results Three discrete factors emerged: Factor I (“Facilitate or empower” knowledge acquisition), Factor II (“Safety Net” Support environment), and Factor III (“Mentoring” learn how to learn). Conclusions The findings of this study support and indicate that peer tutoring is an effective supplementary strategy to promote baccalaureate students' knowledge acquisition, establishing a supportive safety net and facilitating their abilities to learn in the simulation laboratory.

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.

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.

Background Cervical cancer is the most common cancer among women in Nepal. The prevalence of human papillomavirus (HPV) 16 and or HPV 18 among women with cervical pre-cancer and cancer is higher than the incidence of HPV in the world population. The population-based epidemiological data of HPV in the general population in most parts of the country remains unknown. The objective of this study was to assess the prevalence and type distribution of HPV infection and association of abnormal cytology with high risk HPV infection among women in mid-western rural, Nepal. Methods A population-based cross sectional study was conducted in Jumla, one of the most remote districts in Nepal. A total of 1050 cervical samples were collected from married and non- pregnant women aged 20–65 years during mobile Cervical Cancer Screening Clinics conducted from May 2016 to January 2017. The presence of HPV DNA was firstly confirmed by HPV consensus PCR using PGMY09/PGMY11 designed primers, then HPV positive samples were further genotyped by the membrane hybridization method to detect the 21 high-risk HPV (HR-HPV) and low-risk HPV types. The prevalence of HR-HPV among women with normal and abnormal cytology was calculated. Data were analyzed using SPSS software for Windows. P

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.

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.

Summary Background While Asia has the dubious distinction of being the world's most natural disaster-prone area, disaster nursing education and training are sparse in many Asian countries, especially China where this study took place. Objective To explore the earthquake disaster experiences of Chinese nurses and develop a substantive theory of earthquake disaster nursing that will help inform future development of disaster nursing education. Design A qualitative study employing grounded theory, informed by symbolic interactionism. Participants and Setting Fifteen Chinese registered nurses from five hospitals in Jiangxi Province who undertook relief efforts after the 2008 Wenchuan Earthquake. Methods Data were collected in 2012–2013 in digitally-recorded, semi-structured, in-depth interviews and reflective field notes, and analyzed using Glaser's grounded theory method. Results Participants were unprepared educationally and psychologically for their disaster work. Supporting the emergent theory of “working in that terrible environment”, was the core category of “turning into a strong nurse”, a process of three stages: “going to the disaster”; “immersing in the disaster”; and “trying to let disaster experiences fade away”. The participants found themselves thrust in “terrible” scenes of destruction, experienced personal dangers and ethical dilemmas, and tried the best they could to help survivors, communities and themselves, with limited resources and confronting professional work. Conclusions Our rich findings confirm those of other studies in China and elsewhere, that attention must be paid to disaster education and training for nurses, as well as the mental health of nurses who work in disaster areas. Emergent theory helps to inform nurse educators, researchers, leaders and policy makers in China, and elsewhere in developing strategies to better prepare nurses for future disasters, and assist communities to prepare for and recover after earthquake disasters.

Examination of the relationship between patients' coping style, pregastroscopy information, and anxiety associated with gastroscopy in China was the aim of this study. A pretest, post-test, nonrandom assignment study with a two by two design was conducted. One hundred forty-five patients who underwent initial gastroscopy without sedation were classified into 2 groups on the basis of the coping style: information seekers or information avoiders using the Information Subscale of the Krantz Health Opinion Survey (KHOS-I). All participants were given standardized procedural information about gastroscopy as routine care. Half of each group was assigned to receive additional sensory information describing what sensation they would experience and how to cooperate to alleviate the discomfort. State anxiety assessed by the State Anxiety Scale of Spielberg's State-Trait Anxiety Inventory, blood pressure, and pulse were measured at enrollment and before gastroscopy. The information seekers and avoiders who received additional sensory information experienced significantly less state anxiety after the intervention. In contrast, the information seekers and avoiders who received standardized procedural information maintained their preintervention state anxiety level. Most patients reported their preference for sensory information. In conclusion, the provision of sensory information could significantly reduce patients' pregastroscopy anxiety regardless of patients' information coping style.

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

Aim To understand Chinese nurses’ perceptions of health beliefs, their content, origin and the influence of sociocultural factors, as a basis of their evidence-based practice. This study contributes to a larger study to establish the health beliefs of Japanese, Australian, Chinese, South Korean and Thai nurses. Background Registered nurses teach patients and students about maintaining or attaining health are subject to the same range of influences and their health beliefs may be antithetical to current health evidence. Methods Q-method design using q-sort and interview was used to explore the perspectives on a range of health beliefs of 60 nurses in four cities in China. Findings Three factors arose from the perceptions of the participants about health and accounted for 50.2% of the total variance: (1) social impact, (2) ‘the importance of evidence’, and (3) beliefs rooted in culture. Discussion Influence on nurses’ health beliefs was explored in terms of the internalized and frequently unconscious beliefs, values and norms tying them to their communities, reflecting the need for nurses to be aware of their health beliefs and behaviours. Conclusions Education for nurses in practice needs to acknowledge that individual practitioners’ beliefs strongly influence health teaching for patients and families. In order to implement evidenced-based practice and teach in line with current evidence nurses need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs. Implications for nursing policy and health policy Education policy needs to consider that culture and societal pressures affect nurses’ health beliefs and practice. Critical thinking, reflective and evidence-based practice need to be emphasized in clinical training and nurse education. China also needs to develop policies to allow nurses to be able to assess the reliability of health information on the Internet and to make quality health research more available.

OBJECTIVE Workplace violence and its impact on mental health nurses have yet to be thoroughly explored in China. This study aims to investigate the incidence, type, related factors, and effects of workplace violence on mental health nurses as well as identifying coping strategies. METHODS A researcher - designed workplace violence questionnaire and the Maslach Burnout Inventory-General Survey were distributed to nurses at a mental health hospital in Wuhan, China. RESULTS Most nurses reported a high incidence of workplace violence (94.6%) in the past year ranging from verbal aggression, sexual harassment, to physical attack. The forms of violence significantly correlated with each other (r > 0.5, p = 0.000). Working on the psychiatric intensive care unit for adult males and being a male nurse placed nurses at significantly higher risk for workplace violence. Providing routine treatment, caring for male patients, and working the night shift increased the risk of sexual harassment. Nurses who believed that workplace violence was preventable experienced a significantly lower incidence of violence. Burnout levels of the mental health nurses were relatively mild, but increased with age, professional title, years of employment and frequency of workplace violence. CONCLUSION The incidence of workplace violence among mental health nurses is common, and its frequency is correlated with nurses' level of burnout. Management and clinical nurses should work together on an organization-wide strategy targeting the major identified risk areas to reduce the incidence of workplace violence and minimize its impact on nurses.

Background the health and survival of newborns depend on high levels of attention and care from caregivers. The growth and development of some infants are unhealthy because of their mother's or caregiver's lack of knowledge or the use of inappropriate or traditional child-rearing practices that may be harmful. Objective to develop a newborn care educational programme and evaluate its impact on infant and maternal health in Nepal. Design a randomised controlled trial. Participants one hundred and forty-three mothers were randomly assigned to the intervention (n=69) and control (n=74) groups. Eligible participants were primiparous mothers who had given birth to a single, full-term, healthy infant, and were without a history of obstetric, medical, or psychological problems. Methods prior to being discharged from the postnatal unit, the intervention group received our structured newborn care education programme, which consisted of one-on-one educational sessions lasting 10–15minutes each and one postpartum follow-up telephone support within two weeks after discharge, in addition to the hospital's routine general newborn care education. The control group received only the regular general newborn care education. Outcomes were measured by using Newborn care Knowledge Questionnaires, Karitane Parenting Confidence Scale, State-Trait Anxiety Inventory for Adults and infant health and care status. Findings the number of mothers attending the health centre due to the sickness of their babies was significantly decreased in the intervention group compared to the control group. Moreover, the intervention group had significant increases in newborn care knowledge and confidence, and decreases in anxiety, compared with the control group. Conclusions the structured newborn care education programme enhanced the infant and mother health. Moreover, it increased maternal knowledge of newborn care and maternal confidence; and reduced anxiety in primiparous mothers. Thus, this educational programme could be integrated into routine educational programs to promote maternal and infant well-being in Nepalese society.

BACKGROUND: In recent years, with the rapid development of nursing in China, the number of undergraduate nursing students has increased significantly. As professional perception has a great influence on the development of nursing students and the future quality of nursing, exploring factors that influence this perception are very important. AIM: To describe undergraduate nursing students' attitudes towards nursing and to explore if their perceptions of nursing are influenced by demographic characteristics, clinical experience and/or different curriculum designs. METHODS: A cross-sectional descriptive study was carried out in two nursing schools: one with a traditional curriculum and one that had undertaken curriculum reform. Following institutional approval, 176 (92.6%) of the targeted population of 190 students responded to a demographic questionnaire with two semi-structured questions and the Attitude Towards the Nursing Profession Scale. The results were analysed using descriptive statistics, t-test and Spearman correlation analysis. FINDINGS: No correlations were found between nursing students' attitudes towards nursing and their demographic characteristics. Clinical experience apparently had no impact on nursing students' professional perception. However, the curriculum design appears to play an important role in forming the students' attitudes towards nursing. Significant implications and suggestions for nursing educators and nursing managers are presented.

Limited research exists on the workplace and personal factors that might be associated with the physical and mental health of nurses working in China. Therefore, the purposes of this study were to examine, in Chinese hospital nurses, the most frequently occurring workplace stressor, the most often used coping strategy, and the relationships that exist among workplace stressors, coping strategies, psychological hardiness, demographic characteristics, and physical and mental health. Four-hundred-and-eighty hospital nurses from five hospitals in three major Chinese cities were administered five self-report questionnaires. The findings indicated the most frequently cited workplace stressor was workload, while the most commonly used coping strategy was positive reappraisal. Numerous positive and negative correlations were found, suggesting the importance that workplace stress, coping strategies, psychological hardiness, and demographic characteristics play in relationship to each other, as well as to both the physical and mental health of Chinese nurses.

Review of literature: Prior research has suggested that nurses contend with a variety of workplace stressors and personal factors that can contribute either positively or negatively to their physical and mental health. However, limited research in this area has been conducted on nurses within China. Aim: The study sought to determine in Chinese hospital nurses: (a) the most common workplace stressors, (b) the most frequently used ways of coping with stress, and (c) which combination of variables (workplace stressors, ways of coping, psychological hardiness and demographic characteristics) was the best predictor of both physical health and mental health. Methods: The subjects were 480 nurses working in a variety of clinical settings, within five hospitals, located in three major mainland Chinese cities. A survey design was implemented using five self-report instruments. Results: Workplace stressors most frequently identified were workload and dealing with death and dying. Ways of coping most often cited were positive reappraisal, self-control and planful problem solving. The best predictors of physical health were psychological hardiness, conflict with other nurses, uncertainty about patient treatment, seeking social support and confrontive coping. The best predictors of mental health were psychological hardiness, conflict with other nurses, workload, seeking social support, age, likelihood to leave nursing within the next 12 months and escape–avoidance coping. Discussion: These findings suggest areas of concern that need to be addressed, by both hospital and nursing administration, in order to establish a positive and productive work environment for Chinese nurses.

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.

The community-based mental health services were encouraged to improve the quality of life for individuals with chronic mental disorders in Mainland China. This study aims to explore how the quality of life, perceived stigma, and medication adherence differ among a Chinese population with schizophrenia prior to and one-month following discharge.One hundred and twenty-eight Chinese people with schizophrenia completed the self-report scales: the Schizophrenia Quality of Life Scale (SQLS), the Link' Stigma Scale, and the Morisky Medication Adherence Scale (MMAS-8) prior to discharge and at one month after discharge. Data were analyzed using descriptive statistics and a paired sample t-test.The findings of SQLS demonstrate deterioration on psychosocial and motivation/energy domain (P0.001) accompanied by improvement of symptom/side effect (P0.05) after discharge. The scores of perceived stigma and actual stigma coping orientations (P0.001) after discharge were found to be significantly higher than before discharge. Medication adherence was significantly reduced after discharge than before discharge (P0.001).The results of this study provide implications for clinical practices, such as provision of psychosocial and educational rehabilitation programs for individuals who are in a stable mental status and plan to discharge; and to provide effective family education in order to improve family coping strategies and caring capabilities when patients return to the community. The findings provide important policy implications as well to facilitate individuals with schizophrenia to reintegrate into the community and benefit from a favorable QOL.

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.

Q-methodology was used to investigate the health beliefs of Chinese clinical nurses and nurse academics. Twenty-eight participants from one hospital and nursing school in China were involved. The four stages of this study included: (i) concourse development from literature review, Internet searches, and key informant interviews; (ii) A pilot study to develop the Q-sample from the concourse; (iii) participants sorted the Q-sample statements along a continuum of preference (Q-sorting); and (iv) PQ data analysis using principal component analysis and varimax rotation. Five viewpoints were revealed: (i) factor 1--health management and the importance of evidence; (ii) factor 2--challenging local cultural belief, and Eastern and Western influences; (iii) factor 3--commonsense; (iv) factor 4--health and clinical practice; and (v) factor 5--health and nursing education. This study presents a need for nurses and nurse academics to think critically, examine their long-held health beliefs, and promote the use of evidence-based practice.

A cross-sectional study was carried out to explore the knowledge level of newborn care and to investigate the relationship between newborn-care knowledge and selected demographic variables among primiparous mothers. It was carried in outpatient department of a maternity and women's hospital in Kathmandu, Nepal with 276 primiparous mothers between 38 and 42 weeks of gestation. Data were collected during the antenatal period with using two instruments: the Newborn-care Knowledge Questionnaire and State-Trait Anxiety Inventory for Adults. Participants had a moderate level of knowledge on newborn care (56%), and among its four components, participants had lowest knowledge in breastfeeding (44%) and adequate knowledge (78%) of immunization. Maternal education and socioeconomic status had a significant, positive association with newborn-care knowledge. Newborn-care knowledge was strongly predicted by anxiety. This is the first study to examine the maternal levels of knowledge of newborn care in Nepal. This study identified specific knowledge gaps in newborn care among primiparous mothers. Moreover, the results suggest the need of maternal-education programs in improving the health and well-being of mothers and newborns.

Disasters require well trained nurses but disaster nursing education is very limited in China and evidence is urgently required for future planning and implementation of specialized disaster education. This describes the themes arising from narratives of Chinese registered nurses who worked in disaster relief after two major earthquakes. In-depth interviews were held with 12 registered nurses from Hubei Province. Riessman's narrative inquiry method was used to develop individual stories and themes, and socio-cultural theory informed this study. Five themes emerged: unbeatable challenges; qualities of a disaster nurse; mental health and trauma; poor disaster planning and co-ordination; and urgently needed disaster education. Participants were challenged by rudimentary living conditions, a lack of medical equipment, earthquake aftershocks, and cultural differences in the people they cared for. Participants placed importance on the development of teamwork abilities, critical thinking skills, management abilities of nurses in disasters, and the urgency to build a better disaster response system in China in which professional nurses could more actively contribute their skills and knowledge. Our findings concur with previous research and emphasize the urgency for health leaders across China to develop and implement disaster nursing education policies and programs.

The purpose of this study was to clarify how terminally ill patients think and feel while hospitalized, thereby providing some insight into improving the quality of terminal care. The subjects of the study were eight terminally ill patients with cancer. The researchers obtained the patients' consent and their doctors' permission prior to conducting the interviews. Individual, semi-structured interviews were conducted. The patients' thoughts and feelings were extracted and then categorized according to particular themes. As a result, we came up with four major categories: maintaining pain control, living an ordinary life, hoping for improvement of physical condition, and having family nearby. The desire to live life to its fullest given their situation, as well as to maintain a hopeful attitude about their future proved very important. The presence of family also played a crucial role. These factors must be taken into consideration in achieving better care for terminally ill patients.

The purpose of the study was to describe Chinese women’s postpartum physiological and psychological health and adherence to “doing-the-month” practices. A descriptive repeated measures design was used, with data collected at 3 days and 6 weeks postpartum. The convenience sample consisted of 198 healthy childbearing women with a term birth. Maternal physical health was measured by the Six-Minute Walk (endurance), Chair Stand test (muscle strength), severity of physical symptoms, and physical health subscales of SF36v2. Maternal psychological health was measured by the Edinburgh Postnatal Depression scale. Adherence was measured by the Adherence to Doing-the-Month Practices questionnaire. Aerobic endurance and lower-body muscle strength improved significantly across time ( p < .001) but remained suboptimal for maternal age. Women who delivered by Cesarean section had significantly poorer physical health than those who had a vaginal delivery. Physical functioning significantly increased, but general health and role limitations due to physical health significantly decreased over time. Postpartum physical symptoms decreased in number and severity. Depression increased over time ( p < .001). Adherence to doing the month was negatively correlated with aerobic endurance and positively correlated with depression at 6 weeks ( p < .05). These findings challenge the assumption that practices of doing the month are healthy for Chinese women’s recovery after childbirth. Research-based evidence needs to be integrated into doing-the-month practices. Education of Chinese women and families, whether living at home or abroad, is needed about the adverse health effects of doing the month. Routine screening for postpartum depression is also advised.

BACKGROUND: With the transition from infectious disease and acute illness to chronic disease and degenerative illness as leading causes of death, health-related quality of life has become an important aspect in assessing the burden of chronic disease. The quality of life of haemodialysis patients has been studied extensively; however, very limited research using exploratory descriptive design has been carried out in this area in China. OBJECTIVE: The aim of this study was to explore health-related quality of life of end-stage renal disease patients undergoing haemodialysis in China. DESIGN: This study used the qualitative research design approach. METHOD: A semi-structured, in-depth interview was conducted with 16 haemodialysis patients in two hospitals using Colaizzi's phenomenological method to transcribe and analyse the data. RESULTS: The results of this study showed that dialysis patients show improvement in physical competence, but they also experienced emotional instability and psychological distress, financial burdens, inadequate disease knowledge and less social support which influenced their quality of life. CONCLUSION: To optimise the patients undergoing dialysis health-related quality of life, support of psycho-social-economical aspects should be enhanced. RELEVANCE TO CLINICAL PRACTICE: Health care providers should give haemodialysis patients thorough health education, individualised psychological and emotional intervention and adequate social support to optimise health-related quality of life.

Aim. To investigate the current level of Chinese nurses’ knowledge of pain and pain management in older people. Background. Most research about nurses’ knowledge regarding pain has taken place in developed countries; however, limited research in this area has taken place in developing countries and particularly in China. Methods. Registered Nurses (n = 621) in three different hospitals were surveyed with the questionnaire about pain and pain management with respect to older people. Results. The finding showed that a significant knowledge deficit in this area exists. There were no significant differences among nurses in terms of education background, position and whether or not there was attendance in an educational session on pain management. However, there were statistically significant differences based on age; hospital of employment and clinical area in which employed. Conclusion. This survey suggested that nurses’ knowledge of pain in older people should be improved. Basic and continuing education of nurses in this area should be enhanced and their active participation in pain management should be encouraged. Relevance to clinical practice. The findings in this survey highlight a significant pain management knowledge deficit among the nurses in the clinical practice. The findings may help the nurses realize their knowledge deficit in this area and may also suggest curriculum changes for the nurses to improve pain management knowledge.

The purpose of this study was to measure the dimensions of critical thinking (CT) of nursing students at baccalaureate nursing program and registered nurses at general hospital in Japan. Relevant literature on the current environment of Japanese nursing practice and education is reviewed as it provides the background to the key aspects of dimensions of Japanese nurses' and students' CT. The California Critical Thinking Disposition Inventory (CCTDI) was used to measure the dimensions of CT skills. The convenience sample consisted of three small groups: generic students ( n =82) including freshmen and juniors; transfer students ( n =16) at selected baccalaureate nursing program; and registered nurses ( n =67) at selected general hospital were administered CCTDI. Descriptive statistic indicated that all groups had an ambivalent disposition towards CT in majority of sub-scale while they scored a positive disposition towards CT on several sub-scales. A one-way ANOVA indicated that registered nurses scored lower than other two groups of baccalaureate students on the total score and several sub-scale score. The outcomes of this study propose recommendations regarding curriculum review for Japanese nursing education and reflection on professional boundaries for Japanese nursing practice.