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Objective:To explore the current status of quality of pediatric nurses ′ leader-member exchange, recovery experience, thriving at work, as well as to explore the correlation between leader-member exchange, recovery experience, and thriving at work. Methods:A convenience sampling method was used to select 312 pediatric nurses from four tertiary level A hospitals in Qingdao from September to November 2021 as the study population. A cross-sectional survey was conducted using the Leader-Member Exchange Scale, the Recovery Experience Scale, and the Thriving at work Scale. Descriptive statistical analysis, Pearson correlation analysis, and structural equation modeling were conducted on the data to analyze the mediating effect of recovery experience between leader-member exchange and thriving at work, and Bootstrap method was applied to validate the mediating effect.Results:The pediatric nurses ′ leader-member exchange score was (3.94 ± 0.90) points, recovery experience score was (3.47 ± 0.76) points, and thriving at work score was (3.71 ± 0.75) points. Leader-member exchange was positively correlated with recovery experience and thriving at work ( r=0.486, 0.575, both P<0.01); recovery experience was positively correlated with thriving at work ( r=0.711, P<0.01); the test of mediating effect showed that recovery experience partially mediated the effect between leader-member exchange and thriving at work, intermediary effect accounted for 66.9% of the total effect. Conclusions:Pediatric nurses have moderate levels of leader-member exchange, recovery experience, thriving at work. Leader-member exchange can affect pediatric nurses ′ thriving at work both directly and indirectly through the recovery experience. Nursing managers should strengthen the management of relationships with nurses, form good psychological and emotional bonds, and conduct recovery experience training to improve nurses ′ thriving at work, and improve the quality of care.
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Objective:To explore the influence of head nurse empowerment on nurses′ voice behavior and the mediating and moderating effects of nurses′ job crafting and proactive personality.Methods:A total of 805 nurses from the 4 grade A hospitals in Shandong province from February to March 2022 were selected by convenience sampling method, the Nurse Managers′ Empowering Behavioral Scale For Staff Nurses, Job Crafting Scale, Voice Behavior Scale and Proactive Personality Scale were used for cross-sectional survey. The mediating effect was analyzed by SPSS 26.0 and Process 3.4 macro.Results:The total score of nurses′ perception of head nurse empowerment was (4.01 ± 0.57) points, the total score of nurses′ job crafting was (4.19 ± 0.66) points, the total score of nurses′ voice behavior was (4.12 ± 0.62) points, and the total score of nurses′ proactive personality was (6.07 ± 0.90) points. Head nurse empowerment, nurse job crafting, voice behavior and proactive personality were positively correlated with each other ( r values were 0.483-0.824, all P<0.01). The mediating effect of job crafting was 0.541, accounting for 86.4% of the total effect; proactive personality had a positive moderating effect on the first half path of the mediation model ( ? R 2=0.163, P<0.01). Conclusions:Head nurse empowerment influenced voice behavior of nurses directly and indirectly through the mediating role of job crafting, proactive personality can moderate the effect of head nurse empowerment on nurse job crafting. It is suggested that the head nurse appropriately delegate power to the nurses and actively authorize them, identify nurses with high proactive personality, stimulate their job remodeling and voice behavior, and improve the quality of nursing work.
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Objective:To explore the intervention effect of nursing guided by self-efficacy theory on postpartum breastfeeding of patients with gestational diabetes mellitus.Methods:A total of 140 patients with gestational diabetes mellitus in Qingdao Women and Children ′s Hospital were selected as study subjects by convenient sampling method. They were divided into two groups according to the time of diagnosis. Seventy patients recruited from August to September 2019 were named as the control group, while those 70 patients from May to June 2020 were set as the intervention group. The control group took routine care and the intervention group received breastfeeding intervention based on self-efficacy theory. The rate of delayed onset of lactogenesisⅡ(DOLⅡ), breastfeeding knowledge, exclusive breastfeeding rate and breastfeeding self-efficacy in different time were compared. Results:The rate of DOLⅡ in the intervention group was 11.43% (8/70), which was lower than 25.71% (18/70) in the control group, the difference was statistically significant ( χ2=4.72, P<0.05). The score of breastfeeding knowledge in the intervention group at postpartum day 3 was 16.0 (15.0, 17.0) , which was higher than that in the control group 14.0(13.0, 16.0), the difference was statistically significant ( Z=-3.55, P<0.05). The rates of exclusive breastfeeding at postpartum day 3, month 1 and month 3 was 78.57% (55/70), 68.57% (48/70), 61.43% (43/70) in the intervention group and 61.43% (43/70), 45.71% (32/70), 37.14% (26/70) in the control group, the differences were statistically significant ( χ2=4.90, 6.60, 8.26, all P<0.05). The total scores of breastfeeding self-efficacy before intervention, 3 days, 1 month and 3 months postpartum were (48.34 ± 5.37), (50.00 ± 6.06), (52.54 ± 5.41), (52.92 ± 5.62) points in the control group and (48.96 ± 4.30), (53.32 ± 5.94), (56.91 ± 5.03), (59.11 ± 4.70) points in the intervention group. The total score of breastfeeding self-efficacy of patients in the two groups was analyzed by repeated measures of variance, and the differences in time effect, between-group effect and interaction effect were statistically significant ( Ftime=81.61, Fbetween-group=31.31, Finteraction=10.23, all P<0.05). Conclusions:Breastfeeding nursing intervention based on self-efficacy theory can improve the knowledge level of breastfeeding in patients with gestational diabetes mellitus, reduce the rate of DOLⅡ, enhance the sense of self-efficacy of breastfeeding and promote exclusive breastfeeding.
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Objective:To investigate the status and their relationship of new nurses ′ transition shock, spiritual climate and nurses ′ intention to stay on the job, to explore the mediating effect of transition shock between spiritual climate and intention to stay among newly graduated nurses. Methods:A convenient sampling method was used from October to December in 2019 to investigate 231 new graduate nurses from four hospitals in Qingdao City with the general data questionnaire, the New Nurses ′ Transition Shock Scale, the Nurses ′ Intention to Stay on the Job Scale and the Spiritual Climate Scale. Results:The total score of new nurse retention intend was (20.65 ± 4.30) points, spiritual climate score was (63.20 ± 19.28), and transition shock score was (82.92 ± 22.33) points. Transition shock was negatively correlated with spiritual climate and intention to stay ( r values were -0.451, -0.548, P<0.01) ; spiritual climate was positively correlated with intention to stay ( r value was 0.450, P<0.01). Transition shock played a partial mediating role in spiritual climate and intention to stay (37%). Conclusions:Spiritual climate of the work environment can directly or indirectly affect the intention to stay through the transition shock among newly graduate nruses. Managers can take appropriate intervention measures to improve the spirit climate of the department, alleviate the impact of new nurses ′ transformation and stabilize nursing team.
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Objective:To construct an early warning score model for the identification of hand-foot-mouth disease (HFMD) in children using the decision tree, and to provide scientific evidence for early recognition of critical HFMD in clinical practice.Methods:The medical records of 2 488 children with severe and critical HFMD hospi-talized in Qingdao Women and Children′s Hospital from January 2014 to December 2016 were retrospectively analyzed.Multivariate Logistic regression analysis was made to screen the independent risk factors of critical HFMD.An early warning score model for identifying children with HFMD was established by using the chi- square automatic interactive detection method in the decision tree, and the effectiveness of the model was evaluated by the receiver operating characteristic curve (ROC). Results:The multivariate Logistic regression analysis identified 5 independent risk factors of critical HFMD, including age<3 years old, blood sugar≥8.0 mmol/L, body temperature≥39.0 ℃, limb shaking and trembling, and hand-foot herpes.Two risk factors, i.e., blood sugar and body temperature, were included in the tree chart through the decision tree, and scoring criteria were established according to the tree chart.Combining the early warning scoring system for children, the warning model were finally set up, which consisted of 5 dimensions and inclu-ded 9 evaluation indicators: consciousness, skin color, heart rate, capillary refill time, respiratory frequency, participation of respiratory muscles, oxygen therapy, blood sugar and body temperature.Each dimension ranged from 0 to 3 points, totaling 0-15 points.The area under the ROC, sensitivity, specificity, maximum Youden index, and cut-off value of the model were 0.911, 0.910, 0.774, 0.684, and 6.5, respectively. Conclusions:The early warning score model established in this paper can accurately identify critical HFMD, with high sensitivity and specificity.
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Objective To develop an indicator system for the ability of main caregivers of premature in Neonatal Intensive Care Unit (NICU). Methods Delphi method was used to design index system and 16 experts were invited to participate the study. The questionnaire was consulted by emails and we took two rounds of consultation. Results The two rounds of consulting experts enthusiasm coefficients was 100% and the overall authority coefficients was 0.813 and 0.819. In the evaluation index system, there were 8 first grade indexes and 42 second grade indexes, including 11 items of basic care ability , 6 items of feeding and nutrition, 5 items of early itervention, 8 items of common symptoms and sign, 1 item of emergency, 5 items of safety prevention, 4 items of special care and 2 items of parentage. Conclusions The ability of main caregivers of premature in NICU evaluation index system which is designed using Delphi method is scientific and reliable. The results would have important significance to evaluate the level of main caregivers of premature in NICU.
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Objective To explore the successful breastfeeding experience of primiparous women with natural childbirth during the first 6 months postpartum. Methods A phenomenological methodology was used. Semi-structured in depth interviews were conducted among 11 primiparous women of natural childbirth. The data were transcribed, collated, summarized and analyzed using Colaizzi′s method. Results The primiparous women who sustained exclusive breastfeeding for six months after natural delivery experienced three stages which were:anxiety of breastfeeding,gradual adaption of breastfeeding, and coexistence of puzzles and insistence. The first stage was anxiety of breastfeeding including three themes: lack of experience in breastfeeding, conflict of breastfeeding, and noticeable fatigue during feeding.The second stage was gradual adaption of breastfeeding including four themes:family and social support, presenting regular feeding schedules, identification of mother role, and establishing a good mother-child relationship.The last stage was coexistence of puzzles and insistence which containing three themes: coexistence of confusion and perseverance, fear of returning back to work, suffering of maternal separation,and commitment of breastfeed. Conclusions In order to release the anxiety and improve the confidence of breastfeeding of primiparous women, it is vital to rely on the conjoint efforts of the family members,healthcare institutions,communities,enterprises,society and other aspects to improve the rate and duration of exclusive breastfeeding.