Relationships Among Character Strengths, Self-efficacy, Social Support, Depression, and Psychological Well-being of Hospital Nurses

Purpose@#From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. @*Methods@#A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. @*Results@#The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. @*Conclusion@#Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.

Relationships Among Character Strengths, Self-efficacy, Social Support, Depression, and Psychological Well-being of Hospital Nurses

Purpose@#From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. @*Methods@#A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. @*Results@#The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. @*Conclusion@#Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.

Application of the index system for clinical evaluation of implementation effect: An example of vaginal delivery / 中南大学学报(医学版)

Objective:In order to apply the index system for clinical evaluation of implementation effect in hospitals.Methods:A total of 862 patients with vaginal delivery from 9 hospitals were randomly divided into an clinical pathway group (n=496) and a control group (n=366).The patients in the control group received traditional treatment procedure while the patients in the clinical pathway group experienced procedure of the clinical treatment.The index system was used for clinical evaluation of implementation effect.Results:There were obvious advantages in 15 indicators in the clinical pathway group than those in the control group (P＜0.05).The comprehensive score of the clinical pathway group was higher than the control group of the corresponding grade and nature of the hospital.The comprehensive score for secondary hospitals (Ci=0.7967) were higher than that for the tertiary hospitals (Ci=0.2033).The comprehensive score for the general hospitals (Ci=0.8948) were higher than that for the specialized hospitals (Ci=0.1052).As for clinical implementation effect,the secondary hospitals were better than the tertiary hospital,and the general hospitals were better than the specialized hospitals.Conclusion:The index system for clinical evaluation could quantify the implementation effect,and compare the implementation effect in different hospitals,which provides reference for the management of clinical pathway.

Research progress on interventions of psychological distress in young adults cancer patients / 中国医师杂志

Cancer is the most cause death of among adolescents and young adults (AYAs).Psychological distress caused by cancer affects AYAs' effective coping abilities of disease,physical symptoms and treatment.This paper mainly introduces the related concepts,screening tools and intervention progress of psychological distress of AYAs cancer patients to deepen the understanding of these among clinical professionals and provide reference for implement effective interventions to patients.

Translation,revision and assessment of reliability and validity of the Individualized Care Scale-Patient Version / 中华护理杂志

Objective To translate and revise the Individualized Care Scale-Patient Version(ICS-P) into Chinese,then to assess the reliability and validity of the Chinese version of the Individualized Care Scale-Patient Version (C-ICS-P).Methods Standard forward-back translation techniques were used in the translation of the ICS-P according to the Brislin translation model.Cross-cultural revision of the translated ICS-P was carried out through group discussion and pretesting.Totally 223 patients were recruited through convenience sampling method from a tertiary hospital in Changsha and investigated using general information questionnaire and the C-ICS-P,and its reliability and validity were assessed.Results The C-ICS-P contained two subscales,and both C-ICS-P-A and C-ICS-P-B contained 3 factors explaining 61.330％ and 65.263％ of the total variance.The dimensions of C-ICS-P-A were clinical characteristics (6 items),personal life characteristics (4 items) and participation willingness (5 items);the dimensions of C-ICS-P-B were clinical care (6 items),personal life care (4 items) and decisional control over care (5 items).The Cronbach's α coefficients of C-ICS-P-A and its dimensions were 0.897,and 0.730～0.774;the Cronbach's α coefficients of C-ICS-P-B and its dimensions were 0.909,and 0.688～0.754.Split-half reliability was 0.856 for C-ICS-P-A and 0.688～0.754 for its dimensions;split-half reliability was 0.889 for C-ICS-P-B and 0.750～0.758 for its dimensions.Analysis of content validity of the C-ICS-P indicated that I-CVI was at least 0.83,S-CVI was 0.943.Conclusion The reliability and validity of C-ICS-P are satisfactory and well meet the requirements of psychological measurement,indicating C-ICS-P is a reliable and valid instrument in the context of Chinese culture.

Modification and evaluation of assessment of medication literacy / 中南大学学报(医学版)

To translate and revise the Medication Literacy Assessment in English (MedLitRxSE-English) and evaluate its validity and reliability.
 Methods: We introduced MedLitRxSE-English from abroad. According to the principles of Brislin and culture adjustment, we revised it as a Chinese edition. Using random sampling method, from Oct, 2014 to Jan, 2015, 461 non-hospitalized patients from the outpatient departments of the top three hospitals in Changsha city were investigated. The reliability and validity of the scale was tested.
 Results: The test-retest reliability of the Chinese version for medication literacy scale was 0.885; the split reliability was 0.840; K-R was 0.820; the correlations between the assessment of medication literacy and the corresponding items were 0.427-0.587; the confirmatory factor analysis revealed overall good fit. Root mean square error of approximation (RMSEA), χ2/df, goodness of fit index (GFI) and comparative fit index (CFI) was 0.08, 3.06, 0.91 and 0.94, respectively. 
 Conclusion: The Chinese version for the assessment of medication literacy is in good reliability and validity, and it can be used to evaluate the medication literacy in our country.

Relationship between the ischemic ST-T changes in ECG and the coronary artery diseases / 中南大学学报(医学版)

OBJECTIVE@#To analyze the relationship between the ischemic ST-T changes in electrocardiogram (ECG) and the coronary artery diseases based on the perspective of diagnostics.
@*METHODS@#A total of 341 patients, who underwent coronary angiography in Department of Cardiology of Xiangya Hospital, Central South University from June 2013 to April 2014, were enrolled for this study. The internationally recognized diagnostic criteria for ischemic ST-T changes in ECG and the Judkins diagnostic criteria for coronary angiography were applied, respectively. The sensitivity and specificity of ECG were analyzed.
@*RESULTS@#There were more ischemic ST-T changes in women than that in men (P0.05). For ischemic diagnostic tests by ECG ST-T, the total sensitivity and specificity was 83.6% and 54.4%, respectively. The sensitivity and specificity was 82.3% and 68.0% or 85.0% and 28.2% in the male or female group, respectively. 
@*CONCLUSION@#Ischemic ST-T changes in ECG possess important value in the diagnosis of the coronary artery diseases. The sensitivity of ECG in the diagnosis of myocardial ischemia in women was higher than that in men, whereas the specificity of ECG in the diagnosis of myocardial ischemia in men was higher than that in women.

Effect of social support and coping styles on the stress and mental health in relatives of patients with traumatic brain injury / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of social support and coping style on the stress and mental health in relatives of patients with traumatic brain injury.@*METHODS@#The stress, mental health, social support and coping style were investigated in 300 relatives of patients with traumatic brain injury by Relative Stress Scale, Symptom Checklist-90, Social Support Rating Scale and Simplified Coping Style Questionnaire in Changsha City.@*RESULTS@#The mental health problems in relatives of patients with traumatic brain injury were closely related to the levels of stress, the ways of coping and the social support. In addition to the direct eff ect of stress on mental health in relatives of patients, the ways of coping and social support functioned as a mediator in this regard. The value of mesomeric eff ect for coping styles and social support ranged from 23.6% to 43.0%, and social support had an advantage over the coping styles.@*CONCLUSION@#Social support and coping styles should be considered in psychological nursing program to prevent and adjust the mental distress in relatives of patients with traumatic brain injury, which is beneficial to the treatment and recovery for patients.

Factors related to the length of hospital stay for cerebrovascular accident / 中南大学学报(医学版)

OBJECTIVE@#To explore the factors related to the length of hospital stay for cerebrovascular accident and to provide the basis for health administrative department to formulate measures, and for clinical department to develop treatment guidelines.@*METHODS@#We collected the medical record of the hospitalized cerebrovascular accident patients from 2008 to 2013 in the Third Xiangya Hospital, Central South University. The collected data included demographic information, disease characteristics, treatment information and health economics information. Then we analyzed the factors related to the length of hospital stay for cerebrovascular accident. SPSS 13.0 was used for statistical analysis and logistic regression and nonparametric rank sum test was performed.@*RESULTS@#The length of stay in hospital was from one day to 513 days, with a median of 10 days. The length of stay for women was shorter than that of men (OR=0.869). The length of stay for the older patients was longer than that of younger patients (OR=1.158). The length of stay for patients who implemented a surgery was 1.686 times longer than those who were not implemented a surgery (OR=1.686). The length of stay for ischemic cerebrovascular patients was shorter than that of the hemorrhagic cerebrovascular patients (OR=0.275). The patients with new rural cooperative medical insurance or without health insurance usually stayed a short time in hospital.@*CONCLUSION@#Sex, age, surgery, type of cerebrovascular accident and medicare type are the factors that affect the length of hospital stay for cerebrovascular accident.

Early recognition of deteriorating patient program in department of cardiac surgery / 中南大学学报(医学版)

OBJECTIVE@#To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery.@*METHODS@#We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention.@*RESULTS@#After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05).@*CONCLUSION@#Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.

Risk Factors and Intervention in ICU Nosocomial Infection / 中华医院感染学杂志

OBJECTIVE To explore the characteristics and intervention measures of nosocomial infection in ICU.METHODS Retrospective investigation was used to analyze the nosocomial infection cases in 145 patients discharged from ICU.RESULTS Of 145 inpatients,35 developed nosocomial infection with an infection rate of 24.14%.Elderly patients with severe diseases were the high risk group.The causes of infection were related to the increase of traumatic operation,hypoimmumity and unreasonable antibiotics usage.Lacking awareness of cross infection in medical and nursing staff was another factor facilitating the occurrence of infection.CONCLUSIONS Nosocomial infection rate in patients in ICU is high.Close attention should be paid to the old patients.Nursing intervention of respiratory tract,gastrointestinal tract and urinary tract should be given to the patients with severe diseases.The illegal use of antibiotics and traumatic operation should be limited.