Exploring midwifery students' experiences of professional identity development during clinical placement: A qualitative study.

BACKGROUND: Healthy China 2030 has proposed to strengthen the investment in midwifery education to prepare more qualified midwives to address the shortage of midwifery workforce in China. The formation of a strong professional identity has been demonstrated to be a vital enabler for successfully transitioning from university to work. As midwifery is a practice-based profession, clinical placement is a key period for midwifery students' professional identity development, where they can be part of the profession and exposed to professional behaviour and interaction in the real world. However, it has not yet been explored in terms of the professional identity development of midwifery students in China during clinical placement. AIM: To gain insight into the professional identity development experiences of midwifery students in China during clinical placement. DESIGN: A qualitative study using a descriptive phenomenological approach. METHODS: Semi-structured interviews were conducted with fourteen final-year midwifery students who were undertaking clinical placement in four public hospitals in central China between March 2021 and May 2021. The transcribed data were analyzed following the Colaizzi's phenomenological analysis method. RESULTS: A total of one category, two theme clusters and seven themes emerged. The overarching category "conflicting experiences of professional identity development" was identified from the interaction of two theme clusters, "positive experiences motivating professional identity development" and "negative experiences impeding professional identity development". Four themes including "feeling the sense of accomplishment for facilitating smooth births", "developing professional competence", "positive role models of clinical mentors", and "cooperative inter-professional relationships" fell into the theme cluster of "positive experiences motivating professional identity development"; while the other three themes including "high-intensity working state", "emotional instability of birthing women", and "feeling insufficient in professional competence" fell into the theme cluster of "negative experiences impeding professional identity development". CONCLUSIONS: The conflicting experiences of professional identity development among midwifery students might lead to the emergence of confusion and further decrease their retention intention in the profession. Thus, intervention strategies should be adopted to promote midwifery students' professional identity development during clinical placement, so as to prepare confident and motivated midwives to provide high-quality maternal care and address the shortage of midwifery workforce in China.

An evaluation of mental health and emotion regulation experienced by undergraduate nursing students in China during the COVID-19 pandemic: A cross-sectional study.

The COVID-19 outbreak negatively impacted the mental health and emotions of many individuals. The study presented here explores the mental health and emotion regulation experienced by undergraduate nursing students in China during the pandemic. Potential risk factors related to negative mental health symptoms were identified in this study. An online cross-sectional study including 342 respondents was performed from March 6, 2020, to April 1, 2020, at a University in China. A Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Emotion Regulation Questionnaire (ERQ) were used to evaluate mental health and emotions. The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 22. The prevalence of anxiety, depression, or comorbid anxiety and depression were 55.0%, 56.4%, and 31.6%, respectively. The mean score of cognitive reappraisal and expressive suppression was 29.36 ± 8.00 and 15.55 ± 5.14. Lower scores for cognitive reappraisal and higher scores for expressive suppression were susceptible to symptoms of anxiety, depression, or comorbid anxiety and depression. Issues with mental health occurred in nursing students during the COVID-19 pandemic. Findings from this study provide a better understanding of the association between mental health and emotion regulation, which will help direct psychological intervention that relieves these issues during the pandemic.

Community Outbreak Investigation of SARS-CoV-2 Transmission Among Bus Riders in Eastern China.

Importance: Evidence of whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), can be transmitted as an aerosol (ie, airborne) has substantial public health implications. Objective: To investigate potential transmission routes of SARS-CoV-2 infection with epidemiologic evidence from a COVID-19 outbreak. Design, Setting, and Participants: This cohort study examined a community COVID-19 outbreak in Zhejiang province. On January 19, 2020, 128 individuals took 2 buses (60 [46.9%] from bus 1 and 68 [53.1%] from bus 2) on a 100-minute round trip to attend a 150-minute worship event. The source patient was a passenger on bus 2. We compared risks of SARS-CoV-2 infection among at-risk individuals taking bus 1 (n = 60) and bus 2 (n = 67 [source patient excluded]) and among all other individuals (n = 172) attending the worship event. We also divided seats on the exposed bus into high-risk and low-risk zones according to the distance from the source patient and compared COVID-19 risks in each zone. In both buses, central air conditioners were in indoor recirculation mode. Main Outcomes and Measures: SARS-CoV-2 infection was confirmed by reverse transcription polymerase chain reaction or by viral genome sequencing results. Attack rates for SARS-CoV-2 infection were calculated for different groups, and the spatial distribution of individuals who developed infection on bus 2 was obtained. Results: Of the 128 participants, 15 (11.7%) were men, 113 (88.3%) were women, and the mean age was 58.6 years. On bus 2, 24 of the 68 individuals (35.3% [including the index patient]) received a diagnosis of COVID-19 after the event. Meanwhile, none of the 60 individuals in bus 1 were infected. Among the other 172 individuals at the worship event, 7 (4.1%) subsequently received a COVID-19 diagnosis. Individuals in bus 2 had a 34.3% (95% CI, 24.1%-46.3%) higher risk of getting COVID-19 compared with those in bus 1 and were 11.4 (95% CI, 5.1-25.4) times more likely to have COVID-19 compared with all other individuals attending the worship event. Within bus 2, individuals in high-risk zones had moderately, but nonsignificantly, higher risk for COVID-19 compared with those in the low-risk zones. The absence of a significantly increased risk in the part of the bus closer to the index case suggested that airborne spread of the virus may at least partially explain the markedly high attack rate observed. Conclusions and Relevance: In this cohort study and case investigation of a community outbreak of COVID-19 in Zhejiang province, individuals who rode a bus to a worship event with a patient with COVID-19 had a higher risk of SARS-CoV-2 infection than individuals who rode another bus to the same event. Airborne spread of SARS-CoV-2 seems likely to have contributed to the high attack rate in the exposed bus. Future efforts at prevention and control must consider the potential for airborne spread of the virus.