Application of a Hybrid Multi-Criterion Decision-Making Model for Evaluation and Improvement of Nurses' Job Satisfaction.

Background: The global shortage and turnover of nurses is a current challenge. Past studies have shown that nurse job satisfaction may ameliorate nurse shortage. Although there are many studies on the criteria influencing nurses' job satisfaction, few have examined the causal relationships and weight of each criterion from a systematic perspective. Objective: Identify the key criteria and causal relationships that affect nurses' job satisfaction, and help nurse leaders identify high-weight, high-impact dimensions and contextualize them for improvement. Methods: The study developed a hybrid multi-criterion decision-making model, which incorporated the McCloskey/Mueller satisfaction 13-item scale (MMSS-13), and the Decision-Making Trial and Evaluation Laboratory and the Importance-Performance Analysis methods the model was used to analyze key factors of nurse satisfaction and their interrelationships based on the experience of 15 clinical nurse specialists. Results: In MMSS-13's dimension level, "satisfaction with work conditions and supervisor support" (C5) had the highest impact, and "satisfaction with salary and benefits" (C1) had the highest weight. In criteria level, "salary" (C11), "flexibility in scheduling time off" (C24), "maternity leave time" (C31), "opportunities for social contact after work" (C41), and "your head nurse or facility manager" (C51) had high influence under their corresponding dimensions. The "benefits package" (C13) was the top criterion with the highest impact on MMSS-13. Conclusions: This study assessed nurses' job satisfaction from a multidimensional perspective and revealed the causal relationships between the dimensions. It refined the assessment of nurse job satisfaction to help nurse leaders better assess nurse job satisfaction and make strategic improvements. The study found that compensation and benefits had the highest weight in nurses' job satisfaction. Meanwhile, support for family responsibilities and working conditions, and support from supervisors were the cause dimensions of job satisfaction. Among the more detailed criteria, salary, benefits package, maternity leave time, and leadership had a greater impact on nurses' job satisfaction. Nurse leaders should start with these dimensions to achieve efficient improvement of nurses' job satisfaction.

Group-based trajectory modeling to identify health beliefs of COVID-19 vaccination and its predictors: A cohort study in China.

OBJECTIVES: This study aimed to characterize distinct patterns of change in health beliefs and their dimensions of COVID-19 vaccination and to evaluate the predictors of various trajectory groups. METHODS: A total of 1129 participants who completed two doses of COVID-19 vaccines in China were included in this prospective study. Participants' characteristics and health beliefs regarding COVID-19 vaccination were collected before and after the two doses of COVID-19 vaccination. A group-based trajectory model was used to identify the distinct longitudinal patterns of health beliefs and their dimensions. A multinomial logistic regression model was conducted to determine the predictors of different trajectory groups. RESULTS: The group-based trajectory model identified two to four distinct patterns of global health beliefs and their domains, namely, very low-stable (16.1%), low-stable (30.2%), medium-stable (45.6%), and high-stable (8.1%) trajectories for global health beliefs. And the five domains of health beliefs showed two or three trajectory stable progression, which were similar to the global health beliefs trajectories. Sex, occupation post, adverse reactions foreboding, and quality of life were associated with the trajectory of global health beliefs or at least one domain of health beliefs. CONCLUSIONS: During the study, individuals' health beliefs about COVID-19 vaccination were stable without the interference of external factors. Based on the impact of sex, occupation post, adverse reactions foreboding, and quality of life on individuals' health beliefs, personalized interventions can be developed to improve public health beliefs about COVID-19 vaccination and reduce vaccination hesitancy.

Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

Background It has been speculated that patients with sarcopenia are aggravated by the current novel coronavirus disease 2019 (COVID-19) epidemic. However, there is substantial uncertainty regarding the prevalence of sarcopenia in patients with COVID-19. Objectives The purpose of the study was to systematically evaluate the prevalence of sarcopenia in patients with COVID-19, including stratification by gender, study location, study population, study design, and diagnostic criteria. Design This is the systematic literature review and meta-analysis. Methods An electronic search was performed in MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science and Scopus to identify observational studies reporting a prevalence estimate for sarcopenia in patients with COVID-19. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed. Risk of bias (RoB) was assessed using the Newcastle–Ottawa Scale (NOS) for cohort studies and Joanna Briggs Institute (JBI) manual for cross-sectional studies, and Stata 14.0 was used to perform meta-analyses. Results A total of 4,639 studies were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 151 full-text studies. A total of 21 studies, including 5,407 patients, were eligible for inclusion in this review finally. The prevalence of sarcopenia in patients with COVID-19 in individual studies varied from 0.8 to 90.2%. The pooled prevalence of sarcopenia in COVID-19 was 48.0% (95% confidence interval, CI: 30.8 to 65.1%, I2 = 99.68%, p = 0.000). We did not find any significant differences in the prevalence estimates between gender specificity (OR = 1.34;95% CI = 0.80–2.26;p = 0.001). By sex, the prevalence was 42.5% (95% CI: 31.7 to 53.4%) in men and 35.7% (95% CI: 24.2 to 47.2%) in women. The prevalence estimates significantly varied based on population settings and different diagnostic criteria of sarcopenia. ICU patients (69.7, 95% CI: 51.7 to 85.2%) were more likely to suffer from sarcopenia compared to other population settings. Conclusion To our knowledge, this is the first meta-analysis reporting on the prevalence of sarcopenia in patients with COVID-19. Sarcopenia is frequently observed in patients with COVID-19, with varying prevalence across population settings. This study would be useful for clinicians to prompt the increasing awareness of identifying sarcopenia and developing interventions at patients with COVID-19 with high risk of sarcopenia. Further prospective longitudinal studies to define the association of sarcopenia and its prognostic outcomes in COVID-19 survivors are urgently needed to propose the most appropriate treatment strategies during their admission and discharge. Systematic Review Registration [www.crd.york.ac.uk/prospero/], identifier [CRD42022300431].

Application of Rough Set Theory to Improve Outpatient Medical Service Quality in Public Hospitals Based on the Patient Perspective.

Purpose: To analyze the key factors and decision-making behaviors affecting overall satisfaction based on perceptual data of outpatients. Methods: The official satisfaction questionnaire developed by the National Health Commission of the People's Republic of China was used. Rough set theory was used to identify the perception patterns between condition attributes (i.e., service factors) and a decision attribute (i.e., overall service level) and to express them in rule form (i.e., if-then). Results: The four minimal-coverage rules, with strength exceeding 10% in the good class, and six crucial condition attributes were obtained: "Ease of registration (C1)," "Respected by registered staff (C2)," "Registered staff's listening (C3)," "Respected by doctor (C9)," "Signpost (C12)," and "Privacy (C16)." In addition, the average hit rate for 5-fold cross-validation was 90.86%. Conclusions: A series of decision rules could help decision-makers easily understand outpatients' situations and propose more suitable programs for improving hospital service quality because these decision rules are based on actual outpatient experiences.

Comparison of the Characteristics, Management, and Outcomes of STEMI Patients Presenting With vs. Those of Patients Presenting Without COVID-19 Infection: A Systematic Review and Meta-Analysis.

Objectives: This study aimed to investigate the differences in the characteristics, management, and clinical outcomes of patients with and that of those without coronavirus disease 2019 (COVID-19) infection who had ST-segment elevation myocardial infarction (STEMI). Methods: Databases including Web of Science, PubMed, Cochrane Library, and Embase were searched up to July 2021. Observational studies that reported on the characteristics, management, or clinical outcomes and those published as full-text articles were included. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of all included studies. Results: A total of 27,742 patients from 13 studies were included in this meta-analysis. Significant delay in symptom onset to first medical contact (SO-to-FMC) time (mean difference = 23.42 min; 95% CI: 5.85-40.99 min; p = 0.009) and door-to-balloon (D2B) time (mean difference = 12.27 min; 95% CI: 5.77-18.78 min; p = 0.0002) was observed in COVID-19 patients. Compared to COVID-19 negative patients, those who are positive patients had significantly higher levels of C-reactive protein, D-dimer, and thrombus grade (p < 0.05) and showed more frequent use of thrombus aspiration and glycoprotein IIbIIIa (Gp2b3a) inhibitor (p < 0.05). COVID-19 positive patients also had higher rates of in-hospital mortality (OR = 5.98, 95% CI: 4.78-7.48, p < 0.0001), cardiogenic shock (OR = 2.75, 95% CI: 2.02-3.76, p < 0.0001), and stent thrombosis (OR = 5.65, 95% CI: 2.41-13.23, p < 0.0001). They were also more likely to be admitted to the intensive care unit (ICU) (OR = 4.26, 95% CI: 2.51-7.22, p < 0.0001) and had a longer length of stay (mean difference = 4.63 days; 95% CI: 2.56-6.69 days; p < 0.0001). Conclusions: This study revealed that COVID-19 infection had an impact on the time of initial medical intervention for patients with STEMI after symptom onset and showed that COVID-19 patients with STEMI were more likely to have thrombosis and had poorer outcomes.

Healthcare practice strategies for integrating personalized medicine: Management of COVID-19.

Personalized medicine is the tailor-made clinical treatment to the individual characteristics of each patient. It may be considered an extension of traditional approaches to knowing and treating diseases. Personalized medicine has the potential to change the way of identification and management of health problems. Coronavirus disease 2019 (COVID-19) is an infectious disease that primarily affects the patients' lungs. The first case of pneumonia of unknown cause was reported in Wuhan, China on December 31, 2019. As thus, we are quickly approaching the era of personalized medicine. This review discusses the practices currently used in the management of COVID-19 and how they relate to personalized medicine.

Sex Differences in Adverse Reactions to an Inactivated SARS-CoV-2 Vaccine Among Medical Staff in China.

Objective: We investigated whether there were sex differences in adverse reactions to an inactivated SARS-CoV-2 vaccine among medical staff in China. Methods: From 24 February to 7 March 2021 an online cross-sectional survey was conducted with a self-administered COVID-19 vaccine questionnaire among medical staff in Taizhou, China. In total, 1397 interviewees (1,107 women and 290 men) participated in the survey. Results: In our study, 178 (16.1%) women and 23 (7.9%) men reported adverse reactions following their first vaccination, and 169 (15.3%) women and 35 (12.1%) men reported adverse reactions following their second vaccination. After adjusting for confounding factors, adverse reactions to other vaccines, worry about adverse reactions, knowledge of the inactivated vaccine being used in the hospital, taking the vaccine for one's family proactively and receiving an influenza vaccination were significantly related to adverse reactions to both injections in women. In contrast, in men, concerns about adverse reactions independently increased the risk of adverse reactions following either vaccination, and a history of adverse reactions to other vaccines also increased the risk of adverse reactions to both injections. Conclusions: Sex differences in the frequency of reported adverse reactions to an inactivated SARS-CoV-2 vaccine and potential factors were demonstrated in a sample of medical staff.

Exploration of the Relationship Among Key Risk Factors of Acute Kidney Injury for Elderly Patients Considering Covid-19.

Background: Previous systematic reviews and meta-analyses supported the relationship between frailty and risk of acute kidney injury (AKI) in elderly patients. However, few studies evaluated proactive management to wear down AKI risk in such frail populations. Purpose: To understand how AKI risk factors might influence each other and to identify the source factors for clinical decision aids. Methods: This study uses the decision-making trial and evaluation laboratory (DEMATEL) method to establish influential network-relationship diagrams (INRDs) to form the AKI risk assessment model for the elderly. Results: Based on the DEMATEL approach, the results of INRD identified the six key risk factors: comorbidity, malignancy, diabetes, creatinine, estimated glomerular filtration rate, and nutritional assessment. (The statistical significance confidence is 98.423%, which is higher than 95%; the gap error is 1.577%, which is lower than 5%). After considering COVID-19 as an additional risk factor in comorbidity, the INRD revealed a similar influential relationship among the essential aspects. Conclusion: While evaluating the geriatric population, physicians need to pay attention to patients' comorbidities and nutritional assessment; also, they should note patients' creatinine values and glomerular filtration rate. Physicians could establish a preliminary observation index and then design a series of preventive guidelines to reduce the incidence of AKI risk for the elderly.

Insights from the comparisons of SARS-CoV and COVID-19 outbreaks: The evidence-based experience of epidemic prevention in China.

ABSTRACT: Coronavirus disease 2019 (COVID-19) is one of infectious diseases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the beginning of 2020, a sudden outbreak of novel pneumonia, originated from Wuhan, China, swiftly evolves to a worldwide pandemic, alike the severe acute respiratory syndrome (SARS) in 2003. However, Chinese-style innovation in response to the outbreak of COVID-19 helped China to reach a faster and more effective success in the containment of this epidemic. This review summarizes insights from the comparisons of severe acute respiratory syndrome coronavirus (SARS-CoV) and COVID-19 outbreaks on the basis of preventive strategies in China for this coronavirus pandemic.