Are nurses prepared to respond to next infectious disease outbreak: A narrative synthesis.

AIM: The review aimed to present a synthesis of nurses' preparedness for infectious disease and the components of emergency preparedness. DESIGN: Narrative synthesis. METHODS: A systematic search and screening for relevant studies were conducted to locate the relevant articles. The included studies were examined for scientific quality using the Mixed Methods Appraisal Tool. The findings of included studies were synthesized by a narrative synthesis approach. RESULTS: Totally 15 studies were included, and 4 themes associated with nurses' preparedness for pandemic were identified: knowledge and skills, psychological preparation, external resources, and attitude and intention. CONCLUSIONS: Most nurses express a positive willingness to respond to epidemics, although they do not believe they are adequately prepared. Some measures should be taken for improving nurses' emergency preparedness, including providing ongoing training, protective equipment, safe working environment and psychological intervention, improving nurses' resilience and accelerating the sharing of scientific information about epidemics.

Psychological impact of COVID-19 outbreak on frontline nurses: A cross-sectional survey study.

AIMS AND OBJECTIVES: This study aimed to portray the prevalence and associated factors of psychological distress among frontline nurses during COVID-19 outbreak. BACKGROUND: The COVID-19 outbreak has posed great threat to public health worldwide. Nurses fighting against the epidemic on the frontline might be under great physical and psychological distress. This psychological distress was predominantly described as sleep disturbance, symptoms of anxiety and depression, post-traumatic stress, inability to make decisions and even somatic symptoms. DESIGN: Cross-sectional study. METHODS: Frontline nurses from designated hospitals for COVID-19 patients were invited to complete an online survey by convenience sampling, and the survey included six main sections: the General Health Questionnaire, the Perceived Social Support Scale, the Simplified Coping Style Scale, the Impact of Event Scale-Revised, socio-demographic, occupation and work history. Multiple logistic analysis was used to identify the potential risk factors of psychological distress. The study methods were compliant with the STROBE checklist. RESULTS: Of the 263 frontline nurses, 66 (25.1%) were identified as psychological distress. Multiple logistic analysis revealed that working in emergency department, concern for family, being treated differently, negative coping style and COVID-19-related stress symptom were positive related to psychological distress. Perceived more social support and effective precautionary measures were negatively associated with psychological distress. CONCLUSIONS: The study demonstrated that COVID-19 had a significant psychological impact on frontline nurses. Early detection of psychological distress and supportive intervention should be taken according to the associated factors to prevent more serious psychological impact on frontline nurses. RELEVANCE TO CLINICAL PRACTICE: This study highlighted that the frontline nurses were suffering from varying degrees of psychological distress, which needed early screening and supportive intervention for preventing more serious psychological impact on frontline nurses. Beside, more specific measurement should be combined with the GHQ-12 to assess the varying degrees of psychological distress in frontline nurses.

Edaravone attenuates lipopolysaccharide-induced acute respiratory distress syndrome associated early pulmonary fibrosis via amelioration of oxidative stress and transforming growth factor-ß1/Smad3 signaling.

Pulmonary fibrosis is responsible for the both short-term and long-term outcomes in patients with acute respiratory distress syndrome (ARDS). There is still no effective cure to improve prognosis. The purpose of this study was to investigate whether edaravone, a free radical scavenger, have anti-fibrosis effects in the rat model of ARDS associated early pulmonary fibrosis by lipopolysaccharide (LPS) administration. Rats were subjected to intravenous injection of LPS, and edaravone was given intraperitoneally after LPS administration daily for 7 consecutive days. LPS treatment rapidly increased lung histopathology abnormalities, coefficient of lung, hydroxyproline and collagen I levels, stimulated myofibroblast differentiation and induced expression of TGF-ß1 and activation of TGF-ß1/Smad3 signaling as early as day 7 after LPS injection. Moreover, LPS intoxication significantly increased the contents of malondialdehyde (MDA), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), whereas it dramatically decreased superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) activities from day 1 after LPS treatment. On the contrary, edaravone treatment ameliorated LPS-induced myofibroblast differentiation and pulmonary fibrosis, simultaneously, and attenuated LPS-stimulated oxidative stress and activation of TGF-ß1/Smad3 signaling. Collectively, edaravone may attenuate ARDS associated early pulmonary fibrosis through amelioration of oxidative stress and TGF-ß1/Smad3 signaling pathway. Edaravone may be a promising drug candidate for the treatment of ARDS-related pulmonary fibrosis in early period.