Childbirth Readiness Scale (CRS): instrument development and psychometric properties.

BACKGROUND: Childbirth preparation plays an important role in reducing maternal mortality and improving women's childbirth experience. Evaluating childbirth readiness levels before and after interventions provides a basis for formulating more targeted and effective interventions. However, existing tools only assess partial childbirth preparation or have limited evidence of reliability and validity. The aim of this study was thus to develop a new instrument for use during the third trimester to comprehensively assess the readiness level of pregnant women, and test the scale's psychometric properties. METHODS: The scale was developed through exploratory mixed methods including qualitative and quantitative phases. A literature review and in-depth semi-structured interviews were utilized to identify the scale items. A Delphi expert consultation evaluated the content validity. Psychometric testing was conducted in a convenience sample of 731 pregnant women in the third trimester (recruited from 3 tertiary hospitals in Hubei province in China). Item analysis was used to screen items; exploratory factor analysis was performed to extract factors; confirmatory factor analysis was performed to evaluate fit on the factor structures. RESULTS: The final scale consisted of four dimensions and 18 items that explained 65.8% of the total variance. Confirmative factor analysis (CFA) model showed that the 4-factor model fits the data well. The total Cronbach alpha coefficient of the total scale and 4 factors was 0.935 and 0.853-0.914. The split-half reliability was 0.880. The dimensions comprised "Self-management", "Information literacy", "Birth confidence" and "Birth plan". CONCLUSIONS: The childbirth readiness scale we developed has good reliability and validity, and can be used to comprehensively assess the readiness level of pregnant women. In addition to understanding the overall level of women's childbirth readiness, using subscale scores, improvements can be targeted to specific areas of the preparation for childbirth, to improve the efficiency of the intervention.

Chinese version of Tilburg Pregnancy Distress Scale and its reliability and validity test / 中国实用护理杂志

Objective:To translate the Tilburg Pregnancy Distress Scale (TPDS) into Chinese and test its reliability and validity.Methods:The Chinese version of TPDS was formed by adopting forward and back translation, cross-cultural semantic equivalence assessment and pilot testing. A questionnaire survey was conducted among 309 pregnant women who were examined in the obstetrical clinic of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology from September 2019 to January 2020 by convenience sampling method to test the reliability and validity of questionnaire.Results:The content validity of each item ranged from 0.83 to 1.00, while the total table was 0.91. Confirmatory factor analysis showed that the two-factor model fitted well, χ 2/df was 1.380, goodness of fit index was 0.955, normal of fit index was 0.941, Tucker-Lewis index was 0.977, comparative fit index was 0.983, root mean square error of approximation was 0.035. The Cronbach α coefficient of the total scale was 0.834, and the test-retest reliability was 0.826. Conclusions:The Chinese version of TPDS has good reliability and validity, and can be used to measure the level of pregnancy distress in Chinese pregnant women.

Both frequency and duration of rotating night shifts are associated with metabolic parameters: a cross-sectional study.

BACKGROUND: Rotating night shift work contributes to the development of metabolic syndrome and relevant diseases. However, the contribution of different aspects of rotating night shift is rarely studied. AIM: This study investigated the association of frequency and duration of rotating night shift with metabolic parameters. METHODS: A cross-sectional study was conducted in nurses. Socio-demographic characteristics, duration and frequency of rotating night shifts, and metabolic parameters including body mass index (BMI), fasting blood glucose (FBG), blood pressure (BP), triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C), were collected. Sleep quality and perceived stress were assessed with Pittsburgh Sleep Quality Index (PSQI) and Perceived Stress Scale (PSS) respectively. Ratio of rotating night shift years to age (RRSYA) was calculated to present cumulative effect. Metabolic parameters were log-transformed and z-transformed in sequence. Multiple linear regressions were applied to explore the effect of frequency and RRSYA on metabolic parameters. Mediation analysis was used to estimate potential mediating effect of sleep quality and perceived stress. RESULTS: Frequency of rotating night shift work was significantly associated with elevated FBG and BMI, and decreased LDL-C. RRSYA was significantly associated with higher BMI, TC, LDL-C, BP and FBG. Sleep quality exhibited significant mediating effect between rotating night shift features and FBG and BMI. CONCLUSIONS: Our results suggest that frequency and RRSYA are associated with metabolic profile alterations, but the effects are different. Sleep quality appears to be an important mediator of the night shift's metabolic effect. Proper shift arrangement and sleep quality assurance may reduce the negative metabolic changes.

Nurses' Perceptions of Factors Influencing Elder Self-neglect: A Qualitative Study

Purpose@#Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. @*Methods@#Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. @*Results@#Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. @*Conclusion@#Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Nurses' Perceptions of Factors Influencing Elder Self-neglect: A Qualitative Study

Purpose@#Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. @*Methods@#Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. @*Results@#Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. @*Conclusion@#Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Exploring Contributing Factors to Psychological Traumatic Childbirth from the Perspective of Midwives: A Qualitative Study

PURPOSE: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives.METHODS: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews.RESULTS: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations).CONCLUSION: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased.

The study about role function of infusion nurse specialists / 中国实用护理杂志

Objective@#To explore the role function of infusion nurse specialists suitable for China′s national conditions by using Delphi method.@*Methods@#Totally 24 experts were consulted for two rounds, According to the consultation results, the role function of infusion nurse specialists were formulated.@*Results@#After two rounds expert consultation, six primary indexes and fifty-two secondary indexes for the role function of infusion nurse specialists have been developed. The average coefficient of authority, coefficient of determination, coefficient of familiarity of experts were 0.83, 0.93, 0.73 respectively.@*Conclusion@#the consensus has achieved between experts about the indexes of role function, the result of study has high credibility, it could provide reference information for relevant department to set the role function of infusion nurse specialists.

The study about role function of infusion nurse specialists / 中国实用护理杂志

Objective To explore the role function of infusion nurse specialists suitable for China′s national conditions by using Delphi method. Methods Totally 24 experts were consulted for two rounds, According to the consultation results, the role function of infusion nurse specialists were formulated. Results After two rounds expert consultation, six primary indexes and fifty-two secondary indexes for the role function of infusion nurse specialists have been developed. The average coefficient of authority, coefficient of determination, coefficient of familiarity of experts were 0.83, 0.93, 0.73 respectively. Conclusion the consensus has achieved between experts about the indexes of role function, the result of study has high credibility, it could provide reference information for relevant department to set the role function of infusion nurse specialists.

Preference of Chinese general public and healthcare providers for a good death.

OBJECTIVES: The aim of this study is to find and compare the current situation between common people and healthcare providers' preferences for a good death in the context of Chinese culture. METHODS: A cross-sectional anonymous questionnaire survey covering 190 ordinary Chinese people and 323 healthcare providers was conducted. An inventory of the good death was translated and the subjects were surveyed about their attitude toward it. ETHICAL CONSIDERATIONS: Permission to conduct the study was granted by department chiefs, nurse managers and the participants themselves. The participants were informed that they took part on a voluntary and anonymous basis, that they could withdraw at any time, that they had the right to ignore questions they did not wish to answer, and that whatever they chose to do would not jeopardize their employment conditions. RESULTS: The attributes that were perceived as important by major respondents for a good death were maintaining hope and pleasure, good relationship with medical staff, good relationship with family, independence, environment comfort, being respected as an individual, preparation for death, physical and psychological comfort, dying in a favorite place, and not being a burden to others. And some relatively less important characteristics were life completion, receiving enough treatment, natural death, controlling over the future, unawareness of death, pride and beauty, feeling that one's life is worth living, and religious and spiritual comfort. We also found that healthcare providers were more likely than general out-patients to perceive "physical and psychological comfort," "dying in a favorite place," "good relationship with medical staff," and "natural death" as important for a good death. CONCLUSION: This study offers healthcare providers in China a fundamental understanding of the normal expectations of the general public for a good death. It is believed that these findings in our study are valuable to improve palliative care in China. We compared the attitudes of Chinese and Westerners and found some differences, which suggested that cultural difference should be an important consideration to achieve a good death in China. We also found that healthcare providers see good death differently from general public, indicating that the criteria for good death warrant further study.

Literature analysis on oral care research of orotracheal intubated patients / 中国实用护理杂志

Objective To know the progress of research in oral care of orotracheal intubated patients in China and to analyze the existing problems as well as provide the reference for further study.Methods Databases of CNKI,Wanfang,VIP and CBM were searched for literature on oral care for the orotracheal intubated patients by the end of December 2013,and the methods of bibliometrics were used to analyze the research results.Results Three hundred and nine articles that met the inclusion and exclusion criteria from 1997 to 2013 were collected.These papers were mainly included in 22 kinds of nursing journals.The methods of oral care for orotracheal intubated patients could be classified into five types:rinse and swabbing (95 papers),traditional cotton(cotton swab) cleaning or gauze swabbing (58 papers),toothbrushing (54 papers),oral rinse (51 papers),laryngoscope assistance (7 papers).With 54 articles using traditional cotton balls as oral care tool,55 papers using toothbrush,including children toothbrush of soft bristle (29 papers),ordinary toothbrush (14 papers) and electric toothbrush (12 papers).Oral care solution mainly included normal saline(49 papers),traditional Chinese medicine (36 papers),chlorhexidine(36 papers),antibiotics (12 papers),povidone iodine (17 papers),sodium bicarbonate (9 papers),etc.Conclusions The oral care of orotracheal intubated patients has attracted the attention of researchers,but the use of oral care methods,the frequency in oral care and oral care tools still owe specification.More attention should be paid to strengthen the training of nursing staff,to improve the scientific research ability of scientific research workers and to carry out large sample and high quality trials.An oral care guideline that fits into our national conditions should be built in an effort to improve the level of oral care in critical patients in our country.

Health professionals' attitude towards information disclosure to cancer patients in China.

A self-designed questionnaire was given to 634 health professionals in a large teaching hospital in Hubei Province in mainland China, to clarify the participants' attitude towards information disclosure to cancer patients. Statistic description was used to analyze the data. The item 'inappropriate information about cancer easily leads to medical disputes' scored highest at 3.86, while the scores of such items as 'advantages of fully informing patients outweigh disadvantages', 'if their family members demand nondisclosure, you will find it difficult to cooperate in good faith with patients', and 'telling white lies to patients disturbs you a lot' were less than 3. The health care staff placed a high value on both the desire and priority of patients to know the truth, though most of them did not think that patients had received enough information about their disease. In order to improve cancer patients' current state of knowledge, health professionals should learn more about informed consent, and special methods and guidelines compatible with Chinese culture are urgently required in China.

Cone-shaped Moxa Moxibustion Treating Herpes Zoster and Its Mechanism / 华中科技大学学报(医学版)

The therapeutic effect and mechanism of moxibustion in the treatment of Herpes Zoster were studied. It was found that the level of T lymphocyte subsets of the patients with Herpes Zoster was within the normal range before treatment, but slightly lower than in the health group. Th cells and NK cells were significantly decreased in the patients with Herpes Zoster as compared with those in the health group (P＜0. 05),suggesting the cellular immunity of the patients with Herpes Zoster was decreased. After treatment with moxibustion, the level of all the T lymphocyte subsets was increased, close to the normal. Among them the levels of Th cells and NK cells were significantly different from those before the treatment (P＜0. 05). The disappearance of exanthema and relief of neuralgia in the patients was also quicker than in the controls (P＜0. 01). It was indicated that moxibustion had a good effect in the treatment of Herpes Zoster, which was contributed to the enhancement of the body antiviral ability by the improvement of immunity, especially the cellular immunity.

A Study on the Attitude and its Influencing Factors of Cancer Patients towards Information Disclosure / 中国医学伦理学

Objective: To explore the attitude and its influencing factors of patients with cancer towards information disclosure.Methods: 302 patients with cancer were investigated with self-designed questionnaires.Results: The patients' attitudes towards Information Disclosure were significantly affected by the gender,marriage status,personality,duration of cancer information,hospitalization experience and funeral experience,with significant statistical differences﹝P