Perceived social support, resilience and health self-efficacy among migrant older adults: A moderated mediation analysis.

Migrant older adults become more disadvantaged in health due to aging and migration-related problems. This study aimed to examine the mediating role of resilience in the relationship between perceived social support and health self-efficacy, and to test whether gender moderated the mediating effect of resilience between perceived social support and health self-efficacy among migrant older adults. A total of 184 migrant older adults were recruited from five communities. Resilience played a partial mediating role in the relationship between perceived social support and health self-efficacy. Moreover, age moderated the relationship between resilience and health self-efficacy. The relationship between resilience and health self-efficacy was stronger in male older adults than female ones. These findings provide a better understanding of the effects of perceived social support and resilience on health self-efficacy, which could guide targeted interventions for community health nurses to promote health self-efficacy among migrant older adults.

Self-management behaviors in adults with chronic hepatitis B: A structural equation model.

BACKGROUND: Chronic hepatitis B is a serious and chronic health problem, requiring self-management to control the disease and related complications. OBJECTIVES: To develop a structural model to identify how social support, self-efficacy and disease knowledge contribute to their self-management behaviors in adults with chronic hepatitis B. DESIGN: A cross-sectional study. SETTINGS: Hepatology units in two hospitals in Chongqing, China. PARTICIPANTS: A total of 306 patients with chronic hepatitis B were recruited. METHODS: Data were collected using Social Support Rating Scale, Self-Efficacy for Managing Chronic Disease, Hepatitis B Knowledge Questionnaire and Chronic Hepatitis B Self-Management Scale. Structural equation model was applied to analyze the data. RESULTS: The final model showed good model fit. Social support directly influenced self-management behaviors (ß = 0.19, p < 0.01), and indirectly influenced self-management behaviors (ß = 0.20, p < 0.01) through self-efficacy. Self-efficacy directly influenced self-management behaviors (ß = 0.37, p < 0.05). Disease knowledge indirectly influenced self-management behaviors (ß = 0.12, p < 0.05) through self-efficacy. CONCLUSIONS: Our findings indicated that social support, self-efficacy and disease knowledge directly or indirectly affected self-management behaviors in adults with chronic hepatitis B. This provides a theoretical basis for developing self-management interventions for patients with chronic hepatitis B, which may lead to health improvements in this population.

Attitudes towards patient safety culture among postgraduate nursing students in China: A cross-sectional study.

Patient safety is crucial to healthcare quality. It is important to assess the nursing students' safety attitudes to identify the weaknesses for developing education program and fostering students' engagement in patient safety practices. This study aimed to assess attitudes towards patient safety culture among postgraduate nursing students in China, and explore the factors that affect their safety attitudes and the relationships of safety attitudes and safety-related behaviors. This study used a cross-sectional survey design. A convenience sample of 231 postgraduate nursing students from ten medical universities in China completed the Chinese version of Safety Attitude Questionnaire, including six domains: teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions and stress recognition. The mean scores of the six domains ranged from 65.22 to 70.75 on a 100-point scale. Percentages of positive responses for the six domains were below 55%, with the two lowest percentages for working conditions (35.9%) and safety climate (30.7%). Significantly lower domain scores were found in students with younger age, no work experience, higher workload and received safety education. There were positive correlations between the six domains and safety-related behaviors except for stress recognition. Nursing educators should focus more on the improvement of patient safety education and establishment of supportive work environment to enhance postgraduate nursing students' attitudes towards safety culture.

Relationships Among Social Support, Coping Strategy, and Depressive Symptoms in Older Adults With Diabetes.

The current study aimed to examine the relationships among social support, coping strategy, and depressive symptoms in older adults with diabetes, and the mediating role of coping strategy in the relationship between social support and depressive symptoms. Participants were 152 older adults with diabetes from two community health service centers in Chongqing, China. Self-reported questionnaires were used to assess social support, coping strategy, and depressive symptoms. Data were analyzed using descriptive statistics, hierarchical multiple regression, and mediation analysis. Subjective support, support utilization, and coping strategy were significantly associated with depressive symptoms. Positive and negative coping had significant mediating effects on the relationship between subjective support or support utilization and depressive symptoms. To alleviate depressive symptoms in older adults with diabetes, assessment and enhancement of social support and facilitation of positive coping strategy are integral to nursing care for older adults with diabetes. [Journal of Gerontological Nursing, 45(4), 40-46.].

Development and preliminary validation of the chronic hepatitis B self-management scale.

BACKGROUNDS: Chronic hepatitis B (CHB) patients may face many problems resulted from their conditions. To delay the progress of CHB, patients should be responsible for the management of their conditions. There is no dedicated scale for assessing self-management behaviors of CHB patients. OBJECTIVES: This study aimed to develop and validate a self-report measure designed to assess the self-management behaviors for CHB patients (CHBSMS). DESIGN: A cross-sectional descriptive study design. SETTING: Participants were recruited from the infectious disease department of two hospitals in China. PARTICIPANTS: A sample of 248 and 346 CHB patients for item analysis and test for validity and reliability, respectively. METHODS: An initial 45-item scale developed based on item generation and a two-round Delphi survey was assessed by CHB patients for item analysis to develop a final scale. Construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Chronic Disease Self-Management Behavior Scale (CDSMBS) was used to test the criterion validity. Internal consistency and test-retest reliability were assessed by Cronbach's α coefficient and intraclass correlation coefficient (ICC), respectively. RESULTS: A 25-item scale was developed. EFA indicated a four-factor structure (symptom management, lifestyle management, psychosocial coping and disease information management), which accounted for 58.149% of the total variance. CFA indicated appropriate fit of the four-factor model. The total scores of CHBSMS was correlated with that of CDSMBS (r = 0.634, P < 0.01). The Cronbach's α coefficient (α = 0.887) and the test-retest correlation coefficient (ICC = 0.871) showed good internal consistency and stability of the scale. CONCLUSIONS: The 25-item CHBSMS is a reliable and valid measure that can be used to assess the self-management behaviors of CHB patients for improving patient education and health-related outcomes.

Development of Self-Management Indicators for Chronic Hepatitis B Patients on Antiviral Therapy: Results of a Chinese Delphi Panel Survey.

OBJECTIVE: This study aimed to develop a set of indicators that could be used to measure and monitor the self-management performance for chronic hepatitis B (CHB) patients on antiviral therapy in China. METHODS: A two-round Delphi study via e-mail correspondence was conducted, with a group of 30 Chinese experts. The Delphi questionnaire consisted of 53 indicators identified from a literature review. Experts rated and scored the importance of indicators on a five-point Likert scale. Consensus was considered to be reached if a median score in the top tertile (4-5) and ≥ 80% of panel ratings in the top tertile (4-5) after Round 2. The included indicators were validated with a group of 106 CHB patients. RESULTS: The response rates for the first and second rounds were 90.9% (n=30) and 86.7% (n=26), respectively. Three new indicators were suggested in the first round. 55 indicators were included in the second round after modified. 45 (81.8%) indicators achieved on the level of consensus, all of which had an inter-quartile range of 1 or below. The final set included 4 domains and 45 indicators which were well accepted and understandable by CHB patients. CONCLUSION: This Delphi study produced a set of 45 self-management indicators for CHB patients on antiviral therapy in China. These indicators could be used to measure and monitor the patients' self-management performance, with the goal of improving the quality of life in this population.