Effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression: A mixed methods study.

AIMS: To determine the effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression. BACKGROUND: Nursing work in clinical settings is highly stressful and may result in an increase in nurses' turnover rate, which threatens the quality of nursing care and patient safety. METHODS: We used a mixed methods design and a three-month intervention (January to April, 2019) involving a convenience sample of 176 nurses working at a Chinese tertiary hospital. We conducted 12 semi-structured interviews and performed a content analysis. The pre- and post-intervention comparisons of nurses' stress, self-perceived anxiety and depression were performed using a paired t test. RESULTS: The 3-month leisure activities programme significantly decreased nurses' job stress (t = 3.80, p < .01), perceived personal stress (t = 3.30, p < .01), self-perceived anxiety (t = 3.76, p < .01) and depression (t = 2.73, p < .01). The qualitative findings revealed five mechanisms linking leisure activities to subjective well-being: detachment recovery, autonomy, mastery, meaning and affiliation. CONCLUSIONS: A hospital-based leisure activities programme had a positive effect on job stress, self-perceived anxiety and depression, thus improving nurses' well-being. IMPLICATIONS FOR NURSING MANAGEMENT: A hospital-based leisure activities programme provides a beneficial strategy for ameliorating nurses' psychosocial issues. Interventions aimed at facilitating or increasing nurses' participation in leisure activities are greatly needed.

Trust crisis: New frontline nurse managers' ethical experience in their units.

PURPOSE: To explore the ethical experiences of new nurse managers when working at their units and propose response strategies accordingly. DESIGN AND METHODS: A qualitative approach was taken at a Grade 3A hospital in Shandong, China. Data were collected via semi-structured long interviews and analyzed using interpretative phenomenological analysis. A total of 19 new frontline nurse managers participated in the study. FINDINGS: The sample consisted of 17 females and two males, with an age range of 40.11 ± 2.71 years and each worked in a variety of units. Trust crisis, tests on capability, and conflicts with the administration were the main ethical issues of new nurse managers, and trust crisis was the most common, especially with nurses in the unit. Eleven subthemes were also involved in these three themes. CONCLUSIONS: New nurse managers encountered a variety of ethical conflicts and dilemmas in their first year. They should enhance their leadership to cope with the issues, and policy support at the hospital level is also needed. CLINICAL RELEVANCE: Senior hospital managers could use these findings to design interventions that might solve new frontline nurse managers' ethical issues. And medical staff might understand the ethical experiences of new nurse managers and support them in the most critical period of role transition. Findings are conducted in the hope of facilitating new nurse managers to quickly settle into the new position, establishing a good relationship with physicians and patients and improving the quality of nursing services.

Influence of psychological nursing and health education on depression, anxiety and life quality of elderly patients with lung cancer.

BACKGROUND: To explore and analyze the influence of psychological nursing and health education on depression, anxiety and life quality of elderly patients with lung cancer. METHODS: There were 84 elderly patients with lung cancer who were admitted and treated in our hospital since July 2018 till July 2019, serving as the objects of observation. The selected patients were divided into the control group (n = 42) and the observation group in principle of random allocation by computer numbers. Routine care was conducted to the control group, while psychological nursing and health education were implemented to the observation group, so as to compare the improvement effect of depression, anxiety, life quality and compliance on the two groups of patients before/after the two different nursing methods were adopted for intervention. RESULTS: Hamilton Depression Scale and Hamilton Anxiety Scale scores in the observation group were lower than those in the control group, and the levels of various pulmonary function indicators including degree of blood oxygen saturation, forced expiratory volume in 1 second, forced vital capacity and maximum ventilatory capacity and quality of life scores were significantly improved; compared with the control group, the total compliance of the observation group was significantly increased, and the difference between the two groups was statistically significant (P < 0.05). CONCLUSION: The psychological nursing and health education implemented for elderly patients with lung cancer will improve patients' bad mood effectively, enhance life quality and perfect prognosis for patients, maintaining significant value in clinical application.

Nurses' ethical challenges caring for people with COVID-19: A qualitative study.

BACKGROUND: Ethical challenges are common in clinical nursing practice, and an infectious environment could put nurses under ethical challenges more easily, which may cause nurses to submit to negative emotions and psychological pressure, damaging their mental health. PURPOSE: To examine the ethical challenges encountered by nurses caring for patients with the novel coronavirus pneumonia (COVID-19) and to provide nurses with suggestions and support regarding promotion of their mental health. RESEARCH DESIGN AND METHOD: A qualitative study was carried out using a qualitative content analysis. The participants were 18 nurses who agreed to attend an interview and describe their own experiences of providing care to COVID-19 patients in China. They were purposively sampled, and structured, in-depth interviews were performed. Data were iteratively collected and analyzed from February to March 2020. ETHICAL CONSIDERATIONS: The proposal was approved by the Research Ethics Committee of the Second Hospital of Shandong University, China. FINDINGS: The findings revealed three main themes and 10 categories. The themes were the following: (1) ethical challenges (people with COVID-19, inequality, professional ethics, and job competency); (2) coping styles (active control and planning, seeking support as well as catharsis, and staying focused); and (3) impacts on career (specialized nursing skills, scientific research ability, and management skills). CONCLUSION: Nurses faced ethical challenges on multiple fronts in caring for COVID-19 patients. The results may help nurses with more safety, ethics, and humanistic care in nursing practice.

Downregulation of lncRNA PMS2L2 in patients with gastric adenocarcinoma predicts poor prognosis.

Long non-coding RNA PMS1 homolog 2 mismatch repair system component pseudogene 2 (PMS2L2) is a key player in lipopolysaccharide-induced inflammatory responses. Preliminary deep sequencing data revealed that PMS2L2 was downregulated in gastric adenocarcinoma (GA) tissues compared with healthy adjacent tissues and the aim of the present study was to investigate the role of PMS2L2 in GA. In the present study, reverse transcription-quantitative PCR assays were performed to analyze gene expression. Cell transfections were performed to analyze gene interactions and Transwell assays were performed to analyze cell invasion and migration. The results revealed that PMS2L2 expression was downregulated in cancer tissues obtained from patients with GA compared with healthy adjacent tissues and was not significantly affected by clinical stage. Furthermore, low levels of PMS2L2 in cancer tissues were closely associated with a low overall 5-year survival rate in patients. MicroRNA (miR)-25 was upregulated in GA tissues compared with healthy adjacent tissues and inversely associated with PMS2L2 levels. In GA cells in vitro, overexpression of PMS2L2 downregulated the expression of miR-25, while miR-25 overexpression did not significantly affect PMS2L2 expression. Furthermore, PMS2L2 overexpression inhibited the migration and invasion of GA cells. miR-25 overexpression partially rescued the decreased migration and invasion of GA cells caused by PMS2L2 overexpression. Therefore, PMS2L2 may downregulate miR-25 expression to inhibit GA.