Patient satisfaction with humanistic nursing in Chinese secondary and tertiary public hospitals: a cross-sectional survey.

Background: Humanistic care pertains to the abilities, attitudes, and behaviors central to patient-centered care, contributing to patients' sense of safety and wellbeing. This study aimed to assess the satisfaction of patients with humanistic nursing care in Chinese secondary and tertiary public hospitals. Methods: A national cross-sectional survey was conducted across 30 provinces and 83 hospitals in China. Patient satisfaction with humanistic care was assessed using the Methodist Health Care System Nurse Caring Instrument (NCI), which encompasses 20 items across 12 dimensions. Each item was rated on a 7-point Likert scale, yielding a total score of 140. Multiple linear regression analysis was employed to identify factors associated with patients' satisfaction. Results: Moderate satisfaction (mean score 91.26 ± 13.14) with humanistic nursing care was observed among the 17,593 participants. Factors significantly associated with patient satisfaction included age, hospital type, presence of children, educational attainment, place of residence, family monthly income, and medical insurance type. Conclusion: The study findings highlight the importance of tailored interventions, evidence-based practice guidelines, and patient-centered care in improving patients' satisfaction with humanistic nursing care. Continuous emphasis on nursing education and professional development is crucial for enhancing humanistic care and patient satisfaction.

Latent profile analysis of cognitive function and depressive symptoms in Chinese elderly: results from the China Health and Retirement Longitudinal Study.

BACKGROUND: Geriatric cognitive impairment often occurs in conjunction with depressive symptoms. This study focuses on categorising the Chinese elderly with such co-occurring symptoms into homogeneous groups using latent profile analysis (LPA), a person-centred statistical approach. METHODS: Information on cognitive function and depressive states of the elderly was extracted from the China Health and Retirement Longitudinal Study. The underlying characteristics were identified by LPA, and based on those findings, differences in demographic characteristics of different subgroups were explored by chi-squared test and analysis of variance. RESULTS: A total of 6710 Chinese elderly who met the inclusion criteria were selected from the dataset. Four subgroups were identified among this sample by LPA, based on cognitive function associated with depressive symptoms, and named in this study as follows: mild cognitive impairment (n = 3747, 55.84%), moderate cognitive impairment (n = 1306, 19.46%), mild cognitive impairment combined with depressive symptoms (n = 1114, 16.6%), and moderate cognitive impairment combined with depression (n = 543, 8.09%). Age, gender, marital status, and educational level were all significantly different across subgroups (P < 0.001); religious belief and pension mode, however, were not (P > 0.05). CONCLUSIONS: In the present study, four subgroups of cognitive function combined with depressive symptoms were found in Chinese elderly individuals, and differences in demographic factors were noted between the subgroups. In clinical practise, these findings could help clinical workers identify patients accurately and consider the demographic features of each subgroup when designing medical treatment, care, and rehabilitation programmes for those with cognitive impairment and concomitant depressive symptoms.

Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis.

Background and Purpose: Malnutrition is highly prevalent in ischemic stroke patients. We aimed to investigate whether malnutrition indexes may be useful in predicting mortality at 90 days in ischemic stroke patients treated with intravenous thrombolysis. Methods: We retrospectively analyzed consecutive patients who underwent thrombolytic therapy at three comprehensive stroke centers. Malnutrition was assessed using the controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI). Results: Of 979 patients (mean age, 66.8 years; males, 63.6%) included in this study, 91 (9.3%; 95% confidence interval [CI]: 8.4-10.2%) died at 3-month follow up. According to the CONUT, GNRI, and PNI scores, 9.9, 33.7, and 7.0% of patients were moderately or severely malnourished, respectively; 64.0% were at least mildly malnourished by at least 1 malnutrition index. In the multivariate regression model after adjusting for potential confounders, malnutrition (severe risk versus normal nutritional status) was significantly associated with an increased risk of mortality for CONUT scores (adjusted odds ratio [OR] 16.16, 95%CI, 7.86-67.11; P < 0.001), GNRI scores (adjusted OR 9.82, 4.10-23.51; P < 0.001) and PNI scores (adjusted OR 12.74, 5.56-29.19; P < 0.001). Similar results were found when the malnutrition scores were analyzed as continuous variables. Adding the three malnutrition indexes to models containing conventional risk factors significantly improved risk reclassification for 3-month mortality. Conclusion: Our study showed that malnutrition may be associated with a higher risk of mortality at 3 months in ischemic stroke after intravenous thrombolysis.

Mental workload of frontline nurses aiding in the COVID-19 pandemic: A latent profile analysis.

AIMS: To investigate the mental workload level of nurses aiding the most affected area during the Coronavirus disease 2019 (COVID-19) pandemic and explore the subtypes of nurses regarding their mental workload. DESIGN: Cross-sectional study. METHODS: A sample of 446 frontline nurses participated from March 8 to 19, 2020. A latent profile analysis was performed to identify clusters based on the six subscales of the Chinese version of the National Aeronautics and Space Administration Task Load Index. The differences among the classes and the variables including sociodemographic characteristics, psychological capital and coping style were explored. RESULTS: The level of mental workload indicates that the nurses had high self-evaluations of their performance while under extremely intensive task loads. The following three latent subtypes were identified: 'low workload & low self-evaluation' (8.6%); 'medium workload & medium self-evaluation' (35.3%) and 'high workload & high self-evaluation' (56.1%) (Classes 1, 2, and 3, respectively). Nurses with shared accommodations, fewer years of practice, junior professional titles, lower incomes, nonmanagement working positions, lower psychological capital levels and negative coping styles had a higher likelihood of belonging to Class 1. In contrast, senior nurses with higher psychological capital and positive coping styles were more likely to belong to Classes 2 and 3. CONCLUSION: The characteristics of the 'low workload & low self-evaluation' subtype suggest that attention should be paid to the work pressure and psychological well-being of junior nurses. Further research on regular training program of public health emergency especially for novices is needed. Personnel management during public health events should be focused on the allocation between novice and senior frontline nurses. IMPACT: This study addresses the level of mental workload of frontline nurses who aid in the most severe area of the COVID-19 pandemic in China and delineates the characteristics of the subtypes of these nurses.

Reliability and validity of the Chinese version of the LMC Skills, Confidence & Preparedness Index (SCPI) in patients with type 2 diabetes.

BACKGROUND: A variety of diabetes self-management instruments have been developed but few of them consist of the preparedness for diabetes self-management behavior. The novel psychometric evaluation tool "the LMC Skills, Confidence & Preparedness Index (SCPI)" measures three key aspects of a patient's diabetes self-management: knowledge of the skill, confidence in being able to perform skill and preparedness to implement the skill. The objective of this study was to translate, adapt and validate the SCPI for use in Chinese adult patients with type 2 diabetes. METHODS: This study followed the guideline recommended by the American Academy of Orthopaedic Surgeons Evidence Based Medicine Committee (AAOS) to indigenize the scale. Forward and back translation, and cross-cultural language debugging were completed according to the recommended steps. A convenience sample of Chinese patients with type 2 diabetes (n = 375) were recruited from a university-affiliated hospital in Shanghai. The validity (criterion, discriminant validity, and construct validity), reliability (internal consistency and test-retest reliability) and the interpretability of the instrument were examined. The content validity was calculated by experts' evaluation. RESULTS: The Chinese version of SCPI (C-SCPI) has good internal consistency with a Cronbach's alpha of 0.92. The ceiling effects of the preparedness subscales is 21%. The criterion validity of three dimensions of C-SCPI was established with significantly moderate correlations between the DKT, DES-SF and SDSCA (p < 0.05). The S-CVI of the whole scale was 0.83. Except for entry 21, the I-CVI values of all entries were greater than 0.78. The C-SCPI has also shown good discriminative validity with statistically significant differences between the patients with good and poor glycemic control. Confirmatory factor analysis showed that modified results indicate that the fitting degree of the model is good, χ2/df = 2.775, RMSEA = 0.069, CFI = 0.903, GFI = 0.873, TLI = 0.889, IFI = 0.904. The test-retest reliability coefficient was 0.61 (p < 0.01). CONCLUSION: We established a Chinese version of SCPI through translation and cross-cultural adaptation. The C-SCPI is reliable and valid for assessment of the level of self-management in Chinese patients with type 2 diabetes.

A Bibliometric Analysis of Cirrhosis Nursing Research on Web of Science.

The aims and objectives of this study were to (1) analyze the bibliometric characteristics of articles on Web of Science from 1986 to the present using literature mining and information visualization technologies developed by CiteSpace software, (2) reflect the current situation in this field as far as possible, and (3) provide evidence for improving research on nursing and clinical liver cirrhosis in Mainland China. No bibliometric analysis exists on Web of Science regarding cirrhosis nursing research. The status of current research, including hotspots and trends, has been assessed in this study through a bibliometric analysis. Literature related to cirrhosis and nursing was identified via Web of Science. Data were then analyzed using CiteSpace software. From 1986 to 2018, a total of 179 articles were published in 109 journals by 830 researchers in 36 countries/regions. The terms "cirrhosis," "management," and "quality of life" emerged most frequently and indicated the hotspots in liver cirrhosis nursing literature. Among all countries/regions, the United States contributed the most research overall; Asia also played an important role in the field of liver cirrhosis nursing research. The journal Gastroenterology Nursing published the greatest number of articles. Liver cirrhosis nursing research has attracted increasing amounts of attention around the world, although it remains less robust than other fields. Cirrhosis nursing research is still in its infancy in Mainland China, and there is an urgent need for additional support from government or research institutions to improve this research focus and promote international acceptance of the research outcomes.

Heliox-Driven Nebulization Has a Positive Effect on the Lung Function in Lipopolysaccharide-Induced Chronic Obstructive Pulmonary Disease Rat Model.

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a serious lung disease that severely threatens people's health. This study aimed to investigate the effects of heliox-driven nebulization (HDN) on lung function and arterial blood gases in a COPD rat model. MATERIAL AND METHODS Twelve healthy male Wistar rats were selected as controls and 34 rats were used to establish a COPD model induced by lipopolysaccharide. Then 6 rats each from the control and model groups were selected for their symptoms to be observed. The remaining 6 normal rats were used as control group (group A) and the remaining 28 experimental COPD rats were randomly assigned to 4 groups: experimental COPD group (group B), medical oxygen group (group C), and heliox groups (group D, He/O2=63%/37%; group E, He/O2=71%/29%). The lung function indicators and arterial blood gases were analyzed to evaluate the effects of different driving gases on COPD rats. RESULTS The COPD model was successfully established with slow growth and severe lung dysfunction. Inspiratory resistance, expiratory resistance, and forced expiratory volume at 0.10 s (FEV0.10)/FVC were significantly decreased, whereas dynamic lung compliance was significantly increased in groups D and E, compared with the experimental COPD group (group B; P<0.05). Meanwhile, compared with the model group, the values of partial pressure of carbon dioxide in arterial blood were significantly higher, whereas the potential of hydrogen values were significantly lower after atomization in groups C and D but not in group E (P<0.05). The obvious increase in arterial oxygen saturation was found only in group E (P<0.05). CONCLUSIONS HDN improved the lung function and arterial blood gas analysis results in experimental COPD rats, with an optimal percentage of He/O2=71%/29%.

Comparison between Caprini and Padua risk assessment models for hospitalized medical patients at risk for venous thromboembolism: a retrospective study.

OBJECTIVES: This study aimed to evaluate the validity of the risk assessment model (RAM) of Caprini and Padua in identifying venous thromboembolism (VTE) among hospitalized medical patients. METHODS: This retrospective study reviewed a total of 320 VTE and 320 non-VTE patients. Baseline demographics and clinical data of these patients were all recorded. The Caprini and Padua RAMs were implemented and the individual scores of each risk factor were summed to generate a cumulative risk score. Meanwhile, the sensitivity, specificity, and positive and negative predictive values of these two models were analysed. Receiver operating characteristic (ROC) curve was plotted to calculate the area under the curve (AUC) and the Youden index. RESULTS: Significant differences were observed in risk factors between VTE and non-VTE patients. More VTE patients were classified into the high-superhigh risk level by the Caprini RAM than the Padua RAM (70.9 vs 23.4%, P < 0.01). The sensitivity and positive and negative predictive values in the Caprini RAM were higher than those in the Padua RAM (P < 0.05). However, the specificity of the Caprini RAM was lower than that of the Padua RAM (P < 0.01). The AUC and the Youden index were higher in the Caprini RAM than in the Padua RAM (P < 0.01), whereas the Youden index in the Padua RAM at critical point 4 was lower than that at critical point 3 (0.010 vs 0.140, P < 0.05). CONCLUSIONS: The Caprini RAM was suggested to be more effective than the Padua RAM for identification of hospitalized medical patients at risk for VTE.

A nursing care classification system for assessing workload and determining optimal nurse staffing in a teaching hospital in China: A pre-post intervention study.

We aimed to evaluate the effectiveness of a nursing care classification system for re-assessing nurse workload and determining staffing needs. Adequate bed-nurse ratios help manage hospital cost-efficiency, quality of care and patient safety. A prospective pre-post intervention study was conducted from January 2010 to December 2012 in 16 medical-surgical units of a tertiary teaching hospital. Nursing tasks were classified into four grades of care reflecting actual workload. Units were re-staffed accordingly and bed-nurse ratios compared with government-authorized bed-nurse ratios. Patient satisfaction, hospital stays and mortality were evaluated pre- and poststaffing changes. Average bed-nurse ratio (1:0.41) exceeded the national standard (1:0.40) in 16 units, but was inadequate in five units. Re-staffing increased average bed-nurse ratio from 1:0.41 to 1:0.48. Patients' satisfaction increased from 96.9% to 97.6%, and hospital stays decreased significantly. Nursing care classification effectively distributes nurse staffing to match patients' care levels, improving patient outcomes.

The effect of drainage tube on bleeding and prognosis after total knee arthroplasty: a prospective cohort study.

BACKGROUND: To evaluate the effect of drainage tube on prognosis after total knee arthroplasty (TKA) and explore an effective treatment with favorable prognosis. METHODS: In a prospective study, 18 patients with TKA for the first time were included and randomly divided into three groups, group A (no placement of drainage tube), group B (negative pressure drainage), and group C (4 h clamping drainage). Intraoperative and postoperative blood loss, operation time, and the drainage volume were recorded and analyzed. Arthrocele, ecchymosis, and range of motion (ROM) were examined postoperatively. The degree of pain was scored by Visual Analog Scale (VAS) after 6, 12, and 24 h of operation. The complications were examined and HSS (hospital for special surgery) knee score was taken during the follow-up period. RESULTS: There was no significant difference in operation time, total blood loss, intraoperative blood loss, and VAS score among three groups. Meanwhile, the hidden blood loss in group B was significantly decreased compared with group A (P = 0.0015). The postoperative drainage volume of group B was significantly increased compared with group C (P = 0.0002). No drainage increased the rate of arthrocele and ecchymosis. Compared with group A, ROM after 3 days of operation in groups B and C was significantly increased (P = 0.0357, P = 0.0372, respectively). During follow-up study, no deep infection or deep venous thrombosis was found. CONCLUSION: After TKA, early clamping of the drainage tube reduced the bleeding loss without adverse effect on prognosis, which might be useful for clinical application in future.

Effect of oxygen-driven nebulization at different oxygen flows in acute exacerbation of chronic obstructive pulmonary disease patients.

OBJECTIVES: The aim of this study was to study the effect of oxygen-driven nebulization (ODN) at different oxygen flows on heart rate, respiratory rate, SpO2, SaO2, PaO2, PaCO2 and pH of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. METHODS: According to random number table, 9 AECOPD patients were randomly divided into 3 groups, numbered A, B and C and treated with ODN. Oxygen flow of groups A, B and C was 4-5, 6-7 and 8-9 L/min, respectively. Heart rate, respiratory rate, SpO2, SaO2, PaO2, PaCO2 and pH were recorded before ODN and 30 minutes after ODN. Statistical differences of data before or after ODN were analyzed by analysis of variance and F-test, whereas data before and after ODN were tested by paired t test. RESULTS: There was no significant difference of heart rate, respiratory rate, SpO2, PaO2, PaCO2, SaO2 and pH among 3 groups before ODN or after ODN. The heart rate was increased in all groups after ODN. But significant increase was only present in groups A and C but not in group B. SaO2 was significantly increased in group C after ODN but no statistical difference was observed between before and after ODN in groups A and B. There was no significant change in respiratory rate, SpO2, PaO2, PaCO2, SaO2 and pH between before and after ODN in all groups. CONCLUSIONS: Optimal oxygen flow in ODN-treating AECOPD patients may be 6-7 L/min.