Disaster Preparedness Among Nurses in China: A Cross-Sectional Study.

BACKGROUND: Increasingly frequent global disasters such as coronavirus disease 2019 pose a threat to human health and life. The World Health Organization has called on countries to formulate detailed plans to prepare for disasters. It is critical to investigate and evaluate the disaster preparedness of nurses. PURPOSE: This study was designed to investigate the disaster preparedness and psychological condition of nurses in China and analyze the significant factors influencing their disaster preparedness. METHODS: A cross-sectional survey was conducted in 2020, and 1,313 nurses were enrolled using convenience sampling. The study questionnaires were distributed and collected via a networking platform equivalent to Amazon Mechanical Turk. The disaster preparedness of the respondents was measured using the Disaster Preparedness Evaluation Tool, the Hospital Anxiety and Depression Scale was used to evaluate anxiety and depression status, and a self-designed questionnaire developed based on a review of the literature was used to explore the potential factors of influence on disaster preparedness. RESULTS: The average score for disaster preparedness among the participants was 186.34 ( SD = 40.80), which corresponded with a moderate level, especially in skill (mean score = 42.01, SD = 12.39). Items with higher scores included support for the government, personal protection, and health education, whereas items with lower scores included nursing leadership in the community, capacity to cope with chemical or biological attacks, and assessment of posttraumatic stress disorder. Disaster preparedness was negatively related with mental health, including depression and anxiety. The main factors affecting disaster preparedness included educational background, nursing specialty, prior disaster training, prior disaster rescue experience, and depression level. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The disaster preparedness of Chinese nurses must be improved. More attention should be paid to disaster preparedness in nurses, and future tailored interventions are urgently needed to promote nursing leadership in the community, the ability to cope with chemical or biological attacks, and posttraumatic stress disorder assessments. Moreover, relieving negative emotions to promote the mental health of nurses should receive greater attention.

Relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis.

OBJECTIVES: To explore the relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis (axSpA). METHODS: A convenience sample of 131 newly diagnosed axSpA patients and 60 healthy controls was recruited from July 2016 to December 2018. Serum 25-hydroxyvitamin D [25(OH)D] was measured to assess vitamin D levels. Disease activity was assessed by objective indicators [Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the Bath Ankylosing Spondylitis Metrology Index (BASMI)], patient-reported questionnaires [the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI)]. Pain intensity and interference were also assessed. RESULTS: Vitamin D insufficiency [serum 25(OH) D levels<50 nmol/L]was found in 46 (35.1%) and 25 (43.3%) of the axSpA patients and the healthy controls, respectively. Female patients had higher risk (OR:4.928; 95% CI: 1.921-12.642) for vitamin D insufficiency than male patients. Vitamin D was positively correlated with CRP, ESR level, the BASFI, and the BASMI. Logistic regression showed that vitamin D levels were not associated with pain, or disease activity in the newly diagnosed axSpA patients. Gender was the only predictive variable for vitamin D levels. CONCLUSIONS: Vitamin D insufficiency was prevalent in both newly diagnosed axSpA patients and healthy controls. There was no association between vitamin D and pain and disease activity in the newly diagnosed axSpA patients. Monitoring vitamin D levels is important and early intervention for vitamin D insufficiency is needed, especially in female patients.

Associations Between Pain Patterns and Self-Reported Clinical Outcomes in Patients with Knee Osteoarthritis.

OBJECTIVES: To study pain locations and patterns in knee osteoarthritis (OA) and determine associations between knee pain patterns and pain characteristics, functional status, and psychological status. DESIGN: A cross-sectional study. SETTING AND SUBJECTS: A convenience sample of 203 patients with knee OA was recruited from two university-affiliated hospitals from July 2016 to July 2017. METHODS: Pain locations were recorded with Photographic Knee Pain Map. Pain characteristics, functional dysfunction, pain catastrophizing, and pain self-efficacy were assessed, and demographic and radiographic data were also collected. Self-reported clinical outcomes across common pain patterns were compared. RESULTS: The medial joint line area (72.9%) was the most prevalent pain zone. The common pain patterns were diffuse (34.5%), isolated medial (22.7%), isolated anterior (9.9%), and medial-lateral pain (9.9%). Scores of intermittent pain (mean difference [MD] = 9.669, 95% confidence interval [CI] = 2.815 to 16.523) and knee-related function in daily living (MD = -10.353, 95% CI= -17.358 to -3.349) were worse in diffuse pain compared with isolated medial pain. Knee-related symptom scores were higher with isolated medial (MD = 13.146, 95% CI = 6.725 to 19.566), isolated anterior (MD = 15.102, 95% CI = 6.525 to 23.679), and medial-lateral (MD = 15.281, 95% CI = 6.704 to 23.857) pain relative to diffuse pain. Diffuse pain, after adjusting for confounding factors, was associated with more severe knee pain at rest, higher scores of constant and intermittent pain, lower knee-related function scores, higher pain catastrophizing, and lower pain self-efficacy scores (P < 0.05). CONCLUSIONS: The most common pattern is diffuse pain, which is associated with worse knee pain intensity at rest, constant and intermittent pain experiences, and worse physical and psychological status, compared with more localized patterns.

Inflammatory or Neuropathic Pain: Characteristics and Their Relationships with Disease Activity and Functional Status in Axial Spondyloarthritis Patients.

OBJECTIVE: To assess inflammatory back pain (IBP) and neuropathic pain (NP) in patients with axial spondyloarthritis (axSpA) and explore their relationships with disease activity and functional status. DESIGN: Descriptive, cross-sectional study. SETTING AND SUBJECTS: A convenience sample of 132 patients with axSpA was recruited from a university-affiliated hospital in China. METHODS: The presence of IBP or NP, pain intensity and quality, pain interference, disease activity, and functional status were assessed. Univariate analyses and binary logistic regressions were used to identify factors related to IBP or NP. RESULTS: Fifty patients (37.9%) had IBP, and 22 (16.7%) had NP. Scores of pain intensity and pain interference, disease activity, and functional limitation were significantly higher in patients with IBP or NP than those without either (P < 0.05). The quality of IBP or NP was mainly presented as sensory descriptors, and patients with IBP had a higher level of "tiring-exhausting" in affective descriptors (P < 0.05). There was a significant correlation between IBP and disease activity (odds ratio [OR] = 1.813, 95% confidence interval [CI] = 1.196-2.750). NP was related to functional limitation (OR = 1.544, 95% CI = 1.098-2.171). CONCLUSIONS: Though pain quality (sensory and affective pain descriptors) show differently in patients with IBP or NP, the axSpA patients with IBP or NP experience more severe pain intensity and pain interference, higher disease activity, and greater functional limitation. The presence of IBP or NP could reflect higher disease activity or greater functional limitation in patients with axSpA.