Cross-cultural validation and psychometric testing of the Debriefing Experience Scale (DES): a cross-sectional study.

BACKGROUND: The Debriefing Experience Scale (DES) is a tool that is used to explore nursing students' subjective experiences during a debriefing and to help determine best debriefing practices. A Chinese version of the scale has not been found; its development can enhance learning in simulation activites in Chinese healthcare education programs. METHODS: A simplified Chinese version of the DES was developed and tested using 34 Chinese undergraduate (second year) nursing students. They participated in six simulation scenarios and debriefings. Eight experts were consulted to determine the content validity of the scale. Critical ratio method, Cronbach's alpha, intraclass correlation coefficient, correlation coefficient and factor analysis were used in testing the psychometric properties of the scale. RESULTS: Analysis of 200 scales showed that the simplified Chinese version of the DES had good potential in discriminatiing Chinese nursing students' experiences of debriefing. CONCLUSIONS: The simplified Chinese DES was effective in evaluating the experience of debriefing. A larger sample size and multicenter research is needed to confirm these findings.

Anxiety and its association with perceived stress and insomnia among nurses fighting against COVID-19 in Wuhan: A cross-sectional survey.

AIMS AND OBJECTIVES: To investigate the present status of anxiety among nurses fighting the spread of COVID-19 and its association with perceived stress and insomnia. BACKGROUND: With the outbreak of COVID-19, nurses have been caring for infected patients for a considerable length of time in Wuhan, China. Previous COVID-19 studies generally focused on patients' medical treatment, but few considered healthcare workers' psychological needs while working with a pandemic involving an unfamiliar infectious disease. Numerous nurses have experienced mental health problems, such as anxiety. DESIGN: The STROBE guidelines for a cross-sectional questionnaire were implemented. METHODS: An online survey of 643 frontline nurses working with COVID-19-infected patients was conducted from 3-10 March 2020. Sociodemographic data were collected, and the Generalized Anxiety Disorder Scale, the Chinese Perceived Stress Scale and the Athens Insomnia Scale were administered. RESULTS: One-third (33.4%) of participants reported anxiety, which was associated with perceived stress and insomnia among Chinese frontline nurses in Wuhan during the COVID-19 pandemic. Significant associations were found between anxiety, perceived stress, insomnia, working four-night shifts per week, experience working during more than two epidemics and fear of COVID-19. CONCLUSIONS: This study found that a substantial proportion of frontline nurses caring for COVID-19-infected patients experienced anxiety. We recommend that nurse managers focus on working conditions and cultivate safe and satisfactory work environments. Meanwhile, frontline nurses should foster awareness of mental health and rely on online resources for psychological training to alleviate anxiety. RELEVANCE TO CLINICAL PRACTICE: The findings of this study could facilitate better understanding of anxiety among frontline nurses; more importantly, healthcare authorities and nursing managers need to pay more attention to ensuring intervention training to reduce anxiety for frontline nurses worldwide.

The feasibility and safety of PICCs accessed via the superficial femoral vein in patients with superior vena cava syndrome.

OBJECTIVE: To investigate the feasibility and safety of the peripherally inserted central catheters (PICCs) accessed via the superficial femoral vein in patients with superior vena cava syndrome (SVCS). METHODS: From October 2010 to December 2014, 221 cancer patients with SVCS in our center received real-time ultrasound-guidance of the superficial femoral vein inserted central catheters (FICCs) at the mid-thigh. PICC insertion via upper extremity veins had also been investigated in 2604 cancer patients without SVCS as control. The average catheterization time, one-time puncture frequency, catheter duration and complications were compared between two groups. RESULTS: In the FICC group, the mean catheterization time was 31.60 ± 0.15 minutes, one-time puncture frequency was 1.05 ± 0.08, and catheter duration was 168.95 ± 20.47 days. There was no significant difference compared with the upper extremity veins PICC group: 31.11 ± 3.86 minutes, 1.03 ± 0.30, and 173.58 ± 39.81 days, respectively. The major complications included skin allergy to chlorhexidine gluconate (CHG) dressings, exudation, catheter-related infection, catheter occlusions, unplanned catheter withdrawal, venous thrombosis, mechanical phlebitis, and catheter malposition. It is interesting that a higher rate of catheter malposition was observed in the upper extremity veins PICC group than in the FICC group (2.15% vs. 0.00%). There were no significant differences in other complications between the two groups. CONCLUSIONS: Real-time ultrasound-guided PICCs accessed via the superficial femoral vein at the mid-thigh is a new modified technique with low complications, which can be a feasible and safe alternative venous access for patients with SVCS.

Effects of Tai Chi Exercise on Cancer-Related Fatigue in Patients With Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy: A Randomized Controlled Trial.

CONTEXT: Tai Chi exercise has been shown to improve cancer-related fatigue (CRF) and autonomic nervous system (ANS) balance in some cancer patients or survivors; however, such effects are yet to be verified in nasopharyngeal carcinoma (NPC) patients undergoing chemoradiotherapy. OBJECTIVES: To explore the effects of Tai Chi exercise on CRF in NPC patients undergoing chemoradiotherapy and then to evaluate ANS information indicated by heart rate variability parameters and their association with CRF. METHODS: A randomized controlled trial of Tai Chi exercise was conducted from January 2014 to August 2015. Participants in the Tai Chi group practiced Tai Chi a one-hour session, five sessions/week during chemoradiotherapy. Participants in the control group received usual care. The primary end points were scores of the multidimensional fatigue symptom inventory-short form (MFSI-SF). Secondary end points were heart rate variability parameters, including normalized low-frequency (nLF) power, normalized high-frequency (nHF) power, and the nLF/nHF ratio, and their association with CRF. RESULTS: One hundred fourteen patients were recruited in this study, and 83 patients completed the trial. The Tai Chi group and the control group had comparable baseline characteristics. After chemoradiotherapy, the Tai Chi group exhibited lower MFSI-SF total score and three negative subscale (general, physical, and emotional fatigue) scores and higher vigor score compared with the control group (P < 0.01 for all). The nLF/nHF ratio was significantly lower in the Tai Chi group compared to the control group after chemoradiotherapy. The MFSI-SF total score was markedly correlated with the nLF/nHF ratio. CONCLUSION: Tai Chi exercise is conducive to alleviate CRF in NPC patients undergoing chemoradiotherapy. The improvement in ANS balance might fit into the process of Tai Chi for CRF management in this population.

Predictors of the health-related quality of life of patients who are newly diagnosed with lung cancer in China.

The purpose of this study was to explore the level and predictors of the health-related quality of life among patients who were newly diagnosed with lung cancer in China. A descriptive survey design was used to collect the data from 108 patients. The relationships among the variables were analyzed by using Pearson's correlation and multiple regression analyses. The results indicated that the patients in this sample had a poor quality of life in the physical, psychological, and environmental domains of the World Health Organization Quality of Life Questionnaire. Their age, annual family income, social support, and three dimensions of the health locus of control (internal, external, and chance) correlated significantly with the global quality of life. The stepwise multiple regressions showed that only the internal locus of control was statistically significant in predicting the patients' quality of life. The results suggest that healthcare professionals should pay particular attention to demographic characteristics, such as age and family income, and personal characteristics, such as the health locus of control and social support, when treating this patient group.