Knowledge, attitudes, and practice related to the prone positioning of patients among intensive care unit nurses working in COVID-19 units: A cross-sectional study in China.

BACKGROUND: An increasing number of studies persistently demonstrate that prone position ventilation can significantly improve the oxygenation index and blood oxygen saturation for most patients (70-80%) with acute respiratory distress syndrome (ARDS). Studies have also shown that the awake prone position was both safe and effective in helping patients with coronavirus disease 2019 (COVID-19) breathe spontaneously. However, the prone position is not widely adopted when treating patients with COVID-19 or ARDS from other causes. Basic knowledge, positive attitudes, and correct practices among the nursing staff are necessary to increase the use of prone positions, reduce the incidence of complications associated with prone positions, and improve the quality and safety of health care. AIM: This study aimed to investigate the knowledge, attitudes, and practice of prone positioning of patients among intensive care unit (ICU) nurses working in COVID-19 units and provide suggestions for improvement. STUDY DESIGN: ICU nurses were recruited from two designated tertiary hospitals for COVID-19 treatment in Shanghai, China, in April 2022, using convenience sampling. A questionnaire survey focusing on the dimensions of knowledge, attitudes, and practice of the prone position with 42 items, was conducted. RESULTS: A total of 132 ICU nurses participated. The scores on the overall questionnaire and the dimensions of knowledge, attitudes, and practice of prone position were 167.28 (95% CI, 161.70-172.86), 78.35 (95% CI, 76.04-80.66), 32.08 (95% CI, 31.51-32.65), and 56.85 (95% CI, 52.42-61.28) respectively. The overall average score was 79.66% (95% CI, 0.77-0.82). The results of multiple linear regression analysis showed that prior experience in treating patients with COVID-19 and professional titles were related to the level of knowledge, attitudes, and practice of prone position. CONCLUSIONS: The ICU nurses strongly believed in the effectiveness of prone positioning, but their knowledge and practice levels need improvement. The experience in treating patients with COVID-19 and professional titles were related to the level of knowledge, attitudes, and practice of prone position. Nursing managers should ensure that ICU nurses are well trained in prone positioning and help enhance the knowledge and attitudes toward prone positioning to promote its widespread use. RELEVANCE TO CLINICAL PRACTICE: Clinical guidelines and in-service training modules need to be developed to promote the use of prone positioning and reduce prone position-related complications.

Visual Analysis of Psychological Resilience Research Based on Web of Science Database.

Background: The importance of psychological resilience that people show in coping with stress and adversity is prominent, but few studies have used rigorous bibliometric tools to analyze the knowledge structure and distribution of psychological resilience research. Objective: The purpose of this study was to sort out and summarize the previous studies on psychological resilience by using bibliometrics. Specifically, the time distribution of psychological resilience research was determined by publication trend, the power distribution was determined by the distribution of countries, authors, institutions and journals, the hot research spots were analyzed according to the results of keyword cluster analysis, and the research frontier was explored according to the results of burst keywords. Methods: CiteSpace5.8.R3 was used to analyze the literatures on psychological resilience collected in Web of Science core Collection database from January 1, 2010, to June 16, 2022. Results: A total of 8462 literatures were included after screening. Research on psychological resilience has been on the rise in recent years. The United States had made a high contribution in this field. Robert H Pietrzak, George A Bonanno, Connor KM and others were highly influential. J Pers Soc Psychol has the highest citation frequency and centrality. The research hot spots focus on five aspects: study on psychological resilience related to COVID-19 pandemic, influencing factors of psychological resilience, psychological resilience related to PTSD, study on psychological resilience of special population, and the molecular biology and genetic basis of psychological resilience. Psychological resilience related to COVID-19 pandemic was the most cutting-edge research aspect. Conclusion: The current situation and trend of psychological resilience research were found in this study, which may be used to identify more hot issues and explore new research directions in this field.

Assessing emergency department nurses' ability to communicate with angry patients and the factors that influence it.

Aims: To assess emergency department (ED) nurses' ability to communicate with angry patients and to explore the factors that influence nurses' communication skills. Design: A cross-sectional survey design. Methods: This study was conducted in November and December 2020. Stratified sampling was adopted to recruit ED nurses from 18 tertiary hospitals in western, eastern, and central China to complete an online questionnaire. The Nurses' Communication Ability with Angry Patients Scale (NCAAPS) and the General Self-Efficacy Scale were used to assess ED nurses' communication ability and self-efficacy, respectively. Descriptive statistics, the Mann-Whitney U-test, the Kruskal-Wallis H test, Spearman's correlation analysis, and the generalized linear model were used for data analysis. Results: A total of 679 valid questionnaires were collected. The mean total score for the NCAAPS was (3.79 ± 0.47), while the scores for its four dimensions were (3.87 ± 0.59) for communication skills, (3.82 ± 0.59) for anger perception, (3.79 ± 0.53) for self-preparation, (3.73 ± 0.54) for exploring the cause of anger. The generalized linear regression analysis result showed that a longer employment duration, previous communication ability training, and higher self-efficacy were significantly and independently associated with higher NCAAPS scores (p < 0.05). Conclusions: The mean total score and the four dimensions score for the NCAAPS were moderate. But there is still room for improvement in ED nurses' ability to communicate with angry patients. "Exploring the cause of anger" was the lowest score among the four dimensions. To improve ED nurses' ability to communicate with angry patients, future studies should focus on constructing specific communication training, improving nurses' ability to explore the cause of anger and self-efficacy. Impact: The findings of this study provide important insights into ED nurses' ability to communicate with angry patients and can thus guide the future development of intervention programmes to improve this ability among ED nurses.