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Zhang M, Chen W, Liu C, Sui J, Wang D, Wang Y, Meng X, Wang Y, Yue C. Nursing-sensitive quality indicators for pernicious placenta previa in obstetrics: A Delphi study based across Chinese institutions. Nurs Open 2021; 8:3461-3468. [PMID: 33960732 PMCID: PMC8510706 DOI: 10.1002/nop2.895] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
AIM To identify a set of scientific, systematic and clinically applicable nursing-sensitive quality indicators for pernicious placenta previa (PPP). DESIGN A modified Delphi-Consensus Technique. METHODS According to literature retrieval published between 2009-2019, 38 nursing-sensitive quality indicators were chosen and a questionnaire was designed. An online survey was conducted in 20 hospitals in China, and data of experts' opinions were collected and analysed by improved Delphi method. RESULTS 38 nursing-sensitive quality indicators were identified. The response rates in the two rounds of expert consultation were 97.4% and 100%, and the authoritative coefficients were 0.89 and 0.92. The coefficients of variation ranged from 0.04-0.28. The nursing-sensitive quality indicators were successfully constructed based on the modified Delphi technique.
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Affiliation(s)
- Meng Zhang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Weiping Chen
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Cuiping Liu
- School of NursingQingdao UniversityQingdaoChina
| | - Jing Sui
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Dawei Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Xin Meng
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yiqian Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Chongyu Yue
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
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Lu H, Hou L, Zhou W, Shen L, Jin S, Wang M, Shang S, Cong X, Jin X, Dou D. Trends, composition and distribution of nurse workforce in China: a secondary analysis of national data from 2003 to 2018. BMJ Open 2021; 11:e047348. [PMID: 34706946 PMCID: PMC8552175 DOI: 10.1136/bmjopen-2020-047348] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Given the increased ageing population and frequent epidemic challenges, it is vital to have the nurse workforce of sufficient quantity and quality. This study aimed to demonstrate the trends, composition and distribution of nurse workforce in China. DESIGN Secondary analysis using national public datasets in China from 2003 to 2018. SETTING/PARTICIPANTS National population, nurse workforce and physician workforce. PRIMARY AND SECONDARY OUTCOME MEASURES Frequency and proportion were used to demonstrate: (1) the longitudinal growth of nurse workforce; (2) the diversity of nurse workforce in gender, age, work experience and education level; and (3) the distribution of nurse workforce among provinces, rural-urban areas and hospital/community settings. The Gini coefficient and Theil L index were used to measure the inequality trends of nurse workforce. RESULTS The total number of nurses increased from 1.3 million to 4.1 million and the density increased from 1 to 2.94 per 1000 population over 2003-2018. The nurses to physician ratio changed from 0.65:1 to 1.14:1. The majority of the nurse workforce was female, under 35 years old, with less than 30 years of work experience, with an associate's degree and employed within hospitals. Central and eastern regions had more nurses and there were 5.08 nurses per 1000 population in urban areas while less than two in rural areas in 2018. The Gini coefficient and between-provincial Theil index experienced a consistent decline. Within-province inequality accounted for overall inequality has risen from 52.38% in 2010 to 71.43% in 2018 suggested that the differences of distribution are mainly reflected in urban and rural areas. CONCLUSION Chinese nurse workforce has been changed significantly in the past 15 years that may be associated with the reformations of policy, nursing education in China. Our study suggests current features in the nurse workforce and can be used to strengthen future health services.
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Affiliation(s)
- Han Lu
- Peking University School of Nursing, Beijing, China
| | - Luoya Hou
- Peking University School of Nursing, Beijing, China
| | - Weijiao Zhou
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Liqiong Shen
- Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Shida Jin
- Peking University School of Nursing, Beijing, China
| | - Mengqi Wang
- Peking University School of Nursing, Beijing, China
| | | | - Xiaomei Cong
- Nursing Biobehavioral Research Laboratory (BBL), University of Connecticut School of Nursing, Storrs, Connecticut, USA
| | - Xiaoyan Jin
- Peking University School of Nursing, Beijing, China
| | - Dou Dou
- Forth Department of Health Sciences, National Natural Science Foundation of China, Beijing, China
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Llop-Gironés A, Vračar A, Llop-Gironés G, Benach J, Angeli-Silva L, Jaimez L, Thapa P, Bhatta R, Mahindrakar S, Bontempo Scavo S, Nar Devi S, Barria S, Marcos Alonso S, Julià M. Employment and working conditions of nurses: where and how health inequalities have increased during the COVID-19 pandemic? HUMAN RESOURCES FOR HEALTH 2021; 19:112. [PMID: 34530844 PMCID: PMC8444178 DOI: 10.1186/s12960-021-00651-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/30/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses' globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom. MAIN BODY Nurses' health is influenced by the broader social, economic, and political system and the redistribution of power relations that creates new policies regarding the labour market and the welfare state. The vulnerability faced by nurses is heightened by gender inequalities, in addition to social class, ethnicity/race (and caste), age and migrant status, that are inequality axes that explain why nurses' workers, and often their families, are exposed to multiple risks and/or poorer health. Before the COVID-19 pandemic, informalization of nurses' employment and working conditions were unfair and harmed their health. During COVID-19 pandemic, there is evidence that the employment and working conditions of nurses are associated to poor physical and mental health. CONCLUSION The protection of nurses' health is paramount. International and national enforceable standards are needed, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work-life balance. More knowledge is needed to understand the pathways and mechanisms on how precariousness might affect nurses' health and monitor the progress towards nurses' health equity.
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Affiliation(s)
- Alba Llop-Gironés
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Escola Superior d’Infermeria del Mar (ESIMar), Barcelona, Spain
- Social Determinants and Health Education Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ana Vračar
- Organization for Workers’ Initiative and Democratization, Zagreb, Croatia
| | | | - Joan Benach
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- The Johns Hopkins - UPF Public Policy Center (JHU-UPF PPC), Barcelona, Spain
- Transdisciplinary Research Group On Socioecological Transitions (GinTrans2), Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | - Mireia Julià
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Escola Superior d’Infermeria del Mar (ESIMar), Barcelona, Spain
- Social Determinants and Health Education Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Gunn V, Somani R, Muntaner C. Health care workers and migrant health: Pre- and post-COVID-19 considerations for reviewing and expanding the research agenda. J Migr Health 2021; 4:100048. [PMID: 34405193 PMCID: PMC8352207 DOI: 10.1016/j.jmh.2021.100048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022] Open
Abstract
The main purpose of this article is to review several ways in which health care workers could either impact migrant health or be directly impacted by migration and, based on this, suggest the expansion of the current research agenda on migration and health to address a range of topics that are currently either neglected, insufficiently researched, or researched from different perspectives. To ground this suggestion and emphasize the complexity and significance of migrant health research, we start by briefly reviewing several migration-related notions including the process of migration and its key facilitators and benefits; existing barriers to the provision of migrant health care; and the intricate links between health systems, health professionals, and migrant health. The three areas of research examined in this article address (i) the specific role of health workers in providing care to migrants and refugees and their capacity to do so, (ii) the health problems experienced by health workers who become migrants or refugees, and (iii) the precarious employment conditions experienced by both migrant and non-migrant health care workers. After summarizing the current available evidence on these topics, we discuss key information gaps and strategies to address them, while also incorporating several relevant COVID-19 pandemic considerations and research implications. Expanding the focus of research studies on migration and health could not only enhance the results of current strategies by supplying additional information to support their implementation but also spearhead the development of new solutions to the migrant health problem.
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Affiliation(s)
- Virginia Gunn
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
- Karolinska Institute, Sweden
| | - Rozina Somani
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
- Collaborative Specialization in Global Health, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Canada
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