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Hong Y, Chen M, Chen C, Qiu M. Abusive supervision and nursing students' intention to leave the nursing profession: a moderated mediation model of emotional exhaustion and the nurse-patient relationship. BMC Nurs 2024; 23:361. [PMID: 38816748 PMCID: PMC11137899 DOI: 10.1186/s12912-024-02025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Exploration of the relationship between nursing students' abusive supervision and their future intention to leave the nursing profession before completing the final clinical practicum is critical to the issue of nursing staff shortages and how to alleviate them. In order to further dissect the factors influencing turnover intention among student nurses in clinical practice, our study used the conservation of resources theory and job demands-resources model to explain the specific pathways that influence student nurses' intention to leave the nursing profession, with particular focus on nursing students' personality traits and certain organizational factors. METHOD This study followed a cross-sectional design. Between March and May 2022, a convenience sampling method was used to select 531 nursing students from two medical universities in Fuzhou. The Abusive Supervision, Emotional Exhaustion, Nurse-Patient Relationship, and Turnover Intention Scales were employed to collect data. The PROCESS macro (Models 4 and 7) for SPSS 25.0 by Hayes and 5,000 bootstrap samples were used to examine the moderation and mediation impacts. RESULTS Abusive supervision was found to significantly positively predict nursing students' intention to leave the nursing profession. Emotional exhaustion significantly mediated the relationship between abusive supervision and an intention to leave the nursing profession. The moderating effect of the nurse-patient relationship in the mediation model was also found to be significant. CONCLUSIONS Abusive supervision by clinical teaching staff is a work-related stressor that leads to emotional exhaustion, consequently decreasing nursing students' future intention to work as a nurse. A nurse-patient relationship based on trust could buffer the negative effect of abusive supervision on emotional exhaustion. Healthcare organizations and nurse educators should implement programs that educate and train individuals about abusive supervision, emotion regulation, and positive nurse-patient relationships; this would serve to decrease nursing students' intention to leave the nursing profession. This study provides relevant implications for helping nursing instructors develop effective intervention strategies to retain talented nursing personnel.
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Affiliation(s)
- Youjuan Hong
- School of Nursing, Fujian Medical University, Fuzhou, China.
| | - Meijing Chen
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Caimei Chen
- Critical Care Department, Longyan People's Hospital, Longyan, Fujian, China
| | - Meichai Qiu
- Center for information Management, Fujian Provincial Hospital, Fuzhou, Fujian, China
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Yu X, Li M, Du M, Wang Y, Liu Y, Wang H. Exploring factors that affect nurse staffing: a descriptive qualitative study from nurse managers' perspective. BMC Nurs 2024; 23:80. [PMID: 38291385 PMCID: PMC10829222 DOI: 10.1186/s12912-024-01766-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/25/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The appropriate nurse staffing reflects the situation of nursing management of human resources. Nurse managers have a pivotal role in determining a competent and sufficient number of nurses. It is important to understand the factors influencing nurse staffing to promote appropriate staffing levels. The study aimed to explore the factors affecting nurse staffing from the perspective of nursing managers. METHODS Purposive sampling was adopted to recruit 14 nurse managers from secondary and tertiary hospitals located in the central region of China, and semi-structured interviews via telephone were conducted from April to May 2022. Interview transcripts were analyzed and collated using thematic analysis. RESULTS This research identified four themes and ten subthemes influencing nurse staffing. Extracted themes include: government level (inadequacy of mandatory policies, budgetary constraints), hospital level (hospital characteristics, the control of nurse labor costs, inadequate support on nursing), patient level (patient characteristics, increasing care needs), and nurse level (nurse shortage, skill-mix, individual high-level needs). CONCLUSION The findings indicate that it is crucial for decision-makers or policymakers to legislate for safe nurse staffing and establish effective supervision and funding incentives. Tailored interventions are also needed to improve the organizational context, address the nurse workforce and balance the structure of nurse staff.
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Affiliation(s)
- Xiaoyan Yu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Miqi Li
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Meichen Du
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Ying Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Yu Liu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Hui Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China.
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Zhang S, Xiao X, Ai Y, Zhang A, Zhou C, Hu H, Wang Y. Challenges and coping experiences faced by nursing staff in long-term care facilities in China: a qualitative meta-analysis. Front Public Health 2024; 11:1302481. [PMID: 38259783 PMCID: PMC10800415 DOI: 10.3389/fpubh.2023.1302481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Objective The aim of this study is to discern the challenges and coping experiences encountered by nursing staff in long-term care facilities in China. This will be achieved through the identification, evaluation, and qualitative synthesis of comprehensive data. Design This is a qualitative meta-analysis. Methods The research systematically examined relevant literature sourced from six databases, concluding the search in August 2023. The inclusion criteria encompassed qualitative and mixed-methods studies in both Chinese and English, focusing on challenges faced by nursing staff in long-term care facilities and their corresponding coping strategies. The application of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework facilitated the qualitative meta-integration process. Three independent researchers meticulously screened and assessed the quality of the chosen studies. The synthesis process sought to amalgamate and structure analogous findings into novel categories through multiple readings of the original literature. These categories were subsequently distilled into comprehensive themes. Results Analyzed 15 articles revealed 14 sub-themes and 4 overarching analytical themes. These encompassed Sources of Challenges such as multitasking, clinical emergencies, workplace conflict, demand exceeding resources, and occupational discrimination. Psychological impacts included suppressed emotion, compassion fatigue, and self-doubt. Practical consequences involved damaged health, imbalanced life, and occupational disappointment. Coping strategies identified were self-adjusting, feeling validation and belonging, and finding support. Conclusion Our research identified the challenges faced by nursing staff in Chinese long-term care facilities and their coping experiences. We found that most challenges could be mitigated through appropriate adjustments in managerial strategies, such as reasonable human resources planning, and providing resource support, including material, emotional, and informational support. Similarly, institutions should have offered necessary emotional and psychological support to nursing staff to overcome the negative impacts of challenges and encourage them to adopt positive coping strategies.
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Affiliation(s)
- Shibo Zhang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xixi Xiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Older Adult, Wuhan, China
- Hubei Shizhen Laboratory, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei, China
| | - Ailin Zhang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Chunyi Zhou
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Older Adult, Wuhan, China
- Hubei Shizhen Laboratory, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei, China
| | - Yuncui Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Older Adult, Wuhan, China
- Hubei Shizhen Laboratory, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei, China
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Zhao J, Wu X, Chen Y, Li T, Han Y, Liu T, Liu Y. What Makes a Hospital Excellent? A Qualitative Study on the Organization and Management of Five Leading Public Hospitals in China. Risk Manag Healthc Policy 2023; 16:1915-1927. [PMID: 37746043 PMCID: PMC10516193 DOI: 10.2147/rmhp.s424711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose To summarize the organizational and management experiences and explore the organizational theoretical model of five leading public hospitals in China. Patients and Methods Purposive sampling was used to select five leading hospitals in different regions of China under the National Health Commission and Provincial Health Commission as study hospitals for the study. From August 2021 to March 2022, 8 leaders and 39 managers from these hospitals were surveyed using semi-structured interviews. The data and information were analyzed in four dimensions using thematic analysis and grounded theory, focused on summarizing the experiences and practices of China's leading hospitals in organizational system, culture, operations and performance management, and employee development. This study complied with the COREQ guidelines for reporting qualitative research. Results An organizational system model of the characteristics of hospital excellence was developed using four core attributes: organizational system, organizational culture, operations and performance management, and employee development; the model was named the System-Culture-Operation-Performance-Employee (SCOPE) model. Organization and management among leaders and managers in China's leading hospitals are based on the SCOPE process, resulting in employees' well-being, patients' positive outcomes, and organizational excellence. In terms of hospital culture, while adhering to the Hippocratic Oath, the hospital is deeply influenced by traditional Chinese culture, which emphasizes "benevolence" and "love", leading all staff to adhere to "patient-centered care and service." In terms of operations management, a separate operations management department is responsible for hospital operations and performance assessment. As for employee development, the staff's sense of reverence for their profession is emphasized and a reasonable salary system and good practice environment are established to promote staff motivation. Conclusion The SCOPE model reveals the perspectives of leaders and managers in China's leading hospitals regarding organization and management under a Chinese cultural background. These findings can complement the existing literature on hospital management systems.
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Affiliation(s)
- Jinhong Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Xue Wu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yuan Chen
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Tao Li
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yunrui Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
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Chen W, Ma Y, Yu C. Unmet chronic care needs and insufficient nurse staffing to achieve universal health coverage in China: Analysis of the Global Burden of Disease Study 2019. Int J Nurs Stud 2023; 144:104520. [PMID: 37295284 DOI: 10.1016/j.ijnurstu.2023.104520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/21/2023] [Accepted: 04/24/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although China has made impressive progress towards Universal Health Coverage through the health system reform plan since 2009, chronic disease prevention and control implementations are still inadequate to meet the need at large. This study aims to quantify the acute and chronic care needs in China and examine the human resources for health and financial protection for the population to achieve Universal Health Coverage. METHODS The data on disability-adjusted life years, years lived with disability, and years of life lost in China were disaggregated from the Global Burden of Diseases Study 2019 by age and sex based on acute care need or chronic care need. An auto-regressive integrated moving average model was deployed to predict the supply gap of physicians, nurses and midwives from 2020 to 2050. Out-of-pocket health expenditure was compared among China, Russia, Germany, the US, and Singapore to examine the current status of financial protection. RESULTS In 2019, conditions requiring chronic care accounted for 86.4% of all-cause, all-age disability-adjusted life years in China, while acute-care-need conditions accounted for 11.3%. Approximate 25.57% of disability-adjusted life years in communicable diseases and 94.32% in non-communicable diseases were caused by chronic care need conditions. Chronic care-need conditions accounted for more than 80% of both man and woman's disease burden. The proportion of disability-adjusted life years and years of life lost attributable to chronic care was greater than 90% in people aged 25 and up. The nurse and midwife supply will be in absolute shortage and unable to achieve effective universal health coverage effective coverage of 80% or 90% from 2020 to 2050, while the physician supply will be sufficient to maintain effective universal health coverage of 80% and reach 90% from 2036. The out-of-pocket health expenditure decreased with time but was still relatively higher than that of Germany, the US, and Singapore. CONCLUSIONS The present study demonstrates the chronic care needs outweigh those for acute care in China. Nurse supply and the financial protection for the poor were still inadequate to achieve Universal Health Coverage. Better workforce planning and concerted actions on chronic care prevention and control should be taken to meet the population's chronic care needs.
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Affiliation(s)
- Wen Chen
- School of Public Health, Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Yudiyang Ma
- Department of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanhua Yu
- School of Public Health, Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China.
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Hong Y, Qiu M, Liu L, Huang F, Wang K, Lin R. Surface acting, emotional exhaustion, career calling and turnover intention among student nurses: A cross-sectional study. Nurse Educ Pract 2023; 69:103641. [PMID: 37060732 DOI: 10.1016/j.nepr.2023.103641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/17/2023]
Abstract
AIM This study aims to explore the mediating role of emotional exhaustion and the moderating role of career calling in the linkage of surface acting and turnover intention among student nurses in the final clinical practicum. BACKGROUND Turnover rates are especially high for graduating nursing students. Surface acting is considered an important factor that affects this rate among nurses. However, little is known about the relationships between surface acting and turnover intentions among graduating nursing students in the final clinical practicum. DESIGN The current research is a cross-sectional study, and the data were collected from 8 January 2022-22 January 2022. METHODS A survey was completed by 275 graduating nursing students. This survey included Chinese translations of scales measuring surface acting, emotional exhaustion, career calling and turnover intentions. RESULTS Both surface acting (r = 0.47, p < 0.001) and emotional exhaustion (r = 0.59, p < 0.001) correlated positively with turnover intentions. Both surface acting (r = -0.41, p < 0.001) and emotional exhaustion (r = -0.62, p < 0.001) correlated negatively with career calling and career calling (r = -0.72, p < 0.001) correlated negatively with turnover intentions. The association between surface acting and turnover intention was mediated by emotional exhaustion. In addition, career calling moderated the relationship between surface acting and emotional exhaustion. CONCLUSIONS Surface acting results in higher emotional exhaustion and higher turnover intention among graduating nursing students, which was more pronounced among nursing students with a lower sense of career calling.
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Affiliation(s)
- Youjuan Hong
- School of Nursing, Fujian Medical University, Fuzhou, China.
| | - Meicha Qiu
- Center for Information Management, Fujian Provincial Hospital, Fuzhou, China
| | - Liting Liu
- School of Management Studies, Shanghai University of Engineering Science, Shanghai, China
| | - Fajie Huang
- School of Health, Fujian Medical University, Fuzhou, China
| | - Kaixuan Wang
- Departmentof Student Affairs, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rongmao Lin
- School of Psychology, Fujian Normal University, Fuzhou, China.
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Hessulf F, Herlitz J, Lundgren P, Aune S, Myredal A, Engdahl J, Rawshani A. Temporal variation in survival following in-hospital cardiac arrest in Sweden. Int J Cardiol 2023; 381:112-119. [PMID: 37023863 DOI: 10.1016/j.ijcard.2023.03.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/03/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The aim of the study was to investigate what characterizes IHCAs that take place during the "day" (Monday-Friday 7 am-3 pm), "evening" (Monday-Friday 3 pm-9 pm) and "night" (Monday-Friday 9 pm-7 am and Saturday-Sunday 12 am- 11.59 pm). METHODS We used the Swedish Registry for CPR (SRCR) to study 26,595 patients from January 1, 2008 to December 31, 2019. Adult patients ≥18 years with a IHCA where resuscitation was initiated were included. Uni- and multivariable logistic regression was used to investigate associations between temporal factors and survival to 30 days. RESULTS 30-day survival and Return of Spontaneous Circulation (ROSC) was 36.8% and 67.9% following CA during the day and decreased during the evening (32.0% and 66.3%) and night (26.2% and 60.2%) (p < 0.001 and p = 0.028). When comparing the survival rates between the day and the night, survival decreased more (change in relative survival rates) in small (<99 beds) compared to large (<400) hospitals (35.9% vs 25%), in non-academic vs academic hospitals (33.5% vs 22%) and on non-Electro Cardiogram (ECG)-monitored wards vs ECG-monitored wards (46.2% vs 20.9%) (p < 0.001 for all). IHCAs that took place during the day (adjusted Odds Ratio (aOR) 1.47 95% CI 1.35-1.60), in academic hospitals (aOR 1.14 95% CI 1.02-1.27) and in large (>400 beds) hospitals (aOR 1.31 95% CI 1.10-1.55) were independently associated with an increased chance of survival. CONCLUSIONS Patients suffering an IHCA have an increased chance of survival during the day vs the evening vs night, and the difference in survival is even more pronounced when cared for at smaller, non-academic hospitals, general wards and wards without ECG-monitoring capacity.
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Affiliation(s)
- Fredrik Hessulf
- Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Göteborgsvägen 31, Mölndal 431 30, Sweden; Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Johan Herlitz
- PreHospen - Centre of Prehospital Research, Academy of Caring Science, Welfare and Work Life, University of Borås 501 90 Borås, Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Peter Lundgren
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg SE-405 30, Sweden.
| | - Solveig Aune
- Unit for EMS-coordination, Provider Governance and Coordination, Head Office, Region Västra Götaland, Vänersborg SE 462 80, Sweden.
| | - Anna Myredal
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Johan Engdahl
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm 182 88, Sweden.
| | - Araz Rawshani
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg SE-405 30, Sweden.
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Challinor J. Global Oncology Nursing Recruitment and Retention: A SWOT Analysis. Semin Oncol Nurs 2023; 39:151361. [PMID: 36621414 DOI: 10.1016/j.soncn.2022.151361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation. DATA SOURCES Data sources include published and grey literature from around the world. CONCLUSION Despite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses' autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing. IMPLICATIONS FOR NURSING PRACTICE Governments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.
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Affiliation(s)
- Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco.
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Luo Z, Liu S, Li Y, Zhong S. Under the chest pain center mechanism, whether the nursing handover affects the nursing efficiency and the outcomes of patients with STEMI in the emergency department? A retrospective study. BMC Emerg Med 2023; 23:3. [PMID: 36635636 PMCID: PMC9835307 DOI: 10.1186/s12873-023-00773-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The introduction of chest pain centers (CPC) in China has achieved great success in shortening the duration of nursing operations to significantly improve the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The nursing handover period is still considered the high incidence period of adverse events because of the distractibility of nurses' attention, potential interruption, and unclear responsibilities. Under the CPC mechanism, the nursing efficiency and patients' outcome, whether affected by the nursing handover, is still a knowledge gap in research. This is also the aim of this study. METHODS A retrospective study was conducted with data from STEMI patients from a tertiary hospital in the north of Sichuan Province from January 2018 to December 2019 through the Chinese CPC database. Patients are divided into handover and non-handover groups according to the time they presented in the Emergency Department. D2FMC, FMC2FE, FMC2BS, FMC2CBR, FMC2FAD, and D2W were selected to measure nursing efficiency. The occurrence of major adverse cardiovascular events, the highest troponin values within 72 h of hospitalization, and the length of hospitalization were selected to measure the patient outcomes. Continuous variables are summarized as mean ± SD, and t-tests of the data were performed. P-values < 0.05 (two-tailed) were considered statistically significant. RESULTS A total of 231 cases were enrolled, of which 40 patients (17.3%) were divided into the handover period group, and 191 (82.6%) belonged to the non-handover period group. The results showed that the handover period group took significantly longer on items FMC2BS (P < 0.001) and FMC2FAD (P < 0.001). Still, there were no significant differences in D2FMC and FMC2FE, and others varied too little to be clinically meaningful, as well as the outcomes of patients. CONCLUSION This study confirms that nursing handover impacts the nursing efficiency of STEMI patients, especially in FMC2BS and FMC2FAD. Hospitals should also reform the nursing handover rules after the construction of CPC and enhance the triage training of nurses to assure nursing efficiency so that CPC can play a better role.
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Affiliation(s)
- Zhenyu Luo
- Guanyuan Central Hospital, Guangyuan, Sichuan China
| | - Sihui Liu
- grid.429222.d0000 0004 1798 0228The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yunying Li
- Guanyuan Central Hospital, Guangyuan, Sichuan China
| | - Shuyan Zhong
- Guanyuan Central Hospital, Guangyuan, Sichuan China
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Wu Y, Hua W, Zhu D, Onishi R, Yang Y, Hasegawa T. Cross-cultural adaptation and validation of the Chinese version of the revised surveys on patient safety culture™ (SOPS®) hospital survey 2.0. BMC Nurs 2022; 21:369. [PMID: 36572930 PMCID: PMC9792160 DOI: 10.1186/s12912-022-01142-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/09/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey (HSOPS 1.0), developed by the U.S. Agency for Healthcare Research and Quality in 2004, has been widely adopted in the United States and internationally. An updated version, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019, has not yet been applied in China. The aim of the present study was to translate HSOPS 2.0 into Chinese version with cross-cultural adaptations and test its psychometric properties. METHODS A convenience sample was used. Hospital nurses (N = 1013) and a sub-set (n = 200) was invited for the re-test. A three-stage study was conducted. Firstly, the HSOPS 2.0 was translated by a panel. Secondly, the content validity was tested using the two-round Delphi method and cognitive interview. Next, the construct validity was tested by the confirmatory factor analysis and further demonstrated by the convergent validity, discriminant validity, and correlations with the outcome of patient safety. Thirdly, the reliability was tested by internal consistency reliability and re-test reliability. RESULTS The "float or PRN" and "manager" words were deleted as considered unfitted for the Chinese health care system. The content validity index provided evidence of strong content validity (I-CVI = 0.84 ~ 1.00, S-CVI = 0.98). Confirmatory factor analysis revealed a good model fit (χ2/df = 4.05, RMSEA = 0.06, CFI = 0.94) and acceptable factor loadings (0.41 ~ 0.97). Convergent validity, and discriminant validity supported the factorial structure of the Chinese version of HSOPS 2.0. Further evidence for the construct validity was derived from correlations with the outcome of patient safety (r = 0.10 ~ 0.41). A good internal consistency (Cronbach's α = 0.68 ~ 0.93, McDonald's omega = 0.84 ~ 0.96) and test-retest reliability (ICC = 0.78 ~ 0.95) showed acceptable reliability. Additionally, Chinese nurses reported markedly lower scores for three dimensions, including "Response to Error", "Communication Openness", and "Reporting Patient Safety Events", when comparing the findings of this study with those from U.S. research utilizing the HSOPS 2.0. CONCLUSION The Chinese version of HSOPS 2.0 demonstrated good validity and reliability in a Chinese sample of hospital nurses, which suggests that it can be used to measure nurse-perceived patient safety culture in future research and practice. Psychometric properties of the Chinese version of HSOPS 2.0 among other Chinese healthcare professionals remain to be confirmed.
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Affiliation(s)
- Yinghui Wu
- grid.16821.3c0000 0004 0368 8293School of Nursing, Shanghai Jiao Tong University, 227 S Chongqing Rd, Shanghai, 200025 China
| | - Wenzhe Hua
- grid.16821.3c0000 0004 0368 8293School of Nursing, Shanghai Jiao Tong University, 227 S Chongqing Rd, Shanghai, 200025 China
| | - Daqiao Zhu
- grid.16821.3c0000 0004 0368 8293School of Nursing, Shanghai Jiao Tong University, 227 S Chongqing Rd, Shanghai, 200025 China
| | - Ryo Onishi
- grid.265050.40000 0000 9290 9879Department of Social Medicine, Toho University School of Medicine, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540 Japan
| | - Yanna Yang
- grid.16821.3c0000 0004 0368 8293School of Nursing, Shanghai Jiao Tong University, 227 S Chongqing Rd, Shanghai, 200025 China
| | - Tomonori Hasegawa
- grid.265050.40000 0000 9290 9879Department of Social Medicine, Toho University School of Medicine, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540 Japan
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11
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Zhang J, Cao Y, Su M, Cheng J, Yao N. The experiences of clinical nurses coping with patient death in the context of rising hospital deaths in China: a qualitative study. BMC Palliat Care 2022; 21:163. [PMID: 36138401 PMCID: PMC9494800 DOI: 10.1186/s12904-022-01054-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Chinese clinical nurses are increasingly confronting patient death, as the proportion of hospital deaths is growing. Witnessing patient suffering and death is stressful, and failure to cope with this challenge may result in decreased well-being of nurses and impediment of the provision of “good death” care for patients and their families. To our knowledge, few studies have specifically explored clinical nurses’ experiences coping with patient death in mainland China. Objective We aimed to explore nurses’ experiences coping with patient death in China in order to support frontline clinical nurses effectively and guide the government in improving hospice care policy. Methods Clinical nurses were recruited using purposive and snowball sampling between June 2020 and August 2020. We gathered experiences of clinical nurses who have coped with patient death using face-to-face, semi-structured, in-depth interviews. Audio recordings were transcribed verbatim and analyzed using thematic analysis. Results Three thematic categories were generated from data analysis. The first was “negative emotions from contextual challenges.” This category involved grief over deaths of younger persons, pity for deaths without family, and dread related to coping with patient death on night duty. The second category was “awareness of mortality on its own.” Subthemes included the ideas that death means that everything stops being and good living is important because we all die and disappear. The third category was “coping style.” This category included focusing on treating dying patients, recording the signs and symptoms, and responding to changes in the patient’s condition. It also involved subthemes such as avoiding talk about death due to the grief associated with dying and death, and seeking help from colleagues. Conclusions Clinical nurses’ emotional experiences are shaped by intense Chinese filial love, charity, and cultural attitudes towards death. Reasonable nurse scheduling to ensure patient and staff safety is a major priority. “Good death” decisions based on Chinese ethical and moral beliefs must be embedded throughout hospital care. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01054-8.
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Affiliation(s)
- Jinxin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.,School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Joyce Cheng
- Johns Hopkins University School of Medicine, Baltimore, United States
| | - Nengliang Yao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
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12
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Xu M, Chen D, Li H, Wang H, Yang LZ. The Cycling Brain in the Workplace: Does Workload Modulate the Menstrual Cycle Effect on Cognition? Front Behav Neurosci 2022; 16:856276. [PMID: 35722191 PMCID: PMC9201761 DOI: 10.3389/fnbeh.2022.856276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
Recent decades have witnessed increased research efforts to clarify how the menstrual cycle influence females’ cognitive and emotional functions. Despite noticeable progress, the research field faces the challenges of inconsistency and low generalizability of research findings. Females of reproductive ages are a heterogeneous population. Generalizing the results of female undergraduates to women in the workplace might be problematic. Furthermore, the critical cognitive processes for daily life and work deserve additional research efforts for improved ecological validity. Thus, this study investigates cognitive performance across the menstrual cycle using a sample of young nurses with similar duties. We developed a mini-computerized cognitive battery to assess four mental skills critical for nursing work: cognitive flexibility, divided attention, response inhibition, and working memory. Participants completed the cognitive battery at menses, late-follicular, and mid-luteal phases. In addition, they were classified into low- and high workload groups according to their subjective workload ratings. Our results demonstrate a general mid-luteal cognitive advantage. Besides, this study reveals preliminary evidence that workload modulates the menstrual cycle effect on cognition. Only females of low workload manifest the mid-luteal cognitive advantage on divided attention and response inhibition, implying that a suitable workload threshold might be necessary for regular neuro-steroid interactions. Thus, this study advocates the significance of research focusing on the cycling brain under workloads.
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Affiliation(s)
- Min Xu
- Bengbu Medical College, Bengbu, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Dandan Chen
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
| | - Hai Li
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Hongzhi Wang
- Bengbu Medical College, Bengbu, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- *Correspondence: Hongzhi Wang,
| | - Li-Zhuang Yang
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- Li-Zhuang Yang,
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13
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Fu X, You L, Liu X, Zheng J, Gubrud-Howe P, Liu J, Li M, Wan L. Developing trends of initial nursing education in China from 2006 to 2017: A descriptive analysis based on national-level data. NURSE EDUCATION TODAY 2022; 110:105271. [PMID: 35063780 DOI: 10.1016/j.nedt.2022.105271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/15/2021] [Accepted: 01/10/2022] [Indexed: 05/15/2023]
Abstract
INTRODUCTION There is currently a global nurse shortage. Initial nursing education is the primary preparation for a robust nursing workforce that must be strengthened. OBJECTIVES To describe the developing trends of initial nursing education in China from 2006 to 2017 and to analyze related characteristics and issues. DESIGN A descriptive study with secondary data analysis. METHODS The numbers, educational-level composition and regional distribution (i.e., East, Central, West, and Northeast regions) of students recruited into initial nursing education programs from 2006 to 2017 were analyzed. Changes in the numbers of the nursing workforce from 2006 to 2020 were compared with the changes in education sector to facilitate an interpretation of the development trend of initial nursing education. RESULTS The number of recruits into initial nursing education programs has increased from 0.38 million in 2006 to 0.44 million in 2008, and maintained between 0.5 million and 0.54 million during 2009 to 2017. Students recruited to secondary diploma, advanced diploma, and baccalaureate degree programs accounted for 50.55% (71.46% in 2009), 39.36% and 10.09% of the total in 2017, respectively. There were 3.34 nurses per 1000 population in 2020, a substantial increase from 1.09 in 2006. The regional distribution of recruits was imbalanced, with more recruits per 1000 population in the West (0.49), Central (0.40), Northeast (0.34) and the least in the East (0.26) in 2017. The distribution of nurses was relatively balanced among the four regions. CONCLUSIONS The development in initial nursing education in China is significant from 2006 to 2017. The education sector recruited and graduated about 0.5 million nursing students respectively per year in recent years. If simply considering the number of recruits, it could meet the workforce demands, however, to further upgrade nurses' educational preparation, the recruits into advanced diploma and baccalaureate degree programs need to be increased. A maldistribution of recruits among regions persists, while the distribution of nurses is relatively balanced. Multiple strategies should be adopted to achieve a balance between the supply and demand of nurses, with providing more higher-educated nurses in all regions across mainland China.
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Affiliation(s)
- Xue Fu
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Liming You
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Xu Liu
- Department of Infectious Disease, Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China.
| | - Jing Zheng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Paula Gubrud-Howe
- School of Nursing, Oregon Health & Science University, Portland, OR, USA.
| | - Jiali Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, China.
| | - Mengqi Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Lihong Wan
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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14
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A Pathfinding Algorithm for Lowering Infection Exposure of Healthcare Personnel Working in Makeshift Hospitals. Healthcare (Basel) 2022; 10:healthcare10020344. [PMID: 35206958 PMCID: PMC8872626 DOI: 10.3390/healthcare10020344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 12/10/2022] Open
Abstract
Due to the recent COVID-19 outbreak, makeshift (MS) hospitals have become an important feature in healthcare systems worldwide. Healthcare personnel (HCP) need to be able to navigate quickly, effectively, and safely to help patients, while still maintaining their own well-being. In this study, a pathfinding algorithm to help HCP navigate through a hospital safely and effectively is developed and verified. Tests are run using a discretized 2D grid as a representation of an MS hospital plan, and total distance traveled and total exposure to disease are measured. The influence of the size of the 2D grid units, the shape of these units, and degrees of freedom in the potential movement of the HCP are investigated. The algorithms developed are designed to be used in MS hospitals where airborne illness is prevalent and could greatly reduce the risk of illness in HCP. In this study, it was found that the quantum-based algorithm would generate paths that accrued 50–66% less total disease quantum than the shortest path algorithm with also about a 33–50% increase in total distance traveled. It was also found that the mixed path algorithm-generated paths accrued 33–50% less quantum, but only increased total distance traveled by 10–20%.
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15
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Pan C, Wang H, Chen M, Cai Y, Li P, Xiao C, Tang Q, Koniak-Griffin D. Stress and Coping in Nurses Taking Care of People Living with HIV in Hunan, China: A Descriptive Qualitative Study. Neuropsychiatr Dis Treat 2022; 18:303-315. [PMID: 35210777 PMCID: PMC8860345 DOI: 10.2147/ndt.s341151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/27/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/PURPOSE Nurses engaged in the care of people living with HIV (PLWH) are commonly exposed to workplace stress. This study aimed to explore the stress experiences and coping strategies among nurses taking care of PLWH in China. METHODS Nurses were recruited from the AIDS department of a public, general, third-grade class-A hospital, which has the largest HIV care department in the Hunan Province of China. Thirty-three nurses working in the AIDS Department were recruited in this qualitative study. Eight nurses participated in a focus group and 25 nurses underwent in-depth individual interviews aimed at characterizing the nurse's feelings and struggles with stress during caregiving for PLWH. The interviews were audio-recorded, transcribed verbatim, anonymized, and imported into NVivo 8.0 software. The data were coded and subjected to thematic analysis. RESULTS Concerns about occupational exposure, heavy workload, mental health problems and risk behaviors of patients, and discrimination towards nurses caring for PLWH were the four main sources of stress. The negative impact of stress included problems with emotion regulation, somatic health and sleep, and work performance. Some participants also reported a positive impact of work stress on their mental health. Using personality strengths, problem-solving, help-seeking, concealing and avoiding/suppression were common coping strategies employed by nurses caring for PLWH. CONCLUSION Our findings help characterize the stress experienced by nurses caring for PLWH in the Chinese cultural context, and may inform specific interventions to help manage stress and promote mental health of nurses.
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Affiliation(s)
- Chen Pan
- Department of Clinical Psychology, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Honghong Wang
- Department of Fundamental Nursing, Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Minzhen Chen
- Department of AIDS, The First Hospital of Changsha, Changsha, People's Republic of China
| | - Yu Cai
- Department of Clinical Psychology, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Peihuan Li
- College of Resources of Environment, Hunan Agricultural University, Changsha, People's Republic of China
| | - Changgen Xiao
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Qiuping Tang
- Department of Clinical Psychology, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
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16
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Song J, Chen C, Zhao S, Zhou L, Chen H. Trading quality for quantity? Evidence from patient level data in China. PLoS One 2021; 16:e0257127. [PMID: 34529680 PMCID: PMC8445449 DOI: 10.1371/journal.pone.0257127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
In China, overcrowding at hospitals increases the workload of medical staff, which may negatively impact the quality of medical services. This study empirically examined the impact of hospital admissions on the quality of healthcare services in Chinese hospitals. Specifically, we estimated the impact of the number of hospital admissions per day on a patient's length of stay (LOS) and hospital mortality rate using both ordinary least squares (OLS) and instrumental variable (IV) methods. To deal with potential endogeneity problems and accurately identify the impact of medical staff configuration on medical quality, the daily air quality index was selected as the IV. Furthermore, we examined the differential effects of hospital admissions on the quality of care across different hospital tiers. We used the data from a random sample of 10% of inpatients from a city in China, covering the period from January 2014 to June 2019. Our final regression analysis included a sample of 167 disease types (as per the ICD-10 classification list) and 862,722 patient cases from 517 hospitals. According to our results, the LOS decreased and hospital mortality rate increased with an increasing number of admissions. Using the IV method, for every additional hospital admission, there was a 6.22% (p < 0.01) decrease in LOS and a 1.86% (p < 0.01) increase in hospital mortality. The impact of healthcare staffing levels on the quality of care varied between different hospital tiers. The quality of care in secondary hospitals was most affected by the number of admissions, with the average decrease of 18.60% (p < 0.05) in LOS and the increase of 6.05% (p < 0.01) in hospital mortality for every additional hospital admission in our sample. The findings suggested that the supply of medical services in China should be increased and a hierarchical diagnosis and treatment system should be actively promoted.
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Affiliation(s)
- Jinglin Song
- Department of Public Economic System and Policy, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
- * E-mail:
| | - Chen Chen
- Department of Finance, School of Public Finance & Economics, Shanxi University of Finance and Economics, Taiyuan, Shanxi, China
| | - Shaoyang Zhao
- Department of Economics, Sichuan University, Chengdu, China
| | - Leming Zhou
- Computer Science and Information Technology College of Chongqing Post and Telecommunication, Chongqing, China
- Department of Statistics and Development Research, Chongqing Health Information Center, Chongqing, China
| | - Hong Chen
- Chongqing Institute of Translational Medicine, University of Chinese Academy of Sciences, Chongqing, China
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17
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Huang Q, Tian C, Zeng XT. Poor Sleep Quality in Nurses Working or Having Worked Night Shifts: A Cross-Sectional Study. Front Neurosci 2021; 15:638973. [PMID: 34413721 PMCID: PMC8369413 DOI: 10.3389/fnins.2021.638973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/07/2021] [Indexed: 11/23/2022] Open
Abstract
Night shifts are part of clinical care. It is unclear whether poor sleep quality of nurses working both consecutive night shifts and day shifts after quitting night shifts is common. In this cross-sectional study, Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality as study outcome. Univariable and multivariable linear and logistic regressions were performed to compare PSQI score and prevalence of poor sleep quality between 512 nurses currently working consecutive night shifts and 174 nurses having worked night shifts in the past. The prevalence of poor sleep quality was 62.11% in nurses working consecutive night shifts and 55.75% in nurses having worked night shifts before. In multivariable regressions with adjustment for potential confounders, compared with nurses working consecutive night shifts, nurses having worked past night shifts reported decreased PSQI score [mean difference: −0.82 (95% CI: −1.27 to −0.38, p < 0.001)] and lower poor sleep quality [odds ratio (OR): 0.49 (95% CI: 0.29 to 0.80, p = 0.005)]. In nurses working consecutive night shifts, a rising curve that plateaued at the end was observed between years of consecutive night shifts and PSQI score, p = 0.004. To explore the change in PSQI score after quitting night shift, we constructed a hypothetical prospective cohort from the cross-sectional data. Here, 98 pairs of nurses with consecutive and past night shifts were matched for the number of night shift years, religion, marital status, living condition, hypertension, and hyperlipidemia. In each pair, a hypothetical change in PSQI score was calculated between the two types of nurses and hypothetical years after quitting night shifts was obtained from the matched nurse with past night shifts. A U-shaped curve between change in PSQI and years after quitting night shifts was observed, p = 0.007. The rising curve and U-shaped curve together formed an S-shaped curve, which mapped the change in sleep quality. These results based on the hypothetical cohort constructed from cross-sectional data suggested the presence of persistent poor sleep quality in night shift nurses. Also, we support early and continuous sleep hygiene education and reflection for an optimal strategy for when to cease working night shifts with regard to sleep-related problems.
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Affiliation(s)
- Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
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18
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Dousin O, Wei CX, Balakrishnan BKPD, Lee MCC. Exploring the mediating role of flexible working hours in the relationship of supervisor support, job and life satisfaction: A study of female nurses in China. Nurs Open 2021; 8:2962-2972. [PMID: 34390214 PMCID: PMC8510763 DOI: 10.1002/nop2.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/19/2021] [Accepted: 07/10/2021] [Indexed: 11/08/2022] Open
Abstract
Aims To examine the mediating role of flexible working hours on the relationship between supervisor support, job and life satisfaction among female nurses in China. Design A cross‐sectional, quantitative study was conducted with online survey questionnaires. Methods Convenience sampling was implemented with 171 female nurses from two tertiary public hospitals in 2019. Results The mediation analysis demonstrates that flexible working hours significantly and positively mediate the relationship between supervisor support to job (β = 0.775, p < .001) and life satisfaction (β = 0.745, p < .001). In addition, supervisor support and flexible working hours significantly and positively influence job (r = 0.520, p < .01; r = 0.520, p < .01) and life satisfaction (r = 0.487, p < .01; r = 0.487, p < .01). The study suggested that flexible working hours iarean indicator of what supervisor support (r = 0.656, p < .01) is to improve nurses’ job and life satisfaction. The study revealed that flexible working hours and supervisor support are crucial to female nurses who face high demands at both work and home.
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Affiliation(s)
- Oscar Dousin
- Faculty of Business, Economics and Accountancy, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Chen Xi Wei
- Teacher Development Centre, Guangxi Vocational College of Safety Engineering, Guangxi Zhuang Autonomous Region, China
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Mezgebu E, Anwarali S, Durañona M, Challinor J. Pediatric Oncology Nursing Research in Low- and Middle-Income Countries: Exemplars from Three Regions. Semin Oncol Nurs 2021; 37:151168. [PMID: 34148741 DOI: 10.1016/j.soncn.2021.151168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined the status of pediatric oncology nursing research in three low- and middle-income countries (LMICs) as examples across three World Health Organization regions: East Africa, Eastern Mediterranean region, and Latin America. DATA SOURCES Published literature was identified from Google Scholar, PubMed, Scielo, Virtual Health Library, and reference lists of some articles. CONCLUSION The experiences of the three LMIC pediatric oncology nurses illustrate the situation of nurse research in their setting and identify relevant published literature. The authors highlight the challenges for nurses to conduct research (eg, lack of training, mentors, funding, and opportunities). Local evidence to inform nursing practice in LMICs is needed. Recommendations for ameliorating the situation include increased advanced practice nurse education, physician and hospital support, funding, and protected time. IMPLICATIONS FOR NURSING PRACTICE Pediatric oncology nursing practice is culturally and context-driven and requires locally acquired evidence to support best practices. Only when sufficient, sustainable, and local nursing research training and education is available in LMICs, will this evidence be generated. Nursing research training (eg, master's and PhD programs), funding, and protected time are three key steps to guide and motivate staff nurses as well as academic nurses to participate in research that informs the care of children and adolescents with cancer across all countries and not only those with significant resources.
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Affiliation(s)
| | - Shenila Anwarali
- Pediatric Oncology Department, Indus Hospital, Karachi, Pakistan
| | | | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, CA.
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20
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Chen J, Zou Q, Chen X, Liu X, Ding S, Mo Y, Yao S. Quality of life in patients with endometrial carcinoma: A Longitudinal Study. Nurs Open 2021; 9:1815-1821. [PMID: 34009689 PMCID: PMC8994958 DOI: 10.1002/nop2.927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/12/2021] [Accepted: 04/14/2021] [Indexed: 12/24/2022] Open
Abstract
AIM To investigate the quality of life in patients with endometrial carcinoma and provide theoretical basis for nursing care. DESIGN In this study, 69 patients diagnosed with endometrial carcinoma from 2016-2018 were included in the cohort. METHODS Sixty-nine patients from our hospital who underwent endometrial cancer surgeries were selected. The SF-36 was used to investigate and analyse the patients' quality of life in the first, second and third months after their operations. Questionnaires were administered to analyse the factors affecting postoperative quality of life. RESULTS Quality of life for the second and third months was obviously better than that for the first month after the operation (p < .05). Based on multivariate regression analysis, we found that patients with higher family income had better quality of life after surgery(p < .05). These results can provide some guidance for daily nursing work after endometrial cancer operation.
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Affiliation(s)
- Jiebing Chen
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiaojian Zou
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xuanmin Chen
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaochen Liu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Sha Ding
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yinglei Mo
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shuzhong Yao
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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21
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Du H, Yang Y, Wang X, Zang Y. A cross-sectional observational study of missed nursing care in hospitals in China. J Nurs Manag 2020; 28:1578-1588. [PMID: 32726867 PMCID: PMC7589234 DOI: 10.1111/jonm.13112] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 01/22/2023]
Abstract
Aim To identify the risk of missed nursing care (MNC), and contributing factors, in Chinese hospitals. Background National reporting of adverse incidents diminishes errors of commission. To further improve service quality and patient safety, MNC should be reduced. Methods An online survey comprising the MISSCARE Survey and the McCloskey/Mueller Satisfaction Scale was conducted with a convenience sample of nurses (n = 6,158) in 34 Chinese hospitals. Results Participants’ mean age was 30.6 (SD = 7.014), and 2.5% were male. The most frequently missed nursing care items were basic care (12.7%–51.8%). The most frequently reported reasons were human resource issues (63.1%–88.2%). Being female, no child, better educated, a manager, permanently employed, no night shift, inadequate friend support and job dissatisfaction influenced the perception of MNC (odds ratio 1.00–4.848). Conclusions MNC often occurred in basic care involving informal caregivers or in surge status due to a sudden increase in workload. Implications for Nursing Management Nurse managers should prioritize effective measures that target delegation competency and mobilization of nurses for flexible repositioning during need.
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Affiliation(s)
- Hongxia Du
- Department of Nursing, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yuanyuan Yang
- School of Nursing, Cheeloo College of Nursing, Shandong University, Jinan, Shandong Province, China
| | - Xiaohong Wang
- Department of Nursing, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China
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