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The relationship between occupational stress and the quality of nursing care in the operating room (OR) is an area that has not been thoroughly explored in the literature. The present study was designed to examine the correlation between job-related stress and the quality of care delivered by nurses in the OR setting.
A cross-sectional survey was administered to OR nurses at our institution from 1 April to 30 April 2023. Participants were asked to complete a demographic questionnaire and several validated scales: the Good Perioperative Nursing Care Scale (GPNCS), the Operating Room Nurses' Job Stressor Scale (ORNJSS), the Self-rating Anxiety Scale (SAS), and the Self-rating Depression Scale (SDS).
A total of 171 OR nurses participated. The mean score for nursing quality was 143.01 (SD 19.44), job stressors scored an average of 94.12 (SD 22.57), anxiety scores averaged 54.13 (SD 15.76), and depression scores averaged 59.41 (SD 15.03). A robust inverse correlation was identified between the nursing quality score and the job stressor score (r = −0.641). Furthermore, the nursing quality score exhibited significant negative correlations with both anxiety (r = −0.658) and depression (r = −0.626) scores.
The findings of this study demonstrate a substantial inverse correlation between the quality of perioperative nursing care and the intensity of occupational stressors, as well as the prevalence of anxiety and depressive symptoms among OR nurses. It is imperative for hospital management to contemplate and implement interventions aimed at mitigating work-related stress and bolstering the psychological well-being of OR nursing staff.
by Xin Zhang, Zijian Xi, Min Yang, Xiuqin Zhang, Ruikai Wu, Shuang Li, Lu Pan, Yuan Fang, Peng Lv, Yan Ma, Haiping Duan, Bingling Wang, Kunzheng Lv
BackgroundIt is crucial to comprehend the interplay between air pollution and meteorological conditions in relation to population health within the framework of "dual-carbon" targets. The purpose of this study was to investigate the impact of intricate environmental factors, encompassing both meteorological conditions and atmospheric pollutants, on respiratory disease (RD) mortality in Qingdao, a representative coastal city in China.
MethodsThe RD mortality cases were collected from the Chronic Disease Surveillance Monitoring System in Qingdao during Jan 1st, 2014 and Dec 31st, 2020. The distributed-lag nonlinear model and generalized additivity model were used to assess the association between daily mean temperature (DMT), air pollutant exposure and RD mortality. To ascertain the robustness of the model and further investigate this relationship, a stratified analysis and sensitivity analysis were conducted to mitigate potential confounding factors.
ResultsA total of 19,905 mortalities from RD were recorded. The minimum mortality temperature (MMT) was determined to be 23.5°C, and DMT and RD mortality showed an N-shaped relationship. At the MMT of 23.5°C, the cumulative relative risk (cumRR) for mortality within a lag period of 0–14 days from the highest temperature (31°C) was estimated at 2.114 (95% confidence interval [CI]: 1.475 ~ 3.028). The effect value of particulate matter (PM) also increased with a longer cumulative lag time. In the single pollutant model, the highest risk of RD mortality was observed on the lag1-day of per 10 μg/m3 increase in PM2.5 exposure, with an excess risk ratio (ER) of 0.847% (95% CI: 0.335% ~ 1.362%). The largest cumulative effect was found at a lag of 8 days, with an ER of 1.546% (95% CI: 0.483% ~ 2.621%). A similar trend was found for PM10. For O3 exposure, the highest risk was observed on the lag1-day of per 10 μg/m3 increase, with an ER of 1.073% (95% CI: 0.502% ~ 1.647%), and the largest cumulative effect occurred at a lag of 2 days with an ER of 1.113% (95%CI: 0.386% ~ 1.844%). Results from the dual-pollutants model demonstrated that the effect of PM on the risk of RD mortality remained significant and slightly increased in magnitude. Moreover, composite pollutants exhibited a higher risk effect, reaching its peak after one week; however, there was a decrease in single-day cumulative effects as more pollutant types were included. Subgroup analysis showed that females, elderly individuals, and those exposed during warm seasons demonstrated greater susceptibility to PM exposure.
ConclusionThe present study revealed a significant association between short-term exposure to high temperature, PM2.5, PM10 and O3 and the risk of RD mortality in Qingdao, even in dual- and composite-pollutants models. Furthermore, our findings indicate that females, the elderly population, and warm seasons exhibit heightened sensitivity to PM exposure.
by Xiaoyi Shu, Chun Feng, Chak-Lam Ip, Xin Zhang, Nan Yang, Shibo Li, Jia Han, Weibing Wu, Alec Knight
BackgroundFostering a strong professional identity (PI) enhances career fulfillment. In China, therapy education is undergoing development, integrating both Western and traditional health concepts, causing inconsistent PI among therapy students. To date, no validated tools exist to measure and monitor PI of Chinese therapy students. This study aimed to translate and validate the 9-item MacLeod Clark Professional Identity Scale (MCPIS-9) for this purpose.
DesignThis study involved translation and cultural adaptation of the MCPIS-9, followed by a rigorous assessment of its model fit and psychometric properties using data collected via an online questionnaire.
MethodsA forward- and backward- translation process was conducted. Content validity was evaluated using item-level content validity index (I-CVI) and scale level content validity index average method (S-CVI/Ave). Therapy students across all grades at undergraduate and postgraduate levels in China were eligible. Exploratory factor analysis (EFA) examined the underlying factor structure. Model fit was evaluated through confirmatory factor analysis (CFA) using the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR) and Root Mean Square of Error of Approximation (RMSEA). Convergent validity was assessed through Pearson’s correlations coefficient (r) with the Professional Identity Scale for Health Students and Professionals (PISHSP). Internal consistency was examined using Cronbach’s Alpha (Cα) and McDonald’s Omega (ω).
ResultsA total of 1054 students participated. Content validity was excellent (I-CVI = 0.86–1.0, S-CVI/Ave = 0.98). EFA indicated a two-factor structure with acceptable model fit (CFI = 0.978; TLI = 0.968; SRMR = 0.033; RMSEA = 0.063). Reliability was strong (Cα = 0.835; ω = 0.817). Convergent validity demonstrated a strong correlation (r = 0.75) with the PISHSP.
ConclusionsThe Chinese MCPIS-9 is a reliable and valid tool for assessing PI among therapy students. Future research could focus on refining item 4 of this tool, potentially through further exploration of therapy students’ perceptions of PI within the unique context of the Chinese healthcare system.
To analyse and synthesise current evidence on the effectiveness of cancer rehabilitation interventions in increasing physical activity, increasing healthy dietary habits, alleviating psychological distress, and increasing health-related quality of life (HRQoL) in women treated for gynaecological cancers (GCs).
A meta-analysis of randomised controlled trials (RCTs).
A systematic search was conducted in 12 databases from inception to 31 May 2024.
The quantitative results from comparable RCTs were pooled and meta-analysed using Review Manager 5.4 software. The results from non-comparable (i.e., clinically heterogeneous) RCTs were narratively summarised. The methodological quality of all RCTs was assessed using Version 2 of the Cochrane risk of bias tool for randomised trials.
Nine RCTs reported in a total of 12 articles met the inclusion criteria and comprised a total of 418 patients. The interventions had significant effects on total physical activity levels at post-intervention, 6-month follow-up, and 12-month follow-up, and on self-efficacy in physical activity at post-intervention and 3-month follow-up. However, the interventions did not significantly improve overall HRQoL or healthy dietary habits and did not significantly alleviate anxiety and depression. The key intervention components were information provision on health-promoting behaviours; adoption of behavioural change techniques (goal setting, action planning, relapse prevention, problem-solving, self-monitoring, and social support); and stress and emotion management.
Rehabilitation interventions effectively increase physical activity in women treated for GCs, leading to sustainable effects. However, there is limited evidence on the effectiveness of such interventions in improving overall HRQoL, encouraging healthy eating, and alleviating psychological distress in women treated for GCs.
This review found that rehabilitation interventions can increase physical activity levels among women treated for GCs. It also identified the key effective components of such interventions.
This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
None.
Trial Registration: International Prospective Register of Systematic Reviews registration number: CRD42023442877
by Nana Guo, Xuxin Wen, Xiao Wang, Junling Yang, Haidong Zhou, Jianli Guo, Yun Su, Tingxin Zhang
PurposeComparing the outcomes of video-laryngoscopy and flexible fiberoptic bronchoscopy for endotracheal intubation in patients with cervical spine immobilization
MethodsAll of the comparative studies published in the PubMed, Cochrane Library, Medline, Web of Science, and EMBASE databases as of 8 Jan 2024 were included. All outcomes were analyzed using Review Manager 5.4. The primary outcomes were the successful first-attempt intubation rate, intubation time, heart rate after intubation, mean arterial pressure after intubation, overall intubation success rate, risk of tissue damage and sore throat.
ResultsThe meta-analysis included six randomized controlled studies with a total of 694 patients. The outcomes of the meta-analysis revealed that the use of video laryngoscopy was better than flexible fiberoptic bronchoscopy in terms of the successful first-attempt intubation rate (P0.05) between the video laryngoscopy and flexible fiberoptic bronchoscopy groups.
ConclusionsCompared with flexible fiberoptic bronchoscopy, video laryngoscopy has superior tracheal intubation performance in terms of the first-attempt success rate and intubation speed. This finding was observed in patients with cervical spine immobilization who utilized a cervical collar to simulate a difficult airway. Additionally, both types of scopes demonstrated similar complication rates. Current evidence suggests that video laryngoscopy is better suited than flexible fiberoptic bronchoscopy for endotracheal intubation in patients immobilized with a cervical collar.
Trial registrationSystematic review protocol: CRD42024499868.
Diabetic foot ulcers (DFUs) are a serious chronic complication of diabetes mellitus and a leading cause of disability and death in diabetic patients. However, current treatments remain unsatisfactory. Although macrophages are associated with DFU, their exact role in this disease remains uncertain. This study sought to detect macrophage-related genes in DFU and identify possible therapeutic targets. Single-cell datasets (GSE223964) and RNA-seq datasets (GSM68183, GSE80178, GSE134431 and GSE147890) associated with DFU were retrieved from the gene expression omnibus (GEO) database for this study. Analysis of the provided single-cell data revealed the distribution of macrophage subpopulations in the DFU. Four independent RNA-seq datasets were merged into a single DFU cohort and further analysed using bioinformatics. This included differential expression (DEG) analysis, multiple machine learning algorithms to identify biomarkers and enrichment analysis. Finally, key results were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western bolt. Finally, the findings were validated using RT-qPCR and western blot. We obtained 802 macrophage-related genes in single-cell analysis. Differential expression analysis yielded 743 DEGs. Thirty-seven macrophage-associated DEGs were identified by cross-analysis of marker genes with macrophage-associated DEGs. Thirty-seven intersections were screened and cross-analysed using four machine learning algorithms. Finally, HMOX1 was identified as a potentially valuable biomarker. HMOX1 was significantly associated with biological pathways such as the insulin signalling pathway. The results showed that HMOX1 was significantly overexpressed in DFU samples. In conclusion, the analytical results of this study identified HMOX1 as a potentially valuable biomarker associated with macrophages in DFU. The results of our analysis improve our understanding of the mechanism of macrophage action in this disease and may be useful in developing targeted therapies for DFU.
This study explores the intricate relationship between chronic periodontitis (CP) and its implications for wound healing, particularly in the context of arteriosclerotic occlusion (ASO) in the lower extremities. A cohort of 90 individuals was categorized into three groups: those with CP, those with both CP and ASO (ASO + CP) and a healthy control group. Comprehensive assessments including oral examinations, blood tests and questionnaires were conducted. Key oral health indicators such as probing depth (PD), bleeding on probing (BOP) and periodontal inflammatory surface area (PISA) were evaluated to gauge the severity of periodontal wounds. The study found that the ASO + CP group showed a significantly higher number of missing teeth and increased PD compared to the CP group (p < 0.05). Both CP and ASO + CP groups exhibited elevated PD, BOP and PISA compared to the control group (p < 0.05), indicating exacerbated periodontal wounds. Serum analyses showed heightened total cholesterol (TC) and high-sensitivity C-reactive protein (hs-CRP) levels in the ASO + CP group, suggesting a stronger inflammatory response and potential for atherogenesis. Interestingly, FPG and triglycerides (TG) levels did not significantly vary across groups (p > 0.05). Regression analysis identified PD (β = 2.271, p < 0.001) and PISA (β = 0.027, p = 0.001) as significant predictors for ASO presence in CP patients. The findings underscore the clinical correlation between chronic oral wounds in CP and the development of ASO in lower extremities, highlighting the critical need for integrated management strategies focusing on periodontal health to prevent and manage such complex conditions effectively. Elevated inflammatory markers in the ASO + CP group further reinforce the necessity for vigilant monitoring and targeted interventions in these patients.
Chronic obstructive pulmonary disease (COPD) causes airflow blockage and breathing-related issues. This chronic disease impacts people worldwide. Substantial evidence supports the use of cognitive behavioral therapy (CBT) to help patients with chronic illnesses cope with worrisome and painful symptoms. However, the impact of CBT on COPD outcomes is less understood.
In this study, we systematically summarized the effects of CBT on lung function, anxiety and depressive symptoms, and quality of life of patients with COPD.
Six English-language and four Chinese-language databases were systematically searched for relevant randomized controlled trials published through April 15, 2023. Studies in which CBT was the only difference in treatment administered to experimental and control groups were included in the review. The studies' risk of bias was evaluated using the Cochrane Criteria.
Sixteen studies (1887 participants) were included. The meta-analysis showed that CBT improved the percent-predicted forced expiratory volume in 1 second (FEV1%), forced vital capacity (FVC), FEV1/FVC ratio, maximal voluntary ventilation, peak expiratory flow, treatment compliance, and World Health Organization abbreviated quality of life, Self-rating Anxiety and Depression Scale, and St George's Respiratory Questionnaire scores compared with the control (all p < .05).
This review demonstrated that CBT improves the lung function, anxiety and depressive symptoms, treatment compliance, and quality of life of patients with COPD and can be used widely in the clinical treatment of this disease.
The aims of this study were to (i) compare the prevalence of multidimensional frailty in middle-aged and older people with stroke and to (ii) explore the relationship between multidimensional frailty and quality of life (QoL) in this patient population.
In recent years, stroke patients have become increasingly younger. As an important risk factor for stroke patients, frailty has gradually drawn research attention because of its multidimensional nature.
This study used a cross-sectional design.
The study included 234 stroke patients aged 45 and older. Multidimensional frailty was defined as a holistic condition in which a person experiences losses in one or more domains of human functioning (physical, psychological and social) based on the Tilburg Frailty Indicator, and QoL was based on the short version of the Stroke-Specific Quality of Life Scale. Hierarchical regression was used to analyse the correlation factors of QoL. STROBE checklist guides the reporting of the manuscript.
A total of 128 (54.7%) participants had multidimensional frailty, 48 (44.5%) were middle aged and 80 (63.5%) were older adults. The overall QoL mean score of the participants was 47.86 ± 9.04. Multidimensional frailty was negatively correlated with QoL. Hierarchical regression analysis showed that multidimensional frailty could independently explain 14.6% of the variation in QoL in stroke patients.
Multidimensional frailty was prevalent in middle-aged and older people with stroke, and it was a significant factor associated with QoL in stroke patients.
This study emphasises the importance of the early identification of multidimensional frailty. And targeted interventions should be studied to prevent the occurrence of multidimensional frailty and thereby improve the QoL of patients.
There are no patient or public contributions to this study.
To determine the contributions of different kinds of symptoms to the quality of life and mediating effect of psychological and physical symptoms between heart failure symptoms and quality of life.
A multi-centre cross-sectional study.
2006 chronic heart failure patients from four cities were recruited in China from January 2021 to December 2022. Patients' symptoms and quality of life were self-reported, and data were analysed using correlation analysis, dominance analysis and mediating effects analysis.
The dominance analysis revealed that the overall mean contributions of heart failure, psychological and physical symptoms were .083, .085 and .111; 29.5%, 30.2% and 39.5% of the known variance. And heart failure symptoms could negatively affect quality of life through psychological and physical symptoms, accounting for 28.39% and 22.95% of the total effect. Heart failure symptoms could also affect quality of life through the chain-mediated effect of physical and psychological symptoms, accounting for 16.74%.
Physiological symptoms had the strongest effect on quality of life and heart failure symptoms had the weakest. Most of the effect for heart failure symptoms on quality of life in chronic heart failure patients was mediated by psychological and physiological symptoms.
It is important to design non-pharmacological intervention plans for the enhancement of physical and psychological symptoms' management skills, to reduce the adverse impact of heart failure symptoms on quality of life.
Study methods and results reported in adherence to the STROBE checklist.
No patients or members of the public were involved in the study.
A meta-analysis was conducted to evaluate the effect of colostomy or ileostomy on post-operative wound complications. The research was tested using Embase, PubMed and Cochrane Library databases. Included were randomized, controlled clinical trials (RCTs). A sensitivity analysis and a meta-analysis were carried out. The results indicated that there were no statistically significant differences in the reduction of wound infection between LC and LI. Out of 268 related studies, 5 publications were chosen and examined for compliance. Literature quality was evaluated throughout the trial. Studies with poor literature were excluded. The data were analysed with RevMan 5.3, and a decision was taken to analyse the data with either a stochastic or a fixed-effects model. There were no significant differences in the incidence of post-operative infection in patients with LC (OR, 0.79; 95% CI, 0.34, 1.81; p = 0.57), and the incidence of post-operative anastomotic fistulae (OR, 0.98; 95% CI, 0.30, 3.15; p = 0.97) was not significantly different from that with LI. These meta-analyses indicate that no significant reduction in the incidence of post-operative infections or anastomotic fistulae was observed by either LC or LI.
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