Conectar
To analyse trends and characteristics of multidrug-resistant (MDR) bacteria over the past 7 years, in relation to patterns of antimicrobial use, to inform rational antimicrobial use and strengthen hospital infection control measures.
Retrospective cohort study.
A large teaching hospital in Tianjin, a major metropolitan city in northern China.
A total of 190 352 inpatients aged >18 years, admitted between 1 January 2017 and 31 December 2023, were included. Patients were eligible if they had complete clinical data and met the five quality control indicators for multidrug-resistant bacteria (QC-MRB), defined in the ‘Hospital Infection Surveillance Specifications’ (WS/T 312–2023). Patients with MDR infections before admission or those with duplicate results from multiple specimens were excluded.
Statistical analysis revealed a detection rate of 12.11% for the five QC-MRB and an incidence rate of 0.20%. The findings also indicated an upward trend in the detection and incidence rates of carbapenem-resistant Enterobacteriaceae, despite a relatively stable rate of antimicrobial use over 7 years. A positive correlation was observed between the incidence of MDR bacteria and the intensity of antimicrobial use within the hospital setting.
The hospital’s bacterial data align with national trends. It established an interdisciplinary management framework for clinical data analysis and prediction of antimicrobial resistance. This approach enhances infection control measures and supports the rational use of antimicrobials.
Advance Care Planning (ACP) has the potential to enhance end-of-life care and improve the allocation of healthcare resources for patients with cancer. However, its successful implementation requires considerable effort to overcome challenges and deliver health benefits. Healthcare providers and patients are key players in ACP, and their perceptions of the process must be understood to address implementation challenges effectively.
To identify barriers and facilitators to ACP implementation in Chinese oncology settings, providing a foundation for culturally appropriate healthcare strategies.
A qualitative study guided by the Consolidated Framework for Implementation Research (CFIR). Semi-structured interviews (n = 30) were conducted between April and August 2022 to synthesise the perspectives of nurses, physicians, patients with cancer and their families who had participated in ACP. Data were analysed using a directed qualitative content analysis approach, and reporting followed the SRQR guidelines.
Twenty implementation determinants were identified across four CFIR domains, including 13 barriers and 7 facilitators. Key barriers included limited adaptability of ACP to local cultural and family norms, high complexity of ACP processes, insufficient knowledge and skills among clinicians, unclear team responsibilities, low organisational readiness, limited resources and poor public awareness. Facilitators included strong team culture, clinician motivation, supportive leadership and alignment with national policies. Two determinants showed mixed influences: the relative advantage of ACP compared to existing practices, and the extent of collaboration with external organisations.
Our study highlights the challenges of implementing ACP in China, as well as the unique and specific barriers to implementation. These findings contribute to a deeper understanding of context-specific determinants and offer actionable insights to inform the development of culturally tailored ACP implementation strategies in resource-limited healthcare settings.
To inform the development of implementation strategies to promote ACP in healthcare systems dominated by traditional medicine.
To explore the associations between arterial stiffness (AS) onset age and type 2 diabetes mellitus (T2DM) risk.
Large-scale cohort study.
The largest medical centre in central China.
This study enrolled 22 588 participants free of T2DM at baseline. All participants took an annual physical examination from 2012 to 2016, with fasting blood glucose and brachial–ankle pulse wave velocity measurements.
Cox proportional model was used to investigate the association between AS onset age and T2DM risk. Sex-specific analysis was also performed, and the association between early vascular ageing (EVA), normal vascular ageing (NVA), supernormal vascular ageing (SUPERNOVA) onset age and diabetes risk was also examined.
A total of 757 (3.4%) participants were diagnosed with T2DM. Compared with participants free of AS in each specific age group, the earlier AS onset age was more strongly associated with T2DM risk, especially for middle age, with the fully adjusted hazard risk (HR) and 95% CI of 4.63 (2.79–7.67) for AS onset age at 50. Similar results were observed both in males and females, with the fully adjusted HR and 95% CI of 4.54 (2.60 to 7.93) for males and 4.86 (1.48 to 16.01) for females, with AS onset age at 50. Such an association was also observed in the exploration of EVA, NVA and SUPERNOVA onset age and incident T2DM risk.
This study revealed that the middle-aged onset of AS was more significantly associated with a higher T2DM risk. Early screening of AS, especially in middle age, may assist in T2DM detection and postpone diabetic vascular complications.
Oesophageal cancer (EC) presents a substantial global health challenge, ranking eighth in incidence and sixth in cancer-related mortality. Oesophageal squamous cell carcinoma (ESCC) is the primary subtype and accounts for approximately 90% of cases in Asia. Despite treatment advances, the 5-year survival rate remains modest at 10%–30%. Immune checkpoint inhibitors, exemplified by KEYNOTE-590 and CheckMate 577 trials, have reshaped EC therapeutic landscapes. Our study addresses the critical gap in understanding the real-world impact of PD-1 (Programmed Death-1) inhibitors, conducting a multicentre, real-world, observational cohort analysis focused on ESCC. This research endeavours to provide practical insights into PD-1 treatment for EC, facilitating informed clinical decision-making and optimising patient outcomes in diverse healthcare settings.
This multicentre study includes patients diagnosed with histopathologically confirmed ESCC who have consented to treatment with PD-1 inhibitors. It is structured into two distinct segments: Part A, characterised by its retrospective nature, and Part B, representing the prospective arm. Within both parts, four stratified cohorts are delineated, comprising Cohort 1 (preoperative neoadjuvant/conversion therapy), Cohort 2 (postoperative adjuvant therapy), Cohort 3 (first-line therapy for advanced ESCC) and Cohort 4 (≥2 lines of therapy for advanced ESCC). The primary endpoint is the objective response rate in diverse treatment cohorts. Secondary endpoints include pathologic complete response rate, disease-free survival, progression-free survival, overall survival, adverse events, immune-related adverse events, quality of life and the intricacies of immunotherapy patterns and hyperprogression. Furthermore, exploratory endpoints scrutinise potentially predictive biomarkers, as well as the clinical and genomic characteristics inherent to ESCC patients if possible. The study endeavours to enrol 417 participants, subject to a comprehensive 5-year follow-up period.
We will collect and analyse real-world data from Chinese ESCC patients treated with PD-1 inhibitors to observe and describe the efficacy and safety of PD-1 inhibitors in Chinese patients with ESCC at various treatment stages.
Ethical approval was provided by the Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital, China (Approval No. SCCHEC-02-2023-096). Each participating hospital has applied for research permission from the Institutional Review Board of its unit. We will disseminate the results through peer-reviewed journals and academic conferences.
ChiCTR2300078657.
Workplace violence is a pervasive issue in healthcare systems, with nurses being among the most vulnerable healthcare professionals. Despite the recognition of high prevalence, the consequences and mechanisms of workplace violence on professional competency, particularly patient safety competency, warrant further investigation.
This study aimed to examine the relationships among workplace violence, organisational silence behavior, psychological resilience, and patient safety competency among Chinese nurses.
A descriptive cross-sectional correlational design was employed among a convenience sample of clinical registered nurses from public hospitals in Hunan Province, China. An online anonymous questionnaire was utilised to collect research data. SPSS statistical software was used to perform descriptive statistical analyses, Pearson correlation analyses, and mediation effects analyses.
A total of 1440 clinical registered nurses participated in this study, with physical assault being the most prevalent form. Pearson correlation analysis revealed a positive relationship between workplace violence and organisational silence behavior (r = 0.93, p < 0.001), and a negative relationship with psychological resilience (r = −0.84, p < 0.001) and patient safety competency (r = −0.89, p < 0.001). Mediation analysis indicated that organisational silence behavior mediated the negative relationship between workplace violence and patient safety competency, while psychological resilience moderated this association among nurses (All p < 0.05).
This study provides empirical evidence that workplace violence significantly impairs patient safety competency among nurses. The findings underscore the critical role of organisational silence behavior in mediating this relationship, while psychological resilience serves as a protective factor. Targeted interventions aimed at reducing workplace violence, fostering open communication, and enhancing psychological resilience are essential to safeguarding patient safety and improving healthcare quality.
This study offers valuable insights for the development and implementation of targeted support programs and intervention strategies to mitigate workplace violence and enhance patient safety in healthcare settings. Government agencies and healthcare institutions must prioritize preventing all forms of workplace violence against nurses, enhancing psychological resilience, and ensuring patient safety competency to improve healthcare quality and patient outcomes.
This study aimed to validate the mediating role of nurses' AI trust in the relationship between AI uncertainties and AI competence.
A cross-sectional study.
A purposive sample of 550 registered nurses with at least 1 year of clinical experience from three tertiary and two secondary hospitals in Jinan and Hangzhou, China, was used. Data were collected using structured questionnaires assessing AI uncertainty, trust and competence. Demographic data included gender, age, education level, years of clinical experience, professional title and hospital level. Mediation analysis.
Most nurses were from tertiary hospitals (88.9%), held a bachelor's degree (87.6%), and had over 6 years of experience. The mediating role of AI trust between AI uncertainties and AI competence is validated. AI uncertainties affected AI trust (B = 0.39, p < 0.0001), explaining 10% of the variance. AI uncertainties and AI trust affected AI competence (B = 0.25 and 0.67, p < 0.0001), explaining 63% of the variation. AI trust's total effect was 0.51, comprising direct and indirect effects of 0.25 and 0.26, respectively.
Hospitals can reduce uncertainty through an AI-transparent decision-making process, providing clinical examples of AI and training nurses to use AI, thereby increasing trust. Second, AI systems should be designed to consider nurses' psychological safety needs. Hospital administrators utilise optimised AI technology training and promotional techniques to mitigate nurses' resistance to AI and enhance their positive perceptions of AI competence through trust-building mechanisms.
Impact: Enhancing nurses' AI trust can reduce uncertainty and improve their competence in clinical use. Strategies such as transparency, explainability and training programmes are crucial for improving AI implementation in healthcare.
This study focused solely on clinical nurses and did not include patients or the public.
The study adhered to STROBE guidelines.
The optimal method for conducting spontaneous breathing trials (SBTs) remains a subject of ongoing debate. High-flow oxygen via endotracheal tube (HFOT) has emerged as a novel alternative for SBTs. However, studies investigating the associated physiological changes are lacking. Compared to high-flow nasal cannula (HFNC), HFOT has demonstrated diminished physiological effects, likely due to the bypassing of the upper airway, which may limit its widespread adoption as an SBT strategy. Two HFOT interfaces with different expiratory port diameters will be evaluated. It is hypothesised that the narrower interface would generate higher airway pressure and mitigate weakening physiological effects compared to the HFNC. This study aims to compare the physiological effects of two HFOTs compared to T-piece during SBTs.
This is a single-centre, prospective, physiological randomised crossover study in adult patients receiving mechanical ventilation for more than 24 hours who are deemed ready for SBT. After enrolment, each patient will be disconnected from the ventilator and undergo five SBT phases in random order: T-piece at 6 L/min, HFOT via interface with an expiratory port diameter of 9.8 mm at 40 L/min and 60 L/min and HFOT via interface with an expiratory port diameter of 6.9 mm at 40 L/min and 60 L/min. To reduce carryover effects, each phase will be separated by a 10-min washout period during which baseline mechanical ventilation is resumed. Key physiological parameters will be assessed in each study phase, including airway pressure, changes in end-expiratory lung volume, vital signs, oxygenation levels and inspiratory effort. Postextubation inspiratory effort will also be measured. Finally, 20 patients with the complete five SBT phases and postextubation datasets will be analysed
The study protocol has been approved by the Institutional Ethics Committee and Review Board of Beijing Shijitan Hospital, Capital Medical University (IIT2024-157-002). The data generated in the present study will be available from the corresponding author on reasonable request. The results of the trial will be submitted to international peer-reviewed journals.
by Miao Yu, Li Ma, Qingbian Ma
IntroductionTriage is an essential strategy to mitigate crowding and guarantee patients’ safety in emergency departments. To improve the quality of triage in emergency departments, Nurses should be equipped with the necessary competencies. Therefore, this review aims to synthesize available evidence on the competency elements required for triage nurses in emergency departments and to identify factors that influence their competency development.
Methods and analysisThis scoping review will be implemented following the five steps outlined by Arksey and O’Malley. We will use the PCC (population, concept, context) frameworks-Triage nurse (Population), Nursing competency (Concept), and EDs (Context)- to determine the research questions, and formulate the search terms. We will search six electronic databases including PubMed, Embase, CINAHL Plus, Web of Science, and two Chinese databases (China National Knowledge Infrastructure and Wangfang Data). Internet resources including WorldCat, and Google Books will be also searched to ensure comprehensive coverage. Studies will be selected by two independent authors based on defined eligibly criteria, and completed in August 2025. This will be followed by data extraction, and summarizing in October 2025. Then, evidence will be synthesized using descriptive statistics and thematic analysis. Five-domain Consolidated Framework for Implementation Research will be used to guide our thematic analysis of barriers and facilitators to development of competency. The results will be presented in December 2025. Findings from this scoping review will be beneficial to develop the training programs to facilitate the successful transition of nurses into effective triage nurse roles in the future.
RegistrationThe scoping review was registered in Open Science (https://osf.io/6fcr4).
The optimal blood pressure (BP) target for patients with heart failure (HF) remains a topic of debate. The relationship between out-of-office BP measurements and the prognosis of HF patients is still unclear. However, there is a lack of large-scale studies investigating out-of-office BP levels in Chinese populations with HF. This study aims to outline the rationale and design of the Out-of-Office Blood Pressure Measurements in Patients with Heart Failure registry (OOBPM-HF) study in China.
The OOBPM-HF study is a prospective, multicentre, observational cohort study involving participants recruited from 26 hospitals in China. Patents with relatively stable HF symptoms will undergo a screening process to determine their eligibility for study participation. Data from baseline clinical, laboratory and imaging examinations will be collected. BP parameters, including office BP, ambulatory BP and home BP, will be measured and documented. The primary endpoint of the study is the composite endpoint of death from cardiovascular causes and HF hospitalisation. Participants will be followed up for a duration of 18 months.
The study will establish a comprehensive understanding of the associations between out-of-office BP measurements and HF prognosis within the Chinese population. The findings of this study will provide valuable insights into the optimal BP range for patients with HF and will contribute to the management of BP in this patient group.
ChiCTR2400090786; Result.
Postoperative pulmonary complications (PPCs) induced by mechanical ventilation in general anaesthesia are related to poor clinical outcomes. Positive end-expiratory pressure (PEEP) is a key component of the lung protective ventilation strategy. Individualised PEEP guided by end-expiratory oesophageal pressure (Pes) to maintain a positive end-expiratory transpulmonary pressure can avoid alveolar collapse and improve the respiratory mechanics. However, there is no research studying the relationship between the Pes-guided PEEP titration and PPCs. The aim of our study is to investigate the potential role of Pes-guided PEEP titration on the incidence of PPCs and respiratory mechanics.
A total of 232 elderly patients undergoing major laparoscopic surgery under general anaesthesia will be recruited in four tertiary teaching hospitals in China. Patients will be randomly allocated to the control group (PEEP set at 3 cm H2O) without lung recruitment manoeuvres (RMs) or Pes-guided PEEP group with RMs in a 1:1 ratio. Preoperative preparation, anaesthesia management and postoperative care will be performed similarly in both groups. The primary outcome will be the development of PPCs within 7 days after surgery. The intraoperative respiratory parameters, the oxygenation index, vital signs and non-respiratory complications within 7 days after surgery, the 15-item Quality of Recovery-15 questionnaire, unplanned reintubation and unplanned transfer to the intensive care unit, hospital stay, perioperative plasma levels of lung injury biomarkers, complications within 30 days after surgery and 90-day mortality after surgery will be recorded and evaluated as the secondary outcomes.
The study has received ethics approval from the ethics committee of the Zhongshan Hospital, Fudan University (China) with the approval number B2023-334R. The results of the study will be submitted for publication in peer-reviewed journals.
Version 1, on 9 October 2023.
To investigate the association between positive coping style and family resilience, considering the mediating factors of burden and individual resilience within caregivers of chronic obstructive pulmonary disease (COPD) patients.
A cross-sectional survey.
A total of, 204 caregivers of COPD patients were recruited using convenient sampling from April 2023 to May 2024 to investigate general information, family resilience, individual resilience, caregiver burden and positive coping styles on caregivers of COPD patients. Influencing factors were primarily identified using Mann–whitney U test and Kruskal–Wallis H test. Spearman correlation analysis was used to explore the correlation between family resilience, positive coping, caregiver burden and resilience. Linear regression was used to analyse the influencing factors of family resilience of caregiver. Structural equation modelling was used to detect the mediating effects of caregiver burden and resilience.
The STROBE checklist was followed.
The family resilience of caregivers was positively correlated with positive coping styles and individual resilience, and negatively correlated with caregiver burden. The family resilience of caregivers increased with the improvement positive coping style and individual resilience, and decreased with the increase of caregiver burden. Caregiver burden and resilience played the chain mediating roles between positive coping style and family resilience.
Family caregivers of COPD patient with higher education levels also have higher family resilience. Higher positive coping style may lead to higher family resilience of caregivers of COPD patients by reducing caregiver burden and promoting resilience.
There are individual differences in the level of family resilience of caregivers of COPD patients, and nurses can provide personalised interventions to different family caregivers by understanding their characteristics and needs. Nurses can improve the family resilience of caregivers by guiding them to adopt positive coping styles, reducing burdens and promoting resilience.
This study was conducted with the participation of caregivers of COPD patients who contributed data by completing study questionnaires.
This study aimed to establish a comprehensive set of nursing-sensitive quality indicators (NSQIs) for patients with dysphagia following tracheotomy due to acquired brain injury (ABI), based on the ‘structure-process-outcome’ model.
A Delphi survey.
The research utilised a mixed-methods approach, including systematic literature reviews, qualitative interviews and two rounds of Delphi expert consultations. A diverse team comprising specialists in dysphagia rehabilitation and nursing management conducted the research, which involved defining and refining NSQIs through extensive evaluations and consensus among recruited experts.
The finalised NSQI includes 4 structural indicators, 13 process indicators and 4 outcome indicators, covering key aspects such as resource allocation, patient assessment and clinical outcomes. The expert consensus provides verification. Kendall's harmony coefficients are 0.304 and 0.138 (p < 0.001), respectively, and the mean importance assignments of indicators at all levels are 3.90–5.00. The final care of patients with tracheotomy and dysphagia after brain injury was constructed. The evaluation indicators include a total of 4 first-level indicators, 23 second-level indicators and 52 third-level indicators.
The established NSQIs offer a systematic framework to enhance the quality of nursing care for ABI patients with posttracheotomy dysphagia. This model facilitates precise monitoring and proactive management of nursing practices, promising better patient outcomes and streamlined care processes.
This study develops targeted NSQIs to improve dysphagia management in ABI patients’ posttracheotomy, fostering better patient outcomes and advancing nursing education through essential specialised training.
Expert-driven insights from experienced clinicians informed the NSQIs, ensuring their relevance and effectiveness in enhancing patient-centred care.
To investigate the frailty status of inpatients with chronic heart failure (CHF) and analyse its influencing factors, so as to provide evidence for the early identification of high-risk groups and frailty management.
Early identification of frailty can guide the development and implementation of holistic and individualized treatment plans. However, at present, the frailty of patients with CHF has not attracted enough attention.
A cross-sectional study.
From June 2022 to June 2023, a convenience sample of 256 participants were recruited at a hospital in China. Multivariate logistic regression analysis was used to explore the influencing factors of frailty in patients with CHF, and an ROC curve was drawn to determine the cut-off values for each influencing factor. STROBE checklist guides the reporting of the manuscript.
A total of 270 questionnaires were sent out during the survey, and 256 valid questionnaires were ultimately recovered, resulting in an effective recovery rate of 94.8%. The incidence of frailty in hospitalized patients with CHF was 68.75%. Multivariable logistic regression analysis showed that age, self-care ability, nutritional risk, Kinesiophobia and NT-proBNP were risk factors for frailty, while albumin and LVEF were protective factors.
Multidimensional frailty was prevalent in hospitalized patients with CHF. Medical staff should take measures as early as possible from the aspects of exercise, nutrition, psychology and disease to delay the occurrence and development of frailty and reduce the occurrence of clinical adverse events caused by frailty.
This study emphasizes the importance of the early identification of multidimensional frailty and measures can be taken to delay the occurrence and development of frailty through exercise, nutrition, psychology and disease treatment.
Patients contributed through sharing their information required for the case report form and filling out questionnaires.
To review the content, format and effectiveness of shared decision-making interventions for mode of delivery after caesarean section for pregnant women.
Systematic review and meta-analysis.
Six databases (PubMed, Web of science Core Collection, Cochrance Network, Embase, CINAHL, PsycINFO) were searched starting at the time of establishment of the database to May 2023. Following the PRISMAs and use Review Manager 5.3 software for meta-analysis. Two review authors independently assessed the quality of the studies using the risk of bias 2 tool. The protocol was registered in PROSPERO (CRD42023410536).
The search strategy obtained 1675 references. After abstract and full text screening, a total of seven studies were included. Shared decision-making interventions include decision aids and counselling that can help pregnant women analyse the pros and cons of various options and help them make decisions that are consistent with their values. The pooled results showed that shared decision-making intervention alleviated decisional conflicts regarding mode of delivery after caesarean section, but had no effect on knowledge and informed choice.
The results of our review suggest that shared decision-making is an effective intervention to improve the quality of decision-making about the mode of delivery of pregnant women after caesarean section. However, due to the low quality of the evidence, it is recommended that more studies be conducted in the future to improve the quality of the evidence.
This systematic review and meta-analysis provides evidence for the effectiveness of shared decision-making for mode of delivery after cesarean section and may provide a basis for the development of intervention to promote the participation of pregnant women in the decision-making process.
To identify factors associated with health behaviours among stroke survivors, through a multi-centre study.
A sequential mixed methods design.
In the quantitative research phase, a total of 350 participants were recruited through multi-stage sampling from December 2022 to June 2023. General information questionnaires, The Stroke Prevention Knowledge Questionnaire (SPKQ), Short Form Health Belief Model Scale (SF-HBMS), Health Promoting Lifestyle Profile (HPLPII), and the WHOQOL-BREF (World Health Organization Quality of Life Questionnaire, Brief Version) were distributed across five tertiary hospitals in Henan province, China. For the qualitative research component, semi-structured interviews were conducted to explore the barriers and facilitators of health behaviour. This study adheres to the GRAMMS guidelines.
A total of 315 participants (90.0%) completed the survey. Identified barriers to health behaviour included residing in rural areas, higher scores on the Charlson Comorbidity Index (CCI) and mRS, as well as lower scores on SPKQ, SF-HBMS and WHOQOL-BREF. Twenty-four individuals participated in qualitative interviews. Twenty-eight themes were identified and categorised by frequency, covering areas such as knowledge, skills, intentions, social influences, social/professional role and identity, environmental context and resources, beliefs about capabilities, beliefs about consequences and behavioural regulation. Both quantitative and qualitative data suggested that health behaviour among stroke survivors is at a moderate level, and the identified barrier factors can be mapped into the COM-B model (Capability, Opportunity, Motivation and Behaviour).
The study indicates that key barriers to health behaviour among stroke survivors align with the COM-B model. These identified factors should be carefully considered in the planning of future systematic interventions aimed at improving health behaviours among stroke survivors.
Patients were invited to completed questionnaires in the study and semi-structured interviews. The investigators provided explanation of this study’ content, purpose and addressed issues during the data collection.
To investigate whether chronic diseases are associated with higher COVID-19 vaccine hesitancy and explore factors that influence COVID-19 vaccine hesitancy in patients with chronic diseases.
Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID-19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID-19 infection, severe disease or death.
From 6 to 9 August 2021, we performed an internet-based cross-sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID-19 vaccine hesitancy were identified among patients with chronic diseases.
Both before and after propensity score matching, patients with chronic diseases had higher COVID-19 vaccine hesitancy than the general population. In addition, self-reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID-19 vaccine hesitancy among patients with chronic diseases.
Patients with chronic diseases were more hesitant about the COVID-19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system.
Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice.
Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires.
To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social-related factors of older adults with different nutritional statuses.
Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors.
A cross-sectional study.
From January to April 2023, a cross-sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non-demographic instruments [Short-Form Mini-Nutritional Assessment (MNA-SF), Barthel Index (BI) and Mini-mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross-sectional studies were used in this study (Data S1).
209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment.
Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status.
This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition.
This study aimed to describe the knowledge, attitudes and practices (KAP) of nurses in implementing advance directives (ADs) for older patients and analyze the influencing factors before the establishment of the first advance directives act in China.
Multicenter cross-sectional survey. The standards for reporting the STROBE checklist are used.
This cross-sectional study developed a self-designed structured questionnaire to assess nurses' knowledge, attitudes and practices about ADs. Nurses were recruited by stratified random sampling through the Nursing Departments of 12 hospitals in southwest China and were asked to fill out the questionnaire face to face about knowledge, attitudes and practices. Data were analyzed following descriptive statistics, rank-sum test and multiple linear regression.
This study included 950 nurses. The study found that nurses were extremely supportive of ADs. Unmarried nurses had better knowledge of ADs than married ones. Nevertheless, there was a discrepancy between the participants' knowledge, attitude and practice. The participants' practice was lower (4.3%) compared with their attitude (81.9%) and knowledge (42.2%). Knowledge on, attitudes towards and standardized procedures for ADs in the workplace affected nursing practice.
The study recommends that courses on ADs and appropriate support from medical institutions should be provided to nurses to increase their knowledge and confidence in implementing ADs. Healthcare professionals should be sufficiently equipped to implement ADs and handle their execution appropriately to provide adequate end-of-life care corresponding to patients' wishes.
The study results inform rich insights as it discusses the numerous interrelating factors influencing these three fundamental aspects that affect the success of any AD policy by surveying the knowledge, attitudes and practices of clinical nurses. Furthermore, our results hint at distinct areas of improvement in the nursing practice to facilitate the wider implementation and acceptance of ADs in China.
This study involved no patient.
FreshRSS 