BackgroundCognitive impairment as a complication in post-stroke patients has high prevalence throughout the world. However, few studies have focused on the older adult stroke survivors and explored their prevalence and factors of post-stroke cognitive impairment (PSCI). The study aims to evaluate the cognitive status of stroke patients in Hunan Province, China and to determine the potential risk factors associated with PSCI in order to identify the older adult population in advance and promote healthy aging.MethodsThis cross-sectional study was carried out from August to December, 2021. A total of 520 stroke survivors from 6 tertiary hospitals were randomly selected. The information was collected using the general questionnaire, the Barthel Index Rating Scale and the Mini-mental State Examination (MMSE). Analysis was based on descriptive statistics, chi-square test and the significant variables were included in multivariate logistic regression. The reporting of this cross-sectional study followed the STROBE checklist.ResultsA total of 195 older adults (40.37%) were screened for cognitive impairment based on the results of the MMSE score. Patients in the PSCI group had a higher proportion of individuals aged 70 or older (35.90% vs. 24.65%, p<0.001). The potential risk factors for post-stroke cognitive impairment in older adults were being aged between 70 and 79 years old (OR = 3.973, 95% CI, 2.346–6.729, p<0.001), being aged 80 years or older (OR = 3.590, 95% CI, 1.373–9.387, p = 0.009), having a low level of education (OR = 9.183, 95% CI, 5.341–15.789, p<0.001), having hypertension (OR = 1.756, 95% CI, 1.121–2.753, p = 0.014), and having a dominant hemisphere lesion (OR = 1.880, 95% CI, 1.193–2.962, p<0.001).ConclusionThe prevalence of PSCI was high among Chinese older adults, particularly those aged 80 years or older. The factors identified in our study could assist in the early identification of older adults at risk, develop personalized management plans, and promote healthy aging.

OBJECTIVES:This study aimed to describe cardiovascular risk and cardiovascular disease (CVD) knowledge among older adults, and further explore the association between knowledge and risk.METHODS:In this cross-sectional study, we enrolled 1120 older adults who received physical examination in health centers. The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics. A risk prediction chart was used to predict participants' cardiovascular risk based on clinical characteristics and behavioral risk factors. Participants' CVD knowledge was collected with a pretested knowledge questionnaire.RESULTS:Among the 1120 participants, 240 (21.4%) had low cardiovascular risk, 353 (31.5%) had moderate cardiovascular risk, 527 (47%) had high and very high cardiovascular risk. The knowledge level about CVD among 0.8% of the 1120 participants was good while that of 56.9% was poor. Lower CVD knowledge level, older age, lower income, and lower educational level were the independent factors of higher cardiovascular risk level.CONCLUSIONS:This study highlights the need to reduce the cardiovascular risk among older adults. CVD knowledge should be considered when developing health interventions.

OBJECTIVE:To explore nurse managers' perceptions of the frequency and importance of professional activities performed in their daily work in public hospitals in Hunan, China.BACKGROUND:Nurse managers are responsible for the management of almost all nursing activities in Chinese hospitals. Understanding how nurse managers operationalize their role and their perceptions of the importance of each activity is essential for clarification of their role and the competencies required to perform it.METHODS:A cross-sectional questionnaire survey.RESULTS:A total of 1,371 nurse managers in Hunan Province completed the survey. Nursing quality/safety management and patient management were performed most frequently and perceived as most important. Nurse managers performed nursing information management frequently while perceiving it as less important. They seldom performed nursing research management and placed low value on it.CONCLUSIONS:Patient-centred care remains central to nursing management. Nursing managers can create a leadership culture in their hospital settings that includes the effective management of information and facilitation of research knowledge to benefit nurse managers, staff and patients.IMPLICATIONS FOR NURSING MANAGEMENT:The results provide evidence for standardization of roles and job descriptions of nurse managers and for developing their knowledge and skills to ensure quality patient care.

Family caregivers play an important role in the rehabilitation of stroke survivors. The aims of this study were to describe preparedness, uncertainty, and knowledge regarding stroke in family caregivers of people who have undergone strokes and to investigate factors influencing preparedness. A total of 306 caregivers completed the questionnaires, including the Caregiver Preparedness Scale, the Mishel Uncertainty in Illness Scale, and Knowledge of Stroke. The result showed that the mean score of the family caregivers' preparedness was 14.42, the mean score of disease uncertainty was 75.62, and the mean score of stroke knowledge was 10.41. Caregiver preparedness was negatively correlated with disease uncertainty and positively correlated with knowledge. Multivariate stepwise regression analysis showed that educational background, profession, caregiving experience and uncertainty degree of the family caregivers, gender, and age of stroke survivor could predict 45.90% of the total variation in preparedness. The findings suggest that demographic characteristics of stroke survivor and family caregiver, as well as caregivers' disease uncertainty, enable predict the level of caregiver preparedness. Medical professionals should pay attention to providing personalized and targeted approaches to maximize caregivers' preparedness.

目的:考察状态正念与工作满意度的关系,以及知觉压力和情绪在其中的中介作用.方法:采用日记法,通过对90名三级医院护士连续10个工作日的调查,获得700份个体内数据.结果:多水平分析发现,每日状态正念对每日工作满意度的直接效应显著;每日知觉压力、每日积极情绪在每日状态正念和每日工作满意度之间的中介效应显著;且每日知觉压力-每日积极情绪的链式中介效应也显著.结论:状态正念既可以直接预测工作满意度,又可分别通过知觉压力和积极情绪的中介效应、以及知觉压力-积极情绪的链式中介效应间接预测工作满意度.

The current study aimed to explore the relationships between nurses' mindfulness and job satisfaction and the mediating roles of positive affect and resilience. A total of 1,043 Chinese hospital nurses completed self-report questionnaires from March to April 2019. Pearson's correlation analysis was used to identify the relationships among the four variables, and the bias-corrected bootstrap method was used to test the mediation hypotheses. The results revealed that nurses' mindfulness was at a medium-high level, whereas positive affect, resilience, and job satisfaction were at medium levels. The total scores and dimension scores of the four variables showed strong positive correlations, and nurses' mindfulness affected job satisfaction directly and indirectly through the intermediary roles of positive affect and resilience. Nursing managers should recognize the importance of mindfulness and incorporate mindfulness training into health promotion and employee management plans for hospital nurses. In addition, strategies should be implemented to cultivate positive affect and resilience. [ Journal of Psychosocial Nursing and Mental Health Services, 58 (6), 46–55.]

Objective:To investigate the level of nurses' turnover intention in ClassⅢ Grade A hospitals, and explore the correlation and interaction between nurses' psychological capital, social support, and turnover intention.Methods:Totally 2 600 nurses from 3 ClassⅢ Grade A hospitals in Urumqi were selected for questionnaire survey with the general demographic information questionnaire, Psychological Capital Questionnaire (PCQ) , Social Support Scale (SSS) , and Turnover Intention Scale (TIS) between January and August 2018. Totally 2 345 valid questionnaires were recovered. The structural equation model was used to analyze the mediating effect of nurses' psychological capital in the path of social support and turnover intention.Results:The total scores of 2 345 nurses' psychological capital, social support, and turnover intention were (86.30±8.99) , (41.17±7.68) , and (14.39±3.63) , respectively. The correlation analysis showed that nurses' social support and psychological capital scores were negatively correlated with their turnover intention score ( P<0.05) . The structural equation model analysis revealed that psychological capital had a mediating effect between social support and turnover intention, and the mediating effect accounted for 38.2% of the total effect. Conclusions:Nurses in Class Ⅲ Grade A hospitals have a high level of turnover intention. Nursing managers may reduce nurses' turnover intention by improving their social support and psychological capital.

目的:分析O2O模式应用于社区中青年高血压患者健康管理的干预效果.方法:将2017年2-5月在乌鲁木齐市某社区卫生服务中心进行体检以及就诊的262例中青年原发性高血压患者随机分为干预组与对照组,干预组给予O2O模式的健康管理,对照组给予社区签约制服务,干预时间为6个月.结果:干预组患者高血压相关知识和依从性得分高于对照组(P<0.05);两组患者的收缩压、舒张压较干预前均有下降,但干预组降压效果更明显,差异有统计学意义(P<0.05).结论:O2O模式能够提高社区中青年高血压患者健康管理知识,改善患者治疗依从性和血压.

Background: The attitudes and perceptions of cervical cancer survivors (CCS) toward sexual activity after a diagnosis of cervical cancer and its treatment are unknown. This study describes the experience of CCS in Hunan Chinese about sexuality and sexual function after cervical cancer treatment.Methods: We used descriptive phenomenology to qualitatively assess these experiences. Purposive sampling was used to recruit 20 CCS. Data were collected through in-depth interviews and analyzed according to Colaizzi’s method to explore the essence of the experience in sexuality among CCS after cancer treatment.Results: Uncertainty, fear, and worry dominated the attitudes and behaviors of CCS-related to sexual activity after treatment. Four themes explain these complex emotional responses: 1) needing information; 2) dealing with sexual changes physically and emotionally; 3) communicating with a partner; 4) attribution of fault to her one-lifetime sexual partner.Conclusion: Sexual life was influenced by the physical changes associated with cervical cancer treatment. These changes in combination with inadequate information and limited communication led to uncertainty, fear and worry about engaging in sexual activity and relationship distress. Chinese CCS need targeted and patient-centered information on the change in sexual life caused by treatment, anticipatory guidance, and support in communication with providers and partners, and strategies to cope with the physical and psychosexual sequelae of treatment, all of which must be congruent with their cultural norms.

目的 了解胃癌风险人群对胃癌危险因素与预警症状的认知现况及其影响因素.方法 采用自设的胃癌危险因素与预警症状问卷,对1 170名胃癌风险人群进行调查,并对具有不同人口学特征和胃癌行为危险因素的研究对象知识得分情况进行分析.结果 胃癌风险人群对胃癌危险因素与预警症状知识的认知水平较差,平均得分为6.02分(总分22分).多因素logistic回归分析显示:性别、年龄、生活所在地、婚姻状况、经济收入、胃癌家族史、胃部相关疾病、饮食清淡度、腌制食品摄入、饮食规律度、吸烟和饮酒是影响知识水平的因素.结论 胃癌风险人群对胃癌危险因素与预警症状知识掌握不足,不同人口学特征人群的认知水平存在差异,且有胃癌行为危险因素的人群比没有胃癌行为危险因素的人群认知水平更低.医务人员应结合风险人群的具体情况开展个体化指导干预,提高胃癌风险人群知识水平,以促进健康行为,降低胃癌风险.

OBJECTIVES:This study aimed to assess the knowledge of risk factors and warning symptoms and attitude towards gastric cancer screening among the general population in China.SETTING:Hunan province, China PARTICIPANTS: Individuals aged older than 18 years were recruited using a cluster sampling method.DESIGN:A cross-sectional study, and a pretested structured questionnaire was used to assess participants' awareness of gastric cancer.PRIMARY AND SECONDARY OUTCOME MEASURES:Knowledge level of risk factors and warning symptoms of gastric cancer, gastric cancer screening attitude, sociodemographic factors associated with gastric cancer knowledge and screening behaviour.RESULTS:This study comprised 1200 participants with a mean age of 40.31 (SD 16.73) years, of whom 622 (51.8%) were women. The mean score for gastric cancer knowledge was 8.85/22 (SD 6.48). There were 47.0% of the participants who had a low knowledge level about the risk factors and warning symptoms of gastric cancer. In total, 83.8% believed screening is helpful for early detection of gastric cancer, and 15.2% had undergone gastric cancer screening. The most common reason for not undergoing screening was having 'no symptoms' (63.0%), followed by 'fear of undergoing gastroscopy' (38.1%). Independent factors related to lower knowledge levels included male sex, living in rural areas, lower educational level, working as a farmer and without a family history of gastric cancer (p<0.05). Factors independently associated with screening behaviour included white-collar employment, higher income and having upper gastrointestinal tract diseases (p<0.05).CONCLUSIONS:In China, people have poor knowledge about risk factors and warning symptoms of gastric cancer, but a majority have a positive attitude towards the benefits of gastric cancer screening. Being asymptomatic and having a fear of gastroscopy were the main self-reported reasons for not undergoing screening. These results highlight the urgent need for educational campaigns to improve gastric cancer awareness.

Aim: The aim of this study was to examine the feasibility and efficacy of nurse-led team management (NLTM) intervention at improving the self-management of patients with type 2 diabetes (T2D) at community settings in Changsha, Hunan, China. Background: China has become the country with the largest number of patients with diabetes, and that number is growing, causing increasing pressure on the health care system. At present, the main diabetes management model in China is teamwork guided by general practitioners. However, the number of general practitioners is insufficient, and their work is overloaded, which leads to poor outcomes of diabetes management. Therefore, it is important to explore alternative methods of diabetes management, such as NLTM. Patients and methods: In a randomized controlled trial, 171 T2D patients were randomized into the control or intervention arm. Participants in the control group received routine management from the community health service center, whereas the intervention group received 12 months NLTM intervention in addition to the standard care. The diabetes self-management scale, fasting blood sugar, and glycosylated hemoglobin A1c (HbA1c) were assessed at baseline and at 6 and 12 months after the start of the intervention. Results: Baseline data were comparable between arms. Repeated-measurement analysis showed that self-management of the intervention group improved compared with the control group after the intervention (P<0.05). There were no significant differences in HbA1c at 6 months, whereas after 12 months of intervention, there was a significant difference in HbA1c between the two groups (F=10.114, P<0.05). The intervention had no significant effect on fasting blood sugar. Conclusion: The NLTM intervention has resulted in an impact of practical significance on T2D self-management, and was beneficial for controlling the level of HbA1c. The study has demonstrated the feasibility and efficacy of using NLTM in the management of T2D in a Chinese community.

Objective To discuss the application effect of improved hospital nursing emergency management system and human resource allocation in disaster rescue .Methods In June 2016 ,the hospital nursing emergency management system was improved and human resources management was implemented scientifically .156 cases having received emer-gency rescue in typhoon disasters from June 2015 to June 2016 were selected as control group ,and was applied with tradi-tional nursing emergency management system and human resoure allocation ,while 188 cases receiving emergency rescue in typhoon disasters from July 2016 to June 2017 were selected as observation group ,and was applied with improved nursing emergency management system and human resoure allocation .The speed of emergency response before and after improve-ment ,the triage time ,admission time and the success rate of rescue were analyzed retrospectively .Results Time of con-trol group The average emergency response time in the control group was (4 .96 ± 0 .30) min ,more than than that in the observation group(2 .13 ± 0 .40)min .The time of traige and admission in the control group were (4 .83 ± 0 .60)min and (20 .32 ± 0 .40)min ,respectively ,but(1 .96 ± 0 .40)min and(13 .87 ± 0 .50)min in the observation group .The success rate of rescue in the control group was 97 .53％ ,which was significantly higher than that in the observation group of 90 .54％ (all P<0 .05) .Conclusion The improved emergency management system and optimized human resources allocation are very important to shorten the emergency rescue time ,improve the success rate of rescuing patients ,enhance fast and efficient re-sponse to disaster ,and reduce casualties caused by typhoon disaster .

China has a national requirement that children's vaccination status is to be checked upon entry to kindergarten and school; children who have missed vaccine doses are to be referred to vaccination clinics to receive the necessary vaccinations. Most provinces have Immunization Information Systems (IIS) that contain and manage vaccination records of children served by immunization clinics. We conducted an evaluation in Hubei and Ningxia provinces using IIS data to determine the effect of their school entry immunization record checking strategy (SECS) on vaccination coverage and rate of catch-up for selected vaccines. We selected two counties with well-functioning IISs from each province. Names and demographic information of children enrolled in 185 kindergartens and 125 primary school in 2016 were used to identify children in the 115 and obtain their vaccination records. We calculated vaccination coverage before and after implementation of the SECS and determined catch-up rates for 5 vaccines, of which 3 are given before 2 years of age and 2 are given after 2 years of age. Among the 20,215 newly-enrolled children, 75% were able to be matched with IIS records. Few children who had missed one or more doses of the 3 vaccines recommended in the first two years of life received catch-up doses after SECS. For vaccines scheduled after 2 years of age, there was a statistically significant (p < 0.05) coverage increase in both provinces following the school-entry record check. Among children who were age-eligible for the selected vaccines before SCES, the catch-up rate was <50%. SECS provides opportunities to identify incompletely vaccinated children, improve coverage, and remind families of school-age children about up-coming vaccinations; SECS has potential to improve completeness of IIS data and enrollment of children in immunization clinics. Evidence-based policy with implementation guidance and routine monitoring are necessary to improve China's school entry checking strategy. (C) 2018 Elsevier Ltd. All rights reserved.

Abstract Objective:To investigate the status quo of urination behavior of female nursing undergraduates and its influencing factors.Methods:By stratified cluster sampling,the nursing students of 6 nursing universities in China based on region(northeast,East China,central China,Southern China,southwest and northwest) were randomly selected as the research subjects,and a crosssectional survey was carried out by the general data questionnaire and the revised version of female urination behavior scale.Results:The main manifestations of urination behaviors problems in female nursing students were the selection of urination sites and holding up the urine,and the differences in the total score of urination in students in different grades,with chronic constipation and urinary tract infection were statistically significant(all P＜0.01).Pearson correlation analysis showed that age was positively correlated with the total score of urination behavior(r=0.218,P＜0.05).Conclusions:Female nursing undergraduates had problems in urination behavior.The education of constructing correct urination behavior was helpful to enhance their healthy urination behavior.

目的 实验研究黄芪虫藤饮对缺血性脑卒中大鼠梗死灶周围组织血管内皮生长因子(VEGF)及受体(Flk-1)mRNA表达的调节作用.方法 选取SD雄性大鼠88只,通过线栓法来制备脑缺血大鼠模型,依据随机数字表法将大鼠分为两组,观察组(44只),对照组(44只);观察组大鼠在手术以后2 h起使用黄芪虫藤饮药液灌胃,每天两次,对照组同剂量、同时间使用清水灌胃.采用RT-PCR法检测梗死灶周边Flk-1及VEGF mRNA表达情况.结果 不同时间点观察组大鼠Flk-1 mRNA与VEGF表达量对比差异有统计学意义(P<0.05),不同时间点对照组大鼠Flk-1 mRNA与VEGF表达量对比差异有统计学意义(P<0.05);两组大鼠第3天开始其VEGF表达量都呈现为逐渐降低趋势,对两个时间点间直线斜率对比,观察组第3～6天降低速度较对照组快(斜率 α,-0.25<0.18),第6～12天和第12～24天降低的速度较对照组慢(斜率 α,-0.12>-0.15,-0.1>-0.14);两组大鼠第3～6天其Flk-1表达量短暂上升,6 d以后呈现降低趋势,其中观察组大鼠第3～6天Flk-1表达升高速度较对照组快(斜率 α,0.18>0.14),第6～12天和第12～24天降低速度较对照组慢(斜率 α,-0.12>-0.14,-0.22>-0.30).结论 黄芪虫藤饮可能经过对Flk-1及VEGF基因产生作用促进脑梗死灶周边组织血管再生,使脑梗死神经损伤恢复速度加快.

为探讨腹部闭合性损伤患者的急诊诊断和治疗效果,本研究选取本院收治的56例腹部闭合性损伤患者,在及时诊断的基础上,根据诊断结果,对患者实施有针对性的治疗方法,进一步分析评估急诊治疗效果.结果显示,此次纳入研究的56例腹部闭合性损伤患者中,52例采取手术方法进行治疗,治愈50例(96.15％),死亡2例(3.85％),其中1例术中死亡,1例术后死亡,术中死亡原因为多脏器功能衰竭,经手术抢救无效死亡;术后1例则为失血过多出现休克死亡;其余4例采取非手术治疗均治愈.56例患者,治愈54例,治疗总有效率高达96.43％.本研究认为,在临床上,针对腹部闭合性损伤患者,需把握好诊断及治疗时间,掌握患者的手术时机,并选取合理、科学的手术方式,对于非手术方法治疗患者,同样需做好各项生命体征及病情的监测,进一步为治疗成功率的提升奠定坚实的基础.

心理韧性(resilience )也被称为心理弹性,它是指人类面对逆境、创伤或压力时良好的适应过程 ,也是个体的一种品质和能力[1 ] .近年来 ,心理韧性被广泛应用到职业领域 ,尤其是护理研究、教育和临床实践当中.护理工作是公认的高压力、高风险职业,巨大的工作压力对护士的身心健康、工作和生活造成了严重的负面影响 ,并最终危害患者的预后和降低护理质量.心理韧性是帮助护士应对职场逆境的关键因素 ,能避免或减轻工作压力所致各种不利结局 :如工作倦怠、同情心疲乏、焦虑、抑郁、创伤后应激障碍等[2 ] .研究[3-4 ]也发现,虽然面对同样的压力、挑战和复杂的情感需求 ,高韧性护士更能积极应对、适应良好并成功实现自身成长和职业发展.因此 ,关注并提高护士的心理韧性 ,对于促进护士群体的身心健康 ,提高护理安全和质量具有重大意义.目前国内外研究差距较大 ,国内的研究多为现状评估 ,而国外的研究逐渐扩展到对护士心理韧性定义和内涵的探讨、理论模型的建构以及干预的实施与效果评价.现将近年来国外护士心理韧性的研究综述如下 ,以期对国内的研究和实践提供相应的指导和启示.

Neonatal maternal deprivation (MD) leads to depressive-like behaviors by promoting hippocampal neuronal apoptosis, but whether and how ERK1/2 signaling participates in MD-induced hippocampal neuronal apoptosis remains unclear. We therefore explored the role of ERK1/2 signaling pathway in neonatal MD-induced depression. Neonatal rats were divided into control group, PD group given intraperitoneal injections of MAPKK inhibitor (PD98059), MD group, and MD+PD group. The neonatal MD model was confirmed by behavioral tests. Compared with controls, MD group showed increased hippocampal neuronal apoptosis, higher mRNA expressions of Bax, caspase-3 and caspase-9mRNAs, and lower expression of Bcl-2 and BDNF. Similarly, compared with controls, MD group showed higher protein expression and wider distribution of Bax, caspase-3, caspase-9 and Cytochrome C but lower protein expression of Bcl-2, p-CREB, BDNF and p-ERK1/2. The changes in the MD group were reversed in the MD+PD group, except that p-ERK1/2 expression was decreased. In conclusion, MD-induced depression is associated with hippocampal neuronal apoptosis, which may be mediated by the ERK1/2 signaling pathway. These findings may provide novel avenues for depression therapy.

The purpose of the study was to evaluate the effects of a modified mindfulness-based stress reduction (MBSR) program on the levels of stress, affect, and resilience among nurses in general hospitals in mainland China. In addition, the study attempted to determine the impact of the program on job satisfaction. A total of 110 nurses were randomly assigned to the intervention versus control groups. The intervention group participated in a modified 8-week MBSR program. All participants were evaluated with questionnaires at baseline, immediately after the intervention, and 3 months later. The intervention group showed decreases in stress and negative affect and increases in positive affect and resilience after the intervention. No improvement in job satisfaction was observed, but the trends of the data were in the hypothesized direction that job satisfaction would improve. The modified MBSR program is an effective approach for nurses to decrease stress and negative affect and improve positive affect and resilience. In addition, the program has the potential to improve job satisfaction.