BackgroundThe prevalence of mental health issues among secondary school students is on the rise. Secondary school teachers, outside the home environment, are often in a prime position to identify adolescents facing mental health challenges. Limited knowledge regarding the experiences and perspectives of secondary school teachers when encountering this particular group of students, particularly in Asian countries.ObjectivesThis study aimed to describe the lived experiences of secondary school teachers exposed to students with mental health issues in the classroom in a Chinese context.MethodsA descriptive phenomenological approach within the tradition of Husserl was used. A purposive sampling method was used to collect the participants in Changsha, Hunan, China. Sixteen secondary school teachers participated in this study. Individual, face-to-face interviews were conducted, tape-recorded, and transcripted. Colaizzi’s seven-step descriptive phenomenological method was used to do the data analysis.ResultsOne Central theme: Living in fear at the unpredictability of mental health issues in the classroom and four sub-themes emerged: (1) Worried and anxious by the uncertainty of student mental health issues; (2) Scared and afraid by students’ unpredictable behaviors; (3) Afraid of students’ failure and its potential outcome; (4) Students having mental health issues are dangerous.Conclusions and implicationsThe teachers in this study found managing the unpredictability of mental health issues in the classroom deeply distressing and challenging. A comprehensive approach to address the cultural, social, and educational factors influencing secondary school teachers’ experiences is encouraged.

Objectives Mental health first aid (MHFA) may have beneficial effects on the public's knowledge, attitude, and behavior; however, its effectiveness in increasing mental health literacy on college students remains unknown. Methods We systematically searched the PubMed, EMBASE, and Cochrane Library databases from inception to January 2020. We included trials that compared the effect between the MHFA program group and control group on the knowledge, stigmatizing attitudes, confidence, and intention of college students. A random-effects model was used. Results We analyzed five trials involving 1134 participants and found that the MHFA program could significantly increase the student's knowledge (SMD: 0.49, 95% CI: [0.28-0.70]) and confidence (SMD: 0.71, 95% CI: 0.24-1.19). Conclusions Overall, the MHFA program could increase college students' knowledge regarding mental health and confidence to support people with mental health problems. However, well-designed control trials are required to investigate the program's effect on mental health literacy in college students.

Objective:The terms critical care and the Intensive Care Unit(ICU)are often used interchangeably to describe a place of care.Defining critical care becomes challenging because of the colloquial use of the term.Using concept analysis allows for the development of definition and meaning.The aim of this concept analysis is to distinguish the use of the term critical care to develop an operational definition which describes what constitutes critical care.Method:Walker and Avant's eight-step approach to concept analysis guided this study.Five databases(CINAHL,Scopus,PubMed,ProQuest Dissertation Abstracts and Medline in EBSCO)were searched for studies related to critical care.The search included both qualitative and quantitative studies written in English and published between 1990 and 2022.Results:Of the 439 papers retrieved,47 met the inclusion criteria.The defining attributes of critical care included 1)a maladaptive response to illness/injury,2)admission modelling criteria,3)advanced medical technologies,and 4)specialised health professionals.Antecedents were associated with illness/injury that progressed to a level of criticality with a significant decline in both physical and psychological functioning.Consequences were identified as either death or survival with/without experiencing post-ICU syndrome.Conclusion:Describing critical care is often challenging because of the highly technical nature of the environment.This conceptual understanding and operational definition will inform future research as to the scope of critical care and allow for the design of robust evaluative instruments to better understand the nature of care in the intensive care environment.

BackgroundOlder adults' psychological health is a public health issue that cannot be ignored, especially when these psychological health problems and related factors change across different social backgrounds because of rapid changes in traditions and family structures and the epidemic responses after the outbreak of COVID-19 in China. The aim of our study is to determine the prevalence of anxiety and depression and their associated factors among community-dwelling older adults in China.MethodsA cross-sectional study was conducted from March to May 2021 with 1173 participants aged 65 years or above from three communities in Hunan Province, China who were selected using convenience sampling. A structured questionnaire including sociodemographic characteristics, clinical characteristics, the Social Support Rating Scale (SSRS), the 7-Item Generalized Anxiety Disorder scale (GAD-7), and the Patient Health Questionnaire-9 Item (PHQ-9) was used to collect relevant demographic and clinical data and to measure social support status, anxiety symptoms, and depressive symptoms, respectively. Bivariate analyses were conducted to explore the difference in anxiety and depression based on samples' different characteristics. The multivariable logistic regression analysis was performed to test for significant predictors of anxiety and depression.ResultsThe prevalence of anxiety and depression were 32.74% and 37.34%, respectively. Multivariable logistic regression analysis revealed that being female, being unemployed before retirement age, lacking physical activity, having physical pain, and having three or more comorbidities were significant predictors for anxiety. Subjective social support and support utilization were significant protective factors. Regarding depression, religion, lacking physical activity, having physical pain, having three or more comorbidities were found to be significant predictors. Support utilization was a significant protective factor.ConclusionsThe study group showed a high prevalence of anxiety and depression. Gender, employment status, physical activity, physical pain, comorbidities, and social support were associated with psychological health problems of older adults. These findings suggest that governments should focus on the psychological health problems of older adults by raising community awareness of issues related to older adults' psychological health. They should also screen for anxiety and depression among high-risk groups and encourage individuals to seek supportive counseling.

目的 了解大学生感知压力、自我控制与手机成瘾的现状并探讨三者之间的关系.方法 2019年5月抽取湖南省长沙市某高校678名大学生,采用中文版压力知觉量表、自我控制量表和手机成瘾指数量表进行调查,分析大学生的感知压力、自我控制水平及手机成瘾情况现状及三者之间的关系.结果 大学生感知压力总分为(26.52±5.97)分,自我控制总分为(52.53±9.93)分,手机成瘾总分为(42.19±11.02)分;大学生手机成瘾与感知压力、自我控制两两之间呈正相关(r=0.322～0.573,均P<0.01);中介效应分析表明,感知压力通过自我控制间接影响手机成瘾,自我控制的中介效应(β=0.471,95％CI:0.372～0.585)占总效应的79.88％.结论 大学生感知压力水平较高、自我控制与手机成瘾情况不容乐观,自我控制在感知压力和手机成瘾之间起部分中介作用.

Background The outbreak of the COVID-19 pandemic imposed a heavy workload on nurses with more frequent night shifts, which led to higher levels of insomnia, depression, and anxiety among nurses. The study aimed to describe the symptom-symptom interaction of depression, anxiety, and insomnia among nurses and to evaluate the impact of night shifts on mental distress via a network model. Methods We recruited 4,188 nurses from six hospitals in December 2020. We used the Insomnia Severity Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Scale-7 to assess insomnia, depression, and anxiety, respectively. We used the gaussian graphical model to estimate the network. Index expected influence and bridge expected influence was adapted to identify the central and bridge symptoms within the network. We assessed the impact of night shifts on mental distress and compared the network structure based on COVID-19 frontline experience. Results The prevalence of depression, anxiety, and insomnia was 59, 46, and 55%, respectively. Nurses with night shifts were at a higher risk for the three mental disorders. “Sleep maintenance” was the central symptom. “Fatigue,” “Motor,” “Restlessness,” and “Feeling afraid” were bridge symptoms. Night shifts were strongly associated with sleep onset trouble. COVID-19 frontline experience did not affect the network structure. Conclusion “Sleep maintenance,” “Fatigue,” “Motor,” and “Restlessness” were important in maintaining the symptom network of anxiety, depression, and insomnia in nurses. Further interventions should prioritize these symptoms.

目的 探索云班课+BOPPPS+视频反馈教学模型在常用护理技术实验课中的应用效果.方法 将2018级高职护生设为对照组,2019级高职护生设为试验组,对照组采用传统教学模式,试验组采用云班课+BOPPPS+视频反馈教学模型,比较两组常用护理技术课程教学效果.结果 两组期末铺麻醉床、无菌技术6项、密闭式静脉输液3项操作考试成绩差异无统计学意义(P>0.05),但铺床角环节、戴无菌手套环节、排气环节成绩试验组均高于对照组(P<0.05).结论 云班课+BOPPPS+视频反馈教学模型有助于提高高职护生的护理操作质量,培养自主学习能力,树立职业榜样.

Objective:To construct a training program to improve the psychological nursing ability of clinical nurses, so as to provide a strong guarantee for the clinical development of psychological nursing.Methods:By consulting the literature, related books and investigating the curriculum of nursing colleges, the first draft of the training program was drawn up. Four departments of Cardiovascular Medicine of the Second Xiangya Hospital of Central South University from May to August 2019 were recruited and 64 nurses were trained. After the training, the training program was revised again. After two rounds of training and modification, the second draft of the training program was formed, and then Delphi method was used to conduct two rounds of expert consultation on the second draft of the training program.Results:The positive coefficients of experts in the two rounds of consultation were 94.1% and 96.7% respectively, and the average authority coefficient of experts was 0.81. The final training contents included 5 first-class indexes, 18 second-class indexes and 45 third-class indexes. The coefficient of variation of each item of training contents was 0.06-0.23, and the coefficient of variation of training methods and training duration of each part was 0.06-0.17.Conclusions:The training program is scientific, reasonable, detailed and practical, which can provide guarantee for improving the psychological nursing ability of clinical nurses.

目的:分析非暴力沟通培训对护士沟通能力和住院患者护患信任度及对护理服务满意度的影响.方法:2020年10月-12月,选取湖南省某三级甲等医院3个科室6个病区的护士为干预对象,住院患者为观察对象.以病区为单位分为对照组和干预组,对照组病区的38名护士按照专科在职培训计划接受每月的专科培训,干预组病区的38名护士在对照组的基础上增加非暴力沟通培训.在干预前及干预结束后1个月收集两组护士沟通能力量表的得分,在护士接受培训结束后的1个月收集患者的护患关系信任度量表及纽卡斯尔护理服务满意度量表的得分.结果:干预后干预组护士沟通能力总分及各维度得分高于对照组(P＜0.05);干预组患者护患关系信任度及对护理服务的满意度得分均高于对照组(P＜0.05).结论:对护士进行非暴力沟通培训能够提高护士的沟通能力及患者的护患关系信任度和对护理服务的满意度.

Background Nurses are at high risk for depression and anxiety symptoms after the outbreak of the COVID-19 pandemic. We aimed to assess the network structure of anxiety and depression symptoms among Chinese nurses in the late stage of this pandemic. Method A total of 6,183 nurses were recruited across China from Oct 2020 to Apr 2021 through snowball sampling. We used Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder scale-7 (GAD-7) to assess depression and anxiety, respectively. We used the Ising model to estimate the network. The index “expected influence” and “bridge expected influence” were applied to determine the central symptoms and bridge symptoms of the anxiety-depression network. We tested the stability and accuracy of the network via the case-dropping procedure and non-parametric bootstrapping procedure. Result The network had excellent stability and accuracy. Central symptoms included “restlessness”, “trouble relaxing”, “sad mood”, and “uncontrollable worry”. “Restlessness”, “nervous”, and “suicidal thoughts” served as bridge symptoms. Conclusion Restlessness emerged as the strongest central and bridge symptom in the anxiety-depression network of nurses. Intervention on depression and anxiety symptoms in nurses should prioritize this symptom.

When a biological public health event breaks out, due to the characteristics of their work, doctors and nurses must face risks directly when the situation is unknown. Their difficulties and psychological pressure are unimaginable. However, few studies have investigated the difficulties encountered by those doctors and nurses and their requirements for psychological interventions. This study aimed to explore the difficulties and psychological intervention needs of doctors and nurses during the new biological public health events in China in 2019. We carried out a qualitative study using a phenomenological approach. We used convenience sampling to identify participants who provided direct care and treatment for patients with biological events such as coronavirus disease 2019 (COVID-19). They participated in semi-structured, in-depth face-to-face interviews. The interviews were transcribed and analyzed using Colaizzi's seven-step method. Analysis of this study was divided into the difficulties encountered by doctors and nurses and their mental health need. The difficulties encountered by doctors and nurses included four themes: being worried about the impact on others, lack of knowledge and skills, difficult patients, being socially isolated, and the feeling of uncertainty. The mental health need was summarized into two parts, needs expressed by doctors and nurses and needs observed by researchers. Doctors and nurses mostly did not feel that they needed any psychological support, but the researchers noticed several signs of stress or potential mental health problems among interviewees. Doctors and nurses faced significant complex and multidimensional difficulties. Many denied needing psychological support, even though the researchers noted signs that it might be helpful. Interventions and support strategies that involve mental health promotion activities should consider individual needs related to doctors and nurses' situation.

目的:调查失眠患者出院后的睡眠状况及影响因素,为提高失眠的全病程管理治疗提供依据.方法:对中南大学湘雅二医院睡眠病区2016年8月至2020年3月出院的失眠患者进行电话随访及问卷星调查,研究工具包括一般资料问卷、失眠严重指数、患者健康问卷抑郁量表、广泛性焦虑障碍问卷等.结果:电话随访了382例患者,完成随访调查者201例,82.6％的患者睡眠一般或较好.54例患者知情并同意参与问卷星调查,其中无失眠者仅18例(33.3％),失眠严重指数总分为(11.91±7.17)分.不同病程患者的失眠严重指数总分比较差异有统计学意义(P<0.05),两两比较发现病程<1年的患者,其总分均小于其他病程组.不同失眠严重程度组的病程构成比、焦虑均分、抑郁均分比较差异均有统计学意义(P<0.05).结论:大部分失眠患者出院后睡眠状况较好.睡眠与病程有较大关系,病程1年以下者睡眠恢复较好.而轻度及以上的失眠患者,其焦虑、抑郁更明显.建议失眠患者早期规范就诊,以期取得更佳的治疗效果.

目的:突发公共卫生事件对护士造成明显的心理负担,影响护士心理健康.新型冠状病毒肺炎疫情暴发之后,护士的心理健康备受重视.本研究通过调查常态化疫情时期护士的焦虑、抑郁、失眠现状及影响因素,并进一步比较不同级别医院护士、一线抗疫护士和其他护士的焦虑、抑郁及失眠的风险,旨在为医院心理健康工作、管理工作和相关研究提供理论依据.方法:2020年12月选取湖南省内各级医院护士共4237名,采用一般资料调查表、7项广泛性焦虑障碍问卷(Generalized Anxiety Disorder-7 items,GAD-7)、9项患者健康问卷(Patient Health Questionnaire-9 items,PHQ-9)、失眠严重指数(Insomnia Severity Index,ISI)对护士进行问卷调查.采用描述性统计分析了解护士焦虑、抑郁、失眠的情况;采用t检验、方差分析、多元线性逐步回归分析等方法分析护士焦虑、抑郁、失眠的影响因素.结果:4237名护士GAD-7总分为4.44±4.20,中重度焦虑者占10.3％;PHQ-9总分为6.03±4.76,中重度抑郁者占17.5％;ISI总分为8.37±5.42,中重度失眠者占12.3％.不同医院级别、性别、职称、职务、文化程度、最近1年轮晚夜班个数、家庭月收入组的GAD-7、PHQ-9、ISI得分差异有统计学意义(均P<0.05),不同婚姻状况、是否参加一线抗疫、是否参加心理健康知识培训组的GAD-7、PHQ-9、ISI得分差异无统计学意义(均P>0.05).性别、医院级别、职称、学历、最近1年轮晚夜班个数、家庭月收入是GAD-7、PHQ-9得分的影响因素.性别、工龄、职务、医院级别、学历、最近1年轮晚夜班个数、家庭月收入是ISI得分的影响因素.结论:参加抗疫与没有参加抗疫的护士GAD-7、PHQ-9、ISI得分无差别,说明中国对于抗疫医护人员的一系列举措有效;常态化疫情时期,部分护士存在焦虑、抑郁及失眠问题,应着重注意女性、无职务、轮晚夜班个数较多、地市级医院及家庭月收入低的护士的心理健康.建议通过给予政策、提供心理支持及人力资源保障等措施缓解护士的压力,维护其心理健康;同时,建议在应对突发公共卫生事件时,将心理健康知识培训作为上岗前的常规培训内容.

OBJECTIVES Public health emergencies have caused significant psychological burden on nurse and affect their mental health. After the coronavirus disease 2019 pandemic, the nurse's mental health has been paid much attention. This study aims to investigate status and influencing factors for anxiety, depression, and insomnia in nurses during the normalized epidemic period, and to further compare the risk of anxiety, depression, and insomnia among nurses at different levels of hospitals between front-line epidemic nurses and other nurses so as to provide a basis for mental health work, nursing management, and relevant study in hospital. METHODS A total of 4 237 nurses from all levels of hospitals in Hunan Province participated in the survey in December 2020. A self-designed anonymous questionnaire was used in this study. Anxiety, depression, and insomnia were assessed using Generalized Anxiety Disorder-7 items (GAD-7), Patient Health Questionnaire-9 items (PHQ-9), and Insomnia Severity Index (ISI), respectively. Descriptive statistical analysis was used to evaluate nurses' anxiety, depression, and insomnia; t-test, analysis of variance, and multiple linear stepwise regression analysis were used to analyze the influencing factors of nurses' anxiety, depression, and insomnia. RESULTS The scores of GAD-7 among 4 237 nurses were 4.44±4.20, with 10.3% of them experienced moderate to severe level anxiety. The scores of PHQ-9 were 6.03±4.76, with 17.5% of them experienced moderate to severe level depressive symptom. The scores of ISI were 8.37±5.42, with 12.3% of them experienced moderate to severe insomnia. There were significant differences in GAD-7, PHQ-9, and ISI scores among different groups of hospital levels, gender, professional title, position, education level, night shifts, and family monthly income (all P<0.05). Marital status, whether to participate in the front-line, and whether to participate in psychology training groups were not associated with anxiety, depression, and insomnia (all P>0.05). Gender, hospital level, professional title, educational background, more night shifts, and family monthly income were the influencing factors for the GAD-7 and PHQ-9 scores. Gender, length of service, position, hospital level, educational background, night shifts in the last year, and family monthly income were the influencing factors for ISI score. CONCLUSIONS There is no difference in the scores of the GAD-7, PHQ-9, and ISI between nurses whether to participate in the front-line, indicating that series of measures for front-line medical staff are effective in China.Meanwhile, some nurses experienced anxiety, depression, and insomnia, and attention should be paid to nurses with low position, more night shifts, lower-level hospitals, and families with low income. It is recommended that management policies, psychological support, and human resource protection should be given to relieve the pressure and maintain the mental health of nurses. At the same time, it is necessary to make mental health knowledge training as a routine training when responding to public health emergencies.

失眠是一种威胁人类健康的慢性疾病,失眠认知行为治疗被推荐为一线治疗方法,移动应用程序作为移动医疗的主要形式在近几年得到高度关注,尤其是慢性疾病的管理中,本研究从失眠认知行为治疗智能手机应用程序的现状及其在失眠患者管理中的应用进行了文献回顾,以期为国内开展失眠管理的移动医疗服务提供参考.

目的 描述初中学生睡眠现状并探讨其对精神健康的影响.方法 采用自行设计的一般资料调查表、睡眠情况调查表及长处和困难问卷(学生版)调查分层整群随机抽样法确定的653名初中学生的睡眠及精神健康情况.结果 ①初中学生每晚平均睡眠时长为(7.85±1.35)h,自我感觉睡眠很好的学生仅占35.5％,29.7％的学生经常上床后30 min睡不着,13.2％的学生晚上会多次醒来,早上能容易起床的学生仅占60.3％,而仅有66.2％的学生能在上课时间保持清醒;②困难总得分为(12.09±5.67)分,其中行为问题得分为(2.42±1.66)分,多动-注意缺陷得分为(3.65±2.08)分,情绪症状得分为(2.82±2.32)分,同伴关系问题得分为(3.21±1.79)分,亲社会行为得分为(7.02±2.39)分.精神健康问题检出率最高的为亲社会行为(占14.5％),其次为行为问题(11.2％),再者为同伴关系问题(11.0％).③路径分析结果显示,睡眠状况不佳对精神状况有不良影响.结论 初中学生睡眠状况整体欠佳,精神健康存在一定问题,睡眠情况显著影响精神健康.

目的 了解护士新型冠状病毒肺炎(简称新冠肺炎)相关知识现状及影响因素,为开展有效培训提供参考.方法 采用自行编制的护士新冠肺炎相关知识调查问卷,对湖南省长沙市救治新冠肺炎定点医院及其对口指导医院的护士进行调查.结果 3 119名护士新冠肺炎相关知识平均得分为(56.74±10.85)分,其中基础知识维度得分为(25.93±6.39)分,防控知识维度得分为(30.82±6.51)分,多元线性回归显示,医院类型、职称、文化程度、性别、科室是影响知识水平的重要因素(P＜0.05),能够解释3 119名护士新冠肺炎相关知识46.0％的变异度.结论 护士新冠肺炎相关知识水平较低,亟需加强培训.特别是对职称及学历低、男性、非重症病房的护士需要加大培训力度,还提示医院目前已开展的护士新冠肺炎防控知识培训方案也有必要进行改进,提高培训效果.

Background: Studies have shown that manual lymphatic drainage (MLD) has a beneficial effect on lymphedema related to breast cancer surgery. However, whether MLD reduces the risk of lymphedema is still debated. The purpose of this systematic review and meta-analysis was to summarize the current evidence to assess the effectiveness of MLD in preventing and treating lymphedema in patients after breast cancer surgery. Methods: From inception to May 2019, PubMed, EMBASE, and Cochrane Library databases were systematically searched without language restriction. We included randomized controlled trials (RCTs) that compared the treatment and prevention effect of MLD with a control group on lymphedema in breast cancer patients. A random-effects model was used for all analyses. Results: A total of 17 RCTs involving 1911 patients were included. A meta-analysis of 8 RCTs, including 338 patients, revealed that MLD did not significantly reduce lymphedema compared with the control group (standardized mean difference (SMD): -0.09, 95% confidence interval (CI): [-0.85 to 0.67]). Subgroup analysis was basically consistent with the main analysis according to the research region, the publication year, the sample size, the type of surgery, the statistical analysis method, the mean age, and the intervention time. However, we found that MLD could significantly reduce lymphedema in patients under the age of 60 years (SMD: -1.77, 95% CI: [-2.23 to -1.31]) and an intervention time of 1 month (SMD: -1.77, 95% CI: [-2.23 to -1.30]). Meanwhile, 4 RCTs including, 1364 patients, revealed that MLD could not significantly prevent the risk of lymphedema (risk ratio (RR): 0.61, 95% CI: [0.29-1.26]) for patients having breast cancer surgery. Conclusions: Overall, this meta-analysis of 12 RCTs showed that MLD cannot significantly reduce or prevent lymphedema in patients after breast cancer surgery. However, well-designed RCTs with a larger sample size are required, especially in patients under the age of 60 years or an intervention time of 1 month.

目的 探讨在初始沙盘游戏治疗中结合音乐焦点疗愈技术对抑郁症患者的治疗效果,并总结抑郁症患者治疗前后初始沙盘图的特征.方法 采用便利抽样法,收集2016年8月—2017年8月符合抑郁症诊断标准的门诊患者共54例,在初始沙盘游戏治疗中结合音乐焦点疗愈技术对其进行心理治疗.本研究为前后对照研究,采用的评价指标包括:抚沙产生的躯体感受、初始沙盘沙具的总体使用情况、初始沙盘的主题特征、抑郁自评量表,统计分析方法包括描述性统计分析、t检验.结果 (1)抚沙产生的躯体感受与沙盘呈现的情结有关.(2)初始沙盘沙具的总体使用情况:治疗后健康沙具较治疗前增多,而受伤沙具较治疗前减少.(3)初始沙盘的主题特征:通过疗愈焦点沙具,治疗前以创伤主题特征为主,治疗后以治愈主题为主.(4)治疗前后的抑郁自评量表得分差异无统计学意义(P>0.05).结论 结合患者在沙盘游戏治疗前后的特征性表现,提示在初始沙盘游戏治疗中结合音乐焦点疗愈技术对抑郁症有治疗价值.