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Patients’ sense of gain experience (PSGE) is the comprehensive feeling throughout the treatment process, which is a critical benchmark for evaluating comprehensive medical and health system reform in China. This study aims to assess the current status of PSGE in public hospitals and identify important associated factors, providing evidence-based recommendations for improving healthcare services.
This was a cross-sectional study conducted from October to November 2023.
A total of 14 public hospitals in Foshan, Guangdong Province, China.
There were 3223 responses, including 1592 from outpatients and 1631 from inpatients.
PSGE was assessed across five domains: time accessibility, service accessibility, cost affordability, patient participation and efficacy predictability. Participants were also asked to provide an overall rating of the PSGE.
The overall score for PSGE was 4.47±0.53 (mean±SD), with service accessibility receiving the highest score (4.68±0.50) and affordability the lowest (4.17±0.86). Secondary hospitals scored an overall PSGE of 4.55±0.50, while tertiary hospitals scored 4.42±0.54. Key factors associated with PSGE were overall satisfaction (β=0.164, p
This study found that patients reported a positive PSGE with service accessibility but reported a less positive PSGE with cost affordability. A tier-based disparity was evident, with secondary hospitals outperforming tertiary hospitals in overall PSGE outcome. Stronger PSGE was positively associated with higher scores in overall satisfaction, treatment satisfaction, satisfaction with medical reforms, patient loyalty and hospital reputation. Demographic and institutional factors, such as hospital level, patient type and household registration, were associated with the PSGE. Efforts can be focused on enhancing clinicians’ willingness and competence in discussing treatment costs during clinical encounters. It is essential for policymakers to address disparities in healthcare experiences among patient groups across hospital tiers to advance equitable, patient-centred systems.
Colonoscopy is an essential procedure for the early diagnosis of colorectal conditions; however, over 60% of patients undergoing non-sedated colonoscopy report moderate to severe pain. This study aims to investigate the central analgesic mechanisms of transcutaneous electrical nerve stimulation based on wrist-ankle acupuncture theory (TENS-WAA). A multimodal approach combining electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) will be employed to assess pain-related brain activity, with artificial intelligence applied to model the relationship between objective neurophysiological signals and subjective pain experience.
This is a single-centre, randomised, double-blind, controlled trial involving 60 patients undergoing colonoscopy without anaesthesia. Participants will be randomly allocated (1:1) to either an electrical stimulation group receiving TENS-WAA or a sham stimulation group. EEG and fNIRS data will be acquired before, during and after the procedure. The primary outcome is the analysis of EEG-fNIRS signals to characterise cerebral responses associated with pain modulation. Secondary outcomes include patient-reported pain using the Visual Analogue Scale (VAS), total colonoscopy duration and the correlation between EEG-fNIRS indicators and VAS scores. A deep learning framework will be used to enhance pain prediction accuracy.
This study has received ethical approval from the Ethics Committee of Changhai Hospital, Shanghai (approval reference CHEC2025-006), and has been registered at ClinicalTrials.gov. Written informed consent will be obtained from all participants. Findings will be disseminated in peer-reviewed academic journals and at relevant scientific conferences, regardless of outcome, contributing to evidence-based, non-pharmacological pain management strategies.
ClinicalTrials.gov, NCT06813703.
To explore whether vaccine confidence and vaccine delay intention mediated the effect of the pay-it-forward intervention on human papillomavirus (HPV) vaccine uptake.
This secondary mediation analysis of a two-arm randomised controlled trial was conducted among female adolescents aged 15–18 years in Chengdu, China, from July 2022 to June 2023.
This study was conducted in four residential areas representing diverse economic backgrounds in Chengdu.
A total of 321 parents of girls aged 15–18 years who had not received the HPV vaccine participated in the study.
Participants were randomly allocated into two arms. Pay-it-forward participants received a community-contributed subsidy (47.7 USD) to support the HPV vaccination, along with educational postcards and an opportunity to donate to support others. In the standard-of-care arm, participants paid for their vaccination.
Primary outcome was the receipt of the first HPV vaccine dose within a 3-month period following an intervention. Based on previous literature, we hypothesised that vaccine confidence and vaccine delay intention were potential mediators. Vaccine confidence was measured using the vaccine confidence index. Vaccine delay intention refers to the caregiver’s preference to postpone HPV vaccination for their daughter until the preferred vaccine type becomes available, rather than accepting the immediately accessible HPV vaccine. Data on these mediators were collected via a self-administered online questionnaire conducted after the intervention but before vaccination.
Among urban participants, when compared with the standard-of-care arm, about 39% of the effect of the pay-it-forward intervention on vaccine uptake was mediated by a reduction in vaccine delay intention. Notably, vaccine confidence did not appear to mediate the effect of the intervention on vaccine uptake. Among suburban participants, no mediation effects were observed. In the suburban setting, caregivers who vaccinated their daughters showed poorer prior awareness of the HPV vaccine before participating in the trial compared with those who did not vaccinate their daughters (41.5% vs 21.1%; p=0.011).
Our findings indicate that among urban participants, the pay-it-forward may have effectively reduced vaccine delay intention, which was associated with an increased uptake of the HPV vaccine. However, in suburban areas, enhanced awareness might be a potential contributing factor to improved vaccine uptake, but further research is necessary to affirm this.
Chinese Clinical Trial Registry: ChiCTR2200055542.
This study assessed the knowledge, attitude and practice (KAP) of pregnant women in Chongqing, China, regarding pre-eclampsia and examined their inter-relationships.
A cross-sectional survey was conducted using validated questionnaires.
The study was conducted between May 2023 and August 2023 in Chongqing, China.
A total of 427 pregnant women were included, with 68.15% aged ≤30 years and a mean pregnancy duration of 238.18±45.01 days.
This was an observational study, and interventions were applied.
The primary outcomes were the KAP scores (knowledge: 0–40; attitude: 12–60 and practice: 10–50). The correlations and structural equation modelling (SEM) analyses were conducted to explore the relationships among KAP.
Mean scores were 22.19±12.17 (knowledge), 46.38±6.14 (attitude) and 41.96±5.96 (practice). Knowledge positively correlated with attitude (r=0.586, p
Pregnant women exhibited inadequate knowledge and a suboptimal attitude but a proactive practice. Targeted interventions to improve knowledge and attitudes are recommended for better clinical outcomes, particularly in regions where few such studies have been conducted.
by Yanxuan Wu, Fu Li, Hao Chen, Liang Shi, Meng Yin, Fan Hu, Gongchang Yu
BackgroundMetabolic syndrome (MetS) and sarcopenia are major global public health problems, and their coexistence significantly increases the risk of death. In recent years, this trend has become increasingly prominent in younger populations, posing a major public health challenge. Numerous studies have regarded reduced muscle mass as a reliable indicator for identifying pre-sarcopenia. Nevertheless, there are currently no well-developed methods for identifying low muscle mass in individuals with MetS.
MethodsA total of 2,467 MetS patients (aged 18–59 years) with low muscle mass assessed by dual-energy X-ray absorptiometry (DXA) were included using data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES). Least Absolute Shrinkage and Selection Operator (LASSO) regression was then used to screen for important features. A total of nine Machine learning (ML) models were constructed in this study. Area under the curve (AUC), F1 Score, Recall, Precision, Accuracy, Specificity, PPV, and NPV were used to evaluate the model’s performance and explain important predictors using the Shapley Additive Explain (SHAP) values.
ResultsThe Logistic Regression (LR) model performed the best overall, with an AUC of 0.925 (95% CI: 0.9043, 0.9443), alongside strong F1-score (0.87) and specificity (0.89). Five important predictors are displayed in the summary plot of SHAP values: height, gender, waist circumference, thigh length, and alkaline phosphatase (ALP).
ConclusionThis study developed an interpretable ML model based on SHAP methodology to identify risk factors for low muscle mass in a young population of MetS patients. Additionally, a web-based tool was implemented to facilitate sarcopenia screening.
This study aimed to investigate the relationship between coping strategies and compassion fatigue among healthcare professionals in Central Uganda.
A facility-based cross-sectional study conducted between June and July 2023. Three tools were used for data collection: a socio-demographic survey, the Professional Quality of Life Scale (ProQOL-5) and the Brief-Coping, Orientation to Problem Experienced tool. Participants were asked to recall experiences from the previous 30 days.
The study was conducted in five prominent hospitals in Central Uganda.
A total of 548 healthcare providers, including 191 physicians, 256 nurses and 103 technicians.
Compassion fatigue scores.
Most participants were under 29 years old (50.9%) and women (62.0%). High levels of compassion fatigue were reported by 37.8% of participants. Active coping, self-distraction and denial were associated with higher compassion fatigue, while informational support, positive reframing and venting were linked to lower fatigue levels. Seeking social support effectively reduced compassion fatigue.
The findings highlight significant compassion fatigue among healthcare providers in Central Uganda, impacting their well-being and patient care. Coping strategies like active problem-solving and social support are promising in mitigating compassion fatigue. Interventions should focus on reducing self-distraction, enhancing problem-solving skills and fostering supportive work environments to improve healthcare workers’ well-being and patient care quality.
To explore the illness coping experiences of patients with moderate-to-severe burns and provide a reference for healthcare professionals to formulate coping strategies.
Qualitative study using a descriptive phenomenological approach.
From 1 June to 30 September 2024, semi-structured interviews were conducted with 19 patients with moderate-to-severe burns. Colaizzi's seven-step method was used for data analysis.
Seven subthemes and three higher order themes were identified: (1) perception of illness experience; (2) coping with disease threats; and (3) benefits of coping with illness. Most of the participants faced multiple difficulties in their disease experiences, such as increased financial pressure, higher pressure on family caregiving, deformed physical conditions and negative emotions. Positive psychological qualities, family and social support played significant roles in coping with these challenges.
Patients with moderate-to-severe burns experience multiple difficulties during their recovery. Effective coping resources can help them overcome these challenges.
Healthcare professionals should work with patients with moderate-to-severe burns and their families to establish an effective support system that enhances patients' coping abilities and promotes their overall recovery.
Patients with moderate-to-severe burns face diverse challenges. However, their experiences and coping processes during recovery remain unclear. This study provided valuable insights into their illness experiences and coping strategies. The findings highlighted multiple difficulties, such as a significant increase in financial pressure and dependence on family caregiving, painful and deforming physical conditions and various negative emotions. Positive psychological qualities, family and social support play an important role in coping with these challenges. Healthcare professionals should work with patients and their families to establish effective support systems to promote overall recovery.
No patient or public involvement.
The prevalence of postpartum depression in China has been steadily increasing, and community-based interventions are considered an important measure to address this issue. This study aims to design a community intervention programme for postpartum depression based on positive psychology, tailored to the characteristics of postpartum depression and the intervention needs, while integrating primary healthcare practices in the community setting. A cluster randomised controlled trial will be employed to evaluate the effectiveness of the intervention in reducing the risk of postpartum depression among women.
This study will develop and refine the positive psychology-based intervention programme through the integration of qualitative interviews and a literature review. A cluster randomised controlled trial will be conducted, with community primary healthcare service centres as the unit of randomisation and pregnant women as participants. The control group will receive usual primary healthcare support, while the intervention group will receive positive psychology intervention—including six structured online positive psychology intervention sessions with videos and materials, and optional one-on-one consultations—in addition to usual primary healthcare. The Edinburgh Postnatal Depression Scale will be used to assess the risk of postpartum depression in participants, with variables including postpartum depressive symptoms, anxiety and stress. Outcome measures will be evaluated using questionnaires and data from maternal and child electronic health records. Data will be analysed based on both the intention-to-treat principle and the per-protocol principle.
This study was approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (approval no. S127). The findings will be disseminated through presentations at relevant academic conferences and publications in peer-reviewed journals.
To examine the impact of critical care nurses' delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information–motivation–behavioural (IMB) skills model from a behavioural perspective.
Cross-sectional study.
A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson's correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.
The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.
Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses' delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals' sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.
Critical care managers should value nurses' delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses' delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.
The STROBE checklist was used as a guideline.
Nurses completed questionnaires.
Trial Registration: Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216
The magnitude and persistence of diseases and multimorbidity between females and males are different. This study comprehensively quantified sex differences in the onset and progression of 108 major physical and mental diseases to multimorbidity through adulthood in Chinese population.
Quantitative analysis of real-world linked electronic health records.
Linked health records from 160 health facilities across primary, secondary and tertiary healthcare, comprising routinely collected electronic health records from the whole urban residents of Yichang, China between 1 January 2016 and 31 December 2019.
684 455 urban residents aged 20 years and above with documented health records during the study period.
The cumulative incidence, relative risks (RR) and 95% CIs, period prevalence, median age at disease diagnosis and the prevalence of multimorbidity of 108 major physical and mental diseases were computed. All analyses were stratified by sex and age groups.
The analysis included 684 455 individuals (54.8% females, mean age: 46.9), among whom 46.3% had multimorbidity, with a higher prevalence in females (47.6%) than males (44.9%). The chronological disease map revealed stark differences between females and males, with notable lower risk of obstructive sleep apnoea-hypopnoea syndrome (OSAHS, RR: 0.03, 95% CI: 0.01 to 0.11) for young adults, oesophageal cancer (RR: 0.02, 95% CI: 0.0 to 0.17) for mid-age adults and remarkable higher risk of lupus (RR: 8.8, 95% CI: 2.7 to 29.0) for older adults of females. Males exhibited an incidence surge in hypertension, diabetes, coronary disease and chronic obstructive pulmonary disease a decade earlier than females, while females had a life-long higher prevalence in immune-mediated diseases and urinary disorders. For the new incident diseases, the manifestation of eating disorders, anaemia and urinary incontinence was recorded 20 years earlier in females; whereas, males were diagnosed with hyperuricaemia, OSAHS and schizophrenia at younger ages.
The significant variations in disease nature and trajectory between sexes underscore the urgent needs for tailored prevention strategies and appropriate health resources allocation. Sex differences in disease profile should be considered to delay disease and multimorbidity progression, ultimately promoting health equity.
Depression is characterised by disruptions in brain circuitry, and interventions like intermittent theta burst stimulation (iTBS) offer the potential for normalising these circuits and improving clinical symptoms. However, personalised treatment targets for depression remain underexplored. This trial aims to evaluate the clinical efficacy of iTBS as an additional treatment to a stable antidepressant regimen in patients with treatment-resistant depression (TRD) by modulating brain circuits identified through personalized brain functional sectors compared with sham treatment. This work is a part of the China Study to Predict Optimised Treatment bioMarkers of Individualised Neuromodulation in Depression project.
This is a multi-centre, double-blind, sham-controlled randomised trial, with a 2:1 allocation ratio to 21 days of active or sham iTBS. A total of 360 eligible participants, diagnosed with current treatment-resistant unipolar major depressive disorder, who have been on a stable antidepressant regimen for at least 4 weeks and are experiencing moderate-to-severe depressive episodes, will be recruited from seven clinical centres in China. The primary outcome is the change in the Montgomery–Asberg Depression Rating Scale immediately following 21-day treatment. Secondary outcomes include response rate and remission rate, change in the Hamilton Rating Scale for Depression, efficacy sustainability and recurrence within 6 months post-treatment. Additionally, safety, blinding, dropout and potential moderators of response will be examined.
The study has been approved by each centre’s ethics committee, with the first ethical approval granted by the Ethics Committee of Beijing Anding Hospital on 30 December 2022 (approval 2022206FS-2). Written informed consent will be obtained from all participants prior to enrolment. The study results will be published in relevant peer-reviewed journals.
To estimate the prevalence of urinary incontinence (UI) and its subtypes among nulliparous Chinese women with associated risk factors. The prevalence of UI among those living in urban or rural communities was also analysed with potential risk factors.
This is a secondary analysis of epidemiological survey data on UI in Chinese women. The original study was designed as a nationwide cross-sectional study involving 56 460 adult women conducted from October 2019 to December 2021.
Seven geographic regions of China.
Nulliparous women who were aged ≥20 years old and were permanent residents were included in this secondary analysis. Participants who had severe mental or physical disorders or were pregnant were excluded. Data on demographic characteristics, health status and medical history were collected.
The primary outcome was the prevalence of UI, whereas secondary outcome measures were adjusted odds ratios (aOR) for risk factor analysis.
A total of 6244 nulliparous women were included in the analysis. The prevalence of UI was 1.9% for nulliparous Chinese women, with stress, urgency and mixed UI being prevalent at 0.9%, 0.3% and 0.7%, respectively. The prevalence of UI was 2.1% and 1.6% for urban and rural subgroups. Abnormal body mass index was significantly associated with UI in the nulliparous group (underweight, aOR: 1.88, 95% CI: 1.03 to 3.45, p=0.041; overweight, aOR: 2.26, 95% CI: 1.37 to 3.73, p=0.001; and obesity, aOR: 3.64, 95% CI: 1.86 to 7.15, p
UI among nulliparous women deserves greater public attention. Abnormal body mass index, including underweight status, was found to be a risk factor for UI among Chinese nulliparous women. Further research is required to investigate the mechanism underlying the association between underweight status and UI.
The study was approved by Peking Union Medical College Ethics Committee (No. S-K970) and conducted according to the Declaration of Helsinki. All participants signed consent forms before data collection. A completed STROBE checklist detailing compliance with all 22 items is provided.
To explore the heterogeneity of disease-specific anxiety profiles among patients with chronic obstructive pulmonary disease (COPD) using latent profile analysis (LPA), and to identify the associations between distinct anxiety subtypes and inhaler medication adherence in patients with COPD.
Adherence to inhaled medication among patients with COPD continues to be suboptimal. Anxiety, a common comorbidity, may exacerbate this issue. However, the specific relationship between anxiety and adherence to inhaled medications remains unclear.
A prospective cohort study was conducted following the STROBE Checklist.
A prospective observational study employed the Anxiety Inventory for Respiratory Disease (AIR) to assess disease-specific anxiety in patients with COPD. Inhaler medication adherence was evaluated using the Test of Adherence to Inhalers (TAI) 6 months after initiating treatment. Latent Profile Analysis (LPA) was performed to identify distinct anxiety subtypes. Multiple linear regression analysis was conducted to examine the associations between identified anxiety subtypes and adherence dimensions, adjusting for sociodemographic and clinical variables.
Among 298 COPD patients, the overall AIR score was 5 (IQR: 2–11). Using LPA, three distinct anxiety subtypes were identified: Low Anxiety—Irritable Subtype (57.05%), Moderate Anxiety—Tense Subtype (26.85%) and High Anxiety—Anticipatory Subtype (16.10%). Through multiple linear regression analysis, the High Anxiety—Anticipatory Subtype was significantly associated with lower inhaler medication adherence among COPD patients.
This study revealed three latent profiles of disease-specific anxiety among COPD patients. The High Anxiety–Anticipatory Subtype was associated with a lower inhaler medication adherence in individuals with COPD after initiating treatment.
Identifying the relationship between disease-specific anxiety and inhaler medication adherence in patients with COPD after initiating treatment underscores the need for healthcare providers to assess anxiety during patient visits and prioritise patients with high anticipatory anxiety. When high anxiety adversely affects inhaler medication adherence, targeted interventions should be developed to improve adherence and prognosis.
No patient or public contribution.
This study uses a convergent mixed methods approach to investigate the frailty phenotypes and risk factors in peritoneal dialysis (PD) patients.
A cross-sectional mixed methods research study was employed.
This study follows the MMR-RHS reporting guidelines. From November 2023 to August 2024, 213 patients were recruited from the PD centre of a tertiary hospital in Chongqing, China. Quantitative data were collected using a general information questionnaire and standardised scales, including Fried Frailty Phenotype (FFP), Charlson Comorbidity Index (CCI), Mini Nutritional Assessment-Short Form (MNA-SF), Montreal Cognitive Assessment (MoCA) and Hospital Anxiety and Depression Scale (HADS). Concurrently, 19 PD patients in pre-frail or frail states participated in semi-structured interviews. The quantitative and qualitative findings were then integrated for analysis.
Amongst the 213 PD patients, 46.5% were non-frail, 41.3% were pre-frail and 12.2% were frail. Integrated analysis indicated that fatigue and low muscle strength were the primary frailty phenotypes amongst the patients. Age, sedentary behaviour, comorbidities, nutritional status, cognitive function, polypharmacy, psychological state and social connections were identified as risk factors for frailty in this patient population.
Many factors influence the frailty of PD patients. Future research should further explore the complex interactions amongst these factors and effective modulation strategies to mitigate the frailty progression. Incorporating the patients' perspectives in designing comprehensive intervention programmes will help identify key challenges and focal points for intervention.
This study identifies risk factors for frailty in PD patients, offering healthcare professionals a basis for designing targeted interventions. These factors encompass multiple dimensions, indicating the need for multidisciplinary collaboration in managing frailty.
The PD patients in this study provided valuable quantitative data and shared their frailty experiences, enhancing the research conclusions' practical value.
This study aimed to develop a structural model to elucidate the contributions of social support, health literacy and psychological resilience to self-management behaviours in liver transplant recipients after surgery.
Cross-sectional study.
This study included 215 Chinese patients who returned to the outpatient department after liver transplantation between June 2023 and March 2024. Data were collected via a general demographic questionnaire, a self-management questionnaire for liver transplant recipients, a chronic disease resource questionnaire, the Connor–Davidson resilience scale and the health literacy scale for chronic patients. Correlation analysis and structural equation modelling were utilised to analyse the relationships among social support, health literacy, psychological resilience and self-management ability.
The final model showed good fit (χ 2/df = 1.690, GFI = 0.919, IFI = 0.951, TLI = 0.938, CFI = 0.950 and RMSEA = 0.057). The direct effect coefficient of social support on self-management ability is 0.293. The indirect effect value of health literacy on the relationship between social support and self-management ability was 0.312, whereas the indirect effect value of psychological resilience in this context was 0.096. Furthermore, the chain-mediating effect involving both health literacy and psychological resilience between social support and self-management ability was 0.109.
The revised model, grounded in social cognitive theory, demonstrated a strong fit for predicting self-management behaviours among liver transplant recipients. Furthermore, social support, health literacy and psychological resilience exerted both direct and indirect influences on the self-management behaviours of these recipients.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).
In public or patient involvement in this study.
by Lang Qin, Jie Tian, Yuan Zhang, Yanlin Yin, Zhenling Dou, Jie Chen, Zhi Zhang, Yu Gong, Wenhua Fu
The prognosis of non-distant metastatic early-onset esophageal cancer (EC) patients undergoing surgical treatment remains unclear, this study aims to compare the prognosis of early-onset and late-onset EC. Information on non-distant metastatic EC patients who underwent surgical treatment and were initially diagnosed between 2004 and 2015 was collected from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to balance the baseline differences between early-onset and late-onset EC patients. Univariate and multivariate Cox regression analyses were used to calculate hazard ratio (HR) and 95% confidence interval (CI). The Kaplan-Meier method and log-rank test were used to compare the overall survival (OS) between the two groups of patients. Atotal of 5320 EC patients were included, with 571 in the early-onset group and 4749 in the late-onset group. Multivariate Cox regression analysis showed that early-onset EC patients had better OS (HR = 0.732, 95% CI: 0.655–0.819, pThe study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first-episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates.
Cross-sectional study.
A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self-efficacy Scale and Southampton Stroke Self-Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables.
The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self-efficacy and self-management (r = 0.376–0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ 2/df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first-episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD (p < 0.001); (2) QDT indirectly influenced RHD via self-efficacy (p < 0.001); (3) QDT indirectly affected RHD through self-management (p < 0.001); and (4) QDT had an indirect effect on RHD via both self-efficacy and self-management (p < 0.05).
QDT was found to directly influence RHD in patients with first-episode stroke and also exerted indirect effects through self-efficacy and self-management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community.
Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long-term poststroke management are essential for reducing stroke recurrence and mortality rates.
To describe the characteristics and perceived effectiveness of clinical supervision mental health nurses are receiving and further explore any statistical correlations between the perceived effectiveness and satisfaction with the supervisee, supervisor and supervision characteristics.
A cross-sectional survey.
An online survey was distributed to nurses working in public mental health services in Victoria, Australia. A universal recruitment approach was used, and 422 nurses participated in the survey. Of these, 220 nurses who are participating in clinical supervision were eligible for the MCSS-26 survey.
A licensed MCSS-26 questionnaire.
Mental health nurses in the studied environment were likely to receive individual supervision from a senior mental health nurse, with the most common frequency being monthly for 31–60 min, and half receiving it within their workplace location. Half of the participants chose their own supervisor. Our findings indicate that nurses who engage in clinical supervision outside of their immediate workplace and receive individual supervision from a nurse of the same grade perceive higher effectiveness. We also found that clinical nurses may find it most difficult to engage in effective clinical supervision due to time constraints.
This study uniquely contributes to the current clinical supervision literature by reporting the uptake and detailed characteristics of supervision, a facet often overlooked in existing research.
This study reported the characteristics of the supervision, supervisor and the supervisee that are associated with the effective clinical supervision. These insights can lead to tailored implementation strategies that consider the specific roles and settings of nurses.
CROSS (Sharma et al. 2021).
No patient or public contribution.
FreshRSS 