Aims and objectives: This study aimed to portray the prevalence and associated factors of psychological distress among frontline nurses during COVID-19 outbreak. Background: The COVID-19 outbreak has posed great threat to public health worldwide. Nurses fighting against the epidemic on the frontline might be under great physical and psychological distress. This psychological distress was predominantly described as sleep disturbance, symptoms of anxiety and depression, post-traumatic stress, inability to make decisions and even somatic symptoms. Design: Cross-sectional study. Methods: Frontline nurses from designated hospitals for COVID-19 patients were invited to complete an online survey by convenience sampling, and the survey included six main sections: the General Health Questionnaire, the Perceived Social Support Scale, the Simplified Coping Style Scale, the Impact of Event Scale-Revised, sociodemographic, occupation and work history. Multiple logistic analysis was used to identify the potential risk factors of psychological distress. The study methods were compliant with the STROBE checklist. Results: Of the 263 frontline nurses, 66 (25.1%) were identified as psychological distress. Multiple logistic analysis revealed that working in emergency department, concern for family, being treated differently, negative coping style and COVID-19-related stress symptom were positive related to psychological distress. Perceived more social support and effective precautionary measures were negatively associated with psychological distress. Conclusions: The study demonstrated that COVID-19 had a significant psychological impact on frontline nurses. Early detection of psychological distress and supportive intervention should be taken according to the associated factors to prevent more serious psychological impact on frontline nurses. Relevance to clinical practice: This study highlighted that the frontline nurses were suffering from varying degrees of psychological distress, which needed early screening and supportive intervention for preventing more serious psychological impact on frontline nurses. Beside, more specific measurement should be combined with the GHQ-12 to assess the varying degrees of psychological distress in frontline nurses.

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BackgroundLack of adequate self-care, frequent admissions, and poor quality of life are common and serious problems in adult patients with systemic lupus erythematosus (SLE). Some studies have revealed that transitional care is effective in improving self-care and quality of life as well as reducing rehospitalization rates. However, limited studies explored its effects in adult patients with SLE. Therefore, we performed a study to examine the effects of transitional care on self-care, readmission rates, and quality of life in adult patients with SLE.MethodsThis study was a single-center, single-blind, and parallel-group randomized controlled trial comparing transitional care with usual care in SLE patients from a university hospital in China. Evaluations were conducted at baseline before discharge and at 3 months after discharge by using hospital readmission rate, the Exercise of Self-Care Agency Scale, and the Medical Outcomes Study Short Form 36-item Health Survey for self-care and quality of life. Data were collected between June and December 2016.ResultsCompared with the usual care group, the transitional care group reported significantly greater improvement in self-care and quality of life. Additionally, the 30-day readmission rate for the patients in the transitional care group was significantly lower than in the usual care group, and this effect remained significant at 60 and 90 days after patient discharge.ConclusionThis study shows that transitional care improves self-care and quality of life in adult patients with SLE and reduces readmissions. However, further studies are needed.Trial registrationChina clinical trial registry, ChiCTR-IPR-16007708. Registered January 5, 2016.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1670-4) contains supplementary material, which is available to authorized users.

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