Purpose The present study aimed to investigate nurses’ willingness and demand for Internet +home care services in different levels of hospitals in China and analyze the influencing factors. Participants and Methods From October 1 to December 31, 2021, 5714 nurses from 15 hospitals in five regions of China were recruited in this cross-sectional study using a two-stage random sampling method. A self-designed questionnaire with good reliability and validity was used to measure nurses’ willingness and demand for Internet +home care services. χ 2 test, Welch t -test, and multiple linear regression analyses were used to analyze the data. Results Nurses were highly willing to provide Internet +home care services. Statistical differences were found in the willingness to provide Internet +home care services and the preference for service distance, service platform, and single service fee between nurses in different levels of hospitals (both P<0.05). The willingness to provide “catheter maintenance service” and “rehabilitation nursing service” of nurses in different levels of hospitals were statistically significant (both P<0.05). Nurses’ demand for Internet +home care services increased with the level of their hospital. Multiple linear regression showed that professional title, educational level, monthly family income, and mortgage or car loan influence nurses’ demand for Internet +home care services. Conclusion Nurses’ willingness and demand for Internet +home care services vary with the level of their hospitals. It is recommended that government and hospitals regulate the service items, the service distance, single service fee, and other contents according to nurses’ willingness and demand and establish relevant laws and regulations to ensure the steady and orderly development of the Internet +home care services.
Purpose Investigating psychological status and job burnout of nurses working in the frontline of the novel coronavirus in Zhangjiajie city in China during the Delta variant outbreak, comparing differences and analyzing factors of these two variables between the nurses from different nucleic acid testing (NAT) sites. Patients and methods This survey was conducted from August 1 to 31, 2021. The participants were 512 nurses, 198 nurses of whom were from temporary NAT sites in communities/towns in Zhangjiajie city, and the rest were from NAT sites inside hospitals. The psychological status and the job burnout were measured by the Symptom Checklist-90 (SCL-90) and the Maslach Burnout Inventory-General Scale (MBI-GS). Results The prevalence of the SCL-90 positive result and job burnout were 49.4% and 61.1%, respectively. The factors influencing the psychological status of nurses included the contact with COVID-19 patients or their body fluids and specimens, working seniority and the duration of working in the frontline of the novel coronavirus. The independent risk factors of nurses’ job burnout included the following four factors. Firstly, the contact with COVID-19 patients or their body fluids and specimens (OR=150.95, 95% CI=(44.87,507.77), P<0.001). Secondly, five to nine years of working seniority (OR=8.91, 95% CI=(3.59,22.14), P<0.001). Thirdly, 10 to 19 days (OR=2.63, 95% CI=(1.19,5.82), P=0.017), 20 to 29 days (OR=161.31, 95% CI=(49.48,525.9), P<0.001). Lastly, more than 30 days (OR=92.05, 95% CI=(33.88,250.14), P<0.001) of working in the frontline of the novel coronavirus. Conclusion The prevalence of psychological problems and job burnout were at a high level among nurses working in the frontline of the novel coronavirus in different NAT sites. The nurses from NAT sites inside hospitals and temporary NAT sites in communities/towns in Zhangjiajie city had an equal risk of developing psychological problems and job burnout. Interventions need to be immediately implemented to promote psychological well-being and decrease job burnout of nurses.
Purpose The present study aims to evaluate the current situation of knowledge, attitude and practice of clinical nurses in catheter-related thrombosis, analyze its influencing factors, enhance the attention of nursing managers and clinical nurses about catheter-related thrombosis, and provide a basis for formulating catheter-related thrombosis training plan. Patients and Methods The research was conducted from January 1 to February 31, 2022, we recruited 549 nurses from two hospitals in Hunan province in this cross-sectional study using a two-stage random sampling method. We used a self-designed questionnaire with good reliability and validity to measure clinical nurses’ knowledge, attitudes, and practice toward catheter-related thrombosis. We used χ 2 test, Welch t -test, and multiple linear regression analysis to analyze the data. Results The knowledge of clinical nurses about catheter-related thrombosis was insufficient (55.00%), while the attitude was positive (88.49%) and the practice was inadequate (68.62%). Knowledge of clinical nurses was significantly associated with job title (β: 1.069, P <0.001), educational level (β: 0.094, P <0.05), and training times (β: 0.085, P <0.05), which were positive factors while whether they are specialized nurses in intravenous therapy (β: −0.126, P <0.05), and hospital level (β: −0.101, P <0.05) were negative factors. Training times (β: 0.166, P <0.001), job title (β: 0.099, P <0.019), and hospital level (β: 0.090, P <0.05) were associated factors of attitude. Moreover, training times (β: 0.255, P <0.001) was the only factor associated with the practice. Conclusion Although clinical nurses hold a positive attitude towards catheter-related thrombosis, their knowledge level was unsatisfactory and their practice was affected by many factors, suggesting that nursing managers should strengthen the training and skill assessment of catheter-related thrombosis. At the same time, the hospital can formulate relevant rules, regulations, and guidelines to reduce the incidence of catheter-related thrombosis.
Background With the aging of China’s population, the incidence rate of chronic diseases is rising. At the same time, residents’ health awareness is also increasing. Implementing Internet +home care is an inevitable trend in adapting social development. Currently, Internet +home care is in the pilot stage in China, relevant institutional measures are neither standardized nor perfect, and there is no set of quality supervision indicators (QSIs). Purpose The construction of Internet +home care QSIs in China will provide a theoretical basis for Internet +home care quality supervision. Materials and Methods The Service-Quality model was used as the theoretical framework, and a literature review, semi-structured interviews, focus group discussions, and Delphi consultations determined the contents of the QSIs and the weight of each indicator. Results Internet +home care QSIs were constructed and included 5 first-level indicators, 17 secondary indicators, and 69 tertiary indicators. The effective recovery rates of the two rounds of Delphi expert consultation were 100% and 85%, the expert authority coefficients were 0.810 and 0.833, and the Kendall harmony coefficients were 0.189 and 0.125 (P<0.01). The final set of Internet +home care QSIs was as follows: tangibility (4 secondary and 16 tertiary indicators), reliability (4 secondary and 19 tertiary indicators), guarantee (5 secondary and 20 tertiary indicators), responsiveness (2 secondary and 8 tertiary indicators), and empathy (2 secondary and 6 tertiary indicators). Conclusion The construction of Internet +home care QSIs based on the SERVQUAL model is scientifically valid, and the indicators are reliable. They provide guidance and reference values for the continuous improvement and promotion of Internet +home care. This work also provides a theoretical basis for researching and developing an Internet +home care quality supervision platform.
BACKGROUND Cancer is a major public health problem and poses a health threat to the population, and Peripherally Inserted Central Catheters-Unplanned Extubation (PICC-UE) is considered the most adverse event for patient safety. Identifying independent risk factors for PICC-UE, applying high-quality assessment tool early in high-risk population, and adopting precise prevention and treatment can effectively reduce the occurrence of PICC-UE. OBJECTIVE The objective is to identify the independent risk factors for PICC-UE in cancer patients, and to develop a predictive model for PICC-UE for cancer patients, providing a theoretical basis for the prevention and prediction of PICC-UE in cancer patients. METHODS Prospective data were collected from January to December 2022 from cancer patients with PICC at Xiangya Hospital, Central South University, and each patient was followed up until the catheter removal. The patients were divided into UE group (n=3107) and non-UE group (n=284), and independent risk factors were determined by univariate, LASSO algorithm and multivariate analysis. The 3391 patients were then divided into a trainset and a testset according to the ratio of 7:3. The screened predictors were used to build three predictive models using Logistic Regression, Support Vector Machine and Random Forest algorithms, and the optimal model was screened by ROC curve and TOPSIS synthesis analysis. We collected prospective data of 600 cancer patients with PICC from June to December 2022 at the Affiliated Hospital of Qinghai University and Hainan Provincial People's Hospital for external validation. The Area Under the Curve (AUC) of the ROC was used to test the differentiation of the model, and the Calibration Curve to assess the calibration capability and Decision Curve Analysis (DCA) to evaluate the clinical applicability of the model. RESULTS Independent risk factors for PICC-UE in cancer patients included impaired physical mobility (OR=2.775), diabetes (OR=1.754), surgical history (OR=1.734), elevated D-dimer concentration (OR=2.376), targeted therapy (OR=1.441), surgical protocol (OR=1.543), and more than one catheter puncture (OR=1.715); protective factors included normal BMI (OR=0.449), polyurethane catheter material (OR=0.305), and valved catheter (OR=0.639). The results of the TOPSIS synthesis analysis: the Ci values were 0.00, 0.82 and 0.85 in the trainset, and the Ci values were 0.00, 1.00 and 0.81 in the testset for the Logistic, Support Vector Machine and Random Forest models, respectively. The optimal model constructed based on Support Vector Machine was obtained and validated externally, the ROC curve, Calibration curve and DCA curve showed that the model had excellent accuracy, stability, generalizability and clinical applicability. CONCLUSIONS Ten independent predictors of PICC-UE in cancer patients were obtained in this study. The predictive model was constructed based on Support Vector Machine, which has clinical application value through external validation, and provides significant support for the early prediction of PICC-UE in cancer patients.
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