This study examined the mediating effect of resilience in the relationship between spirituality and self-management among older people with chronic obstructive pulmonary disease (COPD). The participants were 151 older people with COPD in four general hospitals in Jiangsu Province, China. Data were collected from September 2020 to May 2021 using a questionnaire developed by the investigator, the Function Assessment of Chronic Illness Therapy-Spiritual Scale (FACIT-SP-12), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and COPD Self-Management Scale (CSMS). One-way ANOVA and t-test were used to compare the level of self-management in patients with different sociodemographic and clinical characteristics. Partial correlation analysis was used to explore the correlation between spirituality, resilience, and self-management. Hierarchical multiple regression analyses were performed to examine the contribution of spirituality and resilience to the prediction of self-management. A bootstrapping test was implemented using the SPSS PROCESS macro to test the statistical significance of the mediating effect. There was a pairwise positive correlation between spirituality, resilience, and self-management. Resilience mediated the relationship between spirituality and self-management. These findings suggested that resilience interventions could be incorporated into future COPD self-management interventions to better improve self-management and health outcomes. Moreover, resilience should be an important component of healthy aging initiatives.

In order to enhance biogas production in the anaerobic digestion of duckweed, and duckweed with excess sludge as single and mixed substrates, the effects of hot alkali pretreatment and variation of the ratio of substrate to inoculum were investigated. The results showed that the delayed stage of anaerobic gas generation could be shortened when the two substrates were mixed during methane production, to give a cumulative gas yield of 2963 mL, which was 11% higher than the calculated value for the complementary substrate. The methane content was 57%, which was 13% higher than that from the duckweed group and 9% higher than from the excess sludge group. Furthermore, the methane yield was improved by 8% after the duckweed was pretreated with hot alkali. When the substrate to inoculum ratio was 1:1, the maximum biogas production of 3309 mL was achieved, with a methane yield of 1883 mL which, respectively, increases of 151 mL and 304 mL compared with the worst group (1:2.5).

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Introduction: Understanding differences in perceived family functioning between pregnant women and their partners can protect and promote women’s health. The purpose of this study was to examine consistency and differences in perceived family functioning within pregnant woman–partner dyads in China and explore correlates of effective family functioning. Method: From 2020 to 2021, 175 pregnant women and husband dyads (100% Han nationality, Mage = 30.3 [4.5] years) were recruited from the women’s psychological clinic of Changsha Hospital for Maternal & Child Health Care using convenience sampling. We assessed family functioning and depression and anxiety symptoms. We examined consistency and differences in perceived family functioning between pregnant women and their husbands. Results: Most pregnant women (76.6%) and husbands (71.4%) perceived their family functioning as effective. Pregnant women and their husbands shared poor consistency in family functioning, with an intraclass correlation of 0.25 and most weighted kappa coefficients of individual items <0.2. Participants reporting effective family functioning had higher education levels and lower depression and anxiety scores. Discussion: Most pregnant women and their partners perceived effective family functioning, but showed poor consistency. Higher education and milder symptoms of depression and anxiety were associated with effective family functioning both in pregnant women and their partners. For primary healthcare system workers, differences in perceptions of family functioning should be fully taken into account when conducting family based integrated care for pregnant women.

AimsTo investigate the level of spiritual health in older patients with chronic obstructive pulmonary disease (COPD) from the core dimensions and to explore its associated factors.DesignA cross‐sectional study.MethodsParticipants were recruited from four hospitals between September 2020 and June 2021, using a convenience sampling. Older patients with COPD (n = 162) completed the demographic and disease‐related information questionnaires, Function Assessment of Chronic Illness Therapy Spiritual Scale, 10‐item Connor‐Davidson Resilience Scale, General Self‐efficacy Scale, Social Support Rating Scale, COPD Assessment Test, 15‐item Geriatric Depression Scale and modified Medical Research Council Dyspnea Scale. Descriptive statistics, Pearson and Spearman correlation analyses, t‐tests, one‐way ANOVA and multiple linear regression models were used.ResultsOlder patients with COPD have a moderate level of spiritual health. The multiple linear regression analysis showed that psychological resilience, general self‐efficacy, social support, symptom burden and monthly income were associated with the core dimensions of spiritual health.ConclusionChinese older patients with COPD have a moderate level of spiritual health. Psychological resilience, general self‐efficacy, social support, monthly income and symptom burden were associated with the core dimensions of spiritual health.ImpactThis study is the first to investigate the level of spiritual health in older patients with COPD from the core dimensions and to explore its associated factors, providing a basis for developing spiritual intervention programs. Our findings can help us realize that intervention strategies of psychological resilience, general self‐efficacy and social support can all be used to enhance spiritual health. Nurses should focus on the spiritual health of older COPD patients with high symptom burden and low monthly income.Patient or Public ContributionAlthough we did not directly involve patients and the public because of the COVID‐19 pandemic, the results of the study will be disseminated to patients and the public through WeChat and seminars.