Liming You

The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave.

The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.

The effectiveness of a self-efficacy-enhancing intervention for Chinese patients with colorectal cancer: a randomized controlled trial with 6-month follow up

BACKGROUND Colorectal cancer is a major public health problem. There is growing support for colorectal cancer survivors who are experiencing problems after cancer treatment to engage in self-management programs to reduce symptom distress. However, there is inconclusive evidence as to the effectiveness of such program especially in Asian region. OBJECTIVES This study tested the effects of a six-month nurse-led self-efficacy-enhancing intervention for patients with colorectal cancer, compared with routine care over a six-month follow up. DESIGN A randomized controlled trial with repeated measures, two-group design. SETTING Three teaching hospitals in Guangzhou, China. PARTICIPANTS One hundred and fifty-two Chinese adult patients with a diagnosis of colorectal cancer were recruited. The intervention group (n=76) received self-efficacy-enhancing intervention and the control group (n=76) received standard care. METHOD The participants were randomized into either intervention or control group after baseline measures. The outcomes of the study (self-efficacy, symptom distress, anxiety, depression and quality of life) were compared at baseline, three and six months after the intervention. RESULTS Sixty-eight participants in the intervention group and 53 in the control group completed the study. Their mean age was 53 (SD=11.3). Repeated measure MANOVA found that the patients in the intervention group had significant improvement in their self-efficacy (F=7.26, p=0.003) and a reduction of symptom severity (F=5.30, p=0.01), symptom interference (F=4.06, p=0.025), anxiety (F=6.04, p=0.006) and depression (F=6.96, p=0.003) at three and six months, compared with the control group. However, no statistically significant main effect was observed in quality of life perception between the two groups. CONCLUSIONS The nurse-led self-efficacy enhancing intervention was effective in promoting self-efficacy and psychological well-being in patients with colorectal cancer, compared with standard care. The intervention can be incorporated into routine care. Future empirical work is required to determine the longer term effects of the intervention.

Effects of enterostomal nurse telephone follow-up on postoperative adjustment of discharged colostomy patients.

Background: People with a new colostomy encounter many difficulties as they struggle to adjust to their ostomies. Nurse telephone follow-up is a convenient way to ensure continuity of care. There is a paucity of studies testing if nurse telephone follow-up can enhance adjustment of postdischarged colostomy patients. Objectives: The purpose of this study was to evaluate the effect of enterostomal nurse telephone follow-up on the adjustment levels of discharged colostomy patients. Methods: This was a randomized controlled trial. Participants (n = 103) who had undergone colostomy operations in China were recruited and randomly assigned to the study or control group. Both the study and control groups received routine discharge care, whereas the study group received 2–3 nurse telephone calls in the follow-up period. The outcome measures included Ostomy Adjustment Scale, Stoma Self-efficacy Scale, satisfaction with care, and stoma complications. Results: Results of this study indicated that participants in the study group had significantly better ostomy adjustment, higher stoma self-efficacy, higher satisfaction with care, and less stoma complications compared with those in the control group. Conclusions: This study provided evidence to support that enterostomal nurse telephone follow-up can improve patient ostomy adjustment level and other related outcomes. Implication for Practice: Nurse telephone follow-up is an effective intervention to support the adjustment of stoma patients after hospital discharge.

Translation and validation of a Chinese version of the 8-item Morisky medication adherence scale in myocardial infarction patients.

RATIONALE, AIMS AND OBJECTIVES Poor medication adherence is a major global public health challenge. A valid, reliable, cost-effective tool for measuring medication adherence would lead to a better understanding of non-adherence and lay the groundwork for interventions aimed at facilitating adherence to therapies. The aim of this study was to translate and evaluate the psychometric properties of the Chinese version of the 8-item Morisky medication adherence scale (C-MMAS-8) in Chinese myocardial infarction (MI) patients. METHODS Psychometric testing of the C-MMAS-8 was conducted using a convenience sample of 176 MI patients recruited from four major hospitals in Guangzhou in southern China. Socio-demographic data, C-MMAS-8 and three subscales of the revised illness perception questionnaire (treatment control, personal control and illness coherence subscales) were administered to the MI patients. Thirty MI patients participated in a 4-week retest. RESULTS The C-MMAS-8 demonstrated good internal consistency (Cronbachs α = 0.77) and test-retest reliability (r = 0.88, P < 0.001). Significant correlations with treatment control subscale (r = 0.32, P < 0.01), personal control subscale (r = 0.47, P < 0.01), and illness coherence subscale (r = 0.44, P < 0.01) of the revised illness perception questionnaire demonstrated good construct validity. CONCLUSIONS The psychometric properties of the C-MMAS-8 are satisfactory.

Psychometric Properties of the Kessler 10 Scale in Chinese Parents of Children With Cancer.

Background: The Kessler Psychological Distress Scale (K10) has been widely used in rating psychological distress in general and clinical populations. However, whether it can be used in parents of children with cancer is unknown. Still lacking is the evidence on its reliability and validity in culturally diverse groups. Objective: The aim of this study was to translate the K10 into Mandarin Chinese and test its psychometric properties (especially the factor structure) of the Chinese version (C-K10) in parents of children with cancer. Methods: By convenience sampling, 2 samples of parents of children with cancer (sample I, n = 206, and sample II, n = 103) were surveyed in Guangzhou, China. Sample I completed the C-K10, and the internal consistency reliability and exploratory factor analysis of the C-K10 were estimated. Sample II completed the C-K10, the State Subscale of State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale; confirmatory factor analysis and concurrent validity estimates were completed. Results: The C-K10 demonstrated strong internal consistency reliability (Cronbach’s &agr; = .93). Both exploratory and confirmatory factor analyses supported a 2-factor structure (ie, anxiety and depression). The concurrent validity was moderate with Pearson correlations greater than 0.50 (P < .001). Conclusion: The C-K10 demonstrated very acceptable reliability and validity in screening psychological distress in Chinese parents of children with cancer. Implications for Practice: This study provides evidence that the C-K10 is a valid tool that can be used in clinical settings to screen for psychological distress in Chinese parents of children with cancer.

Validation of Hospitalization Impact Scale among families with children hospitalized for cancer treatment

AIM To make further modifications to and validate the psychometric properties of the Hospitalization Impact Scale. BACKGROUND A childs repeated and prolonged hospitalization for cancer treatment can result in great changes for the entire family. A hospitalization-specific screening tool is needed to help clinical nurses identify families who are experiencing major impacts during their childs hospitalization. DESIGN A cross-sectional study was employed to examine the psychometric properties of the Hospitalization Impact Scale. METHOD The sample consisted of 253 families with children hospitalized for cancer treatment in four paediatric oncology departments in four hospitals in mainland China from September 2013 - March 2014. Parents completed the 36-item Hospitalization Impact Scale, demographic measures and the Family Impact Module of the Pediatric Quality of Life Inventory. Reliability, construct validity, known-group validity and concurrent validity were examined. RESULT The revised Hospitalization Impact Scale included six factors containing 34 items. It demonstrated sound concurrent validity with the Family Impact Module of the Pediatric Quality of Life Inventory and excellent internal consistency. CONCLUSION The revised Hospitalization Impact Scale met the standard psychometric criteria for reliability and validity. Thus, it could be applied in paediatric oncology departments to help nurses assess and identify families experiencing major impacts during a childs hospitalization for cancer treatment.

Psychometric Validation of an Instrument to Measure Family Coping During a Child's Hospitalization for Cancer.

Background: Families with children hospitalized for cancer treatment experience multiple, serious challenges. Family coping is a crucial moderator between family stress and family adaptation. A newly developed instrument, the Hospitalization Coping Scale (HCS), measures the effectiveness of family coping during a child’s hospitalization. Objective: The aims of this study were to revise and validate the psychometric properties of the HCS for families with children hospitalized for cancer treatment in pediatric oncology departments in Mainland China. Methods: Psychometric properties of the HCS were examined among 253 families with children hospitalized in pediatric oncology departments in 4 hospitals. Reliability, construct validity, known-group validity, and concurrent validity of the revised HCS were examined. Results: The revised 15-item HCS contains 3 renamed factors: maintaining mental stability, mutual support for child care, and seeking support from external systems. Cronbach’s &agr; coefficients for the total and 3 factors were .87, .78, .83, and .79, respectively. The revised scale demonstrated sound known-group validity and concurrent validity. Conclusions: The revised 15-item HCS is a reliable and valid instrument to measure coping effectiveness of families with children hospitalized for cancer treatment. Implications for Practice: The HCS can be used by pediatric oncology nurses to assess the effectiveness of family coping during a hospitalization of their child with cancer and may help pediatric oncology nurses to develop and implement realistic support strategies based on assessments of family coping effectiveness.