摘要：
The current COVID-19 pandemic has caused severe morbidity and mortality worldwide. Although relevant studies show that the smoking rate of COVID-19 patients is relatively low, the current smoking status of people with COVID-19 cannot be accurately measured for reasons. Thus, it is difficult to assess the relationship between smoking and COVID-19. Smoking can increase the risk of severe COVID-19 symptoms and aggravate the condition of patients with COVID-19. Nicotine upregulates the expression of ACE2, which can also increase susceptibility to COVID-19, aggravatiing the disease. Although nicotine has certain anti-inflammatory effects, there is no evidence that it is related to COVID-19 treatment; therefore, smoking cannot be considered a preventative measure. Furthermore, smokers gathering and sharing tobacco may promote the spread of viruses. Despite the COVID-19 epidemic, the findings suggested that COVID-19 has not encouraged smokers to quit. Additionally, there is evidence that isolation at home has contributed to increased smoking behavior and increased quantities. Therefore, it is recommended that governments increase smoking cessation messaging as part of public health measures to contain the COVID-19 pandemic. This review analyzes the existing research on smoking’s impact on COVID-19 so that governments and medical institutions can develop evidence-based smoking-related prevention and control measures for COVID-19.
期刊：
International Journal of Mental Health Nursing,2021年30(5):1149-1159 ISSN：1445-8330
通讯作者：
Juan Liu PhD
作者机构：
[Chen, Bing; Zhu, Xiaodan; Chang, Ru; Wang, Qing] Ningxia Med Univ, Sch Nursing, Yinchuan, Ningxia, Peoples R China.;[Jiang, Xiaojian] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.;[Li, Meizhi] Second Peoples Hosp Hunan Prov, Dept Nursing, Changsha, Peoples R China.;[Liu, Juan] Ningxia Med Univ, Sch Basic Med Sci, Shengli Rd 1160, Yinchuan 750004, Ningxia, Peoples R China.
通讯机构：
[Juan Liu PhD] S;School of Basic Medical Sciences, Ningxia Medical University, Ningxia, China
关键词：
coping styles;schizophrenia relapse;stressful life events
摘要：
This study aimed to explore the relationship between stressful life events, coping styles, and schizophrenia relapse. The sample for this study included 248 patients with schizophrenia from a psychiatric outpatient clinic in Hunan Province, China. Stressful life events, occurrence of schizophrenia relapse, and coping style were assessed by the Scale for the Social Readjustment Rating, Brief Psychiatric Rating Scale, and Simplified Coping Style Questionnaire, respectively. Spearman correlation analysis and binary logistic regression analysis were adopted to explore the relationships among coping styles, schizophrenia relapse, and stressful life events. Stressful life events and negative coping exhibited significant positive association with schizophrenia relapse, while positive coping exhibited a significant negative association with schizophrenia relapse. Stressful life events and positive coping exerted significant effects on schizophrenia relapse, while negative coping did not. We also found that both positive coping and negative coping have moderating effects on the relationship between stressful life events and schizophrenia relapse, but the relationship is weak. The study highlighted the importance of interventions designed to reduce stressful life events, promote positive coping, and address negative coping in patients with schizophrenia.
摘要：
Introduction: Workplace violence (WPV) against healthcare providers has severe consequences and is underreported worldwide. The aim of this study was to present the features, causes, and outcomes of serious WPV against healthcare providers in China. Method: We searched for serious WPV events reported online and analyzed information about time, location, people, methods, motivations, and outcomes related to the incident. Result: Serious WPV reported online in China (n = 379) were mainly physical (97%) and often involved the use of weapons (34.5%). Doctors were victims in most instances (81.1%). Serious WPV mostly happened in cities (90.2%), teaching hospitals (87.4%), and tertiary hospitals (67.9%) and frequently in Emergency Department (ED), Obstetrics and Gynecology Department (OB-GYN), and pediatric departments; it was most prevalent in the months of June, May, and February. Rates of serious WPV increased dramatically in 2014 and decreased after 2015, with death (12.8%), severe injury (6%), and hospitalization (24.2%) being the major outcomes. A law protecting healthcare providers implemented in 2015 may have helped curb the violence. Conclusion: Serious WPV in China may stem from poor patient-doctor relationships, overly stressed health providers in highly demanding hospitals, poorly educated/informed patients, insufficient legal protection, and poor communication. Furthering knowledge about WPV and working toward curtailing its presence in healthcare settings are crucial to increasing the safety and well-being of healthcare workers.
摘要：
Aim This study aimed to explore the changes of cortical thickness in abstinent methamphetamine (MA) patients compared with healthy controls. Materials and Methods Three-tesla structural and functional magnetic resonance imaging (MRI) was obtained from 38 abstinent methamphetamine-dependent (AMD) patients and 32 demographically equivalent healthy controls. The cortical thickness was assessed using FreeSurfer software. General linear model was used to get brain regions with significant different cortical thickness between groups (p < 0.05, Monte Carlo simulation corrected). The mean cortical thickness value and functional connectivity with all other brain regions was extracted from those significant regions. Moreover, correlation coefficients were calculated in the AMD group to assess the relations between the mean cortical thickness, functional connectivity and age when they first took MA and the duration of both MA use and abstinence. Results The AMD group showed significant cortical thickness increase in one cluster located in the parietal cortex, including right posterior central gyrus, supramarginal gyrus, and superior parietal lobule. In addition, cortical thickness values of those regions were all significant and negatively correlated with the age when patients first used MA. The cortical thickness of right posterior gyrus were positively correlated with its functional connectivities with left middle frontal gyrus and both left and right medial orbitofrontal gyrus. Conclusion The higher cortical thickness in the parietal cortex of the AMD group is in agreement with findings in related studies of increased glucose metabolism and gray matter volume. Importantly, the negative correlation between parietal cortical thickness and age of first MA suggested that adolescent brains are more vulnerable to MA's neurotoxic effect.
摘要：
Background: More than 300 million smokers make China the largest cigarette consumer globally, which is a huge economic burden. Smoking cessation (SC) clinics can offer counseling and follow-up services. The operational experience of SC clinics in China needs to be summarized and improved based on research evidence. Purpose: The objectives of this study were to describe quit rates among attendees of SC clinics in Hunan and assess predictors of successful SC. Methods: The participants in this study were smokers who visited the SC clinic of Hunan Cancer Hospital from February 1, 2015 to September 30, 2018. Individuals who received individual counseling and assessment from the SC clinic staff and were willing to quit smoking were eligible for inclusion. Those with critical illness or cancer were excluded. Application of smoking cessation clinic registration form (unified by Chinese Center for Disease Control and Prevention) was used to assess participants at the consultation. Follow-ups and counseling were performed over telephone at 1 week, 1 month, and 3 months after the initial cessation consultation or in times of need. Successful SC was checked for at 3 months after the start of SC. Results: A total of 328 smokers (mean age 45.67 +/- 12.38 years) had participated. The abstinence rate at 3 months was 28.4%. Binary regression analysis revealed significant independent predictors to be the total numbers of SC follow up sessions, previous SC attempts, and participants' decision on when to quit smoking (The relative to quit immediately group, quit within 30 days, quit after 30 days, and undecided quit were less likely to succeed in quitting. while quit within seven days had no statistical significance. Conclusion: SC clinics can achieve a desirably high quit rate. Participant's previous attempts at quitting, three or more follow-ups, and the decision to quit immediately or within seven days were factors helpful in predicting the success of SC.
期刊：
Frontiers in Psychology,2021年12:741821 ISSN：1664-1078
通讯作者：
Jiang, Qin;Zhang, Bin
作者机构：
[Wang, Lin-Lin; Xu, Jia-Bin; Lin, Xian-Hao; Jia, Jun; Jiang, Qin] Fujian Med Univ, Sch Hlth, Fuzhou, Peoples R China.;[Zhang, Bin] Hunan Univ Chinese Med, Sch Humanities & Management, Changsha, Peoples R China.
通讯机构：
[Jiang, Qin] F;[Zhang, Bin] H;Fujian Med Univ, Sch Hlth, Fuzhou, Peoples R China.;Hunan Univ Chinese Med, Sch Humanities & Management, Changsha, Peoples R China.
关键词：
self-handicapping;Academic anxiety;Hardiness;procrastination;Medical students
摘要：
Background: In the face of the 2019 Coronavirus Disease (COVID-19) outbreak, Chinese medical students worried about their future studies which might make them more susceptible to academic anxiety. Previous studies have shown that academic anxiety is an important risk factor for self-handicapping, but there are few studies to explore the relationship between the two which may be mediated or moderated by other variables. Therefore, this study investigated how Chinese medical students' academic anxiety is correlated to their self-handicapping in time of COVID-19 epidemic, and explored the moderating and mediating effects of hardiness and procrastination.</p> Methods: In this study, 320 Chinese medical students' psychological traits were measured with Academic Anxiety Questionnaire, Self-Handicapping Scale, General Procrastination Scale and Hardiness Scale to explore the potential associations between these variables.</p> Results: The most obvious finding to emerge from this study was that self- handicapping had a positive correlation with academic anxiety and procrastination, but had a negative correlation with hardiness; hardiness had a negative association with academic anxiety and procrastination; and academic anxiety and procrastination were positively correlated. In addition, the relationship between academic anxiety and self-handicapping of Chinese medical students was not only partially mediated by procrastination, but also moderated by hardiness. Furthermore, medical students who had lower hardiness had stronger direct effect, while the indirect effect was strong at high and low conditions of hardiness.</p> Conclusion: In time of the COVID-19 epidemic, the academic anxiety and self-handicapping of medical students are influenced by procrastination and hardiness to a great extent. Thus, in addition to suggesting that more attention should be paid to the academic anxiety and procrastination of medical students, in the future, more attention should be paid to cultivating the hardiness of medical students and exerting its interventional role in self-handicapping.</p>
摘要：
We aimed to explore the relationships between mobile phone addiction and cognitive failures in adolescents. Our study sample consisted of 816 adolescents from two high schools in China (female = 413; mean age = 15.86 years, SD = 0.80 years). The adolescents completed the Smartphone Addiction Scale–Short Version, the Mindfulness Attention Awareness Scale, the Ruminative Responses Scale, and the Cognitive Failures Questionnaire. Structural equation modelling and multiple mediation analysis showed that high mobile phone addiction predicted high scores on rumination and low scores on mindfulness, which in turn were positively associated with cognitive failures. Rumination and mindfulness partially mediated the relationship between mobile phone addiction and cognitive failures. Moreover, high levels of rumination predicted low levels of mindfulness. Rumination and mindfulness sequentially mediated the relationship between mobile phone addiction and cognitive failures. These mechanisms underlying the development of cognitive failures have potential implications in preventing or treating adolescents’ cognitive failures.
通讯机构：
[Zhou, Xuhui] H;Hosp Hunan Univ Chinese Med, Peoples Hosp Hunan Prov 2, Dept Psychiat, Changsha, Peoples R China.
关键词：
alcohol dependence patient;Repeatable Battery Neuropsychological Status (RBANS);Event-related potentials;cognitive impairment;Evaluation
摘要：
Background: Recently, the cognitive impairment of patients with alcohol dependence has attracted more and more attention. The combination of Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and event-related potentials (ERPs) for evaluating the degree of cognitive impairment in patients with alcohol dependence has not undergone enough in-depth investigation. Method: Sixty patients with alcohol dependence were selected as alcohol-dependence group, whereas 40 healthy volunteers served as a normal control group. The original scores of the RBANS sub-items, the incubation period, and volatility of ERPs between the two groups were compared, and the correlation among the above indicators in the alcohol-dependence group was further analyzed. Results: The RBANS test showed that the original scores of speech function, attention function, delayed memory, and immediate attention in the alcohol-dependence group were significantly lower than those in the normal control group. Compared with the normal control group, the latencies of P200 and P300 in the alcohol-dependence group were significantly prolonged, and the amplitude of P200 and P300 was significantly reduced. Correlation analysis between RBANS and ERPs in alcohol-dependence group showed that immediate attention score was positively correlated with P300 and P200 amplitude, visual breadth score was positively correlated with P200 latency, and attention function score was negatively correlated with P300 latency. Conclusion: As RBANS scale was highly correlated with the results of ERPs, the combined use of these two scales may serve as an objective basis for early diagnosis of cognitive impairment in patients with alcohol dependence.
摘要：
Background With adverse events and injuries recurring in residential aged care facilities (RACFs), older adults' safety in residential age care settings has attracted extensive attention from governments, researchers, and healthcare providers. Risk management is of utmost importance in reducing risks and improving the quality of care for older adults in long-term care. Although previous studies have made great efforts to explore risk management methods and technologies in RACFs, little is known about how managers identify and respond to risks in practice. Purpose This qualitative study aimed to elucidate the perceptions and experiences of managers involved in risk management in RACFs in China. Participants and methods This study used a phenomenological research design. We conducted semi-structured interviews with 13 managers across 11 RACFs in Changsha City, Hunan Province, China. Data were analysed using Colaizzi's seven steps and NVivo 12 plus software. Results "Facilitation of an error-free culture" emerged as a central theme of managers' perceptions of risk management. Four sub-themes were revealed, namely "creating an age-friendly physical environment," "paying close attention to frail older adults," "improving the competence of nursing staff," and "building effective management programs." Conclusion Facilitation of an error-free culture was of prime importance in risk management. Managers' experiences can help RACFs to better manage risks, as well as provide new perspectives and approaches for RACFs to improve the quality and outcomes of care. This study developed initiatives for improving resident safety in RACFs and may foster interest in the developing these initiatives.
期刊：
JOURNAL OF INTERFERON AND CYTOKINE RESEARCH,2020年40(11):524-529 ISSN：1079-9907
通讯作者：
Liu, Yong
作者机构：
[Zhou, Hongfei; Weng, Wujin; Yu, Qi] Hunan Univ Chinese Med, Sch Med, Changsha, Peoples R China.;[Tang, Yamei] Cent South Univ, Dept Lab Med, Xiangya Hosp 2, Changsha, Peoples R China.;[Ding, Shan; Liu, Yong; Huang, Kai] Cent South Univ, Natl Clin Res Ctr Mental Disorders, Xiangya Hosp 2, Changsha, Peoples R China.;[Ding, Shan; Liu, Yong; Huang, Kai] Cent South Univ, Dept Psychiat, Xiangya Hosp 2, Changsha, Peoples R China.;[Ding, Shan; Liu, Yong; Huang, Kai] Hunan Key Lab Psychiat & Mental Hlth, Changsha, Peoples R China.
通讯机构：
[Liu, Yong] C;Cent South Univ, Natl Clin Res Ctr Mental Disorders, Dept Psychiat, Xiangya Hosp 2, 139 Rennin Middle Rd, Changsha 410011, Peoples R China.
关键词：
FES;platelet parameters;NLR;PLR;MLR
摘要：
Serotonin (5-HT) and inflammation are 2 major hypotheses in schizophrenia (SZ) pathogenesis, both of which involve platelets. However, the association between platelet and SZ has not been well studied. The aim of this study was to evaluate changes of platelet count (PLT), mean platelet volume (MPV), platelet-large cell ratio (P-LCR), platelet distribution width (PDW), and plateletcrit (PCT) in patients with first-episode schizophrenia (FES). Meanwhile, 3 inflammation markers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR), were evaluated. Complete blood count of 106 FES patients, 82 first-episode depression (FED) patients, and 120 healthy controls (HCs) were compared. In addition, PLR, NLR, and MLR were calculated and compared among 3 groups. Our data suggested that PLT, MPV, P-LCR, PDW, PCT, NLR, PLR, and MLR in FES patients were significantly increased than those in the HCs (P < 0.01 or P < 0.05, respectively). PLT, PCT, PLR, and MLR in FED patients were significantly higher than those in the HCs (P < 0.01). However, no significant difference in MPV, P-LCR, and NLR was identified between FED patients and HCs (P > 0.05). Moreover, MPV, P-LCR, PDW, NLR, and MLR in FES patients were significantly higher than those in FED patients (P < 0.01 or P < 0.05, respectively). The elevation of PLT, MPV, P-LCR, PDW, PCT, NLR, PLR, and MLR in FES patients supported 5-HT and inflammation hypotheses in SZ pathogenesis. Further, our data suggested that increasing levels of MPV, P-LCR, PDW, NLR, and MLR might help to distinguish FES from FED. Clinical Trials.gov ID: 2018JJ2580
作者机构：
[Zhou, Bingping; Zhang, Wei; Li, Yaojin] Cent China Normal Univ, Sch Psychol, 152 Luoyu St, Wuhan 430079, Hubei, Peoples R China.;[Zhou, Bingping; Zhang, Wei; Li, Yaojin] Minist Educ, Key Lab Adolescent Cyberpsychol & Behav CCNU, Wuhan, Peoples R China.;[Zhou, Bingping; Zhang, Wei; Li, Yaojin] Cent China Normal Univ, Hubei Human Dev & Mental Hlth Key Lab, Wuhan, Hubei, Peoples R China.;[Xue, Jinfeng] Hunan Univ Chinese Med, Med Sch, Changsha, Hunan, Peoples R China.;[Zhang-James, Yanli] SUNY Upstate Med Univ, Syracuse, NY 13210 USA.
通讯机构：
[Zhang, Wei] C;Cent China Normal Univ, Sch Psychol, 152 Luoyu St, Wuhan 430079, Hubei, Peoples R China.
摘要：
This study tested the causal link between Attention Deficit/Hyperactivity Disorder (ADHD) and Internet addiction (IA) and investigated motivational and executive dysfunction as explanatory mechanisms in this association. A sample of 682 young adults completed self-report measures both at Time1 and Time2, six-months apart, including 54 ADHD participants diagnosed by the Conners’ Adult ADHD Rating Scale and the Continuous Performance Test. According to the performance in four cognitive tasks, ADHD participants were classified into three groups based on the dual pathway model of ADHD: executive dysfunction (ED), motivational dysfunction (MD) and combined dysfunction (CD). Participants’ severity of IA symptoms was assessed using the self-report Chen IA Scale. Results indicated that ADHD scores at Time1 predicted IA scores at Time2 but not vice versa. ADHD participants were easier to be IA than controls, while the severity of IA among the three ADHD groups changed differently. The MD and CD groups became more excessively engaged in Internet use over the course of the six-months while the ED group was unchanged. These findings identify ADHD as a potential risk factor for IA and suggest that motivational dysfunction, characterized by an excessive preference for immediate reward over delayed rewards, is a better predictor of IA than executive dysfunction.
作者机构：
[Zhenhui, Su; Yang, Hu; Yi, Xu; Xiang, Ding; Jianhui, Xie; Lihui, Zhu] Hunan Childrens Hosp, Changsha, Peoples R China.;[Sicheng, Xiong] Hunan Univ Chinese Med, Changsha, Peoples R China.
通讯机构：
Hunan University of Chinese Medicine, China
关键词：
Chinese nurses;cross-temporal meta-analysis;empathy;Jefferson Scale of Empathy-Health Professionals
摘要：
The empathy of nurses is associated with self-care and self-compassion, which may enhance the quality of the nurse-patient relationship. Yet, research on the empathy of nursing staff has mostly used cross-sectional designs, which cannot capture the degree of empathy changes over time. To explore changes in empathy among nurses in China from 2009 to 2018. A cross-temporal meta-analysis was used to examine continuous changes in the empathy of nurses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to conduct this cross-temporal meta-analysis of 57 samples of nurses in China who completed the three subscales (perspective-taking, compassionate care, and walking in the patient's shoes) of the Jefferson Scale of Empathy-Health Professionals from 2009 to 2018 (N = 13,825). This meta-analysis was conducted following good scientific practice in every phase, and approval by ethics committees was not required according to the local regulations in China. The findings suggest that the nurses' mean total scores of empathy and perspective-taking on the Jefferson Scale of Empathy-Health Professionals declined significantly over time, but the trend in compassionate care and walking in the patient's shoes was not significant. No significant changes were found in the overall empathy or the three dimensions of empathy of the nurses in the Eastern region across time, whereas a significant decline was found on the total empathy and perspective-taking scores of the nurses in other regions (i.e. the Central and Western regions). The mean total score of empathy and walking in the patient's shoes of the nurses who worked in the intensive care units showed a significant decrease over time. Furthermore, these findings indicate that the empathy of Chinese nurses has decreased steadily over the past 10 years. High levels of empathy can effectively reduce healthcare risks, errors, and disputes among nursing staff and enhance patient satisfaction and well-being.
摘要：
Introduction It is well-known that altered hypothalamus-pituitary-adrenal (HPA) axis process has an important role in the neurodegenerative process in schizophrenia (SZ). However, this neurodegenerative mechanism has not been clarified in SZ. Therefore, the main purpose of this study was to determine HPA axis damage in the first-episode, unmedicated schizophrenia (FES) patients and chronic schizophrenia (CSZ) patients in comparison with healthy controls (HC) by means of quantitative analysis of the peripheral blood mRNA expression of glucocorticoid receptor (GR), GR transcripts containing exons 1B (GR-1B), and neuron specific enolase (NSE) genes and serum cortisol and NSE, a specific serum marker for neuronal damage. Methods In the present study, 43 FES patients, 39 CSZ, and 47 HC were included. The peripheral blood mRNA expressions for GR, GR-1B, and NSE genes were determined by real-time quantitative polymerase chain reaction (RT-qPCR). Serum cortisol and NSE were analyzed by electrochemiluminescence immunoassay technique. Results Levels of GR mRNA were significantly lower in FES and CSZ than that in HC. The expression of GR-1B mRNA was significantly decreased in CSZ when compared with that in FES. Levels of NSE mRNA were significantly lower in CSZ than that in FES patients or HC patients. CSZ patients showed significantly lower cortisol concentrations than FES and HC patients. FES patients showed significantly higher NSE concentrations than CSZ and HC. Conclusion Our findings support that there is disrupted HPA axis system in the SZ and suggest that CSZ patients suffer a greater HPA axis damage than FES patients. Our research implicated underlying GR mRNA dysregulation in SZ and the potential importance of the functional GR-1B transcription in CSZ.
摘要：
Background Alcohol dependence (AD) patients have a high prevalence of aggressive behavior (AB). The frontal cortex and amygdala contains various neurotransmitter systems and plays an important role in AB, which is also associated with cognitive deficits. However, to date, no study has addressed the association of metabolites in the frontal cortex and amygdala with cognitive deficits in Chinese aggressive behavior-alcohol dependent patients(AB-ADs). Methods We recruited 80 male AD and 40 male healthy controls (HCs), who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Modified Overt Aggression Scale (MOAS), and the proton magnetic resonance spectroscopy (H-1 MRS) scan using 3.0T Siemens. The H-1 MRS data were automatically fitted with a linear combination model for quantification of metabolite levels of n-acetyl-aspartate (NAA), glutamate (Glu), Choline (Cho) and creatine (Cr). Metabolite levels were reported as ratios to Cr. Results The AB-ADs group scored significantly lower than the non-aggression-alcohol dependent patients (NA-ADs) on these two RBANS subscales (immediate memory and attention function indices). The AB-ADs group showed a significant reduction in NAA/CR ratio in the left frontal cortex and Cho/Cr ratio in the left amygdala, and elevation in Glu/Cr ratio in the bilateral amygdala, compared with the NA-ADs group. The NAA/Cr ratio in the left frontal cortex was positively associated with immediate memory (r=0.60, P<0.05), and the Glu/Cr ratio in the right amygdala was negatively associated with delayed memory (r=-0.44,P<0.05) in AB-ADs group. Conclusions Metabolite alterations in the frontal cortex and amygdala may be involved in the pathophysiology of AB in AD and its associated cognitive impairment, especially immediate memory and delayed memory.
期刊：
BioMed Research International,2020年2020 ISSN：2314-6133
通讯作者：
Qiu, Xinjian;Huang, Huiyong
作者机构：
[Qiu, Xinjian; Xu, Xia; Yan, Lijing; Wang, Dongsheng] Cent South Univ, Xiangya Hosp, Inst Integrated Tradit Chinese & Western Med, Lab Ethnopharmacol, Changsha 410008, Hunan, Peoples R China.;[He, Zhenyu] Taizhou Hosp Integrated Tradit Chinese & Western, Taizhou 317500, Zhejiang, Peoples R China.;[Wang, Sheng] Zhejiang Chinese Med Univ, Clin Med Coll 2, Hangzhou 310053, Zhejiang, Peoples R China.;[Zhao, Linlin] Cent South Univ, Dept Hlth Management, Xiangya Hosp 3, Changsha 410013, Hunan, Peoples R China.;[Qiu, Juan] Cent South Univ, Dept Nucl Med, Xiangya Hosp 4, Changsha 410008, Hunan, Peoples R China.
通讯机构：
[Qiu, Xinjian] C;[Huang, Huiyong] H;Cent South Univ, Xiangya Hosp, Inst Integrated Tradit Chinese & Western Med, Lab Ethnopharmacol, Changsha 410008, Hunan, Peoples R China.;Hunan Univ Tradit Chinese Med, Inst Tradit Chinese Med Diag, Changsha 410208, Hunan, Peoples R China.
期刊：
Risk Management and Healthcare Policy,2020年13:523-537 ISSN：1179-1594
通讯作者：
Zhang, Yinhua
作者机构：
[Shi, Chunhong; Li, Chunyan; Li, Pan] XiangNan Univ, Dept Nursing, Chenzhou 423000, Peoples R China.;[Zhang, Yinhua] Hunan Univ Chinese Med, Dept Nursing, Changsha 410208, Peoples R China.;[Zhu, Haili] Hunan Acad Tradit Chinese Med Affiliated Hosp, Dept Nursing, Changsha 410006, Peoples R China.
通讯机构：
[Zhang, Yinhua] H;Hunan Univ Chinese Med, Dept Nursing, Changsha 410208, Peoples R China.
关键词：
residential aged care facilities;Delphi survey;risk factors;Aged care;adverse events
摘要：
Purpose: This study aimed to identify risk factors associated with adverse events in residential aged care facilities in China. Patients and Methods: After compiling a list of risk factors for adverse events generated from in-depth interviews with managers of residential aged care facilities, a three-round Delphi method was used to reach consensus. The synthesized risk factors were presented on a Likert scale to the expert panelists three times to validate their responses. Results: The list identified 67 items as risk factors for adverse events, attached to four first-level indexes (ie, environmental facility, nursing staff, older adults' characteristics, and management factors). The experts' authority coefficient was 0.87. The positive coefficients were 82.76%, 91.67%, and 100%, and the coordination coefficients were 0.154, 0.297, and 0.313 in the first, second, and third rounds, respectively. Conclusion: Using a Delphi method, this study established a consensus on risk factors contributing to adverse events and developed a risk assessment grade for use in future aged care practice and research. The resulting list is useful in prioritizing risk-reduction activities and assessing intervention or education strategies for preventing adverse events in residential aged care facilities. Impact: This study fills the gap in risk identification in the Chinese residential aged care system to ensure provision of best-practice care to this vulnerable population. Nursing staff and management factors at the top of the list are not only the most common causes of adverse events but also the core elements in creating a secure and error-free environment. This list was intended to support predictive and prevention-oriented decision-making by managers and nursing supervisors to reduce preventable adverse events.
