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Aim s : The objective of this study was to examine the relationship between caregiving burden and pre‐death grief, with a specific focus on adult‐child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation. Methods: A convenience sample of 320 adult‐child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit‐Meuser Caregiver Grief Inventory‐Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist‐Revised. Results: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre‐death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre‐death grief, but in the male group, this mediating effect did not exist. Conclusion: The study found evidence supporting the link between caregiving burden and pre‐death grief among adult‐child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre‐death grief. These associations only existed in the female group. Implications: This paper presented the importance of active coping skills in the dementia caregiving process. Impact: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre‐death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre‐death grief. Community‐based and personal care support services should be promoted to alleviate their caregiving burden. Reporting Method: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. Patient or Public Contribution: 'No patient or public involvement'. [ABSTRACT FROM AUTHOR]

Aims: To determine the contributions of different kinds of symptoms to the quality of life and mediating effect of psychological and physical symptoms between heart failure symptoms and quality of life. Design: A multi‐centre cross‐sectional study. Methods: 2006 chronic heart failure patients from four cities were recruited in China from January 2021 to December 2022. Patients' symptoms and quality of life were self‐reported, and data were analysed using correlation analysis, dominance analysis and mediating effects analysis. Results: The dominance analysis revealed that the overall mean contributions of heart failure, psychological and physical symptoms were.083,.085 and.111; 29.5%, 30.2% and 39.5% of the known variance. And heart failure symptoms could negatively affect quality of life through psychological and physical symptoms, accounting for 28.39% and 22.95% of the total effect. Heart failure symptoms could also affect quality of life through the chain‐mediated effect of physical and psychological symptoms, accounting for 16.74%. Conclusions: Physiological symptoms had the strongest effect on quality of life and heart failure symptoms had the weakest. Most of the effect for heart failure symptoms on quality of life in chronic heart failure patients was mediated by psychological and physiological symptoms. Relevance to Clinical Practice: It is important to design non‐pharmacological intervention plans for the enhancement of physical and psychological symptoms' management skills, to reduce the adverse impact of heart failure symptoms on quality of life. Reporting Method: Study methods and results reported in adherence to the STROBE checklist. No Patient or Public Contribution: No patients or members of the public were involved in the study. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to investigate the role of the family in supporting diabetes self‐management and explore the possible mechanisms between family and diabetes self‐management among rural patients in China. Background: The prevalence of Type 2 diabetes mellitus (T2DM) is growing rapidly in rural areas of China, where healthcare resources remain relatively poor and family members play an important role in chronic disease self‐management. Design: This was a multicentre cross‐sectional study. Methods: A total of 276 adults with T2DM were recruited from nine county hospitals in China. Diabetes self‐management, family support, family function, and family self‐efficacy were evaluated using the mature scales. A theoretical model was built based on the social learning family model and previous studies and then verified using a structural equation model. The STROBE statement was used to standardise the study procedure. Results: Family support and general family factors, including family function and self‐efficacy, were positively correlated with diabetes self‐management. Family support fully mediates the relationship between family function and diabetes self‐management and partially mediates the relationship between family self‐efficacy and diabetes self‐management. The model explained 41% of the variability in diabetes self‐management and had a good model fit. Conclusion: General family factors can explain nearly half of the change in diabetes self‐management in rural areas of China, while family support is a mediator between general family factors and diabetes self‐management. Family self‐efficacy, a potential intervention point of family based diabetes self‐management education, can be improved by building special lessons for family members. Relevance to Clinical Practice: This study emphasises the role of family in diabetes self‐management and proposes suggestions for diabetes self‐management intervention among patients with T2DM in rural areas of China. Patient or Public Contribution: Patients and their family members completed the questionnaire which was used for data collection. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio‐ecological model. Background: PA has been linked to poor long‐term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. Design: Cohort study. Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group‐based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow‐up. A STROBE checklist was used to guide the reporting of this study. Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow‐up. Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. Relevance to Clinical Practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. No Patient or Public Contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study. [ABSTRACT FROM AUTHOR]

Aims: To explore the role of self‐efficacy (SE) in the effect of patient empowerment on self‐management behaviours among patients with chronic illness and to investigate the moderating effect of three types of health locus of control (HLC) in this moderated mediation model. Design: Cross‐sectional design. Methods: Data were collected in a general tertiary hospital, and a sample of 254 patients was recruited between August and October 2020. The effect of moderation and mediation was tested by the PROCESS macro (Model 4 and Model 8) for SPSS 25.0 by Hayes using 5000 bootstrap samples. Results: Self‐efficacy significantly mediated the relationship between patient empowerment and self‐management behaviour with a 95% confidence interval excluding zero. The chance HLC demonstrated a moderating effect, and the interaction effect on SE and self‐management behaviour was significant. Conclusion: Patient empowerment may improve confidence and adherence to self‐management among people with chronic illness, and such benefits were conditional on the HLC of patients. Impact: This study addresses the relationship between patient empowerment and self‐management behaviour in patients with different personality characteristics. This result indicated that classifying the type of HLC may enable the identification of subgroups of patients who may subsequently benefit from patient empowerment. In a patient‐centred programme, nurses and other healthcare professionals correctly identifying patients' HLC type and understanding the implications and then providing appropriate health care plans for patients with different health beliefs may be useful to tailor the decision‐making process. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the current situation and analyse influencing factors of resource utilisation in maintenance haemodialysis patients. Background: The self‐management level of patients undergoing maintenance haemodialysis in China is low. The applicability of the Chronic Illness Resources Survey in Chinese maintenance haemodialysis patients has been validated, and this survey can be used to assess the utilisation of self‐management support resources among haemodialysis patients. Determining the influencing factors of resource utilisation can help improve the self‐management behaviour of haemodialysis patients and control the progression of the disease. Design: A descriptive study design was chosen. Methods: A convenience sample of 314 patients undergoing haemodialysis was recruited from dialysis centres in three hospitals in western Xinjiang from June 2018–April 2019. SPSS19.0 software was used to describe the current situation of resource utilisation. Moreover, t test, analysis of variance and multivariate linear regression were applied to explore the influencing factors of patients' resource utilisation. Standards for observational studies STROBE Statement checklist‐v4 were chosen on reporting the study process. Results: The average score of the total resource utilisation was 2.95 ± 0.51. The average item score of seven dimensions from high to low was 3.46 for medical staff, 3.32 for personal, 3.22 for family and friends, 3.16 for work‐related, 3.12 for media policy, 2.55 for neighbourhood/community and 2.23 for organisation. Multiple linear regression showed that there have six main factors, which explained 65.4% of the variance of haemodialysis patients' resource utilisation. Conclusions: The personal, family and friends, work and media and policy subscales were rated the highest, with support from neighbourhood/community and organisation rated the lowest. In general, participants perceived moderate levels of support. Government and healthcare team should pay more attention on haemodialysis patients who had low level of education, poor economic conditions and poor mental condition. Relevance to clinical practice: ESRD has caused a burden on healthcare expenditure and has become a critical public health problem worldwide. Self‐management is particularly important for dialysis patients which have attracted extensive interest. In the future research, we can use this questionnaire to evaluate the related resources of disease management of dialysis patients, encourage patients to make full use of the resources around them and focus on those patients with low education and monthly income level and bad mental state. [ABSTRACT FROM AUTHOR]

This study evaluated the mass transfer, drying, and rehydration kinetics (drying and rehydration curve, moisture diffusivity [Deff]), energy consumption (specific energy consumption [SEC], moisture extraction rate (MER), and specific moisture extraction rate [SMER]), and mathematical modeling of infrared dried Ginkgo biloba seed (GBS) using the various nonthermal pretreatments namely: osmotic (OS), osmovacuum (V + OS), ultrasound (US, ginkgo seed immersed in a distilled water with US), and osmosonication (US + OS, ginkgo seeds immersed in an OS solution with US). Results showed that various pretreatments affected mass transfer, drying, and rehydration characteristics, and energy consumption, which was confirmed by principal component analysis. In terms of mass transfer, US pretreatment recorded the highest weight loss while the osmosonication pretreatment registered the highest solid gain. The entire drying process occurred in the falling‐rate period. The Deff values were within the normal range of agroproducts (10−11 to 10−8 m2/s). The modified Page‐I and Weibull model best fitted the drying and rehydration kinetics, respectively, with the coefficient of determination (R2) > 0.991, root mean square error, residual sum of squares, and reduced chi‐square closer to zero, compared with the other models. The untreated GBS (control) had the lowest energy efficiency (lowest SMER and MER) and the highest SEC than the pretreated GBS. Among the various pretreatments, the US pretreatment of GBS was superior, with the highest Deff, MER, SMER, and drying rate, and lowest drying time and SEC. Based on the findings, sequential US pretreatment and infrared drying is a feasible drying technique for GBS that could be used commercially. Practical Application: Ginkgo tree cultivation in China has exceeded market needs with 60,000 tons per annum of GBS produced. Hence, there is a compelling need to explore new chances to use GBS availability irrespective of the seasonality and address the problem where GBS utilization is limited to the early phases of home‐cooked dishes. Although drying increases the shelf life of ginkgo seeds, there is a higher operation cost. Thus, pretreatment can reduce energy consumption and augment the product quality is ideal. This research reported the impact of nonthermal pretreatments on ginkgo seeds' mass transfer, drying, and rehydration characteristics. The present results will provide a comprehensive understanding of the engineering application of ginkgo seed pretreatment, allowing for the best technique to be selected. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the role of health beliefs in affecting patients' chronic diabetic complication (CDC) screening. Background: Patients' adherence to the guideline‐recommended CDC screening was far from optimal. While many demographic and clinical characteristics were documented to influence patients' adherence, psychological profiles, such as health beliefs, were not well studied before. It is crucial to understand how health beliefs affect patients' CDC screening behaviour and thus to provide implications for future intervention programmes. Design: A cross‐sectional study was conducted. Methods: 785 type 2 diabetes were enrolled from the community health centre in Wuhou District, Chengdu, China. Structured questionnaires were used to collect data regarding the demographic and clinical information, knowledge about CDC, health belief model constructs and CDC screening behaviour. Mediation analysis was performed to explore the mechanisms of health belief model constructs on CDC screening behaviour. The study methods were compliant with the STROBE checklist. Results: Knowledge had a significant indirect effect on CDC screening behaviour through perceived susceptibility, perceived benefits, perceived barriers and self‐efficiency. Cues to action exerted both significant direct and indirect effects on CDC screening behaviour. The indirect effects of cues to action were exerted through perceived susceptibility, perceived barriers and self‐efficiency. Conclusion: Health beliefs played vital roles in mediating the effects of knowledge and cues to action on patients' CDC screening behaviour. Health beliefs should be assessed and modified through creative educational methods. Strategies aimed at increasing cues to action are also expected to facilitate patients' CDC screening behaviour. Relevance to clinical practices: The study contributes to the exploration of how health beliefs affect patients' CDC screening behaviour. The results could be used to inspire future community‐based intervention programmes. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: This study aimed to address the interrelationships among neurocognition, self‐efficacy, motivation and self‐management in individuals with schizophrenia. Background: Self‐management performance of individuals with schizophrenia is relatively poor. The effect of neurocognitive impairment on self‐management in schizophrenia remains inconsistent, which may be attributed to the neglect of possible mediating factors. Little attention has been given to the role of motivation and self‐efficacy for linking neurocognition to self‐management. Design: A cross‐sectional study. Methods: Three hundred and twenty patients were recruited with convenience sampling in this study. Patients' neurocognitive function, self‐efficacy, motivation and self‐management behaviours were measured. Pearson or Spearman correlation analysis and path analysis were performed to examine the interrelationships. This study followed STROBE checklist for cross‐sectional studies (see Appendix S1). Results: The final model, with good fit indices, revealed that (1) neurocognition, self‐efficacy and motivation were directly associated with self‐management, (2) self‐efficacy and motivation partly mediated the impact of neurocognition on self‐management and (3) motivation additionally mediated the association of self‐efficacy and self‐management. Conclusions: Our study extends the current findings, indicating that self‐efficacy and motivation may act as mediators in the relationship between neurocognition and self‐management in schizophrenia. Relevance to clinical practice: Mental health professionals should pay attention to interventions targeting both cognitive and psychosocial components to enhance self‐management in individuals with schizophrenia. [ABSTRACT FROM AUTHOR]

Aims: The aims of the present study were: a) to investigate the current state of postpartum glucose screening in rural China; and b) to explore the factors influencing postpartum blood glucose screening among women with prior GDM based on Andersen's behavioural model of health service use. Design: A multisite, cross-sectional study design, conducted from November 2017 to January 2018. Methods: A total of 465 women with prior GDM were included from two countylevel hospitals in rural China. The potential influencing factors for postpartum blood glucose screening based on Andersen's behavioural model, including predisposing, enabling, and need factors, were collected by self-reported questionnaires. Chisquare tests and logistic regression were used to explore the influence of these factors on whether screening of blood glucose level after delivery occurred. Results: The mean age of the women was 31.92 years old (SD 5.16) and the mean time after delivery was 16.73 months (SD 15.07). The postpartum glucose screening proportion was 32.7%. Women who did not have a full-time job (p= .011) (predisposing factor), had not received any treatment for GDM (p= .002), and were not informed about screening plans for diabetes by health professionals (p < .001) (enabling factor) were less likely to engage in postpartum glucose screening. The need factor, high actual risk of developing type 2 diabetes mellitus (T2DM), was not associated with postpartum blood glucose screening (p> .05). Conclusions: In rural China, most women with prior GDM were not screened for T2DM after delivery. The women with prior GDM who did not have a full-time job or had not received any prior treatment for GDM should be the target population for health education on postpartum glucose screening. Impact: There is a need for data on postpartum blood glucose testing rates among rural women. Future interventions aimed at increasing postpartum blood glucose screening are needed. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the study was to explore the individual, social and environmental factors influencing regular exercise on the basis of the theoretical framework of social ecological model among adults with type 2 diabetes and peripheral neuropathy. A total of 122 participants were chosen from Tianjin Metabolic Disease Hospital from November 2013 to May 2014. Information on exercise status and influencing factors was collected. Most participants took walking as the mode of exercise and exercised alone. Only 59.8% of participants were reported to carry out regular exercise. Logistic regression analysis suggested that being male, longer duration with diabetic peripheral neuropathy, higher self-efficacy for exercise and higher objective support were associated with regular exercise. Exercise status was clearly not ideal among adults with type 2 diabetes and peripheral neuropathy. The study highlighted the need to take measures to improve self-efficacy for exercise and social support in order to promote exercise participation among adults with type 2 diabetes and peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine whether and how stigma influences attitudes towards seeking treatment for urinary incontinence, and whether its effect varies by symptom severity. Background Urinary incontinence is prevalent among women, but few seek treatment. Negative attitudes towards urinary incontinence treatment inhibit from seeking care. Urinary incontinence is a stigmatised attribute. However, the relationship between stigma and attitudes towards seeking treatment for urinary incontinence has not been well understood. Design This was a cross-sectional community-based study. Methods We enrolled a sample of 305 women aged 40-65 years with stress urinary incontinence from three communities in a Chinese city between May-October in 2011. Data were collected on socio-demographic characteristics, urinary incontinence symptoms, stigma and attitudes towards seeking treatment for urinary incontinence using a self-reported questionnaire. Effects of stigma were analysed using path analysis. Results Attitudes towards seeking treatment for urinary incontinence were generally negative. For the total sample, all the stigma domains of social rejection, social isolation and internalised shame had direct negative effects on treatment-seeking attitudes. The public stigma domain of social rejection also indirectly affected treatment-seeking attitudes through increasing social isolation, as well as through increasing social isolation and then internalised shame. The final model accounted for 28% of the variance of treatment-seeking attitudes. Symptom severity influenced the strength of paths: the effect of internalised shame was higher in women with more severe urinary incontinence. Conclusions Stigma enhances the formation of negative attitudes towards seeking treatment for urinary incontinence; public stigma affects treatment-seeking attitudes through internalisation of social messages. Relevance to clinical practice Stigma reduction may help incontinent women to form positive treatment-seeking attitudes and engage them in treatment. Interventions should specifically target the self-stigma domains of social isolation and internalised shame in women with urinary incontinence to most efficiently increase their use of health care. [ABSTRACT FROM AUTHOR]

fang j., qiu c., xu h. & you g. (2013) A model for predicting acute and chronic fatigue in Chinese nurses. Journal of Advanced Nursing 69(3), 546-558. doi: 10.1111/j.1365-2648.2012.06029.x Abstract Aim. To explore a model designed to examine direct and indirect effects of variables on acute and chronic fatigue. Background. Although influencing factors for fatigue have been studied extensively, direct and indirect effects of predictors for acute and chronic fatigue remain poorly understood. Therefore, we proposed an original prediction model for acute and chronic fatigue in Chinese nurses based on previous studies. Design. Cross-sectional, descriptive, correlational design. Methods. We used a multi-stage sampling process to finally include 581 nurses working in the general hospitals in Chengdu, China. Data were collected between November 2007-March 2008 by using questionnaires. A path analysis was applied to test the fit of the hypothesized model and analysis of variance. Results. The final model fits the data well. A total of 44·8% of variance in acute fatigue was directly and indirectly explained by job demand, job control, support at work, exposure to hazards in work environments and sleep quality, and only indirectly influenced by intershift recovery and shift work. Moreover, 61·5% of total chronic fatigue was directly and indirectly accounted for by anxiety, depression, job dissatisfaction, intershift recovery, and acute fatigue, and only indirectly influenced by job control, support at work, exposure to hazards in work environments, shift work, and sleep quality. Conclusion. Acute and chronic fatigue is affected by different factors and nurse managers should generate specific interventions to decrease them. [ABSTRACT FROM AUTHOR]

Aims and objectives. To develop an explanatory framework to understand depression among community-dwelling Chinese older persons in Macau. Background. Depression has been described as the most common psychological problem among Chinese older persons. Dominant psychosocial theories are derived from research conducted mainly in western societies and similar research in Chinese populations is scant. Design. Mixed methods. Methods. Qualitative and quantitative methods (mixed methods) were employed to collect data from 31 participants between 2007-2009 in Macau. Results. Four categories of factors related to depression emerged: (1) negative thinking, (2) physical limitations and complaints, (3) present living conditions and social support and (4) past experiences. Each category interacts with the others and, consequently, one category both affects and is affected by others. The categories captured participants' life-long hardship and bio-psycho-social-cultural disability that lay at the root of their negative thinking. The consequences and impacts of their negative thinking appear to feed and sustain depression. Conclusion. The framework offers a deeper understanding of the nature and meaning of the experiences of depressed older persons in a Chinese context. Relevance to clinical practice. The findings have several implications for clinical practice. First, the cultural context of Chinese older persons should be emphasised in nursing practice. Second, the root of depression among Chinese older persons is seen to lie in their social, family, cultural and day to day living issues. Finally, this study illustrates the potential for incorporating psychosocial nursing interventions as a therapeutic approach on its own or as an adjunct to other therapy. [ABSTRACT FROM AUTHOR]