Nurses at the frontline of public health emergency preparedness and response: lessons learned from the HIV/AIDS pandemic and emerging infectious disease outbreaks

Ethical challenges nurses faced during the COVID-19 pandemic: Scoping review

Nurses encountered a myriad of ethical challenges during the height of the COVID-19 pandemic, such as allocation of scarce resources, the need to balance duty of care with safety of self as well as visitation restrictions. The impact of these challenges on the nursing workforce requires investigation. The aim of this review was to scope and describe the reported literature on ethical challenges faced by nurses during the COVID-19 pandemic, including contextual characteristics and strategies reported to address these challenges. The review was conducted in accordance with JBI methods for scoping reviews and reported using PRISMA-ScR guidance. A published protocol guided conduct of the review. The following databases were searched for eligible studies from November 2019 to January 2023: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions were applied. Studies were reviewed for inclusion by two independent reviewers, and a data extraction form was developed to extract data relevant to the review questions. Results were analyzed and presented according to the concepts of interest, using tables, figures, and supporting narrative synthesis. After searching the databases, 2150 citations were retrieved with 47 studies included in the review. Studies represented 23 countries across five continents. Most of the studies used qualitative designs. Ethical challenges were described in several ways, often without appealing to common ethics language or terms. Few studies reported on strategies to address the specific challenges, which may reflect the dynamic nature of the pandemic. The scoping review highlights the complex and, at times, overwhelming impact of ethical challenges faced by nurses across the globe during the COVID-19 pandemic. Findings from the review can be used as a basis for further research to explore, develop, and implement strategies to address ethical challenges faced by nurses during future public health crises.

Development and preliminary validation of the evaluation scale for nurses' core emergency response abilities in sudden major infectious disease outbreaks

BACKGROUND

In recent years, the escalating frequency and intensity of infectious disease outbreaks have underscored the profound severity and global ramifications of public health challenges confronting healthcare systems. As frontline responders during emerging infectious disease crises, nurses' core emergency response competencies critically influence the timeliness and efficacy of outbreak prevention and control measures. Currently, standardized assessment instruments for evaluating nurses' core emergency response capabilities during major infectious disease outbreaks remain underdeveloped.

AIMS

This study aimed to construct and psychometrically validate a Core Emergency Response Competency Evaluation Scale for nurses during major infectious disease outbreaks.

METHODS

A convenience sample of nurses was recruited from eight tertiary hospitals in Henan Province, China. The three-phase study comprised: (1) item generation (Delphi survey and pilot testing), (2) scale development (item analysis and exploratory factor analysis), and (3) scale validation (reliability and validity assessments).

RESULTS

The finalized 45-item scale encompasses eight dimensions: Fundamental Nursing Knowledge, Legal Policy & Ethical Practice, Core Nursing Skills, Disease Assessment & Monitoring, Emergency Response Coordination, Infection Prevention & Control, Nurse Personal Attributes, and Rehabilitation & Recovery. Exploratory factor analysis demonstrated an 83.353% cumulative variance contribution for the eight-factor model. Confirmatory factor analysis indicated excellent model fit (χ²/df = 1.943, RMR = 0.020, RMSEA = 0.050, IFI = 0.951, TLI = 0.947, CFI = 0.951, PNFI = 0.835). The scale exhibited strong reliability (Cronbach's α = 0.987, split-half = 0.956, test-retest = 0.977) and validity (I-CVI = 0.875-1.00; S-CVI = 0.974). Convergent validity was supported by AVE values (0.611-0.778) and CR values (0.903-0.955).

CONCLUSION

The psychometrically robust Core Emergency Response Competency Evaluation Scale for Sudden Major Infectious Diseases demonstrates excellent reliability and validity, providing a scientifically validated tool for assessing nurses' emergency preparedness in infectious disease crises.

Public health system in post-pandemic Sierra Leone: a scoping review

BACKGROUND

Since the outbreak of the novel SARS-CoV-2 that caused COVID-19 in 2019, the government of Sierra Leone implemented immediate preventive measures to stop the disease from entering the country. On March 24, 2020, the country declared a state of emergency in response to the emerging global COVID-19 pandemic, even though no confirmed cases had been reported at that time. However, Sierra Leone recorded its first COVID-19 case later in March 2020. While there have been few scoping reviews to date, these primarily focuses on experiences from Western countries or expatriates. The main purpose of this scoping review is to document the various COVID-19 pandemic preparedness measures undertaken by the Sierra Leone health system, assess the impacts of the pandemic on health systems, and document the various responses of health systems implemented across different settings from a home-based perspective.

METHODS

We searched peer-reviewed papers and articles under review or submitted for publication in Sierra Leone and the COVID-19 pandemic found in the Web of Science, Scopus, Pubmed, Google Scholar, MedRxiv, and Research Square databases. In addition, we examined gray literature, including Sierra Leone government reports and academic unpublished works on Sierra Leone's COVID-19 situation. Both quantitative and qualitative studies were analyzed, focusing on the Sierra Leone health system or on the essential health services provided by the Sierra Leone health system during the COVID-19 pandemic.

RESULTS

Few (48.7%) studies were multi-country studies (i.e., involving different countries and Sierra Leone). The majority (83.7%) were original articles published either in peer-reviewed journals or were deposited in preprint repositories; 10.9% were editorials, commentaries, or news reports; 1 (2.7%) was a working paper; and 1 (2.7%) was personal correspondence.

CONCLUSION

Sierra Leone's health system was partially prepared for the COVID-19 pandemic, largely due to its previous experience in managing the Ebola virus disease outbreaks from 2013 to 2016. However, the pandemic had significant impact on other health services. Although the country's response to the pandemic was swift, it fell below average in addressing the scale of the challenges posed by the crisis.

Development and psychometric testing of the nurses' core competencies for public health emergencies scale: A multicenter cross-sectional study

BACKGROUND

The significance of addressing public health emergencies (PHEs) emphasizes the pivotal role of a skilled nursing workforce in effective preparedness and response. However, there's a lack of comprehensive assessments tailored to nurses' core competencies, serving as a standard for ongoing education in preparedness.

OBJECTIVE

This study aimed to develop a psychometrically sound scale for identifying and measuring essential core competencies crucial for nurses during public health emergencies.

DESIGN

A multicenter cross-sectional study was conducted.

SETTINGS

Twelve tertiary hospitals in Shanghai.

PARTICIPANTS

Affiliated nurses with prior experience and significant exposure to public health emergencies were recruited.

METHODS

The study underwent development and validation in two stages, utilizing qualitative data analysis, a Delphi expert panel, and an empirical quantitative cross-sectional survey. The Nurses' Core Competencies for Public Health Emergencies (NCC-PHEs) scale and a demographic questionnaire were distributed between January 2023 and March 2023. Exploratory factor analysis, confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were employed to identify theoretical constructs, assess scale reliability, and establish validity.

RESULTS

Analysis was conducted on valid data collected from 1481 nurses. Factor analysis identified 47 professional nursing competencies arranged within a four-factor high-order model: prevention competencies (9 items), preparation competencies (7 items), response competencies (comprising basic and advanced levels) (26 items), and recovery competencies (5 items). Structural equation modelling confirmed satisfactory factor loadings and a good model fit, validating construct integrity. The reliability of the total scale was confirmed.

CONCLUSION

This study presents a valid scale that empirically measures nurses' core competencies crucial for preparedness and response during public health emergencies. The findings offer instrumental support for guiding the development of future courses and training programs in nursing research and practice.

The associated factors of disaster literacy among nurses in China: a structure equation modelling study

AIMS

To examine the association of disaster literacy with collectivism, social support, psychological resilience and self-efficacy among nurses and analyze the influencing mechanisms among these factors.

BACKGROUND

Nurses' disaster literacy is important for future preparation. However, there is a paucity of research in this field.

METHODS

From January to August 2023, we recruited 1573 nurses in 15 hospitals in Zhejiang province, China using convenient sampling. Based on Social-Ecological Model, questionnaires regarding collectivism, social support, psychological resilience, self-efficacy and disaster literacy were distributed via online platform. Data were analyzed using structural equation model to examine the relationships between the study variables.

RESULTS

Nurses had a medium level of disaster literacy with the lowest score in critical literacy. Nurses' collectivism not only had positive direct effect on disaster literacy, but also had indirect pathways from social support, psychological resilience and self-efficacy to influence the level of disaster literacy.

CONCLUSIONS

Multilevel factors including collectivism, social support, psychological resilience and self-efficacy were associated with disaster literacy. Understanding the influencing mechanism would inform effective interventions.

IMPLICATIONS FOR NURSING MANAGEMENT

Our findings illustrate the importance for nurse managers, administrators and authorities to work together to develop and implement effective nursing curriculum and training programs to improve nurses' disaster literacy for future preparation.

A roadmap for the nursing scientific workforce to eliminate health and healthcare inequities

BACKGROUND

The National Academies of Sciences, Engineering, and Medicine's Ending Unequal Treatment report emphasizes immediate actions to eliminate health inequities (i.e., solutions-oriented health inequity research), versus incrementally advancing health equity. Nurse scientists are uniquely positioned to lead national efforts to eliminate health inequities.

PURPOSE

To outline nursing science's contributions to solutions-oriented health inequity research, highlight opportunities and challenges for nursing leadership, and key competencies for which workforce support infrastructure is needed.

METHODS

We draw on the landmark 2024 Ending Unequal Treatment report, supplemented by a review of the literature on scientific nursing-specific workforce challenges.

DISCUSSION

We identify strategies for sustaining and advancing nursing science's leadership in solutions-oriented health inequity research, including objectives, competencies, and programmatic elements needed to support current and future nurse investigators.

CONCLUSION

Bolstering the nursing scientific workforce in solutions-oriented health inequity will elevate the critical role of nursing science in eliminating health inequities and improving population health.

Improving Willingness to Care and Training Needs for PLWHA from the Perspective of Student Nurses in China: A Qualitative Study

People living with HIV and AIDS (PLWHA) deserve equitable and high-quality care. Current HIV and AIDS nursing education may not adequately prepare student nurses for the complexities of caring for PLWHA, and the perspectives of student nurses have not been sufficiently revealed in nursing education research. This study aimed to explore the viewpoints of student nurses with AIDS care experience on methods to improve their care willingness for PLWHA and to identify their educational and training needs. A descriptive qualitative study design was employed, interviewing 18 undergraduate student nurses from 14 tertiary hospitals across 7 provinces in China. Content analysis of transcripts revealed insightful suggestions for improving nursing students' willingness, such as increased HIV and AIDS education and training, psychological preparation, positive role modeling, raising awareness about AIDS patients, and fostering nursing professionalism. Highlighted education and training needs include progress in HIV and AIDS treatment, preventive measures, psychological support for PLWHA, post-exposure protocols, and HIV-infected risk behaviors. These findings highlight the need for HIV and AIDS education, psychological support training, and stigma-reduction strategies. This study provides valuable insights that could inform policymakers, educators, and healthcare providers on preparing future nurses to meet the complex needs of PLWHA.

Competency in responding to infectious disease outbreaks among nurses in primary healthcare institutions: a quantitative, cross-sectional multicentre study

Background

Nurses' competencies are crucial for infectious disease prevention and control. We aimed to investigate competencies in responding to infectious disease outbreaks of nurses in primary healthcare institutions and identify their training needs.

Methods

A cross-sectional study was conducted from June to September 2022, recruiting nurses from primary healthcare institutions across Sichuan Province. Their competencies and training needs were assessed using a modified Emergency Response Competency Scale for Infectious Diseases. Additionally, their sociodemographic characteristics and experience in infectious disease outbreak trainings were collected. Univariate analyses were used to compare competencies and training needs by participant characteristics. Multiple linear regression was conducted to identify determinants of their competencies.

Results

A total of 1,439 nurses from 44 primary healthcare institutions participated in this study. The overall competency and training needs had a median of 3.6 (IQR [3.1, 4.0]) and 4.0 (IQR [3.9, 4.7]), respectively. Age (β = -0.074, p = 0.005), experience in higher authority hospitals (β = 0.057, p = 0.035), infectious disease outbreak trainings attended within the last 5 years (β = 0.212, p < 0.001), and regions where the institutions located were determinants of the competencies.

Conclusion

The competencies in responding to infectious disease outbreaks among nurses in primary healthcare institutions were at a moderate level, influenced by varied factors.

Evidence-based nursing practice and improving pediatric patient care outcomes in the prevention of infection transmission: Emergency department findings

BACKGROUND

Reducing the risk of infection transmission by getting emergency care for pediatric patients is a challenging task.

AIM

The study aim was to assess emergency nurses' readiness to provide care for pediatric patients with infectious diseases.

METHOD

Two hundred Jordanian emergency department nurses were surveyed using a descriptive design.

RESULTS

The study revealed that insufficient safety and infection control procedures were put into place, starting with family support to allow nurses to work 145 (78%), family care plans intended to assist caregivers 139 (74.7%), the availability of respiratory protection and a backup plan for standard precautions, training requirements, and equipment 131 (70.4%), create a unit pandemic safety strategy 124 (66.7%), have a plan for emergencies for at-risk staff 116 (62.4%), have a hospital pandemic safety plan 113 (60.8%), manage inventory 102 (54.8%), use reuse guidelines if there will be severe shortages 99 (53.2%), create a strategy for nurses' access to healthcare for themselves and their families 96 (51.6%), and end with any required system updates for new policies 88 (47.3%). Staff nurses made up a large proportion of participants (145; 78%; 115; 62.8%) who said they lacked experience with care for pediatric patients with infectious illnesses who were critically sick. A 62.8% of nurses reported they did not have training in infectious disease emergency prevention and control for pediatric patients. What nurses prioritize it was determined that the concept of crisis standards of care (34.9%) was the most important educational topic for training emergency room nurses to care for pediatric patients who are critically ill with infectious infections, while the clarity of communication pathways was ranked lowest.

CONCLUSION

More training and support are needed for emergency room nurses to properly care for children's patients with infectious illnesses.

Nurses' Personality Traits and Perceived Work Environments During Public Health Emergencies: Implications for Nursing Workforce Planning

Background

The nursing workforce faces substantial challenges, particularly in the aftermath of the COVID-19 era. Developing an effective strategy for workforce maintenance and the strategic deployment of nurses is crucial.

Purpose

This study aimed to explore and categorize nurses' personality traits, with a focus on analyzing differences in their perceptions of the nursing work environment.

Participants and Methods

Between January 2023 and February 2023, a multi-center cross-sectional study was carried out involving nurses from 12 tertiary hospitals actively engaged in frontline COVID-19 response duties. Through cluster sampling, surveys were distributed among eligible nursing staff, comprising a general information questionnaire, the Chinese Big Five Personality Questionnaire-Short Form, subjective evaluations of emergency nursing management, and the Chinese Nursing Work Environment Scale for Public Health Emergencies. Various statistical analyses, such as descriptive analysis, cluster analysis, non-parametric tests, and general linear model analysis, were employed to investigate the correlation between personality types and the perception of nursing work environments.

Results

The analysis encompassed 1059 valid questionnaires, reflecting the experiences of frontline nurses. The majority of these nurses possessed 1-5 years of experience, held junior professional titles, volunteered for their roles, and served as attending nurses. Categorization based on personality traits revealed three groups: resilient (35.60%), ordinary (16.15%), and distressed (48.25%) types. Significantly distinct perceptions of nursing work environments emerged among these categories, with resilient and ordinary types expressing notably higher satisfaction compared to the distressed group (H value = 256.487, p < 0.001).

Conclusion

This study illustrates the connection between nurses' perceived working environment and their personality traits. Nursing managers should factor in nurses' personality traits when choosing and deploying frontline responders during public health emergencies. Prioritizing resilient-type nurses and crafting a supportive work environment that aligns with nurses' characteristics is indispensable for an effective emergency response.

Learning from digital health investments during COVID-19 vaccine program implementation: a research collaboration and theory of change

Responses to recent epidemics provide critical lessons on how the use of digital technologies and data systems can support timely and evidence-driven responses to public health emergencies. The arrival of COVID-19 and, subsequently, the COVID-19 vaccine, compelled many countries to attempt to create digitized, individual-level records on a large scale and quickly. In 2022, the United States Agency for International Development (USAID) brought together four global USAID-funded projects to explore whether and how USAID's COVID-19 vaccine data and digital health investments supporting the emergency response strengthened the digital health enabling environment and, by extension, contributed to broader health system strengthening. Each project designed and implemented individual learning activities aligned to their specific USAID-funded COVID-19 vaccine response activities. The group collaboratively developed a theory of change to explore the potential relationship between COVID-19 vaccine-related digital and data investments and their immediate COVID-19 response, as well as two intermediate- and longer-term impact pathways: one focused on COVID-19-specific outcomes and impact, and a second focused on strengthening the digital health enabling environment and broader health system. The focus of this supplement is primarily to explore the theory of change associated with this latter pathway. Recognizing that health emergencies triggered by shocks due to disease outbreaks, climate change and conflict are likely to continue to characterize the environment in which health programs are delivered, this research seeks to contribute to a better understanding of how digital technologies and data systems can be most effectively leveraged to meet immediate needs while strengthening country resilience over the long term. Abrégé Les réponses aux récentes épidémies ont permis de tirer d'importants enseignements sur la façon dont le recours aux technologies numériques et aux systèmes de données peut appuyer le déclenchement rapide d'interventions fondées sur des éléments probants contre les urgences de santé publique. L'arrivée de la COVID-19 et, par la suite, celui du vaccin contre la COVID-19 ont contraint de nombreux pays à tenter de créer des dossiers numérisés au niveau individuel à grande échelle et rapidement. En 2022, l'United States Agency for International Development (USAID) a rassemblé quatre projets mondiaux qu'elle finançait dans le but d'explorer si et comment les données de l'USAID relatives au vaccin contre la COVID-19 ainsi que les investissements en santé numérique appuyant la réponse d'urgence avaient renforcé l'environnement propice à la santé numérique et, par extension, s'ils avaient contribué au renforcement du système de santé dans son ensemble. Chaque projet a conçu et mis en œuvre des activités d'apprentissage individuelles alignées sur leurs activités spécifiques de riposte au vaccin contre la COVID-19 financées par l'USAID. Le groupe a collaboré pour élaborer une théorie du changement afin d'étudier la relation potentielle entre les investissements dans le numérique et dans les données liées au vaccin contre la COVID-19 et leur réponse immédiate à la COVID-19 ainsi que deux itinéraires d'impact à moyen et à long terme: l'un était axé sur l'impact et les résultats spécifiques à la COVID-19 et le second sur le renforcement de l'environnement propice à la santé numérique et du système de santé dans son ensemble. Ce supplément a pour objectif principal d'examiner la théorie du changement associée à ce dernier itinéraire. Reconnaissant qu'il est probable que les conflits, les changements climatiques et les urgences sanitaires causées par des chocs dus à des épidémies continueront de caractériser l'environnement dans lequel sont offerts les programmes de santé, cette recherche vise à mieux faire comprendre la façon dont les technologies numériques et les systèmes de données peuvent être exploités le plus efficacement possible pour répondre aux besoins immédiats tout en renforçant la capacité de résilience des pays sur le long terme. Resumen Las respuestas a las epidemias recientes proporcionan lecciones críticas sobre cómo se puede apoyar respuestas oportunas y de base empírica a las emergencias de salud pública mediante el uso de tecnologías digitales y sistemas de datos. La llegada de la COVID-19 y, posteriormente, la vacuna contra esa enfermedad, obligó a muchos países a tratar de crear registros individuales digitalizados, a gran escala y rápidamente. En 2022, United States Agency for International Development (USAID) reunió cuatro proyectos globales que había financiado para estudiar si sus datos sobre la vacuna contra la COVID-19 y las inversiones en salud digital en apoyo de la respuesta de emergencia habían fortalecido el entorno propicio para la salud digital y, por extensión, si habían contribuido a fortalecer el sistema de salud en general, y de qué forma lo habían hecho. En cada proyecto se habían diseñado e implementado actividades de aprendizaje individuales, acordes con las actividades específicas de respuesta vacunal financiadas por USAID. El grupo desarrolló en forma colaborativa una teoría del cambio para analizar la posible relación entre las inversiones digitales y de datos y la vacuna contra la COVID-19 y su respuesta inmediata a la pandemia, así como dos vías de impacto a mediano y largo plazo: una primera centrada en los resultados y efectos específicos en la pandemia, y una segunda centrada en fortalecer el entorno propicio para la salud digital y un sistema de salud más amplio. El enfoque de este suplemento consiste principalmente en examinar la teoría del cambio vinculada con esta última vía. Reconociendo que es probable que las emergencias sanitarias provocadas por los brotes de enfermedades, el cambio climático y los conflictos continúen caracterizando el entorno en el que se ejecutan los programas de salud, esta investigación busca ayudar a que se comprenda mejor la forma en que las tecnologías digitales y los sistemas de datos pueden aprovecharse de manera más efectiva para satisfacer las necesidades inmediatas, fortaleciendo la resiliencia de los países a largo plazo.

Common domains of nurses' competencies in public health emergencies: a scoping review

BACKGROUND

A public health emergency can cause large numbers of deaths in a short period, with devastating social, economic and health consequences. Nurses are the main healthcare providers during such emergencies, and their competencies affect the control and outcomes of the situation. Studies on nurses' competencies in public health emergencies vary between countries and healthcare systems. Therefore, we conducted a scoping review to identify the common domains of nurses' competencies in public health emergencies worldwide.

METHODS

We searched the PubMed, CINHAL, Scopus, Web of Science, Science Direct, Embase, Cochrane Library, WanFang and ECRI databases from their inception to 2023. All published articles on nurses' competencies in public health emergencies that were published in English and Chinese were included. We mainly analyzed and synthesized nurses' competencies, assessment instruments and the training described in the included studies.

RESULTS

A total of 27 competency domains were identified following an analysis and summary. The most frequently cited domains were communication skills, self-protection skills, basic knowledge of a public health emergency, laws and ethics and the capacity for organizational collaboration. The Disaster Preparedness Evaluation Tool and the Emergency Preparedness Information Questionnaire were the most commonly used tools for assessing competencies. Most training was conducted online and the content that was covered varied by country.

CONCLUSIONS

Given the significant roles and responsibilities of nurses in public health emergencies, knowing the domains of their competencies is essential to evaluating, developing, and conducting clinical training.

Visualization and bibliometric analysis of occupational exposure among nurses in Asia

Background

Occupational exposure is of increasing concern, posing a serious threat to nurses, especially in the event of a public health emergency. Bibliometrics sheds novel light on the current state of research and factors influencing nurses' occupational exposures, illuminating hot topics and trends in the literature. Bibliometrics is essential to analyze the potential harm to nurses in Asia.

Methods

Data were extracted from the Web of Science Core Collection on August 6, 2022 with the following search terms: TS= (nurses) AND (TS= (occupational exposure OR occupational health)). CiteSpace and VOSviewer were used to analyze national and institutional collaborations, reference clustering, citations and co-citations of journals and keyword bursts, and HistCite was used to analyze the citation historiography map. To analyze the data and generate statistical charts, Origin and Microsoft Excel were utilized.

Results

A total of 1448 studies on nurses' occupational exposure in Asia were identified. China Medical University had the most publications among Asian institutions, and China had the largest share among Asian countries. Most articles on nurses' occupational exposure in Asia were in the Journal of Occupational Health, and the journal with the highest impact factor was the Journal of Nursing Management. The COVID-19 outbreak caused a substantial shift in the direction of studies on nurses' occupational exposure in Asia. Mental health is a current hot topic, while sharps injuries and bodily fluid exposure are long-term priorities for attention.

Conclusions

The hotspots of research on nurses' occupational exposure in Asia focus on mental health, burnout, blood exposure, infection, and sharps injury. Due to the COVID-19 pandemic, recent research has concentrated on personalized mental health care and the development of protective equipment, and cross-disciplinary collaboration may be a new trend in the future.

HIV Care Profiling and Delivery Status in the Mobile Health Clinics of eThekwini District in KwaZulu Natal, South Africa: A Descriptive Evaluation Study

Mobile health clinics (MHCs) serve as an alternative HIV care delivery method for the HIV-burdened eThekwini district. This study aimed to describe and profile the HIV care services provided by the MHCs through process evaluation. A descriptive cross-sectional quantitative evaluation study was performed on 137 MHCs using total population sampling. An online data collection method using a validated 50-item researcher-developed instrument was administered to professional nurses who are MHC team leaders, following ethical approval from the local university and departments of health. Descriptive statistics were used to analyze the data. The results described that HIV care services are offered in open spaces (43%), community buildings (37%), solid built buildings called health posts (15%), vehicles (9%), and tents (2%) with no electricity (77%), water (55%), and sanitation (64%). Adults (97%) are the main recipients of HIV care in MHCs (90%) offering antiretroviral therapy (95%). Staff, monitoring, and retaining care challenges were noted, with good linkage (91%) and referral pathways (n = 123.90%). In conclusion, the standardization and prioritization of HIV care with specific contextual practice guidelines are vital.

The mediation effect analysis of nurse's mental health status and burnout under COVID-19 epidemic

Aim

The objective of this study is to investigate the mental health status of nurses during the outbreak of novel coronavirus pneumonia. Additionally, we aim to analyze the relationship between anxiety, depression, and burnout among nurses. The findings will provide a scientific basis for promoting the psychological health of nurses.

Methods

Using a cross-sectional study, nurses in Quanzhou in May 2020 completed a general information questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the Maslach Burnout Inventory (MBI). Data analysis was conducted using structural equation model.

Results

372 questionnaires were returned, with a response rate of 92.5%. The prevalence of anxiety and depression among the participants were 45.2 and 41.4%, respectively. The prevalence of severe burnout among nurses was found to be 7.3%. There was a correlation between nurses' anxiety, depression, and job burnout. The correlation coefficients between anxiety and job burnout, depression and job burnout, and anxiety and depression were found to be statistically significant (p < 0.001). Depression plays a mediating role between anxiety and jod burnout (0.584/1.413, 41.3%).

Conclusion

The COVID-19 epidemic has resulted in moderate to high levels of job burnout among nurses. In this context, depression has been found to play a mediating role in the relationship between anxiety and job burnout. It is imperative for hospital administrators to prioritize the mental health of nurses and the provide necessary support to ensure their well-being.

Is the USA on track to end the HIV epidemic?

Despite progress in reducing new HIV infections in the USA, publicly available data suggest that new HIV infections continue to occur at an alarming rate. In this Viewpoint, we highlight the regularity with which the existing systems for HIV prevention and treatment delivery in the USA fail and the clearly inequitable effect of the systems' failure among several priority populations of the Ending the HIV Epidemic (EHE) initiative. Existing data cast doubt on whether the current EHE efforts will suffice to achieve its 2030 goal of reducing annual new HIV infections to fewer than 3000. We outline future directions in four priority areas to regain lost ground in pursuit of the 2030 EHE goals: reducing the stigma affecting people living with and most at risk of HIV; broadening the HIV workforce; mitigating harmful social determinants of health; and recommitting and reinvesting in health in the USA more broadly.

Biomedical association analysis between G2/M checkpoint genes and susceptibility to HIV-1 infection and AIDS progression from a northern chinese MSM population

BACKGROUND

MSM are at high risk of HIV infection. Previous studies have shown that the cell cycle regulation plays an important role in HIV-1 infection, especially at the G2/M checkpoint. ATR, Chk1, Cdc25C and CDK1 are key genes of G2/M checkpoint. However, the association between SNPs of these genes and susceptibility to HIV-1 infection and AIDS progression remains unknown.

METHODS

In this study, 42 tSNPs from the above four G2/M checkpoint genes were genotyped in 529 MSM and 529 control subjects from northern China to analyze this association.

RESULTS

The results showed that rs34660854 A and rs75368165 A in ATR gene and rs3756766 A in Cdc25C gene could increase the risk of HIV-1 infection (P = 0.049, OR = 1.234, 95% CI 1.001-1.521; P = 0.020, OR = 1.296, 95% CI 1.042-1.611; P = 0.011, OR = 1.392, 95% CI 1.080-1.794, respectively), while Chk1 rs10893405 (P = 0.029, OR = 1.629, 95% CI 1.051-2.523) were significantly associated with AIDS progression. Besides, rs34660854 (P = 0.019, OR = 1.364, 95% CI 1.052-1.769; P = 0.022, OR = 1.337, 95% CI 1.042-1.716, under Codominant model and Dominant model, respectively) and rs75368165 (P = 0.006, OR = 1.445, 95% CI = 1.114-1.899; P = 0.007, OR = 1.418, 95% CI 1.099-1.831, under Codominant model and Dominant model, respectively) in ATR gene, rs12576279 (P = 0.013, OR = 0.343, 95% CI 0.147-0.800; P = 0.048, OR = 0.437, 95% CI 0.192-0.991, under Codominant model and Dominant model, respectively) and rs540436 (P = 0.012, OR = 1.407, 95% CI 1.077-1.836; P = 0.021, OR = 1.359, 95% CI 1.048-1.762, under Codominant model and Dominant model, respectively) in Chk1 gene, rs3756766 (P = 0.013, OR = 1.455, 95% CI 1.083-1.954; P = 0.009, OR = 1.460, 95% CI 1.098-1.940, under Codominant model and Dominant model, respectively) in Cdc25C gene and rs139245206 (P = 0.022, OR = 5.011, 95% CI 1.267-19.816; P = 0.020, OR = 5.067, 95% CI 1.286-19.970, under Codominant model and Recessive model, respectively) in CDK1 gene were significantly associated with HIV-1 infection under different models.

CONCLUSIONS

We found that genetic variants of G2/M checkpoint genes had a molecular influence on the occurrence of HIV-1 infection and AIDS progression in a northern Chinese MSM population.

Smartphone conducted DNA portable quantitative detection platform based on photonic crystals chip and magnetic nanoparticles

It is of great significance to develop a highly sensitive and intuitive virus detection tool. A portable platform is constructed for quantitative detection of viral DNA based on the principle of fluorescence resonance energy transfer (FRET) between upconversion nanoparticles (UCNPs) and graphene oxide nanosheets (GOs) in this work. To implement a high sensitivity and low detection limit, GOs are modified by magnetic nanoparticles to prepare magnetic graphene oxide nanosheets (MGOs). Among them, the application of MGOs can not only eliminate the background interference, but also amplify the fluorescence intensity to a certain extent. Whereafter, a simple carrier chip based on photonic crystals (PCs) is introduced to realize a visual solid-phase detection, which also amplifies the luminescence intensity of the detection system. Finally, under the application of the 3D printed accessory and smartphone program of red-green-blue (RGB) evaluation, the portable detection can be completed simply and accurately. In a word, this work proposes a portable DNA biosensor with the triple functions of quantification, visualization and real-time detection can be used as a high-quality viral detection strategy and clinical diagnosis method.

Understanding the student's experience of community health nursing simulations

OBJECTIVES

The purpose of this study was to explore nursing students' experiences after completing community health nursing simulation encounters.

METHODS

The study used a descriptive qualitative design. Through conventional content analysis, the research team analyzed the experiences of 73 nursing students after participating in community health nursing simulation encounters. The data come from nursing students' responses to three post-simulation qualitative questions.

RESULTS

Nursing students identified both positive aspects (simulation as a great learning method, useful in understanding community health nurses' roles, faculty's role in facilitating an effective learning environment) and opportunities for improvement (needing for clear objectives, expectations, and roles).

CONCLUSIONS

Community health nursing simulation encounters can be a powerful educational method to help students experience and understand the roles of community health nurses.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Augmentation of the pre-brief component will further improve students' simulation experiences.

The social support, psychological resilience and quality of life of nurses in infectious disease departments in China: A mediated model

AIM

This paper aimed to investigate the relationship between social support and quality of life for nurses in infectious disease departments in China, as well as the function of psychological resilience in mediating this relationship.

BACKGROUND

Nurses in infectious disease departments play a critical role in the prevention and control of infectious diseases and in public health care services in general, and their quality of life can affect the quality of clinical nursing work they do. However, there are few studies on the relationship between nurses' social support networks and their quality of life.

METHODS

A cross-sectional study was conducted using a sample of 866 clinical nurses from the infectious disease departments of 10 general hospitals in China. Data were collected using a questionnaire survey from January to May 2021. The mediating influence of psychological resilience on social support and quality of life was investigated using structural equation modelling.

RESULTS

The score of quality of life was (36.36 ± 7.64). Quality of life was positively correlated with social support and psychological resilience (r₁  = 0.521, r₂  = 0.583; p < .01), and psychological resilience was positively correlated with social support (r = 0.426; p < .01) as well. The mediating effect of psychological resilience between social support and quality of life was 0.233, accounting for 37% of the total effect.

CONCLUSION

The quality of life of nurses working in infectious disease departments is in the middle level. Psychological resilience is a mediating variable between social support and quality of life.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers can improve the quality of life of nurses by both increasing social support and strengthening psychological resilience. Managers should pay attention to the degree of social support provided to nurses and take proactive measures to build psychological resilience so that nurses can effectively manage stress and negative emotions from work and life in order improve their quality of life.

Dental safety net providers' experiences with service delivery during the first year of COVID-19 should inform dental pandemic preparedness

BACKGROUND

COVID-19 disrupted oral health care delivery and revealed gaps in dental public health emergency preparedness and response (PHEPR). Emerging dental PHEPR frameworks can be strengthened by means of understanding the experiences of the discipline's frontline workers-dental safety net providers-during the initial phase of the COVID-19 pandemic.

METHODS

Experienced qualitative researchers interviewed dental safety net directors and clinicians (n = 21) in 6 states to understand their experiences delivering care from March 2020 through February 2021. Interview transcriptions were analyzed using iterative codes to identify major and minor themes. Conventional qualitative validity checks were used continuously to ensure impartiality and rigor.

RESULTS

Three major themes were identified: unpredictability caused concerns among staff members and patients, while also deepening fulfilling collaborations; care delivery was guided by means of various resources that balanced safety, flexibility, and respect for autonomy; and pandemic-driven changes to oral health care delivery are timely, long-lasting, and can be somewhat fraught.

CONCLUSIONS

The human, material, and policy resources that providers used to control infections, serve vulnerable patients, maintain clinic solvency, and address provider burnout during the first year of the COVID-19 pandemic can improve dental PHEPR.

PRACTICAL IMPLICATIONS

Dental PHEPR should address concerns beyond infection control within and between practice models, governmental agencies, and professional organizations. Examples of such concerns include, but are not limited to, guideline synchronization, materials exigencies, task shifting, and provider resilience.

Mental health outcome and resilience among aiding Wuhan nurses: One year after the COVID-19 outbreak in China

OBJECTIVE

This study aimed to explore whether aiding Wuhan experience of nurses was associated with adverse mental health outcome one year after the COVID-19 outbreak in China.

METHODS

In this study, 100 nurses with and 100 nurses without aiding Wuhan experience a year ago were enrolled from February 1, 2021 to March 31, 2021 in Zhejiang Province, China. Depression, anxiety, insomnia, distress and psychological resilience of participants was assessed and analyzed.

RESULTS

A total of 100 participants from 112 aiding Wuhan nurses completed the survey, with a response rate of 89.3%. Another 100 nurses from the same hospitals without aiding Wuhan experience were enrolled as controls. In both groups, a considerable proportion of participants reported symptoms of depression (46.0% for the aiding Wuhan group vs. 49.0% for the controls, similarly hereinafter), anxiety (40.0% vs. 38.0%), and PTSD (61.0% vs. 56.0%). Aiding Wuhan nurses were more likely to suffer from insomnia (41.0% vs. 29.0%, P = 0.041). Multivariable logistic regression analysis showed that aiding Wuhan experience was not associated with depression (adjusted OR (AOR) 0.22; 95%CI, 0.05-1.01), anxiety (AOR 0.53; 95%CI, 0.12-2.43), insomnia (AOR 1.52; 95%CI, 0.76-3.02), PTSD (AOR 0.50; 95%CI, 0.19-1.34), or resilience (AOR 1.59; 95%CI, 0.78-3.26). Resilience was negatively correlated with depression, anxiety, insomnia, and PTSD.

CONCLUSIONS

This survey indicated that aiding Wuhan experience a year ago did not cause additional adverse mental health outcomes in nurses, expect for insomnia. The psychological status of nurses in general calls for more attention.

Better together: Coalitions committed to advancing health equity

The Future of Nursing 2020-2030 report identifies coalitions as a driving force for advancing health equity. Five coalitions provided insight into their accomplishments, lessons learned, and role in advancing health equity. The exemplar coalitions included Latinx Advocacy Team and Interdisciplinary Network for COVID-19, Black Coalition Against COVID, Camden Coalition, National Coalition of Ethnic Minority Nurse Associations, and The Future of Nursing: Campaign for Action. While all exemplar coalitions, credited relationship building and partnerships to their success, they used unique strategies for striving to meet their populations' needs, whether the needs arose from COVID-19, racial and/or ethnic disparities, socioeconomic disparities, or other barriers to health. Research and policy implications for coalitions are discussed. Nurses play a critical role in every highlighted coalition and in the national effort to make health and health care more equitable.