Publications by authors named "Chulei Tang"

11 Publications

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Readiness for Hospital Discharge and Its Correlates Among People Living With HIV in Hunan, China: A Cross-sectional Study.

J Assoc Nurses AIDS Care 2021 Jun 10. Epub 2021 Jun 10.

Xiaoxia Zhang, RN, MSN, is an Assistant Professor, Department of Nursing, Henan Medical College, Henan, China; and a Graduate Student, Xiangya Nursing School of Central South University, Hunan, China. Chulei Tang, RN, BSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China. Xueling Xiao, RN, MSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China. Manman Sun, RD, MSM, is an Assistant Professor, Department of Preclinical Medicine, Henan Medical College, Henan, China. Honghong Wang, RN, PhD, is a Professor, Xiangya Nursing School of Central South University, Hunan, China.

Abstract: We aimed to (a) describe the readiness for hospital discharge in people living with HIV and (b) explore factors associated with readiness for hospital discharge. A cross-sectional survey was conducted at two infectious disease hospitals in Hunan, China, from May to November 2017. The readiness for hospital discharge scale (RHDS) was used to assess discharge readiness. The average item mean for the RHDS ranges from 0 to 10, and higher scores represent a higher level of readiness for hospital discharge. The mean score of the RHDS was 7.78 (95% confidence interval 7.586-7.968), and 27.6% of participants (n = 56/203) felt unready for discharge (RHDS <7). We found that older age, lack of medical insurance, lower self-rated health status, poorer quality of discharge teaching, and more severe depressive symptoms were significantly associated with a lower level of readiness for hospital discharge. Interventions are needed to improve readiness of people living with HIV for hospital discharge in Hunan, China, especially for those of advanced age, without medical insurance, with worse self-rated health status, and those with higher levels of depressive symptoms.
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June 2021

Co-occurrence Pattern of Posttraumatic Stress Disorder and Depression in People Living With HIV: A Latent Profile Analysis.

Front Psychol 2021 5;12:666766. Epub 2021 May 5.

Xiangya Nursing School of Central South University, Changsha, China.

: The comorbidity of posttraumatic stress disorder (PTSD) and depression is common among people living with the HIV (PLWH). Given the high prevalence and serious clinical consequences of the comorbidity of these two disorders, we conducted a latent profile analysis to examine the co-occurrence pattern of PTSD and depression in PLWH. : The data for this cross-sectional study of PLWH were collected from 602 patients with HIV in China. A secondary analysis using latent profile analysis was conducted to examine HIV-related PTSD and depression symptoms. A four-class solution fits the data best, with the four classes characterized as asymptomatic (42.9%), mild symptoms (33.9%), low to moderate symptoms (19.8%), and high to moderate symptoms (3.4%). The severity of PTSD and depression symptoms was comparable in this solution, and no group was dominated by PTSD or depression. : The absence of a distinct subcluster of PLWH with only PTSD or depression symptoms supports that PTSD and depression in PLWH are psychopathological manifestations after traumatic exposures. Health care staff should pay more attention to the existence of comorbid symptoms of individuals, develop integrated interventions for the symptoms cluster, and evaluate their effectiveness in clinical practice.
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May 2021

Psychometric properties of the Chinese Version of the Readiness for Hospital Discharge Scale for people living with HIV.

Int J Nurs Sci 2020 Apr 28;7(2):220-227. Epub 2019 Dec 28.

School of Nursing, Central South University, Hunan, China.

Objective: The study was conducted to validate the reliability and factor structure of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS-CH) for people living with HIV (PLWH).

Methods: From May 2017 to November 2017, a cross-sectional survey was performed in two AIDS inpatient departments located in two cities in Hunan, China. Reliability was evaluated by examining the internal consistency and split-half reliability of the items. A confirmatory factor analysis was performed to assess the factor structure of the RHDS-CH, and the model was revised according to the modification index.

Results: Cronbach's α for the RHDS-CH was 0.912, and the split-half reliability of the total scale was 0.831. Initially, the results of the confirmatory factor analysis indicated that the sample did not fit this four-factor model and its 23 items well ( / = 3, GFI =0.772, TLI = 0.823, CFI = 0.844, RMSEA = 0.100). To improve the model fit indices, we performed model modification with the guidance of modification indices. Finally, the model fit indices showed an acceptable fit to the data ( / = 2.141, GFI = 0.844, TLI = 0.899, CFI = 0.915, RMSEA = 0.075). Coefficients of corrected item-total correlation of the RHDS-CH ranged from 0.435 to 0.726.

Conclusion: This study is the first to examine the psychometric properties of the RHDS-CH for PLWH. Our findings showed good reliability and confirmed the four-factor structure model for PLWH.
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April 2020

Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis.

BMJ Open 2020 04 27;10(4):e032435. Epub 2020 Apr 27.

Xiangya Nursing School, Central South University, Changsha, Hunan, China

Objectives: Although people living with HIV (PLWH) have been disproportionately affected by post-traumatic stress disorder (PTSD), the global prevalence of PTSD among PLWH is unknown. This study aimed to systematically review the prevalence of PTSD among PLWH worldwide and explore variation in prevalence across sociodemographic and methodological factors.

Design: A meta-analysis using a random-effects model was conducted to pool the prevalence estimated from individual studies, and subgroup analyses were used to analyse heterogeneities.

Setting, Participants And Measures: Observational studies providing PTSD prevalence data in an adult HIV population were searched from January 2000 to November 2019. Measurements were not restricted, although the definition of PTSD had to align with the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases diagnostic criteria.

Results: A total of 38 articles were included among 2406 records identified initially. The estimated global prevalence of PTSD in PLWH was 28% (95% CI 24% to 33%). Significant heterogeneity was detected in the proportion of PLWH who reported PTSD across studies, which was partially explained by geographic area, population group, measurement and sampling method (p<0.05).

Conclusion: PTSD among PLWH is common worldwide. This review highlights that PTSD should be routinely screened for and that more effective prevention strategies and treatment packages targeting PTSD are needed in PLWH.
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April 2020

Moderation effects of food intake on the relationship between urinary microbiota and urinary interleukin-8 in female type 2 diabetic patients.

PeerJ 2020 28;8:e8481. Epub 2020 Jan 28.

Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.

Background: Our previous study demonstrated that the composition of the urinary microbiota in female patients with type 2 diabetes mellitus (T2DM) was correlated with the concentration of urinary interleukin (IL)-8. As the composition of urine is mainly determined by diet, diet might mediate the correlation.

Methods: Seventy female T2DM patients and 70 healthy controls (HCs) were recruited. Midstream urine was used for the urine specimens. Urinary IL-8 was determined by enzyme-linked immunosorbent assay. A Chinese Food Frequency Questionnaire was used to collect food intake data. The independent variables in the hierarchical regression analysis were the relative abundances of the bacterial genera and species that were significantly different between the T2DM and HCs and between the T2DM patients with and without detectable urinary IL-8, and the bacterial genera associated with IL-8 concentration in the multiple regression model reported in our previous research. IL-8 concentration was the dependent variable, and nutrient intakes were moderator variables.

Results: Fiber and vitamin B3 and E intake exerted enhancing effects, and water intake exerted a buffering effect, on the positive relationship between the relative abundance of and IL-8 concentration ( < 0.05). Cholesterol and magnesium intake exerted enhancing effects on the positive relationship between the relative abundance of and IL-8 concentration ( < 0.05).

Conclusion: Modulating T2DM patients' dietary patterns may prevent bladder inflammation.
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January 2020

Prevalence of hypochondriac symptoms among health science students in China: A systematic review and meta-analysis.

PLoS One 2019 17;14(9):e0222663. Epub 2019 Sep 17.

Xiangya Hospital, Central South University, Changsha, Hunan, China.

Background: Hypochondriac symptoms are commonly reported in health science students. With their incomplete medical knowledge, they may compare their own bodily symptoms with disease symptoms during the process of learning, which can lead to mental distress and the need for repeated medical reassurance.

Objective: To estimate the prevalence of hypochondriac symptoms in Chinese health science students.

Methods: A systematic literature search was conducted on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Data on July 1, 2018. Additionally, the references of the retrieved papers were searched. Cross-sectional studies published in either English or Chinese that reported the prevalence of hypochondriac symptoms in health science students were included. The selection process was executed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and study quality was assessed with the checklist recommended by the Agency for Healthcare Research and Quality for cross-sectional studies. A random-effects model according to the DerSimonian-Laird method was used to calculate the pooled prevalence.

Results: Seven cross-sectional studies involving 6,217 Chinese health science students were included. The pooled prevalence of hypochondriac symptoms among health science students was 28.0% (95% CI = 19.0%-38.0%). The symptoms were a little more common in females (30.0%, 95% CI = 19.0%-42.0%) than in males (29.0%, 95% CI = 16.0%-42.0%), but the difference was not significant. No significant differences were found between participants grouped by study year. Only three studies explored the coping styles of students with hypochondriasis, and these revealed a high tendency toward help-seeking behaviors.

Conclusion: Our systematic review and meta-analysis showed a high prevalence of hypochondriac symptoms among health science students, indicating that it is a noteworthy phenomenon. We suggest that counseling and other support services are necessary for health science students.
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March 2020

The influence of cultural competence of nurses on patient satisfaction and the mediating effect of patient trust.

J Adv Nurs 2019 Apr 8;75(4):749-759. Epub 2018 Nov 8.

Xiangya School of Nursing, Central South University, Changsha, China.

Aims: To test a path model evaluating the influence of cultural competence of nurses on patient satisfaction and the mediating role of patient trust.

Background: In China, there has been an increase in medical disputes, which at times has resulted in physical assaults on healthcare providers. Enhanced patient satisfaction may reduce disputes and can perhaps be bolstered by the improved cultural competence of providers.

Design: A cross-sectional path analytic research design was used.

Methods: A random sample of 583 hospitalized patients recruited from six tertiary comprehensive hospitals in Changsha, China in 2016 completed a face-to-face structured questionnaire. Measures included the Consumer Assessment of Healthcare Providers and Systems Cultural Competency Item Set, the Wake Forest Physician Trust Scale, the Patient Satisfaction with Primary Nurses Scale and the Patient Overall Satisfaction with the Hospital Scale.

Results: Significant associations among cultural competence of nurses, patient satisfaction and patient trust were confirmed, and path analyses supported the proposed mediating role of patient trust. Furthermore, the cultural competence subscales of communication-positive behaviours, trust-building behaviours and shared decision-making were positively and significantly correlated with patient satisfaction.

Conclusion: Findings suggest interventions should be designed to improve nurse's cultural competence, especially in the domains of communication-positive behaviours, trust-building behaviours and shared decision-making, and trust, to improve patient satisfaction.
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April 2019

Psychometric testing of the consequences of an HIV disclosure instrument in Mandarin: a cross-sectional study of persons living with HIV in Hunan, China.

Patient Prefer Adherence 2018 17;12:1451-1459. Epub 2018 Aug 17.

Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.

Purpose: This study aimed to examine the psychometric properties of a Mandarin-language version of an instrument that assesses the Consequences of HIV Disclosure (CoHD).

Patients And Methods: The original CoHD instrument developed by Serovich was translated into Mandarin and administered to a random sample of 184 persons living with HIV (PLWH) using face-to-face and structured interviews. The CoHD instrument required respondents to rate the importance of eight costs (eg, might lose the relationship) and ten rewards (eg, would bring us closer) in their decision about whether to self-disclose their HIV status. The participants were directed to respond with respect to a current (or hypothetical) sexual partner.

Results: Internal consistency was acceptable (Cronbach's α for the overall scale 0.82, costs 0.71, and rewards 0.86), as was stability (test-retest reliability overall 0.74, cost 0.63, and rewards 0.82). The CVI for the scale was 0.83, with items rated by subject experts ranging from 0.80 to 1.0. To determine structural validity, exploratory factor analysis extracted two subscales consistent with the original CoHD subscales. The Mandarin CoHD scores were significantly correlated with disclosure self-efficacy (indicating convergent validity), but they were unrelated to safer sex efficacy (indicating divergent validity). This criterion was tested by comparing the scores of PLWH who disclosed their HIV status (mean±SD 53.57±9.06) with those who did not disclose it (mean±SD 49.63±7.45); however, the difference was not statistically significant.

Conclusion: The Mandarin version of the CoHD instrument demonstrates promising psychometric properties when assessing costs and rewards with respect to sexual partner disclosure. This suggests that it might be useful in research on partner notification strategies. In further studies, larger and more diverse samples and an analysis of responses for different disclosure targets are warranted. Moreover, whether the CoHD score is related to the decision of disclosure should be determined.
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August 2018

Sexual Roles, Risk Sexual Behaviours, and HIV Prevalence among Men who Have Sex with Men Seeking HIV Testing in Changsha, China.

Curr HIV Res 2018 ;16(2):174-181

Xiangya School of Nursing of Central South University, 172 Tong Zi Po Road, Changsha 410013, Hunan, China.

Background: HIV infection is prevalent among men who have sex with men (MSM), and sexual roles may be important factors related to it. This study aims to describe the sexual roles, risky sexual behaviors and HIV prevalence among MSM, and to determine associated factors for HIV prevalence.

Methods: A convenient sampling method was used to recruit participants in a non-government organization in Changsha, China. The participants were asked to complete a 38-item self-administered questionnaire regarding demographic characteristics and risky sexual behaviours before collecting blood samples for HIV testing. Chi-square tests and logistic regression analysis were conducted with the Statistical Package for the Social Sciences Version 18.0 and other indexes were statistically described.

Results: A total of 601 MSMs who came to a local non-government organization for voluntary counseling and testing completed a pencil-and-paper survey and were tested for HIV. The overall HIV prevalence of this sample was 13.3%, and that of the bottoms (16.3%) was similar to the versatiles (15.9%) but higher than the tops (6.1%). Bivariate analyses showed that there were significant differences in age, marital status, monthly income, sexual orientation, age at first sex, sex of the first sex partner, sex with a woman in the last 6 months, oral sex with a man in the last 6 months and role of oral sex among 3 subgroups of MSM (p < 0.05). Multivariate analyses indicated that MSMs who played the role of either the bottoms or the versatiles were more likely to be HIV positive than the tops. While MSMs who used condoms in anal sex in the last 6 months, had sex with a woman in the last 6 months or had oral sex with a man in the last 6 months were less likely to be HIV positive.

Conclusion: Different sexual roles are associated with high-risk sexual behaviors among MSMs and their HIV infection status. Further research should target preventive interventions, and improve the effectiveness of the intervention according to the characteristics of the subgroups to reduce the HIV transmission among Chinese MSM.
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April 2019

Self reported adherence to antiretroviral treatment and correlates in Hunan province, the Peoples Republic of China.

Int J Nurs Sci 2018 Apr 14;5(2):162-167. Epub 2018 Apr 14.

School of Nursing of Central South University, Hunan, China.

Aims: This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province, China.

Methods: Across-sectional survey study was done at two major HIV treatment sites within Hunan province in China from July 2011 to Oct 2012 through face-to-face interviews. Adherence measures were captured using a 30-day visual analog scale (VAS).

Results: A total of 418 participants consented and completed the questionnaires with the mean age being 38 years old. Based on VAS, 28% of the participants had lower than 90% ART adherence level. The main reasons for missing drugs were; forgetting, being away from home, being busy and feeling worse after taking drugs. Logistic regression results showed that drug use ( = 0.68,  = 2.11), time on ART ( = -0.31,  = 0.72) and side effects ( = 0.64,  = 1.82) were significantly associated with adherence to ART.

Conclusion: Patients on ARVs in Hunan province are faced with adherence challenges notably drug abuse, drug regime scheduling challenges at the initial stages of therapy and drug side effects. It is therefore necessary to institute specific adherence interventions that target those who abuse drugs, ART naïve patients, and those experiencing side effects in order to achieve optimal ART adherence.
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April 2018

Factors associated with acceptance of provider-initiated HIV testing and counseling among pregnant women in Ethiopia.

Patient Prefer Adherence 2018 25;12:183-191. Epub 2018 Jan 25.

Department of Fundamental Nursing, Xiangya School of Nursing, Central South University, Changsha, China.

Introduction: The global human immunodeficiency virus (HIV) epidemic disproportionately affects sub-Saharan African countries, including Ethiopia. Provider-initiated HIV testing and counseling (PITC) is a tool to identify HIV-positive pregnant women and an effective treatment and prevention strategy. However, its success depends upon the willingness of pregnant women to accept HIV testing.

Objectives: To describe the level of acceptance of PITC and associated factors among pregnant women attending 8 antenatal care clinics in Adama, Ethiopia.

Methods: Trained nursing students and employees from an HIV clinic conducted face-to-face structured interviews in private offices at the clinics from August to September, 2016.

Results: Among the 441 respondents, 309 (70.1%) accepted PITC. Women with more antenatal care visits (odds ratio [OR] =2.59, 95% CI: 1.01-6.63), reported better quality of the PITC service (OR =1.91, 95% CI: 1.19-3.08), and higher level of knowledge on mother-to-child transmission (OR =1.82, 95% CI: 1.03-3.20), were more likely to accept PITC, while women who were older in age (OR =0.37, 95% CI: 0.19-0.74) and perceived negative attitudes from their partners toward HIV-positive results (OR =0.31, 95% CI: 0.10-0.94) were less likely to accept the PITC service.

Conclusion: About one-third of pregnant women are not willing to accept PITC. When designing intervention program to improve the acceptance of PITC, we should take into consideration the personal factors, HIV-related knowledge, and attitude of women as well as institutional factors.
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January 2018