Publications by authors named "Xueling Xiao"

20 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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http://dx.doi.org/10.1097/JNC.0000000000000278DOI Listing
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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http://dx.doi.org/10.3389/fpsyg.2021.666766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131520PMC
May 2021

Napping in Older Adults: A Review of Current Literature.

Curr Sleep Med Rep 2020 Sep 25;6(3):129-135. Epub 2020 Jul 25.

Johns Hopkins University School of Nursing.

Purpose Of Review: Daytime napping-frequently reported among older populations-has attracted increasing attention in geriatric research due to its association with multiple health conditions. This review aims to integrate the latest knowledge about napping in older adults to provide implications for future research.

Recent Findings: The prevalence of napping in older adults ranges from 20% to 60% in different studies, but has been consistently reported to be higher than in other age groups. Age-related changes in circadian rhythm and sleep patterns, cultural beliefs, chronic conditions, medications, and lifestyle changes contribute to the high prevalence of napping in older adults. Daytime napping has been associated with multiple health conditions in older adults. Naps of short duration (e.g., 30 minutes) are reported in adults with better health; naps with longer durations (e.g., >90 minutes) have been linked to adverse cardiovascular and diabetes outcomes, declining cognitive function, and increased mortality. Current evidence in the literature, however, is not enough for us to determine the exact role of napping in the health of older adults.

Summary: Longitudinal and interventional studies are needed to investigate the influence of napping and the critical parameters such as duration, timing, and frequency on health in older adults and the underlying mechanisms. A combination of objective and self-reported measurements of napping are recommended instead of self-reported data only.
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http://dx.doi.org/10.1007/s40675-020-00183-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992388PMC
September 2020

lncRNA NEAT1 ameliorates LPS‑induced inflammation in MG63 cells by activating autophagy and suppressing the NLRP3 inflammasome.

Int J Mol Med 2021 02 22;47(2):607-620. Epub 2020 Dec 22.

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, Department of Orthodontics and Pediatrics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

The mechanisms of inflammation in bone and joint tissue are complex and involve long non‑coding RNAs (lncRNAs), which play an important role in this process. The aim of the present study was to screen out differentially expressed genes in human osteoblasts stimulated by inflammation, and to further explore the mechanisms underlying inflammatory responses and the functional activity of human osteoblasts through bioinformatics methods and in vitro experiments. For this purpose, MG63 cells were stimulated with various concentrations of lipopolysaccharide (LPS) for different periods of time to construct an optimal inflammatory model and RNA sequencing was then performed on these cells. The levels of nuclear enriched abundant transcript 1 (NEAT1), various inflammatory factors, Nod‑like receptor protein 3 (NLRP3) protein and osteogenesis‑related proteins, as well as the levels of cell apoptosis‑ and cell cycle‑related markers were measured in MG63 cells stimulated with LPS, transfected with NEAT1 overexpression plasmid and treated with bexarotene by western blot analysis, RT‑qPCR, immunofluorescence, FISH, TEM and flow cytometry. There were 427 differentially expressed genes in the LPS‑stimulated MG63 cells, in which NEAT1 was significantly downregulated. LPS upregulated the expression of inflammatory cytokines and NLRP3, inhibited the expression of autophagy‑related and osteogenesis‑related proteins, promoted apoptosis and altered the cell cycle, which was partially inhibited by NEAT1 overexpression and promoted by bexarotene. LPS stimulated inflammation in the MG63 cells and inhibited the retinoid X receptor (RXR)‑α to downregulate the expression of NEAT1 and decrease levels of autophagy, which promoted the activation of NLRP3 and the release of inflammatory factors, and impaired the functional activity of osteoblasts, thus promoting the development of inflammation.
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http://dx.doi.org/10.3892/ijmm.2020.4827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797466PMC
February 2021

The Role of Resilience and Gender in Relation to Infectious-Disease-Specific Health Literacy and Anxiety During the COVID-19 Pandemic.

Neuropsychiatr Dis Treat 2020 8;16:3011-3021. Epub 2020 Dec 8.

Xiangya Nursing School of Central South University, Changsha, Hunan, People's Republic of China.

Background: Anxiety is one of the psychological problems being experienced by the general population during the current coronavirus disease 2019 (COVID-19) pandemic. Health literacy, such as infectious-disease-specific health literacy, is associated with anxiety, but the mechanism of such association is not clear. This study explored the relationship between infectious-disease-specific health literacy and anxiety.

Methods: We conducted an online survey in Hubei province, the early epicenter of the COVID-19 pandemic. A total of 1038 COVID-19-negative participants accomplished a battery of online survey tools determining their sociodemographic characteristics, perceived risk of acquiring COVID-19, infectious-disease-specific health literacy, resilience, and anxiety symptoms. We examined the moderated mediation models, in which the mediator was resilience and the moderator was gender.

Results: Most (63%) of the study participants experienced at least mild anxiety. The indirect effect of infectious-disease-specific health literacy on anxiety through resilience was -0.282 (95% confidence interval [CI] = [-0.511, -0.083]), contributing to 32.7% of the total effect of health literacy on anxiety. Resilience fully mediated the association. The mediation effect of resilience tended to be stronger for the male participants than for the female participants as the moderation effect of gender remained until we included perceived risk of acquiring COVID-19 in the model.

Conclusion: Resilience was found to mediate the association between infectious-disease-specific health literacy and anxiety. Individuals with good infectious-disease-specific health literacy are more likely to acquire higher resilience, which may in turn decrease their anxiety level. Males may benefit more from the mediation effect of resilience during the current pandemic. Infectious-disease-specific health literacy programs may help reduce the anxiety of the program participants by enhancing their resilience during a pandemic.
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http://dx.doi.org/10.2147/NDT.S277231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733452PMC
December 2020

Effectiveness of non-pharmacological interventions to decrease fatigue in people living with HIV/AIDS: a protocol of systematic review and meta-analysis.

BMJ Open 2020 09 22;10(9):e040996. Epub 2020 Sep 22.

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

Introduction: Fatigue is a common symptom among people living with HIV (PLWH). It has a substantial adverse impact on functional status and the ability to conduct activities of daily living. Identifying effective strategies to prevent or reduce fatigue is significant to promote the quality of life of this vulnerable population. The purpose of this review is to synthesise the non-pharmacological evidence and assess the effects of interventions on reducing HIV-related fatigue among PLWH.

Methods And Analysis: We will comprehensively search literature available up to 30 June 2020, in the following databases: PubMed, Embase, CINAHL, Cochrane Library, Web of Science and PsycINFO. The reference list of selected studies and relevant published reviews will also be screened to retrieve potential articles. Two reviewers will identify the eligible articles, extract data and identify the biases in the selected studies. Any disagreements will be referred to a third reviewer. We will qualitatively synthesise the evidence and pool data with meta-analysis according to the heterogeneity of different studies.

Ethics And Dissemination: This systematic review will not raise any ethical issues since it is a secondary data collection and analysis. The results will inform effective strategies to reduce fatigue among PLWH. The final report will be published in a peer-reviewed journal and academic conferences.

Prospero Registration Number: CRD42020153715.
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http://dx.doi.org/10.1136/bmjopen-2020-040996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509953PMC
September 2020

Ways of coping mediate the relationship between self-efficacy for managing HIV and acceptance of illness among people living with HIV.

J Adv Nurs 2020 Nov 6;76(11):2945-2954. Epub 2020 Sep 6.

Johns Hopkins School of Nursing, Baltimore, MD, USA.

Aim: The purpose of this study was to examine the relationship between self-efficacy for managing HIV and acceptance of illness and to identify the potential mediation effect of active coping and passive coping on this relationship.

Design: The study used a cross-sectional survey.

Methods: A sample of 555 people living with HIV were recruited from September-December 2018 in the HIV clinic of a tertiary general hospital in Changsha, China. Survey data were collected through face-to-face interviews that included measures of sociodemographic and HIV-related clinical characteristics, Acceptance of Illness Scale, the Simplified Coping Style Questionnaire and the Self-efficacy for Managing Chronic Disease Scale. Step-by-step linear regression models combined with bootstrap testing were used to test the relationships when controlling for gender and HIV diagnosis duration.

Results: Self-efficacy was positively related to acceptance of illness and this relationship was partially mediated by both active coping and passive coping. Acceptance of illness increased by 0.175 for every point increase in self-efficacy indirectly through active coping, while acceptance of illness decreased by 0.034 for every point increase in self-efficacy via passive coping.

Conclusion: The findings highlighted the importance of self-efficacy for managing HIV and ways of coping, especially active coping, for illness acceptance.

Impact: The findings suggested that interventions that improve confidence in managing HIV and active coping may enhance the illness acceptance of people living with HIV.
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http://dx.doi.org/10.1111/jan.14488DOI Listing
November 2020

Antiretroviral therapy improves neurocognitive impairment in people living with HIV? A meta-analysis.

Int J Nurs Sci 2020 Apr 23;7(2):238-247. Epub 2020 Mar 23.

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

Objectives: Although effective antiretroviral therapy (ART) has been used for more than two decades, HIV-associated neurocognitive disorder remains prevalent. Thus, whether ART can improve neurocognitive impairment is controversial. This review aims to explore the effects of ART on cognitive impairment in people living with HIV (PLWH).

Methods: A systematic literature search was conducted in eight databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, China Biology Medicine disc, and WanFang) to identify studies that compare cognitive function between study groups who are administered and not administered ART. We searched for articles published up to April 2019. Article evaluation and data extraction were independently conducted by two reviewers.

Results: Sixteen articles (6,694 participants)-14 cross-sectional studies and 2 cohort studies-were included in this meta-analysis. The cross-sectional studies demonstrated that ART group did not perform better than the non-ART group ( = 1.16; 95% CI, 1.03-1.30). However, the cohort studies reported a significant improvement in cognitive function at three months ( = 4.01; 95% , 2.35-6.85) and six months ( = 9.24; 95% CI, 1.71-49.96) after ART initiation compared with the baseline data. No significant cognitive improvement was found in participants younger than 55 years old, but the two cross-sectional studies showed that ART may improve cognitive function in PLWH under 65 years old with poor physical condition and immune status.

Conclusions: ART could improve cognitive function in PLWH with poor physical condition and immune status, but it does not considerably improve cognition in the entire PLWH population.
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http://dx.doi.org/10.1016/j.ijnss.2020.03.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355192PMC
April 2020

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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http://dx.doi.org/10.1016/j.ijnss.2019.12.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355158PMC
April 2020

Patient safety culture and obstacles to adverse event reporting in nursing homes.

J Nurs Manag 2020 Oct 26;28(7):1536-1544. Epub 2020 Aug 26.

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

Aims: To investigate patient safety culture and its relationship with obstacles to adverse event reporting in Chinese nursing homes.

Background: Reporting obstacles are related to high incidences and unreported rates of adverse events. Patient safety culture is also associated with adverse events. However, the relationship between reporting obstacles and patient safety culture in nursing homes is unclear.

Methods: A cross-sectional survey was conducted with a random sampling method among 549 staff members in six nursing homes using instruments of the Nursing Home Survey on Patient Safety Culture and the Adverse Event Reporting Obstacle Scale. The Pearson correlation coefficient, independent t tests, ANOVA tests and multivariate regression analysis were used.

Results: Patient safety culture in nursing homes was associated with facility ownership (p < .001), facility scale (p < .001), reporting management (p < .001), whether it was an integrated care institution (p = .006), frequency of concern about patient safety (p = .001), occurrence of adverse events in departments (p = .001) and a punitive atmosphere (p = .044). Adverse event reporting obstacles were negatively correlated with patient safety culture (p < .05).

Conclusion: An improvement in patient safety culture was associated with a reduction in reporting obstacles in nursing homes.

Implications For Nursing Management: A barrier-free adverse event reporting system should be built to reduce reporting obstacles and create a non-punitive patient safety culture in nursing homes.
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http://dx.doi.org/10.1111/jonm.13098DOI Listing
October 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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http://dx.doi.org/10.1136/bmjopen-2019-032435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213849PMC
April 2020

Identification of key pathways and genes in nonalcoholic fatty liver disease using bioinformatics analysis.

Arch Med Sci 2020 2;16(2):374-385. Epub 2020 Mar 2.

Department of Gastroenterology, Zhongshan Hospital affiliated to Xiamen University, Xiamen, Fujian, China.

Introduction: Nonalcoholic fatty liver disease (NAFLD) is one of the most common types of liver disease in the world. However, the molecular mechanisms regulating the development of NAFLD have remained unclear.

Material And Methods: In the present study, we analyzed two public datasets (GSE48452 and GSE89632) to identify differentially expressed mRNAs in the progression of NAFLD. Next, we performed bioinformatics analysis to explore key pathways underlying NAFLD development.

Results: Gene Ontology (GO) analysis showed that differentially expressed genes (DEGs) were mainly involved in regulating a series of metabolism-related pathways (including proteolysis and lipid metabolism), cell proliferation and adhesion, the inflammatory response, and the immune response. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that DEGs in NAFLD were mainly enriched in the insulin signaling pathway, peroxisome proliferator-activated receptor (PPAR) signaling pathway, and p53 signaling pathway. We also constructed protein-protein interaction (PPI) networks for these DEGs. Interestingly, we observed that key hub nodes in PPI networks were also associated with the progression of hepatocellular carcinoma (HCC).

Conclusions: Taken together, our analysis revealed that a series of pathways, such as metabolism and PPAR signaling pathways, were involved in NAFLD development. Moreover, we observed that many DEGs in NAFLD were also dysregulated in HCC. Although further validation is still needed, we believe this study could provide useful information to explore the potential candidate biomarkers for diagnosis, prognosis, and drug targets of NAFLD.
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http://dx.doi.org/10.5114/aoms.2020.93343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069441PMC
March 2020

Correlation between serum 25-OH vitamin D expression and non-alcoholic fatty liver disease.

Exp Ther Med 2020 Mar 2;19(3):1681-1686. Epub 2020 Jan 2.

Department of Geriatric Medicine, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, Fujian 361004, P.R. China.

This study investigated changes in the level of serum 25-OH vitamin D [25-hydroxyvitamin D, 25(OH)D] in patients with non-alcoholic fatty liver disease (NAFLD) and the correlation between the severity of NAFLD and 25(OH)D. A retrospective analysis was performed on 385 NAFLD patients (NAFLD group) admitted to the Zhongshan Hospital Affiliated to Xiamen University from January 2015 to December 2017 and 347 healthy people with physical examination (control group). The height and weight of all subjects were measured, and BMI was calculated. Fasting venous blood was extracted for the determination of blood glucose, blood lipid and 25(OH)D. The indicator levels of patients in the two groups were compared and analyzed. Spearman's correlation analysis was used to investigate the correlation between the severity of NAFLD and the level of 25(OH)D. The levels of BMI, FPG, FPI, HbA1c, TG, TC and LDL-C of patients in the NAFLD group were significantly higher than those in control group (P<0.05). The level of 25(OH)D in the NAFLD group was lower than that in control group (P<0.05). There was a significant negative correlation between 25(OH)D and the severity of patients in the NAFLD group (r=-0.868, P<0.001). BMI, FPG, FPI, HbA1c, TG, TC and LDL-C were independent risk factors for the low level of 25(OH)D (P<0.05). Lowly expressed in the serum of NAFLD patients, 25(OH)D has a significant negative correlation with the severity of NAFLD, which is of guiding significance for the prevention and treatment. 25(OH)D is a novel biomarker for NAFLD diagnosis and a potential drug target.
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http://dx.doi.org/10.3892/etm.2020.8411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027146PMC
March 2020

Cognitive Impairment Among Aging People Living With HIV on Antiretroviral Therapy: A Cross-Sectional Study in Hunan, China.

J Assoc Nurses AIDS Care 2020 May-Jun;31(3):301-311

Xueling Xiao, MSN, RN, is a PhD Student, Xiangya School of Nursing, Central South University, Hunan, China. Hui Zeng, PhD, RN, is a Professor, Xiangya School of Nursing, Central South University, Hunan, China. Caiyun Feng, BSN, RN, is a Postgraduate Student, Xiangya School of Nursing, Central South University, Hunan, China. Hang Tan, BSN, RN, is a Postgraduate Student, Xiangya School of Nursing, Central South University, Hunan, China. Lanlan Wu, BSN, RN, is a Postgraduate Student, Xiangya School of Nursing, Central South University, Hunan, China. Hui Zhang, BSN, RN, is a Postgraduate Student, Xiangya School of Nursing, Central South University, Hunan, China. Mary-Lynn Brecht, PhD, is Research Statistician and Adjunct Professor, University of California Los Angeles School of Nursing, Los Angeles, California, USA. Honghong Wang, PhD, RN, is Professor, Xiangya School of Nursing, Central South University, Hunan, China. Deborah Koniak-Griffin, RNC, EdD, FAAN, is Professor, Emerita and Audrienne H. Moseley Endowed Chair in Women's Health Research (on recall), University of California, Los Angeles, School of Nursing, Los Angeles, California, USA.

Our cross-sectional study examined the prevalence of cognitive impairment among people living with HIV (PLWH) aged 60 years or older. The sample, composed of 250 PLWH, was recruited from 2 clinics in Hunan, China. Structured questionnaires guided face-to-face interviews, including items addressing demographic characteristics, regimens of antiretroviral therapy, and cognitive status as measured by the Montreal Cognitive Assessment. Findings revealed cognitive function of this population was significantly lower than that of uninfected individuals based on historical comparisons; 87.2% (n = 218) of PLWH in our study had cognitive impairment. Global cognitive function as well as the domains of language and orientation decreased with age. Global cognitive function was associated with sex and education, but not with antiretroviral therapy regimens. These findings support an urgent need to include routine screening for cognitive function in older PLWH and the need to consider the complexity of the evaluation process.
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http://dx.doi.org/10.1097/JNC.0000000000000122DOI Listing
November 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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http://dx.doi.org/10.1111/jan.13854DOI Listing
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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http://dx.doi.org/10.2147/PPA.S168571DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103303PMC
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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http://dx.doi.org/10.2174/1570162X16666180711101643DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182933PMC
April 2019

Obeservations on association between third molar agenesis and craniofacial morphology.

J Orofac Orthop 2017 Nov 27;78(6):504-510. Epub 2017 Oct 27.

State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China.

Objective: This study was designed to examine the relationship between third molar agenesis and skeletal morphology in the Chinese population.

Materials And Methods: A total of 1043 patients' records were analyzed with panoramic radiographs and cephalograms. Congenitally missing third molars were assessed with respect to gender, jaw, and side, and assessed in various types of facial morphology. Linear, angular, and proportional cephalometric measurements were analyzed and compared among the samples. For the evaluation of results, the following statistics were used: the Pearson χ test, one-way ANOVA, and the Student-Newman-Keuls method.

Results: The overall prevalence of third molar agenesis was 28.7%. Missing third molars were more common in the maxilla and on the right side, while the difference was not statistically significant (P > 0.05) between genders. Every hypodontia group had a smaller SN-GoGn angle, Y-axis-FH angle, and a larger S-Go/N-Me ratio. The group with third molar agenesis in both jaws had smaller SNA and Wits values. The frequency of third molar agenesis in subjects with a Class II malocclusion was significantly lower than in other types of malocclusion (P < 0.05), and the incidence of third molar agenesis in hypodivergent growth pattern was higher than in other patterns (P < 0.05).

Conclusion: The results demonstrate a possible association between third molar agenesis and both sagittal and vertical craniofacial morphology.
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http://dx.doi.org/10.1007/s00056-017-0109-xDOI Listing
November 2017

Acceptability and efficacy of interactive short message service intervention in improving HIV medication adherence in Chinese antiretroviral treatment-naïve individuals.

Patient Prefer Adherence 2017 10;11:221-228. Epub 2017 Feb 10.

Xiangya School of Nursing, Central South University, Changsha, Hunan, People's Republic of China.

Aim: The aim of this study was to examine the acceptability and efficacy of interactive short message service (SMS) in improving medication adherence in antiretroviral treatment (ART)-naïve individuals living with HIV/AIDS in Hengyang, Hunan, China.

Background: SMS via mobile phone has emerged as a potential tool for improving ART adherence. However, most studies used SMS only as a medication reminder, with few studies exploring the effect of comprehensive, interactive SMS.

Patients And Methods: In a randomized controlled trial, 100 HIV-positive patients on ART for <3 months were randomized into control or intervention arm. Participants in the control group received routine standard instruction for ART medication in the HIV clinics, while the intervention group received 6 months of an SMS intervention in addition to the standard care. A total of 124 text messages within 6 modules were edited, preinstalled, and sent to participants according to personalized schedules. Knowledge (of HIV and HIV medications), self-reported antiretroviral adherence (Visual Analog Scale [VAS] and Community Programs for Clinical Research on AIDS [CPCRA] Antiretroviral Medication Self-Report), and CD4 count were assessed at baseline and immediate post-intervention. Intervention participants were interviewed after completion of the study about their satisfaction with and acceptability of the SMS intervention.

Results: Baseline assessments were comparable between arms. Repeated-measures analysis showed that both HIV-related and ART medication knowledge of the intervention group showed better improvement over time than those of the control group after the intervention (<0.0001). For the adherence measures, compared with the control group, participants in the intervention group had significantly higher VAS mean score (=2.735, =0.006) and lower suboptimal adherence rate (=2.208, =0.027) at the end of the study. The intervention had no effect on CD4 cell count. Almost all (96%) intervention participants reported satisfaction or high satisfaction with the SMS intervention, with 74% desiring to continue to receive the SMS intervention. The preferred frequency of messages was 1-2 messages per week.

Conclusion: An interactive SMS intervention with comprehensive content shows promising efficacy in promoting medication adherence in ART-naïve individuals. Future work might further refine its ability to optimally tailor the intervention for individual preferences.
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http://dx.doi.org/10.2147/PPA.S120003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312688PMC
February 2017

[Status and influencing factors of rush poppers use and HIV infection among men who have sex with men in Changsha].

Zhonghua Yu Fang Yi Xue Za Zhi 2016 Feb;50(2):148-52

Xiangya School of Nursing, Central South University, Changsha 410013, China.

Objective: To explore the relationship between use of rush poppers and HIV infection, and associated factors among men who have sex with men in Changsha.

Methods: A cross-sectional study was conducted in Changsha from April to December, 2014. Men who have sex with men who came for HIV counseling and testing services were invited to fill out a survey. A total of 608 MSM were finally recruited. The survey included socio-demographic characteristics, sexual roles, sexual behaviors in last 6 months and rush poppers use, HIV infection among MSM. After finishing the questionnaire, 5 ml blood was also drawn for HIV testing. Chi-square test or Fisher probabilities was used to compare usage of rush poppers and HIV antibody positive rate among MSM who had different characteristics and sexual behaviors. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use and HIV infection of MSM.

Results: Among 608 MSM, 29.8% (181) said they ever used rush poppers, and 13.3% (81 cases) were HIV positive. Among MSM who ever used rush poppers, 18.8% (34/181) were HIV positive; While among those who never used rush poppers, 10.5% (45/427) were HIV positive (χ(2)=7.65,P=0.006). Compared with MSM who had no For One Night sex in the last 6 months,OR (95% CI) value of MSM who had 6-10 times For One Night sexes in last 6 months to use rush poppers was 4.32 (1.77-10.57). Compared with MSM who self-identified as top,OR (95% CI) value of MSM who self-identified as bottom or versatile using rush poppers were 2.99 (1.53-5.86), or 3.60 (2.13-6.09). Compared with MSM who self-identified as top, OR (95% CI) value of MSM who self-identified as bottom or versatile to infect HIV were 3.19 (1.35-7.58), or 2.33 (1.12-4.85). Compared with MSM who used condoms at every anal sex,OR (95% CI) value of MSM who used condoms sometimes or never used to infect HIV were 1.93 (1.12-3.35) or 1.87 (0.64-5.50). Compared with MSM who never used rush poppers,OR (95% CI) value of MSM who ever used rush poppers to infect HIV was 1.88 (1.12-3.16).

Conclusion: A large percentage of MSM population in Changsha used rush poppers, and HIV antibody positive rate among MSM was high. MSM who had more frequencies of For One Night sexes, self-identified as bottom or versatile were more likely to use rush poppers and more susceptible to HIV infection. In addition, MSM who had low frequency of condom use in the last 6 months in anal intercourse were more likely to infect HIV.
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http://dx.doi.org/10.3760/cma.j.issn.0253-9624.2016.02.009DOI Listing
February 2016
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