Publications by authors named "Yuli Zang"

21 Publications

  • Page 1 of 1

Chinese stroke survivors' perceptions of participation in exercise or sitting Tai Chi.

Eur J Cardiovasc Nurs 2021 May 19. Epub 2021 May 19.

School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.

Aims: Exercise promotes functional recovery among stroke survivors and is recommended to be commenced as soon as is feasible. However, little is known about stroke survivors' perception of participation in exercise or sitting Tai Chi, a more culturally appropriate and popular movement in China. To explore Chinese stroke survivors' perceptions of participation in exercise or sitting Tai Chi.

Methods And Results: Face-to-face semi-structured interviews and content analysis of transcripts were conducted with a purposive sample of 30 stroke survivors. The qualitative study explored perceptions of post-stroke participation in exercise or sitting Tai Chi. The consolidated criteria for reporting qualitative research checklist was used to report findings. Perceived facilitators of exercise participation were healthcare professionals' encouragement and recommendations, family and peer support and survivors' motivation, intention, and self-perceived benefits. Perceived barriers were fear of falling, physical discomfort, and challenges in standing. Despite some reservations, most participants were willing to try sitting Tai Chi.

Conclusions: Encouragement and support, motivation, and perceived benefits were important for exercise participation after stroke. With the premise that all medical and nursing students in China are trained in Tai Chi, for stroke survivors with no access to formal exercise programmes, sitting Tai Chi may offer an appropriate alternative.
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http://dx.doi.org/10.1093/eurjcn/zvab036DOI Listing
May 2021

Chinese adolescents' sexual and reproductive health education: A quasi-experimental study.

Public Health Nurs 2021 May 5. Epub 2021 May 5.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR.

Objective: This study investigated the effectiveness of an interactive sexual and reproductive health education program in aspects of knowledge, attitudes, and self-efficacy among adolescents.

Design: Quasi-experimental study underpinned by social cognitive theory.

Sample: A stratified cluster sample of 469 students from the two-branch middle school in a city in eastern China who were assigned to the experimental (n = 233) and control (n = 236) groups.

Measurements: Students' sexual knowledge, attitudes, and refusal self-efficacy were assessed before (T0), immediately after (T1), and 1 month after the intervention (T2), respectively.

Intervention: Students in the experimental group received two 40-min sessions of the educational program while the control group received the usual mode of sexual and reproductive health education.

Results: Compared with the control group, students in the experimental group acquired more sexual knowledge (p < .01), and developed more positive sexual attitudes (p < .05) and stronger sexual self-efficacy (p < .05) across the study period.

Conclusions: The proposed sexual and reproductive health education program incorporating various interactive activities was effective and could be used for school-based implementation led by nurses and other health care workers.
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http://dx.doi.org/10.1111/phn.12914DOI Listing
May 2021

Dispatched nurses' experience of wearing full gear personal protective equipment to care for COVID-19 patients in China-A descriptive qualitative study.

J Clin Nurs 2021 Jul 24;30(13-14):2001-2014. Epub 2021 Mar 24.

Nursing Department, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, China.

Aims And Objectives: We explored dispatched nurses' experiences of wearing full gear personal protective equipment to care for patients with coronavirus disease-2019 (COVID-19) in Wuhan, China.

Background: Full gear personal protective equipment is the primary and foremost measure to prevent the contact and transmission of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2); however, working in full gear personal protective equipment may hinder nursing care activities and thus negatively affect patients' and nurses' health.

Design: This descriptive qualitative inquiry followed the COREQ guidelines.

Methods: Individual semi-structured telephone interviews were conducted in a purposive sample of 15 frontline nurses who were dispatched to the outbreak epicentre from March to April 2020. Verbatim transcripts were content analysed.

Results: Four themes emerged from the data: inadequate preparedness for working with full gear personal protective equipment, full gear personal protective equipment stimulated stress responses, coping strategies and professional growth. Participants learned a great deal from problem-focussed and emotion-focussed strategies to tackle challenges related to the prolonged wearing of full gear personal protective equipment for quality nursing care and reduced risk of exposure. They became more vigilant to the adherence to evolving protocols and appropriate training concerning full gear personal protective equipment use.

Conclusions: Frontline nurses confronted various but diminishing challenges related to the use of full gear personal protective equipment when caring for patients with COVID-19 across the approximate 40-day period. Consistent use of coverall personal protective equipment to protect from SARS-CoV-2 in high exposure settings would be feasible if nurses were better prepared; therefore, scenario-based skill training concerning the prolonged use of full gear personal protective equipment should be offered regularly and intensively.

Relevance To Clinical Practice: This study informs future decisions concerning improved full gear personal protective equipment-related psychomotor training and promoting ways for nurses to cope with the stress that comes from working in highly contiguous environments.
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http://dx.doi.org/10.1111/jocn.15753DOI Listing
July 2021

Psychometric properties of the Chinese version of the Trunk Impairment Scale in people with a stroke.

Health Qual Life Outcomes 2021 Mar 10;19(1):85. Epub 2021 Mar 10.

School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.

Background: The Trunk Impairment Scale (TIS) has been translated into Chinese, but the psychometric properties of the Chinese version of the TIS (TIS-C) have not yet been established. We aimed to examine the reliability and validity of the TIS-C for assessing sitting balance among Chinese people with a stroke.

Methods: A descriptive, cross-sectional design was used. We recruited a convenience sample of 170 subacute stroke patients aged 18 years or over from the neurology departments of four traditional Chinese medicine hospitals in China. Patients completed the TIS-C, the Berg Balance Scale and the Modified Barthel Index. The psychometric properties of the TIS-C were examined to establish test-retest reliability, internal consistency, equivalence, and content, criterion, and construct validity.

Results: Intraclass correlation coefficients for inter-rater and intra-rater reliability ranged from 0.75 to 0.89 and from 0.90 to 0.97, respectively. The TIS-C Cronbach α was 0.86. The strong correlation between the total score of the TIS-C and the Berg Balance Scale (r = 0.81, p < 0.001) or Modified Barthel Index (r = 0.84, p < 0.001) suggested good concurrent and convergent validity, respectively. Known-group validity was supported by the significant difference (p < 0.001) in TIS-C scores between participants with mild and moderate stroke.

Conclusions: The TIS-C is a valid and reliable tool for assessing static and dynamic sitting balance as well as coordination of trunk movement among stroke survivors with mild and moderate stroke.
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http://dx.doi.org/10.1186/s12955-021-01730-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948338PMC
March 2021

Emergency preparedness for heat illness in China: A cross-sectional observational study.

Int Emerg Nurs 2021 Jan 25;54:100957. Epub 2020 Dec 25.

F8 Esther Lee Building, The Nethersole School of Nursing, Shatin, New Territory, The Chinese University of Hong Kong, HKSAR, China. Electronic address:

Background: The morbidity and mortality rates from heat illness have increased due to a higher number of heatwaves. Effective urgent care of heat illness is crucial for optimizing patient outcomes. However, few studies have examined the emergency preparedness measures required for treating such patients.

Methods: From December 23, 2019, to January 23, 2020, a content-validated instrument containing the Perceived Emergency Preparedness Scale for heat illness (heatPEPS) was administered to emergency nurses in China through WeChat. Some of these nurses were retested two weeks later. SPSS 26, IRTPRO 4.2, and NVivo 12 Plus were used for data analysis.

Results: In total, 46.4% (200/431) of the participants returned valid responses. With dichotomous scoring, a high score for heatPEPS (mean 7.29; SD 1.667) was elicited. The reduced 9-item heatPEPS had a perfect fit with the 2PL model (M = 27.24, p > 0.05; RMSEA = 0.01) and acceptable internal (α = 0.68) and test-rest reliability (intraclass correlation = 0.56). Many participants (74%) were dissatisfied with their heat illness-related knowledge and skills, suggesting an area that could be improved for better emergency preparedness.

Conclusion: Emergency departments appear to be well-prepared; however, this is subject to social desirability bias. The 9-item heatPEPS is a reliable and valid tool to measure emergency preparedness for heat illness.
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http://dx.doi.org/10.1016/j.ienj.2020.100957DOI Listing
January 2021

The effects of sitting Tai Chi on physical and psychosocial health outcomes among individuals with impaired physical mobility.

Medicine (Baltimore) 2020 Aug;99(34):e21805

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.

Background: Impaired physical mobility, most often seen in people with neurological disorders (i.e., stroke and spinal cord injury survivors), musculoskeletal diseases or frailty, is a limitation in independent and purposeful physical movement of the body or one or more extremities. The physical restrictions result in negative consequences on an individual's physical and psychosocial functions. This proposal describes a systematic review protocol to determine the effectiveness and approaches of sitting Tai Chi intervention for individuals with impaired physical mobility. Our review would inform stakeholders' decisions in integrating this complementary therapy into current rehabilitation services.

Methods: Randomized controlled trials or quasi-experimental studies that compared an intervention group receiving sitting Tai Chi with a control group among adult participants with impaired physical mobility resulting from any health condition(s) will be included. Outcomes of interest will include physical and psychosocial health outcomes. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PubMed, CINAHL, Scopus, Web of Science, AMED, PsycINFO, SPORDiscus, PEDro, WanFang Data and China National Knowledge Infrastructure will be searched from their inception to January 2020. Additional searches will be performed to identify studies that are being refereed, to be published, unpublished or ongoing. Two reviewers will select the trials and extract data independently. The risk of bias of the included studies will be assessed using the Cochrane risk-of-bias tools. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess evidence quality for each review outcome. Data synthesis will be performed using Review Manager 5.3. When a meta-analysis is possible, we will assess the heterogeneity across the studies by computing the I statistics.

Results: A high-quality synthesis of current evidence of sitting Tai Chi for impaired physical mobility will be stated from several aspect using subjective reports and objective measures of performance.

Conclusion: This protocol will present the evidence of whether sitting Tai Chi is an effective intervention for impaired physical mobility.

Prospero Registration Number: CRD 42019142681.
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http://dx.doi.org/10.1097/MD.0000000000021805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447489PMC
August 2020

A cross-sectional observational study of missed nursing care in hospitals in China.

J Nurs Manag 2020 Oct 17;28(7):1578-1588. Epub 2020 Aug 17.

The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.

Aim: To identify the risk of missed nursing care (MNC), and contributing factors, in Chinese hospitals.

Background: National reporting of adverse incidents diminishes errors of commission. To further improve service quality and patient safety, MNC should be reduced.

Methods: An online survey comprising the MISSCARE Survey and the McCloskey/Mueller Satisfaction Scale was conducted with a convenience sample of nurses (n = 6,158) in 34 Chinese hospitals.

Results: Participants' mean age was 30.6 (SD = 7.014), and 2.5% were male. The most frequently missed nursing care items were basic care (12.7%-51.8%). The most frequently reported reasons were human resource issues (63.1%-88.2%). Being female, no child, better educated, a manager, permanently employed, no night shift, inadequate friend support and job dissatisfaction influenced the perception of MNC (odds ratio 1.00-4.848).

Conclusions: MNC often occurred in basic care involving informal caregivers or in surge status due to a sudden increase in workload.

Implications For Nursing Management: Nurse managers should prioritize effective measures that target delegation competency and mobilization of nurses for flexible repositioning during need.
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http://dx.doi.org/10.1111/jonm.13112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589234PMC
October 2020

Barriers and facilitators in the use of formal dementia care for dementia sufferers: A qualitative study with Chinese family caregivers in Hong Kong.

Geriatr Nurs 2020 Nov - Dec;41(6):885-890. Epub 2020 Jul 4.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Building, Shatin, New Territories, Hong Kong, China. Electronic address:

Understanding the barriers and facilitators in the use of formal dementia care for dementia sufferers is crucial. However, such studies have largely been conducted in Western countries, and current evidence is not fully applicable to Asian societies. This qualitative enquiry aims to identify the barriers and facilitators for family caregivers of persons with dementia (PwDs) to use relevant services at communities in Hong Kong. Semi-structured face-to-face interviews with 15 PwDs were conducted in three elderly care centres. The content analysis of transcribed audiotaped interviews revealed various barriers related to financial support, service availability and accessibility, life burden, and referral, and facilitators about family responsibility, perceived benefits, and caring relations. The culture rooted in Confucianism with a British melioration may play an important role in shaping PwDs' experiences in the use of dementia services in Hong Kong. Cultural sensitive services could be attempted to attract more PwDs to utilise them.
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http://dx.doi.org/10.1016/j.gerinurse.2020.06.018DOI Listing
July 2020

Barriers and facilitators in the use of formal dementia care for dementia sufferers: A qualitative study with Chinese family caregivers in Hong Kong.

Geriatr Nurs 2020 Nov - Dec;41(6):885-890. Epub 2020 Jul 4.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Building, Shatin, New Territories, Hong Kong, China. Electronic address:

Understanding the barriers and facilitators in the use of formal dementia care for dementia sufferers is crucial. However, such studies have largely been conducted in Western countries, and current evidence is not fully applicable to Asian societies. This qualitative enquiry aims to identify the barriers and facilitators for family caregivers of persons with dementia (PwDs) to use relevant services at communities in Hong Kong. Semi-structured face-to-face interviews with 15 PwDs were conducted in three elderly care centres. The content analysis of transcribed audiotaped interviews revealed various barriers related to financial support, service availability and accessibility, life burden, and referral, and facilitators about family responsibility, perceived benefits, and caring relations. The culture rooted in Confucianism with a British melioration may play an important role in shaping PwDs' experiences in the use of dementia services in Hong Kong. Cultural sensitive services could be attempted to attract more PwDs to utilise them.
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http://dx.doi.org/10.1016/j.gerinurse.2020.06.018DOI Listing
July 2020

The Influence of Confucianism on the Perceptions and Process of Caring Among Family Caregivers of Persons With Dementia: A Qualitative Study.

J Transcult Nurs 2021 03 13;32(2):153-160. Epub 2020 Feb 13.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.

Scant evidence reveals the influences of Confucianism on family caregiving in dementia. The purpose of this study was to explore the influence of Confucianism on the perceptions and process of caring among the Chinese family caregivers. A qualitative study was conducted using semistructured interviews with 15 Chinese family caregivers of persons with dementia in three elderly care centers in Hong Kong. The interviews were audiotaped and transcribed, while a thematic analysis was performed to analyze the transcript at the latent level. Three themes emerged from the interviews: (a) setting family as a top priority, (b) growth and development in families, and (c) enhancing family relationships. Our findings provided insights into how Confucianism influences the experience of family caregivers in caring persons with dementia in Chinese communities. These findings help develop culturally adapted interventions to improve the support for family caregivers of persons with dementia.
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http://dx.doi.org/10.1177/1043659620905891DOI Listing
March 2021

The Influence of Confucianism on the Perceptions and Process of Caring Among Family Caregivers of Persons With Dementia: A Qualitative Study.

J Transcult Nurs 2021 03 13;32(2):153-160. Epub 2020 Feb 13.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.

Scant evidence reveals the influences of Confucianism on family caregiving in dementia. The purpose of this study was to explore the influence of Confucianism on the perceptions and process of caring among the Chinese family caregivers. A qualitative study was conducted using semistructured interviews with 15 Chinese family caregivers of persons with dementia in three elderly care centers in Hong Kong. The interviews were audiotaped and transcribed, while a thematic analysis was performed to analyze the transcript at the latent level. Three themes emerged from the interviews: (a) setting family as a top priority, (b) growth and development in families, and (c) enhancing family relationships. Our findings provided insights into how Confucianism influences the experience of family caregivers in caring persons with dementia in Chinese communities. These findings help develop culturally adapted interventions to improve the support for family caregivers of persons with dementia.
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http://dx.doi.org/10.1177/1043659620905891DOI Listing
March 2021

An integrative review: Developing and measuring creativity in nursing.

Nurse Educ Today 2018 Mar 13;62:1-8. Epub 2017 Dec 13.

School of Nursing, Shandong University, 44 Wenhua West Road, Jinan 250012, Shandong Province, China. Electronic address:

Objective: To analyze and synthesise the existing evidence on creativity in nursing.

Design: An integrative review.

Data Sources: A systematic search was conducted using seven English databases (PubMed, Science Direct, Web of Science, Cochrane, EBSCO, Wiley, and Medline) and the top three best Chinese databases (CNKI, Wanfang Data, and VIP).

Review Methods: The combined keywords, creativity and nursing/nurse, were used to search for relevant journal articles that were written in English or Chinese from January 1995 to December 2016. The components of articles, i.e. title, abstract, full-text and the cited reference, were screened, filtered, evaluated and recorded according to the PRISMA statements and Joanna Briggs Institute Checklists. Thematic analysis was performed to synthesise evidence from the full-texts of studies.

Results: Fifteen quantitative and seven qualitative studies were included in this review. A joyful affective perspective enriched the conceptualization of creativity in nursing. Many intrinsic factors (e.g. learning styles, thinking styles, intrinsic passion, interest in nursing and achievement motivation) or extrinsic factors (mostly workplace problems and nurses' shortage) could influence nurses' and nursing students' creativity. Artistic expressions (e.g. painting, music, and pottery), self-directed learning and group/team work were reported to have a positive effect on creativity enhancement. None of existing instruments can adequately measure nurses' or nursing students' creativity.

Conclusions: The concept of creativity requires an explicit definition, which is essential to the development and evaluation of creativity in nursing education and practice. Many factors influencing nurses' and nursing students' creativity can be implemented to achieve positive outcomes through efforts at artistic expressions, self-directed learning and teamwork. An instrument with satisfactory psychometric properties should be available for monitoring creativity development among nurses and nursing students.
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http://dx.doi.org/10.1016/j.nedt.2017.12.011DOI Listing
March 2018

Cross-sectional survey of the disaster preparedness of nurses across the Asia-Pacific region.

Nurs Health Sci 2015 Dec 5;17(4):434-43. Epub 2015 Aug 5.

Centre for Nursing and Midwifery Research (CNMR), James Cook University, Cairns, Australia.

Healthcare workers who have received disaster preparedness education are more likely to report a greater understanding of disaster preparedness. However, research indicates that current nursing curricula do not adequately prepare nurses to respond to disasters. This is the first study to assess Asia-Pacific nurses' perceptions about their level of disaster knowledge, skills, and preparedness. A cross-sectional survey was conducted with 757 hospital and community nurses in seven Asia-Pacific countries. Data were collected using the modified Disaster Preparedness Evaluation Tool. Participants were found to have overall low-to-moderate levels of disaster knowledge, skills and preparedness, wherein important gaps were identified. A majority of the variance in disaster preparedness scores was located at the level of the individual respondent, not linked to countries or institutions. Multilevel random effects modelling identified disaster experience and education as significant factors of positive perceptions of disaster knowledge, skills, and management. The first step toward disaster preparedness is to ensure frontline health workers are able to respond effectively to disaster events. The outcomes of this study have important policy and education implications.
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http://dx.doi.org/10.1111/nhs.12211DOI Listing
December 2015

Development of key indicators of hospital resilience: a modified Delphi study.

J Health Serv Res Policy 2015 Apr 11;20(2):74-82. Epub 2014 Dec 11.

Professor, Center for Emergency and Disaster Management, School of Public Health and Social Work, Queensland University of Technology, Australia.

Objectives: Hospital resilience is an emerging concept, which can be defined as 'a hospital's ability to resist, absorb, and respond to the shock of disasters while maintaining its critical health care functions, and then recover to its original state or adapt to a new one'. Our aim was to develop a comprehensive framework of key indicators of hospital resilience.

Methods: A panel of 33 Chinese experts was invited to participate in a three-round, modified Delphi study to develop a set of potential measures previously derived from a literature review. In the first round, these potential measures were modified to cover the comprehensive domains of hospital resilience. The importance of proposed measures was scored by experts on a five-point Likert scale. Subsequently, the experts reconsidered their voting in light of the previous aggregated results. Agreement on measures was defined as at least 70% of the responders agreeing or strongly agreeing to the inclusion of a measure.

Results: A large proportion of preliminary measures (89.5%) were identified as having good potential for assessing hospital resilience. These measures were categorized into eight domains, 17 subdomains, and 43 indicators. The highest rated indicators (mean score) were: equipment for on-site rescue (4.7), plan initiation (4.6), equipment for referral of patients with complex care needs (4.5), the plan execution (4.4), medication management strategies (4.4), emergency medical treatment conditions (4.4), disaster committee (4.4), stock types and quantities for essential medications (4.4), surge capacity of emergency beds (4.4), and mass-casualty triage protocols (4.4).

Conclusions: This framework identifies a comprehensive set of indicators of hospital resilience. It can be used for hospital assessment, as well as informing priority practices to address future disasters better.
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http://dx.doi.org/10.1177/1355819614561537DOI Listing
April 2015

Progress and challenges of disaster health management in China: a scoping review.

Glob Health Action 2014 10;7:24986. Epub 2014 Sep 10.

Center for Emergency and Disaster Management, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia;

Background: Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries.

Objective: This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity.

Design: A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims.

Results: The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue.

Conclusions: One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161949PMC
http://dx.doi.org/10.3402/gha.v7.24986DOI Listing
May 2015

Validation of a framework for measuring hospital disaster resilience using factor analysis.

Int J Environ Res Public Health 2014 Jun 18;11(6):6335-53. Epub 2014 Jun 18.

Center for Emergency and Disaster Management, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia.

Hospital disaster resilience can be defined as "the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one." This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.
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http://dx.doi.org/10.3390/ijerph110606335DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078582PMC
June 2014

Strengthening and preparing: enhancing nursing research for disaster management.

Nurse Educ Pract 2015 Jan 25;15(1):68-74. Epub 2014 Mar 25.

Shandong University, China. Electronic address:

Nurses are often first line responders in a large scale emergency or disaster. This paper reports an evaluative study of a tailored research capacity building course for nurse delegates from the Asia Pacific Emergency and Disaster Nursing Network (APEDNN). Twenty-three participant delegates from 19 countries attended a three-week course that included learning and teaching about the critique and conduct of research. An outcome of the course was the collaborative design of a study now being implemented in a number of countries with the aim of investigating nurses' preparedness for disaster response. Formal mentoring relationships have also been established between more and less experienced peers and facilitators to provide support in implementing this collaborative study. Overall, participant delegates rated the planning, implementation and content of the course highly. Recommendations from this study include funding a mix of face-to-face and distance mentoring and writing for publication workshops to ensure the sustainability of outcomes from a research capacity building course such as the one described.
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http://dx.doi.org/10.1016/j.nepr.2014.03.006DOI Listing
January 2015

A randomised trial on pubertal development and health in China.

J Clin Nurs 2011 Nov 26;20(21-22):3081-91. Epub 2011 Aug 26.

School of Nursing, Shandong University, Jinan, Shandong Province, China.

Background: Puberty signifies noticeable physical, psychosocial and sexual development. It is crucial to help adolescents reach an understanding about puberty and related health issues. Considering the sexually conservative culture in some areas, to explore appropriate ways to address sexuality and health-related concerns during puberty is of interest to all stakeholders.

Aims: This study aimed to examine the effectiveness of the ecological approach to improve adolescents' understanding about puberty and related health risks.

Design: Modified Solomon four group design.

Methods: Two Grade7 classes were randomly selected to form experiment and control group, respectively. A two-hour seminar and a brochure about health and development during puberty were provided, and some students, parents and instructors in the experimental group commented on the intervention. Pre- and post-tests were conducted to measure students' pubertal development status and their knowledge, attitudes and behaviours related to puberty.

Results: Students (n = 228) were aged 13·0 years (SD 0·45). The majority was categorised at the stage of mid-puberty or later, and approximately 11·2% of 116 girls and 22·3% of 112 boys were classified as overweight or obese according to body mass index. No significant changes were identified within or between groups about knowledge, attitudes and behaviours related to puberty and health before and after the intervention. The invention was considered helpful, and an enriched delivery was required.

Conclusions: Although the overall feedback was positive, this ecological approach to adolescent health and development targeting at Grade7 students failed to generate significant effects on students' knowledge, attitudes and behaviours surrounding puberty and health.

Relevance To Clinical Practice: This study reveals that sexuality, particularly romantic relationships during puberty, may be perceived negatively in the local society. There is a need for school nurses to help all relevant people to understand and respond to sexuality-related concerns in a cultural appropriate way.
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http://dx.doi.org/10.1111/j.1365-2702.2011.03831.xDOI Listing
November 2011

Rehabilitation nurses practices in relation to urinary incontinence following stroke: a cross-cultural comparison.

J Clin Nurs 2009 Apr;18(7):1049-58

Centre for Gerontological Practice, Glasgow Caledonian University, Glasgow, UK.

Aim: To explore nurses' practices and influences in relation to urinary incontinence following stroke, in the UK, Sweden and China.

Background: Urinary incontinence following stroke is common, under-recognised and poorly researched. Before appropriate rehabilitation interventions can be developed, an understanding of nurses' current management approaches and cultural influences is required.

Design: Qualitative.

Methods: Semi-structured interviews were undertaken with ten registered nurses from at least four different stroke units in three countries (n = 30). Interviews were carried out in the participants' first language, using an agreed interview guide. Following translation, thematic analysis focusing on manifest meaning was undertaken, using an iterative approach involving electronic and face-to-face discussions.

Results: The consequence of only superficial assessment was no systematic identification of types or causes of urinary incontinence and no individualised plans developed. A process model of practice, common to all three countries, was identified for stroke survivors with urinary incontinence. Routine core activities were followed by the palliative pathway (most frequently), where urinary incontinence was contained to protect the stroke survivors' safety and ensure social continence; or the rehabilitative route (more rarely), where simple continence promoting activities were implemented with the purpose of facilitating recovery of bladder function.

Conclusions: Nurses' reactively manage urinary incontinence following stroke, adopting a routinised approach based on local custom and practice. Promotion of urinary continence is not a priority area of stroke rehabilitation for nurses in western or eastern countries.

Relevance To Clinical Practice: The dearth of evidence-based interventions available to rehabilitate bladder function following stroke means that stroke nursing practice is an experience-based endeavour. This study explains the nurses' focus on containment and social continence and highlights the need to systematically assess stroke survivors' bladder rehabilitation needs, identify types of urinary incontinence and adopt appropriate urinary continence promoting practices.
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http://dx.doi.org/10.1111/j.1365-2702.2008.02688.xDOI Listing
April 2009

Promoting urinary continence with older people: key issues for nurses.

Int J Older People Nurs 2009 Mar;4(1):63-9

Senior Research Fellow, School of Nursing, Midwifery and Community Health, Glasgow Caledonian University, Glasgow, UKSenior Lecturer, Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, SwedenAssociate Professor, Shandong University School of Nursing, Jinan, Shandong Province, China.

Urinary incontinence is one of the most common and distressing of the conditions experienced by older people. It is not just associated with physical and cognitive frailty but also features significantly in the fit community living population. Urinary incontinence is known to be hidden and under-reported. Yet the needs of older people across the globe in relation to urinary incontinence will increase with the changing demography. Palliative strategies to contain urinary incontinence predominate in practice, although the reasons for this are not fully understood. Conservative approaches including lifestyle adjustments and behavioural therapies form the mainstay of active continence promotion but their routine use by nurses working with older people seems to be minimal. Promoting continence with older people is an area of practice long overdue for significant and sustainable practice development.
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http://dx.doi.org/10.1111/j.1748-3743.2008.00159.xDOI Listing
March 2009