To explore the influencing factors of perceived stress among frontline nurses during COVID-19, and the role of positive psychological capital in anxiety sensitivity and stress perception, so as to provide evidence for reducing the perceived stress of frontline nurses. From December 2021 to January 2022, 475 frontline nurses from 8 hospitals in X city were investigated by general data questionnaire, positive psychological capital, anxiety sensitivity index and perceived stress scale. The results showed that there were significant differences in nurses’ perceived stress in age, working years, professional title and salary. Perceived stress was positively correlated with anxiety sensitivity, negatively correlated with positive psychological capital, and anxiety sensitivity was negatively correlated with positive psychological capital. Anxiety sensitivity can not only directly predict perceived stress, but also negatively affect perceived stress through positive psychological capital. Therefore, during the epidemic prevention and control in COVID-19, nurses can obtain effective stress coping strategies by strengthening their positive psychological capital, thus reducing their anxiety and perceived stress, and better providing high-quality nursing services for patients.

Objective:To understand main problems existing in the construction of advanced stroke centers in China and put forward solutions, for reference in promoting the standardization construction of advanced stroke centers and improving the efficiency of acute stroke treatment.Methods:The data were derived from relevant data of on-site export guidance in the construction of advanced stroke centers at 175 tertiary hospitals from 2020 to 2021, and the scores of on-site evaluation indicators for the establishment of stroke centers and their formal approval were compared and analyzed. Based on on-site investigation and expert consultation, the common problems existing in the construction of advanced stroke centers were summarized. All data were analyzed by descriptive analysis, the scores of on-site evaluation indicators were expressed by ± s, and paired t test was used for comparison between groups. Results:Compared with the total score(693.04±72.06) of on-site evaluation at the stage of project launch, the total score(747.94±78.10) of on-site evaluation for formal approval of stroke centers of 70 hospitals was higher, and the difference was significant( P<0.01). There were seven common problems in the construction of stroke centers in 175 hospitals, including insufficient attention paid by hospitals, lack of effective performance incentive policies, imperfect treatment procedures and medical norms, and so on. Conclusions:Experts on-site guidance plays an important role in the construction of stroke centers in China. At present, there were still problems to tackle in the construction of stroke centers in hospitals. In order to promote the standardized construction of stroke centers in China and improve the efficiency of stroke treatment, the authors suggest fuorther strengthening the importance attached by hospital leadership and the coordination and organization of functional departments, establishing stroke center models conforming to the actual situation of the hospital, seting up the post of brain and heart health manager, and improving the regional prevention and treatment level of acute stroke.

A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ⩾ 15.0µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY 15.0µmol/L). Finally, 110 551 residents ⩾ 40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9µmol/L (interquartile range 7.9-15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338-2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.
China/epidemiology* ; Humans ; Hyperhomocysteinemia/epidemiology* ; Hypertension/epidemiology* ; Male ; Prevalence ; Risk Factors ; Stroke/epidemiology*

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.

Objective:To investigate the epidemiological characteristics and adherence to hypoglycemic agents of the ischemic stroke patients combined with diabetes.Methods:The study recruited 23 044 ischemic stroke cases from 2013-2015 screening period of China National Stroke Screening Survey. Standardized questionnaires were used to obtain information on demographic data, stroke history, the presence of influence factors, as well as the type of stroke, diagnosis date, frequency, chronic diseases history and hypoglycemic therapy. We used logistics model to investigate the possible risk factors of ischemic stroke combined with diabetes, and calculated the population attributable risk proportion ( PARP). We also investigate the adherence to hypoglycemic agents. Results:The mean age of 23 044 ischemic stroke patients was (64.99±9.42) years old, 50.91% were males (11 731). In ischemic stroke patients, 21.52% had diabetes. According to the results of logistics model, ischemic stroke patients with hypertension, dyslipidemia, atrial fibrillation or family history of stroke had higher risk to combine with diabetes, their Odds Ratios ( OR) were 2.18 (1.87-2.55), 1.99 (1.78-2.23), 1.64 (1.39-1.92) and 1.19 (1.06-1.33). Considering the prevalence of each influence factor in ischemic stroke patients, atrial fibrillation had the highest PARP (95% CI) of 62.65% (61.27%-63.76%). In ischemic stroke patients combined with diabetes, 70.73% (3 463/4 896) had taken hypoglycemic agents. Conclusion:There still were a large number of ischemic stroke patients combined with diabetes and a low rate of adherence to hypoglycemic agents.

Objective:To investigate the risk factors of first recurrence in ischemic stroke patients at different periods after first attack.Methods:The subjects were from the screening population of China National Stroke Screening Survey (CNSSS) from 2013 to 2015. The basic demographic information, stroke history, influencing factors and modified Rankin Scale (mRs) scores were collected by using standardized face-to-face questionnaires. A case-control study was conducted to investigate the risk factors of first recurrence in ischemic stroke patients who relapsed for the first time within 12 months, 24 months and 36 months as the case group and non-recurrent ischemic stroke patients as the control group. Further, the subjects were stratified into different subgroups by age, gender and urban-rural distribution to investigate the risk factors of first recurrence in different periods.Results:Diabetes ( OR=1.71, 95% CI: 1.08-2.71) and coronary heart disease ( OR=1.55, 95% CI: 1.09-2.19) were significantly associated with the risk of first recurrence within 12 months after the first onset of ischemic stroke. The diabetes was significantly associated with the risk of first recurrence within 24 months ( OR=1.94, 95% CI: 1.33-2.83) and 36 months ( OR=1.64, 95% CI: 1.15-2.34) after the first onset of ischemic stroke. With the increase of mRs score, the risk of first recurrence within 12 months, 24 months and 36 months in ischemic stroke patients increased significantly. In the same period, the risk factors of ischemic stroke recurrence differed in patients with different age, gender and urban-rural distribution. Conclusions:The risk factors of first recurrence in ischemic stroke patients are diverse at different periods after the first onset of ischemic stroke. In different subgroups, the risk factors of first recurrence and the strength of its corresponding association are also different.

Objective:To investigate the epidemiological characteristics and adherence to hypoglycemic agents of the ischemic stroke patients combined with diabetes.Methods:The study recruited 23 044 ischemic stroke cases from 2013-2015 screening period of China National Stroke Screening Survey. Standardized questionnaires were used to obtain information on demographic data, stroke history, the presence of influence factors, as well as the type of stroke, diagnosis date, frequency, chronic diseases history and hypoglycemic therapy. We used logistics model to investigate the possible risk factors of ischemic stroke combined with diabetes, and calculated the population attributable risk proportion ( PARP). We also investigate the adherence to hypoglycemic agents. Results:The mean age of 23 044 ischemic stroke patients was (64.99±9.42) years old, 50.91% were males (11 731). In ischemic stroke patients, 21.52% had diabetes. According to the results of logistics model, ischemic stroke patients with hypertension, dyslipidemia, atrial fibrillation or family history of stroke had higher risk to combine with diabetes, their Odds Ratios ( OR) were 2.18 (1.87-2.55), 1.99 (1.78-2.23), 1.64 (1.39-1.92) and 1.19 (1.06-1.33). Considering the prevalence of each influence factor in ischemic stroke patients, atrial fibrillation had the highest PARP (95% CI) of 62.65% (61.27%-63.76%). In ischemic stroke patients combined with diabetes, 70.73% (3 463/4 896) had taken hypoglycemic agents. Conclusion:There still were a large number of ischemic stroke patients combined with diabetes and a low rate of adherence to hypoglycemic agents.

Objective:To investigate the risk factors of first recurrence in ischemic stroke patients at different periods after first attack.Methods:The subjects were from the screening population of China National Stroke Screening Survey (CNSSS) from 2013 to 2015. The basic demographic information, stroke history, influencing factors and modified Rankin Scale (mRs) scores were collected by using standardized face-to-face questionnaires. A case-control study was conducted to investigate the risk factors of first recurrence in ischemic stroke patients who relapsed for the first time within 12 months, 24 months and 36 months as the case group and non-recurrent ischemic stroke patients as the control group. Further, the subjects were stratified into different subgroups by age, gender and urban-rural distribution to investigate the risk factors of first recurrence in different periods.Results:Diabetes ( OR=1.71, 95% CI: 1.08-2.71) and coronary heart disease ( OR=1.55, 95% CI: 1.09-2.19) were significantly associated with the risk of first recurrence within 12 months after the first onset of ischemic stroke. The diabetes was significantly associated with the risk of first recurrence within 24 months ( OR=1.94, 95% CI: 1.33-2.83) and 36 months ( OR=1.64, 95% CI: 1.15-2.34) after the first onset of ischemic stroke. With the increase of mRs score, the risk of first recurrence within 12 months, 24 months and 36 months in ischemic stroke patients increased significantly. In the same period, the risk factors of ischemic stroke recurrence differed in patients with different age, gender and urban-rural distribution. Conclusions:The risk factors of first recurrence in ischemic stroke patients are diverse at different periods after the first onset of ischemic stroke. In different subgroups, the risk factors of first recurrence and the strength of its corresponding association are also different.

Objective:To construct the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective so as to provide a basis for clinical teaching management of undergraduate nursing students.Methods:From May 2018 to September 2019, the expert enquiry questionnaire on the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective was developed by the literature review and expert interview. Delphi technique was used to select 20 nursing teaching management experts, 16 of them from 4 ClassⅢ Grade A teaching hospitals in Beijing, 4 of them from a nursing undergraduate university to carry out two rounds of expert enquiry.Results:The initial construction of the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective included 5 first-level indexes and 30 second-level indexes. The valid recovery rates, expert authoritative coefficients, Kendall coordination coefficients of two rounds of expert enquiry questionnaire were 100%, 0.83 and 0.86, 0.395 and 0.554 respectively ( P<0.01) with the satisfied consistency test results and credible enquiry results. Conclusions:The construction of the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective is scientifically rigorous. The system has definite evaluation indexes, rational administrative levels, objective and reliable system which could provide a basis for clinical teaching management of undergraduate nursing students.

Objective:To explore the status quo of nurse-patient communication ability in undergraduate nursing students in the early stage of clinical practice and its influencing factors, and provide a basis for clinical nursing education managers to formulate a training plan for communication skills of undergraduate nursing students in the clinical practice stage.Methods:From August to September 2019, totally 960 undergraduate nursing students engaging in clinical nursing practice for≤3 months were investigated. The survey content included demographic data, training content of nurse-patient communication ability, and clinical communication ability of nursing students. The status quo and influencing factors of communication ability of undergraduate nursing students in the early stage of clinical practice were analyzed.Results:The nurse-patient communication ability score of 960 undergraduate nursing students in the early stage of clinical practice was (2.18±0.21) , with the highest score in the dimension of acute listening (2.42±0.51) and the lowest score in the dimension of verification feeling (1.88±0.51) . Univariate analysis showed that there were statistically significant differences in the nurse-patient communication ability in the early stage of clinical practice between undergraduate nursing students with different gender, with or without training for nurse-patient communication in the early stage of clinical practice in the hospital and with different training forms ( P<0.05) . Pearson correlation analysis revealed that the nurse-patient communication ability score of undergraduate nursing students in the early stage of clinical practice was positively correlated with the number of nurse-patient communication training sessions in the hospital ( r=0.456, P<0.01) . According to multiple linear regression analysis, the number of training sessions and training forms in the hospital were main influencing factors to the nurse-patient communication ability of undergraduate nursing students in the early stage of clinical practice ( P<0.05) . Conclusions:The level of nurse-patient communication ability in undergraduate nursing students in the early stage of clinical practice is low and needs to be further improved. Clinical nursing teaching managers should formulate effective training programs based on its influencing factors to strengthen training accordingly.