ObjectivesNurses are the largest group of healthcare workers on the front line of efforts to control the COVID-19 pandemic. An understanding of their nursing experiences, the challenges they encountered and the strategies they used to address them may inform efforts to better prepare and support nurses and public health measures when facing a resurgence of COVID-19 or new pandemics. This study aimed to explore the experiences of nurses caring for people with suspected or diagnosed COVID-19 in Hong Kong.DesignA qualitative study was conducted using individual, semistructured interviews. All interviews were audio-recorded and transcribed verbatim for thematic analysis.SettingParticipants were recruited from acute hospitals and a public health department in Hong Kong from June 2020 to August 2020.ParticipantsA purposive sample of registered nurses (N=39) caring for people with COVID-19 in Hong Kong were recruited.ResultsTwo-thirds of the nurses had a master’s degree and over a third had 6–10 years of nursing experience. Around 40% of the nurses cared for people with COVID-19 in isolation wards and a quarter performed COVID-19-related work for 31-40 hours/week. Most (90%) had training in COVID-19 and three-quarters had experience of working in infection control teams. Six key themes emerged: confronting resource shortages; changes in usual nursing responsibilities and care modes; maintaining physical and mental health; need for effective and timely responses from relevant local authorities; role of the community in public health protection and management; and advanced pandemic preparedness.ConclusionsOur study found that nurses possessed resilience, self-care and adaptability when confronting resource shortages, changing nursing protocols, and physical and mental health threats during the COVID-19 pandemic. However, coordinated support from the clinical environment, local authorities and community, and advanced preparedness would likely improve nursing responses to future pandemics.

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To examine the psychometric properties of a Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES) among stroke survivors. Methods:The PS-SES was translated into Chinese. A cross-sectional descriptive study was conducted with 336 stroke survivors recruited from the neurology departments of five hospitals in China. Reliability, concurrent validity, and construct validity of the scale were determined. Results:The Chinese version of the PS-SES (PS-SES-C) showed good internal consistency and test-retest reliability, with a Cronbach's α of 0.98 and intraclass correlation coefficient of 0.79. There was a moderate to strong positive correlation between the PS-SES-C and Chinese version of General Self-Efficacy Scale (r = 0.59, p < 0.001), positive correlations between the PS-SES-C and Chinese versions of the Modified Barthel Index (r = 0.59, p < 0.001), Rivermead Mobility Index (r = 0.70, p < 0.001), and Reintegration to Normal Living Index (r = 0.70, p < 0.001), and a negative correlation between the PS-SES-C and National Institutes of Health Stroke Scale (r = -0.63, p < 0.001). Known-group validity and factorial validity were also supported. Conclusions:The PS-SES-C is a reliable and valid instrument for assessing self-efficacy in managing participation of Chinese stroke survivors.

Background COVID-19 pandemic causes major impact on economic, physical, mental well-being of people all over the world. Doctors are working in stressful, unprepared, limited resource setting, and they are under the continuous threat of getting infection. Managing mental health of these warriors is great importance. Hence the present study to estimate the psychological impact of COVID-19* and factors associated with it among doctors in tertiary care hospital, Madurai. Methods A Cross-sectional study was conducted during October–November 2020 using a pre-designed semi structured questionnaire and DASS-21 scale which were sent through Google form to doctors who were in their quarantine period after the COVID duty. Totally 292 responses were received. Descriptive statistics done to find frequencies and percentages. Correlation for continuous variables; Univariate and multivariate regression for categorical variables were used to predict the factors influencing the psychological impact. Results In our study, 42.1% doctors were depressed, 43.8% were stressed and 50.7% had anxiety. Depression*, anxiety*, stress* scores were positively correlated with number of COVID duties(r 2 0.163,0.138,0.133), number of elderly persons(r 2 0.188,0.169,0.188) in their family and negatively correlated with sleep duration(r 2 –0.219,-0.281,-0.239), attitude of study participants(r 2 -0.319,-0.274,-0.291). Multiple logistic regression showed that disturbed sleep(odd'sratio = 3.931,2.734,3.420) and poor quality of sleep which affect the next day function(odd'sratio = 3.470,2.968,3.122) were significant predictors for all three psychological impacts. Conclusion High prevalence of psychological impact estimated, ensures the requirement of early screening with timely psychological intervention and establishment of guideline policies to support mental health of healthcare workers* for maintaining the functionality of healthcare system.

Background While there is a growth in the number of advanced practice nurses, there is a dearth of research examining their role transition from registered nurses. This study aimed to identify critical elements in the career path of nursing graduates who have taken up advanced practice roles and examine their perceived impact on patient care. Methods An exploratory descriptive study was performed. Individual semi-structured interviews were conducted face-to-face with 10 nursing graduates now in advanced practice roles, and their ten respective managers. All interviews were audio-recorded and transcribed verbatim for latent and manifest content analyses. Results The nursing graduates, six of whom were male, had a mean age of 35 years. All possessed a master’s degree and formal post-registration education and/or training. Six had at least three years’ experience as an advanced practice nurse. The managers, all female, had a mean age of 49 years. Eight had at least one year’s experience in their current position. Six key themes emerged: prior enhancement of personal and professional knowledge and skills; active participation in clinical roles and knowledge translation in preparation for advanced practice; adapting to new and diverse advanced practice nursing responsibilities; role of advanced practice nurses in leadership; personal qualities crucial for success in advanced practice; and provision of evidence-based patient-centered care. Conclusions Postgraduate education, management knowledge and leadership skills, and active participation in clinical roles and knowledge translation appear crucial ingredients for promotion of nursing graduates to advanced practice roles. Other ingredients include a positive outlook, flexibility and adaptability, and good interpersonal, communication and problem-solving skills.