Background: Little empirical evidence is known about the sleep quality of frontline health professionals working in isolation units or hospitals during the novel coronavirus disease (COVID-19) outbreak in China. This study thus aimed to examine the prevalence of poor sleep quality and its demographic and correlates among frontline health professionals.Methods: This is a multicenter, cross-sectional survey conducted in Liaoning province, China. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI).Results: A total of 1,931 frontline health professionals were recruited. The prevalence of poor sleep quality was 18.4% (95%CI: 16.6%-20.11%). Multivariate logistic regression analysis found that older age (OR=1.043, 95%CI=1.026-1.061, P < 0.001), being nurse (OR=3.132, 95%CI=1.727-5.681, P < 0.001), and working in outer emergency medical team (OR=1.755, 95%CI=1.029-3.064, P=0.039) were positively associated with poor sleep quality. Participants who were familiar with crisis response knowledge were negatively associated with poor sleep quality (OR=0.70, 95%CI=0.516-0.949, P=0.021). Conclusion:The prevalence of poor sleep quality was relatively low among frontline health professionals during the COVID-19 epidemic. Considering the negative impact of poor sleep quality on health professionals' health outcomes and patient outcomes, regularly screening and timely treatments are warranted to reduce the likelihood of poor sleep quality in health professionals.

Objective: Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses. Methods: Researches have been conducted within Cochrane Library, PubMed, Ovid, Scopus, EBSCO, and CINAHL published from inception to 2019. In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists from articles included in the final review. Two reviewers independently selected and assessed, and any disagreements were resolved through a larger team discussion. A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies. Data from each study were extracted independently using a pre-standardized data abstraction form. The the Risk of Bias in Systematic reviews and assessment of multiple systematic reviews (AMSTAR) 2 tool were used to evaluate risk of bias and quality of included articles. Results: A total of 22 studies published from 2014 to 2019 were eligible for analysis. Previous studies have examined burnout among physicians (n = 9), nurses (n = 6) and healthcare providers (n = 7). The MBI was used by majority of studies to assess burnout. The included studies evaluated a wide range of interventions, individual-focused (emotion regulation, self-care workshop, yoga, massage, mindfulness, meditation, stress management skills and communication skills training), structural or organizational (workload or schedule-rotation, stress management training program, group face-to-face delivery, teamwork/transitions, Balint training, debriefing sessions and a focus group) and combine interventions (snoezelen, stress management and resiliency training, stress management workshop and improving interaction with colleagues through personal training). Based on the Risk of Bias in Systematic reviews and AMSTAR 2 criteria, the risk of bias and methodological quality included studies was from moderate to high. Conclusions: Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.

BackgroundSkin disease is a global public health problem that often has physiological, psychological and social impacts. However, it is not very clear how to adapt to these impacts, especially psychosocial adaptation of patients with skin disease.MethodsWe searched EMBASE, PubMed, CINAHL and PsycINFO from 2009 to 2018. The following themes were extracted from the included articles: the concepts, related factors, and interventions for psychosocial adaptation of patients with skin disease. Two reviewers independently screened and analyzed.ResultsFrom 2261 initial records, 69 studies were identified and analyzed. The concept of psychosocial adaptation in patients with skin disease was referred to under an assortment of descriptions. The related factors for psychosocial adaptation in patients with skin disease included the following: demographic factors (sex, age, education level, ethnicity, BMI, sleep quality, marital status, exercise amount, family history, the use of topical treatment only, personality and history of smoking); disease-related factors (disease severity, clinical symptoms, localization and duration); psychological factors (anxiety/depression, self-esteem, body image, stigma and suicidal ideation); and social factors (social support, social interaction, sexual life, economic burden and social acceptance). Despite being limited in quantity, several studies have clarified the benefits of adjuvant care in the form of cognitive behavioral training, educational training and self-help programs, all of which have become common methods for dealing with the psychosocial impacts.ConclusionsBased on the previous literatures, we constructed a protocol of care model for psychosocial adaptation in patients with skin disease. It not only provided the direction for developing new instruments that could assess psychosocial adaptation statue, but also a basis for helping patients adjust to changes in skin disease.

Poor psychiatric status and sleep quality were common among frontline healthcare workers (FHWs) during the outbreak of the 2019 novel coronavirus disease (COVID-19), but the change in these mental health outcomes overtime remained unknown. This study compared the psychiatric status and sleep quality of FHWs during and after the COVID-19 outbreak in China. FHWs who volunteered to work in Hubei province (the COVID-19 epicenter) were assessed at baseline during the COVID-19 outbreak and re-assessed when they returned to their place of origin (Liaoning province) after the COVID-19 outbreak. Participants’ psychiatric status and sleep quality were measured with the Symptom CheckList-90 (SCL-90) and the Pittsburgh Sleep Quality Index (PSQI), respectively. A total of 494 FHWs was assessed at baseline and 462 at follow-up assessments. The prevalence of poor psychiatric status was 10.5% at baseline and increased to 14.9% at the follow-up assessment (P = 0.04). The corresponding figures of poor sleep quality at baseline and follow-up assessment were 16.4% and 27.9%, respectively (P < 0.001). Multiple logistic regression analysis found that severe fatigue (p = 0.003, OR = 1.266, 95% CI = 1.081–1.483), poor sleep quality (p < 0.001, OR = 1.283, 95% CI = 1.171–1.405), and history of pre-existing psychiatric disorders (p < 0.001, OR = 5.085, 95% CI = 2.144–12.06) were independently associated with higher odds of poor psychiatric status among the FHWs. Poor psychiatric status and sleep quality were common among FHWs during the COVID-19 outbreak, and the prevalence increased following their volunteer experiences. This suggests a critical need for longer-term psychological support for this subpopulation.

AimThis study aims to conduct a meta-analysis to identify and compare the effectiveness of compressive cryotherapy and cryotherapy alone for patients undergoing knee surgery.BackgroundPostoperative management is an important guarantee for the success of surgery. Cryotherapy and compression are two common nursing techniques after knee surgery, and are considered to be effective for postoperative clinical symptoms such as local pain and swelling. However, no previous meta-analyses have compared the effectiveness of compressive cryotherapy and cryotherapy alone in patients undergoing knee surgery.DesignA meta-analysis of randomized controlled trials (RCTs).MethodsWe conducted a search in MEDLINE (via Pubmed, 1990–2014), EMBASE (via Elsevier, 1990–2014), Cochrane Central Register of Controlled Trials (The Cochrane Library, 1990–2014), CINAHL (1990–2014) and China National Knowledge Infrastructure (1990–2014) databases for RCTs published in English and Chinese. The primary outcome measure of interest was visual analog scale and girth measure. Finally, a meta-analysis was carried out using RevMan 5.3.ResultsAmong the 593 RCTs, 10 RCTs were selected and included into this study. These studies included 522 patients who underwent knee surgery. Patients who underwent compressive cryotherapy tended to have less pain than patients who underwent cryotherapy alone at POD2 and POD3, while compressive cryotherapy had a strong tendency towards less swelling over cryotherapy alone at POD1 and POD2. However, there was no significant difference between compressive cryotherapy and cryotherapy alone at the intermediate stage of rehabilitation after knee surgery. All adverse reactions were recorded in all included RCTs.ConclusionCurrent evidence suggests that compressive cryotherapy is beneficial to patients undergoing knee surgery at the early rehabilitation stage. At the last stage, the effectiveness of compressive cryotherapy and cryotherapy alone were found to be similar.