Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

Adjuvant therapy for hormone receptor-positive breast cancer: Perspective from a survey on breast cancer physicians' acceptance of practice-changing data

A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.

COVID-19 Downgraded Already Impaired Mental Health of Medical Undergraduates during the Pandemic Years

Background: Measures to contain the COVID-19 transmission reached teaching routines of universities worldwide with possible mental health consequences for anxiety. This study assessed prevalence and risk factors for stress, depression, and anxiety (SDA) in medical students during quarantine by COVID-19. Methods: A cross-sectional observational study of medical students by means of the DASS-21 questionnaire. Risk factors for SDA were assessed based on epidemiologic questions related to COVID-19. Receiver Operating Characteristics (ROC) curves were calculated for each predictor, as well as sensitivity and specificity. Results: This survey reached 1009 responses. A prevalence of 77.5% for some SDA disorder was found, 63% being severe. Previous diagnosis of psychiatric disorder was a factor of risk for anxiety (OR 2.78 CI95% 1.44 - 14.25, p = 0.044), as well as for depression (OR 3.37 CI95% 1.98 - 6.02, p Conclusion: Psychiatric conditions as well as chronic illnesses were risk factors for high prevalence of anxiety, depression and stress during the COVID-19 pandemic among medical students.

Sense of courage:The mediating role of courage between emotional reflexivity and work-life integration among nurses in Indian hospitals

Objectives:This study aimed to determine the relationship between emotional reflexivity and work-life integration through the mechanism of moral courage and enhance our understanding of the importance of these nursing concepts to enable the nurses to develop better coping strategies for work-life integration.Methods:A cross-sectional survey was performed with 249 nurses,including staff nurses,ICU and critical care nurses,operation theatre nurses,pediatric nurses from 17 hospitals.Emotional Reflexivity,work-life integration,and courage were measured using a demographic information questionnaire,Life Project Reflexivity Scale(LPRS),Nurse’s Moral Courage Scale(NMCS),andWork-Life Boundary Enactment(WLBE)scale.A series of multiple regressions analyzed the mediating effect.Results:Emotional Reflexivity was positively correlated with work-life integration(b=0.66,P<0.01).There was a positive correlation between emotional reflexivity and moral courage.But the path did not get the necessary support in the structural equation modeling(SEM)(b=0.13,P=0.40).When controlling for courage(b=0.42,P<0.01),the association was significant between emotional reflexivity and work-life integration with partial mediation.Conclusion:The study reported a positive correlation between reflexivity and work-life integration.Thus,nurses’work-life integration becomes better by reinforcing their emotional reflexivity and moral courage.

Analysis of adversity quotient of nursing students in Macao:A crosssection and correlation study

Objectives: To investigate the adversity quotient (AQ) of Macao undergraduate nursing students and analyse its influencing factors.Methods:A cross-section design was used,and a convenience sample of nursing students(n=158 valid)was selected from a tertiary institute in Macao.In addition to demographic questions,the Chinese versions of the Adversity Quotient Scale,the Emotional Intelligence(EI)Scale,the Simplified Coping Style Questionnaire and the Parenting Styles Scale were used to assess the students'characteristics.Results:The average AQ score of the students was 116.72±11.39.AQ scores were negatively correlated with coping-negative,and maternal style(excessive interference,excessive protection)(r=-0.332,P<0.001;r=-0.167,P=0.036).Coping-negative entered the regression equation(F=19.154,P<0.001).The female nursing students had higher scores in ownership dimension of AQ than their male counterparts(31.98±3.26 vs.29.21±3.08,t=-4.442,P<0.001).Conclusions:The average AQ scores of Macao undergraduate nursing students were moderate.The female nursing students are more likely to attribute the cause of adversity to themselves,and specific psychosocial and cultural issues may be at play.There is a necessity for Macao nursing students to improve their ability to overcome setbacks.Special attention should be paid to the cultivation of students'positive coping styles.

HIV/AIDS related perception and behavior: A comparative study among college students of different majors in China

Objective:In order to carry out proper education and intervention of AIDS based on different features and demands of different majors,this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge,attitudes and behaviors.Methods:A questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China,who were recruited through stratified cluster sampling.AIDS-related knowledge,attitude,condom-use intention,self-efficacy and sexual behavior of these students were investigated.Results:AIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use.Students of music or fine arts had the strongest intention to use condoms,while the students majoring in education had the weakest.The sexually active percentages of male students from different majors ranked as follows:music or fine arts(29.5%),minority nationality(12.2%),science&tech(10.9%),medicine(10.6%),educationmajor(10.0%),and liberal arts(8.2%).Among female students,the rank was music or fine arts(11.0%),science&tech(6.2%),education-major school(4.5%),minority nationality(4.5%),liberal arts(4.1%),and medicine(2.8%).Conclusion:It is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities,for example,to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.

Nurses’perception on competency requirement and training demand for intensive care nurses

Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element that must be studied in order to adopt appropriate educational measures.This study aimed to evaluate nurses’perception of the importance of intensive care training in Spain.Methods A descriptive,cross-sectional,multicentre study was conducted on a national level in Spain.Totally 85 ICUs took part in the study.The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’perception on competency requirements and training needs.The evaluation was conducted by a 10-point Likert scale.Results The sample was 568 Spanish nurses.Significant differences were found on an academic level,in terms of gender and hospital type,and in the professional experience of the nurse when it comes to evaluating the different training items;the differences in overall questionnaire scores among these groups were statistically significant(P<0.05).The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU.Conclusion Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system.Nurses benefited from training focused on the skills and knowledge of each moment of their working life.Nurses have a different evaluation of their training needs throughout their professional cycle.Therefore,their training must be adapted to the professional stage of each nurse.

Abusive supervision and turnover intention: Mediating effects of psychological empowerment of nurses

Objective: This study aims to determine the mediating effects of psychological empowerment on abusive supervision and turnover intention as perceived by nurses to provide information to change the status of nurse turnover.Methods: A cross-sectional survey (a questionnaire examining perceptions of abusive supervision,measurement of psychological empowerment,and questionnaire for turnover intention) was used to collect data.A total of 1127 clinical nurses,who were recruited through convenience sampling,participated in the survey.Results: Nurses' average perceived abusive supervision,psychological empowerment,and turnover intention scores were 1.62 ± 0.95,3.24 ± 0.83,and 14.17 ± 3.78,respectively.Psychological empowerment was found to mediate the relationship between abusive supervision and turnover intention (P< 0.01).Turnover intention tends to be stronger and psychological empowerment reduced when nurse managers adopt an abusive leadership style.Conclusions: Nurses' psychological empowerment is an intermediary variable that predicts the relationship between abusive supervision and turnover intention.Nurse managers should manage abusive supervision to increase nurses' psychological empowerment and decrease turnover intention.

Continuous use of fitness apps and shaping factors among college students: A mixed-method investigation

Objective:This current study pursued an exploration of the psychological mechanism that determines college students'continuance intention to use fitness apps.Methods:This current study adopted a mixed methods research that composed two distinct phases.Study 1 was quantitative research that helped to identify determinants of Chinese college students'continuance intention to use.A self-reported questionnaire was completed by 379 college students to ascertain their user experience.Study 2 was qualitative research.A semi-structured interview was conducted with a sample of 10 college students.Study 2 can be seen as a follow-up study and it pursued an in-depth understanding on how college students use fitness apps in the everyday life and their views towards study 1's major findings.Results:The results revealed that five factors(confirmed usefulness,confirmed ease of use,satisfaction,fitness achievement and social connection)were found to significantly and positively affect college students'continuous intention to use fitness apps.Entertainment did not show obvious impact.In the interview,college students reported that even if they don't obtain entertainment from fitness apps,they will still push themselves to use them,because they have a very specific goal when using fitness apps,which is to achieve health and fitness.Conclusion:These findings indicated that successful fitness apps should make users feel convenient to use and indeed improves the fitness user's efficiency.Besides,people are more eager to get the information with strong credibility with the negligible effort.This implies more efforts should be made to design apps that can provide high-quality services.Moreover,if apps designers can pay more attention to protecting the personal information and data,it will inspire more people to use social connection functions.

Hospital ethical climate associated with the professional quality of life among nurses during the early stage of COVID-19 pandemic inWuhan,China:A cross-sectional study

Objectives:To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight inWuhan and especially examine whether the hospital ethical climate was independently associated with nurses’professional quality of life.Methods:A cross-sectional online survey was conducted from March 2020 to April 2020.The nurses working in Wuhan from the other parts of China were the target population.The Professional Quality of Life Scale version 5,the Hospital Ethical Climate Survey,and a basic information sheet were used to collect data.Descriptive statistics,t-test,ANOVA,Pearson correlation,and multiple linear regression analysis were used to analyze the data.Results:In total,236 nurses participated in this study,and 219 valid questionnaires were analyzed.The average age of the participants was 31.2±5.0 years.Most nurses were female(176/219;80.4%)and married(145/219;66.2%).In term of professional quality of life,nurses reported moderate(129/219;58.9%)to high(90/219;41.1%)levels of compassion satisfaction,low(119/219;54.3%)to moderate(100/219;45.7%)levels of burnout,and low(67/219;36.0%)to high(10/219;4.6%)levels of secondary traumatic stress.Regarding hospital ethical climate,nurses reported moderately high hospital ethical climates with an average score of 4.46.After controlling for socio-demographic characteristics,the multiple linear regression models showed that the hospital ethical climate subscale of“relationship with physicians”was independently associated with the compassion satisfaction(b=0.533,P<0.01)and burnout(b=0.237,P<0.05);the hospital ethical climate subscale of“relationship with peers”(b=0.191,P<0.01)was independently associated with the secondary traumatic stress.Conclusions:During the early stage of the pandemic,nurses demonstrated moderate to high level of compassion satisfaction,low to moderate level of burnout,and all nurses experienced secondary traumatic stress.Nurses perceived a high level of hospital ethical climate,and the perceived hospital ethical climate played an important role in promoting nurses’professional quality of life during a lifethreatening infectious disease pandemic.

Reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire for patients with head and neck cancer and their caregivers

Objectives:This study aimed to assess the reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire(HaNiQ).Methods:The HaNiQ was translated into a Chinese version using internationally recognized forwardand back-translation procedures.The reliability and validity of the HaNiQ were measured using Cronbach’s a coefficient,split-half reliability,exploratory factor analysis,and Pearson correlation analysis.Results:A total of 207 patients in different head and neck cancer(HNC)stages and 174 caregivers completed the Chinese version of the HaNiQ.Internal consistencies varied between good and very well(Cronbach’s α coefficient 0.74-0.90);the split-half coefficient and the content validity index(CVI)of the questionnaire were 83.5%and 83.33%,respectively.The cumulative contribution rates of the 5 subscales in patients with HNCand their caregivers were 62.41%and 61.19%,respectively.However,there are some differences between the Chinese questionnaire for caregiver and the original questionnaire regarding the attribution of items.Items 22,23,and 27 in the Psychosocial subscale of the English version were assigned to the Survivorship subscale in the Chinese version for caregivers.Conclusions:The results demonstrated that the Chinese version of the HaNiQ is a reliable and valid instrument for measuring the information needs of patients with HNC and that of their caregivers.Though the structure of the Chinese versionwas different from the English version for caregivers of HNC patients,the Chinese version of the HaNiQ appears to be reliable and would benefit from further testing.

Knowledge of COVID-19 and its prevention among rural residents in Fuqing,China

Objectives:Rural areas are the weakest place for epidemic prevention and control,yet few studies have specifically conducted surveys in rural areas.The purpose of this study is to assess rural residents’knowledge of the COVID-19 and its prevention in China.Methods:A cross-sectional survey study containing 1,426 samples was conducted in Fuqing,China to assess rural residents’knowledge of the COVID-19 and its prevention.Logistic regression was used to identify potential differences in participants’knowledge of COVID-19 and its prevention and control in different population subgroups.Results:The mean and median of residents’knowledge of COVID-19 was 5.53 and 6 points,respectively.The mean and median of residents’knowledge related to self-protection against COVID-19 was 10.34 and 11 points,respectively.Older adults(AOR45e59=2.26,95%CI 1.20 to 4.27;AOR60-69=3.13,95%CI 1.63 to 5.98;AOR70=4.68,95%CI 2.35 to 9.33)were more deficient in knowledge of COVID-19.Those who were better educated and with a higher average annual household income were less likely to be deficient in the knowledge of COVID-19 and knowledge of self-protection against COVID-19.Moreover,those who were single,divorced,or widowed(AOR=1.67,95%CI 1.13 to 2.46)were more deficient in the knowledge of self-protection against COVID-19.Conclusions:Our study suggests that when facing a pandemic like COVID-19,the key is to inform the public to understand simple and effective self-protection measures.Therefore,we call on the govern-ments to give priority to publicity and education on self-prevention measures for the targeted pop-ulations and regions.This is most evident among the vulnerable groups like those who were unmarried,elderly,and those with low education or low income.Similar suggestions may be of use in other countries as well.

Development and validation of a self-management ability questionnaire for patients with chronic periodontitis

Objective: This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis.Methods: A questionnaire was developed through theoretical research,literature review,semistructured interview,and expert consultation.A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling.Validity and reliability were analyzed.Results: The questionnaire consisted of 24 items.Exploratory factor analysis identified three principal factors,which explained 66.949% of the total variance.The item-level content validity was between 0.800 and 1.000,and the scale-level content validity was 0.969.The coefficient of correlation between the gold standard and the whole questionnaire was 0.869.Cronbach's α of the whole questionnaire was 0.931,and the test-retest reliability coefficient was 0.825.Conclusion: The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity.It is useful for clinical work to measure self-management among patients with chronic periodontitis.

Needs assessment and expectations regarding evidence-based practice knowledge acquisition and training activities:A cross-sectional study of healthcare personnel in China

Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.

Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China

Objectives:This study aimed to describe cardiovascular risk and cardiovascular disease(CVD)knowledge among older adults,and further explore the association between knowledge and risk.Methods:In this cross-sectional study,we enrolled 1120 older adults who received physical examination in health centers.The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics.A risk prediction chart was used to predict participants'cardiovascular risk based on clinical characteristics and behavioral risk factors.Participants'CVD knowledge was collected with a pretested knowledge questionnaire.Results:Among the 1120 participants,240(21.4%)had low cardiovascular risk,353(31.5%)had moderate cardiovascular risk,527(47%)had high and very high cardiovascular risk.The knowledge level about CVD among 0.8%of the 1120 participants was good while that of 56.9%was poor.Lower CVD knowledge level,older age,lower income,and lower educational level were the independent factors of higher cardiovascular risk level.Conclusions:This study highlights the need to reduce the cardiovascular risk among older adults.CVD knowledge should be considered when developing health interventions.

Development and psychometric assessment of the public health emergency risk perception scale:Under the outbreak of COVID-19

Objective:Correctly understanding and evaluating the level of public risk perception toward public health emergencies not only helps experts and decision-makers understand the public’s preventative health behaviors to these emergencies but also enhances their risk information communication with the public.The aim of this study was to develop a risk perception scale for public health emergencies and test its validity and reliability during the coronavirus disease 2019(COVID-19)pandemic.Methods:Guided by the theoretical model of risk perception,an initial scale was generated through literature review,group meetings,resident interviews,and expert consultation.A pretest and item screening were then conducted to develop a formal risk perception scale for public health emergencies.Finally,the reliability and validity of the scale were validated through a questionnaire survey of 504 Chinese adults.Results:The final scale had 9 items.The content validity index of the scale was 0.968,and the content validity index of individual items ranged from 0.83 to 1.00.Three common factors,dread risk perception,severe risk perception,and unknown risk perception,were extracted for exploratory factor analysis,and together they explained 66.26%of the variance in the score.Confirmatory factor analysis showed that the model had a satisfactory fit,whereχ^(2)/df=1.384,the goodness-of-fit index(GFI)=0.989,root mean square error of approximation(RMSEA)=0.028,root mean square residual(RMR)=0.018,comparative fit index(CFI)=0.995,normed fit index(NFI)=0.982,and non-normed fit index(NNFI)=0.990.The correlations between dimensions ranged from 0.306 to 0.483(P<0.01).Cronbach’s a was 0.793 for the total scale and ranged between 0.687 and 0.801 for the individual dimensions.The split-half coefficient was 0.861 for the total scale and ranged from 0.727 to 0.856 for induvial dimensions.The test-retest coefficient was 0.846 for the total scale and ranged from 0.843 to 0.868 for induvial dimensions.Conclusion:The developed scale for the risk perception of public health emergencies showed acceptable levels of reliability and validity,suggesting that it is suitable for evaluating residents’risk perception of public health emergencies.

Interprofessional education in nursing: The impact of collaboration between physical and mental health care professionals

Objectives:lnterprofessional collaboration in the training of nursing and psychology students helps provide students of both disciplines with the ability and competences they need to best attend to their patients.This study implemented and analyzed a method for developing the competences of each discipline in a scenario of joint clinical simulation that incorporates mental and physical health simultaneously,and measured the caring ability of the participating students.Methods:Participants took a self-applied survey measuring their own caring ability.After,a clinical simulation was performed where nursing students performed clinical interviews on psychology students,who acted as standardized patients.Caring abilities were measured in the nursing students,and the psychology students implemented an intervention service measuring caring ability and brief-debrief simulation by coaching to nursing students.Results:The results indicated that the self-applied questionnaire of caring ability resulted in scores significantly higher than what was measured by observers.Conclusions:The results contribute to the development of protocols,training and collaborative work practices in interprofessional education,which allow the scaling of these competences.

Correlation of long-term medication behaviour self-efficacy with social support and medication knowledge of kidney transplant recipients

Aim:This study aimed to explore the correlation of long-term medication behaviour self-efficacy with social support and medication knowledge of kidney transplant recipients.Methods:A convenient sample of kidney transplant recipients in a general hospital in Guangzhou was recruited from November 2016 to January 2017.Self-reported survey data were provided by the kidney transplant recipients using long-term medication behaviour self-efficacy scale(LTMBSES),perceived social support scale(PSSS)and scale for patient-perceived medication knowledge in medication usage.Descriptive statistics and Spearman's correlation analysis were used for data analysis.Results:A total of 195 kidney transplant recipients(132 men and 63 women)were recruited for this study.The mean scores of all LTMBSES dimensions,namely personal attitudes,environmental and taskrelated and behavioural factors,were 32.49±4.34,60.90±7.56 and 32.32±4.40,respectively.The mean scores of three PSSS dimensions,namely,family,friends and significant others,were 24.91±3.42,22.71±4.66 and 22.15±4.26,correspondingly.The mean scores of two five-item knowledge subscale dimensions,namely,general and interaction knowledge,were 9.56±1.07 and 13.02±2.67,respectively.Spearman's correlation analysis showed that social support(rs=0.232,P<0.01)and medication knowledge(rs=0.352,P<0.01)were positively associated with long-term medication self-efficacy in the kidney transplant recipients.Conclusion:The levels of long-term medication self-efficacy,perceived social support and medication knowledge of the kidney transplant recipients were high.Social support and medication knowledge were correlated with self-efficacy.

Cross-Sectional Survey of Views on COVID-19 and Its Vaccines Among Pregnant Women

Objective:The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their anxiety and knowledge on COVID-19 compared to our previous study.Methods:This cross-sectional survey was performed in the antenatal clinics of United Christian Hospital and Tseung Kwan O Hospital of Hong Kong,China.Questionnaires were distributed to pregnant women for self-completion when attending follow-up from August to October 2021.Apart from basic demographic data,the questionnaire comprised of questions including knowledge on COVID-19 and its vaccines in pregnancy as well as attitudes and behaviors of pregnant women and their partners toward COVID-19.Continuous variables were analyzed by Student’s test and Levene’s test was used to confirm normal distribution and homogeneity of variance for continuous variables,whereas categorical variables were analyzed by the Chi-squared test or Fisher’s exact test as appropriate.AP value of <0.05 was considered to be statistically significant.Results:A total of 816 completed questionnaires were included for analysis.Pregnant women were less worried about COVID-19 in the current survey as compared to the last survey (393/816,48.2%vs.518/623,83.1%,P<0.001).Fewer pregnant women believed that pregnancy were more susceptible to contract SARS-CoV-2 as compared to the last survey (265/816,32.5%vs.261/623,41.9%,P<0.001).They have significant knowledge gap and concerns about COVID-19 vaccines.Nearly half of the participants believed that pregnant women cannot have COVID-19 vaccination (402/816,49.3%) and it is unsafe to fetus (365/816,44.7%).Around a third of women perceived that they were more prone to the side effects and complications of COVID-19 vaccines than the general population (312/816,38.2%) and did not recognize that maternal COVID-19 vaccination could effect transferral of antibodies to the fetus to promote postnatal passive immunity (295/816,36.2%).Most of them had not been vaccinated (715/816,87.6%) and only (12/715) 1.7% of them would consider vaccination during pregnancy.Conclusion:Despite the local and international recommendations for pregnant women to be vaccinated,the uptake of COVID-19 vaccines during pregnancy remained extremely low.Efforts should be made to effectively provide information about the safety and benefits of COVID-19 vaccines during pregnancy.There is an urgent need to booster vaccination rates in pregnant women to avoid excessive adverse pregnancy outcomes related to COVID-19.

Associated factors of professional identity among nursing undergraduates during COVID-19:A cross-sectional study

Objectives Professional identity plays an important role in the long-term development of nurses,and it will change when public health emergency occurs.The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19.Methods A cross-sectional survey design with convenience sampling was used.A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020.A general information questionnaire was used to collect students’information,and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic.Results The score of professional identity in the later stage(59.49±12.41)was higher than that in the early stage(56.96±12.61).The stepwise regression indicated that several factors were associated with professional identity,including gender,residential area,major,impact of the epidemic on intention to work after graduation,reasons for choosing nursing major and students’scores of professional identity in early stage.Conclusions Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students.Meanwhile,educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.