OCCUPATION AND HEALTH

Mediating effect of occupational stress on relationship between sleep quality and burnout of soldiers in a troop

SHI Lei, WANG Yuan, REN Fei, CAO Miao-miao, LI Ke, MA Hui-zhen

2023, 39(3): 289-292.

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Objective To investigates the relationship among sleep quality and burnout，occupational stress of soldiers in a troop. Methods A total of 1 092 soldiers from three troops were invited to complete the Pittsburgh sleep quality index（PSQI），Maslach burnout inventory-general survey（MBI-GS），and occupational stress scale（OSS） from June to December 2020，and the data were analyzed. Results The score M（P₂₅，P₇₅） of sleep quality，occupational stress and burnout was 4.0（2.00，7.00），26.00（17.00，34.00） and 3.53（3.13，4.00）points. There were not statistically significant differences in levels of sleep quality，occupational stress and burnout among groups in different age and length of military service（all P>0.05）. There were statistically significant differences in levels of sleep quality，occupational stress and burnout among groups in different gender and education（all P<0.05）. The correlation analysis showed that the sleep quality of soldiers was positive correlated with occupational stress and burnout（r=0.410，0.569，both P<0.01）. The occupational stress and burnout levels had a certain impact on sleep quality，explaining 33.1%. And burnout had an incomplete mediating effect between occupational stress and sleep quality（effect amount was 75.5%）. Conclusion The sleep quality of soldiers is related to burnout and occupational stress，and it can alleviate occupational stress by reducing the level of burnout，which has positive significance for improving the sleep quality of soldiers.

Occupational fatigue status and its relationship with work stressors and sleep quality in 153 medical workers in neurology department in Suzhou City

JIN Jin, ZHANG Lan, SHEN Xiao-fang

2023, 39(3): 293-296.

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Objective To understand the occupational fatigue status and influencing factors of medical workers in neurology departments of tertiary hospitals in Suzhou City，analyze its relationship with work stressor and sleep quality. Methods From January to February 2022，the questionnaires were distributed to 153 medical workers in neurology departments of four tertiary hospitals in Suzhou City using the convenient sampling method. The questionnaire included general information questionnaire，occupational fatigue scale，work stressor scale and Pittsburgh sleep quality index scale，and the data were analyzed. Results The total score of occupational fatigue of 153 medical workers in neurology department was （18.12±4.37）points，the total score of work stressor was （68.49±14.53）points，and the total score of Pittsburgh sleep quality index scale was （7.15±1.84）points. The scores of each dimension and total score of work stressors and sleep quality of medical workers in neurology department were positively correlated with the total score of occupational fatigue（all P<0.05）. The overtime >10 times/month，night shift ≥3 times/month，unqualified results of physical examination，work pressure，and sleep quality were all influencing factors of occupational fatigue of medical workers in neurology department（B=0.591，0.724，0.526，0.813，0.579，all P<0.05）. Conclusions The occupational fatigue status of 153 medical workers in neurology department of tertiary hospitals in Suzhou City is not optimistic. The excessive overtime，frequent night shifts，unqualified results of physical examinations，high work pressure，and poor sleep quality are all factors that affect the occupational fatigue of neurosurgery medical staff. Among them，the greater the work pressure and the worse the sleep quality，the more serious the occupational fatigue.

Mediation of psychological capital on challenge-hindrance stressor and work performance of full-time infection prevention and control practitioners

LI Ying-ying, DING Ping, WANG Ping, XU Ming-xing, ZHANG Wen-zhen, ZHANG Xiu-ping

2023, 39(3): 297-301.

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Objective To understand the status quo of work performance of full-time infection prevention and control practitioners（IPCP），explore mediation of psychological capital on challenge-hindrance stressor and work performance of IPCP. Methods In November 2021，415 full-time IPCP in 112 hospitals of Anhui Province were selected by the convenience sampling method，they were investigated by the general situation questionnaire，challenge-hindrance stressor scale，psychological capital questionnaire and work performance scale，and the data were analyzed. Results The total scores of challenge stressor，hindrance stressor，psychological capital and work performance of 415 full-time IPCP were （22.65±4.58），（13.68±4.24），（103.71±15.60） and （45.01±6.16）points，respectively. The correlation analysis showed that challenge stressor was positively correlated with work performance and with psychological capital（r=0.302，0.293，both P<0.01），hindrance stressor was negatively correlated with work performance and with psychological capital（r=-0.247，-0.357，both P<0.01），and psychological capital was positively correlated with work performance（r=0.791，P<0.01）. The psychological capital played a partial mediating effect between challenge stressor and work performance，and a complete mediating effect between hindrance stressor and work performance. Conclusions The psychological capital plays a mediating effect between challenge-hindrance stressor and work performance of full-time IPCP. Hospital managers should focus on the character of stressor，and actively improve the psychological capital level of full-time IPCP，so as to promote the improvement of work performance level.

Evaluation of radiation protection effect of new nuclear medicine department in a hospital of Danzhou City

LI Ling-ling, AN Gang, WANG Jiao

2023, 39(3): 302-307.

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Objective To evaluate of radiation protection effect of new nuclear medicine department in a hospital of Danzhou City，understand the radiation protection level of single-photon emission computed tomography（SPECT-CT），thyroid function determination and hyperthyroidism therapy. Methods From August to October 2021，the field investigation and testing method were used to conduct the radiation protection detection，surface pollution detection，equipment performance detection，ventilation detection and radiation protection evaluation in the workplace of new nuclear medicine department in a hospital of Danzhou City. Results The dose rates of injection table window（open），cabinet observation window，operation port（open），waste room protection door，observation room protection door in SPECT-CT work area were high. The peripheral dose equivalent rate of computed tomography（CT） workplace radiation level in SPECT-CT was 0.13-0.19 μSv/h，which was in the environmental base level. The surface contamination detection results in radiation workplace of nuclear medicine department were less than the low limit of detection，that was <0.09 Bq/cm². The equipment performance detection indicators of SPECT and CT in SPECT-CT all met the relevant standards. The wind speed of ventilation cabinet section did not reach 1 m/s，and ventilation in some radioactive workplaces was less than 4 times/h. Conclusions It is suggested that the hospital should strengthen the radiation protection management for the areas with high dose rate，set up warning signs and warning instructions in Chinese，and the medical staff and the interviewees stay briefly，and shall not stay in the above areas after the completion of the prescribed process. It is necessary to use the high-power fan in the ventilation cabinet to increase the cross-section wind speed. The one-way electric valve should be added in functional rooms to avoid ventilation exchange of ventilation pipes between rooms. It is necessary feasible to add the replaceable activated carbon filter device at the exhaust outlet of the ventilation cabinet and functional rooms，and replace the activated carbon regularly.

Analysis on current status of occupational hazards in small and micro enterprises in Huai'an City

JIANG Ze-run, HE Dong-dong, WANG Hong-liang, HUO Bin-bin

2023, 39(3): 308-311.

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Objective To understand the current situation of occupational hazards in small and micro enterprises in Huai'an City，provide a basis for improving the prevention and control of occupational diseases in small and micro enterprises. Methods From July to October 2020，the investigation was carried out according to the requirements of the Implementation plan for the current situation investigation of occupational hazards in Huai'an City，including category and exposure of occupational hazard factors and detection of occupational hazard factors，and the monitoring data of small and micro enterprises derived from the monitoring system of occupational hazards in the workplace were analyzed. Results The survey covered a total of 5 076 small and micro industrial enterprises in Huai'an City，including 2 814 micro enterprises（55.44%） and 2 262 small enterprises（44.56%）. The industry was dominated by textile and garment，apparel and metal industries. The exposure ratio of occupational hazards among employees of small and micro enterprises was 56.50%，of which the ratio in micro enterprise（64.56%） was higher than small enterprise（56.62%）（P<0.05）. The physical hazards were mainly noise，the dust mainly included cotton dust，other dust and iron and its compound dust，and the chemical factors were mainly other chemical factors，carbon monoxide and benzene. The occupational hazards project declaration and training were not optimistic，especially for micro enterprises（P<0.05）. Only 7.37% of small and micro enterprises have carried out occupational hazards detection in the past three years，and only 7.27% of enterprises have carried out occupational health monitoring. Conclusion The occupational hazards of small and micro enterprises in Huai'an City are relatively serious，especially micro enterprises，and it is necessary to strengthen supervision，improve the working environment of workers and safeguard the health rights and interests of workers.

Investigation on status of active surveillance of pneumoconiosis in Jiangsu Province in 2021

LIAN Xu-rong, HAN Lei, ZHAO Yuan, XIE Li-zhuang, ZHOU Lang, WANG Shu-ping

2023, 39(3): 312-316.

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Objective Through the implementation of active monitoring of pneumoconiosis and the analysis of monitoring results，to study and judge the implementation and effect of pneumoconiosis prevention and control policies and national occupational health standards，provide reference for formulating（revising） policies and standards. Methods A total of 267 small，medium and micro enterprises in 25 monitoring points in 13 cities in Jiangsu Province were selected to carry out active monitoring of occupational disease hazards in the workplace. A total of 6 576 people were monitored，and free health checks were conducted for dust-exposed workers. The statistical analysis was carried out on the results of chest X-ray and lung function. From variables such as region，dust exposure type，industry，enterprise size，gender，age，length of service，and whether dust monitoring was qualified，it was analyzed whether there was a statistical difference in abnormal rate between different groups. Results The active monitoring found that chest X-ray showed four people with pneumoconiosis-like changes，and the detection rate of pneumoconiosis-like changes was 0.06%. Four workers were male，aged 25-<55 years old，had dust exposure age of 4-<15 years，worked in metal products industry，small and medium-sized enterprises，distributed in Yangzhou and Zhenjiang areas，and exposed to silica dust and welding fumes. There were statistically significant differences in the abnormal chest X-ray rates among workers in different region，dust exposure type，industry，enterprise scale，gender，age，length of service and whether dust monitoring was qualified（all P<0.05）. There were statistically significant differences in the abnormal rates of forced vital capacity（FVC） and lung capacity in one second（FEV1.0） among workers in different region，dust exposure category，industry，enterprise scale，gender，age，and working years（all P<0.05）. There were statistically significant differences in the abnormal rates of the amount of air exhaled in the first second as a percentage of total lung volume（FEV1.0/FVC） among workers in different region，industry and working years（all P<0.05）. There was no statistically significant difference in the pulmonary function abnormality rate among workers with and without qualified dust monitoring（all P>0.05）. Conclusions The lung health of dust-exposed workers is related to region，type of dust exposure，industry，enterprise size，gender，age，length of service and dust monitoring. It is necessary to improve the occupational health protection and occupational health monitoring of high-risk groups in enterprises that are unqualified for dust hazard factor monitoring，pay attention to the occurrence of pneumoconiosis in key industries and high-risk groups，and achieve early detection，early diagnosis and early treatment of pneumoconiosis.

Effects of Lycium barbarum polysaccharides on T cell subtypes and related inflammatory factors in blood of sleep deprived rats

LUAN He-zhi, SHAN Tie-qiang, JIANG Liu, HAN Chang-hai, QI Jiao, LYU Jing

2023, 39(3): 317-321.

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Objective To analyze the effects of Lycium barbarum polysaccharide（LBP） on the number of T cell subtypes，related inflammatory factors and behavioral ability of sleep deprived rats，explore the immune protective mechanism of LBP on sleep deprived rats. Methods SD rats were successfully prepared into sleep deprivation rat models by "multiplatform water environment" technology. According to the intervention methods，they were equally divided into three groups（model group，LBP intervention group and western medicine intervention group） with six rats in each group，at the same time，six healthy rats of the same genus were used as the control group. After successful modeling，the intervention drugs of the four groups were different every day. LBP intervention group was given LBP（0.54 mg/kg） orally，western medicine intervention group was given estazolam（6 g/kg） orally，and model group and control group were given equal volume three distilled water orally，continuous medication for four weeks. The number of T lymphocyte subsets CD3⁺ T cells，CD4⁺ T cells，and the ratio of CD4⁺ T/CD8⁺ T in the blood were detected. The contents of tumor necrosis factor-α（TNF-α），γ-interferon（IFN-γ），interleukin-1β（IL-1β），interleukin-2（IL-2） and interleukin-6（IL-6） in blood. The behavioral indicators of rats in four groups were tested to measure the changes of brain learning and memory function. Results Compared with the control group，the percentage of CD4⁺ T cells in the blood of model group decreased[（25.64±2.53）%]，the percentage of CD8⁺ T cells increased[（20.71±2.21）%]，the ratio of CD4⁺ T/CD8⁺ T decreased（1.66±0.13），the contents of the inflammatory factor in the blood increased，which included TNF-α[（15.99±2.02）ng/mL]，IFN-γ[（3.22±0.45）ng/mL]，IL-1β[（22.70±2.87）pg/mL]，IL-2[（15.85±1.77）ng/mL] and IL-6[（64.65±6.23）pg/mL]，and the behavioral ability of rats[（42.36±4.60）s，（10.26±1.68）times] increased（all P<0.01）. Compared with the model group，the percentage of CD4⁺ T cells in the blood of LBP intervention group increased[（35.63±3.00）%]，the percentage of CD8⁺ T cells decreased[（14.10±1.94）%]， the ratio of CD4⁺ T/CD8⁺ T increased（2.38±0.21），the contents of the inflammatory factor in the blood decreased，which included TNF-α [（10.25±1.72）ng/mL]，IFN-γ[（2.13±0.34）ng/mL]，IL-1β[（16.26±1.80）pg/mL]，IL-2[（11.90±1.50）ng/mL] and IL-6[（46.74±4.39）pg/mL]，and the behavioral ability of rats[（31.51±3.98）s，(16.90±2.72）times] decreased（all P<0.05）. LBP intervention group and western medicine intervention group had not significant difference in the above indexes（all P>0.05）. Conclusion Lycium barbarum polysaccharide can improve the behavioral ability of sleep deprived rats by regulating the number of T cell subtypes and reducing the content of inflammatory factors in blood.

Investigation on pollution of pepper and its products in Chongqing in 2020

YANG Jing, HU Di, FAN Qing, HUANG Shun-li, ZHAO Qing-ting

2023, 39(3): 322-325.

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Objective To determine and analyze 17 substances such as sulfur dioxide，some metals，organophosphorus pesticides and pyrethroid pesticides in pepper in 12 districts and counties of Chongqing in 2020，understand the pollution status of these substances in pepper，so as to provide scientific basis for government departments to carry out food safety risk assessment and food safety supervision. Methods The pepper samples from supermarkets and farmers markets in 12 districts and counties of Chongqing were determined for 17 chemical pollutants，and the results were statistically analyzed. Results A total of 295 peppers were collected，including 145 samples of fresh peppers，the over standard rate of chromium and acephate was 2.5% and 5.5% respectively. Among 150 samples of dry peppers，the over standard rate of triazophos was 6.7%. Conclusion There were excessive chemical pollutants in pepper and its products in 12 districts and counties of Chongqing in 2020，and the market supervision should be strengthened to ensure the food safety of the people.

Analysis of pathogenic Vibrio contamination in aquatic products in Cangzhou City of Hebei Province in 2021

WU Bing-lun, ZHANG Rui, BI Hong-jie, LU Wei, HU Qian-qian, WANG Ju-zhong

2023, 39(3): 326-328.

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Objective To investigate the pollution status of pathogenic Vibrio in aquatic products in Cangzhou City，provide data support for the prevention and control of foodborne diseases and monitoring of food poisoning. Methods The samples of aquatic products in Cangzhou City in 2021 were collected by random sampling. According to the methods of National work manual for risk monitoring of food contamination and harmful factors，four kinds of pathogenic Vibrio were detected，the virulence genes of Vibrio cholerae and Vibrio parahaemolyticus were determined，and the Vibrio cholerae was serotyped. Results The pathogenic Vibrio was detected in 74 of 220 aquatic products，and the detection rate was 33.64%. The detection rate of Vibrio parahaemolyticus，Vibrio alginolyticus，Vibrio cholerae and Vibrio vulnificus was 22.73%，7.27%，2.73% and 0.91%，respectively. All 50 strains of Vibrio parahaemolyticus isolated carried the tlh genotype，but did not carry the tdh and trh genes. The six strains of Vibrio cholerae were non-O1/O139 group，and the ctx virulence gene was negative. Conclusions In 2021，there is pathogenic Vibrio contamination in some aquatic products in Cangzhou City，mainly Vibrio parahaemolyticus and Vibrio alginolyticus. The market supervision department should strengthen the supervision of various aquatic products to reduce the risk of foodborne diseases caused by pathogenic Vibrio.

Investigation on mental health status of psychological assistance hotline operators during COVID-19 epidemic and analysis of its influencing factors

JIANG Hua-dong, ZHUANG Rong, BAI Li-feng, ZHANG Meng-han, WANG Yi, SU Yan-li

2023, 39(3): 329-333.

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Objective To explore the work and mental health status of the psychological assistance hotline operatora in Xi'an City during Coronavirus Disease 2019（COVID-2019） epidemic，so as to provide evidence for carrying out the mental health intervention among the hotline operators under the situation of normalization of epidemic prevention and control. Methods From December 2021 to January 2022，128 hotline operators were investigated by general data questionnaire，Shaanxi Xi'an psychological assistance hotline operator questionnaire，Chinese perceived stress scale（CPSS），generalized anxiety scale（GAD-7），and patient health questionnaire 9（PHQ-9），and the data were analyzed. Results During the prevention and control of COVID-19 epidemic，the CPSS score of the operators of Xi'an psychological assistance hotline was （27.13±6.59）points，the GAD-7 score was （1.27±1.87）points，the PHQ-9 score was （1.45±2.27）points，and the job satisfaction score of the hotline was （8.61±1.06）points.There were statistically significant differences in the CPSS scores among operators with different number of calls answered in a working time（P<0.01）. The CPSS score of operators was positively correlated with the GAD-7 score and the PHQ-9 score（r=0.539，0.567，both P<0.01），and negatively correlated with the total score of hotline job satisfaction（r=-0.359，P<0.01）. The number of calls answered in a working time，the GAD-7 score，the PHQ-9 score and hotline job satisfaction were the influencing factors of the CPSS score（all P<0.01），which can explain 54.1% of the total variation. Conclusion Under the prevention and control of COVID-2019，the psychological pressure of the operators of the psychological assistance hotline in Xi'an City of Shaanxi Province is low，and it is necessary to pay attention to the related factors affecting the psychological pressure to promote the good development of the hotline work.

Construction of competency evaluation index system for medical nursing assistants

LI Tian, SHI Mei-xia

2023, 39(3): 334-338.

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Objective To construct the competency evaluation index system for medical nursing assistants in China. Methods Based on literature analysis，open questionnaire and semi-structured interview，the competency evaluation index system for medical nursing assistants was initially formulated. 21 experts were consulted by Delphi method in September-November 2021，and the index weight was calculated by analytic hierarchy process. Results The effective questionnaire recovery rates of the two rounds of expert consultation was 80.77% and 100.00%，the expert authority coefficient was 0.914 and 0.912 respectively，and the Kendall coefficient was 0.134-0.341（P<0.01），forming the competency evaluation index system including 5 first-level indexes，14 second-level indexes and 56 third-level indexes. The weights of the five first-level indexes of theoretical knowledge，operational skills，social ability，professional attitude and personal characteristics were 0.108 2，0.388 8，0.166 3，0.269 2 and 0.067 5，respectively. Conclusion The competency evaluation index system for medical nursing assistants is relatively scientific and reliable，which can provide reference for the training，assessment and evaluation of medical nursing assistants.

Chinese version of chronic disease health literacy questionnaire in Chinese population and its reliability and validity test in stroke patients

SUN Hui-jun, LIANG Qi-wen, ZHANG Jie

2023, 39(3): 339-345.

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Objective To introduce and sinicize the Health literacy questionnaire for chronic disease patients in China，explore its applicability in stroke patients. Methods From January to July 2019，539 stroke patients were selected by convenience sampling method in four grade-A tertiary hospitals in Shanghai，and were investigated by the simplified Chinese version of health literacy questionnaire for chronic disease patients in China. The simplified Chinese version questionnaire was formed by the item analysis，total-sub reliability，retest reliability，structural validity，aggregation and differentiation validity，and calibration correlation validity verification，and was verified in stroke patients. Results There were statistically significant differences in 13 items in the simplified Chinese questionnaire between high and low groups（all P<0.05）. The total-sub correlation coefficients were 0.317-0.442 （all P<0.01），and the Pearson correlation coefficient（PCCs） was 0.746（P<0.01）.The PCCs of retest reliability was >0.8. The kaiser-meyer-olkin measure of sampling adequacy（KMO） was 0.914，the exploratory factors were extracted，the chi-square of minimum discrepancy/degree of freedom（CMIN/DF）=1.544，root of the mean square residual（RMR）=0.024，comparative fit index（CFI）=0.969，normed fit index（NFI）=0.918，incremental fit index（IFI）=0.969，goodness-of-fit index（GFI）=0.804，root-mean-square error of approximation（RMSEA）=0.066. The standardized load values range was 0.702-0.991. The combination reliability of four dimensions was 0.980，0.868，0.918 and 0.936，respectively. The average variance extracted（AVE） amount of four dimensions was 0.803，0.623，0.742 and 0.787，respectively. The square root of AVE of the four dimensions in discriminant validity was 0.896， 0.789，0.861 and 0.887，respectively. The average score of health literacy level of stroke patients was （31.51±1.35）points，which was <36 points. Conclusion Health literacy questionnaire for chronic disease patients in China is suitable for stroke patients，and the health literacy of stroke patients is in the middle level.

Correlation analysis between nurses' adversity quotient and spiritual care competence

LUO Li-qun, WEN Xiu-lin, WANG Jing-rong, XIAO Qian

2023, 39(3): 346-350.

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Objective To understand the status quo of adversity quotient and spiritual care ability of clinical nurses，analyze the correlation between them，and provide basis for the development of effective training intervention program. Methods A total of 709 nurses from seven hospitals in Shaanxi Province were surveyed by convenience sampling from March to April in 2022 using general data questionnaire，nurses' adversity quotient self-evaluation scale and spiritual care ability scale. Results The total score of adversity quotient of 709 nurses was （130.98±34.95）points. The four dimensions were adversity control[（35.05±10.18）points]，adversity attributions[（22.42±6.34）points]，adversity influence[（41.05±11.75）points]，adversity tolerance[（32.46±10.42）points]. The total score of spiritual care ability was （70.88±12.99）points. The spiritual care ability of nurses was negatively correlated with the score of adversity quotient，adversity control，adversity attribution and adversity tolerance（reverse scoring）（r=-0.56，-0.52，-0.51， -0.48，-0.56，all P<0.01）. The multiple hierarchical regression analysis showed that the adversity quotient had an effect of 51.80% on spiritual care ability after controlling for general data. Conclusions The higher the level of adversity quotient，the stronger the spiritual care ability of nurses. The nursing educators and administrators should fully realize the necessity of training nurses' adversity quotient，actively explore the cultivation strategy of improving nurses' adversity quotient，so as to improve nurses' spiritual care ability，serve people's health，and improve patients' medical experience.

Study on correlation between family care，sense of life control and subjective well-being of rural elderly people in Dabie Mountain area

WU Min, MA Zu-chang, XIE Hui

2023, 39(3): 351-354.

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Objective To explore the present situation and influencing factors of subjective well-being of rural elderly people in Dabie Mountain area，analyze the correlation between family care，sense of life control and subjective well-being. Methods From December 2021 to February 2022，432 rural elderly people in Dabie Mountain area of Anqing City were selected by convenience sampling method. The general information questionnaire，family care index questionnaire，sense of control in life scale and University of Newfoundland happiness scale（MUNSH） were used for investigation. Results The total score of subjective well-being of 432 rural elderly people in Dabie Mountain area was（28.44±10.30）points，the total score of sense of family care index was （4.86±2.76）points，and the total score of life control was（19.01±4.73）points. The family care，sense of life control and subjective well-being were positively correlated（all P<0.01）. The older group and poor self-rated health were risk factors for subjective well-being of rural elderly people in Dabie Mountain area（all P<0.01）. Many children，high family care and high sense of life control were the protective factors of subjective well-being of rural elderly people in Dabie Mountain area（all P<0.01）. Conclusion The primary medical staff should actively carry out psychological nursing，encourage families to play a good family function，enhance the sense of life control of the elderly，and constantly improve the happiness of the elderly.

Analysis on change trend of premature death probability of major chronic diseases in Panyu District of Guangzhou City from 2013-2020

YOU Na, LIANG Xiao-xian, RUAN Hui-hong

2023, 39(3): 355-358.

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Objective To analyze the death of major chronic diseases and the probability of premature death of residents in Panyu District of Guangzhou City from 2013 to 2020，evaluate the completion of the goal of reducing the probability of early death. Methods The death data of registered residents who died from 2013 to 2020 in Panyu District were collected，to analyze the death situation，premature death probability and average annual change rate of four major chronic diseases，and estimate the achievement of control targets in 2025 and 2030 for the probability of premature death from four major chronic diseases. Results From 2013 to 2020，the premature death probability caused by four major chronic diseases in Panyu District decreased from 14.01% to 11.26%，the average annual decline rate was 3.07%，the premature death probability of major chronic diseases in males was much higher than that in females，and the premature death probability in malignant tumors and cardiovascular diseases was much higher than that in chronic respiratory and diabetes mellitus. Compared with 2015 baseline，at the current average annual rate of decline in the premature death probability，the malignant tumors，cardiovascular and cerebrovascular diseases，chronic respiratory diseases and total of four main chronic diseases in Panyu District can achieve control targets in 2025 and 2030. However，the risk of premature death in all gender and whole population diabetes and female malignant tumors are not up to the target. Conclusions Males are the key groups in the prevention and treatment of chronic diseases in Panyu District，while malignant tumors，cardiovascular and cerebrovascular diseases and diabetes are the key diseases of chronic disease prevention and control. It is necessary to improve the monitoring and intervention of related risk factors，actively carry out early diagnosis and early treatment，and reduce the premature death probability，so as to strive to successfully achieve the objectives of "China's medium and long term plan for the prevention and treatment of chronic diseases（2025） "and the outline of the "healthy China 2030" plan.

Investigation on sleep quality and emotional state of officers and soldiers in a warship

WANG Meng-meng, XU Jin, WANG Yi-hao, HAN Yi, LOU Biao-lei

2023, 39(3): 359-363.

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Objective To study the status of sleep quality and emotional state of navy officers and soldiers in warships，explore their correlation and influencing factors，so as to provide scientific basis for maintaining physical and mental health of navy officers and soldiers. Methods From December 2021 to January 2022，394 officers and soldiers in a naval warship of southeast coastal area of China were selected randomly as study objects，and the states of sleep，anxiety and depression of which were investigated by Pittsburgh sleep quality index（PSQI），generalized anxiety disorder-7（GAD-7） and patient health questionnaire-9（PHQ-9）. Results Among 394 navy officers and soldiers，166 objects（42.13%） had sleep disorders（PSQI>7 points），mainly including short subjective sleep time，long sleep latency，poor sleep quality and poor daytime function. Totally 122 objects（30.96%） had anxiety（GAD-7≥5 points） and 146 objects（37.06%） had depression（PHQ-9≥5 points）. In addition，sleep was related to objects' age，military age and ship age（all P<0.05），but not to their gender，marital status，educational level，military level and occupational category（all P>0.05）. The anxiety and depression were related to the age，military age，ship age，marital status and military level of officers and soldiers（all P<0.05），but not to the gender，educational level and occupational category of officers and soldiers（all P>0.05）. The sleep status of naval officers and soldiers was significantly correlated with anxiety and depression emotions（all P<0.01）. Conclusions The officers and soldiers in warships generally have poor sleep state，anxiety and depression emotions. The sleep status of them is affected by their age，military age and ship age，and is significantly correlated with anxiety and depression emotions. It suggests that the physical and mental health of officers and soldiers in warships，especially those with older age，longer military age and ship age，deserves special attentions synchronously. Advocating sleep guidance，psychological support and intervention，and strengthening the construction of ship medical services are conducive to maintaining the physical and mental health of officers and soldiers in warships.

Research on life education of the elderly in Zhaoqing City from perspective of active aging view

DAI Huang-yan, LUO Jing-bin, LIN Jing, ZHANG Qing-qing, CHEN Ke-yi

2023, 39(3): 364-369.

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Objective To investigate and analyze the status quo of active aging and life attitude of the elderly in Zhaoqing City and its influencing factors，explore the promotion path of life education for the elderly from the perspective of positive aging view，and provide ideas and methods for the follow-up research of life education. Methods From July to August 2021，433 elderly people in Zhaoqing City were surveyed and analyzed using the self-compiled general questionnaire，positive aging scale and self-compiled life attitude questionnaire. Results The total score of active aging of the elderly in Zhaoqing City was （113.13±16.71）points，the total score of life attitude was （61.18±5.76）points，all of which were above the middle level. There was statistically significant difference in the score of self-care ability among the elderly with different levels of education（P<0.05）. There was statistically significant difference in the score of active learning and social integration among the elderly of different age（P<0.05）. There were statistically significant differences in the score of establishing economic security among the elderly with different residence type，monthly pension and education level（all P<0.05）. There were statistically significant differences in the score of developing mental intelligence among the elderly with different pension and education level（all P<0.05）. There was statistically significant difference in the score of positive social contribution among the elderly of different age（P<0.05）. There was a significant positive correlation between active aging and life attitude（r=0.54，P<0.01），the higher the positive aging level，the more positive life attitude of the elderly. Conclusions Younger，living with spouse/children，higher monthly pension and higher education level are the protective factors of various dimensions of positive aging in the elderly. Applying the theory of positive aging view to the life education for the elderly can help them to actively deal with aging and aging life and cherish the value of life.

Research on influencing factors of medical staff loyalty based on structural equation model

XIAO Shu-ya, LIU Shan, TAN Lei, WANG Meng-hua, GAO Li, PU Xin-ming

2023, 39(3): 370-374.

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Objective To explore the influencing factors of medical staff loyalty in integrated traditional Chinese and Western medicine hospitals，as well as the relationship between "Western medicine learns traditional Chinese medicine" training，job satisfaction，traditional Chinese medicine professional quality and loyalty. Methods A random sampling survey method was used to conduct questionnaire investigation on 457 medical workers in two hospitals in Xinjiang that were deeply involved in the transformation of "Western medicine learns traditional Chinese medicine" by the job satisfaction questionnaire，the evaluation form of professional quality of traditional Chinese medicine，and the loyalty questionnaire of employees to hospitals，and the data were analyzed. Results Totally 457 medical workers completed the questionnaire（97 completed the "Western medicine learns traditional Chinese medicine" training，233 were in training，and the rest did not participate in the training），with an average loyalty score[M（P₂₅，P₇₅）] of 41（35，45）points. There were statistically significant differences in the loyalty of medical personnel with different academic qualifications，positions and "Western medicine learns traditional Chinese medicine" training situation（all P<0.01）. The "Western medicine learns traditional Chinese medicine" training had a positive impact on loyalty through the intermediary of professional quality of traditional Chinese medicine and job satisfaction. For the path with professional quality of traditional Chinese medicine as the only intermediary，the effect value was 0.106. For the mediated by the influence of professional quality of traditional Chinese medicine on job satisfaction，the effect value was 0.07，and the 95% confidence interval of Bootstrap test was >0，and paths work significantly. Conclusions The academic qualifications，positions and "Western medicine learns traditional Chinese medicine" training are the influencing factors of medical staff loyalty，and "Western medicine learns traditional Chinese medicine" training not only has a direct effect on loyalty，but also has an indirect effect on loyalty through the professional quality of traditional Chinese medicine and job satisfaction. Therefore，understanding individual differences，strengthening collaboration，and encouraging participation in "Western medicine learns traditional Chinese medicine" training can help increase the loyalty of medical staff.

Study on correlation between professional well-being，professional mission and professional commitment in outpatient nurses

YU Qing, JIANG Li-li, YIN Di

2023, 39(3): 375-379.

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Objective To explore the correlation between occupational well-being，occupational mission and occupational commitment of outpatient nurses in the Affiliated Qingdao Central Hospital of Qingdao University. Methods A cross-sectional survey method was used to select 43 outpatient nurses from the Affiliated Qingdao Central Hospital of Qingdao University by the convenience sampling in December 2021，and questionnaires were administered to them using the general information questionnaire，the medical staff professional well-being scale，the professional mission scale，and the professional commitment scale，respectively，to analyze the correlation between the professional well-being and professional mission of outpatient nurses and their professional commitment. Results The total score of the 43 outpatient nurses was （81.19±10.26）points in the occupational well-being scale，（39.82±4.51）points in the occupational mission scale，and （86.43±9.15）points in the occupational commitment scale. Pearson correlation analysis showed that outpatient nurses' occupational well-being and sense of professional mission were positively correlated with the level of occupational commitment（r=0.442，0.429，both P<0.05）. Univariate analysis showed that there were statistically significant differences in the occupational commitment scores among outpatient nurses with different age，professional title，personnel relationship and personal monthly income（all P<0.05）. Multiple regression analysis showed that professional title，personnel relationship and personal monthly income，physical and mental health，value/ability performance，economic income，meaning and value were the main influencing factors of outpatient nurses' professional commitment level（all P<0.05）. Conclusion The professional commitment of outpatient nurses in the Affiliated Qingdao Central Hospital of Qingdao University is at an intermediate level，and both professional well-being and professional mission are correlated with professional commitment，and are its main influencing factors.

Study on combined toxicity of three typical pollutants in water environment to marine luminescent bacteria

ZHANG Jian-jiang, LIU Jian-ling, CHEN Si-ping

2023, 39(3): 380-383.

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Objective To analyze the combined toxicity of three typical pollutants，including cyanogen（CN^-），mercury（Hg²⁺） and glyphosate，in water environment to marine luminescent bacteria. Methods The different concentrations of CN^-，Hg²⁺ and glyphosate were combined on pairwise mode in equal volumes to form a mixed solution. At the same time，3% NaCl solution was used as the blank control，and Photobacterium phosphoreum T3 variant was added. The luminosity of the samples and the blank control were tested with a biological toxicity tester，to calculate the luminescent loss rate，and the data were analyzed. Results There was statistically significant difference in the luminous loss rate caused by the combination of CN^- and Hg²⁺ at different concentrations（P<0.01）. The combination of CN^- and Hg²⁺ at the concentration of median effective concentration（EC₅₀），which reduced the luminescent rate of Photobacterium phosphoreum by 50%，resulted in the highest luminescent loss rate of （84.00±16.74）%. For the combinations of CN^- and glyphosate or Hg²⁺ and glyphosate，it also showed a similar trend（all P<0.01）. The luminous loss rate caused by the combination of CN^- and glyphosate at the concentration of EC₅₀ was （81.07±17.22）%，and the luminous loss rate caused by the combination of Hg²⁺ and glyphosate at the concentration of EC₅₀ was （82.47±19.73）%. Conclusions With the increase of the concentration of combined pollutants，the luminous loss rate also gradually increases. The luminous loss rate caused by the mixture of the two pollutants is greater than that caused by the two pollutants alone. Using marine luminescent bacteria to monitor and evaluate the toxicity of combined pollutants in water environment has certain advantages.

Study on influence of spiritual health on learning burnout in nursing college students

YANG Rui, XUE Cheng-jing, LI Jian-min, LI Hong-mei, ZHANG Jin-mei, WANG Yu-long

2023, 39(3): 384-388.

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Objective To explore the spiritual health level and learning burnout level in nursing college students，analyze the influence of spiritual health on learning burnout. Methods In March 2021，588 nursing students were collected from a medical college in Fenyang City of Shanxi Province by the random cluster sampling，and investigated by general information questionnaire，spiritual health scale and learning burnout questionnaire，and the data were analyzed. Results The detection rate of learning burnout among nursing college students was 22.62%，the total score of learning burnout was （51.42±10.08）points，the total score of spiritual health was（91.76±12.94）points，and there was a negative correlation between spiritual health score and learning burnout score（r=-0.320，P<0.05）. Hierarchical regression analysis showed that spiritual health could independently explain 28% of the total variation of learning burnout（P<0.05）. Conclusions The spiritual health and learning burnout in nursing college students need to be further improved，and the spiritual health can negatively predict learning burnout. The nursing educators can improve students' spiritual health from developing good interpersonal relationship，clarifying the meaning of life，correctly understanding themselves，improving the inverse quotient and ability to surmount adversity.

Analysis on status of health self-management ability and e-health literacy and their correlation among medical students

HAO Shuai-jia, TU Xiao-min, LIANG Shun-hua, LIU Ting

2023, 39(3): 389-394.

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Objective To understand the current situation of health self-management ability and e-health literacy among 515 medical undergraduates in a university at Qingdao City in Shandong Province，analyze their relationship，and provide a basis for improving the health self-management ability of college students. Methods Using the convenience sampling method，515 medical undergraduates enrolled in a university in Shandong Province were selected for a survey from July to September 2021，and the data were analyzed. Results The total score of health self-management ability among medical undergraduates in a university of Qingdao City was （150.66±23.71）points，the score of e-health literacy was （62.97±13.78）points，and the score of peer influence resistance was （27.56±3.71）points. The health self-management ability was significantly and positively correlated with e-health literacy and peer influence resistance（all P<0.05）. There were statistically significant differences in the overall health self-management ability among medical students in different major，gender，grade，nationality，place of origin，mother's education level，academic performance，health status，times of physical exercise，class hours，whether to be a student cadre，studying human health courses and participation in school community health activities（all P<0.05）. The gender，academic performance，being student cadre，health status in the past year，number of physical exercise per week，e-health literacy and peer influence resistance were the independent influencing factors of medical students' overall health self-management ability，which together explained 25.0% of the variance. Conclusion The health self-management ability among medical students in a university of Qingdao City is at an intermediate level and is influenced by multiple factors，so relevant departments should offer related courses，pay attention to the positive influence of e-health literacy in health self-management，and take advantage of the internet and peers in order to improve medical students' health self-management.

Study on correlation between readiness for inter-professional collaborative learning and hardiness personality of nursing undergraduates in a university in Jinan City

AN Ran, LI Shao-jie, YIN Yong-tian, LIU Guan-lin, SUN Tong, TANG Kai-xuan

2023, 39(3): 395-399.

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Objective To explore the current situation of preparation degree of the readiness for inter-professional collaborative learning and hardiness personality among nursing undergraduates，analyze the relationship between them，so as to provide reference for strengthening inter-professional collaborative learning education of nursing students in nursing colleges. Methods The convenience sampling method was used to select 739 nursing undergraduates from a university in Jinan City in November 2021. The questionnaire was carried out using general data questionnaire，readiness for inter-professional learning scale and college students' hardiness scale. Results The score of the readiness for inter-professional collaborative learning of nursing undergraduates was （74.55±8.45）points，and the score of hardiness personality was （72.21±12.49）points. The results of correlation analysis showed that hardiness personality and dimensions of toughness，control and engagement were negatively correlated with the dimensions of roles and responsibilities in the readiness for inter-professional collaborative learning（r=-0.150--0.075，all P<0.05）. The score of hardiness personality and all dimensions were significantly positively correlated with the score of the readiness for inter-professional collaborative learning and the dimensions of teamwork，negative professional identity and positive professional identity（r=0.181-0.531，all P<0.01）. The hardiness personality was negatively correlated with the dimensions of roles and responsibilities（r=-0.114，P<0.01）. The gender，grade，attitude to nursing specialty，resilience and challenge were the main influencing factors of nursing undergraduates' readiness for inter-professional collaborative learning（all P<0.01）. Conclusions The nursing undergraduates have a higher level of inter-professional collaboration learning and hardiness personality，and hardiness personality has a positive impact on the readiness for inter-professional collaborative learning. The nursing educators can develop special training courses to shape the hardiness personality of nursing students so as to further improve their inter-professional collaboration learning.

Effect of occupational noise on electrocardiogram of workers in China：A meta analysis

YANG Tao, HU Heng, DING Kun, GE Xu-hua

2023, 39(3): 400-404.

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Objective To systematically evaluate the effect of occupational noise on electrocardiogram（ECG） of workers in China. Methods Using "noise" and "electrocardiogram" as keywords，the correlation studies on the effect of occupational noise on ECG of Chinese workers published in CNKI，Wanfang，VIP，CBM and Pubmed databases from 2002 to 2021 were searched. Stata MP 16 software was used for meta-analysis. Results A total of 25 of literature were included in this study，with a total of 17 785 cases， 10 083 in the noise-exposed group and 7 702 in the control group. The combined effect size（OR） of abnormal ECG detection rate in noise exposure group and control group was 2.34，95%CI was 2.02-2.69（P<0.05）. After the heterogeneity test，six articles with greater heterogeneity were deleted. The results showed that the combined effect size（OR） of abnormal ECG detection rate in noise exposure group and control group was 2.14，95%CI was 1.93-2.37（P<0.05），moreover，the incidence of sinus arrhythmia，conduction abnormalities，cardiac hypertrophy，high voltage，and ST-T changes in the exposure group was higher than that in the control group（P<0.05）. Conclusion Noise exposure is the risk factors of abnormal electrocardiogram in workers in China，it is necessary to strengthen the protection of workers' noise exposure and conduct regular health examination.

Visualization analysis of occupational safety research trend based on CiteSpace

QIAO Wan-guan, LIU Quan-long, CHNE Xue

2023, 39(3): 405-409.

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Objective To analyze the current situation in the field of occupational safety by using the scientific knowledge map，intuitively reflect the research hotspot and development trend in the field of occupational safety，and provide reference for the follow-up research in the field of occupational safety. Methods Based on 12 067 occupational safety papers collected in Web of Science database from 2009 to 2019，the visualization analysis was conducted by the literature visualization software CiteSpace V to study the research areas，institutions，word frequency and hot spots in the field of occupational safety. Results The top two countries with the highest volume of articles in the field of occupational safety from 2009 to 2019 were the United States（4 334 articles） and Canada（953 articles）. The top two institutes with the highest volume of articles were the National Institute of Occupational Safety and Health of the United States and the University of Toronto of Canada，with 507 and 248 respectively. The journals with the highest source centrality were the American Journal of Medicine and Environmental and Occupational Health. The research hotspots mainly focused on legislation，government supervision and other fields. Conclusion The number of occupational safety literature shows a rapid growth trend，and the research in the fields of occupational safety technology and behavioral safety has also begun to become a hot spot.

Effect evaluation of front line field epidemiology training in Tianjin

DU Ying, CHEN Ruo-nan, YU Jie, XU Ying

2023, 39(3): 410-413.

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Objective To evaluate the effectiveness of Tianjin front line field epidemiology training program（TJFETP） which the grassroots epidemic prevention and control capacity improvement project carried out two phases in 2021，understand the problems and needs，and provide reference for the future carrying out the front line field epidemiology. Methods The students who participated in TJFETP in 2021 were selected as the survey object. The basic information of the trainees，their satisfaction with the training work and teachers，their knowledge before and after the training，and their ability improvement before and after the training were collected through questionnaires，to evaluate the effectiveness of training. Results The trainees' overall satisfaction with the theoretical teaching was 98.30%，satisfaction with the schedule was 94.87%，satisfaction with the content was 98.30%，and satisfaction with the teaching form was 98.29%. The satisfaction with theoretical teachers was 97.32%，with the practical teachers was 97.44%. The scores of tests in different stages increased from （66.85±14.90） and （71.79±8.70）points before training to （77.95±11.74） and （74.23±6.23）points after training. The defense score increased from （73.59±10.06）points in the preliminary defense to （80.18±2.96）points in the formal defense. Among the five core competencies，the awareness of making public health policy based on the results of monitoring analysis increased from （4.69±1.56） before training to （7.41±1.77）points，the ability of collecting，analyzing and interpreting monitoring data increased from （5.64±1.58） to （7.69±1.59）points，the ability of improving the quality and utilization of disease and outbreak surveillance data increased from （5.31±1.45） to （7.69±1.66）points，ability of sharing and dissemination the public health information increased from （4.87±1.58） to （7.49±1.67）points，and the ability of responding to case investigation and outbreak investigation of public health events increased from （5.54±1.79） to （7.85±1.66）points. Conclusions The front line field epidemiology training is beneficial to improve and supplement the field epidemiology training system in China. The front line field epidemiology training in Tianjin has a good effect，which plays an obvious role in improving the field epidemiology ability of professional and technical personnel in local centers for disease control and prevention.

Grey correlation analysis on attractiveness to high-level talents in Nantong Center for Disease Control and Prevention

JIANG Ye, YAO Yu-nan, CHEN Yu-jie

2023, 39(3): 414-417.

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Objective To study the changing trend of talent structure in Nantong Center for Disease Control and Prevention（CDC） from 2015 to 2020 and the attractiveness to foreign high-level talents，so as to optimize the structure and stability of disease control talents. Methods The grey correlation analysis method is used to analyze the influencing factors of the attractiveness to high-level talents in Nantong CDC from 2015 to 2020. Results There was a strong positive correlation between the development level and the attractiveness to high-level talents of Nantong CDC. The correlation between the proportion of people with master degree or above and the attractiveness to high-level talents was 0.984，ranking first. The correlation between average annual per capita salary and the attractiveness to high-level talents was 0.938，ranking second. There was a strong positive correlation between local gross domestic product（GDP） of Nantong City the attractiveness to high-level talents，which the correlation was 0.921， ranking third among all factors. The attractiveness to high-level talents was not strongly related to the personnel mobility. The grey correlation of the retired and new recruits to the attractiveness of high-level talents in Nantong City was 0.657 and 0.737 respectively， ranking eighth and ninth respectively. Conclusion It is necessary to improve the personnel training system and enhance the attractiveness to preventive medicine to talents，implement the subsidy for disease control personnel and gradually improve the salary of public health personnel，aim at the frontier of science and technology and build a first-class disease control brand.

Analysis on current situation and demand forecast of health technicians in Sichuan Province

ZHOU Ming-hua, TAN Hong, HE Si-zhang

2023, 39(3): 418-423.

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Objective To forecast the demand for health technicians in Sichuan Province，provide scientific basis for the rational planning of health technicians in Sichuan Province. Methods The manpower to population ratio method，manpower economic ratio method and manpower health expenditure ratio method were used to predict the number of health technicians. The predicted number and the actual number were statistically tested and the most accurate method was selected for prediction. Results The number of health technicians predicted by manpower to population ratio method，manpower economic ratio method and manpower health expenditure ratio method was not significantly different from the actual number，and the three prediction methods were all feasible.Through comparison，it was found that the difference between the actual value and the predicted value of the manpower economic ratio method was smaller，and the prediction was more accurate.According to forecasts，there will be 856 036.85 health technicians in Sichuan Province in 2025. From the perspective of professional classification，in 2025，there be 288 368.11 practicing（assistant） physicians，456 907.75 registered nurses，34 745.43 pharmacists and 94 948.95 other personnel，and the ratio of doctors to nurses will reach 1 ∶ 1.58. From the perspective of the classification of institutions，the number of health technicians，practicing（assistant） physicians，registered nurses，pharmacists and other personnel in primary medical and health institutions in 2025 will be 257 031.60，107 976.88，123 630.06，11 165.39 and 28 857.43，respectively，and the ratio of doctors to nurses will reach 1 ∶ 1.14. From the perspective of the classification of hospitals，in 2025，there will be 125 790.24 health technicians，37 194.35 practicing（assistant） physicians，68 975.33 registered nurses，5 865.25 pharmacists and 14 607.72 other personnel in secondary hospitals. Conclusions The growth rate of health technicians is inconsistent，the professional category structure is unreasonable，the distribution of different types of institutions is uneven，and the allocation of health technicians in different levels of hospitals is inconsistent.It is necessary to clarify the functional positioning of secondary hospitals，strengthen the training of health technical personnel，and focus on strengthening the construction of nursing staff in primary medical and health institutions and practicing（assistant） physicians in professional public health institutions.

A review on effect of paints exposure on incidence of lung cancer

HU Wen-yan, QIN Qin, ZHU Zi-wei

2023, 39(3): 424-427.

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Globally，the incidence and death of lung cancer are on the rise，posing a great threat to human health.m Paints are applying widely，which contain a variety of the chemical composition of carcinogenicity，thus to explore the paint exposed in the etiology of lung cancer may appear very important. We review the research progress of relationship between exposure and the incidence of lung cancer at home and abroad so as to improve our understanding of the paint carcinogenicity，strengthen the paint protection measures and reduce the incidence of lung cancer in the future.

Research progress on post-traumatic growth of nurses

ZHANG Ben-yan, LI Guo-rong, GAO Jing, CAO Meng-ke, WANG Yu, XU Cui-ping

2023, 39(3): 428-432.

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Nurses often experience or witness trauma in the workplace，and the pressure they face at work will exacerbate the related effects of trauma. In this process，the positive psychological change that nurses produce is post-traumatic growth. The level of post-traumatic growth affects the physical and mental health of nurses and the completion of their work. Understanding the post-traumatic growth of nursing professionals can guide interventions to improve professional well-being. This article reviews the concept，present situation and assessment tools of nurses' post-traumatic growth，and introduces the influencing factors of nurses' alternative trauma and interventions to improve post-traumatic growth，so as to improve the attention of nursing managers to the post-traumatic growth of nurses and provide reference for relevant research.

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