Objective To investigate the current status of death coping ability, death attitude and stress state among emergency department nurses, and to analyze the relationship between the three. Methods Participants were selected using the convenience sampling method from emergency department nurses working at five tertiary hospitals in Chongqing between December 2024 and January 2025. Data were collected using a general information questionnaire, the Coping with Death Scale, the Chinese version of the Death Attitude Profile-Revised, and the Chinese version of the Perceived Stress Scale. Results A total of 246 valid questionnaires were retrieved. The average total score of death coping ability among emergency department nurses was (136.93±26.98), which fell into the moderate level based on the Coping with Death Scale classification criteria. Neutral acceptance was the predominant death attitude, with an average item score of (3.71±0.62), accompanied by the polarizing feature of coexisting death avoidance and death fear. The average total score of perceived stress was (26.19±5.61), indicating a state of stress overload. The results of hierarchical multiple linear regression analysis showed that age, neutral acceptance, approaching acceptance, educational background, and sense of loss of control had an impact on death coping ability (P＜0.05). Conclusion It is recommended to construct a three-level intervention system encompassing death education, stress management skills training, and individualized psychological support, so as to enhance emergency department nurses’ death coping ability and occupational mental health.
ObjectiveTo analyze the epidemiological and clinical characteristics of severe cases of coronavirus disease 2019 (COVID-19) in order to provide reference for clinical diagnosis and treatment.MethodThe epidemiological histories, clinical characteristics, laboratory examinations, chest images, and treatment outcomes of 20 confirmed cases of severe COVID-19 admitted to Public Health Clinical Center of Chengdu from January 16th to February 5th, 2020 were retrospectively analyzed.ResultsAmong the 20 patients with severe COVID-19, 12 were male and 8 were female. The age ranged from 34 to 84 years old, with an average of (57.4±16.5) years old. Thirteen patients (65.0%) had one or more co-existing diseases, such as hypertension (9 cases), diabetes (6 cases), and coronary atherosclerotic heart disease (4 cases). Eleven cases (55.0%) had a history of living or traveling in Wuhan, 4 cases (20.0%) had a history of living in non-Wuhan areas of Hubei Province, 3 cases (15.0%) had a history of contact with confirmed COVID-19 patients, while 2 cases had no above-mentioned epidemiological history, but had a history of traveling in non-epidemic areas. The main symptoms were fever (100.0%), cough (100.0%), shortness of breath (75.0%), and fatigue (65.0). Some patients developed into acute respiratory distress syndrome in 3-10 d after onset. The white blood cell count of the patients was normal or decreased, the hypersensitive C-reactive protein and serum amyloid protein significantly increased, while the CD4+ T lymphocyte count and CD56+ natural killer cell count significantly decreased. Sixteen patients (80.0%) were given transnasal hyperbaric oxygenation [among whom 6 patients (30.0%) were transferred to non-invasive ventilator after no improvement], 3 patients (15.0%) were given tracheal intubated ventilator, and 1 patient (5.0%) was treated by tracheal intubated ventilator combined with extracorporeal membrane oxygenation to support breathing. By April 8th, 2020, 3 patients died and the remaining 17 had been cured and discharged, with an average length of hospital stay of 21.4 d. The 3 death cases were all elderly with underlying diseases such as heart disease and pulmonary disease.ConclusionsSevere COVID-19 is associated with hypertension, diabetes, heart disease, and other basic diseases, and some patients develope acute respiratory distress syndrome. Respiratory support may help to improve prognosis.