The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all (clients and staff) while at the same time curtailing the individual's autonomy. This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy, beneficence, nonmaleficence, and ethical theories. Given that nursing workforce was limited and workload among psychiatric nurses was heavy, physical restraint was one of the coercive interventions managing aggressive behavior. In relation to address ethical dilemmas, it was proposed to acquire informed consent of physical restraint from the individuals and provide person-centered care. Effective communication and negotiation with patients could help to strike a balance between patients' autonomy and nurses' accountability when using physical restraint. In addition, guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint. Finally, a collaboration among nurses, psychiatrists, and families is essential to protect patients' autonomy concerning physical restraint use.

Objective: The aim of this study is to investigate the mediating effect of self-efficacy between diabetes-related distress and self-management in empty-nest elderly patients with type 2 diabetes mellitus (T2DM).
Methods: A total of 347 empty-nest elderly patients with T2DM from Jiangsu Province Hospital of Chinese Medicine and Affiliated Hospital of Yangzhou University were investigated by a self-designed General Information Questionnaire, the Self-efficacy for diabetes, the Diabetes Distress Scale, and the summary of diabetes self-care activities. Diabetes-related distress and diabetes self-management were tested for correlation analysis with self-efficacy. Meditational analyses were conducted to test the hypothesized mediating effects of diabetes self-efficacy as an intervention variable between diabetes distress and self-management.
Results: About 68.59% of patients suffered from diabetes-related distress. The results of bivariate correlations revealed that self-efficacy was negatively correlated with diabetes-related distress (r =–0.627, P < 0.01) and positively correlated with self-management (r = 0.356, P < 0.01). The relationship effects of diabetes distress on self-management were fully mediated by self-efficacy.
Conclusions: Diabetes-related distress prevails in empty-nest elderly patients with T2DM. Self-efficacy plays a mediate role between diabetes-related distress and self-management. Psychological intervention is contributed to reducing diabetes-related distress.

Background: Globally, there is a high demand for nurses, resulting in migration from low-to high-income countries. The emigration of nurses is the act of leaving one's own country to settle permanently in another country, leading to a shortage in the number of nurses in their home countries. Consequently, this study aims to assess the impact of the emigration of nurses on the health-care delivery system in Nigeria.
Materials and Methods: A descriptive cross-sectional survey was conducted with a stratified sampling technique to select 270 nurses from three selected hospitals in Benin-city Edo state. A self-structured questionnaire with open and Likert scale questions were used as an instrument to assess the Impact of the Emigration of nurses on the Health Care Delivery System. Data collected were analyzed using tables, percentages, means, standard deviation and t-test.
Results: The result showed a mean score of 1.59 ± 0.92 impacts of the emigration of nurses on health-care delivery system and identified how to reduce it. The study also showed that there is no significant difference between gender and reason for emigration among nurses (t = 3.84, P ≤ 0.001).
Conclusion: The emigration of nurses is severely affecting the health care delivery system in the country. Recently, the Nursing and Midwifery Council of Nigeria gave the directive for training schools to increase their training capacity and number of students' intake to cushion the effect, and this study shows that this palliative can only be a short time measure, and however will encourage more nurses traveling abroad on the long run. Therefore, the hospital managers and government should provide a conducive working environment, better remuneration, attractive retirement benefit, and other incentives as a push in factor for nurses to stay back in their home countries.

Objective: The objective of this study is to analyze the current status of nursing research in COVID-19 through literature metrology and provide ideas and references for further research.
Methods: The search terms such as “novel coronavirus/COVID-19” and “nursing” were used to search the nursing-related papers published in China National Knowledge Infrastructure, Wanfang Data, VIP Data, SinoMed, Web of Science, and PubMed from October 1, 2019, to March 30, 2020. The bibliometric methods and related software were used for analysis.
Results: A total of 234 articles were included from 48 journals, and core journals accounted for 61.1%. There were five nursing literature topics and 14 document types. There is a cooperative relationship between six institutions. Keywords include nursing staff, nursing management, and protection.
Conclusions: The opening of journal green channels and the establishment of database columns will help the spread of anti-epidemic academic results. The topics of nursing literature include clinical nursing, nursing management, prevention and control, nursing education, and social surveys. Nursing literature types focus on cross-sectional research and experience summary; the cooperation between researchers and research institutions has begun to take shape, and it is recommended to strengthen the research on iatrogenic injuries and nurse training in future nursing research.

Objective: The objective of the study is to explore the effect of flapping-meridians combined with thunder-fire moxibustion in the treatment of upper limb dysfunction after stroke.
Materials and Methods: This randomized, single-blind, controlled trial included 140 patients with stroke. According to the random number table, the patients were divided into four groups: the control group (receiving conventional nursing alone), the intervention group 1 (receiving conventional nursing combined with flapping-meridians), the intervention group 2 (receiving conventional nursing combined with thunder-fire moxibustion), and the intervention group 3 (receiving conventional nursing, flapping-meridians, and thunder-fire moxibustion). All four groups were intervened 4 weeks, 6 days a week. The outcome indicators (Fugl-Meyer Assessment of the upper extremity and body mass index of shoulder abduction, elbow extension, and wrist flexion) were assessed at the beginning and the end of treatment.
Results: The effect of the intervention group 3 was better than that of the intervention group 2, intervention group 1, and control group (P < 0.05).
Conclusion: The flapping-meridians combined with thunder-fire moxibustion can significantly improve the upper limb motor function and muscle strength of stroke patients with hemiplegia, and its effect is better than that of single treatment.

Objective: The objective of this study is to investigate the effect of scraping therapy in the treatment of knee osteoarthritis.
Materials and Methods: A total of eighty patients with knee osteoarthritis were assigned to the moxibustion group and the scraping therapy group according to the random numerical table method, with forty cases in each group. Patients in both two groups received functional exercise and moxibustion therapy, and those in the scraping therapy group were supplemented with scraping therapy. The serum indexes of interleukin-1 (IL-1), IL-6, tumor necrosis factor-alpha (TNF-α), and superoxide dismutase (SOD) were detected before and after the treatment. The clinical syndrome integral and Visual Analog Scale (VAS) on pain of patients were assessed. The clinical therapeutic efficacy was evaluated and compared between the two groups.
Results: Patients in the scraping therapy group received better outcomes of serum IL-1, IL-6, TNF-α, and SOD compared with those in the moxibustion group at 2 months after treatment (P < 0.05). The scores of clinical syndrome integral and VAS on pain were decreased in two groups at 2 months after the treatment and were lower in the scraping therapy group than those in the moxibustion group (P < 0.05). The overall effective rate in the scraping therapy group was higher than that in the control group (87.50% vs. 67.50%, P < 0.05).
Conclusion: The scraping therapy is potentially effective to ameliorate the clinical symptom and pain degree of patients with knee osteoarthritis.

Objective: The objective of this article is to investigate the competence of Central Sterile Supply Department (CSSD) staff in insulation testing on electrosurgical instruments, to analyze the needs of training for CSSD staff, and also to strengthen the effectiveness of monitoring the insulation testing on electrosurgical instruments for CSSD staff to provide a reference for the nursing safety training.
Materials and Methods: A total of 180 CSSD staff from 36 hospitals were enrolled as the research objects and investigated using “self-assessment questionnaire of the competence in insulation testing on electrosurgical instruments and the needs of training”.
Results: The overall self-assessment score of competence in insulation testing on electrosurgical instruments for CSSD staff is 3.10 ± 0.42, including four dimensions which are attitude, system, cognition, and skills with the scores 3.31 ± 0.55, 2.80 ± 0.63, 2.74 ± 0.68, and 3.03 ± 0.36, respectively. Based on the survey of training needs for CSSD staff, the top three ranked training needs are trace management record of insulation testing on electrosurgical instruments (93.89%), disposal procedures for insulation damage of electrosurgical instruments (92.78%), and adverse events caused by leakage of electrosurgical instruments (80.55%).
Conclusion: The competence of insulation testing for CSSD staff is at a low level by overall. The competence of CSSD staff could be improved by analyzing the needs of training, establishing a systematic training system, and taking effective training action, thus ensuring the safety of patients and medical personnel.

The coronavirus disease (COVID-19) has claimed thousands of lives. The patients have been quarantined and treated in special shelter hospitals, and mild illness accounts for the majority of the total number of patients. This article reports one case of the first batches of infected medical staff, who got infected with 2019 novel coronavirus and later discharged 2 weeks after receiving treatment and nursing care in Wuhan Union Hospital. Considering all aspects of the patient's hospitalization, the patient was performed ward environment management, medical nursing, symptomatic treatment, nutrition management, vital signs monitoring, observation and nursing, psychological assessment and support, and infection protection and management. As the earliest successful case of cure, the patient's manifestations are classical and common. Moreover, we hope to share it with colleagues to fight against COVID-19 for reference. The treatment and nursing guidelines can be applied to treat a large number of mild cases, thus improving the discharge rate of patients and reducing the pressure of epidemic situation.