COVID-19 infection can cause psychological distress and profoundly impact patients’ lives, but it can also lead to positive changes and post-traumatic growth (PTG), or positive psychological change in response to challenging life circumstances. Current research on the influence of COVID-19 infection has mainly focused on its negative effects. Therefore, the aim of this study was to investigate whether patients with COVID-19 in China experienced PTG and, if so, what changed for them during the process of PTG. We used a qualitative descriptive approach to conduct this study. Using the purposive sampling recruitment method, patients with a confirmed COVID-19 diagnosis were recruited from a COVID-19 designated hospital in Shanghai, China, from April to July 2020. Data were collected using semi-structured, in-depth interviews conducted via cell phone or in person while social distancing to prevent the spread of COVID-19. Forty confirmed COVID-19 patients (19–68 years old) were recruited. Several prominent themes and subthemes were extracted from the interview responses regarding participants’ experiences of PTG. The following are among the positive changesthat occurred for these participants after their diagnosis of COVID-19: (1) Reevaluation of their life priorities, which included a greater appreciation of being alive and re-evaluating their values and goals, (2) Improved relationships within their social circles, which included establishing or maintaining closer relationships with family and friends and a greater willingness to help others, and (3) Perceived changes regarding themselves, which included personal growth and increased awareness of the importance of their health. The study identified potential positive impacts of COVID-19 on patients, which could be helpful in the implementation of interventions to facilitate PTG among COVID-19 survivors.

The aim of this study was to describe the resilience of nurses who cared for patients with a confirmed COVID‐19 diagnosis, as well as factors that potentially contributed to that resilience. A total of 23 frontline nurses who cared for patients with COVID‐19 were recruited from a COVID‐19–designated facility in Shanghai, China, using purposive sampling strategies. In‐depth interviews were conducted from March to May 2020. Qualitative data were transcribed verbatim and content analysis was used. Nurses exhibited psychological resilience while caring for patients with COVID‐19. They displayed an ability to bounce back from negative mental experiences and transform to a positive mindset to cope with the stress they faced. Factors that enhanced the nurses' resilience during the pandemic were their becoming familiar with infectious disease protocols, having a sense of professional achievement, receiving social support, having trust in the infection‐control response team in the hospital, and using self‐regulation strategies. This study could guide the design of future resilience‐enhancing interventions that provide positive coping strategies for nurses caring for individuals with infectious diseases during a pandemic.

China is experiencing a rapid increase in the number of HIV-infected women. In this study, we describe the development and preliminary evaluation of an intervention tailored for Chinese HIV-infected women and caregivers to improve their self- and family management, with goals of enhancing their physical quality of life (QOL) and decreasing their depressive symptomatology. Forty-one HIV-infected women and their caregivers were recruited from two premier Chinese hospitals from July 2014 through March 2016. Participants were randomized to either the control or intervention arm for the Self- and Family Management Intervention (SAFMI). Each study dyad in the intervention arm received three counseling sessions with a nurse interventionist. At baseline, immediate post-intervention (month 1) and follow-up (month 3), the participants were assessed by a self-reported survey. Generalized Hierarchical Linear Modeling was used to evaluate the efficacy of the intervention. Chinese HIV-infected women in the intervention arm had significantly higher probability of higher physical QOL at month 1 and lower probability of clinically meaningful depressive symptomatology at month 3 compared with women in the control arm. In contrast, the effects of the intervention were less salient for caregivers. This study represents one of the first in China to include family caregivers in HIV management. Feasibility and acceptability were high, in that family members were willing to join the study, learn about HIV, and practice new skills to support the HIV-infected women in their lives. A larger trial is needed to fully evaluate this intervention which shows promising preliminary effects in promoting physical QOL and decreasing depressive symptomatology among Chinese HIV-infected women.

Aim: To understand COVID patients’ experiences of and perspectives on disclosure of their illness and to explore and describe the factors affecting disclosure decisions among COVID patients in China.Background: Disease disclosure is a critical component of prevention and control of a virus outbreak, and this is especially true during the COVID‐19 pandemic. Understanding COVID patients’ experiences and perspectives on disclosure could play a vital role in COVID management.Design: A qualitative study.Methods: A semi‐structured interview guide was used to conduct qualitative in‐depth interviews from April to June 2020. All the interviews were audio‐recorded and transcribed, and then, a thematic analysis was conducted. The Standards for Reporting Qualitative Research (SRQR) were applied to this study.Results: A total of 26 COVID‐confirmed patients were recruited for the in‐depth interviews. Four themes emerged from the thematic analysis on disclosure: persons disclosed to, reasons for disclosure, reasons for nondisclosure and impact of disclosure. The participants disclosed their COVID diagnosis to different groups, including family, close friends, community members and workplace contacts. The main reasons for disclosure included the following: government policy, social responsibility, gaining support and fear of being blamed for nondisclosure. However, some participants decided not to disclose to some groups for fear of facing stigma and discrimination or to protect family members from discrimination. Despite the potential benefits of obtaining support after disclosure, many participants did experience stigma and discrimination, privacy exposure, psychological distress and social isolation.Conclusions: An individual's decision as to whether to disclose their COVID‐positive status is affected by many factors. To prevent the spread of COVID‐19 and reduce the potential risks of disclosure, such as discrimination and privacy exposure, a balanced intervention should be designed to protect COVID patients and to secure any contact tracing. Therefore, the chances of discrimination could be decreased and patients’ confidentiality could be protected.Relevance to Clinical Practice: As the number of COVID patients increases, disclosure of an individual's infectious status is encouraged by health departments. Despite the potential benefits of disclosure, discrimination and privacy exposure should not be ignored. A disclosure protocol is necessary to ensure patients’ privacy regarding their COVID status.

In China, there are currently an estimated 180,000 women between 16 and 45 years of age living with HIV. However, we know very little about their lived experiences. Given the spread of the AIDS epidemic in China and the burden it exerts on quality of life, there is an urgent need to understand how HIV affects Chinese women, particularly in the context of their marriages. How do they negotiate the extreme stigma of their illness in making decisions about disclosure and social support, especially in the context of their family life? We recruited 26 Chinese women with HIV in Beijing and Shanghai for in-depth interviews employing a phenomenological approach. We examined the process and outcomes of disclosure within the course of the women's search for social support. Women in HIV-discordant relationships often experienced a termination of their marriage after disclosure, yet others exhibited remarkable resilience, finding new strength through the challenge of their illness. Findings underscore the need for accessible and culturally acceptable interventions for Chinese women with HIV who face considerable stigma in their search for support.

Aims and objectives: This study explores how sleep and energy levels were affected in Chinese women diagnosed with HIV in China employing the Actiwatch actigraphy system to collect data on the women's sleep characteristics.Background: The worldwide AIDS pandemic, a major impetus behind the recent focus on global aspects of health, is one area in which the behavioural and biomedical expertise of nursing science is sorely needed. In particular, few studies of HIV+ women have examined the association of HIV‐related stress with sleep disturbance and fatigue. Especially, fatigue and sleep disturbances are a common complaint among people with HIV.Design: A qualitative study with actigraphy device used.Methods: In‐depth interviews were conducted with 19 HIV+ women in Shanghai, China, from December 2009–March 2010 and within this group, nine of the women agreed to wear an Actiwatch actigraphy device for 72 hours.Results: Two major themes emerged from the in‐depth interviews are as follows: sleep disturbance and fatigue. Participants presented varying amounts of sleeplessness, and fatigue resulting from nightmares, worrying about whether to disclose their diagnosis, and whether they might transmit the disease to their partners or children. Among the nine Actiwatch study participants, data shown that those who experienced fragmented sleep also slept more during the daytime.Conclusions: In this study, Chinese HIV+ women described how stress had caused them to become sleepless. The objective data collected via Actiwatch showed that these women required longer nap times, which indicates they did not have refreshing nocturnal sleep. Designing a culturally acceptable stress management intervention for these women is urgently needed.Relevance to clinical practice: Sleep and fatigue level should be evaluated in each visit with HIV care. Nurses need to be trained in evaluating the HIV+ patients' sleep and fatigue status and refer them to psychologist and/or relaxation technique accordingly. Self‐management intervention for HIV+ individuals should also include the sleep hygiene into consideration.