Introduction Frontline healthcare providers are redeployed to areas outside their clinical expertise and assigned high-loading workload to address the surge of patients with each coronavirus outbreak. Their importance in crisis is not in doubt. However, they experienced considerable physical distress and psychological stressors, even leading to psychological illness and infection in this environment. There is an urgent need to accurately, comprehensively and objectively understand their experiences, perceptions and current situation of burnout, post-traumatic stress disorder (PTSD), anxiety, depression, insomnia and coronavirus infection. Therefore, this protocol is to conduct a mixed-methods systematic review to summarise the evidence on the experiences of healthcare providers and impacts of the coronavirus on their psychological status and infection during the pandemics. Methods Published studies on experience, perspective, impact, burnout, PTSD, anxiety, depression, insomnia, and infection of healthcare providers with SARS, Middle East respiratory syndrome and COVID-19, and written in English and Chinese will be accepted. Databases (MEDLINE, EMBASE, CENTRAL, Web of Science, PubMed, Psychology Information, WanFang and SinoMed) from inception until 30 July 2020 will be searched. Two reviewers will select, screen, extract data and assess the risk of bias independently. Risk of bias of results will be using the Mixed-Methods Appraisal Tool. Using a convergent integrated approach on qualitative/quantitative studies, we will synthesise qualitative and quantitative data separately. The incidence and number of cases about burnout, PTSD, anxiety, depression, insomnia and coronavirus infection among medical staff will be extracted. Then we will transform quantitative data to synthesise narrative findings. This protocol will be reported per the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Ethics and dissemination Ethical assessment is not required due to the nature of the proposed systematic review. Findings of our research will be disseminated at conferences related to this field and through publication in peer-reviewed journals. PROSPERO registration number CRD42020198506.

Background: Coronary heart disease has a high incidence rate, a high mortality rate, a high recurrence rate, and a high medical cost. In addition, some patients need to undergo percutaneous coronary artery stent implantation (CASI), which is a kind of traumatic treatment. Patients can easily experience negative emotions such as anxiety and depression after surgery, which seriously affects quality of life.Objectives: The aim of this study was to evaluate the effectiveness of an empowerment-based telephone follow-up intervention on resilience and quality of life in patients who underwent CASI.Design: The design of the study is a randomized controlled trial.Methods: A total of 92 patients were recruited after CASI from the Internal Medicine Cardiovascular Department of a Grade A tertiary hospital in Xi’an, China. The patients were randomly divided into a control group and an intervention group. The control group performed routine care, whereas the intervention group developed a telephone follow-up program based on empowerment theory while carrying out routine care. Patients were investigated using the coronary heart disease-related knowledge questionnaire, the Connor–Davidson Resilience Scale (CD-RISC), and the 36-Item Short-Form Health Survey (SF-36) to compare the effects of the intervention before and after 1 month of intervention.Results: After a 1-month telephone follow-up intervention based on the empowerment theory for patients after CASI, the variations in knowledge related to coronary heart disease and all of its subscale scores were greater in the intervention group than in the control group. Except for the three dimensions of risk factor, induction factor, and rehabilitation-related knowledge, the variations in knowledge related to coronary heart disease and the other subscale scores were significantly different between the two groups (p < 0.05). The variations in resilience and scores on the three subscales in the intervention group were greater than those in the control group, and the difference between the two groups was statistically significant (p < 0.05). The variations in the quality of life and overall health, emotional functions, and social functions were significantly greater in the intervention group than in the control group (p < 0.05).Conclusions: A telephone follow-up intervention based on the empowerment theory can effectively improve the resilience and quality of life of patients after CASI. This follow-up approach can provide a theoretical basis and practical reference for hospitals and communities to carry out targeted continuing nursing for patients after CASI. The long-term effects of the intervention and its underlying mechanisms require further study.Clinical trial registration: http://www.chictr.org.cn/showproj.aspx?proj=173682, identifier ChiCTR2200064950.

Background: Exercise training has a lot of potential benefits for hemodialysis patients. And some guidelines emphasize the importance of exercise for maintenance hemodialysis. However, there are many barriers to encourage hemodialysis patients to increase their level of physical activity. A broader understanding of the specific barriers is needed. Methods: MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, PubMed, CBM, CNKI, and WangFang will be searched electronically. The Reference lists of included studies will be retrieved manually. If the study is designed with qualitative or mixed methods and directly explores the factors related to the exercise of dialysis patients, the study will be selected. The Critical Appraisal Skills Programme Qualitative Checklist will be applied for the study appraisal. The study search, selection and evaluation of the study will be conducted by 2 independent reviewers. Thematic synthesis will be used for synthesizing the findings of the primary studies. Results: This study will provide a high-quality synthesis to examine the barriers and facilitators affecting exercise in hemodialysis patients from the perspective of patients, caregivers, and health care providers. Conclusion: This systematic review will contribute to the in-depth understanding of barriers and facilitators affecting exercise in hemodialysis patients, and improve the prognosis of this population. Ethic and dissemination: The content of this article does not involve moral approval or ethical review because no individual data will be collected. PROSPERO registration: CRD42020200278. (https://www.crd.york.ac.uk/prospero/#recordDetails).

Background: Maintenance hemodialysis patients exhibit low physical activity, which is associated with sarcopenia, increased risk of cardiovascular events, and elevated all-cause mortality. Social support is an important resource for promoting healthy behaviors. But the mechanisms of influencing these patients’ intrinsic psychological processes to raise physical activity levels are unclear. Methods: This study was a cross-sectional observational study from September 2021 to February 2022, enrolling 460 hemodialysis patients from four tertiary hospitals in Xi’an City. We assessed social support, exercise self-efficacy, and exercise benefits and barriers perceptions with the Social Support Rating Scale (SSRS), the Self-Efficacy for Exercise Scale (SEE), and the Dialysis Patient-perceived Exercise Benefits and Barriers Scale (DPEBBS) respectively. Daily total step count was measured using an Omron electronic pedometer (model HJ-321) worn continuously for seven days. Descriptive statistics, Pearson correlation analysis, and chain mediation analysis using the PROCESS macro developed by Hayes (Model 6) were performed; the significance of mediation effects was tested via bootstrapping. Results: Pearson correlation analysis revealed significant positive correlations among social support, exercise self-efficacy, perceived exercise benefits and barriers, and total daily steps ( r = 0.289–0.507; all P < 0.01). Chain mediation model analysis indicated social support’s total effect on daily steps was 0.289. Specific mediation pathways included: (1) social support → exercise self-efficacy → total daily steps; (2) social support → perceived barriers to exercise benefits → total daily steps; (3) social support → exercise self-efficacy → perceived barriers to exercise benefits → total daily steps. Significant positive correlations were observed among social support, exercise self-efficacy, perceived exercise benefits and barriers, and total daily steps (all P < 0.01). Chain mediation analysis revealed that social support’s total effect on daily steps was 0.289 (95% CI: 0.201–0.377). Three significant mediation pathways were identified: social support → exercise self-efficacy → daily steps; social support → perceived barriers to exercise benefits → daily steps; and the chain mediation pathway social support → exercise self-efficacy → perceived barriers to exercise benefits → daily steps. Conclusion: Social support not only directly and positively influences physical activity levels among patients undergoing hemodialysis but also indirectly promotes physical activity by enhancing exercise self-efficacy and improving perceptions of barriers to exercise benefits. A chain mediation pathway "social support → exercise self-efficacy → perception of barriers to exercise benefits → physical activity "was identified. Trial registration: The study protocol was approved by the Ethics Committee of Xi’an Jiaotong University (approval number: 20211575).