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Background: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Aim: To construct an evaluation index system for the core competence of nurses in sleep medicine specialties. Background: Specialized nurses in sleep medicine must handle treatment, nursing, and management well, which requires nurses to have excellent competence in knowledge, skills, and ability. However, a competency evaluation system for sleep medicine nurses has not been established in China. Methods: We used a literature review and an expert meeting to establish a draft indicator system. Subsequently, two rounds of correspondence were conducted with 27 experts from 5 provinces using the Delphi method to solicit their opinions on the core competency evaluation indicators for sleep medicine nurse specialists and to qualitatively evaluate the experts' scores. The consensus was defined in advance as a mean score of 4.0 or above, with at least 75% agreement among participants. In this way, the final indicator framework was determined. Results: The final evaluation indexes of the core competencies for sleep medicine Nurse Specialists included 6 first-level indexes (Practical ability, Theoretical Knowledge, Critical thinking, Communication and coordination, Nursing Management, and Professional Development), 16 s-level indexes, and 64 third-level indexes. The effective response rates of the two expert consultation rounds were 100%. The expert authority coefficients were 0.878 and 0.865 in the first and second rounds of consultation, respectively. In the second round of consultation, the first, second, and third indexes of Kendall's coefficient of concordance were 0.373, 0.351, and 0.286, respectively (P < 0.05). Conclusion: The core competence evaluation index system for sleep medicine nurses established in this study is scientific and reliable and can provide a theoretical reference for the training, assessment, and evaluation of sleep medicine nurses in the future. Implications for nursing management: The evaluation index system of sleep medicine nurses' core competence will provide an effective practical framework for nursing management to evaluate, train, and examine the core competence of sleep medicine nurses. [ABSTRACT FROM AUTHOR]

Background: Promoting patient participation stands as a global priority in nursing care. Currently, there is a lack of a standardized tool to assess the culture of patient participation from the perspective of nurses in China. Aims: To translate and examine the validity and reliability of the Patient Participation Culture Tool for healthcare workers (PaCT-HCW) on general hospital wards in Chinese nursing context. Methods: A cross-sectional research study was conducted among 812 nurses. Brislin's recommendations were adhered to during the translation of the scale. Validity was assessed using construct validity, content validity, and face validity. Split-half reliability, test–retest reliability, and internal consistency reliability were used to evaluate dependability. The study was guided and reported following the STROBE checklist and recommendations for reporting the results of studies of instrument and scale development and testing. Results: The Chinese version of PaCT-HCW (the PaCT-HCW-C) exhibits good face validity and content validity. A rigorous exploratory factor analyse verified a six-factor (competence, support, perceived lack of time, information sharing and dialogue, response to questions and acceptance of a new role) scale structure with a cumulative variance contribution of the factors with 44 items of 68.840%. With a Cronbach's α coefficient of 0.962, split-half reliability of 0.866, and intraclass correlation coefficients of 0.989, the instrument demonstrates great reliability. Confirmatory factor analysis results validated the consistency of the six factors with the structure of the PaCT-HCW-C scale. Conclusions: The 44-item PaCT-HCW-C is a valid and reliable instrument with satisfactory psychometric properties. It could serve as a tool for assessing the effectiveness of international programs aimed at fostering patient participation from the perspective of nurses, while also providing insights from China's practical experiences. [ABSTRACT FROM AUTHOR]

Background: Nursing students encounter various stressors during their clinical practicum; however, the stressors are not the same during different periods. At present, studies on the stressors and coping styles of nursing students in the middle period of their clinical practicum are rare. Aims: The current study aimed to explore the stressors and coping styles of nursing students in the middle period of their clinical practicum. Methods: A qualitative study with a descriptive phenomenological method was conducted to collect data from 10 nursing students undergoing the middle period of their clinical practicum from December 2020 to February 2021. The data were collected by semistructured interviews using interview outlines prepared in advance. The data were analyzed by Colaizzi's analysis method. Results: The stressors experienced by nursing students in the middle period of their clinical practicum mainly included personal reasons, teaching arrangements, interpersonal relationships, occupational particularity and career planning. Additionally, nursing students coped with the stressors that they face in the clinical practicum by eliminating stressors and regulating emotions. Conclusions: Nursing students experienced various stressors and used a variety of coping styles in the middle period of their clinical practicum, which was different from what occurred in the early and late periods. Targeted interventions should be formulated and implemented to relieve nursing students' stress and guide them to adopt effective coping styles. [ABSTRACT FROM AUTHOR]

Background: Nursing research training is important for improving the nursing research competencies of clinical nurses. Rigorous development of such training programs is crucial for ensuring the effectiveness of these research training programs. Therefore, the objectives of this study are: (1) to rigorously develop a blended emergent research training program for clinical nurses based on a needs assessment and related theoretical framework; and (2) to describe and discuss the uses and advantages of the ADDIE model (Analysis, Design, Development, Implementation, Evaluation) in the instructional design and potential benefits of the blended emergent teaching method. Methods: This intervention development study was conducted in 2017, using a mixed-methods design. A theoretical framework of blended emergent teaching was constructed to provide theoretical guidance for the training program development. Nominal group technique was used to identify learners' common needs and priorities. The ADDIE model (Analysis, Design, Development, Implementation, Evaluation) was followed to develop the research training program for clinical nurses based on the limitations of current nursing research training programs, the needs of clinical nurses, and the theoretical foundation of blended emergent teaching. Results: Following the ADDIE model, a blended emergent research training program for clinical nurses to improve nursing research competence was developed based on the needs of clinical nurses and the theoretical framework of blended emergent teaching. Conclusions: This study indicates that nominal group technique is an effective way to identify learners' common needs and priorities, and that the ADDIE model is a valuable process model to guide the development of a blended emergent training program. Blended emergent teaching is a promising methodology for improving trainees' learning initiative and educational outcomes. More empirical studies are needed to further evaluate blended emergent teaching to promote the development of related theories and practice in nursing education. [ABSTRACT FROM AUTHOR]

Background: Delirium is an acute mental state associated with poor outcomes. The incidence of delirium is high, especially in the paediatric intensive care unit (PICU). It is important for staff, particularly nurses, to understand delirium and implement interventions to prevent it. We performed a survey with the aim of evaluating and analysing the factors influencing the knowledge, attitudes and behaviour of PICU nurses towards delirium. Methods: This cross-sectional descriptive study included 215 PICU nurses in 6 PICUs from five teaching hospitals in Sichuan Province, China. An online survey about the knowledge, attitudes and practices related to delirium care was conducted among PICU nurses used a self-made and validated questionnaire. The data were analysed using descriptive statistics; differences between groups were compared using t tests, ANOVA and rank-sum tests. Variables with a significance level of 0.05 in the univariate analysis were entered into the multivariable regression analysis to identify predictors. Results: Only 14.4% of the nurses had a good understanding of delirium, and 40.9% had received relevant training. The mean knowledge score was 9.01 ± 3.86, and the overall passing rate of knowledge was 49.8%. The mean attitude and behaviour scores were 40.95 ± 5.62 and 40.33 ± 8.01, respectively. Among the hospitals, different delirium assessments for children and specific training were performed, explaining approximately 10% of the variability in knowledge scores (F = 6.152), approximately 10% of the variability in attitude/belief scores (F = 5.908), and approximately 17% of the variability in practice scores (F = 10.767). Conclusions: PICU nurses have poor knowledge of delirium, particularly regarding its clinical manifestations, influencing factors and medications used, and they have adequate attitudes and confidence and good behaviour regarding delirium in children. To better prevent delirium, we suggest that PICU departments routinely assess delirium and conduct delirium training for nurses. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Transition shock occurs at a vulnerable time in newly graduated registered nurses' careers and has a clear impact on both newly graduated registered nurses' productivity and patient recovery outcomes. Identifying classification features of transition shock and targeting interventions to support newly graduated registered nurses is imperative. The study aimed to explore potential transition shock subgroups of newly graduated registered nurses and further explore the impact of population characteristics and two indices of health on transition shock. Methods: A descriptive, cross-sectional design was conducted. An online questionnaire was sent via WeChat to newly graduated registered nurses who started work in 2021 at seven hospitals between August and November 2021, and 331 nurses filled out the questionnaire. Latent class analysis was used to identify the potential class of the transition shock of newly graduated registered nurses, and multinomial logistic regression analyses were used to determine the factors of potential classification. Results: The study identified four classes of transition shock in newly graduated registered nurses, namely, "high transition shock", "physical fatigue-lack of knowledge", "development adaptation" and "low transition shock-worry" groups. Newly graduated registered nurses who urinated less than 4 times per day (OR = 0.051, 95% CI = 0.005–0.502) were likely to be in the "high transition shock" group. Newly graduated registered nurses who did not delay urination (OR = 4.267, 95% CI = 1.162–11.236) were more likely to belong to the "low transition shock-worry" group. Newly graduated registered nurses without sleep disturbance were more likely to be in the "physical fatigue - lack of knowledge" (OR = 3.109, 95% CI = 1.283–7.532), "development adaptation" (OR = 8.183, 95% CI = 2.447–27.066), and "low transition shock-worry" (OR = 8.749, 95% CI = 1.619–47.288) groups than in the 'high transition shock' group. Conclusions: This study highlights potential patterns of transition shock among newly graduated registered nurses. Two indices of health, namely, delayed urination and sleep disturbance, can predict the subgroups of newly graduated registered nurses with transition shock. [ABSTRACT FROM AUTHOR]

Background: With social transformation, rapid economic development and deepening awareness of psychological health in China, people's demand for psychological health services is becoming increasingly urgent. A key challenge for Chinese medical organizations is to train enough qualified psychological care nurses. A greater understanding of psychological care competences (PCC) can help in clinical nurse selection, training, and assessment. Objective: To develop a PCC framework for Chinese nurses and obtain a consensus on the framework among experts. Methods: A descriptive mixed methods study was designed consisting of a literature review and semi-structured interviews followed by three Delphi rounds. The experts (n = 16) involved were nurses, nursing managers and educators from nine Chinese provinces with a specific interest in psychological care. Descriptive statistics assisted in data analysis. Results: Using the Iceberg Model as a theoretical foundation, five main dimensions and associated subdomains were integrated from 39 chosen articles. The semi-structured interviews with 24 nursing managers and nurses confirmed all of the themes from the literature review while generating new themes, both of which were incorporated into the initial PCC framework. After three Delphi rounds, the experts reached consensus on the PCC framework, including five domains (knowledge, skills, professional ethics, personal traits, internal motivations) and 22 subdomains with connotations. The response rate (RR) values for the three rounds of consultation were 80.00%, 87.50% and 92.86%, the composite reliability (Cr) values were 0.89–0.90, and the Kendall coordination coefficients were 0.155-0.200 (P < 0.05). Conclusions: On the basis of the Iceberg Model, literature review and qualitative research methods along with Delphi technique were used to develop a scientific and systematic PCC framework. The research methods were feasible and the results were reliable, thereby providing a basis for adopting this framework into nursing education. A formal assessment tool should be developed to test the PCC of nurses in clinical practice. [ABSTRACT FROM AUTHOR]

Background: With the development of information technology, information has been an important resource in clinical medicine, particularly within the emergency department. Given its role in patient rescue, the emergency department demands a high level of information literacy from nurses to effectively collect, analyze, and apply information due to the urgency and complexity of emergency nursing work. Although prior studies have investigated the information literacy of nursing staff, little has been undertaken in examining the patterns of information literacy and their predictors among emergency department nurses. Aim: To clarify the subtypes of information literacy among nurses in the emergency department and explore the factors affecting profile membership. Methods: A cross-sectional study was conducted among a convenience sample of 2490 nurses in the emergency department from April to June 2023. The clinical nurses completed the online self-report questionnaires including the general demographic questionnaire, information literacy scale, self-efficacy scale and social support scale. Data analyses involved the latent profile analysis, variance analysis, Chi-square tests and multivariate logistic regression. Results: Four latent profiles were identified: 'Low information literacy (Class 1)', 'Moderate information knowledge (Class 2)', 'High information knowledge and support (Class 3)' and 'High information literacy (Class 4)', accounting for 20.14%, 42.11%, 23.36% and 14.39%, respectively. Each profile displayed unique characteristics representative of different information literacy patterns. Age, years of work, place of residence, hospital grade, title, professional knowledge, using databases, reading medical literature, participating in information literacy training, self-efficacy, and social support significantly predicted information literacy profile membership. Conclusions: Information literacy exhibits different classification features among emergency department nurses, and over half of the nurses surveyed were at the lower or middle level. Identifying sociodemographic and internal-external predictors of profile membership can aid in developing targeted interventions tailored to the needs of emergency department nurses. Nursing managers should actively pay attention to nurses with low information literacy and provide support to improve their information literacy level. Relevance to clinical practice: Insights from the current study of the latent profile analysis are beneficial to hospital managers in understanding the different types of emergency department nurses' information literacy. These insights serve as a reference for managers to enhance nurses' information literacy levels. [ABSTRACT FROM AUTHOR]

Background: China is experiencing an aging population, leading to a significant demand for "Internet + nursing services" tailored for elderly individuals. However, there are many risk problems in the process of nurse service, which hinder the development of the service, and a scale is needed to assess the risk problems faced by nurses in "Internet + nursing services" for the elderly. Objective: The purpose of this study is to develop an assessment scale for risk factors and outcomes related to nurses' involvement in the "Internet + Nursing Service" for the elderly and to assess its reliability and validity. Methods: Based on literature analysis, focus group, the Delphi method, and a presurvey, we designed an initial scale. The initial scale comprised two sections: risk factors and risk outcomes for nurses. In January and February of 2023, nurses engaged in "Internet + nursing services" for the elderly in Shanxi Province were chosen through a convenience sampling technique for a questionnaire survey. Subsequently, item analysis and exploratory factor analysis were employed to refine and develop a test version of the scale further. A follow-up questionnaire survey was carried out in March and April 2023 using a similar approach. The reliability and validity of the scale were assessed through confirmatory factor analysis, culminating in the formation of the final scale. Results: The initial survey yielded 244 valid responses. The cumulative variance contributions of the two segments from the exploratory factor analysis were 84.584% and 90.089%, respectively. A subsequent survey garnered 220 valid responses. The confirmatory factor analysis results indicated: χ2/df = 2.086, comparative fit index (CFI) = 0.918, normative fit index (NLI) = 0.855, root mean square of residuals (RMR) = 0.045, and root mean square of error of approximation (RMSEA) = 0.070. These results demonstrate good structural, convergent, and discriminant validity. The content validity index at the item level (I-CVI) ranged between 0.875 and 1.000, while the content validity index at the scale level (S-CVI/Ave) was 0.941. Cronbach's alpha coefficient for the entire scale stood at 0.970. Moreover, the scale exhibited a split-half reliability of 0.876 and a retest reliability of 0.980 (p < 0.01). Conclusion: The risk factors and risk outcomes associated with nurses involved in "Internet + nursing services" for elderly individuals, as developed in this study, demonstrate strong reliability and validity. They are well suited to the Chinese national context. [ABSTRACT FROM AUTHOR]

Background: Video health education has been increasingly adopted in the clinic to expand patient guidance and improve perioperative outcomes. To date, however, it is unclear whether the use of short-form videos and web-based clinician-created forums actually improve the perioperative experience of patients. Objective: To evaluate the effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures. Methods: This study is a quasi experimental study, using convenient sampling method and grouping according to historical control., one hundred and twenty-two patients admitted with lower limb fractures to the orthopedic ward of a tertiary first-class general hospital in Fujian, China were enrolled in this study. Based on their admission order, patients admitted from September 2021 to November 2021 were enrolled into the control group (n = 61) and patients admitted from December 2021 to March 2022 were enrolled in the intervention group (n = 61). Both groups received identical admission-based patient education, perioperative care, and discharge rehabilitation instructions. The control group received the traditional education method while the intervention group received a short-form educational video in addition to the traditional education method. Patient perioperative health knowledge and patient satisfaction with nursing care during treatment of lower limb fractures were compared across the two groups. Results: Preoperative health knowledge in the intervention group was 95.1%, compared to 82.0% in the control group (χ2 = 3.954, P<0.05). The Newcastle satisfaction with nursing scales score in the intervention group was (80.902 ± 7.016) points, compared to (78.131 ± 8.213) points in the control group. These group differences were statistically significant (P < 0.05). Conclusion: The application of a short-form educational video during the perioperative care of patients with lower limb fractures may improve patients' understanding of perioperative health and increase satisfaction with nursing care. [ABSTRACT FROM AUTHOR]

Background: The curriculum humanistic competence of nursing teachers is important to cultivate the humanistic qualities of undergraduate nursing students. However, there are no evaluation tools for the curriculum humanistic competence of undergraduate nursing teachers in China. Objective: To develop an index system to evaluate the curriculum humanistic competence of undergraduate nursing teachers. Design: This research conducted a Delphi study. Participants: Semi-structured interviews were held with 19 experts, and Delphi rounds were conducted with 18 experts. Settings: This study was conducted in 12 universities and 4 Grade A tertiary hospitals in China. Methods: A literature review and semi-structured interviews were conducted to develop an initial framework. A two-round Delphi survey was employed to build the index system for undergraduate nursing teachers' curriculum humanistic competence. Results: After two rounds of consultation, the index system included 5 first-level indicators, 11 second-level indicators and 41 third-level indicators. The Cr for two rounds of consultation were 0.929 and 0.923, and Kendall's W was 0.152(P<0.001). Conclusions: The index system for the evaluation of undergraduate nursing teachers' curriculum humanistic competence offers guidelines for undergraduate nursing teachers in China. It can be used in practice to develop high humanistic qualities in undergraduate nursing teachers. [ABSTRACT FROM AUTHOR]

Background: Turnover intention occurs frequently in nurses and psychological empowerment has been shown to be major factors that influence turnover intention. However, little is known about the driving force behind turnover intention among nurses in China during the COVID-19 pandemic. Objectives: To investigate the mediating role of job satisfaction and emotional exhaustion on the association between psychological empowerment and turnover intention among Chinese nurses during the COVID-19 pandemic. Methods: A cross-sectional design was conducted in China. A total of 507 nurses completed scales of psychological empowerment, job satisfaction, emotional exhaustion and turnover intention anonymously. Descriptive analysis, Pearson's correlation analysis in SPSS 23.0 and structural equation modeling (SEM) by Mplus 7.4 Results: Psychological empowerment had a significantly effect on turnover intention through three significantly indirect pathways: (1) through job satisfaction (B = -0.14, SE =.03, 95% CI = [-.19, -.09]). (2) through emotional exhaustion (B = -0.07, SE =.02, 95% CI = [-.11, -.03]). (3) through the chain mediating effect of "job satisfaction → emotional exhaustion" (B = -0.12, SE =.02, 95% CI = [-.16, -.09]). Conclusions: Intervention measures to reduce the incidence of turnover intention of nurses should include the evaluations of work demands and emotional exhaustion of nurses and organization's management strategies to promote their psychological empowerment and job satisfaction. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has spread worldwide. Older adults are at the greatest risk of contracting and dying from the virus. Nursing homes are densely populated places for older adults who are generally vulnerable and at high-risk. Although Chinese nursing homes have been trying to protect their residents, the needs and expectations of the residents and their families have been ignored. This study aimed to promote the safety of NH residents, including their physical and psychological safety, and to meet their expectations during the COVID-19 pandemic in China. Methods: Data were collected through face-to-face semi-structured interviews with nursing home residents and focus group online interviews with family members between June 2021 and February 2022. Data analysis was performed using inductive content analysis. Results: 16 residents and 24 family members were interviewed. Four themes with 10 sub-themes were identified from the participants' descriptions. Their expectations were mainly focused on prevention and control measures for COVID-19, medical capacity of nursing homes, health literacy and expectations for some aged care policies. Conclusions: In the face of concerns about the impact of COVID-19 on nursing homes, we sought to bring firsthand perspectives to the forefront by interviewing residents and their family members about their expectations for safety to address this issue. Our findings provide important areas on which should be focused and may improve the sense of gain, happiness, and security of nursing home residents during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence treatment includes conservative treatment, physical devices, medication, and surgery. Pelvic floor muscle training combined with bladder training is among the most effective, non-invasive, and economical ways to treat urinary incontinence, and compliance with training is essential in urinary incontinence treatment. Several instruments assess pelvic floor muscle training and bladder training. However, no tool has been found that assesses compliance with pelvic floor muscle training when combined with bladder training for urinary incontinence. This study aimed to develop a rehabilitation training compliance scale for patients with urinary incontinence and to evaluate its validity and reliability. Methods: This study was performed in two tertiary hospitals in Hainan, China between December 2020 and July 2021, 123 patients were included. A literature review, group discussions, and two rounds of letter consultations were performed to acquire the item pool and finalise the 12 items for this scale. Exploratory and confirmatory factor analysis, Cronbach's α, split-half reliability, test–retest reliability, content validity, construct validity, convergent and discriminant validity, and criterion-related validity were used to examine the items in the scale. Results: A 12-item scale comprising three factors accounted for 85.99% of the variance in the data. The Cronbach's α, split-half reliability, test–retest reliability, and content validity index of the scale were 0.95, 0.89, 0.86, and 0.93, respectively. Comparison with the Chen pelvic floor muscle exercise self-efficacy scale showed high calibration correlation validity (coefficient = 0.89). Conclusions: The training compliance scale developed in this study is a valid and reliable measurement tool to assess pelvic floor muscle training and bladder training compliance in patients with urinary incontinence. [ABSTRACT FROM AUTHOR]

Background: Self-management behaviours can be crucial to improving disease symptoms and health outcomes in rheumatoid arthritis (RA) patients. Currently, the tools available for measuring self-management behaviours in RA patients are either generalized for patients with chronic diseases, which lack specificity or have poor reliability in the only specific scale—self-care behaviours scale (SCBS). The aim of this study was to develop a self-management behaviours scale for RA patients and evaluate its psychometric properties. Methods: The study included two steps: scale development and the psychometric evaluation. The items were developed from a literature review, in-depth individual interviews, nominal group technique, Delphi expert consultation, and a pilot test. For the psychometric evaluation, a sample of 561 patients with RA was recruited. Item analysis, content validity, exploratory and confirmatory factor analysis, convergent and discriminant validity, and internal consistency reliability were conducted to examine the psychometric properties of the RA-SMBS. Results: The final scale consists of 23 items with 4 dimensions, including medication management, exercise and joint protection, resource utilization and emotional management, and symptom management. The content validity index was 0.78. Exploratory factor analysis explained 61.89% of the total item variance. Confirmatory factor analysis indicated that the RA-SMBS fit well. Good internal consistency reliability was demonstrated (Cronbach's alpha = 0.908), and the test–retest reliability was found to be acceptable (ICC = 0.628, r = 0.780). Conclusions: The scale has good content validity, construct validity, and internal consistency reliability. It can be used to assess the level of self-management behaviours in RA patients. [ABSTRACT FROM AUTHOR]

Background: Psychological capital is affected by different cultures and professional characteristics and its constituent dimensions and evaluation tools are heterogeneous. There is a lack of measurements for assessing nurses' psychological capital considering nursing professional characteristics and Chinese cultural impacts. Aims: To develop a psychological capital scale that conforms to the Chinese cultural background and the characteristics of nursing profession, and evaluate the preliminary validation of the Nurses Psychological Capital Scale. Methods: Nurses were conveniently recruited from two tertiary hospitals, Hebei, China. The research process included three steps: item development (Delphi survey and pilot survey), scale development (item analysis and exploratory factor analysis), scale validation (reliability and validity test). Results: Exploratory factor analysis and confirmatory factor analysis showed that the 43-item scale comprised three factors (work task-oriented psychological capital, interpersonal relationship-oriented psychological capital and learning development-oriented psychological capital). Exploratory factor analysis showed the factor loadings ranging from 0.460 to 1.029. Three factors explained 68.71% of the variance. Confirmatory factor analysis showed an adequate model fit (x2/df =2.839, RMR = 0.041, RMSEA = 0.078, IFI = 0.872, TLI = 0.863, CFI = 0.871, PNFI = 0.768). The Cronbach's α for the scale was 0.975. The item-level content validity index (I-CVI) was 0.83 ~ 1.00, scale-level average content validity index (S-CVI/Ave) was 0.988. Conclusion: The Nurse Psychological Capital Scale had good reliability and validity, which is a reliable evaluation measure for assessing psychological capital among nurses. [ABSTRACT FROM AUTHOR]

Background: The flipped classroom (FC) method is becoming increasingly popular in China's nursing education. It is an important breakthrough improvement in the quality of learning in nursing education reforms. Purpose: This study aimed to determine the effects of blended task-oriented flipped classroom (TFC) on nursing students undertaking the Fundamentals of Nursing course. Methods: A pre-and post-test quasi-experimental design was adopted. This study was conducted in the Autumn semester, 2021 academic year in a Chinese university. Using cluster sampling technique, this study enrolled second-year undergraduate nursing students from six classess who were studying Fundamentals of Nursing course. A blended TFC was developed and implemented with three classes (experimental group: n = 152). In-class traditional lectures were applied to the other three classes (control group: n = 151). The Self-Directed Learning Instrument, Problem-Solving Inventory, and California Critical Thinking Disposition Inventory were used to evaluate students' learning outcomes, and final examinations were conducted at the end of after course. In addition, students in the flipped classroom group were required to answer five open-ended questions concerning their flipped classroom learning experiences. Results: Students in the experimental group showed significant improvement in academic performance compared to those in the control group (p = 0.001). Considering total scale and factors, students in the experimental grouped recorded significantly higher scores in self-directed learning ability, problem-solving skills, and critical thinking ability compared to those in the control group (p < 0.05). Furthermore, improved abilities and skills such as team cooperation, communication, presentation, identifying /solving clinical problems, and accountability were reported. Conclusion: A blended TFC teaching approach positively impacted students' core competencies and improved learning outcomes in the Fundamentals of Nursing course. [ABSTRACT FROM AUTHOR]

Background: Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey (HSOPS 1.0), developed by the U.S. Agency for Healthcare Research and Quality in 2004, has been widely adopted in the United States and internationally. An updated version, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019, has not yet been applied in China. The aim of the present study was to translate HSOPS 2.0 into Chinese version with cross-cultural adaptations and test its psychometric properties. Methods: A convenience sample was used. Hospital nurses (N = 1013) and a sub-set (n = 200) was invited for the re-test. A three-stage study was conducted. Firstly, the HSOPS 2.0 was translated by a panel. Secondly, the content validity was tested using the two-round Delphi method and cognitive interview. Next, the construct validity was tested by the confirmatory factor analysis and further demonstrated by the convergent validity, discriminant validity, and correlations with the outcome of patient safety. Thirdly, the reliability was tested by internal consistency reliability and re-test reliability. Results: The "float or PRN" and "manager" words were deleted as considered unfitted for the Chinese health care system. The content validity index provided evidence of strong content validity (I-CVI = 0.84 ~ 1.00, S-CVI = 0.98). Confirmatory factor analysis revealed a good model fit (χ2/df = 4.05, RMSEA = 0.06, CFI = 0.94) and acceptable factor loadings (0.41 ~ 0.97). Convergent validity, and discriminant validity supported the factorial structure of the Chinese version of HSOPS 2.0. Further evidence for the construct validity was derived from correlations with the outcome of patient safety (r = 0.10 ~ 0.41). A good internal consistency (Cronbach's α = 0.68 ~ 0.93, McDonald's omega = 0.84 ~ 0.96) and test-retest reliability (ICC = 0.78 ~ 0.95) showed acceptable reliability. Additionally, Chinese nurses reported markedly lower scores for three dimensions, including "Response to Error", "Communication Openness", and "Reporting Patient Safety Events", when comparing the findings of this study with those from U.S. research utilizing the HSOPS 2.0. Conclusion: The Chinese version of HSOPS 2.0 demonstrated good validity and reliability in a Chinese sample of hospital nurses, which suggests that it can be used to measure nurse-perceived patient safety culture in future research and practice. Psychometric properties of the Chinese version of HSOPS 2.0 among other Chinese healthcare professionals remain to be confirmed. [ABSTRACT FROM AUTHOR]

Background: While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design. Methods: A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied "Clinical Critical Thinking Training" together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann–Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience. Results: The students' interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p < 0.05). Three themes emerged regarding simulated interprofessional teaching: clarifying team positioning, improving team efficiency, and optimizing the learning experience. Conclusion: SIPE can build students' critical thinking, teamwork, and interprofessional core competencies, which makes it a useful teaching design. [ABSTRACT FROM AUTHOR]

Aims: To translate the U.S. version of the Nursing Brand Image Scale to Chinese (NBIS-C) and evaluate its psychometric properties when administered to a national sample of Chinese nurses, and identify nursing brand image profiles in Chinese nurses. Design: A cross-sectional study was conducted to validate the NBIS-C among nurses in China. Methods: The psychometric properties of the NBIS-C were tested in accordance with the COSMIN checklist. The reliability, validity, and responsiveness of the 42-item NBIS-C were examined in a national sample of 759 nurses recruited from 29 Chinese provinces. Latent Profile Analyses (LPA) were conducted to reveal nurses' perceptions of the brand image of nursing. Results: Results of this study demonstrated acceptable validity (content validity, structural validity, and construct validity), reliability (internal consistency and test-retest reliability), adequate responsiveness, and no floor/ceiling effect of the NBIS-C. LPA yielded five subgroups: Integrated, Traditional, Subordinate, Creative and Leader. Conclusion: The psychometric properties of the NBIS-C are suitable for assessing the image of nursing among Chinese nurses. Future studies with a larger, more diverse sample are recommended. Although the role of nurses in China has evolved, nurses in general have failed to communicate a consistent, positive, and accurate brand image for the nursing profession. [ABSTRACT FROM AUTHOR]

Background: Patients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses' understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses' during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education. Methods: Except for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student's skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors. Results: All 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice. Conclusion: Simulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents. [ABSTRACT FROM AUTHOR]

Background: A high turnover rate has become a critical issue in the field of nursing and how to tackle the problem of nursing turnover has received increased attention worldwide. Hope, career identity, job satisfaction may be useful for reducing turnover. The aim of this study is to explore the relationships among career identity, hope, job satisfaction, and the turnover intention of nurses, and to test the mediating role of job satisfaction on the associations of hope and career identity with turnover intention. Methods: A descriptive cross-sectional design was used. A total of 500 nurses were recruited from five comprehensive tertiary hospitals using convenience sampling. The questionnaire included items about sociodemographic information as well as the Adult Dispositional Hope Scale, Nursing Career Identity Scale, Job Satisfaction Index Scale, and Nurse Turnover Intention Scale. Pearson's correlation, multiple linear regression, and structural equation modeling were used to analyze the data. We describe the study in accordance with the STROBE statement. Results: Hope (r = − 0.227, p < 0.001) and career identity (r = − 0.342, p < 0.001) were negatively correlated with turnover intention. Job satisfaction played a completely mediating role on the associations of hope and career identity with turnover intention (β1 = − 0.09, β2 = − 0.33). Conclusions: Job satisfaction mediated the associations of career identity and hope with turnover intention. Thus, effective measures can be taken to enhance nurses' hope and career identity in order to improve their job satisfaction and thereby reduce their turnover intention. Providing nurses with more support, helping them find a spiritual foundation, and holding mindful activities that stimulate positive emotions are helpful. In addition, colleges should pay more attention to instilling nursing students with career identity and nursing values. [ABSTRACT FROM AUTHOR]

Background: Research into evidence-based practice has been extensively explored in nursing and there is strong recognition that the organizational context influences implementation. A range of barriers has been identified; however, the research has predominantly taken place in Western cultures, and there is little information about factors that influence evidence-based practice in China. The purpose of this study was to explore barriers and facilitators to evidence-based practice in Hunan province, a less developed region in China. Methods: A descriptive qualitative methodology was employed. Semi-structured interviews were conducted with staff nurses, head nurses and directors (n = 13). Interviews were translated into English and verified for accuracy by two bilingual researchers. Both Chinese and English data were simultaneously analyzed for themes related to factors related to the evidence to be implemented (Innovation), nurses' attitudes and beliefs (Potential Adopters), and the organizational setting (Practice Environment). Results: Barriers included lack of available evidence in Chinese, nurses' lack of understanding of what evidence-based practice means, and fear that patients will be angry about receiving care that is perceived as non-traditional. Nurses believed evidence-based practice was to be used when clinical problems arose, and not as a routine way to practice. Facilitators included leadership support and the pervasiveness of web based social network services such as Baidu (百度) for easy access to information. Conclusion: While several parallels to previous research were found, our study adds to the knowledge base about factors related to evidence-based practice in different contextual settings. Findings are important for international comparisons to develop strategies for nurses to provide evidence-based care. [ABSTRACT FROM AUTHOR]