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Aim s : The objective of this study was to examine the relationship between caregiving burden and pre‐death grief, with a specific focus on adult‐child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation. Methods: A convenience sample of 320 adult‐child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit‐Meuser Caregiver Grief Inventory‐Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist‐Revised. Results: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre‐death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre‐death grief, but in the male group, this mediating effect did not exist. Conclusion: The study found evidence supporting the link between caregiving burden and pre‐death grief among adult‐child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre‐death grief. These associations only existed in the female group. Implications: This paper presented the importance of active coping skills in the dementia caregiving process. Impact: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre‐death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre‐death grief. Community‐based and personal care support services should be promoted to alleviate their caregiving burden. Reporting Method: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. Patient or Public Contribution: 'No patient or public involvement'. [ABSTRACT FROM AUTHOR]

Aims: To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association. Background: There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational‐level solutions to prevent it. Methods: A cross‐sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire‐Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis. Results: A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate. Conclusion: The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses. Impact: This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB. Patient or Public Contribution: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. [ABSTRACT FROM AUTHOR]

Aims: To describe the changes in moderate‐to‐late preterm infants' (MLPIs) growth during 12 months of corrected age (CA) and to examine the predictive role of NICU‐related stress, postpartum depression trajectory and family coping ability on the physical developmental trajectory of MLPIs. Design: A prospective longitudinal study. Methods: There were 237 mother–infant dyads with at least two follow‐up data records included. General characteristics and NICU‐related stress were recorded from medical records at baseline. Infants' physical growth was measured at 40 weeks, 1, 3, 6, 9 and 12 months CA during outpatient follow‐up. Maternal postpartum depressive symptoms and family coping ability were assessed by questionnaires at 1, 3, 6, 9 and 12 months CA and 1 month CA respectively. We investigated the modifiable factors inside and outside of NICU on the trajectories of physical growth in the first year in MLPIs, mainly by using latent growth curve models with time‐varying covariates. Results: The curved trajectories of weight, length and head circumference in the first year in MLPIs demonstrated gradually slowed growth rates and these infants were above the WHO growth standards for the same age and sex. The latent growth curve models indicated that more NICU‐related stress was negatively associated with the weight and length at 40 weeks CA, and family coping ability (parent–child relationship) at 1 month CA was associated with the growth rate of weight. Besides, more NICU‐related stress predicted faster length growth rate. The infants of mothers who were in the group of high‐level postpartum depression trajectory had a slower growth rate of head circumference. Conclusions: Our study identified the modifiable factors along the care continuum influencing the trajectory of MLPIs' physical growth. Nurses should receive more training about infant stress measurement and family‐centred care to work in partnership with parents so that MLPIs can reach their full developmental potential. Also, multidisciplinary interventions including stress reduction strategies, close psychological monitoring and education improving parent–infant relationships should be further developed to achieve optimizing growth in the first year of MLPIs. Implications for the Profession and/or Patient Care: It is recommended that nurses pay attention to the long‐term physical growth status of MLPIs, and closely support their families. Quantifying NICU‐related stress and developing reduction strategies should be the priority for clinical staff during hospitalization. After discharge, persistent screening of depressive symptoms, psychological intervention and education about the parent–child relationship need to be included in the follow‐up visits. Patient or Public Contribution: No patient or public contribution. The study only included patients who were research participants. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self‐efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. Design: A cross‐sectional study. Methods: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self‐efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. Results: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self‐efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. Conclusion: Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self‐efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. Impact: These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self‐efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. Patient or Public Contribution: Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. Summary Statement: What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self‐regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self‐efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses. [ABSTRACT FROM AUTHOR]

Background: The quality of life of patients with advanced gastrointestinal cancer is seriously impaired, and socioeconomic deprivation often has a serious impact on their quality of life. However, little is known about the relative contribution of non-socioeconomic factors to the quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation. Aim: This study aims to investigate the situation and predictors of quality of life of patients with socioeconomic deprivation and evaluate the independent effects of some non-socioeconomic factors. Design: A retrospective study based on cross-sectional design. Methods: Data were obtained from 1075 patients with advanced gastrointestinal cancer who received family palliative treatment in the hospice ward of Zhongnan Hospital of Wuhan University from March 2010 to October 2020, including demographic and clinical questionnaires, Karnofsky Performance Status scale and Cancer Pain and Quality of Life Questionnaire of Chinese Cancer Patients. Results: The quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation is impaired and is affected by gait, self-care ability, abdominal distension, nutritional status, weight loss, constipation and posture. Improvement in six of these factors--gait, self-care ability, abdominal distension, nutritional status, weight loss and posture--has an independent positive impact on the development of a healthy quality of life for patients. Conclusions: Gait, self-care ability, abdominal distension, nutritional status, weight loss and posture are important determinants of healthy quality of life in patients with advanced gastrointestinal cancer with socioeconomic deprivation, and early identification and strength management of these non- socioeconomic factors may neutralize the negative impact of socioeconomic factors on the quality of life. Implications for Practice: This study provides new ideas and intervention entry points for global nurses in practice innovations to improve the quality of life of socioeconomically deprived patients with advanced gastrointestinal cancer. It enables them to focus on the effectiveness of non-socioeconomic factors in the development and implementation of targeted care plans for patients with advanced gastrointestinal cancer experiencing socioeconomic deprivation globally. Reporting Method: This study was reported in strict compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To investigate the level of spiritual health in older patients with chronic obstructive pulmonary disease (COPD) from the core dimensions and to explore its associated factors. Design: A cross‐sectional study. Methods: Participants were recruited from four hospitals between September 2020 and June 2021, using a convenience sampling. Older patients with COPD (n = 162) completed the demographic and disease‐related information questionnaires, Function Assessment of Chronic Illness Therapy Spiritual Scale, 10‐item Connor‐Davidson Resilience Scale, General Self‐efficacy Scale, Social Support Rating Scale, COPD Assessment Test, 15‐item Geriatric Depression Scale and modified Medical Research Council Dyspnea Scale. Descriptive statistics, Pearson and Spearman correlation analyses, t‐tests, one‐way ANOVA and multiple linear regression models were used. Results: Older patients with COPD have a moderate level of spiritual health. The multiple linear regression analysis showed that psychological resilience, general self‐efficacy, social support, symptom burden and monthly income were associated with the core dimensions of spiritual health. Conclusion: Chinese older patients with COPD have a moderate level of spiritual health. Psychological resilience, general self‐efficacy, social support, monthly income and symptom burden were associated with the core dimensions of spiritual health. Impact: This study is the first to investigate the level of spiritual health in older patients with COPD from the core dimensions and to explore its associated factors, providing a basis for developing spiritual intervention programs. Our findings can help us realize that intervention strategies of psychological resilience, general self‐efficacy and social support can all be used to enhance spiritual health. Nurses should focus on the spiritual health of older COPD patients with high symptom burden and low monthly income. Patient or Public Contribution: Although we did not directly involve patients and the public because of the COVID‐19 pandemic, the results of the study will be disseminated to patients and the public through WeChat and seminars. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to describe sleep quality among community‐dwelling older people; determine the association between sleep quality (total and multidimensional), frailty and overall health; study frailty as a mediator in the association between sleep quality and overall health. Design: This longitudinal, correlative study used data from 2020 to 2022. Methods: A total of 181 community‐dwelling older people in a city in Southeast China were assessed twice. Sleep quality was measured using the Pittsburgh Sleep Quality Index at Time 1 (year 2020); frailty was measured using the FRAIL scale, and overall health was measured using the EuroQol visual analogue scale at Time 1 and 2 (1 year later). Associations and indirect effects were examined using linear regression analyses using the PROCESS Macro (Model 4). Results: Poor sleep quality (higher scores) was associated with increased frailty over time (total scale), as well as subjective sleep quality, sleep duration, sleep efficiency and daytime dysfunction. Mediation analyses indicated that frailty change had an indirect effect on the association between sleep quality total score Time (T) 1 and overall health T2 and between the dimensions subjective sleep quality, sleep duration, sleep efficiency and daytime dysfunction and overall health. All analyses were adjusted for age, multimorbidity and overall health T1. Conclusions: Poor sleep quality is a common problem associated with poor overall health after 1 year, and the progression of frailty mediates this association. Impact: The findings provide a better understanding of the association between sleep quality and overall health and elucidate the mediating effect of frailty. Regular screening and effective treatment by healthcare providers for sleep problems and frailty in older people are necessary to improve their overall health and enhance healthy ageing. Patient or Public Contribution: Participants in the study provided the data used for all data analysis in the manuscript. Patient or public were not involved in data analysis, interpretation or manuscript preparation. Staff in the community health centre helped with data collection. [ABSTRACT FROM AUTHOR]

Aims: To explore predictors of lymphedema self‐management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables. Design: Further analysis of a multicentre cross‐sectional and survey‐based study. Methods: A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self‐reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed. Results: The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self‐management behaviours. The final structural model showed good model fit. Social support, self‐efficacy and lymphedema knowledge positively affected lymphedema self‐management behaviours, directly and indirectly. Self‐regulation acted as a crucial mediator between these variables and self‐management. The direct path between social support and self‐regulation was not significant. Lymphedema knowledge and social support also influenced self‐management via illness perception, self‐efficacy and self‐regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self‐management behaviours. Conclusions: The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self‐management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self‐efficacy, social support and self‐regulation directly and indirectly influenced lymphedema self‐management behaviours. Impact: This study provides a theoretical basis for the assessment and interventions of lymphedema self‐management behaviours in breast cancer patients. Lymphedema self‐management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors. Reporting Method: This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Patient or Public Contribution: No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. What Does This Paper Contribute to the Wider Global Clinical Community?: This study focused on identifying and predicting mechanism of self‐management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high‐risk populations, and inspire the assessment and interventions facilitating self‐management behaviours. Study Registration: This study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084). Implications for the Profession and/or Patient Care: For breast cancer patients with poor lymphedema self‐management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self‐management is multi‐faced. Strategies targeted at improving social support, self‐regulation, knowledge, self‐efficacy and illness perception should be also addressed in lymphedema self‐management programs, to facilitate more effective improvement of lymphedema self‐management behaviours. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to explore the relationship between nurses' well‐being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship. Design: This was a quantitative cross‐sectional study. Methods: This cross‐sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well‐Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z‐test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well‐being was completed by AMOS 23.0 statistical software. Results: The scores of nurses' well‐being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well‐being. Spearman's analysis showed that nurses' well‐being was positively correlated with ethical leadership (r =.507, p <.01) and workplace mindfulness (r =.600, p <.01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses' well‐being accounting for 38.5% of the total effect ratio [p <.001, 95% CI = (0.215, 0.316)]. Conclusion: Nurses' well‐being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses' well‐being. Impact: This suggests that nursing managers need to pay attention to clinical nurses' well‐being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well‐being and integrate core values such as positivity and morality into nurses' daily routines, so as to improve the work enthusiasm and well‐being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to measure sleep quality and its possible association with fear of progression (FOP) in patients with chronic heart failure (HF). Design: A cross‐sectional study. Methods: A total of 254 patients with chronic HF were recruited from two tertiary hospitals in China. The sociodemographic and clinical data of participants were collected using a general information questionnaire. The Pittsburgh Sleep Quality Index and Fear of Progression Questionnaire‐Short Form were used to evaluate sleep quality over 1 month and FOP. Pearson correlation and hierarchical regression were conducted to analyse the relationship between sleep quality and FOP. Results: Of all participants, 85.8% had poor sleep quality, with a mean score of 12.3 ± 4.2 (possible score could be 0 to 21). The severity of FOP was positively correlated with poor sleep quality. HF hospitalization in the past year, numbers of HF drugs, monthly income and total score of FOP were strong predictors of decreased sleep quality, accounting for 24.2% of the variance in the sleep quality of these patients. Conclusions: Patients with chronic HF generally reported poor sleep quality, which should be highly concerned for medical workers. Alleviating FOP as a therapeutic strategy may improve sleep quality. Impact: It is urgent to raise clinical attention that Chinese patients with chronic HF have poor sleep quality, which is not just due to the symptoms of HF itself. FOP is an important psychological factor influencing sleep quality in patients with chronic HF, which has not been explored in China. This study provides a new perspective on targeted interventions for poor sleep quality in chronic HF. Patient and public involvement: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the features of depressive and anxiety symptoms and illness perception and their associations in patients with acute coronary syndrome (ACS). Design: Secondary analysis of data from a cross‐sectional study and baseline data from a randomized controlled trial. Methods: From June to July 2019 and June to September 2020, patients with ACS in four public hospitals in China completed measurements of depressive and anxiety symptoms, illness perception, and sociodemographic and clinical characteristics. Data were analysed using univariate and multiple logistic regression analyses. Results: This study included 510 participants (mean age, 61.0 ± 9.9 years; 67.8% male). The prevalence of depressive and anxiety symptoms was 66.3% and 56.5%, respectively. Total score of illness perception was 43.5 ± 9.1 and mean scores of each dimension ranged from 5.5 to 7.6, suggesting relatively negative illness perceptions. The top two perceived causes of illness were negative emotions or stress (27.3%) and dietary habits (25.5%) and 24.7% of participants were unaware of causes regarding their illness. After adjusting for potential confounders, a one‐point increase in scores on illness perception regarding consequences and emotional response (range, 0–10) was related to a 22% increased probability of depressive symptoms. Every one‐point increase in scores on illness perception related to emotional response, personal control and illness comprehensibility was associated with a 38% increased, 13% decreased and 9% decreased probability of anxiety symptoms, respectively. Conclusion: Depressive and anxiety symptoms are prevalent at high rates in patients with ACS. They have a relatively negative illness perception that is associated with the prevalence of depressive and anxiety symptoms. Impact This study highlights the importance of screening for depressive and anxiety symptoms in patients with ACS, especially for those with negative illness perceptions. Targeted strategies are imperative to improve patients' health outcomes. No Patient or Public Contribution: These details do not apply to this work. [ABSTRACT FROM AUTHOR]

Aims: To explore the relationship between patient activation (subjective initiative of patients to participate in disease management in self‐health care), social support, self‐efficacy and online health information seeking among older patients with coronary heart disease. Design: A cross‐sectional and survey‐based design. Methods: A total of 451 older patients with coronary heart disease were recruited from July to November 2021 from four communities in Qingdao, China. We collected data using the Patient Activation Measure, Social Support Rating Scale, Self‐Efficacy Scale and Online Health Information Seeking Scale. We performed structural equation modelling to analyse the data. Results: The final model showed good model fit. Patient activation influenced online health information seeking directly (β =.39, p <.05) and indirectly through self‐efficacy (β =.17, p <.05). Social support influenced online health information seeking directly (β =.23, p <.05) and indirectly through self‐efficacy (β =.03, p <.05). Self‐efficacy directly influenced online health information seeking (β =.26, p <.05). Conclusions: We identified the interrelationships of patient activation, social support and self‐efficacy and their influence on the online health information seeking of older patients with coronary heart disease. Our findings provide a theoretical basis for developing and evaluating interventions to enhance online health information seeking for older patients with coronary heart disease. Impact These findings add a better understanding of the relationship between patient activation, social support, self‐efficacy and online health information seeking in older patients with coronary heart disease, and help community health workers to intervene in the early stage of disease diagnosis. [ABSTRACT FROM AUTHOR]

Aims: Guided by the biopsychosocial‐spiritual model, this study aimed to evaluate the spiritual needs of Chinese women with breast cancer and explored factors associated with those spiritual needs. Design: This study has a cross‐sectional design. Methods: This cross‐sectional study involved 228 breast cancer patients in China, between May 2019 and July 2019. Data were collected using the general information form, the Spiritual Needs Scale, the Perceived Social Support Scale and the Hospital Anxiety and Depression Scale. Data were analysed by Spearman correlation analysis, univariate analysis and multiple linear regression, and a structural equation model (SEM) was constructed by maximum likelihood estimation. Results: There was a slightly higher average score for spiritual needs. Of the five dimensions of spiritual needs, those with the highest and lowest levels were 'meaning and purpose' and 'relationship with transcendence' respectively. Religion, time since confirmed diagnosis and education level were related to spiritual needs. The proposed model linking spiritual needs perceived social support, anxiety, and depression revealed a satisfactory fit to the data. Specifically, a higher level of social support predicted lower levels of anxiety and depression, which in turn predicted stronger spiritual needs. Conclusions: The spiritual needs of breast cancer patients were associated with individual characteristics and psychosocial elements. Patients' spiritual needs should therefore be effectively evaluated, especially the needs of those who are not religious. Furthermore, comprehensive, needs‐tailored interventions that incorporate spiritual, biological, psychological and social support should be formulated. Impact Nurses should become more aware of the spiritual needs of breast cancer patients, incorporate a spiritual focus into their care and develop comprehensive needs tailored to their characteristics as well as interventions based on biopsychosocial factors. [ABSTRACT FROM AUTHOR]

Aim: To adapt and psychometrically test two scales from The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) for measuring nurses' preparedness to manage intimate partner violence (IPV) and opinions on IPV in China. Design: A cross‐sectional study for cross‐cultural adaptation and validation of instruments. Methods: The study was conducted in two tertiary hospitals in northeastern and southwestern China in 2020: (Step 1) translation and back‐translation by four translators; (Step 2) expert consultation to assess content validity by a five‐person panel; (Step 3) cognitive debriefing to evaluate the online survey with six nurses; (Step 4) pilot testing to finalize the survey with 79 nurses; and (Step 5) psychometric evaluation of construct validity and internal consistency reliability including post hoc analysis with 1071 nurses. Results: The Chinese scales of Perceived Preparation and Opinions demonstrated generally acceptable content validity, construct validity and internal consistency reliability; some factor analysis results were uninterpretable, and socially desirable responses existed. A post hoc inspection of item and score distributions assisted the item classification into Confident, Cautious and Concerned regarding the authenticity of nurses' responses. Conclusion: Reliability and construct validity of the Chinese versions of Perceived Preparation and Opinions were supported in this sample. The instrument measures nurses' preparedness and opinions towards IPV. Item classification into Confident, Cautious and Concerned categories is a pragmatic way to interpret the results. Impact The Chinese scales can be used to measure nurses' preparedness and opinions towards IPV in China. The study also provides an approach for interpretation of results and identification of socially desirable responses in validation and survey studies in other contexts. The adaptation and use of the Chinese scales serve as a primary step in responding to IPV in China's health sector and can be used as a template for adapting the instrument in other low‐ and middle‐income countries. [ABSTRACT FROM AUTHOR]

Aims: To describe adult intensive care nurses' experiences and attitudes towards intrahospital transport (IHT) of critically ill patients and to assess the relationship between nurses' characteristics, attitudes and experiences. Design Cross‐sectional survey. Methods: Factor analysis identified factors within the attitudinal and experience domains. Univariate analysis was performed to demonstrate the relationship between attitudinal and experience factors and demographic and professional characteristics of the participants. Multiple regression equations were applied to determine associations between nurses' experiences and attitudes. The study took place from July to August 2019. Results: A total of 480 nurses from 12 adult intensive care units in China participated, with a response rate of 65%. Most respondents had a baccalaureate nursing degree (75%). The majority (80%) had participated in IHT of critically ill more than five times in the previous 12 months and 90% agreed that checklists led to an improvement in patient safety during transport. However, 75% of respondents expressed that transport increased the workload of the nurses who accompany patients off unit and those who remained in the intensive care unit (66%). Variables that were associated with a favourable perception of transport competency and checklists/tool use were nurses' prior transport experiences and knowledge/training. Conclusion: Nurses perceived IHT was a sourse of stress and increased workload. Checklists and training were beneficial for patient safety during IHT. Impact The findings point out a clear need for ICU nurse training, standardised policy/procedure and customisation of existing intrahospital transfer checklists according to hospital procedures and local circumstances. New research is needed to evaluate the impact of novel IHT interventions on patient safety and nurses' stress. [ABSTRACT FROM AUTHOR]

Aim: This study protocol aims to examine the effectiveness and preconditions of a self‐management program—named REducing Delay through edUcation on eXacerbations (REDUX)—in China. Background: The high disease burden in people with chronic lung disease is mainly due to exacerbations. There is a need for effective exacerbation‐management interventions. A nurse‐led program, REDUX, helped patients self‐manage exacerbations. Design: A single‐arm pre‐post study. Methods: Fifty‐four patients and 24 healthcare professionals (HCPs) in Chinese primary care will be included. The core element of the program is a personalized action plan. HCPs will receive training in using the action plan to help patients manage exacerbations. The intervention will start when a patient is referred to the nurse for a post‐exacerbation consultation and ends when the patient presents for the second post‐exacerbation consultation. During the first post‐exacerbation consultation, the patient and nurse will create the action plan. The primary outcomes in patients will include the delays between the onset of exacerbation and recognition, between exacerbation recognition and action, between exacerbation recognition and consultation with a doctor, and when the patients feel better after receiving medical help from HCPs. The secondary outcomes will include preconditions of the program. The ethics approval was obtained in September 2021. Discussion This study will discuss a culturally adapted nurse‐led self‐management intervention for people with chronic lung disease in China. The intervention could help Chinese HCPs provide efficient care and reduce their workload. Furthermore, it will inform future research on tailoring nurse‐led self‐management interventions in different contexts. Impact The study will contribute to the evidence on the effectiveness and preconditions of REDUX in China. If effective, the result will assist the nursing of people with chronic lung disease. Trial registration: Registered in the Chinese clinical trial registry (ID: 2100051782). [ABSTRACT FROM AUTHOR]

Aims: The present study investigated the association between resilience, stigma, life satisfaction and the intention to receive a COVID‐19 vaccination among Chinese HCWs. It also explored the mediating role of stigma and life satisfaction on the association between resilience and intention to receive a COVID‐19 vaccination. Design: An anonymous cross‐sectional survey. Methods: 1733 HCWs from five hospitals in four provinces of mainland China completed a cross‐sectional online survey in October and November 2020. Results: Among the HCWs, the rate of intention to receive a COVID‐19 vaccination was 73.1%. Results from structural equation modelling showed that resilience was associated both directly, and indirectly with greater intent to receive a COVID‐19 vaccination through two pathways: first by increasing life satisfaction, and second by reducing stigma and increasing life satisfaction. Conclusion: Promoting the resilience of HCWs has the potential to increase the COVID‐19 vaccination uptake rate among HCWs in China. Impact: This study tested the relationship between several psychological factors and the COVID‐19 vaccination intention of HCWs in China, finding that resilience played a significant role in improving COVID‐19 vaccination intention rates by reducing stigma and increasing life satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To measure the prevalence of compassion fatigue among Chinese clinical nurses and to examine the effects of resilience and self‐efficacy on compassion fatigue. Design: A cross‐sectional descriptive survey was conducted in accordance with the STROBE guidelines. Methods: Participants were recruited from three tertiary hospitals in central China from October 3 to December 15, 2019, using convenience sampling. Clinical nurses (n = 992) from different nursing departments completed the General Information Questionnaire, Professional Quality of Life Scale, Connor‐Davidson Resilience Scale, and General Perceived Self‐Efficacy Scale. Descriptive statistics, t‐tests, one‐way analysis of variance, Pearson or Spearman's correlation analyses, and multiple linear regression models were used. Results: Nurses experienced moderate levels of compassion fatigue (burnout and secondary traumatic stress). Resilience and self‐efficacy were significantly negatively correlated with burnout but not with secondary traumatic stress. Linear regression analysis showed that resilience, self‐efficacy, exercise, and physical conditions were the main predictors of burnout. Only physical conditions and marital status significantly predicted secondary traumatic stress. Conclusion: Nurses are vulnerable to compassion fatigue in China. Resilience and self‐efficacy significantly negatively predicted nurses' compassion fatigue. Physical conditions, healthy lifestyles, and social support are also important factors for compassion fatigue. Impact: Our findings can be used to generate targeted intervention and coping strategies for nurses to improve their resilience and self‐efficacy to alleviate compassion fatigue. [ABSTRACT FROM AUTHOR]

Aims: To verify a hypothesized model of the relationships between compassion fatigue, burnout and compassion satisfaction, as well as their influencing factors and consequences, among emergency nurses. Design: A descriptive, cross‐sectional design. Methods: A hypothesized model was proposed on the basis of the current literature. A convenience sample was conducted of nurses working in the emergency departments of six hospitals in Shanghai, China, from July to September 2020. A total of 445 valid data points were collected using various self‐designed and well‐validated instruments. Descriptive statistics and correlations were computed, and a path analysis was used to assess model fitness and to investigate direct and indirect effects. Results: The final model reported a desirable fit with significant paths. Compassion satisfaction and compassion fatigue directly and inversely affected burnout, and compassion satisfaction positively influenced compassion fatigue. Perceived social support directly improved compassion satisfaction and protected against compassion fatigue. Compassion satisfaction and compassion fatigue directly affected mental health, and burnout directly influenced physical health. Compassion fatigue, burnout and compassion satisfaction had complicated effects on turnover intention. Conclusion: Emergency nurses' compassion satisfaction and compassion fatigue may be two coexisting constructs, and both affect burnout. Perceived social support acts as a protector of the three dimensions, and their effects on health status and turnover intention can be significant and complicated. Impact: Emergency nurses may experience high levels of compassion satisfaction and compassion fatigue simultaneously, which can help to explain why compassion fatigue did not directly increase emergency nurses' turnover intention. The direct effects of compassion fatigue and burnout on emergency nurses' health status and working engagement were significantly different. Support from significant others, professional psychological intervention and emergency nursing system reforms are required to tackle emergency nurses' compassion fatigue and burnout and improve their compassion satisfaction. [ABSTRACT FROM AUTHOR]

Aims: To compare levels of nurse burnout across eastern and western cultures, as well as examine the influence of burnout on patient safety cross‐culturally. Design: Comparative cross‐sectional study. Methods: Survey data were collected from nurses between August and October 2017 in Australia (n = 730) and between April and October 2019 in China (n = 1107). Variables included burnout (emotional exhaustion, depersonalization, personal accomplishment), nurse leadership and support, staffing and resource adequacy, and perceived patient safety. Data were analysed separately for each jurisdiction using bootstrapped hierarchical regressions, which tested the relationships between burnout indicators and patient safety, controlling for support resources. Results: Emotional exhaustion and depersonalization scores were significantly higher in the Australian sample compared with the Chinese sample. Australian participants reported significantly lower patient safety grades than Chinese participants and were less likely to agree that support resources were present in their current job. Separate regressions indicated that patient safety was significantly associated with staffing and resource adequacy, nurse leadership and support, and depersonalization among Australian participants (30% of variance explained in the final regression model), while staffing and resource adequacy, nurse leadership and support, personal accomplishment and emotional exhaustion predicted patient safety for Chinese participants (22% of variance explained in the final model). Conclusion: Australian nurses are at greater risk of burnout than Chinese nurses. Burnout dimensions are differentially associated with patient safety across cultures. Culturally relevant interventions may be more optimal than universal approaches for improving burnout and patient safety in nursing. Impact: This study increased understanding of cross‐cultural differences in nurse burnout and the relationship with patient safety. Australian nurses were at greater risk of burnout than Chinese nurses. Emotional exhaustion, depersonalization and personal accomplishment influenced patient safety distinctively across the countries. These findings inform interventions designed to reduce nurse burnout and improve patient safety internationally. [ABSTRACT FROM AUTHOR]

Aims: To examine patient-caregiver concordances about psychological distress among Chinese patients with breast cancer undergoing chemotherapy and identify factors related to concordance among patients and family caregivers. Design: Cross-sectional study. Methods: From October 2019 to June 2020, 137 patient-caregiver dyads were enrolled. Sociodemographic information, the distress thermometer (including the problem list), the Distress Disclosure Index and the Family Adaptability and Cohesion Evaluation Scale were used to collect data. Data were analysed using intraclass correlation coefficients (ICC), kappa statistics, two related samples test, chi-square tests and/or Fisher's exact tests and binary logistic regression. Results: Overall, fair agreement was identified between patients' and caregivers' reports (intraclass correlation coefficients [ICC] = .528). Patients reported significantly higher psychological distress scores than paired caregiver reports. Lower psychological distress concordance was found among patients with comorbidities (odds ratio [OR], 0.352; 95% confidence interval [CI], 0.155-0.798) and lower levels of self-disclosure (OR, 0.402; 95% CI, 0.186-0.868). Conclusion: There was relatively low concordance between patients' reports and caregivers' perceptions of psychological distress. Family caregivers tended to underestimate patients' psychological distress. A comorbid condition and lower levels of self-disclosure contributed to this bias. Impact: Having an awareness of the incongruence between patient and caregiver may help healthcare providers better interpret caregiver assessments. Healthcare providers should reinforce patient-caregiver dyadic psychosocial education to improve concordance. More psychological care and substantial emotional support should be provided for Chinese breast cancer patients undergoing chemotherapy by family caregivers and healthcare providers. [ABSTRACT FROM AUTHOR]

Aim: The aims of this study were to examine the prevalence of adverse childhood experiences (ACEs) among health science students in China; associations between the number of ACE exposures and severity of depressive and anxiety symptoms; and the extent to which resilience moderates the effect of ACEs on mental health outcomes. Design: This descriptive, cross‐sectional study was conducted May–August 2020. Methods: Five hundred and sixty‐six health science students (18–38 years) from China completed online surveys measuring ACEs using the Simplified Chinese version of the ACE‐International Questionnaire, depressive and anxiety symptoms and resilience. Descriptive statistical analysis, ANOVA with Tukey HSD post hoc tests and multiple regression analysis were performed using SPSS 27. Results: 88.5% of participants reported at least one ACE; 42.6% reported four or more ACEs. Higher number of ACEs was associated with more symptoms of depression and anxiety. Four or more ACEs were associated with significantly worse mental health outcomes than those with no ACEs and those with one to three ACEs. Greater resilience significantly attenuated the effects of ACEs on mental health symptoms. Conclusions: ACEs are highly prevalent among Chinese health science students but their impact on mental health can be buffered by higher levels of resilience. Impact: Screening for ACEs and strength‐based, trauma‐informed interventions on fostering resilience is needed to promote mental health among Chinese young adults. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationships and pathways between dyadic coping, intimate relationship and post‐traumatic growth (PTG) in Chinese patients with breast cancer. Design: A cross‐sectional study. Methods: Between November 2019 and November 2020, 133 patients with breast cancer who received therapy in tertiary grade‐A hospitals at Dalian, China completed questionnaires including demographic and clinical questionnaires, Locke–Wallace Marriage Adjustment Test, Chinese version of the Dyadic Coping Inventory and Chinese version of the Post‐traumatic Growth Inventory. Structural equation modelling was used to analyse the pathways. Results: Dyadic coping was positively interrelated with PTG and intimate relationship (r =.355, p <.01; r =.213, p <.05); intimate relationship was negatively interrelated with PTG (r = −.207, p <.05). The structural equation model demonstrated adequate fit. Dyadic coping and intimate relationship directly affected PTG (β =.469, p <.05; β = −.309, p <.05). Dyadic coping indirectly affected PTG through intimate relationship (β = −.066, p <.05). Conclusions: Dyadic coping was a stimulus factor, but intimate relationship was an obstructive factor in enhancing PTG for the Chinese patients with breast cancer. Furthermore, intimate relationship may have significant mediating effects in the link between dyadic coping and PTG. Strategies that improve dyadic coping level and avoid excessive intimacy relationships between couples contribute to the development of PTG among patients with breast cancer. Impact: The research provides new ideas and intervention entry points for global nurses and psychotherapists so that they can enact and implement targeted PTG intervention plans for patients with breast cancer worldwide. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID‐19 prevention measures in Chinese Healthcare students. Design: A cross‐sectional survey collecting data in Hong Kong and Fujian Province of China in April 2020. Methods: A convenience and snowball sample of 2706 students aged 18 years or older and studying a healthcare programme were recruited in tertiary education institutions/universities in Hong Kong and Putian. The participants completed the questionnaire with six scales: Social Distancing Scale; Personal Hygiene Scale; Empathic Responding Scale; Wishful Thinking Scale; Perceived Stress Scale and Perceived Threat Scale. Path analysis was performed to identify factors associated with the preventive measures outcomes. p value <.05 was considered as statistical significance. Results: The participants reported high compliances to both social distancing (SoD) and personal hygiene measures (PHM). Confidence to manage the current situation, wishful thinking and empathetic responding directly predicted compliance with SoD and PHM. The final model constructed demonstrated a very good fit to the data. Conclusion: The findings suggest that students who are male, habituate in Hong Kong, have more clinical experience and weak confidence to manage the threat tend to have lower compliance with the COVID‐19 preventive measures. Impact: The predictive model constructed is the first one to explore factors associating with the compliance with infection control measures in healthcare students amid the COVID‐19 outbreak. As the infection control behaviours of healthcare students, whom are still under training and are the high‐risk group of being infected and infecting others in the community, are rarely reported in literature, this study has provided empirical evidence to nurses and other healthcare professionals to identify students susceptible to poor compliance and provide early monitoring and education to suppress the COVID‐19 transmission. [ABSTRACT FROM AUTHOR]

Aims: To examine new graduate nurses' perceptions of competency on coping with dying and death and the relationship with death self‐efficacy and death anxiety. Design: A multicentre, cross‐sectional study. Methods: Three hundred and forty new graduate nurses from five metropolitan hospitals were recruited between August–November 2018. Participants completed the Coping with Death Scale, Death Self‐efficacy Scale, and Death Anxiety Scale. Results: Two hundred and ninety‐eight new graduate nurses responded to the survey. The mean score of coping with death and death self‐efficacy was 120.11 (SD 24.59), 259.11 (SD 57.70) respectively. 88.9% feared a painful death, 81.5% were particularly afraid of getting cancer, and 80.2% were afraid of death. There was a positive relationship between coping with death and death self‐efficacy, a negative relationship between coping with death and death anxiety and a negative correlation between death self‐efficacy and death anxiety. Five variables, including death self‐efficacy, three dimensions of death anxiety including emotion, cognition with life and death and stress and distress and religion in total accounted for 46.9% of the variance of coping with death. Conclusion: New graduate nurses are at a disadvantage in terms of death self‐efficacy, less well prepared in coping with death and are more anxious about death. Impact: It is imperative for educational institutions to support new graduate nurses with pre‐licensure learning related to patient death issues and care. Organizations are also strongly advised to support new graduate nurses to cope with patient death through development of culturally sensitive interventions and guidelines, which may in turn assist with decreasing new graduate nurses' risk of burnout and increasing their longevity in the profession. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationships among hope, meaning in life, and post‐traumatic growth (PTG) in patients with chronic obstructive pulmonary disease. Design: A cross‐sectional study design. Methods: Between October 2018–September 2019, 221 chronic obstructive pulmonary disease patient completed the questionnaires including sociodemographic information, Chinese Version of Herth Hope Index, Meaning in Life Questionnaire, and Post‐traumatic Growth Inventory. Descriptive analysis, Spearman's correlation analysis, the Kruskal–Wallis H test, the Mann–Whitney U test, and the ridge regression analysis were used for analysis. Results: Spearman's correlation analysis showed that hope and meaning in life were positively interrelated with PTG (r = 0.20–0.45, r = 0.36–0.54, p < 0.01). Ridge regression analysis results showed that hope, meaning in life, time since diagnosis, habitation, medical insurance, and monthly income could explain 47.30% of the variance in PTG (F = 33.863, p < 0.001). Conclusion: Chinese patients with chronic obstructive pulmonary disease experienced a slightly positive change in meaning in life and a moderate degree of hope and PTG. Results suggested that hope and meaning in life were positively connected with PTG. Therefore, enhancing hope and meaning in life might be crucial for patients with chronic obstructive pulmonary disease to promote PTG. Impact: The findings added better understanding of relationships among hope, meaning in life, and post‐traumatic growth in patients with chronic obstructive pulmonary disease which can help nurse give interventions in the early stage of disease diagnosis. [ABSTRACT FROM AUTHOR]

Aims: The aims of the present study were: a) to investigate the current state of postpartum glucose screening in rural China; and b) to explore the factors influencing postpartum blood glucose screening among women with prior GDM based on Andersen's behavioural model of health service use. Design: A multisite, cross-sectional study design, conducted from November 2017 to January 2018. Methods: A total of 465 women with prior GDM were included from two countylevel hospitals in rural China. The potential influencing factors for postpartum blood glucose screening based on Andersen's behavioural model, including predisposing, enabling, and need factors, were collected by self-reported questionnaires. Chisquare tests and logistic regression were used to explore the influence of these factors on whether screening of blood glucose level after delivery occurred. Results: The mean age of the women was 31.92 years old (SD 5.16) and the mean time after delivery was 16.73 months (SD 15.07). The postpartum glucose screening proportion was 32.7%. Women who did not have a full-time job (p= .011) (predisposing factor), had not received any treatment for GDM (p= .002), and were not informed about screening plans for diabetes by health professionals (p < .001) (enabling factor) were less likely to engage in postpartum glucose screening. The need factor, high actual risk of developing type 2 diabetes mellitus (T2DM), was not associated with postpartum blood glucose screening (p> .05). Conclusions: In rural China, most women with prior GDM were not screened for T2DM after delivery. The women with prior GDM who did not have a full-time job or had not received any prior treatment for GDM should be the target population for health education on postpartum glucose screening. Impact: There is a need for data on postpartum blood glucose testing rates among rural women. Future interventions aimed at increasing postpartum blood glucose screening are needed. [ABSTRACT FROM AUTHOR]

Aims: To investigate the job satisfaction among psychiatric nurses in China and to explore its associated factors. Design: A cross‐sectional survey among a nationwide sample from 32 tertiary psychiatric hospitals in 29 provincial capitals in China. Methods: Nurses (N = 9.907) were targeted for this survey in December 2017. In all, 8,493 responded (response rate = 85.7%) and 7,881 (79.5%) were included in the analysis. An online questionnaire was used to collect demographics and factors related to the work environment. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Multilevel regression was used to examine the association between job satisfaction and these factors. Results: The mean job satisfaction score was 73.7. The multiple regression analysis indicated that self‐rated health, monthly income, medical liability insurance coverage, perceived respect from patients, social recognition, nurse–physician collaboration, and trust were significantly associated with higher job satisfaction scores, while age, work hours, and directly experiencing patient‐initiated violence were negatively associated with job satisfaction (p < .05). Conclusion: Overall, Chinese psychiatric nurses are closer to satisfied than neutral and some demographics and factors related to stressful work environments were associated with nurses' job satisfaction scores. Impact: This study examined factors associated with the job satisfaction of Chinese psychiatric nurses in a nationwide sample and indicated that to improve nurses' job satisfaction, the government and hospital administrators could consider ways to promote nurses' personal health and to modify the stressful work environments, such as improving income, reducing work hours, promoting the psychiatric nursing specialty in ways that increase the public's respect for it, increasing awareness of medical liability insurance coverage, and protecting nurses from patients' violence. [ABSTRACT FROM AUTHOR]

Aims: To clarify gender differences in the demographic variables and infertility problems associated with depression among men and women undergoing infertility treatment. Design: A cross‐sectional study. Methods: We surveyed 380 women and 360 men undergoing infertility treatment at the reproductive medicine center of a hospital in China's Ningxia Province from March ‐ September 2016. Results: For women, ethnicity, the number of clinic visits, social concern, and sexual concern were factors linked with depression symptoms. For men, treatment cost pressure and social concern were significantly associated with depression symptoms. Conclusion: Psychological counseling and intervention programs should be integrated into in‐vitro fertilization treatments and interventions should be targeted based on gender differences. Impact: The provision of treatment‐related sexual knowledge by nurses is indispensable for infertile participants. Mental health policies should be developed to facilitate the implementation of psychological services. Psychological counseling and intervention programs should be integrated into in vitro fertilization treatment to help men and women with infertility cope with psychological distress. [ABSTRACT FROM AUTHOR]

Aim: To investigate the distribution of pressure injuries among older adults in China and to identify the associated risk factors. Design: Cross‐sectional study. Methods: The identified subjects were collected from 2012 wave of a national Chinese Longitudinal Healthy Longevity Survey. Older people were defined as being 65 years of age or older. We used chi‐square test and binary logistic regression to investigate the risk factors of pressure injury development. Results: A total of 55 older people were documented as suffering from pressure injuries among 6,961 older Chinese adults, with a prevalence of 0.8%. In the group of disability, the prevalence of pressure injuries from high to low was 3.6% in the highly limited group, 0.4% in the moderately limited group, and 0.3% in the not limited group. The prevalence of pressure injury among older people with stroke, cancer, and dementia were 2%, 4.2%, and 6.6%, respectively. According to the final binary logistic regression analysis, age, disability, incontinence, cancer, and dementia emerged as important risk factors for pressure injury development. Conclusion: Pressure injury among Chinese community‐dwelling aged people was shown to be associated with age, disability, incontinence, cancer, and dementia. As the development of pressure injury may distinctly increase the burden on individuals and healthcare systems, the social and related institutions should actively prevent and control the disease. Impact: The results of this study will improve the identification of pressure injury among older Chinese people and contribute to the development of effective pressure injury risk management interventions. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to examine the psychometric properties of the 11-item Chinese version of the Career Success Scale. Background Nurses play an important role in the healthcare system. Opportunities to achieve success and satisfaction from one's career affect the retention and stability of the nursing workforce. The Career Success Scale was originally developed in English and has been translated into Chinese. Psychometric testing of the Chinese Career Success Scale for measuring career success in nurses has not been performed. Design A cross-sectional survey was conducted. Method A convenience sample of 1148 clinical nurses were recruited from 10 level-3 hospitals in Guangdong Province, mainland China, from December 2010-December 2011. Results Results indicated that the Chinese Career Success Scale demonstrated good internal consistency and test-retest reliability. Principal component analysis supported the three-factor structure of the original instrument: Career Satisfaction, Perceived within Organization Competitiveness and Perceived External Organization Competitiveness. There were significant correlations among the three factors, which demonstrated the good construct validity of the Chinese version of this scale. Conclusion The Chinese Career Success Scale appears to be a reliable and valid instrument. It has the potential to be used to measure nurses' career success in mainland China. The findings will be useful for nurse leaders and policymakers in the evaluation of nurses' self-perceived career success and to develop strategies to promote nurse retention and career development. [ABSTRACT FROM AUTHOR]

Aim To translate the validated measure, Self- Management of Type 1 Diabetes in Adolescents, into the Mandarin Chinese language and to test the psychometric properties of the Chinese version. Background Although research on self-management of Type 1 diabetes has been increasing over the past 20 years, few health-related instruments have been available in the Chinese language for youth with Type 1 diabetes. Design A two-phase design was used in this study, including instrument translation and psychometric testing. Methods The instrument translation, from October 2008-April 2009, included three steps: forward translation, back translation, and comparison of versions via Translation Validity Index - with multiple rounds, group discussion, and achievement of consensus at each step. Psychometric properties of the Chinese version Schilling's Self- Management of Type 1 Diabetes for Adolescents scale was assessed in a convenience sample of 136 Chinese youth (ages 8-19) with Type 1 diabetes between June 2009-August 2009. Results The internal consistency and test-retest reliabilities indicated generally good consistency and temporal stability of the Chinese version. Evidence of construct validity and criterion-related validity was obtained via correlations of subscales with established measures of diabetes adherence and quality of life and also with haemoglobin A1c. Results from hypothesis testing also supported construct validity. Conclusion The Chinese version of Self- Management of Type 1 Diabetes for Adolescents scale is sound and will facilitate cross-cultural studies, while also enabling nurses to monitor and enhance the diabetes self-management of Chinese youth with Type 1 diabetes. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to evaluate the self-help behaviour of individuals with eating disorders in an Internet-based self-help programme developed in the Asia-Pacific region and to determine their compliance with the programme. Background. Eating disorders represent a growing health problem affecting both Western and Asian countries. Without timely and adequate treatment, individuals with eating disorders are at risk of premature death. Self-help approaches for treating eating disorders offer therapeutic promise. Design. An open trial design was used. Method. This study, conducted from August 2006-July 2011, included 280 participants recruited from outpatient eating disorder clinics and treatment units and through a university student newspaper and Internet websites. This open trial evaluated an Internet-based self-help programme, which included components on healthy eating, family education, health assessment, motivation enhancement, self-help strategies, and psychological health promotion. The progress of participants was followed up via monthly e-mails. A tracking system was implemented to determine their compliance with the programme. Findings. A small majority of the participants (56·9%) were already undergoing treatment for their eating disorders. About 63% ( n = 176) demonstrated self-help behaviour, as manifested by their completion of health assessment questionnaires, involvement in motivation enhancement exercises, or the use of self-help strategies such as monitoring, normalizing eating behaviour, and stress management. Improvements were observed in their eating disorder psychopathology, motivational stage of change and psychological health from baseline to the 1-month follow up. Conclusion. Internet-based self-help programmes for eating disorders are helpful adjuncts to professional treatment. [ABSTRACT FROM AUTHOR]

Aim. A protocol for a new peer-led self-management programme for community-dwelling older people with diabetes in Shanghai, China. Background. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Design. Quasi-experimental. Methods. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. Discussion. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks, is especially promising considering healthcare resource shortage in China. [ABSTRACT FROM AUTHOR]

ma c., chen s., you l., luo z. & xing c. (2012) Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension. Journal of Advanced Nursing 68(6), 1402-1413. Abstract Aim. This article is a report of the development and psychometric testing of the Treatment Adherence Questionnaire for Patients with Hypertension. Background Hypertension is the most prevalent health problem among adult patients affecting approximately 200 million people in China and about 1 billion persons worldwide. Adherence to medication and lifestyle for hypertensive patients result in blood pressure control and reduce adverse outcomes. At present, few specific adherence instruments are available to completely evaluate medication and lifestyle for hypertensive patients. Methods. A multi-phase psychometric questionnaire development method was used to develop the instrument. The item pool was generated using literature review and focus group. Content validity was evaluated by expert panel. Then, the field testing was conducted by a convenience sampling of 278 hypertensive patients from December 2009 to May 2010 in Guangdong Province of China. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed. Results. The new measure consisted of six dimensions with 28 items, explaining 62·54% of the total variance in the data. Confirmative factor analysis supported a good overall fit of the six-factor model. Cronbach's α of the overall questionnaire was 0·86 and 0·82 for test-retest reliability. Conclusions. The questionnaire was a brief and psychometrically sound instrument to evaluate hypertensive patients' treatment adherence and to be applied in the research and clinical fields. [ABSTRACT FROM AUTHOR]

quan l., dong j., li y. & zuo l. (2012) The effectiveness of intensive nursing care on seasonal variation of blood pressure in patients on peritoneal dialysis. Journal of Advanced Nursing 68(6), 1267-1275. Abstract Aim. This article is a report of a study to reduce the seasonal variation of blood pressure in patients on peritoneal dialysis through an intensive programme of nursing care. Background. The seasonal variation of blood pressure is a common phenomenon in patients on maintenance dialysis. Whether or not this variation can be reduced through a given intervention is unknown. Methods. The programme of intensive nursing care including education on volume control, home blood pressure monitoring and intensified antihypertensive treatment, was implemented from December 2006. The blood pressure, fluid and sodium removal and defined daily doses of antihypertensive agents were measured at 1-monthly intervals and averagely quarterly for seasonal values for spring, summer, autumn and winter, respectively, before (December 2005-November 2006) and after intervention (December 2006-November 2007). Findings. A total of 76 clinically stable patients on peritoneal dialysis were enrolled and finally analysed. The mean age was 60·6 years, and dialysis duration was 23·2 months. Before intervention, there were important seasonal variations in systolic and diastolic blood pressure. After intensive nursing care was implemented, the seasonal variation of systolic blood pressure disappeared. The diastolic blood pressure still represented a season pattern, but the discrepancy between winter and summer decreased. There were no seasonal patterns of total fluid and sodium removal before and after intervention. Conclusions. Intensive nursing care reduced the seasonal variation of blood pressure in patients on peritoneal dialysis. These data provided an evidence for implementing nurse-centred interventions in this population. [ABSTRACT FROM AUTHOR]

gao y.-q., pan b.-c., sun w., wu h., wang j.-n. & wang l. (2011) Depressive symptoms among Chinese nurses: prevalence and the associated factors. Journal of Advanced Nursing 68(5), 1166-1175. Abstract Aim. This article is a report of exploration of depressive symptoms and the associated factors among Chinese nurses working at public city hospitals. Background. Hospital nurses are known to work in psychologically and physically demanding work environment, which may lead to depressive symptoms. However, little research has been done to address this problem in Chinese nurses. Methods. A cross-sectional survey was carried out in seven randomly selected city hospitals of Liaoning Province, northeast of China in 2009. Depressive symptoms of the nurses were measured with the Chinese version of the Center for Epidemiologic Studies Depression Scale. Job Content Questionnaire and the effort-reward imbalance, demographic features, life style and work conditions were measured as the related factors. Results. A total of 1592 nurses participated in the study and the effective response rate was 79·5%. The prevalence of depressive symptoms among the nurses was 61·7% ( n = 886), of whom 74·9% ( n = 664) had mild depressive symptoms. Multivariate logistic regression analysis showed that lower job rank, higher over commitment, alcohol consumption, worse nurse-patient relationship and higher education background were positively associated with depressive symptoms, whereas supervisor support, taking regular meals, doing physical exercises, higher skill discretion and higher job satisfaction were negatively associated with depressive symptoms. Conclusion. More than half of the Chinese nurses had depressive symptoms. As depressive symptoms may adversely affect quality of life and quality of care, consultation for the nurses with healthy life styles, work stress coping techniques and advice to administrator to improve social aspects of the work environment might be helpful to reduce the depressive symptoms in nurses. [ABSTRACT FROM AUTHOR]

Wang L, Tao H, Ellenbecker CH & Liu X (2012) Job satisfaction, occupational commitment and intent to stay among Chinese nurses: a cross-sectional questionnaire survey. Journal of Advanced Nursing 68(3), 539-549. Abstract Aim. This study was designed to identify the level of nurses' job satisfaction, occupational commitment and intent to stay among mainland Chinese nurses, to explore the relationship among them. Background. Little is known about the magnitude of Chinese nurses' intent to stay. Understanding the association among demographic characteristics and job satisfaction, occupational commitment and intent to stay among Chinese nurses is most important in a time of nurse shortages. Methods. A descriptive correlation design was used to examine the relationship among variables related to intent to stay. Data were collected by a self-administered survey questionnaire from 560 nurses working in four large hospital facilities in Shanghai in 2009. Results. The mean scores for nurses' job satisfaction, occupational commitment and intent to stay were 3·25(0·48), 3·11(0·40) and 3·56(0·65), respectively. Job satisfaction and occupational commitment were significantly related to intent to stay. A statistically significant positive correlation was found between occupational commitment and job satisfaction. Age and job position were significantly related to job satisfaction, occupational commitment and intent to stay. Conclusion. Levels of job satisfaction, occupational commitment and intent to stay reported by nurses in this study can be improved. Suggested strategies for improvement are: increasing salaries, decreasing workloads, modifying task structure, cultivating work passion and creating more professional opportunity for nurses' personal growth development and promotion. Enhancing nurses' job satisfaction and occupational commitment are vital to improve nurses' intent to stay and for strategies to address the nursing shortage. [ABSTRACT FROM AUTHOR]

zeng y.c., liu x. & loke a.y. (2012) Addressing sexuality issues of women with gynaecological cancer: Chinese nurses' attitudes and practice. Journal of Advanced Nursing 68(2), 280-292. Abstract Aim. This paper reports a study conducted to describe Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. Background. Women with gynaecological cancer face numerous challenges to their sexuality. The importance of addressing sexuality concerns of people with cancer is emphasized by a growing body of literature in Western countries. Methods. This is a descriptive and correlational study. An inventory was adopted to explore Chinese nurses' attitudes and practice related to sexuality care in nursing. Data were collected from December 2009 to February 2010. Results. A sample of 202 nurses working in gynaecological units in China was recruited. Study results revealed that the majority (77·7%) held the attitude that 'sexuality is too private an issue to discuss with patients'. Only 34·2%'make time to discuss sexual concerns with patients'. Regression analysis revealed that nurse' marital status and hospital type in which they were working influenced their practice in sexuality care. Nurses' conservative attitudes towards sexuality, their prejudices about gynaecological cancer, the lack of availability of private environment, the lack of sexuality care training and the failure to include sexuality care in routine nursing care, were found to be factors that significantly influenced sexual care and nursing practice (adjusted R2 = 0·542, P < 0·001). Conclusions. The study findings contribute to the understanding of Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. There is a need to increase Chinese nurses' awareness of their roles and the importance of equipping themselves with relevant skills in sexuality care in nursing practice. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a descriptive comparative pilot study of use of a method that simultaneously tests the content validity and quality of translation of English-to-Chinese translations of two patient satisfaction questionnaires: the La Monica-Oberst Patient Satisfaction Scale and Hospital Consumer Assessment of Healthcare Providers and Systems. Background. Patient satisfaction is an important indicator of the quality of healthcare services. In China, however, few good translations of patient satisfaction instruments sensitive to nursing services exist. Methods. The descriptive pilot study took place in 2009 and used content validity indexing techniques to evaluate the content, context and criterion relevance of a survey question. The expert raters were 10 nursing faculty and 10 patients who evaluated the two patient satisfaction questionnaires. The experts evaluated the relevance of each item on a scale of 1-4 and the research team compared their responses to choose the most appropriate. Only the nurse faculty experts, who were bilingual, evaluated the quality of the translation using a binary rating. Results. The 'Nurse Rater' relevance scores of the LaMonica-Oberst Patient Satisfaction Scale and the Hospital Consumer Assessment of Healthcare Providers and Systems were 0.96 and 0.95 respectively, whereas the patient's overall relevance scores were 0.89 and 0.95. A Mann-Whitney U-test demonstrated that results between the two groups were statistically significantly different (P = 0.0135). Conclusions. Using content validity indexing simultaneously with translation processes was valuable for selecting and evaluating survey instruments in different contexts. [ABSTRACT FROM AUTHOR]