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Background: Inquiry‐based learning is a salient instructional approach to cultivate students' higher order thinking skills (HOTS). With the presence and advancement of new technologies, their usage for inquiry learning in university context is increasingly ubiquitous. However, in most circumstances, college students cannot integrate technologies to their inquiry learning in efficient ways or their abilities to use technologies are not good enough. Previous studies found that intrinsic motivation (IM), peer interaction (PI) and classroom connectedness (CC) were key factors to influence students' approaches to using technologies from the personal, behavioural and environmental perspectives. Objectives: This study investigated the influence of these three essential learning factors (IM, PI and CC) on students' HOTS and the mediate influence of deep approach to using technologies (DAUT) between these learning factors and HOTS in the technology‐enhanced open inquiry‐based learning context. Methods: A questionnaire was administered to 80 university students who had studied with the technology‐enhanced open inquiry‐based learning approach. The partial least squares method was employed to investigate the relationships among learning factors, DAUT and HOTS. Results and Conclusions: Results showed that CC and PI were positively directly related to HOTS. DAUT was a significant mediator between two (i.e., IM and PI) of the three learning factors and HOTS. The findings of the study have practical implications for instructors, indicating that they should pay attention to students' IM and PI in deepening their approach to using technologies as well as to improve students' HOTS in technology‐enhanced open inquiry‐based learning. Lay Description: What Is Already Known About This Topic: Inquiry‐based learning is considered to be a salient instructional approach to cultivate students' higher order thinking skills (HOTS).Technologies usage in inquiry learning is ubiquitous in university context.In most cases, college students are not able to integrate technologies in their inquiry learning in effective ways. What This Paper Adds: This paper proposed a research model that explains and predicts the mediating influence of deep approach to using technologies on the association between learning factors and HOTS in the technology‐enhanced open inquiry‐based learning context.The mediating effect of approaches to using technologies between learning factors and HOTS was identified.Two of the three learning factors (peer interaction and classroom connectedness) had direct effect on HOTS.Deep approaches to using technologies variable significantly mediates two of the three learning factors (peer interaction and intrinsic motivation) and HOTS. Implications for Practice or Policy: Instructors should pay attention to students' intrinsic motivation (IM) and peer interaction in order to deepen their approach to using technologies.Instructors should pay particular attention to peer interaction and classroom connectedness when conducting technology‐enhanced open inquiry‐based learning activities to improve college students' HOTS.Students' interest improvement and IM in using technologies, the integration of technologies and open inquiry‐based learning activities could be discussed and decided by both the instructor and students. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to produce a new parent‐report measure, the Diagnostic Receptive Expressive Assessment of Mandarin‐Infant Toddler Assessment of Communication and Language (DREAM‐IT) in order to provide norms for the developmental skills of children aged 0–36 months in four areas: expressive language, receptive language, cognitive play and social skills. Methodology: The scale was designed to be both broader and deeper than existing instruments that neglect one or more of these significant domains involved in early language. Items were chosen by a group of specialists with clinical experience working with the age group and with attention to the developmental literature. Caregivers were tested individually by a trained person who asked the questions and provided examples. In addition to an extensive health questionnaire, caregivers answered questions in Mandarin about their child's behaviour using a scale of 'not yet', 'sometimes' or 'always' or listing out words and/or sounds understood or said by the child. The 476 participating caregivers were recruited at maternal and child healthcare clinics centred in Chengdu, China, 191 of whom were tested a second time seven months later. The children were sampled in three‐month age‐bands from 0 to 36 months. The sample was balanced for child gender by age band, and parental education was balanced. Caregivers of 0–24‐month‐old children and caregivers of 12–36 months were each asked a different set of questions, to determine the appropriate age range and cutoff points for each question, requiring the sample size to be doubled for children aged 12–24 months. Results: The results were subject to item‐response theory analysis to remove outlying items, and the resulting internal reliability was high for each domain (average Cronbach's alpha=0.87). The final instrument (between 67 and 113 questions in total) was refined to include the least redundant questions that had the highest intercorrelations, with attention paid to coverage of all domains across the age range. Two scales were developed: one for children 0–18 months, the second for children aged 18–36 months. The longitudinal design permitted the creation of growth curves and norms for each domain for six‐month intervals from 0 to 36 months. A small sample of 32 parents of children with Down syndrome aged 18–36 months provided validation that the scales are highly sensitive to developmental delay. Conclusion: The instrument shows considerable promise for detecting early communication problems in children in China. WHAT THIS PAPER ADDS: What is already known on the subject: In China, efforts were made in recent years to develop language assessments for infants and toddlers, but limitations existed with the domains included and number of items included per age group. Many clinical practitioners also continued to rely on language subtests of general developmental scales, which were limited in depth and breadth of language skills tested and were never intended for diagnosis of language delay. What this paper adds to existing knowledge: This paper discusses the development of a valid caregiver report instrument for early communication and language skills of infants and toddlers in mainland China. The Diagnostic Receptive Expressive Assessment of Mandarin‐Infant Toddler (DREAM‐IT) includes foundational domains necessary for language and communication development in young children (receptive language, expressive language, cognitive play and social communication domains). The results show strong internal reliability (Cronbach's alpha) for each domain on a sample of 716 children sampled in three‐month age bands from 0 to 36 months. The external validity proved strong when tested on a group of 32 young children with Down syndrome. What are the potential or actual clinical implications of this work?: Besides helping to inform the diagnosis of language delays in infants and toddlers in China, the caregiver report instrument has special features to support clinical practitioners in a field that is just emerging in China. The unique support features include the automatic generation of a profile of relative strengths and weaknesses of the child on the report and the recommendation of child‐specific caregiver coaching videos on a companion app. [ABSTRACT FROM AUTHOR]

Background: Data literacy (DL) is vital for teachers, as it enables them to build on data and improve teaching and learning. Therefore, developing DL among pre‐service teachers is critical. Objectives: The purpose of this study is threefold: to evaluate whether a feedback visualisation of peer assessment‐based teaching approach (FVPA‐based teaching approach) can (1) promote pre‐service teachers' DL; (2) enhance their learning motivation; and (3) improve their cognitive load. Methods: The research was conducted based on a pre‐test‐post‐test control group quasi‐experimental design. With 20 participants in the experimental group and 21 in the control group, a total of 41 pre‐service teachers were included in the study. The pre‐service teachers in the experimental group adopted the FVPA‐based teaching approach, and those in the control group adopted the traditional peer assessment‐based learning approach. Results and Conclusions: The experimental group participants outperformed the control group participants in DL, learning motivation, and cognitive load. FVPA was conducive to helping pre‐service teachers critically interpret data, understand their teaching and learning issues, and improve self‐reflection. The findings indicate a reciprocal relationship between learning motivation and DL; improving the learning motivation of pre‐service teachers could promote their DL. Implications: This study contributes to current knowledge by providing empirical evidence on the benefits of an FVPA‐based teaching approach in improving pre‐service teachers' DL, motivation, and cognitive load. The study findings, limitations, and prospects for future research are discussed. Lay Description: What is already known about this topic?: Teacher data literacy has emerged as a crucial competency for the forthcoming generation of educators, gaining attention from education institutions globally.Peer assessment, a well‐established practice in pre‐service teacher education, has proven effective in enhancing the learning experience for disadvantaged students by fostering motivation and improving academic performance.Despite the acknowledged benefits of feedback visualisation in facilitating self‐reflection, motivation, and academic performance, creating meaningful visualisations remains a challenge for educators and learners. What this paper adds?: This study introduces feedback visualisation in peer assessment to enhance comprehension of feedback information among pre‐service teachers.Feedback visualisation augments the benefits derived from peer assessment, refining data literacy, improving learning motivation, and alleviating cognitive load among pre‐service educators.The analysis of data directly relevant to pre‐service teachers and the provision of timely feedback can motivate critical analysis and utilisation of data, facilitating the identification of pedagogical and learning challenges.The study explores intricate interactions among learning motivation, data literacy, and cognitive load within the context of peer assessment visual feedback. The implications of study findings for practitioners: We encourage teacher educators to implement peer assessment instruction grounded in visual feedback for a comprehensive understanding of learning outcomes, identification of pedagogical challenges, determination of causes, and evidence‐informed instructional decision‐making.Teacher educator should diversify strategies to augment the motivation of pre‐service teachers, cultivating their proactive engagement in data analysis, interpretation, and application to enhance overall data literacy.We recommend that teacher educators provide rich visual feedback or present complex data in a visually accessible format for pre‐service teachers who need additional assistance to mitigate cognitive load and facilitate successful learning outcomes. [ABSTRACT FROM AUTHOR]

Background: Zoomorphism, an obverse of conventional anthropomorphism, has been shown in many cases to be a powerful tool with respect to the metaphorical use of animals. Objectives: This study introduced zoomorphism into the instructional video design of pedagogical agents (PAs). Method: We first developed three image sets, each of which corresponded to a type of zoomorphic PA image construct (full panda, a human face with a panda body, and a human body with panda head imagery). Then, we conducted an image‐screening experiment in which 177 second‐grade students from a primary school were asked to select their favourite PA image for each image construct set. We used a realistic human PA as the baseline. Next, 114 second‐grade students from another school were randomly assigned to learn instructional videos on the topic of pandas using a PA with one of four imageries. Results and Conclusions: ANOVA and Kruskal–Wallis tests indicated that students presented with PAs with full‐panda imagery achieved significantly higher learning performance, learning experience, social presence, and learning interest than those presented with other imageries of PAs. The regression results showed that the effect of zoomorphic PAs with full‐panda imagery on learning performance was exerted in a direct way and that its effect on learning experience was mediated by social presence and learning interest. Implications: Our findings suggest that zoomorphic appearance is an essential quality for video learning that merits further investigation for the efficient imagery construction of PAs. Lay Description: What is already known about this topic: The inclusion of pedagogical agents with images that are attributed human qualities to animals known as anthropomorphism is very popular in multimedia education; however, the existing studies on the effects of such images on learning have shown inconsistent results. What this paper adds: We introduced the alternative philosophy of animal use‐zoomorphism, which is the obverse of anthropomorphism, into agent image building. Implications for practice and/or policy: Our study demonstrated that the zoomorphism of agent images increases learning performance and experience; thus, our findings suggest the prospect of zoomorphism in the development of agent image patterns. [ABSTRACT FROM AUTHOR]

Background: Pragmatics has generally been defined as the ability to use language in social situations, it is commonly regarded as the third major component of language ability. To date, there is no tool for assessing early pragmatic development of Chinese‐speaking children. Aims: To describe the translation of the Language Use Inventory (LUI) from English to Mandarin Chinese and to report findings on the Chinese version's reliability, validity and developmental sensitivity. Methods & Procedures: The original English version of the LUI was translated into Mandarin Chinese. Parents of 177 typically developing (TD) toddlers and preschool children completed the inventory to examine its internal reliability and construct validity and how scores differed across ages and sexes. A total of 31 parents out of the 177 completed the LUI‐Mandarin, again within 4 weeks, to assess test–retest reliability. To examine discriminative validity, 43 parents of age‐ and sex‐matched TD children and children with autism spectrum disorder (ASD) recruited from Nanjing Brain Hospital affiliated with Nanjing Medical University completed the LUI‐Mandarin. Outcomes & Results: Cronbach's alpha values for the LUI‐Mandarin's three parts and for 11 of 12 LUI‐Mandarin subscales were 0.707–0.992, with most values in the 0.825–0.992 range. Test–retest reliability ranged from 0.66 to 0.95, indicating good to excellent reliability. Factor analysis of the LUI‐Mandarin revealed two different factors, and the total variance explained was 74.38%. The LUI‐Mandarin total scores and subscale scores increased with age for both boys and girls, providing evidence of the inventory's developmental sensitivity. Girls, however, had higher total scores than boys at earlier ages (18–23 months). The results of the discriminant validity study revealed that performance was significantly lower in the ASD group than in the TD group with respect to LUI total scores and subscale scores (except for subscale A). Conclusions & Implications: The LUI‐Mandarin is the first and only questionnaire available in China that evaluates the pragmatic language skills of children aged between 18 and 47 months. The results of the study show that the LUI‐Mandarin is a valid and reliable tool for Chinese toddlers and preschool children. What this paper adds: What is already known on this subject: The LUI is a parent‐report questionnaire that can provide comprehensive information about very young children's communicative competence. It is widely used both for assessment and to guide intervention. Additionally, it has been translated into French, Italian, Polish, Arabic, Portuguese and Norwegian and it shows good reliability and validity. What this paper adds to existing knowledge: In the present study we describe the translation of the LUI from English to Mandarin Chinese and report findings on the Chinese version's reliability, validity and developmental sensitivity. What are the potential or actual clinical implications of this work?: The LUI‐Mandarin is the first and only questionnaire available in China that can evaluate pragmatic language skills of children aged between 18 and 47 months. The results show that the LUI‐Mandarin is a valid and reliable tool for use with Chinese toddlers and preschool children. [ABSTRACT FROM AUTHOR]

Background: Self‐regulated learning (SRL) ability is the key determinant of the success of full‐time online learning. Thus, exploring the influencing factors of SRL and their influencing mechanisms is necessary to improve this ability among K‐12 students. Objectives: The purpose of this study was to investigate the influence mechanism of teacher autonomy support on students' online SRL by examining the structural relationship among teacher autonomy support, parental autonomy support, students' self‐efficacy, and students' online SRL. Methods: We use structural equation modelling and effect analysis to analyse the collected data from 961 Chinese K‐12 students who engaged in full‐time online learning in their homes during the coronavirus disease 2019 (COVID‐19) outbreak. Results and Conclusions: Parental autonomy support and students' self‐efficacy play crucial independent mediating roles in the influence of teacher autonomy support on students' online SRL. Parental autonomy support and students' self‐efficacy have a chain mediating effect on the influence of teacher autonomy support on students' online SRL. Implications: On the basis of the results, we suggest that in order to develop students' online SRL ability, it is important for teacher to improve parental autonomy support and students' self‐efficacy. In addition, base on the chain mediating effect, to improve students' online SRL, teacher autonomy support needs focus on parental autonomy support, and then parental autonomy support needs focus on improving students' self‐efficacy. Lay Description: What is already known about this topic: • Self‐regulated learning (SRL) ability is the key determinant of the success of online learning. • To improve K‐12 students' SRL ability, it is important to explore the influencing factors and their influencing mechanisms on students' online SRL. • Teacher autonomy support play an important role for students' learning. What is not known about this topic?: • How does teacher autonomy support influence students' online SRL, especially in full‐time online learning? • Do parental autonomy support and student' self‐efficacy play a chain mediating role in the influence of teacher autonomy support on students' online SRL? What this paper adds: • Parental autonomy support and students' self‐efficacy play crucial independent mediating role in the influence of teacher autonomy support on students' online SRL. • Teacher autonomy support has a indirect influence on students' online SRL through the chain mediating effect of parental autonomy support and students' self‐efficacy. Implications for practice and/or policy: • Given that parental autonomy support and students' self‐efficacy mediating the influence of teacher autonomy support on students' online SRL, it is important to improve parental autonomy support and students' self‐efficacy. • In order to improve students' online SRL ability, teachers need focus on parental autonomy support, and parental autonomy support focus on improving students' self‐efficacy. [ABSTRACT FROM AUTHOR]

Aims: To translate and validate the Publication Pressure Questionnaire‐revised (PPQ‐r) among the Chinese nurses. Design: A cross‐sectional descriptive study. Methods: The classical forward/backward translation of the PPQ‐r was conducted first, and then the psychometric values were tested using the data collected in September, 2021 among 924 Chinese nurses from a university hospital in China by calculating its content validity index, construct validity, both convergent and discriminant validity, and internal consistency reliability following the COSMIN guidelines. Results: The proposed three‐factor structure of original PPQ‐r cannot be confirmed in present study. With exploratory factor analysis, a new two‐factor structure with 9 items was extracted, accounting for 62.718% of the variance. Confirmatory factor analysis indicated satisfactory goodness of all fit index values: χ2 = 75.53; df = 23; χ2/df = 3.28; CFI = 0.973; TLI = 0.958; RMSEA = 0.07 and SRMR = 0.047. Both sub‐scales yielded good internal consistency with Cronbach's alpha being 0.845 and 0.876, respectively. The Chinese version of PPQ‐r could be accepted as a reliable and valid tool to measure the Chinese nurses' publication pressure. Patient or Public Contribution: Participation of nurses in this study was limited to the data provided through participant survey. [ABSTRACT FROM AUTHOR]

In spite of the potentials promised by MOOCs (massive open online courses), the adoption rate of MOOCs is still low, especially in developing countries. Research on the adoption of MOOCs in developing countries is also limited. To fill this research gap, this research aims to study the adoption of MOOCs by extending current research on innovation and technology adoption in order to promote the diffusion of MOOCs in developing countries. Here, a conceptual framework, technology–user–environment was proposed to identify influential drivers and barriers of MOOC adoption. Eight hundred and twenty‐seven individuals in a developing country, were invited to participate in a questionnaire survey. Data were analysed by hierarchical regression, and the results show that for the (a) technological characteristics, perceived usefulness has the most significant influence, followed by lack of accessibility and performance‐to‐cost value; for the (b)user factors, self‐regulation was the most significant predictor of MOOC adoption, and female learners showed higher willingness to adopt MOOCs; and for the (c) social environmental factors, tradition and social norms and lack of information about MOOCs were negatively associated with adoption of MOOCs. Implications and suggestions are discussed at the end of this paper. Lay Description: What is already known about this topic: MOOCs (massive open online courses), as educational innovations, are supposed to bridge the digital divide and promote educational equity globally.The benefits of MOOCs for learners are obvious.However, the adoption rate of MOOCs is still relatively low while the dropout rate is high, especially in developing countries.Research on the adoption of MOOCs in developing countries is still limited.What this paper adds: This research proposed a conceptual framework, namely, technology–user–environment, in order to identify influential drivers and barriers from the technological characteristics of MOOCs as well as the user and the social environmental factors.After conducting a survey among 827 learners in a developing country, it was found that perceived usefulness of MOOCs, performance‐to‐cost value, and self‐regulation are positively associated with learners' intention of adopting MOOCs, whereas lack of accessibility tradition and social norms and lack of supporting information are negatively associated with their intention of MOOC adoption.Implications for practice and/or policy: For MOOC content provider, it is necessary to enhance the usefulness of MOOCs, as perceived usefulness is ranked as the strongest predictor of MOOC adoption.Universities in developing countries should help students overcome the potential obstacles at the beginning of MOOC learning by providing instructions to learners to search for course materials and how to use MOOCs to supplement their formal learning.Governments of developing countries are encouraged to be involved and support the development and delivery as well as the usage of MOOCs. Such participation by active stakeholders in developing countries has potential to bridge the digital divide between developed and developing countries.For learners, they should be equipped with self‐regulating strategies so that they will be competent to manage challenges (e.g., distractions) while learning in MOOCs. [ABSTRACT FROM AUTHOR]

Aim: Many people see nursing as a high‐pressure, high‐risk profession. Therefore, job burnout among nursing staff has become an important topic of study and has received widespread attention worldwide. This research intended to evaluate the frequency of and variables related with work burnout among nurses in public hospitals in China. Design: Using a multistage random sample procedure, a cross‐sectional survey was carried out in the eastern, central and western areas of China. Method s : The Maslach Inventory‐Human Service Survey and demographic information made up the two sections of the questionnaire. Of the 5250 questionnaires sent, 4865 were deemed legitimate, yielding an effective response rate of 92.67%. A linear regression analysis was performed to investigate the variables linked to nursing work burnout. Results: Among the 4865 nurses, women accounted for 97.4% of the survey respondents, most of whom were aged 26–35 years. Results showed that the total scores of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA) were 20.02 ± 12.04, 4.78 ± 5.54 and 34.42 ± 10.32 respectively. 50.7% of subjects obtained high or moderated scores on EE, 32.8% of subjects obtained high or moderated scores on DP and 80.4% of subjects obtained low or moderated scores on PA. Age, department, position, post‐establishment, work shift type in recent months, overtime times in recent months and night shift frequency in recent months were negatively correlated with EE, and child status, monthly income, working days per week and sleep quality in recent 1 month were positively correlated with it (F = 141.827, P < 0.01, R2 = 0.243). Age, gender, department, post‐establishment, overtime hours in recent months and night shift frequency in recent months were negatively correlated with DP, and child status and sleep quality in the last 1 month were positively correlated with it (F = 78.794, p < 0.01, R2 = 0.115). Child status, years of nursing work and sleep quality in the last 1 month were negatively correlated with PA, whereas age, position, work shift type in recent months and night shift frequency in recent months were positively correlated with it (F = 67.981, p < 0.01, R2 = 0.089). [ABSTRACT FROM AUTHOR]

Fish are vital in river ecosystems; however, traditional investigations of fish usually cause ecological damage. Extracting DNA from aquatic environments and identifying DNA sequences offer an alternative, noninvasive approach for detecting fish species. In this study, the effects of environmental DNA (eDNA), coupled with PCR and next‐generation sequencing, and electrofishing for identifying fish community composition and diversity were compared. In three subtropical rivers of southern China, fish specimens and eDNA in water were collected along the longitudinal (upstream–downstream) gradient of the rivers. Both fish population parameters, including species abundance and biomass, and eDNA OTU richness grouped 38 sampling sites into eight spatial zones with significant differences in local fish community composition. Compared with order‐/family‐level grouping, genus‐/species‐level grouping could more accurately reveal the differences between upstream zones I−III, midstream zones IV−V, and downstream zones VI–VIII. From the headwaters to the estuary, two environmental gradients significantly influenced the longitudinal distribution of the fish species, including the first gradient composed of habitat and physical water parameters and the second gradient composed of chemical water parameters. The high regression coefficient of alpha diversity between eDNA and electrofishing methods as well as the accurate identification of dominant, alien, and biomarker species in each spatial zone indicated that eDNA could characterize fish community attributes at a level similar to that of traditional approaches. Overall, our results demonstrated that eDNA metabarcoding can be used as an effective tool for revealing fish composition and diversity, which is important for using the eDNA technique in aquatic field monitoring. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the psychometric properties of the Advance Care Planning Readiness Scale (ACPRS‐C) within the context of community‐dwelling older adults with chronic diseases residing in suburban counties in China. Design: Descriptive, cross‐sectional survey. Method s : The research method employed in this study is characterized as a methodological study. Self‐reported survey data were collected among community‐dwelling older adults with chronic diseases residing in suburban counties in China. Including the following psychometric characteristics, item analysis was performed using the decision value method and Pearson's correlation analysis. Content validity was assessed through expert panel evaluation. The internal consistency of the questionnaire was determined by calculating Cronbach's alpha coefficient and corrected item‐total correlation. Additionally, confirmatory factor analysis (CFA) was utilized to assess the construct validity of the ACPRS‐C. Results: A total of 228 older adults participated in this psychometric study from August to October 2023. The item content validity index ranged from 0.80 to 1.00, while the scale content validity index was 0.945. The scale demonstrated excellent internal consistency (Cronbach's alpha = 0.931), and the correlation between items and total score was satisfactory. The structural validity was deemed robust (CFA model fit: chi‐square/df = 1.121, comparative fit index = 0.992). Conclusion: The ACPRS‐C is a scale with strong psychometric properties to assess the ACP readiness within the context of community‐dwelling older adults with chronic diseases residing in suburban counties in China. Its reliability and validity hold considerable significance for both research and clinical practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to investigate the correlation between fear of COVID‐19 and mental health of nurses and the effects of psychological capital and burnout in this relation. Design: A cross‐sectional study. Methods: The online surveys were conducted among mainland Chinese nurses. Participants (n = 445; average age 32.89 ± 6.76 years) completed an online‐questionnaire based on the Fear of COVID‐19 Scale, the Psychological Capital Scale, Maslach Burnout Inventory Human Services Survey for Medical Professionals Scale and the 12‐Item Short Form Health Survey. Data analysis was conducted by Pearson's correlation analysis, Harman single‐factor test and the bootstrap method for mediating effect testing. Results: (1) The study demonstrated a significant direct effect of fear of COVID‐19 on nurses' mental health, as well as on mediating factors such as burnout and psychological capital. (2) Regression analyses confirmed that while psychological capital bolstered mental health, burnout undermined it, with fear of COVID‐19 further imposing a negative influence. (3) Fear of COVID‐19 exerted an effect on the mental health of nurses by the independent and chain intermediary functions of psychological capital and burnout, resulting in a total mediating effect of −0.233. [ABSTRACT FROM AUTHOR]

Objectives: To explore the mediating role of self‐esteem in social anxiety and QoL during the COVID‐19 local epidemic in China. Design: A cross‐sectional survey. Methods: This study conveniently selected 344 hypertensive patients from a Grade‐A tertiary hospital in Wuhu, Anhui Province, as the study population. Participants completed the demographic questionnaire, the social phobia inventory, the self‐esteem scale and the 36‐item short‐form health survey. Results: Social anxiety, self‐esteem and QoL were significantly correlated with each other. Social anxiety showed no direct effect on QoL (β = 0.011, p > 0.05). Social anxiety showed an indirect effect on QoL (β = −0.248, p < 0.001). Self‐esteem fully mediated the association between social anxiety and QoL in hypertensive patients. Patient or Public Contribution: Hypertensive patients in this study were participants during the data collection process. Nursing staff from the cardiology department at the hospital of a hospital in Wuhu City, Anhui Province assisted in the recruitment phase of the data collection process. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties. Design: A cross‐sectional design was used. Methods: A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis. Results: Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I‐CVI was 0.75–1.00, the S‐CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients. Patient or Public Contribution: After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions. [ABSTRACT FROM AUTHOR]

Aim: To develop a Chinese version of the return‐to‐work self‐efficacy (RTW‐SE‐11) and verify its reliability and validity. Design: A validation study. Methods: The RTW‐SE‐11 was translated into Chinese according to the Brislin's model, and then the semantic adjustment of questionnaire was carried out through multi‐field expert evaluation and preliminary investigation. Results: All 11 items of the original questionnaire were retained. Content validity index (CVI) of the Chinese version of RTW‐SE‐11 indicated good validity, with Inter‐rater Agreement (IR) of 0.97, item CVI of 0.90–1.00 and questionnaire CVI of 0.91. Cronbach's α coefficient of RTW‐SE‐11 (Chinese version) was 0.923, suggesting high internal consistency, with test–retest reliability of 0.799 and half‐fold reliability of 0.926. Patient or public contribution: The Chinese version of the RTW‐SE‐11 questionnaire confirmed good reliability and validity for the assessment of return to work self‐efficacy in Chinese breast cancer patients. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to identify the mediating and moderating mechanisms by which social connectedness predicts life satisfaction among Chinese nurses. Background: Previous researchers have primarily focused on sociodemographic and occupational domain risk factors for nurses' life satisfaction with relatively little insight into facilitative and protective factors and underlying psychological mechanisms. Methods: We investigated 459 Chinese nurses' social connectedness, work–family enrichment, self‐concept clarity, and life satisfaction via a cross‐sectional design. We explored the underlying predictive mechanisms among these variables by creating a moderated mediation model. We followed STROBE checklist. Results: Work–family enrichment played a mediating role in understanding the positive effects of social connectedness on nurses' life satisfaction. In addition, the moderating effect of self‐concept clarity was manifested itself in the association between work–family enrichment and life satisfaction. Discussion and conclusion: Interpersonal asset (social connectedness) and the positive aspect of the work–family interface (work–family enrichment) were significant contributors to nurses' life satisfaction. In particular, high self‐concept clarity can enhance the beneficial effect of work‒family enrichment on life satisfaction. Implications for nursing policy and practice: Strengthening social connectedness, promoting synergy in work‒family roles, and maintaining a clarity of self‐concept are important intervention pathways to enhance the health and well‐being of nurses. [ABSTRACT FROM AUTHOR]

Objectives: This study developed the Mandarin Chinese version of the Aging Voice Index (AVI), with preliminary validation of the scale for potential clinical applications. Study Design: Scale development. Methods: The experimental procedure involved: (1) cross‐cultural adaptation of the original AVI into the Mandarin Chinese version (CAVI); (2) evaluation by expert panel; (3) back translation; (4) pilot testing; (5) development of the final CAVI; (6) scale validation with 68 older adults of 60–89 years old (29 females and 39 males), 34 with voice disorders and 34 age‐matched with normal voice. Internal consistency reliability, test–retest reliability, content validity, criterion‐related validity, and discriminatory ability (diagnostic accuracy) of the CAVI were evaluated. Results: There were high internal consistency (Cronbach's alpha = 0.9733), high test–retest reliability (intraclass correlation coefficient = 0.9578, p < 0.01), high content validity (content validity index = 0.9710), high criterion‐related validity (Pearson's r = 0.9439, p < 0.01 between CAVI and Voice Handicap Index‐10; r = 0.8070, p < 0.01 between CAVI and voice‐related quality of life [V‐RQOL]), and significant difference in CAVI scores between the two groups with huge effect size (t(34.69) = −11.59, Cohen's d = 2.81, p < 0.001). Receiver operating characteristic analysis revealed a high diagnostic accuracy of the CAVI, with an area under the curve of 0.9974 (p < 0.001) and a cut‐off score of 12.0 with 100% sensitivity and 97.1% specificity. Conclusion: Our findings suggested that the CAVI could be a reliable and valid standardized self‐assessment questionnaire tool for clinical evaluation of the impact of voice problems specifically for Mandarin‐speaking older adults. Further studies should explore a full‐scale validation of the CAVI for being a standard clinical tool, including for older adults in Mainland China. Level of evidence: 3b (case–control study). [ABSTRACT FROM AUTHOR]

This cross‐sectional study explored the relationship between violent video game exposure (VVGE) and aggression in left‐behind adolescents (LBAs) in China, taking into account the effects of moral sensitivity and father presence. A cluster sampling design was applied in this study; we recruited 615 adolescents (45.85% male, age range 12–18 years, Mage = 14.70 years, SD = 1.66) from China. The results by using SPSS 25.0 and the PROCESS macro showed that VVGE was positively associated with LBAs' trait aggression and its items, and moral sensitivity played a partial mediating role in these relationships. Moreover, father presence moderated VVGE and LBAs' trait aggression, verbal aggression and hostility. Specifically, at a high level of father presence, the direct effect of VVGE on trait aggression was significantly moderated by increasing the level of father presence, whereas this moderating effect was not significant at a low level of father presence. The results were similar for verbal aggression and hostility. Thus, moral sensitivity and father presence should be considered in prevention and intervention strategies aimed at reducing LBAs' aggression. [ABSTRACT FROM AUTHOR]

There is evidence that grandchildren and grandparents in Chinese left‐behind families (CLBF) suffer from immense life stressors. The well‐being of both generations is of great concern. Guided by the family adjustment and adaptation response model and ecological model of well‐being, the present study aimed to investigate the dyadic associations between family resilience and subjective well‐being (SWB) of left‐behind grandchildren and grandparents. Furthermore, we explored the extent to which relationship quality accounts for such reciprocal associations. A sample of 130 left‐behind grandparent–grandchild (GP–GC) pairs completed self‐reported questionnaires. Actor–partner interdependence model (APIM) revealed that both grandchildren's and grandparents' reported family resilience positively associated with their own SWB but not the other's SWB. Grandchildren's and grandparents' perceived relationship quality mediated the association between their perceived family resilience and their own SWB. Moreover, grandchildren‐perceived relationship quality mediated the association between grandchildren‐perceived family resilience and grandparents' SWB. Meanwhile, grandparent‐perceived relationship quality mediated the association between grandparent‐perceived family resilience and grandchildren's SWB. The findings highlighted the significance of family resilience and relationship quality in boosting the two generations' SWB in CLBF. The results also suggested that left‐behind grandchildren and their grandparents depend on each other. Future intervention programs could be benefitted from integrating the enhancement of family resilience and improvement of grandparent–grandchild relationship quality to promote the well‐being of left‐behind family members. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to translate and adapt the traditional Chinese Food Allergy Quality of Life‐Parental Burden Questionnaire (TC‐FAQL‐PB) into simplified Chinese language and determine the validity and reliability of the translated version. Design: A methodologic study design involving instrument translation and psychometric evaluation was used for the present study. Methods: The simplified Chinese FAQL‐PB (SC‐FAQL‐PB) was developed following Guillemin's guidelines for cross‐cultural adaptation. A convenience sample of 230 participants was recruited. The psychometric properties were examined using internal consistency, test–retest reliability, item discrimination, content validity and construct validity. Results: The values of I‐CVI ranged from 0.83 to 1.00. The CFA model revealed that the study supported the two‐factor model. The questionnaire had good internal consistency with a Cronbach's alpha coefficient of 0.946. The item‐total correlation values ranged from 0.707 to 0.866. Test–retest reliability showed that the intraclass correlation coefficient was 0.926 (95% CI, 0.830–0.968). [ABSTRACT FROM AUTHOR]

In the wake of the COVID‐19 pandemic, most countries have adopted strict regulation strategies such as travel restrictions, gathering restrictions, and daily health reporting. With the normalization of the pandemic, people have shown resistance to these highly intensive regulations. Yet few studies have explored the mechanisms of behavioral change from compliance to non‐compliance from the perspective of vicarious experiences. Based on the social cognitive theory, we constructed a model linking vicarious experiences, risk perception, and non‐compliance behavior to reveal the mechanism of why individuals do not comply with pandemic prevention rules and regulations. A sample of 1080 Chinese participants was obtained from a time lagged design. The results indicated that vicarious experiences could influence non‐compliance with prevention rules and regulations via perceived probability and perceived consequence of being caught. In addition, public trust in the government could negatively moderate the direct effect of the intention of violating prevention rules and regulations on non‐compliance. This direct effect is stronger for citizens with low levels of public trust in the government than for those with high levels. Our findings advance the understanding of the mechanisms behind the way vicarious experiences affect citizens' non‐compliance behavior with COVID‐19 prevention rules and regulations. [ABSTRACT FROM AUTHOR]

BACKGROUND: School principals usually have to sacrifice health and family obligations to obtain sufficient work time. This study investigates school principals' somatic and psychological discomfort related to their time allocation to diverse work contexts and life domains, so as to test the optimal allocation of time to each context and domain. METHODS: This study is based on survey data of 347 school principals, from the preexisting 2021 Survey of School Teachers' Living Conditions in Shanghai. Generalized linear regression modeling was adopted to analyze the data according to the research purpose. RESULTS: This study finds that school principals' daily time spent on work at home, sleep, breakfast, exercise, and family obligations significantly predict their somatic or psychological discomfort. However, their time spent on work at school, daytime napping, lunch, and dinner are not of significance. CONCLUSIONS: This study reveals several unhealthy ways of working and lifestyle habits among school principals from a perspective of time allocation, such as extended periods working at home, sleep deficits, hurried breakfast, lack exercise, and failure to meet familial obligations. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of enhanced recovery after surgery (ERAS)‐optimized management system with nurse‐led multidisciplinary cooperation. Design: A quasi‐experimental design. Methods: Nursing department cooperated with medical and clinical department to establish an ERAS‐optimized management system. After the system was developed, it was applied in surgical departments of the hospital. Using convenience sampling, 220 selective surgical patients, 82 nurses and 98 doctors from January 1st, 2021 to July 31st, 2021 were selected as the trial group. 220 selective surgical patients, 82 nurses and 98 doctors were selected as the control group from January 1st, 2020 to July 31st, 2020. ERAS observation indicators were compared between the two groups before and 6 months after implementation. The nurse professional identity scores and satisfaction of medical cooperation scores of the two groups at different time points were analysed by repeated analysis of variance. Results: After the implementation, ERAS observation indicators in the trial group were better than the control group (p < 0.05). There were significant differences in the group main effect, time main effect and interaction effect of nurse professional identity scores, satisfaction of medical cooperation scores and scores in all dimensions between the two groups (p < 0.05). The scores of the experimental group at 3 months and 6 months after implementation were better than those of the control group (p < 0.05). Conclusions: Enhanced recovery after surgery‐optimized management system with nurse‐led multidisciplinary cooperation was an effective working method. It could promote patients recovery and enhance nurse professional identity. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to develop and psychologically test the mobile health information‐seeking behaviour (MHISB) questionnaire in people with cancer. Design: Instrument development. Methods: The study was conducted in three phases in a southeastern city of China from May 2017 to April 2018. In phase one, an item pool was constructed based on a literature review and semistructured interviews. In phase two, expert evaluation and cognitive interviews were used to evaluate the content validity of the questionnaire. In phase three, a cross‐sectional study was conducted with people with cancer. Cronbach's α was calculated for reliability analysis. Validity evaluation included content validity and construct validity. Results: The developed MHISB questionnaire has four dimensions (information‐seeking frequency, information‐seeking self‐efficacy, health information evaluation and information‐seeking willingness) and 25 items. Psychometric findings were satisfactory and supported the questionnaire's reliability. Conclusions: The construction process of the MHISB questionnaire was scientific and feasible. The MHISB questionnaire had acceptable validity and reliability, and it requires further improvement in future studies. [ABSTRACT FROM AUTHOR]

Aim: To investigate undergraduate nursing students' general study engagement using intra‐individual assessment and to evaluate the impact of core self‐evaluation and career calling on study engagement. Design: A descriptive and cross‐sectional design. Methods: Data were collected using a self‐administered questionnaire survey. Four hundred and twenty nursing students from first‐ to fourth (final)‐academic year in Guangzhou Medical University were invited to participate in the spring of 2021. The Cronbach's alpha, one‐way analysis of variance, Bonferroni post hoc analysis, Pearson correlation analysis and multiple stepwise regression analysis were used to analyse the data. Results: The first‐ and fourth‐year undergraduates showed significantly higher levels of study engagement (first‐year undergraduates, 3.52 ± 0.59; fourth‐year undergraduates, 3.54 ± 0.64), core self‐evaluation (first‐year undergraduates, 3.04 ± 0.48; fourth‐year undergraduates, 3.11 ± 0.45) and career calling (first‐year undergraduates, 3.65 ± 0.47; fourth‐year undergraduates, 3.69 ± 0.50) than those of second‐year undergraduates (study engagement, 3.32 ± 0.61; core self‐evaluation, 2.93 ± 0.52; career calling, 3.41 ± 0.50) and third‐year undergraduates (study engagement, 3.16 ± 0.61; core self‐evaluation, 2.88 ± 0.50; career calling, 3.34 ± 0.38). The Pearson correlation analysis among nursing students revealed a significant positive correlation between core self‐evaluation, career calling and study engagement (p < 0.01). A partial mediation effect of career calling was present in the relationship between core self‐evaluation and study engagement. [ABSTRACT FROM AUTHOR]

Background: Most nursing interns have suffered some form of workplace violence in clinical settings, which has been linked to the jeopardizing of patient safety. Although previous research studies have examined the effect of workplace violence on patient safety, few studies have examined whether workplace violence is associated with patient safety through professional identity and professional burnout among nursing interns. Aims: To test whether professional identity and professional burnout play mediating roles in the relationship of workplace violence and patient safety among nursing interns. Design: Cross‐sectional study. Methods: The study included 466 nursing interns from three tertiary grade A hospitals. The Workplace Violence Scale, the Professional Identity Scale, the Maslach Burnout Inventory‐General Survey, and the Patient Safety Behaviour Scale were used to gather data. Associations among workplace violence, professional identity, professional burnout, and patient safety were assessed by correlation and the serial‐multiple mediation analysis. Results: Workplace violence, professional identity, professional burnout and patient safety were significantly correlated. Workplace violence can have a direct positive impact on patient safety of nursing interns, but also an indirect impact on patient safety through three paths: the independent mediating role of professional identity, the independent mediating role of professional burnout, and the chain mediating role of professional identity and professional burnout. Conclusions: Our findings suggest that workplace violence can affect patient safety through decreasing professional identity and increasing professional burnout among nursing interns. Interventions aimed at decreasing workplace violence among nursing interns would be beneficial for professional attitude and patient safety. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the reliability and validity of the Chinese version of the Kidney Transplant Understanding Tool (K‐TUT) among patients in China. Design: Cross‐sectional study. Methods: A convenience sample of 171 kidney transplant (KT) candidates and 272 KT recipients was recruited from two tertiary and Grade A hospitals in Hunan Province, China. The reliability was calculated by half‐fold reliability, test–retest reliability and Cronbach's alpha. The validity was analysed by the content validity index. Results: For KT candidates, the Chinese version of K‐TUT deleted items 4, 6, 7 and 8, Cronbach's α coefficient was 0.778, half‐fold reliability values were 0.792, and test–retest reliability values were 0.902. For KT recipients, the tool deleted items 3, 4, 6, 7 and 8, Cronbach's α coefficient was 0.769, half‐fold coefficient values were 0.701, and retest coefficient values were 0.888. The content validity index was 0.967. Conclusions: The K‐TUT is an acceptable and reliable measurement for evaluating the relevant knowledge of KT recipients and candidates. Impact It is anticipated that this new tool will help the nursing staff to identify specific areas of deficiency that could be targeted in health education to improve the KT knowledge of patients. [ABSTRACT FROM AUTHOR]

Background: As a non‐cognitive trait, grit plays an important role in human learning. Although students higher in grit are more likely to perform well on tests, how they learn in the process has been underexamined. Objectives: This study attempted to explore how students with different levels of grit behave and learn in an exploratory learning environment. Methods: In this study, 66 students participated in seven exploratory tasks in Snap! for approximately 60 min after a 30‐min lecture. Students were categorized into a high grit group and low grit group using a grit scale. The Mann–Whitney U test, epistemic network analysis and lag sequential analysis were used to explore the differences between groups in learning performance, technology acceptance and behavioural patterns. Results: Students with different levels of grit engaged in explorative tasks in a short period of time might not present significantly different learning performance, perceptions of usefulness and ease of use, but students higher in grit, actively engaging more different types of activities, tended to put greater sustained effort to solve the challenging task. Take Away: Although grit was not significantly correlated with learning performance when students engage in classroom‐based explorative activities, grit did predict whether students are more likely to explore and put greater sustained effort into solving the challenging task. Lay Description: Students higher in grit are likely to be actively engaging more different types of activities.Students higher in grit tend to put greater sustained effort to solve the challenging task.Grit was not significantly correlated with learning performance in classroom‐based explorative activities. [ABSTRACT FROM AUTHOR]

Background: Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied. Aims: The present study examined relationships between turnover intention and demographic characteristics, job‐related factors, depressive symptoms, and organizational commitment among emergency department nurses. Study Design: A cross‐sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self‐rated health status), job‐related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses. Results: A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self‐rated health status (β = 0.25, p <.001), working more than 11 night shifts per month (β = 0.14, p <.01), experiencing workplace violence in the past year (β = 0.08, p <.05), and higher depressive symptom scores (β = 0.07, p <.001) positively correlated with turnover intention. More years of service (β = −0.38, p <.001) and higher organizational commitment scores (β = −0.45, p <.001) negatively correlated with turnover intention. Conclusions: Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention. Relevance to Clinical Practice: To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore the mind of Chinese nursing students transitioning to online education in the pandemic using health as expanding consciousness (HEC) as methodology. Design: A qualitative, descriptive study based on interviews. Methods: This qualitative study was conducted from September to November 2021 by students in the Guangzhou university of Chinese medicine. Thirteen participants were recruited using purposive sampling. A questionnaire containing two sections with demographic information, the General Self‐Efficacy Scale (GSES) and the Connor‐Davidson resilience scale (CD‐RISC)‐10 was collected to explore the health of participants. Results: A total of 13 participants were enrolled in the study (69% female). Students ranged in age between 19 and 24 years and the mean age was 22 years. All students lived with their families. Five participants (38%) had a master's degree in nursing, three (23%) were in fourth year of college, four (30%) were in third year of college and one (7%) was in their second year of college respectively. More than half of the participants had high levels of mental toughness and self‐efficacy. Four generic categories were identified form a unitary‐transformative paradigm perspective. The respondents reported three health pattern phases: Curriculum Transformation, Curriculum adaptation and Curriculum expansion. Conclusion: This research backs up Newman's hypothesis, and supports the theoretical framework. HEC explains well the psychology of nursing students during the epidemic. More research is needed in the future to develop comprehensive, targeted emotional regulation therapies for nursing students. [ABSTRACT FROM AUTHOR]

Aims: This study aims to explore the relationship between family function, alexithymia and social anxiety among Chinese nursing students, especially to determine whether alexithymia acts as a mediator between family function and social anxiety among this social group. Design: A cross‐sectional study. Methods: From January to March 2021, a cross‐sectional study was conducted among 204 Chinese nursing students at a nursing school of a medical university in the Northeastern Region of China. The interaction anxiousness scale, APGAR family function scale and Tronto alexithymia scale were used for measurement of social anxiety, perceived family function and alexithymia respectively. The data were subjected to correlation analysis, multiple linear regression and structural equation modelling (SEM). Results: Results indicated that social anxiety score was negatively correlated with perceived family function (r = −.232), but positively with alexithymia (r =.307). After controlling for demographic variables, family function and alexithymia could explain 14.5% of the total variance in social anxiety. The SEM results suggested that the effect of family function on social anxiety was partially mediated by alexithymia with a 36.9% mediating effect. Conclusions: This study reveals that alexithymia might partially mediate the impact of family function and social anxiety in Chinese nursing students. In this sense, improvement of alexithymia is expected to be an effective strategy to ameliorate the severity social anxiety in Chinese nursing students, especially for those with a dysfunctional family context. [ABSTRACT FROM AUTHOR]

Background: Conducting routine mild cognitive impairment (MCI) and dementia screening for older adults in the community is important, which not only can improve our understanding of these diseases but also can increase early detection and treatment. Methods: To analyze the reliability and validity of the informant AD8 and explore the cut‐off values for screening MCI and dementia in the community‐dwelling older adults, this study adopted a multi‐stage cluster sampling method to recruit 327 participants aged 60 and over in communities. The informant AD8 and Clinical Dementia Rating (CDR) scales were used to evaluate cognitive function of the subjects, and the receiver operating characteristic curves (ROC) was conducted to test the screening efficacy. Results: Among the 327 participants, 33.0% of them met the criteria of MCI, and 3.4% of them met the criteria of dementia. The area under the receiver operating characteristic curve (AUC) of the informant AD8 for screening dementia was 0.974, with a screening cut‐off of three, sensitivity of 90.9% and specificity of 89.0%. But it has a poor discriminability in MCI screening [AUC = 0.645, 95% confidence interval (CI): 0.578–0.711]. Conclusions: This study suggests that the informant AD8 is an ideal and useful tool for dementia screening in community‐dwelling older adults. However, it is less capable to distinguish older adults with MCI from those with normal cognitive function. [ABSTRACT FROM AUTHOR]

Objective: The revised Fibromyalgia Impact Questionnaire (FIQR) was developed to measure the quality of life of patients with fibromyalgia in randomized controlled trials and routine care. The purpose of this study was to translate and adapt the FIQR from English to Chinese, and to examine the validity and reliability of the Chinese version of the FIQR (CFIQR). Methods: Following the translation of the FIQR, fibromyalgia patients from 6 centers were recruited and completed the CFIQR, the validated Chinese version of the Medical Outcome Study Short Form 36 Health Survey (SF‐36) and the Beck Depression Inventory (BDI). In this study, Cronbach's alpha coefficient, test–retest reliability and item total correlation were used for evaluating external and internal reliability; and criterion and structural validity were evaluated. Results: A total of 200 fibromyalgia patients completed the study. The internal consistency was excellent (Cronbach's alpha.90,.88,.88 and.93 for function, overall impact, symptoms scales and total score, respectively; item‐total correlations from.25 to.83.) Test–retest reliability levels of the CFIQR total and subscale scores were strong correlation (intraclass correlation coefficient >0.75). Furthermore, there were significant correlations between the 3 subscale and the total score of the CFIQR and the SF‐36, as well as the CFIQR and the BDI, by criterion validity (P <.01). Confirmatory factor analysis gave an acceptable value for structural validity according to the 3‐factor structures of function, overall impact and symptoms. Conclusions: The CFIQR is a valid and reliable instrument for both clinical practice and research purposes with Chinese speakers globally. [ClinicalTrials.gov: NCT03381131]. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to (1) assess the relationship between intensive care unit (ICU) nurses' burnout, organizational commitment and turnover intention, (2) examine the moderating effect of the organizational commitment on the relationship between ICU nurses' burnout and turnover intention, and (3) explore the prevalence and influencing factors of hospital workplace violence among ICU nurses. Design: Cross‐sectional study design. Methods: Data were collected from August to October 2020 and a convenience sample of registered nurses was recruited. To control common method biases, one‐month temporal separation, Harman's single‐factor analysis and method of latent variables were adopted. The moderating effect was tested by SPSS Hayes PROCESS Macro. Chi‐square and logistic regression were used to examine workplace violence data. Results: Organizational commitment (β = −.23, 95% confidence interval −.45 to −.03) and continuance commitment (β = −.15, 95% confidence interval −.24 to −.16) have negative moderation effects on the relationship between emotional exhaustion and turnover intention. 77.7% of ICU nurses experienced workplace violence, male and staff nurses, and nurses with lower professional titles and shorter working years have greater odds of experiencing this violence. [ABSTRACT FROM AUTHOR]

Aim: To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. Design: A descriptive study design and STROBE checklist were applied in this research. Methods: The theoretical framework of the questionnaire was knowledge–attitude–behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed. Results: A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80–1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split‐half reliability value of the overall questionnaire were 0.93 and 0.97, respectively. Conclusions: This questionnaire has good validity and reliability, but needs further testing in multi‐centered settings. [ABSTRACT FROM AUTHOR]

Background: Nurses in intensive care units (ICUs) play a crucial role in providing palliative care. Effective provision of palliative care in the ICU requires nurses' active engagement, yet little is known about the confidence for palliative care that ICU nurses hold in China. Aim: To explore confidence in performing palliative care among ICU nurses in China and factors related to nurses' level of confidence. Study design: A cross‐sectional design was implemented. Methods: This study utilized convenience sampling to recruit ICU nurses from nine hospitals in Wuhan, China. Data were collected via an online survey. Multiple regression was conducted to identify the predictors of the ICU nurses' confidence in performing palliative care. Results: A total of 231 ICU nurses participated in the study, resulting in a response rate of 78% (231/296). Participants reported a relatively low level of confidence for carrying out palliative care (mean score = 2.60 ± 0.53; range = 1‐4). Nurses who had more positive attitudes toward palliative care communication (P <.001), higher levels of formal training on palliative care (P <.001), more years of working as an ICU nurse (P <.05) and those working in integrated ICU (P <.001) showed a higher level of confidence in carrying out palliative care. Conclusion: Participants' lack of confidence in performing palliative care makes for increased challenges, particularly in uncertainty about family assessments, palliative care discussions and lack of palliative care training. Strengthening palliative care curricula in nursing education and professional training is imperative to enhance ICU nurses' confidence. Relevance to clinical practice: Strengthening palliative care education and training, particularly in relation to palliative care communication, is critical. Implementing and tailoring culturally relevant palliative care call for attention to practice and for policy changes in palliative care delivery in China. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the effect of training on organizational commitment, the mediating effect of employability and the moderating role of person–organization fit. Design: A correctional cross‐sectional research design was adopted for this study. Methods: A questionnaire‐based survey of 859 nurses in a public hospital in Western China was conducted to identify their perceptions of training, employability, organizational commitment and person–organization fit. Hierarchical linear regression and conditional process analysis on moderated mediation were performed. Results: Training had a positive effect on organizational commitment (p <.01). Internal and external employability mediated the relationship between training and organizational commitment (p <.01). Person–organization fit enhanced the indirect effect of training on organizational commitment through external employability (p <.05). [ABSTRACT FROM AUTHOR]

Aim: To explore whether sense of mastery can mediate the relationship between social support and illness perception in patients with atrial fibrillation (AF) who were at the "Blanking Period." Design: A cross‐sectional design. Methods: 405 patients with AF who were at the "Blanking Period" in the Affiliated Hospital of Qingdao University were recruited; they completed a set of questionnaires, including the Perceived Social Support Scale, the Personal Mastery Scale and the Brief Illness Perception Questionnaire. Results: Social support and sense of mastery were both adversely connected to illness perception. The indirect effect of social support on illness perception through sense of mastery was negative, accounting for 86.04% of the total effect. Conclusion: During the "Blanking Period," better social support and sense of mastery contribute to a positive illness perception of AF patients. Social support also can influence patients' illness perception indirectly via the mediator of sense of mastery. [ABSTRACT FROM AUTHOR]

Medical research is important to scientific progress and medical education. Institutions worldwide have sought to increase student involvement in research such as clinician–scientists training programs, while little is known about how medical undergraduates perceive research. A cross‐sectional study was conducted in Chongqing Medical University, Chongqing, China, with first–fourth year undergraduates. An online, anonymous, and self‐rating 5‐point Likert questionnaire was conducted to investigate medical undergraduates' demographic characteristics and assess motivation, self‐efficacy, perception, curiosity, and barriers regarding medical research. Content validity was checked with experts and face validity was checked for clarity and understanding of the questionnaire. The Cronbach's alpha coefficient of the questions ranged from 0.813 to 0.879. A total of 3273 medical undergraduates were surveyed, and 86.62% (2835) participants (male 962, female 1873) were identified as effective. Males scored higher than females on self‐efficacy (p < 0.001), perception (p = 0.017), and curiosity (p < 0.001), and lower on barriers (p < 0.001). The second year students are at the peak of their perception (p = 0.006) and lowest barrier scores (p = 0.003). Students with scientific research experience scored higher in motivation (p = 0.002), self‐efficacy (p < 0.001), perception (p < 0.001), and curiosity (p < 0.001). Lack of proper mentoring opportunity (86.2%) and knowledge (84.5%) were the main barriers in conducting research. Even though they have a positive perspective, only a few undergraduates enrolled in research. Medical universities should encourage faculties to supervise and guide undergraduates' projects, and provide feasible solutions for students to learn scientific knowledge and skills. It is vital to build a research‐oriented environment and academic atmosphere. [ABSTRACT FROM AUTHOR]

Background: Group size is one of the important factors that affect collaborative learning, however, there is no consensus in the literature on how many students should the groups be composed of during the problem‐solving process. Objectives: This study investigated the effect of group size in a K‐12 introductory Artificial Intelligence course by comparing the students' cognitive load, learning motivation, collaborative problem‐solving quality, and in‐classroom interaction between two‐ and three‐student groups. Methods: Forty‐eight high school students were randomly assigned to two kinds of groups (i.e., the two‐student group, and the three‐student group, each consisting of 24 students). During the experiment, Xiaofei robots were used to teach the theoretical and practical content of five AI topics over 6 weeks for 1.5 h each week. Results: The ANOVA results indicated that group size mattered in the AI course, the two‐student group was more effective in terms of enhancing students' learning motivation and collaborative problem‐solving quality, as well as imposing more cognitive load than the three‐student group. The advantage was more obvious in the practical problem context. The Lag Sequential Analysis results indicated that more collaborative learning behavioural sequences existed in the two‐student group than in the three‐student groups. Contribution: This research provides empirical evidence and potential guidance for group design in Artificial Intelligence Education. Although group size did not affect students' learning achievement, it affected learning motivation, cognitive load, and problem‐solving quality and processes. Two‐student groups work better than three‐student groups in the AI course. Lay Description: Group size affected students' learning motivation, cognitive load, and problem solving process, but not their learning achievement.The two‐student group was more effective in terms of enhancing students' learning motivation and collaborative problem‐solving quality, while imposing more cognitive load than the three‐student groups.The Lag Sequential Analysis results indicated that more collaborative learning behavioural sequences existed in the two‐student group than in the three‐student groups. The tendency was more obvious in the practical problem context than in the theoretical problem context.Overall, in terms of problem‐solving and learning, group size should be considered in instructional design of AI courses. [ABSTRACT FROM AUTHOR]

Aims: To develop a competency scale for operating room nurses and test its reliability and validity. Background: The existing Chinese Registered Nurse Competency Scale and the core competency scale for operating room nurses developed abroad cannot fully meet the capacity needs of Chinese operating room nurses. Methods: The scale was developed based on the results of qualitative interview and the Delphi method. Ten experts were selected for expert consultation, and 300 operating room nurses were recruited by convenience sampling for a cross‐sectional survey to test the reliability and validity of instrument.The reliability and validity of the scale was assessed based on internal consistency reliability, test–retest reliability and confirmatory factor analysis. Data collection was conducted between March to July, 2015. Results: An initial scale with 42 items was confirmed, and 36 items remained. The internal consistency Cronbach's α was 0.97 for the overall scale and 0.88–0.94 for the subscales. The retest reliability ranged from 0.55–0.96. Five factors were extracted by exploratory factor analysis, and they explained 66% of the total variance. The fitting indices of the confirmatory factor analysis were as follows: χ2/df = 3.47, CFI = 0.83, TLI = 0.81, SRMR = 0.06 and RMSEA = 0.09. Conclusions: The core competency scale for operating room nurses with 5 components and 36 items had acceptable reliability and validity. The scale could continue to be optimized in the future. [ABSTRACT FROM AUTHOR]

The understanding of stigma resistance and its prevalence is limited due to the limitation of existing measures. This study aims to modify the Stigma Resistance Scale (SRS) and assess the psychometric properties of Chinese patients with mental illness. Seven experts were invited to assess the content validity of the Chinese version of the SRS (C‐SRS), which has been translated and adapted into Chinese. Convenience samples were included from two psychiatric hospitals and three community healthcare centers in Beijing, China. A total of 484 patients completed the survey from November 2020 to July 2021. Samples were randomized into two parts exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA (n = 242) yielded three factors with Cronbach's α of 0.932 for the total scale, and 0.835, 0.877, and 0.858 for the subscales. CFA (n = 242) revealed good model fit (χ2/df = 2.190, RMSEA = 0.070). The domain‐total correlation scores were 0.834–0.939. The correlation coefficient of test‐retest ranged from 0.726 to 0.887. The correlation coefficient between the C‐SRS and Stigma Resistance subscale of the Internalized Stigma of Mental Illness scale was 0.399. This study found that the C‐SRS has evidence of excellent reliability and validity for assessing stigma resistance. It could be used in Chinese people with mental illness to identify and address stigma resistance. [ABSTRACT FROM AUTHOR]

Aim: To explore the prevalence of nurse‐patient disputes and the influencing factors based on an analysis of patient characteristics. Design: A cross‐sectional study. Methods: This study used the convenience sampling method. Three self‐designed questionnaires based on clinical experience and literature review were used to collect the current status of nurse‐patient disputes and to assess patients' humanistic qualities and patients' recognition of nursing work. The Big Five personality questionnaire was used to assess the five personality traits of patients. Results: Of the patients, 9.6% reported having a dispute with nurses. The results of binary logistic regression analysis indicated that patients' humanistic quality, recognition of nursing work and agreeableness in personality traits had a negative predictive effect on nurse‐patient disputes, while family monthly income and neuroticism in personality traits positively predicted disputes. [ABSTRACT FROM AUTHOR]

Aim: To investigate the influencing factors in professional identity of undergraduate nursing students after the outbreak of COVID‐19. Design: Cross‐sectional study. Methods: The study covered 2,999 nursing students in six undergraduate nursing schools. Several self‐report questionnaires were used to collect the general information, psychological stress, coping styles and professional identity of the undergraduate nursing students. Results: The overall average score of the professional identity of nursing students (3.67 ± 0.51) has increased significantly after the outbreak of COVID‐19. The professional identity of the undergraduate nursing students was negatively correlated with psychological stress (r = −0.23, p <.001), expectation (r = −0.12, p <.001) and avoidance (r = −0.16, p <.001), but was positively correlated with solving problems (r = 0.18, p <.001) and seeking support (r = 0.12, p <.001). Academic performance, positions, grades, reasons for choosing a nursing profession, parents or relatives engaged in nursing work and the risk degree of residence were the factors influencing the professional identity score of undergraduate nursing students' (p <.001). [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to determine the psychometric properties, construct validity and internal consistency of the Chinese language version of the Nurse Professional Competence scale short form. Design: A methodological design was used. Methods: Questionnaire data from 260 nursing students nearing graduation from 2 universities in China were analysed using confirmatory factor analysis, known‐group validity and internal consistency. Results: The confirmatory factor analysis revealed that the model was acceptable, and the analyses for known‐group validity revealed statistically significant differences in all factors and the total scale of the Nurse Professional Competence scale short form. Internal consistency revealed that Cronbach's alpha values exceeded 0.70 for all factors and the total scale. The Chinese language version of the Nurse Professional Competence scale short form has acceptable construct validity and good internal consistency. [ABSTRACT FROM AUTHOR]

Aims: To investigate the attitudes and beliefs towards the implementation of nurse prescribing among general nurses and nurse specialists. Design: A cross‐sectional survey among general nurses and nurse specialists was conducted in seven provinces and one autonomous region in mainland China using convenience sampling method. Methods: The attitudes and beliefs towards nurse prescribing were assessed using the Nurse Attitudes and Beliefs towards Nurse prescribing scale, of which Cronbach's coefficient was 0.902, retest reliability was 0.808. Respondents from eight hospitals across the country were employed to complete an online questionnaire. Results: Nurse specialists (n = 399) had statistically significantly more favourable intentions towards nurse prescribing than general nurses (n = 415; 105.64 ± 12.83 vs. 96.39 ± 13.16; p <.001). The years of clinical work experience, professional title, education degree were positively correlated with general nurses' and nurse specialists' attitudes and beliefs towards nurse prescribing (p <.05). Among nurse specialists, the variety of specialties and whether they work in nurse‐led clinics on an outpatient basis have positively influence on their intentions towards nurse prescribing (p <.05). [ABSTRACT FROM AUTHOR]

Aim: To develop and evaluate psychometric property of quality nursing care scale (QNCS) from nurses' perspective in the Chinese context. Design: A cross‐sectional survey design. Methods: This study was conducted in two phases. In Phase I, literature review and interviews were conducted to develop the items. In Phase II, content validity was evaluated by five experts. Construct validity was tested through exploratory factor analysis (EFA) among 302 nurses and confirmatory factor analysis (CFA) among 510 nurses from October 2014 to January 2015. Additionally, internal consistency reliability was tested. Results: The EFA extracted six factors including staff characteristics, task‐oriented activities, human‐oriented activities, physical environment, patient outcomes and precondition. All six factors accounted for 74.78% of the total variance to explain quality nursing care. The modified measurement model of the final version of QNCS was supported by the CFA with 48 items in six dimensions. The internal consistency reliability of final QNCS was acceptable. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore the association between diabetes‐related distress as a dependent variable and fear of hypoglycaemia as a independent variable in Chinese individuals with type 2 diabetes, which can provide a basis for the development of effective nursing interventions. Design: A cross‐sectional descriptive study. Methods: Pre‐piloted scales were used to determine whether they experienced fear of hypoglycaemia and whether this impacted upon their management of the disease. From June–October 2019, participants were asked to complete the "hypoglycaemia fear survey" and "diabetes distress scales" to assess levels of fear and distress. Stepwise multivariate regression analysis was applied to reveal relationship between distress as a dependent variable and fear as a independent variable. Covariates included demographic, clinical or lifestyle factors. Results: A total of 258 participants were recruited for the survey, and they were characterized by little or no distress (39.53%), moderate distress (45.35%) and high distress (15.12%). The prevalence of moderate to severe distress in patients was 60.47%. Increased diabetes‐related distress was strongly correlated with increased fear of hypoglycaemia and closely associated with the scores of the worry and behaviour subscales. These results indicated that 62.3% of diabetes‐related distress may be explained by fear of hypoglycaemia. Conclusion: Increased diabetes‐related distress is associated with increased fear of hypoglycaemia in individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aim: To develop a questionnaire on the health behaviour of breast cancer women with adjuvant endocrine therapy and to test its reliability and validity. Design: An instrument‐development study was applied that comprised three steps: conceptualization, item generation, content validity and field testing of the health behavior properties. Methods: On the basis of literature review, the conceptual framework and initial items of each dimension of were designed. The questionnaire investigation was divided into two steps: pre‐experiment (group 1) and psychometrics evaluation (group 2). Correlation procedure and factor analysis were employed to rescreen the items. Reliability testing and validity testing were conducted to analyse the psychometric properties of questionnaire. Results: Exploratory and confirmatory factor analyses yielded a five‐factor solution. Cronbach's α was 0.93, the sub‐semi‐reliability of the questionnaire was 0.79 and internal consistency coefficients was 0.70. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to test the psychometric properties of a Chinese version of the Sense of Coherence Scale (C-SOC-13) in women with cervical cancer in Mainland China. Methods The C-SOC-13 and Health-related Quality of Life scale (Functional Assessment of Cancer Therapy-Cervix) were administered to 238 women with cervical cancer. Validity was assessed in terms of factor validity, predictive validity, divergent validity and stability, whereas reliability was evaluated using Cronbach's alpha coefficient. Results This study showed that in confirmatory factor analysis, the first-order interrelated three-factor model and second-order model were performed based on Antonovsky's theoretical structure of Sense of Coherence (SOC). Both models fitted the data satisfactorily when the largest modification index was released. The chi-square value/degrees of freedom was 2.120, the goodness-of-fit index was 0.919, the root mean square error of approximation was 0.069, and the comparative fit index was 0.911. The Pearson correlation coefficient between SOC and Functional Assessment of Cancer Therapy-Cervix was 0.611. Enter multiple regression with SOC as a dependent variable and medical and socio-economic variables as independent variables showed no statistically significant partial coefficient of any independent variable in regression equation except for age. The Cronbach's alpha coefficient for the scale was 0.824. Conclusion The factor validity, predictive validity and divergent validity of C-SOC-13 were reasonable, as well as the internal consistency. In general, C-SOC-13 showed to be suitable as an SOC measurement for women with cervical cancer in Mainland China. However, SOC may have a different meaning to Chinese people because of the philosophy and culture that shape the context of their lives. Generalizing the findings to other populations requires further psychometric evaluation of C-SOC-13. Further longitudinal studies are also needed to explore the stability. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]