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Aims: This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. Background: Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. Design: This cross‐sectional study was designed based on the theory of unpleasant symptoms. Methods: Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) Results: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. Conclusion: The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self‐coping and symptom management for kidney transplant recipients. Summary statement: What is already known about this topic? Fatigue is a common symptom of kidney transplant recipients and can impair postoperative recovery, reemployment, quality of life, social activities and physical and mental states, causing the body to be in a state of chronic energy consumption.Owing to the imperceptible physical injury upon kidney transplant recipients, fatigue is often underappreciated or even disregarded. What this paper adds? It was found that the rate of fatigue in kidney transplant recipients was high.The risk factors for fatigue in kidney transplant recipients based on the theory of unpleasant symptoms were analysed in three ways: physiological, psychological and situational. The results showed that sleep quality, duration after transplantation, serum potassium level, anxiety, depression, education level, financial burden and social support were associated with fatigue in kidney transplant recipients. The implications of this paper: Clinical nurses should conduct timely and multidimensional fatigue evaluations of kidney transplant recipients and pay more attention to those with a high level of fatigue.The findings can provide a scientific basis for kidney transplant specialist nurses to conduct targeted interventions and facilitate fatigue management for kidney transplant recipients. They can also help to develop fatigue intervention models based on the displeasure symptom theory to improve fatigue in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to introduce the Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) into China and test its applicability in Chinese infertile population. Background: Infertility‐related stress not only influences patients' psychological well‐being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. Design: The design used in this study is a cross‐sectional survey. Methods: A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI‐FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman–Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. Results: The revised Chinese version of COMPI‐FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI‐FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman–Brown coefficient was 0.836, explaining excellent reliability. Conclusion: The revised Chinese version of COMPI‐FPSS shows good reliability and validity, and it can be used to evaluate the infertility‐related stress of infertile patients in China. Summary statement: What is already known about this topic? With the number of infertile people on the rise globally, infertility‐related stress needs attention.Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) with its brief and accessible entries is extensively applied abroad.China currently lacks such a tool. What this paper adds? This study translated the COMPI‐FPSS into Chinese and the Chinese version of COMPI‐FPSS contains 11 items and 2 dimensions, including personal stress domain and social stress domain, which has good reliability and validity. The implications of this paper: The Chinese version of COMPI‐FPSS could provide a short and reliable tool for clinical practice and research, which will reduce the burden on researchers and patients. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to assess the overall social housing development, point out factors affecting it and propose some policy implications for social housing development. Design/methodology/approach: The research investigated investors, credit institutions and officials involved in social housing development. Bac Ninh province currently has 51 social housing projects that have been and are being implemented. The hypothetical regression model has seven latent variables and is tested by the criteria through the SPSS25.0 software. Findings: There are 29 factors belonging to seven groups affecting housing development. Their impact rates range from 3.47% to 30.25%. Research limitations/implications: The study has only identified the factors affecting social housing development but has not undertaken an in-depth assessment of its development status and forecast for the future. Therefore, this gap needs to be further studied. The proposed research method could also be applied when researching social housing developments in other countries around the world. Practical implications: To develop social housing to meet the needs of the real estate market, it is necessary to improve the policies that have the strongest impact first. Then, it is necessary to improve the factors with a smaller impact. Social implications: The study proposes policy implications for faster housing development for low-income people that improve their living standards. Originality/value: To the best of the authors' knowledge, the paper has studied for the first time social housing development and the factors affecting it. The paper also shows the level of their impact so that priority policies can be applied to each factor. [ABSTRACT FROM AUTHOR]

The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression.SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services.Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. What the paper adds to existing knowledge?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression.MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression.The positive preferences for providing information and family involvement in treatment decision‐making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. What are the implications for practice?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision‐making actively.A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression.SDM‐related training should be encouraged for MHPs to promote widespread SDM. Introduction: Shared decision‐making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well‐documented. Aim: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. Method: In this cross‐sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision‐Making Questionnaire—Physician Version (SDM‐Q‐Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. Results: The mean SDM‐Q‐Doc was 80.47 (±16.31). Within the six specific decision‐making situations, most MHPs selected non‐SDM (52.7%–71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision‐making, working in an outpatient clinic and receiving SDM training (F = 23.582; p =.000; R2 =.198; adjusted R2 =.189). Discussion: Although the MHPs' self‐rated score of SDM‐Q‐Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM‐related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer‐practitioner relationship. Implications for Practice: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high‐quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families. [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: It has been reported that the knowledge, attitudes and practices of nurses play a significant role in preventing incontinence‐associated dermatitis (IAD), and these three factors influence and interact with each other. This study aimed to translate the English version of the Knowledge, Attitudes and Practices of Incontinence‐Associated Dermatitis Questionnaire (KAP‐IAD‐Q) into Chinese and assess the validity and reliability of the Chinese KAP‐IAD‐Q (C‐ KAP‐IAD‐Q) used with Chinese nurses. Methods: The KAP‐IAD‐Q was translated into Chinese strictly in accordance with the Brislin translation model, and a Chinese version of IAD was formed after discussion by experts. From October to November 2021, a total of 259 Chinese nurses were recruited through a convenience sampling method and investigated using the Chinese version of the knowledge, attitudes and practices of the incontinence‐associated dermatitis questionnaire (C‐KAP‐IAD‐Q) and the general self‐efficacy scale to assess its reliability and validity. Results: Three factors were extracted by exploratory factor analysis comprised of 22 items. The Cronbach's α coefficients were 0.961, 0.929 and 0.833, and the intraclass correlation coefficient was 0.98 totally. The scale‐level content validity index (S‐CVI) was 0.95, and the item‐level content validity (I‐CVI) was 0.83–1.00. The correlation coefficient between the general self‐efficacy scale and the C‐KAP‐IAD‐Q was 0.561 (P < 0.01). Conclusion: The 22‐item C‐KAP‐IAD‐Q seems to be culturally well adapted and has good psychometric properties used by Chinese nurses. Summary statement: What is already known about this topic? There is a knowledge gap among nurses, and the attitudes of nurses to prevent incontinence‐associated dermatitis (IAD) have a significant impact on the final implementation of preventive interventions.The Knowledge, Attitudes and Practices of the Incontinence‐associated Dermatitis Questionnaire (KAP‐IAD‐Q) was developed and assessed as a valid and reliable tool in Singapore.China does not currently have such a tool.What this paper adds? This study translated the KAP‐IAD‐Q into Chinese and formed the Chinese version of the KAP‐IAD‐Q (C‐ KAP‐IAD‐Q).The C‐KAP‐IAD‐Q comprises 22 items and three factors, including knowledge, attitudes and practices towards IAD prevention with proper psychometric properties.The implications of this paper: The C‐KAP‐IAD‐Q could be used in clinical practice and research to provide a reference for improving the knowledge, attitudes and practices towards IAD prevention in China.The C‐KAP‐IAD‐Q can make a great contribution to supporting the education and management of IAD. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

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]

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

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]

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]

Aims: To explore how family functioning and family resilience mediate the relationship between disability severity and quality of home‐based care among families with disabled older adults. Methods: A cross‐sectional survey was conducted with 431 families with Uygur and Kazakh disabled older adults in Xinjiang, China, in 2020. The data were collected using the Katz Activity of Daily Living Scale; Mini‐Mental State Examination; Family Adaptation, Partnership, Growth, Affection and Resolve Index Scale; Family Resilience Assessment Scale; and Family Caregiving Consequences Inventory Scale. All mediation effects were estimated in SPSS26.0. Results: Disability severity, family functioning and family resilience were all significantly correlated with home‐based care quality. Disability severity had a 46.16% direct effect on home‐based care quality and a 53.84% indirect effect on home‐based care quality independently and in series through family functioning and family resilience. Conclusions: Disability severity directly affected home‐based care quality and had an indirect influence via family functioning and family resilience. Multidisciplinary care teams should focus on families with disabled older adults and help them improve family functioning and family resilience by implementing targeted interventions, so as to improve home‐based care quality. Summary statement: What is already known about the topic? Literature has clarified that social support and caregiver competence mediate the path relationship between disability severity and home‐based care quality from the perspective of individuals.Long‐term care for disabled older adults affects not only informal caregivers but also the whole family.The role of the family, such as family functioning and family resilience, in the whole process remains unclear. What this paper adds? Findings indicated relationships between disability severity, family functioning, family resilience and home‐based care quality.Disability severity can indirectly influence home‐based care quality not only through family functioning or family resilience but also through family functioning affecting family resilience. The implications of this paper Findings indicate that community nurses should not only pay attention to disabled older adults and their informal caregivers but also consider the impact of family functioning and family resilience when formulating interventions to improve the quality of home‐based care.When disabled older adults are transferred from hospitals to home, community rehabilitation nurses should intervene as early as possible, providing guidance on rehabilitation training and daily living skills for disabled older adults to restore and maintain function and prevent complications.Community nurses can conduct case counselling services for family members to understand and satisfy their care needs, enhancing their confidence, cohesion and problem‐solving abilities to improve the quality of home‐based care. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China. Methods: The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China. Results: A 49‐item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four‐factor structure of the 49‐item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four‐factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001). Conclusions: The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer. Summary Statement: What is already known about this topic? Nurses generally provide supportive care services and play imperative roles in supporting patients in cancer.Using a valid and reliable instrument to assess supportive care needs for patients with cancer is a critical step for the improvement of clinical practice and research. What this paper adds? Mixed methods were beneficial for developing the new self‐report and culturally appropriate instrument for Chinese patients with cancer.The Professional Nursing Support Scale (PNSS) is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the needs. The implications of this paper: The PNSS is expected to a reliable needs evaluation tool. [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]

Aim: The purpose of this study was to translate the Stoma‐quality of life into Chinese and evaluate its psychometric properties in Chinese patients. Background: Quality of life is an important issue for patients with colostomy, and its appropriate and precise measurement is beneficial to promoting better care. The Stoma‐quality of life questionnaire has been widely used; however, the validity and reliability of its Chinese version has not been determined. Design A cross‐sectional validation study was conducted. Methods: We translated the Stoma‐quality of life into Chinese using standardized methods. Then it was psychometrically tested on a convenience sample of 513 patients with colostomy. Construct validity was evaluated via exploratory factor analysis and confirmatory factor analysis. Reliability was measured with Cronbach's alpha and the split‐half Spearman–Brown coefficient. Results: The content validity, the Cronbach's α coefficient and the Spearman–Brown split‐half reliability coefficient indicated adequate validity and reliability. The exploratory factor analysis yielded four common factors, and the cumulative variance contribution rate was 67.5%. Moreover, the confirmatory factor analysis showed a good model fit. Conclusion: This study confirmed that the Chinese version of Stoma‐quality of life is an effective and reliable measurement for evaluating the quality of life of patients with colostomy. Summary statement: What is already known about this topic? Quality of life (QOL) is an important issue for patients with colostomy, and it is conducive to evaluate the effect of specific treatment and nursing interventions. However, a tailored instrument measuring QOL in Chinese patients with colostomy is lacking.The Stoma‐QOL is a widely used stoma‐specific instrument based on Hunt and McKennal's basic QOL demand model and has shown acceptable psychometric properties. What this paper adds? This study provides evidence of the construct validity and internal consistency reliability of the Stoma‐QOL‐C.The four‐factor structure of the scale shows the aspects and complexity of QOL of patients with colostomy.The study proves the Stoma‐QOL‐C a valid and reliable measure of assessing QOL of patients with colostomy. The implication of this paper: The Stoma‐QOL‐C could be used as a disease‐specific scale to evaluate the QOL of patients with colostomy.This study adds the knowledge of the psychometric properties regarding the inventory in diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to verify the mediating role of commitment between market-oriented organizational culture and international market performance, and to discuss the moderator effect of national institutional environment on this mediating role. Design/methodology/approach: The research design follows a mixed methodology, combining qualitative and quantitative data collection and analysis. In the first phase, research hypotheses are proposed based on a literature analysis. In the second phase, sample data are collected through interviews and questionnaires sent to domestic contractors in China and South Korea, and a validity analysis of the results is carried out. Correlation and regression analyses are then performed on the valid data to verify hypotheses to prove the existence and influence of mediating effects. Hayes PROCESS Macro is used on the regression results to test the mediating effect of commitment on international project performance and the moderation effect of institutional environment. Findings: The results reveal that the commitment between partners has a mediating effect on the relationship between market culture and international project performance; however, no hierarchy culture is revealed. The mediating effect of commitment is regulated by the institutional environment. Research limitations/implications: Although the reliability and validity of the questionnaire data in this study are in line with research standards, a larger sample size would improve the reliability of the results. Further, the interviewed samples are mainly from China and South Korea; large representative samples from additional countries, such as Japan, should be considered to gain a fuller understanding and more comprehensive results. Originality/value: By emphasizing the differences between the two institutional environments of developing and developed countries in East Asia, a theoretical and empirical basis is provided. International construction enterprises in other countries can apply the findings to improve their international market performance in different institutional environments. The findings also provide an empirical reference that international construction enterprises in China and South Korea may use to adjust their organizational cultures and commitments to improve market performance. [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: Elders' disability severity and caregiver health could predict elders' informal care time, but the mechanism by which the degree of disability in the elderly affects informal care time is unclear. Aim: The aim of this works is to explore the mediating roles of caregiver health and home‐based care quality between disability severity of elders and informal care time in far north‐western low‐income areas in China. Method: From September 2017 to February 2018, three hundred fifty‐two dyads of Kazakh disabled elders and informal caregivers in Xinjiang were interviewed. Structural equation modelling analyses were applied. Results: Significant positive correlations were observed between elders' disability severity and informal care time, caregiver health and informal care time, elders' disability severity and caregiver health. Significant negative correlations were observed between home‐based care quality and informal care time, elders' disability severity and home‐based care quality, caregiver health and home‐based care quality. Elders' disability severity had 71.94% direct effect on informal care time, 28.06% indirect effect on informal care time mediated by home‐based care quality and caregiver health. Conclusion: Caregiver health and home‐based care quality play mediating roles on the path relationship between the elders' disability severity and informal care time. Summary statement: What is already known about this topic? Elders' disability severity and caregiver health are critical factors that affect informal care time.The mechanism by which the degree of disability in the elderly affects informal care time is unclear. What this paper adds? Elders' disability severity is positively associated with caregiver health and negatively associated with home‐based care quality.The better home‐based care quality, the shorter the informal care time.Disabled elders' severity degree had a direct effect on informal care time and indirect effects on informal care time mediated by caregiver health and home‐based care quality. The implications of this paper: Community nurses, doctors and health care teams should provide medical services, nursing skills and knowledge for the dyads of disabled elders and informal caregivers and should provide emotional support for other family members to enable growth of the entire family in the process of long‐term care and to reduce informal care time.The government should attach great importance to the informal care time for disabled elders and propose specific informal care time cost compensation policies based on path relationships that influence informal care time. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis. Methods: This cross‐sectional study was conducted in 243 patients with rheumatoid arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi‐Dimensional Questionnaire, Arthritis Self‐Efficacy Scale‐8, Visual Analogue Scale for pain, physical function subscale of Short Form 36‐Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self‐designed demographic and disease‐related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one‐way ANOVA and correlation analysis on the level of fatigue. Results: Stepwise linear multiple regression analyses showed that disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance. Conclusion: Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue. Summary statement: What is already known about this topic? Fatigue is a common problem in patients with rheumatoid arthritis (RA).Little research has investigated what factors are associated with fatigue in patients with RA.Nurses need to understand the factors that potentially influence fatigue in patients with RA, in order to improve the quality of life. What this paper adds? Fatigue is moderate in Chinese patients with RA, which is lower than the results of western countries.Disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety are important factors affecting fatigue in patients with RA. The implications of this paper: Special attention should be paid to the RA patients with high level of fatigue.The findings of this study highlight the need to develop effective strategies to alleviate fatigue and eventually improve the quality of life in patients with RA. [ABSTRACT FROM AUTHOR]

Background: Multiple chronic conditions (MCCs) are highly prevalent in primary care. Coping is an important psychological factor that influences patients' ability to adapt physically and mentally to MCCs. Testing a reliable and valid psychometric inventory is necessary to identify coping strategies before developing coping‐oriented interventions. Purpose The purpose of this study is to examine the psychometric properties of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE‐CN) inventory in patients with MCCs. Method: This study adopted a cross‐sectional design. A convenience sample of 290 Chinese patients with MCCs was recruited from a tertiary hospital in East China. The Brief COPE‐CN, sociodemographic characteristics and clinical data were collected using a self‐reported questionnaire from November 2017 to May 2018. Factor analysis and reliability analysis were performed. Results: The mean age of the participants was 58.5 years (range from 23 to 95 years), and approximately half of the participants were female (49.3%). Most participants had two chronic conditions (82.1%) and reported having had MCCs for more than 2 years. The explanatory factor analysis (EFA) identified five factors in the Brief COPE‐CN that explained 58.4% of the total variance. The Cronbach's α coefficients ranged from.65 to.85 for the five subscales. Conclusions: The psychometric properties of the Brief COPE‐CN were acceptable for use with Chinese patients with MCCs. With further evaluation, this instrument may help health‐care professionals understand patients' coping and develop coping‐based interventions to promote coping in this population. Summary statement: What is already known about this topic? There is a growing predominance of chronic diseases in China, with many Chinese patients living with multiple chronic conditions (MCCs) that can adversely impact physical and psychological health.Coping‐oriented interventions that address and enhance patients' coping strategies are beneficial in terms of improving their health.There is no valid and reliable Chinese tool to measure coping strategies among patients with MCCs. What this paper adds? This study reports a five‐factor structure of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE‐CN) established by explanatory factor analysis.The five‐factor structure of the Brief COPE‐CN has good internal consistency. The implications of this paper: The five‐factor Brief COPE‐CN has the potential to measure coping strategies effectively in Chinese patients with MCCs.With further evaluation, this instrument may be a useful tool for developing specific interventions to promote coping in Chinese patients with MCCs. [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]

Aim: To investigate whether a novel decision support tool would effectively minimize physical restraint use in critically ill adult patients. Design A nonequivalent quasi‐experimental design combined with a descriptive qualitative approach was used. Methods: A Restraint Decision Tree was developed based on a qualitative study that explored the barriers to employ the Restraint Decision Wheel. During the quasi‐experimental study, patients admitted to the unit between October 2017 and March 2018 were enrolled as the control group receiving the Restraint Decision Wheel (n = 528), whereas patients between April 2018 and September 2018 were enrolled as the intervention group receiving the Restraint Decision Tree (n = 564). The physical restraint rate, accidental catheter removal rate and nurses' satisfaction were compared. Results: The Restraint Decision Tree significantly decreased physical restraint use. No significant difference in the rate of accidental catheter removal was found. Nurses reported increased satisfaction with the restraint decision‐making. Conclusions: The Restraint Decision Tree could minimize physical restraint use. Physicians' involvement in the restraint decision‐making and nurses' competence in delirium assessment may be essential for successful implementation of the Restraint Decision Tree. Summary statement: What is already known about this topic? Physical restraint is a common practice in the intensive care unit.Minimizing physical restraint use does not increase the risk of catheter self‐removal.Nurses equipped with clinical decision‐making skills could promote the appropriateness of restraint application. What this paper adds? The Restraint Decision Tree could help nurses make appropriate restraint decisions for critically ill adult patients, thus decreasing the use of physical restraint.Multidisciplinary decision‐making improves nurses' satisfaction with the restraint decision process. The implications of this paper: This study suggests that the Restraint Decision Tree can be implemented in the intensive care unit as an effective decision‐making tool to decrease physical restraint use while maintaining patient safety.A strong culture of multidisciplinary collaboration and delirium screening is called for prior to utilizing the Restraint Decision Tree. [ABSTRACT FROM AUTHOR]

INTRODUCTION In recent years, e-cigarettes as an emerging tobacco product have been favored by college students. Our study aims to explore the factors affecting the use of e-cigarettes among college students and to put forward feasible suggestions for effectively controlling the use of e-cigarettes among college students. METHODS The participating students were from three undergraduate and three specialized colleges in Guangdong Province, surveyed from January to March 2022. The Fuzzy-set Qualitative Comparative Analysis (fsQCA) method was used to analyze the influence mechanism and path of five antecedents: self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, on the use of e-cigarettes. The fsQCA used in this study is a novel research methodology that combines the strengths of qualitative and quantitative analyses, through which we can determine which conditions are essential to the outcomes that lead to e-cigarette use among college students, and which combinations of conditions are more important than others. RESULTS The interaction of self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, affected college students' use of e-cigarettes. Through the fsQCA method, it was found that self-efficacy alone constitutes a necessary condition for college students not to use e-cigarettes. There are four possible pathways for college students not to use e-cigarettes, with higher self-efficacy, correct cognition, and a healthy social environment influencing the most important combination of conditions for college students to use e-cigarettes. CONCLUSIONS The use of e-cigarettes by students in Guangdong Province is the result of the synergistic effect of multiple factors. Tobacco control action suggestions focus on improving students' self-efficacy and paying attention to the combination of different factors to achieve more effective tobacco control. [ABSTRACT FROM AUTHOR]

Aims: Our study aims to investigate the effect of work–life balance programmes on Chinese nurses' psychological well‐being, directly and indirectly, via learning goal orientation. Our research also aims to investigate the moderating role of servant leadership, a holistic leadership style that prioritizes serving employees, in the association between work–life balance programmes and psychological well‐being. Design: A questionnaire‐based, time‐lagged study (1‐week interval). Methods: From September 2022 to October 2022, we collected a total of 211 matched and valid responses from nurses working for hospitals in Jiangsu Province, China. Data regarding work–life balance programmes, servant leadership, learning goal orientation and psychological well‐being were gathered using a survey administered in two waves, 1 week apart. We utilized the PROCESS Model 5 to test the moderated mediation model. Results: Work–life balance programmes significantly improved nurses' psychological well‐being. Moreover, learning goal orientation mediated the relationship between work–life balance programmes and psychological well‐being. However, servant leadership did not moderate the association between work–life balance programmes and psychological well‐being. Conclusion: Our study contributes to extant nursing literature by attending to the organizational strategies that promote psychological well‐being. This study is novel because it evaluates the mediating and moderating process through which work–life balance programmes improve nurses' psychological well‐being. Impact: The provision of work–life balance programmes could enhance learning goal orientation, resulting in possible improvement in nurses' psychological well‐being. Moreover, servant leadership styles may contribute to psychological well‐being. Our study can help nurse managers enhance their organizational strategies (e.g. work–life balance programmes) and leadership resources (e.g. servant leadership styles) to address nurses' well‐being issues. Patient or Public Contribution: This paper addresses the United Nations' Sustainable Development Goal 3 regarding 'Good Health and Well‐being'. [ABSTRACT FROM AUTHOR]

Background: The aging population is increasing, making it essential to have a standardized, convenient, and valid electronic memory test that can be accessed online for older people and caregivers. The electronic version of the Hopkins Verbal Learning Test-Revised (HVLT-R) as a test with these advantages and its reliability and validity has not yet been tested. Thus, this study examined the reliability and validity of the electronic version of the HVLT-R in middle-aged and elderly Chinese people to provide a scientific basis for its future dissemination and use. Methods: We included 1,925 healthy participants aged over 40, among whom 38 were retested after 3-6 months. In addition, 65 participants completed both the pad and paper-and-pencil versions of the HVLT-R (PAP-HVLT-R). We also recruited 42 Alzheimer's disease (AD) patients, and 45 amnestic mild cognitive impairment (aMCI) patients. All participants completed the Pad-HVLT-R, the Hong Kong Brief Cognitive Test (HKBC), the Brief Visual Memory Test-Revised (BVMT-R), and the Logical Memory Test (LM). Results: (1) Reliability: the Cronbach's α value was 0.94, the split-half reliability was 0.96. The test-retest correlation coefficients were moderate, ranging from 0.38 to 0.65 for direct variables and 0.16 to 0.52 for derived variables; (2) Concurrent validity: the Pad-HVLT-R showed a moderate correlation with the HKBC and BVMT-R, with correlation coefficients between total recall of 0.41 and 0.54, and between long-delayed recall of 0.42 and 0.59, respectively. It also showed a high correlation with the LM, with correlation coefficients of 0.72 for total recall and 0.62 for long-delayed recall; (3) Convergent validity: the Pad-HVLT-R was moderately correlated with the PAP version, with correlation coefficients ranging from 0.29 to 0.53 for direct variables and 0.15 to 0.43 for derived variables; (4) Discriminant capacity: the Pad-HVLT-R was effective in differentiating AD patients, as demonstrated by the ROC analysis with AUC values of 0.834 and 0.934 for total recall and long-delayed recall, respectively. Conclusion: (1) The electronic version of HVLT-R has good reliability and validity in middle-aged and elderly Chinese people; (2) The electronic version of HVLT-R can be used as an effective tool to distinguish AD patients from healthy people. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Prior research has demonstrated that childhood trauma can increase adolescents' suicidal ideation, and perceived stress plays a mediating role in the relationship between childhood trauma and adolescents' suicidal ideation. Character strengths, which are trait‐like positive personality characteristics, have also been found to be closely related to decreased stress and suicidal ideation. However, it is unclear whether character strengths act as a transfer mechanism that links childhood traumatic experiences with perceived stress and eventually suicidal ideation. What the paper adds to existing knowledge?: This study found that character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation. Specifically, childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. This study provided important theoretical implications for preventing suicidal risk among adolescents who are exposed to traumatic events during childhood. What are the implications for practice?: This study highlighted the roles of character strengths and perceived stress in the relationship between childhood traumatic experiences and suicidal ideation, which provided suggestions for designing nursing interventions to reduce adolescents' suicidal ideation, especially for those with traumatic childhood experiences. In addition to family nursing, school‐based regular monitoring and interventions of character strengths and perceived stress are necessary. Aim: This study sought to examine the mediating effects of character strengths and perceived stress on the relationship between childhood trauma and suicidal ideation among adolescents. Methods: A cross‐sectional survey was conducted on a sample of 1069 Chinese adolescents. The Chinese versions of the Suicidal Ideation Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and Character Scale for Adolescents were used to assess adolescents' suicidal ideation, childhood trauma, perceived stress and character strengths. Results: The findings showed that childhood trauma influenced suicidal ideation directly and indirectly via perceived stress. Moreover, character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation, implying that childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. Conclusions: This study highlighted the joint contribution of childhood trauma, character strengths and perceived stress to suicidal ideation, providing theoretical and practical implications to guide mental health nurses to reduce the suicide risk among adolescents. Implications for Practice: These findings highlighted the importance of developing character strengths and stress‐coping strategies. Family nursing and school‐based regular monitoring and interventions of character strengths and perceived stress are necessary among adolescents who exposed to a high level of childhood trauma experiences to reduce their suicidal ideation and foster mental health. [ABSTRACT FROM AUTHOR]

Cyber dating abuse victimization (CDAV) among female adolescents is common and harmful; however, little is known regarding how CDAV relates to victims' experiential avoidance in the Chinese context. Drawing from general strain theory, this cross-sectional study investigated possible differences in the relationships among CDAV, experiential avoidance, and self-compassion according to female adolescents' levels of interpersonal flexibility (low vs. high). A sample of 420 female adolescents aged 13 to 17 years (mean age = 15.78 years) who had been in intimate relationships during the past year participated in a voluntary and anonymous paper-and-pencil survey. Participants completed four self-reported measures on CDAV experience, self-compassion, experiential avoidance, and interpersonal flexibility. The findings indicated that nearly 49% of participants had experienced CDAV in the last year; CDAV exposure was directly linked with experiential avoidance and indirectly related to experiential avoidance through self-compassion. Moderation analyses showed that the negative associations between CDAV and experiential avoidance and self-compassion were only significant among participants with low interpersonal flexibility. These findings deepen the understanding of CDAV as a risk factor for reduced self-compassion and increased experiential avoidance in female adolescents. However, high interpersonal flexibility is a potential protector. This study has implications for the prevention of experiential avoidance among female adolescents exposed to CDAV and supports incorporating self-compassion and interpersonal flexibility skills to combat the negative outcomes of CDAV. [ABSTRACT FROM AUTHOR]

Background: Disease-related knowledge deficits are common in Chinese immigrants living in Western countries, putting them at risk of disease progression and mortality, particularly those with a coronary heart disease (CHD) diagnosis. However, no measurement instrument is available to assess CHD-related knowledge in this population. Objectives: The aim of this study was to culturally adapt and examine the psychometric properties of the short version of Coronary Artery Disease Education Questionnaire (CADE-Q SV) (simplified Chinese version) in Chinese immigrants with CHD. Methods: Mandarin-speaking people recruited from medical centers and cardiology clinics across metropolitan Sydney completed the 20-item CADE-Q SV (5 domains; potential scores: 0-20). Internal consistency was assessed using Cronbach a. A subgroup (n = 40) repeated the survey 2 weeks later for test-retest reliability by intraclass correlation coefficient. Factor structure (confirmatory factor analysis) and discriminant (known-groups) validation using education and English proficiency (univariate general linear model) were also undertaken. Results: Participants (n = 202) had a mean (SD) age of 66.08 (10.93) years, 45.1% were male, and the mean (SD) total CADE-Q SV score was 13.07 (4.57). Reliability and consistency were good (intraclass correlation coefficient > 0.70; Cronbach a coefficients > 0.70, for total and per domain, respectively). The 5-domain structure was validated by confirmatory factor analysis. The scale demonstrated discriminant validity, with loweducation (P < .001) and lowEnglish proficiency (P = .017) associated with lower knowledge scores. Conclusion: The CADE-Q SV (simplified Chinese version) can be used as a valid and reliable instrument, either paper based or digital, to evaluate the CHD-related knowledge of Chinese immigrants. This scale can be adapted to other migrant populations in the future. [ABSTRACT FROM AUTHOR]

The formation of information security behavioural intention (ISBI) can be complex and dynamic in different contexts. This paper aims to examine and compare different users' ISBI formalisation mechanisms when dealing with their personal affairs (non-work users) and organisational affairs (work users). Drawing on two principles of Conservation of Resources (COR) theory (i.e. resource loss principle, and resource gain principle), we developed two models to examine how situational support affects ISBI formation. The results of a study of 432 non-worker users and 261 work users indicate a curvilinear relationship between situational support and ISBI through subjective norms and risk perception for non-worker users, whilst a linear relationship via subjective norms is found for worker users. This is the first time that COR has been applied to explain the formation of ISBI. The findings broaden the research scope of individuals' ISBI by revealing how situational support affects the formalisation mechanism for different users in cross-contexts. The theoretical and practical implications of the findings and the future study are discussed. [ABSTRACT FROM AUTHOR]

Aim: Guided by the social embeddedness model of thriving at work, this paper explores how nursing organizational culture, work engagement and affective commitment affect nurses' thriving at work. Background: Thriving at work has implications for better employee and organization outcomes. The antecedents of thriving at work among the nursing population needs to be expanded by analysing the cross‐level impact of organizational and individual characteristics. Methods: A cross‐sectional design was used to collect data from 1437 frontline nurses in a tertiary teaching hospital in China between April and May 2020 through an online survey about perceived nursing culture, work engagement, affective commitment and thriving at work. Data were analysed using SPSS, and a structural equation model was established using the PROCESS macro. Results: Our results showed that work engagement and affective commitment mediated the relationship between nurses' perceived nursing culture and their thriving at work. Among nurses, work engagement was positively correlated to affective commitment. Conclusion: Our study confirmed the social embeddedness model of thriving at work by showing that both contextual and dispositional factors can influence nurses' thriving at work. Nurse leaders can foster nursing staff's thriving at work by building an inclusive work environment and by providing adequate resources to staff. Future research is needed to elaborate on employee and organizational outcomes associated with thriving at work. Impact: Nurse leaders should be the advocate for nurses to improve their organizational identification, fostering their thriving at work. Individual nurses can also take an active role in developing work‐related resources to sustain their thriving through self‐adaption processes. Collective thriving in the nursing workforce is needed to overcome adversity and hardship in the ever‐changing and increasingly demanding health care industry and to further contribute to the vitality of the broader social and public environments. 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]

Aim: This paper aimed to investigate the relationship between social support and quality of life for nurses in infectious disease departments in China, as well as the function of psychological resilience in mediating this relationship. Background: Nurses in infectious disease departments play a critical role in the prevention and control of infectious diseases and in public health care services in general, and their quality of life can affect the quality of clinical nursing work they do. However, there are few studies on the relationship between nurses' social support networks and their quality of life. Methods: A cross‐sectional study was conducted using a sample of 866 clinical nurses from the infectious disease departments of 10 general hospitals in China. Data were collected using a questionnaire survey from January to May 2021. The mediating influence of psychological resilience on social support and quality of life was investigated using structural equation modelling. Results: The score of quality of life was (36.36 ± 7.64). Quality of life was positively correlated with social support and psychological resilience (r1 = 0.521, r2 = 0.583; p <.01), and psychological resilience was positively correlated with social support (r = 0.426; p <.01) as well. The mediating effect of psychological resilience between social support and quality of life was 0.233, accounting for 37% of the total effect. Conclusion: The quality of life of nurses working in infectious disease departments is in the middle level. Psychological resilience is a mediating variable between social support and quality of life. Implications for Nursing Management: Managers can improve the quality of life of nurses by both increasing social support and strengthening psychological resilience. Managers should pay attention to the degree of social support provided to nurses and take proactive measures to build psychological resilience so that nurses can effectively manage stress and negative emotions from work and life in order improve their quality of life. [ABSTRACT FROM AUTHOR]

The role of formal volunteering in mental health promotion among older adults in China has been widely discussed during recent decades. However, the relationship connecting mental health with cross‐level interaction (i.e., average levels of participation in the community vs. individual participation) is still unclear. This paper examined the effects of cross‐level formal volunteering on depressive symptoms among older adults living in China. Using two waves of the China Longitudinal Aging Social Survey, a sample of 3128 Chinese older adults was surveyed in 2014 and 2016. Depressive symptoms were measured using the abbreviated CES‐D‐9. Individual fixed‐effects ordinary least squares regression models assessed the associations between individual‐ and community‐level formal volunteering and depressive symptoms in urban and rural areas separately. We found that in the urban sample, formal volunteering activities were negatively associated with depressive symptoms at the individual level (β = −0.49, SE = 0.22, p < 0.05). Higher community‐level formal volunteering was positively associated with depressive symptoms (β = 2.82, SE = 1.42, p < 0.05). When adding interactions between individual and community levels, engagement in individual‐level formal volunteering was associated with lower rates of depressive symptoms as community volunteering participation levels increased (β = −3.07, SE = 1.07, p < 0.01). High community‐level volunteering participation was detrimental for non‐volunteers. In rural areas, neither community‐ nor individual‐level formal volunteering was associated with changes in depressive symptoms. The current findings demonstrate formal volunteering may not always benefit mental health for all. The effects may depend on the community context and individual choices. Social policies aimed to promote mental health through formal volunteering need to be tailored according to the specific community social environment. [ABSTRACT FROM AUTHOR]

Background: Risk perception is a key factor influencing the public's behavioral response to major public health events. The research on public risk perception promotes the emergency management system to adapt to the needs of modern development. This article is based on a risk information perspective, using the COVID-19 event as an example. From the micro and macro perspectives, the influencing factors of public risk perception in major public health events in China are extracted, and the attribution model and index system of public risk perception are established. Methods: In this paper, the five-level Likert scale is used to collect and measure the risk perception variable questionnaire through the combination of online and offline methods (a total of 550 questionnaires, the overall Alpha coefficient of the questionnaire is 0.955, and the KMO test coefficient t=0.941), and through independent samples t-test, correlation analysis, multiple regression analysis and other methods to draw relevant conclusions. Results: The results showed that gender and age were significantly associated with risk perception (p< 0.005), and education level was significantly negatively associated with risk perception (p < 0 0.005). Risk information attention and risk perception were significantly positively correlated (p< 0.005), media credibility was significantly positively correlated with risk perception (p< 0.005), while risk information identification and media exposure had no significant interaction with risk perception (p=0.125, p=0.352). Conclusion: Factors such as gender, age, education level, place of residence, media exposure, media credibility, risk information attention, and recognition lead to different levels of risk perception. This conclusion helps to provide a basis for relevant departments to conduct public risk management of major public health events based on differences in risk perceptions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Because of increasingly stressful, dangerous and unpredictable psychiatric nursing work, psychiatric nurses have experienced higher job stress than general ward nurses.Little is known about the factors that affect the turnover intention of Chinese psychiatric nurses. Understanding the influencing factors of nurses' turnover intention will help to formulate targeted measures to stabilize psychiatric nursing teams. What does this paper add to existing knowledge: The results showed that 70.2% of psychiatric nurses had higher turnover intention. The strong turnover intention of Chinese psychiatric nurses is a problem that needs to be considered by managers.The results showed that having more children, between 31 and 39 years old, and having a part‐time job were strongly associated with turnover intention. In addition, "job stress" was also an important factor, psychiatric nurses' turnover intention decreased as their job stress level decreased. What are the implications for practice: Nursing managers should pay attention to nurses who have more children, between 31 and 39 years old, and take on part‐time jobs. Additionally, nursing managers should reduce job stress and implement targeted programmes to prevent psychiatric nurses' turnover.Experience‐sharing meetings and mindfulness‐based stress reduction training are also useful to improve the mental health status of psychiatric nurses with great job stress. Nursing managers should arrange human resources and shifts appropriately to give nurses with more children more time with their families. Provide more development opportunities for psychiatric nurses between 31 and 39 years old. Managers explore the reasons why nurses take on part‐time jobs and take targeted interventions (such as increasing income) to reduce the behaviour that happens. Introduction: Nurses' turnover is the main cause of nursing shortages, greatly affected by nurses' intention to leave. Nurses' turnover rate is particularly high in psychiatric wards. Several factors influencing the turnover intention of psychiatric nurses have not been well identified in China, and the association between job stress and turnover intention is still limited. Aims: To examine the relationship between job stress and turnover intention and identify the influencing factors of psychiatric nurses' turnover intention. Methods: Data were collected from 2355 psychiatric Chinese nurses using a cross‐sectional design with an online questionnaire investigation. Results: Psychiatric nurses had higher turnover intention. Significant factors influencing their turnover intention were job stress, having more children, age between 31 and 39 years old, part‐time jobs, education, income and patient‐to‐nurse ratio. Discussion: Demographics and job‐related factors should be considered when developing strategies to reduce the turnover intention of psychiatric nurses. Implications for practice: Nursing managers should pay attention to nurses with higher job stress levels and different demographic characteristics. Effective measures should be taken to reduce psychiatric nurses' job stress and turnover intention, such as arranging reasonable shifts, implementing targeted family‐friendly policies, increasing their occupational possibilities and promoting mental health. [ABSTRACT FROM AUTHOR]

Aims: To examine the differences in decisional conflict, decision regret, self‐stigma and quality of life among breast cancer survivors who chose different surgeries, as well as the effects of decisional conflict, decision regret and self‐stigma on quality of life. Design: Observational study. Methods: Paper and online surveys were used to collect data from March to September 2020. The Chinese version of the Decisional Conflict Scale, Decision Regret Scale, Self‐Stigma Form and Functional Assessment of Cancer Treatment‐B were used to measure the corresponding health outcomes for breast cancer survivors who chose different surgeries from three university‐affiliated hospitals. One‐way analysis of variance, Pearson's correlation coefficient and hierarchical multiple regression analysis were used for data analysis. Results: Among the 448 participants, only 21% chose breast conservative surgery, while 79% chose mastectomy with or without reconstruction. Women who chose mastectomy with reconstruction reported higher decisional conflict (p =.028) and more decision regret (p =.013) than women who chose breast conservative surgery; women who chose mastectomy without reconstruction indicated higher decisional conflict (p =.015), more decision regret (p <.001), and higher self‐stigma (p =.034) than women who chose breast conservative surgery. Decisional conflict (r = −.430), decision regret (r = −.495), and self‐stigma (r = −.561) were negatively correlated with quality of life. After controlling for sociodemographic and clinical variables, decisional conflict and decision regret explained 19.7% and self‐stigma explained 12.9% of the variance in quality of life. Conclusion: Decisional conflict, decision regret and self‐stigma vary according to different breast surgeries and are greatly associated with the quality of life of breast cancer survivors. Impact Future studies are warranted to investigate the decision‐making process and the underlying reasons for surgical choices. Decision support strategies pre‐surgery are needed to inform women about the risks and benefits of surgery options. Moreover, psychosocial support post‐surgery is warranted to relieve women's self‐stigma, thus improving their quality of life. [ABSTRACT FROM AUTHOR]

Individuals' gender development is influenced by the characteristics of personal and contextual environments. However, the role of sibling contexts in shaping gender norms has rarely been studied among Chinese youth at early adolescence as most of them were the only child. The aim of this paper is to compare perceived gender norms among adolescents aged 10–14 with different sibling configurations, to help inform and tailor guidance for sexual and reproductive health education in the future. We used the Global Early Adolescent Study baseline data collected from Shanghai, China. The sample for analysis was 1615 students. We used univariate analysis and multivariate ordinal logistic regression to compare perceived gender-stereotyped traits and gender role attitudes, stratified by age and sex. The results showed that sibling context was more influential for boys than girls at early adolescence in their gender socialization process. Among boys those who were with mixed-sex siblings scored higher on gender-stereotyped traits (ORonly-childvs. mixed-sex siblings = 0.67, 95% CI: 0.48–0.94, p = 0.019; ORsame-sex siblingsvs. mixed-sex siblings = 0.59, 95% CI: 0.37–0.96, p = 0.033). Younger early adolescents aged 10–12 who were the only child or who had mixed-sex siblings perceived more traditional gender role attitudes than those living with same-sex siblings (ORonly-childvs. same-sex siblings = 1.71, 95% CI: 1.06–2.75, p = 0.028; ORmixed-sex siblingsvs. same-sex siblings = 1.74, 95% CI: 1.03–2.94, p = 0.037). Comprehensive sexuality education with gender and power components being well addressed, both in and out of the family, is needed to provide extra gender-inclusive and gender-egalitarian environments for youth. [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]

The vulnerable children refer to the special group of children with deviation in the process of children's psychological development and personality formation due to growth dilemmas. This may incur a series of serious social and family problems. The vulnerable children mainly cover the children suffering from children's psychological problems, such as childhood autism, autism, social anxiety and hypersensitivity, fear, depression, and PTSD arising from other factors. At present, the research results at home and abroad mainly focus on the psychological dynamic correlation investigation and solution discussion of a certain kind of difficult factor in the children's psychological development based on statistical data by the experimental methods, such as scale and model, and there is a blind spot in the humanistic orientation theory construction of psychological treatment for vulnerable children, causing the social reflection on children's psychological predicament from the humanistic perspective cannot be performed in related researches and going against searching for universal and integral theoretical paradigm for solving related problems. Sophisticated technologies for the observations have emerged increasingly for enabling the psychological features of vulnerable children through developmental cognitive neuroscience experiments. This paper introduces humanistic art therapy theory, focuses on the construction of a theoretical paradigm, and verifies its effectiveness based on the experimental results on the psychological development of vulnerable children, with an efficient performance. This study mainly refers to children with difficulty in social inclusion and psychological development. The results showed that two kinds of art therapy can obviously improve the psychological disorders of vulnerable children. The goal was to enhance self-cognition, strengthen emotional interaction, and implement positive motivation. [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]

To explore the correlation between academic performance and learning motivation in English course under a corpus-data-driven blended teaching model, this study set research objects as 62 year-2020-enrolled undergraduate students majoring in English from a university in Jinan City, Shandong Province, eastern China. According to their previous frequencies of using information technology to learn English, these 62 students were divided into two groups: practice group with high frequency and control group with low frequency, with 31 students in each group. The two groups of students were taught 3 English lessons per week for a total of 15 weeks by the exact same teachers using a corpus-data-driven blended teaching model. The students' English academic performances were assessed by well-organized final tests, and their English learning motivations were measured by a motivation scale and questionnaires. The results show that the correlation coefficients between the average score of motivation questionnaires, intrinsic motivation factors, extrinsic motivation factors, and the average score of academic performances in practice group were 0.894, 0.682, and 0.724, respectively, while those in control group were 0.749, 0.836, and 0.904. In all the above correlation analyses, the significance level is 0.01, and all coefficient values are higher than critical value. Hence, there is a positive correlation between learning motivation and academic performance of the two groups of subjects. It is found that the corpus-data-driven blended teaching model has a significant impact on college students' English academic performance and learning motivation, and it has a positive effect on the improvement of their English academic performance and the cultivation of learning motivation. In general, the key to this teaching model lies in reasoning and acquisition by analyzing the language provided by the corpus, and the whole process of data-driven learning is student-centered. Students are exposed to a large number of authentic language knowledge and cultural information, which promotes the sensitivity to relevant points. The results of this paper provide a reference for further research on the analysis of the correlation between academic performance and learning motivation in English course under the corpus-data-driven blended teaching model. [ABSTRACT FROM AUTHOR]

Fourth Industrial Revolution (4IR) technologies have elevated the capabilities and possibilities of improvement and efficiency in the energy sector. This paper interrogates how energy companies in South Africa, Germany and China apply 4IR technologies. A total of 26 energy companies in those countries were surveyed. An analysis was carried out using the Cronbach Alpha, Kruskal-Wallis and Mann-Whitney tests. Survey results indicate that 85% of companies acknowledge good levels of participation in the 4IR, and were clear about which 4IR technologies are important, although few companies develop these themselves. Technologies enabling access to big, real-time data (BRTD) and BRTD analysis software, are valued the most in measured importance, efficiency, reliability and ability to be integrated across the energy system. The transfer of data using the Internet of things ranked highly as a 4IR technology, whereas artificial intelligence, robotics and machine-human integration (also referred to as machine-human interaction) are considered less important, efficient, and reliable. China rates 4IR technologies as more important than South Africa and Germany do. For South Africa to be competitive in the global energy sector it needs to engage with and embrace 4IR technologies to a greater extent. [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]

The experience of family harmony, as an individual's subjective evaluation of harmonious family relations, has an important influence on the development of their physical and mental health. This study aimed to develop the College Students' Experience of Family Harmony Questionnaire that is fit for college students in China. On the basis of literature analysis and survey with questionnaires, five pairs of opposite assessment indexes were constructed in this paper, namely, Atmosphere of family (getting along vs. conflict), Responsibility to housework (undertaking housework vs. refusing housework), Time-sharing (sharing vs. self-isolatedness), Seeking help (help-seeking vs. avoidance), and Supporting family members (support-providing vs. indifference). Items of this questionnaire were collected from investigation, relevant scales, and discussion with experts. Here, 562 college students were selected for the pre-test and 696 for the formal test. The results showed that, except for the dimension of refusing housework, which has been deleted, other dimensions remain unchanged, and the final nine dimensions accounted for 66.03% of variance variation. Furthermore, the result of confirmatory factor analysis indicates that the model fit well with the data in construct validity [χ2/ df = 2.71, Incremental Fit Index (IFI) = 0.90, Tucker–Lewis Index (TLI) = 0.89, Comparative Fit Index (CFI) = 0.90, root mean square error of approximation (RMSEA) = 0.05, standardized root mean square residual (SRMR) = 0.05]. The Cronbach's alpha (α) coefficient of this questionnaire was 0.97. The split-half reliability was 0.92, and the test–retest reliability was 0.75 for the total questionnaire. The total score of the questionnaire was significantly positively correlated with the total score of family function, family cohesion, family adaptability, and well-being (r = 0.73, 0.71, 0.75, 0.51, respectively, all p < 0.01), and it had a significant negative correlation with loneliness (r = −0.56, p < 0.01). The results showed that the final structure was reasonable, and reliability and validity conformed to the requirements of psychometrics. Therefore, the questionnaire developed in this study can be used as a valid instrument for assessing the experience of family harmony among college students in China. [ABSTRACT FROM AUTHOR]

Introduction: The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties. Methods: The translation and adaptation processes were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a crosssectional study with 386 patients with diabetes attending one of 20 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method was used to assess the construct validity. Confirmation factor analysis was used to evaluate model fit of the modified version. Cronbach's alpha was used to ascertain the internal consistency reliability. Results: During the translation and adaptation process, all 24 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Five factors (person-centeredness, clinical integration, professional integration, team-based coordination, organizational integration) with 15 items were determined by exploratory factor analysis, accounting for 53.51% of the total variance. Good internal consistency was achieved with each item correlated the highest on an assigned subscale and Cronbach's alpha score of 0.890. Moderately positive associations (r= 0.4, p<0.01) between the score of the scale and these correlations indicate good construct validity. Conclusions: The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT patient version. Its application in China will promote the development of people-centered integrated primary care. However, future studies with diverse samples crossing regions would be needed to test its psychometric properties for the various Chinese primary care contexts. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to study the impact of the interactive effect of knowledge characteristics – tacitness, specificity and availability – and resource structure – complementarily and asymmetric – on learning race behavior among international joint venture (IJV) partners in China. Design/methodology/approach: Preliminary in-depth interviews with three IJV managers were conducted to develop and evaluate the tentatively developed questionnaire. The finalized survey questionnaire was distributed to middle and top-level managers of IJVs, resulting in a total of 124 usable surveys. The psychometric properties of data were evaluated using Cronbach's alpha and confirmatory factor analysis and hypotheses were tested using a generalized linear model. Findings: The results show that partners in IJV have low tendencies to acquire tacit and specific knowledge, but, when the resource is complementary, it stimulates the learning race. Also, when resources are asymmetric, IJV partners engage in the learning race more aggressively, particularly for highly specific knowledge. The situation reverses for highly available knowledge. Originality/value: The findings provide important insights for both researchers and managers on knowledge characteristics and resource structure influencing learning race behavior. This insight allows firms to leverage features of knowledge and resource conditions to prevent or facilitate the learning race for either common or private interests. [ABSTRACT FROM AUTHOR]

Background After discharge, patients with enterostomy face problems with poor self-nursing ability and low levels of psychological and social adjustment, which, without timely intervention, seriously affect their quality of life. We delivered health education to discharged enterostomy patients based on a WeChat health management program and evaluated its impact on their ostomy self-care ability and psychosocial adaptation level. Methods Based on the WeChat health management program, we conducted continuous health education in the first, third, seventh, 11th, and 23rd weeks after discharge of enterostomy patients/before temporary enterostomy restoration to observe its impact on their self-care ability and psychosocial adaptation levels, as evaluated by an ostomy self-care ability questionnaire and ostomy adjustment inventory-20 checklist. Results We included 4201 patients with enterostomy. Our findings showed that the self-care score of patients with enterostomy at discharge (baseline) (mean = 15.23, standard deviation (SD) = 5.22) was lower than that after intervention (mean = 17.71, SD = 1.28) (P < 0.05). The enterostomy psychosocial adaptation score of the enterostomy patients at discharge (baseline) (mean = 44.59, SD = 9.82) was lower than that after intervention (mean = 50.25, SD = 12.97) (P < 0.05). Conclusions Health education for enterostomy patients after discharge can improve their self-care ability and psychological adaptation. Future studies could further explore the views and attitudes of this population toward health education based on the WeChat health management program. [ABSTRACT FROM AUTHOR]

Background Suboptimal health status (SHS) is a non-clinical or pre-disease state between optimal/ideal health and disease. While its etiology remains unclear, lifestyle is considered one of the most important risk factors. We aimed to examine the effects of lifestyles on SHS through a nationwide survey in China. Methods We conducted a cross-sectional survey in 148 cities across China between 20 June and 31 August 2022, on 30505 participants from rural and urban communities gathered through stratified quota sampling. We measured SHS with the Short-Form Suboptimal Health Status Questionnaire (SHSQ-SF). We gathered information on participants' lifestyles (ie, smoking, alcohol consumption, breakfast habits, weekly food delivery frequency, intermittent fasting, sleep duration and physical activities) through face-to-face interview. We determined the relationship between lifestyle and SHS logistic regression analysis by based on odds ratios (ORs) and 95% confidence intervals (CIs). Results We included 22897 participants (female: 13056, male: 9841), 12 108 (52.88%) of whom reported exposure to SHS. After adjusting for demographic characteristics, individuals who currently smoked (OR = 1.165; 95% CI = 1.058-1.283) and those who drank alcohol (OR = 1.483; 95% CI = 1.377.1.596) were at a higher risk of SHS than those who have never done either. In a dose-response way, takeaway food consumption was associated with a higher risk of SHS, while increased frequency of breakfast and mild-intensity exercise conversely reduced said risk. Individuals with shorter sleep duration had a higher risk of SHS when compared to those who slept for more than seven hours per day. Conclusions We observed a relatively high prevalence of SHS across China, highlighting the importance of lifestyle in health promotion. Specifically, adopting healthy dietary habits, engaging in regular physical activity, and ensuring high-quality sleep are key in preventing SHS. [ABSTRACT FROM AUTHOR]

Background Workplace violence against emergency physicians is a global concern. However, there was relatively little research on the incidence and correlated factors of workplace violence among emergency physicians in China. We aimed to investigate the occurrence and correlated factors of physical and verbal violence among emergency physicians in China. Methods We conducted a nationwide cross-sectional study from July 2018 to August 2018. We included a total of 10457 emergency physicians from 31 provinces across China in the analysis. The questionnaire covered socio-demographic characteristics, work-related factors, psychological characteristics, and workplace violence. We applied binary logistic regression to examine the correlated factors of physical and verbal violence among emergency physicians. Results The prevalence of physical and verbal violence among emergency physicians in China was 27.63% and 81.81%, respectively. Regarding socio-demographic factors, male emergency physicians with bachelor's degrees or higher, poor sleep quality, and unfavorable health conditions were more likely to experience workplace violence. Concerning work-related factors, emergency physicians who had longer years of service, worked a higher frequency of night shifts per month and served more patients per day had a greater prevalence of workplace violence. As for individual psychological characteristics, negative affect was positively correlated with workplace violence, while self-efficacy and positive affect were negatively correlated with workplace violence. Conclusions The situation of physical and verbal violence against emergency physicians in China is severe, especially verbal violence. Hospital administrators should pay more attention to the workplace violence of emergency physicians and take measures to decrease the occurrence of workplace violence efficiently, such as reducing their workload and cultivating their positive affect and self-efficacy. [ABSTRACT FROM AUTHOR]