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Background: Anticipatory grief has been shown to be highly prevalent among family caregivers of patients with advanced illness. Qualitative study suggests that illness uncertainty may be one of the core characteristics of anticipatory grief, but it has not been confirmed in quantitative studies. Therefore, the purpose of this study was to explore the relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer and to determine the factors influencing anticipatory grief. Methods: This descriptive cross-sectional study used a convenience sampling method and recruited 254 inpatient family caregivers from the thoracic medicine ward of Liaoning Cancer Hospital & Institute in Shenyang, mainland China. Anticipatory grief (Anticipatory Grief Scale (AGS), illness uncertainty (Uncertainty in Illness Scale Family Caregiver Version) and sociodemographic information (Self-compiled general information questionnaire) were measured using validated self-report measures. Results: Chinese family caregivers of patients with advanced lung cancer had high levels of anticipatory grief (73.5 ± 16.1). The results of the correlation analysis showed a positive association between anticipatory grief and illness uncertainty (r = 0.580, P < 0.001). The final linear regression model with anticipatory grief as the dependent variable included four variables: illness uncertainty (β = 0.674, P < 0.001), lack of informativeness (β = − 0.168, P = 0.08), monthly income (β = 0.139, P = 0.006), and caregiving burden (β = − 0.196, P < 0.001). Conclusions: Illness uncertainty is probably an important factor affecting anticipatory grief. Excessive caregiving burden is associated with high levels of anticipatory grief. Improving illness uncertainty and caregiving burden may effectively reduce anticipatory grief among Chinese family caregivers. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand the factors that influence nurses empathy towards patients and to explore its influence on effort–reward imbalance involving empathy. Background: Empathy is highly valued in nurse–patient relationships. However, currently, little evidence currently exists on the impact of work‐related stress measured by effort–reward imbalance and empathy. Design: An anonymous, cross‐sectional online survey using a sample of convenient was conducted. Methods: Convenient online sampling was conducted with select nurses from seven cities in Shandong province, China. The nurses worked in clinical settings in 10 different hospitals. Two questionnaires, for example the Effort‐Reward Imbalance Questionnaire and the Jefferson Scale of Physician Empathy, were used. Medians, percentages, related analysis and regression analysis were used to measure the relationship between Effort‐Reward Imbalance and empathy levels among nurses in China. In addition, this study adhered to the EQUATOR checklist, STROBE (see Supplementary file 1). Results: Among 1,077 participants, 26.5% stated experiencing an Effort‐Reward Imbalance, with a mean empathy score among Chinese nurses, was 109.78 ± 13.98. Multiple regression analysis revealed that females and head nurses had higher levels of empathy, and that those who had no experience learning about empathy‐related courses and an Effort‐Reward Imbalance ratio were negatively associated with empathy. Conclusions: Gender, department, position, experience learning about empathy‐related courses and Effort‐Reward Imbalance ratio were significant elements related to nurses' empathy levels. Relevance to clinical practice: As we all know, empathy can affect the relationship between nurse and patient. If nurses are in an Effort‐Reward Imbalance, they may have less empathy. It is advised to improve the reward level of nurses, so that the level of empathy towards patients is enhanced. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence and characteristics of unintentional injuries among 5 to 9 grades students for both urban and migrant children groups, and probe the major socio-demographic and psychosocial risk factors. Methods: A cross-sectional survey was conducted from May to June in 2013 with 2266 urban and 1770 migrant children among 5 to 9 grades from 13 schools in Yinzhou, Southeast China. Unintentional injuries and psychosocial factors were measured via self-administered questionnaires. Descriptive statistics and binary logistic regression were employed in data analysis. Results: The annual prevalence of unintentional injury in the past year was 38%. Compared with urban children, migrant children reported lower prevalence of sprains/fractures (15.5 vs. 18.7%), but higher in animal bites (15.7 vs. 9.6%), burns (20.7 vs. 16%), nonfatal drowning (6 vs. 2.7%), and unintentional injury (40.9 vs. 35.7%). Binary logistic regression analysis revealed that male, young age, attending migrant children school, scoring high in emotional symptoms, conduct problems or hyperactivity, with suicide ideation, and experiencing verbal maltreatment were associated with unintentional injury incidence in the past 12 months. Conclusions: The annual prevalence of unintentional injury among 5 to 9 grades schoolchildren in Yinzhou was high. Child unintentional injuries were associated with multi-level psychosocial factors. Although the direct correlation between migrant status and unintentional injuries was unobserved, migration could have an indirect relationship with injury. The findings could inform some implications for prevention strategies in urban area. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to evaluate the health‐related quality of life of nursing workers and influential factors. Background: Nursing workers are under great occupational stress. However, few population‐level studies of nursing workers' health conditions have been reported from China. Design This was a cross‐sectional study conducted in 12 medical institutions in east China between January and March 2015. Methods: Social‐demographic information, nursing workers' work‐related information and health‐related quality of life using the Chinese (mainland) version of the Short Form 36 health survey were collected by a self‐administrated questionnaire. Results: Nursing workers reported significantly lower scores of the vitality, mental health dimensions, and mental component summary of the Short Form 36 survey compared with general population reference values. They scored significantly higher for five other dimensions and comparably for the physical role dimension. Pre‐job training, families' positive attitudes to their job, and good relationships with clients were positively related with nursing workers' mental well‐being. Conclusion: To promote nursing workers' mental health, compulsory work‐related training, voluntary psychological counselling, and targeted legislation are needed. SUMMARY STATEMENT: What is already known about this topic? Shortages of professional medical staff in medical institution at all levels will not be quickly met, and nursing workers are thought to be an important supplement in China.Population‐level study on nursing workers' point of view of their work and health condition has been little reported in China. What this paper adds? Nursing workers were mentally vulnerable regarding their vitality and mental health scores.Job training, families' positive attitudes to their job, and good relationships with clients were all protective factors for nursing workers' mental well‐being. The implications of this paper: Compulsory work‐related training for nursing workers provided by intermediary companies can help promote nursing workers' well‐being.Voluntary psychological counselling provided by hospitals can also be helpful to build a supportive work environment for nursing workers.Governments need to regulate this market and protect nursing workers' rights and benefits by legislation. [ABSTRACT FROM AUTHOR]

This article investigates the reliability and validity of the Chinese version of the 7-item Fear of Cancer Recurrence Questionnaire (FCR-7). A total of 1,025 cancer patients were recruited and asked to complete the Chinese FCR-7, Fear of Progression Questionnaire—Short Form (FoP-Q–SF), 9-item Patient Health Questionnaire (PHQ-9), and 7-item General Anxiety Disorder Questionnaire (GAD-7). The internal consistency and test–retest reliabilities were examined. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted on random split-half samples. Overall relationships of FCR-7 with other psychological constructs were examined. The Chinese FCR-7 showed good internal consistency (Cronbach's alpha =.87), test–retest reliability (r =.90), and item–total correlations (range =.583–.872). The unitary factor structure was supported by the EFA and the CFA fit statistics (comparative fit index =.99, root-mean-square error of approximation =.039, 95% confidence interval [.01,.07]). The total score of FCR-7 was positively associated with FoP-Q–SF (r =.756, p <.01), PHQ-9 (r =.522, p <.01), and GAD-7 (r =.553, p <.01). Patients with low monthly income (p <.001) and family cancer history (p =.012) and those who had gone through chemotherapy (p =.001) tended to report higher fear of cancer recurrence (FCR). The FCR-7 has been translated and successfully culturally adapted into a Chinese version. It is a reliable and valid measurement for assessing FCR. The present study suggests that the Chinese version of the seven-item Fear of Cancer Recurrence Questionnaire is a reliable and valid measure for assessing patients' recurrence fears. Additionally, patients with low income and family cancer history and those who had gone through chemotherapy were more likely to report higher fears. Therefore, specific and flexible psychological interventions are needed for these high-risk populations. [ABSTRACT FROM AUTHOR]