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Aims: To explore older inpatients and their caregivers' care experience and how this relates to the gerontology care practice. Background: Research interest in the conceptualization of safe care for older inpatients was growing, and these studies were predominantly reported from a single or healthcare perspective. There is a shortage of literature on how patients and their caregivers conceptualise safe care. Design: Constructivist grounded theory. Methods: Stage 1 included semi‐structured interviews with inpatients. Stage 2 included semi‐structured interviews with caregivers and six field notes. Purposive and theoretical sampling were used to recruit 61 participants across six healthcare institutions. Data analysis included initial coding, focused coding, and theoretical coding using constant comparative, field notes and memo writing. Results: The substantive theory to emerge from the data was A balance of unsafe care incidents and interactive cooperative care. This core concept was informed by four categories: unsafe care incidents, interactive cooperative care, person‐centred care, contextual conditions, and one care outcome. The relationships between these categories constituted a balance in which patient‐centred care was the core, unsafe care incidents were the barriers, interactive cooperative care was the facilitator, and the result of the balance was the care outcome. The balance constituted a safe care ecosystem under the interaction of contextual conditions. Conclusions: Interactive cooperative care is vital in enabling care stakeholders to reduce unsafe care incidents, which facilitates them in achieving safe care and further constructing a healthy care ecosystem. Relevance to Clinical Practice: This theory identifies barriers and facilitators encountered by care stakeholders to cope with everyday problems and guides them in developing personalised care plans to ensure patient safety. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery. Methods: A prospective observational study was conducted based on inclusion and exclusion criteria. A total of 384 elderly patients undergoing abdominal surgery under general anesthesia were enrolled in a grade A tertiary hospital in Chengdu, Sichuan Province from October 2021 and October 2022. After anesthesia induction, inflatable warming blankets were routinely used for active heat preservation, and nasopharyngeal temperature was monitored to observe the occurrence of intraoperative hypothermia. Patients were divided into hypothermia group and nonhypothermia group according to whether hypothermia occurred during the operation. Anesthesia recovery time and the incidence of adverse events or unwanted events during anesthesia recovery between the two groups were compared. Results: The numbers (percentage) of 384 patients who underwent abdominal surgery developed intraoperative hypothermia occurred in 240 (62.5%) patients, all of whom had mild hypothermia. There were statistically significant differences between mild hypothermia after active warming and nonhypothermia in the occurrence of shivering (χ2 = 5.197, P = 0.023) and anesthesia recovery time (Z = -2.269, P = 0.02) in elderly patients undergoing abdominal surgery during anesthesia recovery, and there were no statistically significant differences in hypoxemia, nausea or vomiting, hypertension, hypokalemia, hypocalcemia, analgesic drug use,postoperative wound infection or postoperative hospitalization days. Conclusions: The incidence of intraoperative mild hypothermia after active warming was high in elderly patients who underwent abdominal surgery. Mild hypothermia increased the incidence of shivering and prolonged anesthesia recovery time in elderly patients undergoing abdominal surgery. [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low‐ and middle‐income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV. Design: An explanatory sequential mixed‐methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data. Methods: The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In‐depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research. Results: The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV‐related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti‐domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first‐line support requirements even without formal education or training on IPV) were identified. Conclusions: Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening. Clinical Relevance: The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector. [ABSTRACT FROM AUTHOR]

Background: Workplace violence among nurses has emerged as a critical issue, posing a significant threat to their occupational safety. Education and training are the primary measures employed to prevent and respond to workplace violence. However, the current approaches have proven ineffective, possibly due to a lack of consideration for the specific needs of clinical nurses. Therefore, it is essential to explore the effectiveness of an informational education and training platform tailored to nurses' requirements. This study aimed to investigate the impact of such a platform on the incidence, severity, and coping resources of WPV in nurses. Methods: This research was a quasi-experimental study. An information-based education and training platform focused on nurse workplace violence was developed through literature reviews, expert meetings, consultations with software development companies, and a trial run. A tertiary general hospital in Suzhou was selected, in which hospital district A was the intervention group and hospital district B was the control group. A total of 276 nurses were recruited, 140 in the intervention group and 136 in the control group. The nurses' incidence, severity, coping resources status, and evaluation of the application were measured before the intervention and at 1, 3, and 6 months after the intervention. Results: The overall incidence of workplace violence, verbal aggression, and verbal threat among nurses showed statistically significant differences (P < 0.05) for the time effect, while the incidence of physical aggression demonstrated statistically significant differences (P < 0.05) for the between-group effect and the time effect. The severity of physical violence among nurses exhibited statistically significant differences (P < 0.05) for the between-group effect and time effect, and the severity of psychological violence showed statistically significant differences (P < 0.05) for the time effect. Nurses' total coping resources score and dimensions also showed statistically significant differences in terms of group, time, and interaction effects (P < 0.001). The evaluation questionnaire for the mobile application indicated usefulness scores of 2 (1, 2); ease of learning scores of 2 (1, 2); ease of use scores of 2 (1, 2); trust scores of 2 (1, 2.75); acceptance score of 1 (1, 2); and satisfaction scores of 2 (1, 2). Conclusions: Implementing the nurse workplace violence information-based education and training platform proved beneficial in reducing the incidence and severity of workplace violence among nurses and enhancing their coping resources. This outcome suggested the platform's potential for further application and promotion in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Paraspinal vein misplacement is an uncommon complication of central venous catheterization via lower extremities, most of which have been reported in case reports. Aim: To determine the clinical characteristics of paraspinal vein misplacement. Design: This was a systematic review. Methods: A systematic literature search in the PubMed, EMBASE, Scopus, and Web of Science databases was performed from their inception to 18 June 2019. Case reports and small case series describing central venous catheter misplacement in the paraspinal vein were included. Data on the catheterization procedure, catheter tip position, complications, and radiographic features of misplacement were extracted. Results: Thirty studies with a total of 36 patients were included. The ascending lumbar vein accounted for the majority of misplacements (n = 30), followed by the lumbar vein (n = 4), iliolumbar vein (n = 1), and vertebral venous plexus (n = 1). Six patients had eventful catheterization procedures. Twenty‐six patients experienced misplacement‐induced complications, of whom seven died. The most common complications included cerebrospinal fluid abnormalities, neurological symptoms, and deteriorated respiration. Among the entire case cohort, the onset of complications was the primary sign that alerted medical staff to misplacement (n = 23). The typical radiographic characteristics were posterior deviation of the catheter course overlapping with the spine on lateral X‐rays and a bend, kink, or hump in the catheter course on anteroposterior X‐rays at the L4 to L5 levels. Conclusions: Nurses should be aware of this particular complication if a patient who has undergone catheterization via a lower extremity presents deterioration of neurological function and respiration. Relevance to clinical practice: Lateral X‐ray radiography is an effective method to verify misplacement and is recommended as routine practice during catheterization via lower extremities. [ABSTRACT FROM AUTHOR]

Aim(s): To construct structural equation models to test the mediating role of emotional intelligence in the relationship between mindfulness and occupational burnout. Background: Reports assessing the relationships among mindfulness, emotional intelligence and burnout, specifically in ICU nurses, are scarce. Methods: This was a descriptive, correlational, cross‐sectional research design with 883 ICU nurses enrolled by convenience sampling from 29 ICUs in seven tertiary hospitals in urban areas of Chengdu, China. Mediation analysis was performed by structural equation modelling. Indirect effects were evaluated through bootstrapping. Results: The associations among mindfulness, emotional intelligence, emotional exhaustion, depersonalization and personal accomplishment were all significant (p <.001). In the mediation models, emotional intelligence partially mediates the relationships between mindfulness and emotional exhaustion (indirect effect 0.118, p =.006; direct effect −0.374, p =.010; total effect −0.492, p =.011) and between mindfulness and depersonalization (indirect effect −0.182, p =.006; direct effect −0.452, p =.015; total effect −0.633, p =.018). Emotional intelligence plays a total mediating role between mindfulness and personal accomplishment (indirect effect 0.293, p =.004; direct effect 0.119, p =.053). Conclusions: The results suggest that nursing manager could implement mindfulness training to improve occupational burnout in ICU nurses. Implications for Nursing Management: Nursing managers could help create a more favourable working environment by providing mindfulness training. Such mindfulness training could help improve nursing quality, reduce errors and ensure patient safety, possibly improving patient prognosis and probably satisfaction. [ABSTRACT FROM AUTHOR]

Background: Although evidence shows that reminiscence therapy relieves depression in the elderly, few studies have explored its mechanisms and it is unclear whether old public photos rather than personal photos are effective prompts. Objectives: The aims of this functional magnetic resonance imaging (fMRI) study with an event-related design were to explore whether old public photos can evoke autobiographical memories and compare brain-activation responses to photos between elderly women with depressive symptoms (DS) and normal controls (NC). Methods: Elderly women with DS (n = 16) and NC (n = 18) were recruited from urban communities in Southwest China. Participants responded with a key press to indicate which of 40 photos evoked autobiographical memories at first sight during 3.0 T scanning. Afterward, they rated photos on a 9-point Likert-type scale on the degrees of recall (DOR), arousal, and pleasure elicited and the degree to which photos felt old. Results: Mean DOR scores were 8.47 ± 0.77 and 1.37 ± 1.09 for high- and low-DOR photos, respectively. Response time was longer in DS compared to NC participants. Brain areas activated by exposure to high-DOR photos differed between groups, with reminiscence leading to decreased activation of the bilateral superior temporal gyrus, left inferior frontal gyrus, right parahippocampal gyrus, left cingulate gyrus, right insular lobe, and bilateral cerebellum anterior lobe in DS compared to NC participants. Conclusion: Old public photos can evoke autobiographical memory. DS are associated with brain dysfunction. Early intervention for DS is recommended in the elderly. [ABSTRACT FROM AUTHOR]

Nursing students from vocational college programs contribute to over 60% of the nursing student population in China. However, there remains a lack of systematic, quantitative studies examining the prevalence of mental health problems in this population. The purpose of this study was to explore the prevalence of depression, anxiety and stress symptoms and associated factors in vocational college nursing students in Sichuan, China. A total of 554 nursing students from vocational colleges participated in this cross-sectional study. Outcomes were measured with the Depression, Anxiety and Stress Scale 21 (DASS 21). Logistic regressions analysis was performed to examine correlates of mental health problems. The prevalence rates of depression, anxiety and stress symptoms among vocational college nursing students in China were 28.7% (95% CI 24.9%–32.5%), 41.7% (95% CI 37.6%–45.9%) and 20.2% (95% CI 16.8%–23.6%). Mental health problems were elevated as compared to a reference population of Chinese college students of all majors. However, only two percent indicated to seek treatment. The most consistent correlates of mental health problems were reduced engagement in physical and other leisure activities, poor sleep quality, experience of negative life events and poor self-perceived mental health. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the effectiveness of individual reminiscence therapy in community‐dwelling older women with depressive symptoms and to explore the characteristics of participants’ verbalisation in the process. Background: Previous studies have found reminiscence was related to depression and anxiety. Although reminiscence therapy is widely used to reduce depression, little is known about how it works, and the content of verbalisations might provide one explanation. Design: The study employed a one‐group pretest–post‐test design. Methods: Twenty‐seven participants underwent 6‐week interventions of individual reminiscence therapy at home that were conducted by one nurse and induced through seeing old photographs. The Geriatric Depression Scale, Zung Self‐rating Anxiety Scale, Reminiscence Functions Scale and Cognitive Emotion Regulation Questionnaire were used to measure the emotional states, reminiscence functions and cognitive emotion regulation strategies. Participants’ verbalisations were categorised using the Client Behavior System. Results: Reminiscence therapy relieved depression and anxiety. Both the reminiscence function and cognitive emotion regulation became more favourable after interventions. Furthermore, higher frequencies of recounting, cognitive‐behavioural exploration and affective exploration were noted in the process. Participants with more severe depressive symptoms tended to display a higher frequency of affective exploration. The reduction in depression, self‐negative reminiscence and negative‐focused emotion regulation were respectively associated with verbalisations. Conclusions: Individual reminiscence therapy might relieve negative emotion and improve reminiscence function and cognitive emotion regulation. The participants’ verbalisation is worthy of our attention, due to its correlation with the severity of depression and its mitigating effects on the depression, anxiety, self‐negative reminiscence and negative‐focused regulation in older women. The results contribute to our understanding of the therapeutic procedure and suggest a need for more research on the therapeutic processes. Relevance to clinical practice: Study on processes could help training novice clinical interveners so that reminiscence therapy can work better on emotional disorders in clinical practice. [ABSTRACT FROM AUTHOR]

We investigated the status of caregiver burden and identified the factors related to caregiver burden among family caregivers of patients with heart failure in southwest China. A cross-sectional descriptive design with a convenience sample was adopted. Patient and family caregiver dyads ( n = 226) in four hospitals in Chengdu, China were recruited from June 2013 to July 2014. The instruments used in this study included the Social Support Rating Scale, the Zarit Burden Interview, and the General Self-Efficacy Scale. Multivariate analysis was used to identify the factors associated with caregiver burden. Forty-four percent of the variance of the caregiver burden was explained by the payment type for treatment, monthly family income, relationship to the patient, caregivers' self-efficacy, and social support. The caregiver burden in southwest China was higher than studies conducted in developed areas. Specific to southwest China, the financial burden and insufficient resources are the main factors associated with caregiver burden. The results suggest that self-efficacy and social support in underdeveloped areas are potential areas for future intervention. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the associations among professional self-concept, organisational commitment and burnout, and to analyse the mediating role of organisational commitment on the relationship between professional self-concept and burnout among community health nurses in Chengdu, China. Background Previous studies have focused on work environmental variables that contributed to burnout in nurses. However, no study has explored the mediating effect of organisational commitment on the correlation between professional self-concept and burnout in community health nurses. Design A cross-sectional descriptive study. Methods This study was conducted at 36 community health centres in Chengdu, China with 485 nurses sampled using a two-stage sampling method. The measures used in our study included Nurses' Self-concept Questionnaire, Organisational Commitment Scale and Maslach Burnout Inventory. Results The results of structural equation model techniques indicated that, in the direct approach, positive professional self-concept resulted in increased organisational commitment and reduced burnout. Higher organisational commitment resulted in less burnout. In the indirect approach, organisational commitment performed as a partial mediator on the correlation between professional self-concept and burnout. Conclusions Positive perception of professional self-concept can result in reduced burnout via enhancing organisational commitment. Relevance to clinical practice It is crucial for nursing administrators to develop effective intervention strategies such as skills escalator training and assertive training, and establishing a supportive working environment to enhance nurses' professional self-concept and organisational commitment, and decrease burnout. [ABSTRACT FROM AUTHOR]

Venous thromboembolism is the leading cause of death in cancer patients, second only to tumor progression. The Khorana score is recommended by clinical guidelines for identifying ambulatory cancer patients at high risk of venous thromboembolism during chemotherapy. However, its predictive performance is debated among cancer patients. To map the applicability of the Khorana score in cancer patients and to assess its predictive performance across various cancer types, providing guidance for clinicians and nurses to use it more appropriately. Systematic review and meta-analysis. A comprehensive literature search of the electronic database was first conducted on August 30, 2023, and updated on May 20, 2024. Studies examining the Khorana score's predictive performance (including but not limited to the areas under the curve, C-index, and calibration plot) in cancer patients were included. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was applied to evaluate the methodological quality of the included studies. Data synthesis was achieved via random-effects meta-analysis using the R studio software. The subgroup analysis was performed according to the study design, clinical setting, cancer type, anti-cancer treatment stage, and country. The review incorporated 67 studies, including 58 observational studies and nine randomized controlled trials. All included studies assessed the Khorana score's discrimination, with the C-index ranging from 0.40 to 0.84. The pooled C-index for randomized controlled trials was 0.61 (95 % CI 0.51–0.70), while observational studies showed a pooled C-index of 0.59 (95 % CI 0.57–0.60). Subgroup analyses revealed the pooled C-index for lung cancer, lymphoma, gastrointestinal cancer, and mixed cancer patients as 0.60 (95 % CI 0.53–0.67), 0.56 (95 % CI 0.51–0.61), 0.59 (95 % CI 0.39–0.76), and 0.60 (95 % CI 0.58–0.61), respectively. Inpatient and outpatient settings had the pooled C-index of 0.60 (95 % CI 0.58–0.63) and 0.58 (95 % CI 0.55–0.61), respectively. Calibration was assessed in only four studies. All included studies were identified to have a high risk of bias according to PROBAST. The Khorana score has been widely validated in various types of cancer patients; however, it exhibited poor capability (pooled C-index < 0.7) in accurately discriminating VTE risk among most types of cancer patients either in inpatient or outpatient settings. The Khorana score should be used with caution, and high-quality studies are needed to further validate its predictive performance. The protocol for this study is registered with PROSPERO (registration number: CRD42023470320). [ABSTRACT FROM AUTHOR]

The negative synergistic effect of cancer and a peripherally inserted central catheter could significantly increase the incidence of thrombosis. Rather than identifying risk factors for peripherally inserted central catheter–related thrombosis, exploring the effect of these risk factors might be a promising method to improve the outcomes of thrombosis. To analyze the effect of systemic and local risk factors on triggering peripherally inserted central catheter–related thrombosis in the first two weeks post–insertion in cancer patients. A prospective cohort study. The study was conducted at a 4500-bed university-affiliated medical center in China. One hundred seventy-three cancer patients with peripherally inserted central catheters were included. Peripherally inserted central catheter–related thrombosis was assessed using ultrasound at a series of timepoints, once every two days post–insertion. Data on age, body mass index, blood hypercoagulation, insertion attempts, catheter-to-vein ratio, and blood flow velocity were collected as risk factors. Descriptive statistics and structural equation modeling were used to describe the study samples and analyze the effects of systemic and local risk factors. Among the 173 cancer patients included, 126 (72.8%) patients were diagnosed with peripherally inserted central catheter–related thrombosis. Most thromboses (n = 118, 93.7%) were detected within five days, and 100% were detected within nine days post–insertion. Structural equation modeling analysis showed that local risk factors [catheter-to-vein ratio (standardized path coefficient = 0.32, p < 0.05) and blood flow velocity (standardized path coefficient = −0.35, p < 0.05)] had a greater effect than systemic factors [age (standardized path coefficient = 0.13, p < 0.05) and blood hypercoagulation (standardized path coefficient = 0.17, p < 0.05)] on triggering peripherally inserted central catheter–related thrombosis. Peripherally inserted central catheter–related thrombosis is quite common and can occur very early post–insertion in cancer patients. Among the common risk factors, local risk factors reflecting peripherally inserted central catheter technology itself had a greater effect than systemic risk factors reflecting predisposition to thrombosis. Clinical Registration: Clinical Trials ChiCTR1900024890. [ABSTRACT FROM AUTHOR]