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To assess career satisfaction among Chinese nurses, explore influencing factors, and examine the mediating role of role breadth self-efficacy (RBSE) in the relationship between subjective age and career satisfaction.
A multi-centre, cross-sectional study.
Between June and October 2024, 2033 questionnaires were distributed to nurses across seven geographic regions in China, collecting data on demographics, subjective age, RBSE, and career satisfaction. Descriptive statistics, Pearson correlation analysis, multiple linear stepwise regression, and path analysis were used to identify determinants of career satisfaction and test the mediating effect of RBSE.
The effective response rate was 97%. Chinese nurses reported moderate-to-high career satisfaction, younger subjective age relative to chronological age, and moderate RBSE levels. Multivariate linear regression analysis identified education level, work institution, salary, weekly working hours, subjective age, and RBSE as significant predictors of career satisfaction. Path analysis revealed a significant negative association between subjective age and career satisfaction (β = −0.23, p < 0.001), which was partially mediated by RBSE (indirect effect = −0.11, 95% CI: −0.18 to −0.05).
The career satisfaction of Chinese nurses is at a moderately high level; the influencing factors include the intensity of nursing work and salary levels. There is a certain difference between the subjective age and the chronological age of Chinese nurses. RBSE partly mediates the relationship between subjective age and career satisfaction.
Valuing the breadth of nurses' roles, self-efficacy, and subjective age may help improve job satisfaction.
What problem did the study address?: This study elucidates the present level of career satisfaction among nurses in China and the variables affecting it. What were the main findings?: The subjective age of Chinese nurses influences career satisfaction, with RBSE partly mediating the connection between subjective age and career satisfaction. Where and on whom will the research have an impact?: This study presents novel variables of subjective age and RBSE in the investigation of factors influencing career satisfaction among Chinese nurses, offering new avenues for enhancing career satisfaction in this demographic in the future.
We adhered to STROBE guidelines for cross-sectional research.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study examined the moderating effects of income inequality and nurse–patient relationships on the association between occupational stress and nurse turnover intentions in large urban hospitals in China, providing evidence for developing targeted retention strategies.
A cross-sectional study.
Data from 13,298 nurses in 46 hospitals in Xi'an, China (October–December 2023) were analysed using hierarchical regression to assess associations between occupational stress, organisational and professional turnover intentions and the moderating roles of the expected income achievement rate (calculated as [actual/expected income] × 100%) and nurse–patient relationship quality.
Eighty-three percent of nurses reported moderate-to-severe occupational stress. Compared to nurses experiencing mild stress, those with moderate/severe stress demonstrated significantly higher organisational and professional turnover intentions. After adjusting for covariates, significant interaction effects were observed. Higher expected income achievement rate showed a modest but significant moderating effect, associated with reduced turnover intentions. While the nurse–patient relationship also moderated this relationship, its protective effect was attenuated under conditions of severe stress. Despite small effect sizes, the consistent patterns and theoretical coherence of these interactions warrant further investigation.
Occupational stress significantly predicts nurse turnover intentions in urban Chinese hospitals, with income inequality and nurse–patient relationship quality serving as modifiable moderating factors. Interventions should integrate equitable compensation, nurse–patient relationship enhancement programmes and stress management initiatives.
This study demonstrates that equitable income consistently buffers the effects of occupational stress on nurse turnover, while nurse–patient relationships show stress-level-dependent moderation. By implementing region-specific compensation benchmarks and structured communication training, healthcare policymakers can effectively address economic security and relational care quality in workforce stabilisation.
The study has been reported following the STROBE guidelines.
No patient or public contribution.
In recent years, the critical role of health literacy in diabetes management has become increasingly prominent. The aim of this study was to investigate the impact of social support on health literacy among patients with diabetes, to test the mediating role of self-efficacy and empowerment between social support and health literacy, and the moderating role of eHealth literacy.
A cross-sectional study conducted between August 2023 and June 2024.
This study adopted the cluster sampling method and conducted a questionnaire survey among 251 patients with diabetes in a tertiary hospital in Wuhu City, Anhui Province. The questionnaires included the Social Support Rating Scale, the Self-Efficacy for Diabetes scale, the Health Empowerment Scale, the eHealth Literacy Scale and the Diabetes Health Literacy Scale.
Social support was positively associated with health literacy in patients with diabetes. Self-efficacy and empowerment mediated the relationship and formed chained mediation pathways respectively. eHealth literacy has a moderating role between self-efficacy and empowerment.
The results revealed that social support influences health literacy among patients with diabetes through the mediating pathways of self-efficacy and empowerment, and that this process is moderated by eHealth literacy. These findings provide a theoretical basis and practical insights for improving health literacy among patients with diabetes.
Enhancing health literacy among people with diabetes by strengthening social support, self-efficacy and empowerment levels, while focusing on the technology-enabling role of eHealth literacy in this context.
This study adheres to the relevant EQUATOR guidelines based on the STROBE cross-sectional reporting method.
We thank all patients who participated in the study for their understanding and support.
This study was to create an interpretable machine learning model to predict the risk of mortality within 90 days for ICU patients suffering from pressure ulcers.
We retrospectively analysed 1774 ICU pressure ulcer patients from the Medical Information Mart for Intensive Care (MIMIC)-IV database.
We used the LASSO regression and the Boruta algorithm for feature selection. The dataset was split into training and test sets at a 7:3 ratio for constructing machine learning models. We employed logistic regression and nine other machine learning algorithms to build the prediction model. Restricted cubic spline (RCS) was used to analyse the linear relationship between the Braden score and the outcome, whereas the SHAP (Shapley additive explanations) method was applied to visualise the model's characteristics.
This study compared the predictive ability of the Braden Scale with other scoring systems (SOFA, APSIII, Charlson, SAPSII). The results showed that the Braden Scale model had the highest performance, and SHAP analysis indicated that the Braden Scale is an important influencing factor for the risk of 90-day mortality in the ICU. The restricted cubic spline curve demonstrated a significant negative correlation between the Braden Scale and mortality. Subgroup analysis showed no significant interaction effects among subgroups except for age.
The machine learning-enhanced Braden Scale has been developed to forecast the 90-day mortality risk for ICU patients suffering from pressure ulcers, and its efficacy as a clinically reliable tool has been substantiated.
Patients or public members were not directly involved in this study.
To explore the effects of telehealth-based exercise interventions on balance, motor function, walking ability and activities of daily living (ADLs) in patients with stroke.
Meta-analysis of randomised controlled trials.
This meta-analysis of randomised controlled trials was reported to follow the PRISMA statement and the Cochrane Handbook guidelines. The study employed either a fixed-effects model or a random-effects model according to the statistical heterogeneity observed.
The literature search was performed in six databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO and CINAHL from inception to December 2023.
A total of 15 randomised controlled trials were included in this meta-analysis. Most of the studies were evaluated for some concerns. The quality of the evidence in this analysis ranged from low to moderate in terms of the outcome. Meta-analysis revealed that telehealth-based exercise interventions presented significant effects on walking ability, motor function and ADLs in patients with stroke. Nonetheless, the balance remained unaffected by statistical significance.
Telehealth-based exercise interventions could effectively improve walking ability, motor function and ADLs in patients with stroke; however, the impact on balance was not significant. Telehealth-based exercise interventions are recommended for stroke survivors residing in remote areas or facing economic constraints.
This meta-analysis showed that telehealth-based exercise interventions could bring benefits to the rehabilitation of patients with stroke. Telehealth-based exercise interventions should be considered effective to better promote the rehabilitation of patients.
The study was reported in compliance with the PRISMA statement.
None.
PROSPERO (https://www.crd.york.ac.uk/PROSPERO): CRD42024501015
To explore the motivations, capacity preparations and career development plans of specialist nurses (SNs) to provide insights for promoting further specialisation in nursing and enhancing the quality of nursing services.
A descriptive phenomenological qualitative study was conducted.
The study was conducted from April to May 2024 at a tertiary hospital in China. A purposive sampling method was used to recruit 35 nurses from various departments of the hospital who had completed specialist nursing training and obtained the necessary qualifications. These SNs participated in face-to-face semi-structured interviews.
Three overarching themes and ten subthemes were extracted. (1) career choices for SNs, included the following subthemes: ‘Social support’, ‘Specialist nursing is charismatic’, ‘Demand for specialized nursing’ and ‘Possessing specialized nursing qualities’. (2) career preparations for SNs, comprised subthemes such as ‘Professional preparation’, ‘Quality requirements’ and ‘Qualification requirements’. (3) career development for SNs, encompassed subthemes like ‘Personal growth’, ‘Team building’ and ‘Disciplinary developments’.
This study explores the motivations and experiences of SNs' career transitions, highlighting social support, the appeal of specialty nursing, industry demand and professional competence. Governments should provide resources for career preparation, while nurses should enhance their knowledge and skills. Becoming a SN marks a new career phase, requiring skill improvement, teamwork and discipline involvement. The study offers insights for general nurses transitioning to specialty nursing and informs SNs' career planning.
These findings provide important guidance for the career development of nurses as specialists, highlighting the crucial role of government, hospitals and nursing advocates in fostering their professional growth.
The study was reported following the Consolidated Criteria for Reporting Qualitative Research Checklist.
No patient or public contribution.
(1) Impact on patients: this study underscores the significance of specialised nursing care and its potential to improve patient outcomes through enhanced expertise and individualised care. (2) Impact on clinical practice: by identifying the motivations and preparations for SNs' career transitions, the research emphasises the importance of specialised knowledge and continuous professional development to enhance clinical practice and quality of care. (3) Impact on education: the study advocates for more comprehensive educational programs and continuous professional development for SNs, ensuring they stay updated with the latest practices and research. (4) Impact on social and economic issues: Promoting specialty nursing can help address healthcare challenges, particularly with aging populations and chronic diseases, improving healthcare efficiency and reducing costs through targeted care.
(1) Establishing a standardised training and certification system is essential to ensure the professionalism, consistency and quality of specialist nursing practice. (2) Developing well-defined career pathways with research opportunities, leadership training and skill enhancement programs fosters SNs' professional growth, and strengthens their ability to adapt to evolving healthcare demands. (3) Enhancing professional autonomy and interdisciplinary collaboration will maximise the impact of SNs in improving patient care and driving healthcare innovation.
This review aims to explore factors influencing family resilience in families providing care for patients with cancer and to provide suggestions for future research directions.
Six electronic databases were searched including Web of Science, CINAHL, EMBASE, PsycINFO, PubMed and CNKI from their inception to December 2023. The article reference lists were also manually searched. The Mixed Method Appraisal Tool was used to assess the included studies in this review. The 27-item checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to report this review.
Twenty-one studies from six online databases reported that either individual or family factors have effects on family resilience and were described into five clusters on the basis of the Walsh model of family resilience, including demographic and clinical factors, personal strengths and resources, family stressors, family resilient coping processes and family resilient adaptation outcomes.
Family resilience in cancer families plays a pivotal role in coping with family stressors and facilitating positive outcomes through domains of coping. Future researches need to explore factors related to family resilience from dyadic perspectives and to establish multidisciplinary intervention strategies for developing levels of family resilience in cancer families.
PROSPERO: CRD42024535349
To evaluate the duration of subsyndromal delirium (SSD) in intensive care unit (ICU) patients and the factors associated with SSD duration.
This retrospective study included adult patients admitted to the ICU of Affiliated Hospital of Nantong University between December 2019 and June 2020. All patients with Richmond Agitation Sedation Scale scores of ≥−2 were evaluated every 8 h using the confusion assessment method of the intensive care unit (CAM-ICU) until the patients with SSD were negative, progressed to delirium, fell into a coma, died, or were discharged from the ICU. Multivariable Cox regression analyses were performed to determine the factors associated with SSD duration.
Of the 388 patients, 53.6% had SSD, and 20.7% progressed from SSD to delirium. The duration of SSD ranged from 8 to 248 h, and the median duration was 48 h (interquartile range, 24–72). Age (hazard ratio [HR] = 0.985, 95% confidence interval [CI], 0.971–0.999, p = 0.035), surgery or not (HR = 0.514; 95% CI, 0.310–0.850; p = 0.010), duration of ventilation (HR = 1.003; 95% CI, 1.000–1.006; p = 0.044), duration of hypoxia (HR = 0.212; 95% CI, 0.103–0.438; p < 0.001), and adapted cognitive exam scores (HR = 1.057; 95% CI, 1.030–1.085; p < 0.001) were independently associated with the duration of SSD.
The duration of SSD was associated with age, surgery, duration of ventilation, duration of hypoxia, and cognitive function. SSD has a high incidence among ICU patients, and many patients progress to delirium.
The study team met with public members of the evaluation teams throughout the project in a series of workshops. Workshops informed study design, data collection tools and data interpretation.
ICU staff should pay attention to SSD patients with older age, history of surgery, longer duration of ventilation, prolonged duration of hypoxia, and lower ACE scores.
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.
An explanatory sequential mixed-methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data.
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.
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.
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.
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.
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