Conectar
This study aimed to examine the level of vicarious posttraumatic growth among intensive care unit nurses in China and explore the mediating role of death coping ability in the relationship between moral resilience and vicarious posttraumatic growth.
A multicentre, cross-sectional study was conducted in accordance with the STROBE guidelines.
Between January and March 2025, a questionnaire survey was conducted among 666 intensive care unit nurses from nine tertiary Grade A hospitals across five provinces in China. Participants completed three standardised instruments: the Rushton Moral Resilience Scale, the Coping with Death Scale–Short Version, and the Vicarious Posttraumatic Growth Inventory. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, and correlation analyses, and employed AMOS 27.0 to perform structural equation modelling for testing mediation effects.
Intensive care unit nurses demonstrated a moderate level of vicarious posttraumatic growth. Moral resilience was positively associated with both death coping ability and vicarious posttraumatic growth. Death coping ability was found to play a partial mediating role in the relationship between moral resilience and vicarious posttraumatic growth.
Moral resilience and death coping ability are key factors associated with vicarious posttraumatic growth among intensive care unit nurses. Nurses with stronger moral resilience are more likely to cope constructively with death-related stress, which may support psychological growth in trauma-intensive environments.
This study highlights the need to enhance intensive care unit nurses' moral and emotional capacities through ethics education, emotional coping training, and institutional support strategies. Strengthening these competencies may foster professional development and mental wellbeing in critical care settings.
In the era of ‘Undetectable = Untransmittable’ (U=U), reductions in condom use and increases in casual partnerships may contribute to elevated risks of coinfection with other sexually transmitted infections (STIs) and HIV super-infections among men living with HIV. These trends may reflect a shift in personal attitudes towards sexual behaviour and HIV risk, yet their influence on actual behaviours remains unclear.
To investigate how changes in personal attitudes and safe sex self-efficacy influence sexual decision-making.
Two-wave longitudinal study design.
We conducted a 3-month longitudinal study from March to December 2023 among HIV-positive men (≥ 18 years) initiating ART in Changsha, China. Cross-lagged panel analysis and half-longitudinal mediation analysis were used to examine how changes in personal attitudes influenced sexual behaviours.
427 men living with HIV were included at baseline, and 301 completed the follow-up survey. Sexual behaviours were associated with personal attitudes, namely safe sex fatigue, viral load/transmission beliefs, and sexual sensation seeking. More positive personal attitudes in these domains at baseline predicted lower safe sex self-efficacy over 3 months, while reduced baseline self-efficacy increased the likelihood of engaging in condomless sex and/or multiple sexual partners. All three personal attitude domains had significant indirect effects on sexual behaviours via safe sex self-efficacy.
In the era of U=U, the changed personal attitudes among men living with HIV may lead to the increased likelihood of engaging in condomless sex and/or having multiple sexual partners, and safe sex self-efficacy serves as a mediator in this relationship.
This study highlights the potential influence of attitudinal changes on sexual behaviours among men living with HIV in the ‘U=U’ era. Findings provide valuable evidence for developing more targeted interventions that address not only behavioural outcomes but also underlying personal attitudes.
No patient or public contribution.
Labour companionship is a recommendation by WHO that health authorities enable women to choose a companion during labour to ensure a safe and dignified labour experience for the birthing woman. However, most healthcare facilities in low- and middle-income countries do not necessarily consider this maternal need, which hampers a positive maternal experience during labour.
This study aims to examine midwives' perception towards the involvement of male partners in labour companionship.
An exploratory phenomenological approach was chosen and semi-structured interviews were used for this study.
The four main themes identified in this study include ‘Understanding of male partners' involvement in labour companionship’, ‘Involvement of midwives in decision-making’, ‘Barriers to male partners' involvement in labour companionship’ and ‘Facilitators of male partners' involvement in labour companionship’.
This study found a lack of understanding among midwives of the significance of male partners' involvement in labour companionship; and the identification of hierarchical and authoritarian leadership as a barrier to midwives' participation in decision-making highlights the need for transformational leadership styles to empower midwives. Overall, the findings of this study can inform maternity care policy as well as resource development, education and professional training in the field of midwifery.
To explore the association between body image, fear of childbirth and maternal-fetal attachment and the mediating effects of fear of childbirth among different body image profiles.
A cross-sectional study.
Pregnant women were recruited from obstetric outpatient clinics between February 2022 and October 2023. Face-to-face data were collected using validated questionnaires. First, the mediating role of fear of birth was examined between body image and maternal-fetal attachment by calculating the total scores. Then, latent analysis was performed to identify body image profiles, and the relative mediation effects were examined for fear of childbirth in the association between body image profiles and maternal-fetal attachment.
This study included 676 pregnant women, most of whom were in their third trimester. Using the total score, fear of childbirth was found to partially mediate the relationship between body image and maternal-fetal attachment. Latent profile analysis revealed three body image profiles in pregnant women: positive, moderate and negative. Using positive body image as the reference, pregnant women with moderate body image experienced a higher fear of childbirth, resulting in lower maternal-fetal attachment. Notably, the relative mediating effect of fear of childbirth was more pronounced in women with more negative body image profiles.
Body image affected maternal-fetal attachment directly and indirectly through fear of childbirth, with stronger mediating effects among women with more negative body image profiles.
The findings provide evidence on the underlying pathways between body image and maternal-fetal attachment and suggest body image and fear of childbirth as potential intervention targets to improve maternal-fetal attachment. Pregnant women with more negative body image may benefit more from such interventions.
Little is known about the pathway between body image and maternal-fetal attachment in pregnant women. Body image affects maternal-fetal attachment directly and indirectly through fear of childbirth. The mediating effects of fear of childbirth were more pronounced among women with more negative body image profiles. These findings highlight fear of childbirth in the association between body image and maternal-fetal attachment and identify women with a more negative body image as high-risk populations, which provides insights for developing personalised interventions to improve perinatal psychological health.
The study has followed the STROBE checklist for reporting method.
No patient or public contribution.
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