Conectar
by Mingming Pan, Yanhua Shen, Jiayu Wu, Chaonan Liu, Meihong Zhu, Zhengyu Zhou
This study aimed to investigate the therapeutic effects of ELASEM®Flex and ELASEM®ProFlex, two eggshell membrane (EM) products, on sodium iodoacetate (MIA)-induced osteoarthritis (OA) in rats. An OA model was established by a single intra-articular injection of MIA into the knee joint. After modeling, rats were administered diclofenac sodium, ELASEM®Flex, and ELASEM®ProFlex by gavage daily for 4 consecutive weeks. During the experiment, food intake, water intake, body weight, and plantar mechanical pain threshold (MPT) of rats were measured weekly. Serum levels of TNF-α, COX-2, IL-1β, and CTX-II were assessed at weeks 2 and 4. After 4 weeks, knee joints were harvested for histopathological examination (HE staining and Safranin-O fast green staining). Results indicated that knee joints of OA rats showed significant swelling, which was alleviated to varying degrees in all treatment groups. Both ELASEM®Flex and ELASEM®ProFlex significantly increased the MPT (P ®Flex and ELASEM®ProFlex can exert preventive and reparative effects on knee OA in rats by alleviating arthritis pain, inhibiting inflammatory factor expression, reducing type II collagen degradation, and promoting chondrocyte proliferation.To compare the effectiveness of multifactorial and exercise programs in preventing falls among older adults, with a specific focus on evaluating the individual and combined contributions of their key intervention components.
This study was a systematic review and component network meta-analysis. PubMed, Embase, and Web of Science were searched from inception to February 2025 for randomized controlled trials, focusing on four primary outcomes: fallers, recurrent fallers, injurious fallers, and fractured fallers. Risk of bias was evaluated using the Cochrane tool, and additive component network meta-analysis compared intervention group and component efficacy.
69 randomized controlled studies were included. In multifactorial interventions, traditional health education could increase fall risk (iRR: 1.10, 95% CI [1.03; 1.67]) and recurrent fall risk (iRR: 1.25, 95% CI [1.06; 1.48]). Medication management can increase recurrent fall risk (iRR: 1.35, 95% CI [1.09; 1.67]) and fracture risk (iRR: 2.11, 95% CI [1.48; 3.00]). Exercise (iRR: 1.24, 95% CI [1.01; 1.53]) increased fracture risk, and environment modification (iRR: 0.56, 95% CI [0.61; 0.79]) reduced it. The additive effect of risk assessment and advice, exercise, and environment modification reduced fall risk. In exercise programs, gait and balance (iRR: 0.58, 95% CI [0.36; 0.93]) can reduce recurrent fall risk. An intervention containing two components (gait and balance + strength and resistance) reduced the risk of falls and fall-related injuries.
Environment modification reduced fracture risk, emphasizing the value of creating safe living spaces. The combination of risk assessment, advice, exercise, and environment modification reduced fall risk, suggesting a holistic approach may be effective in preventing falls. Traditional methods of health education and medication management are in urgent need of updating to synergize with other exercise components and enhance the effectiveness of fall prevention. Prospective clinical trials are needed to optimize combinations of exercise components, particularly integrating gait and balance training with strength and resistance exercises.
The review was registered online in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number (CRD42025643530)
Pressure injury (PI) is common in the ICU and not well captured by single-risk tools such as the Braden scale. We aimed to develop and internally validate a machine-learning model to predict new-onset PI using routinely collected ICU data. This retrospective single-centre cohort included adult ICU patients with length of stay ≥ 48 h (2018–2023). The primary outcome was new-onset PI during ICU stay. Candidate predictors were pre-specified: minimum albumin, maximum lactate, SOFA, APACHE II, first recorded Braden score, age, BMI, a nutrition score and treatment indicators. Missing values were imputed (median/mode). A gradient boosting model (GBM) was evaluated with stratified 3-fold cross-validation; a random forest (RF) served as a benchmark (stratified 70/30 train–test split). Discrimination (AUC) was primary; calibration, Brier score, decision-curve analysis (DCA) and feature importance were secondary. Logistic regression quantified independent associations. Among included ICU stays, 14.6% developed PI. On multivariable analysis, higher lactate, lower albumin, lower Braden scores, older age, CRRT, prone positioning, enteral nutrition and analgesic exposure were associated with increased PI risk, whereas sedatives showed an inverse association. The GBM achieved AUC≈0.69 with acceptable calibration and net clinical benefit across thresholds commonly used in preventive workflows (≈0.10–0.50). Single markers or simple combinations displayed only modest discrimination. A GBM built from routine ICU data provided moderate, well-calibrated discrimination for predicting new-onset PI and demonstrated decision-relevant net benefit. The model can complement Braden-based screening by refining risk stratification and prioritising intensified prevention for patients most likely to benefit. External validation and prospective evaluation are warranted.
by Xiuxin Liu, Yuhui Han, Ruixue Kuang, Wenjiong Sheng, Yan Zhang, Xinyu Jia, Xiaoxiao Gao, Yanchao Ma
DNA damage-induced by radiotherapy is a critical factor in promoting the death of colorectal cancer cells (CRC). Although high mobility group box 1 (HMGB1) reportedly plays a vital role in tumor radioresistance by modulating DNA damage repair, the precise mechanisms remain unclear. In this study, HMGB1 knockdown markedly enhanced cell apoptosis after radiation. HMGB1 downregulation significantly inhibited DNA damage repair and reactive oxygen species (ROS)-mediated redox homeostasis after irradiation in CRC cells. Mechanistically, HMGB1 interacts with KU70 via its region spanning residues 95–163. This interaction subsequently activates the non-homologous end joining (NHEJ) pathway to facilitate DNA damage repair, ultimately leading to reduced radiation-induced cell apoptosis. KU70 silencing showed the same effect as HMGB1 depletion mediated cell apoptosis and DNA damage response both in vitro and in vivo. Additionally, HMGB1 and KU70 were overexpressed in CRC tissues. Analysis of the GEPIA database indicated that elevated levels of both genes showed a trend toward association with poor patient prognosis, although this did not reach statistical significance. The current study revealed that HMGB1 may promote DNA damage repair through KU70 and its mediated NHEJ pathway to affect apoptosis in CRC cells after irradiation. Thus, targeting the HMGB1/KU70/NHEJ axis may be a potential therapeutic target to promote the response of CRC to radiotherapy and in-depth study of the specific mechanism of this axis in CRC radioresistance will help to the develop more effective treatment strategies.by Yu Chen, Xinjie Zhao, Ying Yue, Zhenyi Li, Si Chen
ObjectivesTo investigate factors associated with susceptibility to wild mushroom consumption using machine learning approaches and identify key predictors for targeted intervention development.
MethodsA cross-sectional survey of 216 Chinese university students employed three machine learning algorithms (Logistic Regression, Random Forest, Extremely Randomized Trees [ExtraTrees]) to predict consumption susceptibility based on demographics, media usage, and cognitive factors. Susceptibility was assessed through scenario-based questions following established frameworks from tobacco research. Model performance was evaluated using AUC with 95% confidence intervals calculated via bootstrap resampling (1,000 iterations). Sensitivity analyses were conducted using alternative susceptibility thresholds.
Results65.3% were classified as susceptible to consumption. Logistic Regression achieved highest performance (AUC = 0.776, 95% CI: 0.679–0.862). Risk perception emerged as the strongest predictor (importance = 0.133 ± 0.044), followed by mushroom picking experience (0.101 ± 0.017) and content impression (0.089 ± 0.018). Among the 63 participants (29.2%) who reported using AI models, 75.93% indicated trust levels of ‘fairly trust’ or above.
ConclusionsIn this exploratory study of Chinese university students from a single institution, cognitive factors, particularly risk perception and identification ability, showed the strongest associations with consumption susceptibility. These preliminary findings suggest that targeted interventions enhancing risk awareness may be relevant for this population, though replication across diverse samples is needed before broader conclusions can be drawn.
by Hang Sun, Haozhi Xu, Junying Li, Xiaoman Xie, Junmei Zhang, Hongjie Dong, Huanhuan Xie, Qi Wang, Guihua Zhao, Kun Yin, Jingyu Yang, Jianwei Zhou, Ruili Wu, Chao Xu
Gastric cancer (GC) is one of the most common and lethal cancers globally. methyltransferase-like 3 (METTL3)-mediated N6-methyladenosine (m6A) RNA methylation plays a crucial role in tumor initiation and progression by regulating RNA function. STM2457, a highly efficient METTL3 inhibitor, can inhibit METTL3 activity and may serve as a potential therapeutic strategy in cancers. However, the role of STM2457 for GC cells is still unknown. In this study, we analyzed the expression profile data of GC in TCGA and GEO databases, and further explored the expression involvement of METTL3 in GC cell line, investigated the therapeutic effect of STM2457 targeted inhibition of METTL3 in GC both in vitro and in vivo experiments. The results indicated that STM2457 could suppress GC cell proliferation and migration by inhibiting METTL3, and also promoted cell apoptosis and arrest the cell cycle in S phase. In addition, STM2457 could inhibit tumor growth in subcutaneous xenotransplantation mouse model. Our findings suggested that STM2457 had great potential for the treatment of GC and could serve as a foundation for future clinical applications.Doctoral research in nursing is central to advancing scientific knowledge, strengthening professional identity, and informing evidence-based practice, education, and health policy. Analyzing the thematic content of doctoral theses offers insight into research priorities and national variations in nursing scholarship. Yet, no systematic cross-country analysis has examined the thematic focus of such work.
To explore and describe the diversity and scope of doctoral nursing research themes across eight countries in the Sigma Europe Region, identifying key areas of scholarly focus and shared priorities.
A document-based qualitative study using reflexive thematic analysis, as outlined by Braun and Clarke, to examine patterns of meaning within thesis summaries.
The study included doctoral nursing thesis summaries defended between January 2020 and December 2023, sourced from national and institutional repositories in eight countries of the Sigma Europe Region. A total of 15 repositories (4 national, 11 institutional) were systematically searched, and additional summaries were obtained via direct contact with universities offering doctoral nursing programmes.
Data were collected between September 2024 and February 2025 using predefined inclusion and exclusion criteria. In total, 431 eligible thesis summaries were analyzed following Braun and Clarke's six-phase framework, supported by MAXQDA software for data management and coding.
Thematic analysis identified three overarching domains: (1) foundations of nursing practice and care philosophy, (2) systemic and organizational dimensions of nursing, and (3) clinical innovation and public health impact. Ten interrelated themes emerged, including holistic and patient-centred care; emotional, psychological, and quality-of-life dimensions; communication in healthcare; workforce challenges; transforming nursing practice; maternal, neonatal and pediatric health; digital and virtual health innovations; public health and chronic disease management; and disease management, caregiving, and outcomes. Cross-cutting elements such as cultural sensitivity and resilience spanned multiple themes.
This cross-national synthesis demonstrates the breadth and depth of doctoral nursing research in the Sigma Europe Region. Findings highlight nursing's pivotal role in addressing healthcare needs through innovative, person-centred, and evidence-informed solutions, and underscore the value of international collaboration in shaping resilient, equitable, and future-ready healthcare systems.
Open elbow arthrolysis effectively treats post-traumatic elbow stiffness, but severe postoperative pain during early rehabilitation impedes recovery. Continuous brachial plexus blocks, though effective, face limitations such as catheter displacement and infection risks. Liposomal bupivacaine, an ultra-long-acting local anaesthetic, offers prolonged analgesia and may circumvent these challenges. This study aims to compare the analgesic efficacy of a single-dose liposomal bupivacaine supraclavicular block versus continuous ropivacaine infusion in patients undergoing open elbow arthrolysis.
This single-centre, randomised, double-blind, non-inferiority trial will enrol 72 adults (ASA I–III，the American Society of Anesthesiologists physical status classification for preoperative risk) scheduled for open elbow release surgery. Participants will be randomised (1:1) to receive either a single supraclavicular block with 10 mL liposomal bupivacaine plus 10 mL 0.5% ropivacaine followed by saline infusion (liposomal bupivacaine group) or continuous catheter infusion with 20 mL 0.5% ropivacaine followed by 0.2% ropivacaine infusion (control group). The primary outcome is the weighted area under the curve (AUC) of Numerical Rating Scale (NRS) pain scores during functional exercises within 72 hours postoperatively. Secondary outcomes include resting NRS scores, sleep quality (Pittsburgh Sleep Quality Index), rehabilitation metrics (range of motion, grip strength), recovery quality (Quality of Recovery -15) and long-term functional outcomes (Quick Disabilities of the Arm, Shoulder and Hand scores, Quick-DASH scores) at 2 weeks, 6 weeks and 12 weeks. Non-inferiority will be established if the upper 95% confidence limit of the AUC difference is ≤1.3. Statistical analyses will employ intention-to-treat principles with SPSS V.24.0.
Ethical approval was granted by Beijing Jishuitan Hospital Ethics Committee (K2025-213-00). The trial is registered with the Chinese Clinical Trial Registry (ChiCTR2500103911). Results will be disseminated via peer-reviewed journals, contributing evidence on liposomal bupivacaine’s role in perioperative analgesia and rehabilitation for elbow surgery.
Chinese Clinical Trial Registry (ChiCTR ID provided on acceptance).
To evaluate the relationship between preoperative COVID-19 infection and major postoperative pulmonary complications (PPC) risk after major elective surgeries during the Omicron wave.
A multicentre, prospective, observational cohort study.
Four tertiary medical centres in Beijing, China.
All adult patients who underwent major elective surgeries under general anaesthesia from 30 December 2022 to 18 May 2023 were screened for eligibility. A total of 3211 patients were included.
The primary outcome was 30-day major PPC, defined as pneumonia, acute respiratory distress syndrome or unexpected postoperative ventilation. The secondary outcomes included length of hospital stay (LOS), reoperation and mortality.
Major PPC occurred in 3.5% of patients with preoperative COVID-19 and 3.3% of those without. Inverse probability of treatment weighting-adjusted analysis showed no significant association between preoperative COVID-19 within 12 weeks and PPC risk (adjusted OR, 0.89; 95% CI 0.69 to 1.13). However, multivariable analysis revealed that COVID-19 infection within 3 weeks was independently associated with an increased PPC risk (OR, 3.44; 95% CI 1.37 to 8.68). Cardiothoracic surgery (OR, 12.47; 95% CI 8.11 to 19.17) and longer duration of surgery (OR, 1.24 per hour; 95% CI 1.13 to 1.37) were significant risk factors. In the cardiothoracic subgroup, PPC risk was significantly elevated within 7 weeks of infection. No significant differences were observed in LOS, reoperation rates or mortality between patients with and without preoperative COVID-19 infection.
Preoperative COVID-19 infection within 12 weeks was not associated with an increased overall risk of major PPC during the Omicron wave. Although very short infection-to-surgery intervals and cardiothoracic surgery showed exploratory signals of higher risk, these findings should be interpreted cautiously and support an individualised approach to perioperative risk assessment.
ChiCTR2200067250.
To compare the distribution, aetiology, treatment patterns and 2-year outcomes of moderate to severe valvular heart disease (VHD) between men and women in China.
Nationwide, prospective, multicentre cohort study.
46 tertiary hospitals across China, representing a mix of primary and secondary care settings.
A total of 13 917 adult patients with moderate-to-severe VHD were enrolled between April and June 2018. Of these, 6296 (45.24%) were women. Inclusion criteria included moderate or severe native valve disease, infective endocarditis or prior valve intervention.
Patients received either conservative therapy or valve interventions, including surgical repair/replacement or transcatheter procedures. Intervention decisions were based on clinical assessment.
2-year all-cause mortality, cardiovascular mortality, heart failure hospitalisation and major adverse cardiovascular events. Multivariable Cox and logistic regression analyses were conducted to identify outcome predictors.
The overall intervention rate was 31.72%, with no gender difference (men: 31.26% vs women: 32.27%). Among the 5427 patients with severe symptomatic VHD, 49.11% received interventional therapy. The sex-specific pattern was particularly significant in severe symptomatic multiple valvular heart disease, where women had a higher propensity for intervention (p
The 2-year survival rate was 90.85% with no gender difference (men: 90.41% vs women: 91.38%, p=0.086). Valve intervention improved survival to 97.0%, with no gender disparity (men: 96.92% vs women: 97.01%, p=0.87). Multivariate Cox regression confirmed no significant gender effect (p>0.05).
Significant gender differences exist in VHD aetiology and subtypes in China. Women had more rheumatic VHD, while men had more degenerative and functional VHD. Intervention improved survival, with no gender disparity. Age and VHD subtype influenced intervention rates and prognosis, supporting individualised, sex- and age-stratified management strategies.
Preoperative anxiety is prevalent among neurosurgical patients and is associated with adverse clinical outcomes. Virtual reality (VR) technology offers an innovative approach to delivering immersive preoperative education, particularly in familiarising patients with the intensive care unit (ICU) environment. This study aims to evaluate whether a VR-based ICU orientation can reduce perioperative anxiety and improve psychological preparedness in adult neurosurgical patients.
This single-centre randomised controlled trial plans to enrol 108 patients at Xuanwu Hospital. Using a computer-generated random sequence, participants will be randomly assigned in a 1:1 ratio to two groups: a control group receiving standard preoperative guidance, and an experimental group receiving standard guidance plus a VR-based ICU experience tour conducted 1 day before surgery. The primary outcome measure is the incidence of anxiety within 24 hours before discharge from the ICU. Secondary outcome measures include the incidence of depression, cognitive impairment and delirium, duration of delirium, safety events and other clinical outcomes. Data collection points include baseline (T0), 24 hours before surgery (T1), during ICU stay (T2) and 30 days after discharge (T3). All data analyses will be performed using SPSS V.26.0 software and will follow the intention-to-treat principle. This study seeks to determine the effectiveness of a VR-based ICU experience tour in reducing perioperative psychological stress and improving postoperative clinical outcomes.
This study was approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University (Approval ID: (2024) NO.152-002). The initial approval was obtained on 4 July 2024, and remains valid through 4 July 2026. All participants will provide written informed consent before any data collection takes place. The research findings are intended to be disseminated through publication in peer-reviewed scientific journals.
ChiCTR2400093170.
To investigate the association between systolic blood pressure time in target range (SBP-TTR) and the risk of all-cause mortality in patients with atherosclerotic cardiovascular disease (ASCVD).
Analysis of data from a prospective cohort.
This study used data from the Kailuan Study. Participants diagnosed with ASCVD from 11 hospitals affiliated with the Kailuan Group in Tangshan, China were included in the analysis.
We included 6732 participants who developed ASCVD between 1 July 2006 and 31 December 2013, and who had two or more blood pressure measurements recorded between the ASCVD diagnosis date and 31 December 2017. All participants were followed up until 31 December 2022.
SBP-TTR was defined as the proportion of time during which SBP remained within the target range, calculated using the linear interpolation method. Participants were stratified into five SBP-TTR categories: 0%, >0% to
When the target SBP range was defined as 120–140 mm Hg, compared with the SBP-TTR=0% group, the multivariable-adjusted HRs (95% CIs) for all-cause mortality were 0.92 (0.78 to 1.07), 0.82 (0.72 to 0.94), 0.79 (0.68 to 0.92) and 0.76 (0.65 to 0.89) for the SBP-TTR groups of
This study demonstrated a significant inverse association between SBP-TTR and all-cause mortality among patients with ASCVD. The association between maintaining SBP within the 120–140 mm Hg target range and reduced mortality was more evident in younger individuals. These findings suggest that sustained and stable blood pressure control may improve long-term survival in patients with ASCVD.
ChiCTR-TNC-11001489.
Hypertension remains a major public health challenge in rural China, where blood pressure control rates remain low, primarily due to inadequate self-management behaviours among patients. While physician-patient interaction plays a critical role in shaping self-management behaviours, few interventions leveraging this mechanism—particularly those tailored to individual behavioural trajectories—have been implemented in rural primary care. This study aims to design and evaluate the effectiveness of an adaptive, interaction intervention to improve self-management behaviours among patients with hypertension in rural China.
A Sequential Multiple Assignment Randomised Trial (SMART) will be used to develop and evaluate an adaptive intervention based on physician-patient interaction. Two initial strategies will be tested: (1) a standard strategy involving monthly interactive follow-ups and (2) an enhanced strategy incorporating behavioural incentives into the standard protocol. In the first stage, 320 patients were recruited from 16 villages and were randomised to either strategy. After 6 months, patients with adequate improvement will continue their original strategy, while those with suboptimal progress will be re-randomised to either an enhanced intervention with a reminder or a further version with both the reminder and physician feedback. All interventions will be delivered via a Smart Medical Assistant Telephone Robot (SMAT-R) integrated within routine primary care services. The primary outcome is patient self-management behaviour, assessed using the Hypertension Patient’s Self-Management Behaviour Rating Scale; secondary outcomes—including blood pressure, quality of life and acceptability of the intervention—will be collected by trained personnel using standardised procedures and the SMAT-R digital system. Data will be collected at baseline, 6 months and 12 months post-implementation. Marginal structural models will be used to assess the dynamic effects of intervention.
This study aims to inform the development and evaluation of an adaptive, scalable and technology-assisted intervention to improve self-management behaviours among patients with hypertension in rural primary care settings. Using a SMART design, the trial will generate evidence on optimal sequencing and tailoring of strategies based on behavioural responses. The findings are expected to guide sustainable improvements in chronic disease management within primary care systems in low-resource contexts.
This trial has been approved by the Ethics Committee of West China Forth Hospital and West China School of Public Health, Sichuan University (Gwll2024130). The study was conducted in accordance with the Declaration of Helsinki. All the participants provided written consent before participation. Trial results will be shared through peer-reviewed publications, ClinicalTrials.gov, and with healthcare providers and local health authorities, without publication restrictions.
Hypoxic-ischaemic encephalopathy (HIE), a leading cause of neurological disability in neonates, is managed with therapeutic hypothermia, yet systematic data on its aetiology and prognosis are lacking, particularly in China. Herein, our study addresses this gap by establishing a prospective registry in Shenzhen and aims to clinically characterise HIE, identify its risk factors and document its long-term outcomes.
We will recruit 200 neonates with HIE from 10 hospitals in Shenzhen, China, between January 2025 and December 2028. In parallel, clinical data will be collected during hospitalisation, with supplemental referral information obtained from birth hospitals via an online, specialised HIE database. We will include HIE severity, survival status and the incidence of serious complications, such as arrhythmias, pulmonary haemorrhage, neonatal acute respiratory distress syndrome, persistent pulmonary hypertension of the newborn and disseminated intravascular coagulation, to assess key outcomes of HIE in neonates.
Longitudinal follow-up is scheduled for 18, 24 and 36 months, involving assessments using physical developmental scales, video-electroencephalogram (VEEG) recordings, the Chinese version of the Bayley Infant and Toddler Developmental Scale, Fourth Edition and cranial MRI at 18 months. The primary objectives of this study are to determine survival status, track loss-to-follow-up rates and evaluate neurodevelopmental outcomes at 3 years, with the ultimate goal of enhancing our understanding of HIE risk factors, hypothermia therapy and prognosis to reduce HIE-related morbidity and disability.
This study protocol has been approved by the Medical Ethics Committee of Shenzhen Children’s Hospital (Ethics No. 2024096), and the findings will be disseminated through presentations at national academic conferences and publication in peer-reviewed paediatric journals.
ChiCTR2400094994.
To analyse the current status of psychological resilience in Parkinson's disease (PD) patients and its correlation with social support and coping style.
A cross-sectional study.
PD patients hospitalized in a tertiary-level hospital in Shijiazhuang, Hebei Province, from March 2022 to March 2023 were selected for the study using the convenience sampling method. A general information questionnaire, psychological resilience scale, Medical Coping Modes Questionnaire and Perceived Social Support Scale were used to investigate 111 cases of PD. SPSS 25.0 software was used for statistical analysis. The data were analysed using independent samples t-test, one-way ANOVA, multiple linear regression analysis and the Pearson correlation coefficient.
Parkinson's disease patients have a moderate level of psychological resilience. The results of the Pearson correlation analyses showed that the level of psychological resilience was positively correlated with social support and confrontation and was negatively correlated with avoidance and acceptance-resignation. The results of multiple linear regression analysis showed that social support and acceptance-resignation were the influencing factors of psychological resilience in PD patients.
The psychological resilience of PD patients is at a moderate level. Social support and acceptance-resignation are the factors influencing the psychological resilience of PD patients.
This study analysed the level of psychological resilience in PD patients and its correlation with social support and coping style from the perspective of positive psychology to provide some reference for targeted clinical interventions. Our study found that social support and acceptance-resignation are influential factors in psychological resilience in PD patients. Medical staff should encourage patients to face the disease positively and their social support should be increased in order to improve their level of psychological resilience.
No patient or public contribution.
To investigate the experience and perceptions of the effectiveness of retention strategies of nurses and nursing associates in district nursing services.
Mixed methods cross-sectional online survey.
Electronic invitations were circulated via district nursing professional networks to complete an online survey in England. The survey questions were developed from international evidence-based guidance. Quantitative data were analysed descriptively and using multinomial regression analysis, tested the variation in experienced strategies by job and work characteristics. Content analysis informed qualitative data analysis.
Three hundred and forty-five completed surveys were received. Over 60% of respondents reported experiencing strategies related to a safe working environment (75%), flexible work schedules (65%), well-being (64%) and professional development opportunities (60%). The least frequently reported strategies experienced were involvement in service policymaking (26%), reducing job demands (31%); and creating cohesive nursing teams (40%). Nurses on lower pay grades were statistically less likely than those on the higher pay bands to experience strategies involving professional growth opportunities and involvement in service decision-making. Nurses working in affluent areas were statistically more likely to report experiencing more types of retention strategies than those working in socio-economically deprived areas. Participants' views on effective strategies were mixed but attention to financial aspects (particularly travel costs), manageable workloads, flexibility in work scheduling plus tailored induction/support for those new to district nursing were given the most testimony as effective.
Retention strategies are created and enacted by those within employing organisations, district nursing services and district nursing teams, but within the context of a wider health care and labour market system. We suggest the findings could be the starting point for review by district nursing services experiencing high vacancy rates. Our findings raise questions for subsequent investigation across health systems.
This paper adhered to the relevant Equator guideline A Consensus-Based Checklist for Reporting of Survey Studies (CROSS), https://doi.org/10.1007/s11606-021-06737-1.
This study did not include patient or public involvement in its design, conduct or reporting.
This study investigates how observed workplace ostracism affects nurses' helping behaviour from a bystander's perspective, examining the mediating roles of moral courage and employee resilience to inform strategies for fostering workplace harmony in nursing settings.
A cross-sectional study design was adopted.
A survey of 346 nurses from two Grade III, Level A hospitals in Henan, China, utilised scales measuring workplace ostracism, moral courage, helping behaviour and employee resilience. SPSS Statistics 26.0, Mplus 8.3 and the SPSS macro program Process 4.1 plugin were used to test the associations among variables.
Observed workplace ostracism positively correlated with nurses' helping behaviour, with moral courage partially mediating this relationship. Employee resilience moderated both the link between observed workplace ostracism and moral courage, and the indirect effect of observed workplace ostracism on helping behaviour through moral courage.
Nurses with high levels of resilience demonstrate moral courage when observing workplace ostracism and engage in helping behaviours towards those ostracised.
This study examines how workplace ostracism undermines nursing team cohesion and individual well-being. It highlights that bolstering nurses' resilience and moral courage can alleviate these adverse effects, thereby improving patient care quality. Nursing managers are advised to adopt targeted strategies, such as resilience training, to mitigate workplace ostracism.
This study employs a questionnaire to explore nurses' views of workplace ostracism and helping behaviours, aiming to inform strategies for fostering nursing team harmony and improving care quality.
This study strictly follows the STROBE reporting guidelines to ensure the clarity and credibility of the research findings.
Data were collected from hospital nurses through electronic questionnaires.
Lower extremity lymphedema (LEL) is a debilitating complication for patients with gynecologic cancer. A series of strategies have been recommended to mitigate the risk of LEL and improve patient outcomes; however, investigation into LEL risk management behaviours in this population is limited, and the absence of reliable and valid tools is an important reason.
To develop and evaluate the psychometric properties of the lower extremity lymphedema risk management behaviours questionnaire (LELRMBQ) for Chinese patients with gynaecologic cancer.
This was a methodological study.
Initial items were generated using a literature review. The initial LELRMBQ was refined, and its content validity was evaluated by conducting two rounds of expert consultation and a pilot study. Psychometric testing of 389 participants recruited by convenience sampling was conducted from December 2022 to June 2023. Exploratory factor analysis (EFA; subsample 1, N = 158) and confirmatory factor analysis (CFA; subsample 2, N = 231) were performed separately to determine the multi-dimensional structure of the questionnaire. Known-group validity, internal consistency reliability, and test–retest reliability were also evaluated.
A total of 25 items with satisfactory content validity were included in psychometric testing. The EFA identified a four-factor structure, comprising 18 items, which explained 74.49% of the total variance. The CFA supported this structure with acceptable fit indices. Known-group validity was partially supported by significant differences in total LELRMBQ scores among groups with different education levels, residence, cancer type, and LEL awareness. Internal consistency and temporal stability were acceptable.
The 18-item LELRMBQ demonstrated sufficient reliability and validity as a tool for measuring LEL risk management behaviours in patients with gynaecologic cancer.
The LELRMBQ has potential applicability in assessing LEL risk management behaviours, identifying gaps in educational practices, tailoring effective interventions, and evaluating intervention effectiveness.
This manuscript followed the STROBE guidelines.
Patients with gynecologic cancer participated in this study and provided the data through the survey.
This study aims to explore the mediating role of resilience and perceived social support in the relationship between gratitude and the work reintegration adaptability of cancer patients in China.
A cross-sectional and correlational study.
A total of 402 participants were collected from July to December 2023 from a tertiary hospital in Jiangsu Province, China, using a convenience sampling method. The survey utilised the General Information Questionnaire, the Gratitude Questionnaire-6 (C-GQ-6), the Cancer Patient Return-to-Work Adaptation Scale, the resilience Scale (CD-RISD), and the Perceived Social Support Scale (PSSS) to collect data. The theoretical hypothesis was tested using structural equation modelling (SEM) analysis, with model fit corrections performed to examine the internal relationships and pathways among gratitude, resilience, perceived social support and return-to-work adaptability.
Gratitude, resilience, and perceived social support were significantly correlated with work reintegration adaptability. Resilience and perceived social support independently mediate the relationship between gratitude and work reintegration adaptability, with mediation effects of 56.63% and 7.77%, respectively. Additionally, resilience and perceived social support fully mediate the relationship between gratitude and work reintegration adaptability, with a chain mediation effect of 35.60%.
Gratitude can affect cancer patients' return to work adaptation through resilience and perceived social support.
Healthcare professionals should focus on the impact of gratitude on cancer patients' adaptability to work reintegration. Interventions targeting resilience and perceived social support should be developed to enhance patients' work reintegration and promote their overall recovery and social reintegration.
STROBE checklist.
No patient or public contribution.
FreshRSS 