To explore the competency of nursing graduates from the four dimensions of clinical practice, research ability, teaching ability and management ability, analyse its influencing factors and provide data support for improving the post ability of nurses with a master's degree.
In September 2024, a convenience sampling method was used to administer a self-designed questionnaire regarding post-graduation post-competency to 330 nursing master's degree graduates from 68 tertiary hospitals and five medical universities across China.
The average scores of clinical competence, research competence, teaching competence and management competence of nursing graduates were more than 7 (out of 10 points). Based on the Benner model, all the abilities of the participants were at the level of competent. Multivariate linear regression analysis indicated that marital status (p < 0.001), years since graduation (p < 0.001), major (p < 0.001) and et al., significantly influenced clinical competency. Furthermore, marital status, major, hospital rank and graduate type were key research competency factors. For teaching competency, major, training nature and professional title played a crucial role, whereas major, professional title, marital status and hospital rank were essential for management competency. Multivariate logistic regression analysis indicated that job position (χ 2 = 11.375, p = 0.01) significantly influenced SCI publication, whereas the training nature and type of graduate school were independent factors affecting publication in Chinese core journals. Moreover, years since graduation and professional title were independent factors that influenced the publication of scientific core journals.
The post-competency scores of nursing master's degree graduates in the four dimensions of clinical, research, teaching and management were moderate, indicating substantial potential for enhancement. Managers should develop personalised training programs based on different factors that influence the overall competency of nursing master's degree graduates, thereby improving nursing quality and ensuring patient safety.
With an aging population worldwide, pressure injury (PI) is becoming a critical challenge for healthcare professionals. We aimed to investigate the difference in PI trend globally across age groups from 1990 to 2021.
This study utilized data from the Global Burden of Diseases (GBD) 2021 to determine the age-standardized incidence rate (ASR) of PI stratified by age groups from 1990 to 2021. Estimated annual percentage changes (EAPCs) were calculated to measure corresponding temporal trends.
Over three decades, the incident cases of PI have doubled from 1.1 million to 2.5 million worldwide. The incidence of PI showed an exponential rise with increasing age groups in 2021. The significant increasing trends were observed in the population aged 20–54 years (EAPC = 0.11) and 55+ years (EAPC = 0.55) from 1990 to 2021. The ASR among males has increased from 32.53 to 33.34 per 100,000 population, with an EAPC of 0.27, while the ASR among females decreased. The ASR was increased with higher income levels and the highest ASR was observed in the high-income region (49.95 per 100,000 population). Among six regions, the Americas had the highest ASR in 2021 (90.20 per 100,000 population), while South-East Asia showed the fastest increase (EAPC = 1.22).
The global burden of PI is a growing global health problem among the elderly population, particularly in the Americas. A greater incidence burden in males and high-income level regions was found. This study advocates for urgent attention to coping strategies for aging populations and older people with PI.
This study advocates for urgent attention to coping strategies for aging populations.
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.
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 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.