Hospitals In Shandong Province Research Articles

Workplace violence and depressive symptoms: the mediating role of fear of future workplace violence and burnout among Chinese nurses

BackgroundThe mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms.MethodsWe conducted a cross-sectional web survey at 12 tertiary hospitals in Shandong province, China, in 2020. The Center for Epidemiologic Studies Depression Scale (CESD-10), the Chinese version of the Maslach Burnout Inventory-General Survey and the Fear of Future Violence at Work Scale were used to collect data. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson’s correlation coefficient, and ordinary least squares regression with bootstrap resampling were used to analyze the data.ResultsThe prevalence of depressive symptoms was 45.9% among nurses. The regression model showed that FFWV and burnout mediated the relationship between WPV and depressive symptoms. The total effects of WPV on depressive symptoms (3.109, 95% bootstrap CI:2.324 − 3.713) could be decomposed into direct (2.250, 95% bootstrap CI:1.583 − 2.917) and indirect effects (0.769, 95% bootstrap CI:0.543 − 1.012). Indirect effects mediated by FFWV and burnout were 0.203 (95% bootstrap CI:0.090 − 0.348) and 0.443 (95% bootstrap CI:0.262 − 0.642), respectively. Furthermore, serial multiple mediation analyses indicated that the indirect effect mediated by FFWV and burnout in a sequential manner was 0.123 (95% bootstrap CI:0.070 − 0.189).ConclusionThe prevalence of depressive symptoms among Chinese nurses was high. The WPV was an important risk factor for depressive symptoms and its negative effect was mediated by FFWV and burnout. The importance of decreasing WPV exposure and level of FFWV and burnout was emphasized to prevent depressive symptoms among nurses. The findings implied that hospital managers and health policy makers should not only develop targeted interventions to reduce exposure to WPV in daily work among all nurses, but also provide psychological support to nurses with WPV experience to reduce FFWV and burnout.

The relationship between family resilience, post-traumatic growth, and caregiver burden among family caregivers of stroke survivors: a cross-sectional study

ABSTRACT The study aimed to explore the relationship between family resilience, post-traumatic growth(PTG), and caregiver burden among family caregivers of stroke survivors. Researchers conducted a cross-sectional study to recruit 253 family caregivers of stroke survivors from a public hospital in Shandong Province, China. Caregivers completed sociodemographic information, the Shortened Chinese Version of the Family Resilience Assessment Scale, the Post-traumatic Growth Inventory, and the Zarit Caregiver Burden Interview. We used Amos 24.0 to construct structural equation models and examine the mediating effects of stroke survivors’ post-traumatic growth. Family resilience was positively associated with post-traumatic growth, and both family resilience and post-traumatic growth were negatively associated with caregiver burden. Post-traumatic growth partially mediated the relationship between family resilience and caregiver burden, and the mediating effect accounted for 21.27% of the total effect. Targeted interventions should address family resilience and post-traumatic growth as protective factors of caregiver burden.

Factors Associated With Pain Catastrophizing in Patients With Chronic Neuropathic Pain: A Cross-Sectional Study

BackgroundPain catastrophizing is a significant factor in the recovery of patients with chronic pain. This topic has not received the warranted attention in clinical practice, while the outcomes of pain interventions have been suboptimal. This study explores the current situation of pain catastrophizing in patients with chronic neuropathic pain, its influencing factors, and further analyzes the complex relationship between these factors. MethodsA cross-sectional study design was used to select preoperative patients hospitalized in the pain and spine surgery departments of two tertiary hospitals in Shandong Province, China, between February and August 2022. The Pain Catastrophizing Scale, Toronto Alexithymia Scale, Connor-Davidson Resilience Scale-Short, Somatization Sub-Scale of Symptom Checklist 90, and a sociodemographic questionnaire were used to evaluate participants’ pain catastrophizing, alexithymia, psychological resilience, somatization, and relevant sociodemographic variables, respectively. Descriptive statistics, correlation, univariate, and multivariate analyses were employed throughout this process. ResultsPain catastrophizing in patients with chronic neuropathic pain was affected by pain severity, disease type, alexithymia, psychological resilience, and somatization (p < .05). The mediating effect values of psychological resilience and somatization between alexithymia and pain catastrophizing were both 0.05, with 95% confidence intervals of (0.02, 0.09) and (0.02, 0.07), respectively. ConclusionsPain severity, disease type, alexithymia, psychological resilience, and somatization all had a significant effect on pain catastrophizing. Healthcare workers must provide timely and accurate assessments of patients’ pain levels to help prevent the onset of pain catastrophizing. Adopting measures to improve alexithymia and somatization symptoms, and focusing on enhancing patients’ psychological resilience can also help reduce the level of pain catastrophizing. Cognitive behavioral therapy may be an effective treatment method for pain catastrophizing.

Determinants of Knowledge, Attitudes, and Practices among Young Adults Type 2 Diabetes Patients in Selected Tertiary Hospitals in Shandong Province, China

Objective: The purpose of this study is to understand the current situation of knowledge, attitude, and practice of self-management in young patients with type 2 diabetes mellitus (T2DM) and to explore the relationship between general conditions (personal, social, and environment, clinical factors) and their knowledge, attitude, and practices (KAP) of diabetes self-management, This aims to provide patients with high-quality nursing care management and services, as well as to provide relevant recommendations for effective self-management. Methods: This study is a descriptive correlational study that used the purposive sampling method to investigate 359 patients with T2DM aged 18–25 years in four designated tertiary hospitals in Shandong Province. Results: Knowledge of self-management was correlated with sex, age, education level, occupation and work situation, monthly household income, medical payment method, family and friend support, frequency of diabetes health education, and diabetes complications. The attitude subscale was correlated with sex, age, education level, work situation, and family and friend support. The practice subscale was associated with age, education level, work situation, family and friend support, frequency of diabetes health education, and HbA1c values. Conclusion: Young adults aged 18–25 with T2DM have positive attitudes towards diabetes self-management, but there are still deficiencies in knowledge acquisition and behavioral practice. The KAP of self-management of diabetes is influenced by personal factors such as sex, age, and education level, and socio-environmental factors such as family income and family or friends’ social support. Additionally, clinical factors such as complications and HbA1c values significantly impacted the patient’s disease self-management ability.

Hepatic artery infusion chemotherapy with systemic capecitabine and camrelizumab for treating unresectable hilar cholangiocarcinoma: An initial investigation of efficacy and safety.

This study aimed to evaluate the efficacy and safety of sequential treatment of continuous transcatheter hepatic artery infusion chemotherapy (HAIC) with systemic capecitabine monotherapy and camrelizumab for treating unresectable hilar cholangiocarcinoma (HCCA). This study retrospectively analyzed patients with unresectable HCCA admitted to Linyi Cancer Hospital in Shandong Province from October 2019 to December 2021. All enrolled patients were treated with HAIC (mFOLFOX7) + camrelizumab for 2-6 cycles and administered systemic therapy with capecitabine and camrelizumab. The objective response rate (ORR), disease control rate (DCR), and adverse reactions of patients were assessed. The Kaplan-Meier method was used to describe overall survival (OS), and univariate and multivariate Cox regression models were utilized to analyze the influencing factors of OS. This study included 34 patients, ORR was 61.76% (21/34), and DCR was 97.06% (33/34) after two HAIC cycles. The median follow-up time was 17.5 months, with an average of 18.32 ± 8.06 months, and the median OS was 20.0 months. HAIC-related adverse reactions included mainly gastrointestinal symptoms and hematological toxicity caused by chemotherapy drugs, all of which were grades 1-2. Further, adverse events for camrelizumab treatment included fatigue, skin rash, and hypothyroidism, all of which were grade <3. Cox regression analysis revealed that the periductal infiltrating type of growth pattern indicated a worse OS, whereas more HAIC cycles (5 ~ 6) were a protective factor for OS. HAIC sequentially combined with systemic capecitabine chemotherapy and a programmed death-1 inhibitor displayed favorable effects for unresectable HCCA, with controllable adverse reactions.

Factors influencing the thriving of emergency department nurses in China

IntroductionThriving is a positive feeling arising from nurses' work and is increasingly valued by managers. Given their demanding workloads and various duties, it is necessary to research the determinants of ED nurses' thriving. This study aimed to investigate the factors influencing thriving and the mechanisms of interaction between the factors among ED nurses. Methods380 ED nurses from six tertiary hospitals in Shandong Province, China, participated in this cross-sectional study. The instruments used were the General Information Questionnaire, Challenge-Hindrance Stressors Scale, Psychological Detachment Scale, and Thriving at Work Scale. Data analysis methods included univariate analysis, Pearson correlation, PROCESS 4.0, and hierarchical multiple regression. ResultsWeekly working hours affected nurses' thriving. Challenge stressors and psychological detachment were positively related to thriving. Hindrance stressors had a negative link with thriving. Psychological detachment suppressed the relationship between challenge stressors and thriving; however, it mediated the relationship between hindrance stressors and thriving. ConclusionChallenge-hindrance stressors and psychological detachment are significant elements influencing ED nurses' thriving. Nursing administrators should help ED nurses properly address stressors with different attributes and adopt appropriate strategies to improve nurses' thriving by enhancing psychological detachment.

Latent Classes of Personality Traits and Their Relationship with Workplace Bullying among Acute and Critical Care Nurses

Objective. To identify the latent classes of personality traits among nurses in acute and critical care departments, as well as the relationship between latent classes of different personality traits and workplace bullying. Methods. A total of 245 nurses working in the acute and critical care department at a 3 A-grade hospital in Shandong Province, China, were recruited by convenient sampling. The Chinese Big Five Personality Inventory brief version was used to assess personality traits, and the Negative Acts Questionnaire was used to measure workplace bullying. Latent profile analysis was used to identify the latent classes of personality traits. Multiple linear regression analysis was used to examine the relationship between latent classes of personality traits and workplace bullying. Results. Four latent classes of personality traits among acute and critical care nurses were identified, namely, the negative group (49.0%), flexible group (16.0%), neurotic group (18.1%), and stable group (16.9%), respectively. Compared with the neurotic group, the negative group (B = −6.227, P&lt;0.05), stable group (B = −16.562, P&lt;0.001), and flexible group (B = −19.208, P&lt;0.001) experienced less workplace bullying. Conclusion. Our findings explore latent classes of personality traits among acute and critical care nurses, identify subgroups susceptible to workplace bullying, and suggest the development of appropriate interventions to reduce workplace bullying. Implications for Nursing Management. Hospital managers can identify nurses who are prone to workplace bullying based on their personality traits and provide them with psychological counseling services and psychological healing groups to help them establish good interpersonal relationships and maintain their mental and physical health.

Association between body mass index and burnout among nurses in China: a cross-sectional study

ObjectivesBody mass index (BMI) can affect an individual’s health. The night shift is a characteristic of the nursing profession, which is associated with an abnormal BMI. However, few studies have...

CNP model intervention effect on acute urticaria patients' psychological status, compliance, and life quality.

This study aimed to evaluate the impact of the clinical nursing pathway (CNP) on the psychological state, treatment adherence, and quality of life in patients with acute urticaria. A total of 240 patients diagnosed with acute urticaria at a tertiary hospital in Shandong Province were retrospectively assigned to either a control group, receiving standard care, or an intervention group, receiving care according to the CNP model. The primary outcomes assessed were levels of anxiety, depression, quality of life, and patient compliance. Statistical analyses were employed to evaluate the outcomes. Following the intervention, significant differences were observed in the anxiety and depression scores (P < .001), with the intervention group demonstrating lower levels of both. The control group's psychological state exhibited significant variance pre- and post-intervention (P < .001), alongside notably reduced overall compliance (P < .01). Post-intervention, patients in the intervention group showed enhanced treatment compliance, with a rapid increase within the first hour and a stable ascent over the following 10 hours, albeit with a marginally greater increase in the CNP group. Beyond 10 hours, the CNP group's compliance gradually declined, with a slight uptick in noncompliance rates. By 14 hours, the control group's overall compliance began to wane, with a sharp decline in full compliance and a rapid rise in noncompliance rates observed after 19 hours. At the 20-hour mark, the control group's noncompliance rate surpassed both the partial and full compliance rates. Conversely, post-20 hours, the CNP group maintained higher rates of full and partial compliance, with a lower noncompliance rate. No significant changes were noted in the control group's physiological or mental state, except in the domains of self-care and social ability, where notable differences were absent pre- and post-intervention. In contrast, the CNP group showed significant improvements in physiological and mental states, self-care, and social abilities post-intervention (P < .001), with noticeable differences in these domains evident 6 hours into the treatment (P < .01), leading to an enhanced quality of life. The CNP-based clinical nursing model intervention significantly benefits patients with acute urticaria by alleviating anxiety and depression, enhancing treatment adherence, and improving overall quality of life.

Epidemiological characteristics of Epstein-Barr virus infection in children and distribution of disease spectrum in hospitalized patients in shandong province.

This study aims to investigate the epidemiological characteristics of Epstein-Barr virus (EBV) infection in children and the distribution of disease spectrum in hospitalized patients in Shandong Province. A retrospective analysis was conducted on the clinical data of children with EBV infection admitted to hospitals in Shandong Province from January 2022 to December 2022. The epidemiological characteristics, including age, gender, and clinical manifestations, were analyzed. The detection rate of EBV antibodies and the seropositivity rates of different antibodies were also examined. A total of 7124 children with EBV infection were included in this study, with an average age of 7.5 years. The male-to-female ratio was 1.43:1. Among the patients, the positive detection rate of EBV antibodies was 78.40%. The seropositivity rate of Epstein-Barr viral capsid antigen-Immunoglobin G antibodies was 57.09%. The highest incidence of EBV infection was observed in the age group 36-72 months. The urban positive rate was higher than that in rural areas. EBV infection in children in Shandong Province exhibits specific epidemiological characteristics, with a higher incidence in the age group of 36-72 months. Fever, sore throat, and fatigue are the main clinical manifestations. The detection rate of EBV antibodies is relatively high among hospitalized patients. These findings provide valuable information for controlling the transmission of children with suspected Epstein-Barr virus infection.

The Moderating Effect of Organizational Identification on Occupational Stress and Insomnia Among Nurses

Objective: To explore the relationship between organizational identification, occupational stress, and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress and insomnia. Methods: Through stratified sampling, 720 nurses working in a tertiary A-level hospital in Shandong Province from March to May 2021 were surveyed using an effort-reward imbalance questionnaire, an organizational identification questionnaire, and the Athens Insomnia scale. Results: Organizational identification was negatively correlated with occupational stress and insomnia (r1 = -0.121, P1 &lt; 0.01; r2 = -0.144, P2 &lt; 0.01). Occupational stress was positively correlated with insomnia (r = 0.379, P &lt; 0.01). Organizational identity significantly moderated nurses’ occupational stress and insomnia (β = -0.192, t = -2.558, P &lt; 0.05). Conclusion: Occupational stress and organizational identification can predict insomnia. Organizational identification could negatively mediate the relationship between occupational stress and insomnia. Improving organizational identification may help alleviate insomnia symptoms by relieving occupational stress.

What affects how Chinese patients wish to be involved in health care delivery? Perspectives of the Chinese policy and institutional contexts.

The benefits of involving patients and carers include improving health outcomes and safety, reducing costs and enhancing an open, accountable and equitable relationship between service providers and users. However, the willingness for involvement and participation is largely affected by a range of factors, including those at the micro, meso and macro levels. As the previous studies have given much attention to the factors at the individual level, it is worthwhile to explore the factors at the broader levels of the policy and institutional contexts. The objective of the research is to understand how the policy and institutional contexts in China affect how patients wish to be involved in their health care delivery. An abductive research strategy was used to generate emergent hypotheses in the first stage of data construction. In the second stage of fieldwork, hypotheses were tested using the deductive approach. Three local hospitals in Shandong Province, China, were selected. The case study method was designed with qualitative methods of policy documents and interviews. Interviews included health professionals, health board managers, local administrators and service users. Thematic analysis and framework analysis were conducted. Four policy and institutional contexts were identified: insufficient policy support, the current institutional design of involving users, the heterogeneity of organisational autonomy and resources, as well as the demography of the population of service users. As a policy strategy at the state level, there is a lack of policy support for patient involvement and participation in the Chinese health system. The heterogeneity of the institutional context of health facilities plays a key role in affecting how patients wish to be involved in health care delivery.

Heterogeneity in Psychological Adaptation Patterns and Its Predictive Factors Among Patients with Inflammatory Bowel Disease: A Latent Profile Analysis.

To identify the distinct profiles of psychosocial adaptation of Chinese inflammatory bowel disease (IBD) patients and the predictive factors. A cross-sectional survey method was used to recruit 263 IBD patients who were treated in a tertiary hospital in Shandong Province from July 2022 to April 2023. The general information questionnaire, Inflammatory Bowel Disease Psychosocial Adaptation Questionnaire, Resilience Scale for Inflammatory Bowel Disease, Chinese Benefit Finding Scale, and Stigma Scale for Chronic Illnesses, Medical Coping Modes Questionnaire and Inflammatory Bowel Disease-Disk were used as the instruments for investigation. Latent profile analysis was conducted with the six dimensions of the IBD Psychosocial Adaptation Questionnaire as the explicit indicators. The predictors of profile membership were analyzed by multinomial logistic regressions. Four profiles of psychosocial adaptation in IBD patients were identified: Low level psychosocial adaptation (14.1%), Medium level psychosocial adaptation - High body image distress (25.5%), Medium level psychosocial adaptation - Low body image distress (30.0%) and High level psychosocial adaptation (30.4%). Compared with Low level psychosocial adaptation group, High level psychosocial adaptation group had a higher level of positive cognition (OR=2.930, 95%IC 0.017-0.305, p< 0.001) and overall psychological resilience (OR=1.832, 95%IC 0.000-0.016, p < 0.001), more health behaviors (OR= 2.520, 95%IC 0.191-1.358, p=0.001), a lower level of internal stigma (OR=0.135, 95%IC 0.043-0.420, p < 0.001) and overall stigma (OR=0.010, 95%IC 0.003-0.118, p=0.001), less acceptance-resignation coping style (OR=0.055, 95%IC 0.209-3.200, p < 0.001) and lower disease burden (OR=0.407, 95%IC 0.298-0.698, p=0.006). About a half of IBD patients had a medium level of psychosocial adaptation. Psychological resilience, benefit finding, stigma, medical coping styles and disease burden predicted psychosocial adaptation profiles. Healthcare providers need to focus on the heterogeneity of psychosocial adaptation of IBD patients and formulate personalized intervention programs for patients with different profiles to improve their psychosocial adaptation.

Physical activity, sleep disorders, and type of work in the prevention of cognitive function decline in patients with hypertension

BackgroundHypertensive patients are likelier to have cognitive function decline (CFD). This study aimed to explore physical activity level, sleep disorders, and type of work that influenced intervention effects on cognitive function decline in hypertensive patients and to establish a decision tree model to analyze their predictive significance on the incidence of CFD in hypertensive patients.MethodsThis cross-sectional study recruited patients with essential hypertension from several hospitals in Shandong Province from May 2022 to December 2022. Subject exclusion criteria included individuals diagnosed with congestive heart failure, valvular heart disease, cardiac surgery, hepatic and renal dysfunction, and malignancy. Recruitment is through multiple channels such as hospital medical and surgical outpatient clinics, wards, and health examination centers. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Moreover, we obtained information on the patients' type of work through a questionnaire and their level of physical activity through the International Physical Activity Questionnaire (IPAQ).ResultsThe logistic regression analysis results indicate that sleep disorder is a significant risk factor for CFD in hypertension patients(OR:1.85, 95%CI:[1.16,2.94]), mental workers(OR:0.12, 95%CI: [0.04,0.37]) and those who perform both manual and mental workers(OR: 0.5, 95%CI: [0.29,0.86]) exhibit protective effects against CFD. Compared to low-intensity, moderate physical activity(OR: 0.53, 95%CI: [0.32,0.87]) and high-intensity physical activity(OR: 0.26, 95%CI: [0.12,0.58]) protects against CFD in hypertension patients. The importance of predictors in the decision tree model was ranked as follows: physical activity level (54%), type of work (27%), and sleep disorders (19%). The area under the ROC curves the decision tree model predicted was 0.72 [95% CI: 0.68 to 0.76].ConclusionModerate and high-intensity physical activity may reduce the risk of developing CFD in hypertensive patients. Sleep disorders is a risk factor for CFD in hypertensive patients. Hypertensive patients who engage in mental work and high-intensity physical activity effectively mitigate the onset of CFD in hypertensive patients.

Epidemiology and antifungal susceptibility of fungal infections from 2018 to 2021 in Shandong, eastern China: A report from the SPARSS program

PurposeWe analyzed the pathogenic fungal epidemiology and antifungal susceptibility from 2018 to 2021 in Shandong Province, China, to provide the basis for empiric antifungal therapy. MethodsFungal isolates were collected from 54 hospitals in Shandong province from 2018 to 2021 through the Shandong Province Pediatric bacterial & fungal Antimicrobial Resistance Surveillance System (SPARSS), WHONET v5.6 and SPSS software v20.0 were used for statistical analysis. ResultsA total of 15,348 strains of fungi were collected, with Candida accounting for 78.25 %, followed by Aspergillus at 15.45 %, and other species at 6.27 %. Candida albicans was the predominant Candida species, but more than half of the Candida isolates were non-albicans species, with C. tropicalis being the most dominant (22.74 %), followed by C. glabrata (17.50 %) and C. parapsilosis (11.02 %). The composition of fungi varied significantly among different age groups. Children had a higher proportion of C. albicans (47.30 %) compared to non-children (32.06 %). The non-wild-type phenotype rate of Candida for Amphotericin B was less than 3 %, while Cryptococcus neoformans was 16.67 %. In addition, less than 6 % of C. albicans and C. parapsilosis were resistant to fluconazole and voriconazole, and 96.30 % of C. glabrata were SDD to fluconazole. We also found that 80.56 % of C. glabrata and 83.70 % of C. krusei were voriconazole WT/susceptibility phenotype. However, the susceptibility rates of C. tropicalis to fluconazole/voriconazole decreased from 70.40 %/46.40 % in 2018 to 62.30 %/35.20 % in 2021. The comprehensive susceptibility rate to fluconazole of C. albicans, C. tropicalis, C. parapsilosis and C. glabrata isolated from the blood has decreased from 69.36 % to 56.62 %. ConclusionsThe study reveals that the composition and antifungal susceptibility of pathogenic fungi in Shandong Province differ from other regions. Moreover, the resistance to azoles is more severe, especially in C. tropicalis. These findings indicate the need for region-specific antifungal treatment strategies to combat fungal infections effectively.

Unveiling the antecedent configurations of cerebral infarction recurrence using qualitative comparative analysis

BackgroundIschemic stroke is characterized by high incidence, high disability rate, and high recurrence rate. Stroke recurrence is a complex pathological phenomenon involving multiple factors. Logistic regression analysis is widely used in traditional medical statistical analysis. However, this method mainly investigates the net effect of single factors using large sample sizes. The fsQCA method is a more suitable means of analyzing the configuration effect of risk factors affecting cerebral infarction recurrence, because it is based on holism and considers interaction effects among the risk factors. ObjectiveThe purpose of this study was to explore the risk factors of cerebral infarction recurrence using fsQCA, to reveal the configurations that resulted in cerebral infarction recurrence, and to provide novel ideas for the prevention of recurrence. MethodsA total of 155 cerebral infarction patients admitted to the Department of Neurology of a tertiary class hospital in Shandong province from June 2020 to June 2021 were selected to participate. The demographic characteristics and risk factors associated with recurrence of cerebral infarction were collected, and participants were followed for one year. ResultsThe comparative analysis was performed by fuzzy-set (fsQCA 3.0) software. We conducted a configuration analysis of the risk factors of cerebral infarction recurrence and generated eight different configurations by analyzing various combinations of eight risk factors. ConclusionThis study presented results different from those reported in studies using linear regression models. It took into consideration the configurational effect of each conditional variable on cerebral infarction recurrence. To prevent such recurrences, medical workers should evaluate the combination of multiple influencing factors, instead of focusing on a single factor.

Pathogenic bacteria and fungi in bioaerosols from specialized hospitals in Shandong province, East China

Bacteria and fungi are abundant and ubiquitous in bioaerosols in hospital environments. Understanding the distribution and diversity of microbial communities within bioaerosols is critical for mitigating their detrimental effects. Our knowledge on the composition of bacteria or fungi in bioaerosols is limited, especially the potential pathogens present in fine particulate matter (PM2.5) from specialized hospitals. Thirty p.m.2.5 filter samples were collected from five hospitals (i.e., oral, dermatology, chest, eye, and general hospitals) in Shandong Province, East China. The diversity of bacteria and fungi was analyzed at the species level using single-molecule real-time sequencing of the 16 S and internal transcribed spacer 1 (ITS) ribosomal genes, respectively. Significant differences were detected across sampling sites in terms of microbial diversity and community composition in PM2.5 as well as pollution concentrations. The range of PM2.5 concentrations observed in hospital halls was higher, ranging from 39.0 to 46.2 μg/m3, compared to the wards where the concentrations ranged from 10.7 to 25.2 μg/m3. Furthermore, microbial variations in PM2.5 bioaerosols were associated with hospital type. The most dominant pathogens identified were Vibrio metschnikovii, Staphylococcus epidermidis, Staphylococcus haemolyticus, Fusarium pseudensiforme, and Aspergillus ruber. Among these, A. ruber was identified as an opportunistic fungus in a hospital setting for the first time. Nine potentially novel strains of F. pseudensiforme, showing 84.5%–92.0% ITS sequence similarity to known Fusarium isolates, were identified in PM2.5 samples from all hospitals (excluding an eye hospital). This study highlights the importance of hospital environments in shaping microbial aerosol communities. To the best of our knowledge, this is the first study to provide insights into the bacterial and fungal biodiversity of PM2.5 in specialized hospitals, enriching research in healthcare environmental microbiology and carrying significant public health implications.

Relationship between transition shock and humanistic practice ability among Chinese newly graduated nurses: Mediating effect of organizational socialization

BackgroundHumanistic practice ability serves as an indispensable skills that newly graduated nurses strive to develop. Yet, there is a dearth of knowledge regarding the role of organizational socialization in mediating the association between transition shock and humanistic practice ability in Chinese newly graduated nurses. AimTo breakdown the association between humanistic practice ability and transition shock among Chinese newly graduated nurses, with a simultaneous concentration on the mediating effect of organizational socialization in the association. DesignUtilizing a descriptive cross-sectional study design, this research aimed to provide a comprehensive overview of the variables being examined. MethodsA web-based survey was completed by 417 newly graduated nurses from three general public hospitals in Shandong Province, eastern China from February to March 2023. Three questionnaires were administered: the Nurse Humanistic Practice Ability Scale (NHPAS), the Organizational Socialization Questionnaire(OSQ) and the Transition shock of Newly Graduated Nurses Scale (TSNGNS). The IBM SPSS 22.0, AMOS 22.0 and GraphPad Prism 9.0.0 was applied for figure preparation and statistical analyses. ResultsFindings indicated a significant statistical association among organizational socialization, transition shock and humanities practicing ability. A significant negative correlation was uncovered between OrS and TrS (r=−0.468, p<0.001), significant and negative correlation (r = −0.412, p < 0.001) was unmasked between the TrS and the HPA,whereas a significant positive correlation was observed between OrS and HPA (r=0.641, p<0.001). Moreover, in the mediation models, organizational socialization was identified as a partial mediating role in the association between transition shock and humanities practicing ability (indirect effect −0.324, p<0.001; direct effect −0.100, p =0.026; total effect −0.424, p =0.001). Conclusion/implications for practiceTrS has a significantly negative influence on HPA among newly graduated nurses, and OrS partially mediating the negative effect of TrS on HPA. Nursing managers and nursing educators can reduce the adverse consequences resulted from TrS through enhancing the benefits of organizational socialization programs and eventually improve the level of HPA of newly graduated nurses.

Molecular epidemiology and antibiotic resistance of Pseudomonas aeruginosa isolated from blood in a hospital in Shandong Province from 2014 to 2021

Objective: To identify the antibiotic resistance, virulence genes, and sequence types of Pseudomonas aeruginosa (P. aeruginosa) strains isolated from blood. Methods: From November 2014 to December 2021, a total of 94 nonrepetitive P. aeruginosa isolates were obtained from blood samples of patients at the First Affiliated Hospital of Shandong First Medical University in Shandong Province, China. The bacteria were identified using matrix-assisted laser desorption ionization time of flight mass spectrometry. Antibiotic resistance of the P. aeruginosa isolates was detected using Vitek 2 Compact system. Polymerase chain reaction (PCR) was conducted for the 18 virulence genes, and multi locus sequence typing (MLST) was performed to identify the sequence types of the P. aeruginosa strains. The resistance rates and distributions of virulence genes between carbapenem resistant pseudomonas aeruginosa (CRPA) and carbapenem susceptible pseudomonas aeruginosa (CSPA) isolates were compared using the Chi-square test. Results: Among 94 P. aeruginosa isolates, 19 (20.2%) isolates were found to be multidrug resistant (MDR) bacteria, of which 17 were CRPA isolates and 2 were CSPA isolates. All strains contained more than 10 virulence genes. Except for exoU gene, the detection rate of other genes was above 83%. MLST analysis revealed a total of 66 different STs, including 59 existing STs and 7 novel STs. Among them, ST244 (n=11, 11.7%) and ST270 (n=7, 7.4%) were the dominant STs. Although these two types of isolates harbored the same virulence genes, the resistance rates to carbapenem were different. 54.5% (6/11) ST244 isolates were CRPA but all 7 ST270 isolates were CSPA. Conclusion: Although the resistance rates of P. aeruginosa strains isolated from blood were at a low level, some MDR and CRPA isolates were detected. As the high virulence gene detection rates and genetic diversity were found for P. aeruginosa strains isolated from blood, close attention should be paid to avoid transmission and outbreaks.

Job burnout on subjective wellbeing among clinicians in China: the mediating role of mental health.

Although job burnout and mental health difficulties are prevalent negative influences on clinicians' subjective wellbeing (SWB), there are few investigations into their relationships. This research investigates the mediating role of mental illness in the association between clinicians' SWB and job burnout in China. This study used the data collected from a cross-sectional survey conducted in China. Using convenience sampling, we conducted a face-to-face questionnaire survey among clinicians in a tertiary hospital in Shandong Province from August to September 2019. The 22-item Maslach Burnout Inventory-Human Service Survey (Chinese version) and the Personal Wellbeing Index-Adult assessed job burnout and SWB. The Chinese short version of Depression, Anxiety and Stress Scale (DASS-C21) assessed mental health. We also collected data on participants' sociodemographic characteristics and job-related factors. Structural equation modeling (SEM) was applied to examine the associations between variables. Among the 422 participants, 80.8% of the participants reported at least one symptom of job burnout, whereas 5.7% reported all three symptoms of burnout. The prevalence rates of depression, anxiety, and stress were 40.3, 41.7, and 24.9%, respectively. Only 12.8% of the participants had high level of SWB. In mediation analysis, job burnout is positively associated with mental illness (β = 0.809, P < 0.001), mental illness had a significant negative association with SWB (β = -0.236, P = 0.013), and a negative association between job burnout and SWB was significant (β = -0.377, P = 0.002). Mental illness played a partially mediated role in the association between job burnout and SWB (indirect effect = -0.191, 95% CI: -0.361∼-0.017), and the mediating effect of mental illness can explain the 33.6% of the total effect of job burnout on SWB. This study provides evidence that the effect of job burnout on SWB is partially mediated by mental illness among clinicians in China. Medical administration departments and hospital administrators should pay close attention to the job burnout and mental health of clinicians, so as to effectively improve the SWB of clinicians.