Hospitals In Shandong Province Research Articles

Anxiety, depression, and post-traumatic stress disorder in nurses exposed to horizontal violence: a network analysis

BackgroundHorizontal violence can cause serious mental health problems for nurses, particularly anxiety, depression, and post-traumatic stress disorder. However, the intrinsic linkage mechanism between mental symptoms of anxiety, depression, and post-traumatic stress disorder in nurses exposed to horizontal violence is unclear. This study aims to elucidate the characteristics of anxiety, depression, and post-traumatic stress disorder networks among nurses with horizontal violence exposure.MethodsData for this cross-sectional study were obtained from the baseline portion of a short longitudinal survey conducted at four tertiary hospitals in Shandong Province, China. A total of 510 nurses with horizontal violence exposure completed the General Information Scale, the Negative Acts Questionnaire, the Seven-item Generalized Anxiety Disorder Scale, the Nine-item Patient Health Questionnaire, and the Four-item SPAN. The network model was constructed using network analysis. The expected influence and the bridge expected influence of nodes were calculated. The stability and accuracy of the network were estimated.ResultsThe results show that A4 (Trouble relaxing) and P1 (Startle) had the highest expected influence in the network. D9 (Suicidality ideation) and A5 (Restlessness) were the key bridge symptoms.Conclusions“Trouble relaxing”, “Startle”, “Suicidality ideation”, and “Restlessness” are all mental symptoms that need to be urgently improved the most in nurses exposed to horizontal violence. Nursing administrators and policymakers should implement mental health intervention programs for these symptoms as early as possible to maximize nurses’ mental health.

Effect of self-efficacy on self-management ability for colorectal cancer patients with stoma: a path analysis.

Colorectal cancer threatens health and causes heavy social burdens. The purpose of this study is to analyze the pathway model for the effect of self-efficacy on self-management ability in colorectal cancer patients with stoma. A cross-sectional study was conducted from December 2022 to April 2023, with a convenience sample of 422 colorectal cancer patients with stoma at six tertiary grade A hospitals in Shandong Province, China. Statistical analysis was undertaken using SPSS 26.0 and Amos 24.0 software. A pathway model based on individual and family self-management theories was developed and analyzed by collecting data through onsite survey and online survey. Chinese colorectal cancer patient's self-management ability score is 105.19 (17.19), which shows medium-level self-management ability. The self-efficacy of colorectal cancer patients with a stoma is influenced by social support, which ultimately leads to changes in their self-management ability. The findings may help healthcare professionals to identify the factors that influence self-management skills of colorectal cancer patients with stoma and provide a basis for developing interventions.

Knowledge, attitudes, practices, and barriers of oncology nurses in promoting physical activity in cancer survivors: a cross-sectional survey in China

PurposeTo explore the knowledge, attitudes, and practices of Chinese nurses in promoting physical activity among cancer survivors and the relationships between these attributes and to identify the factors hindering nurses’ clinical practice.MethodsNurses from oncology-related departments of 10 public tertiary hospitals in Shandong Province completed self-administered questionnaires that included information about demographics; knowledge, attitudes, and practices of physical activity promotion; and barriers to clinical practice. The STROBE statement for observational studies was applied.ResultsA total of 502 valid questionnaires were obtained. The average standardized scores of knowledges, attitudes, and practice were 75.33%, 82.36%, and 62.60%, respectively. Oncology specialist nurses and nurses who had received relevant training had higher levels of knowledge, nurses from general hospitals reported higher levels of practice, and nurses who had learned the relevant guidelines were better in terms of knowledge, attitude, and level of practice. Attitude had a statistically significant mediating effect between knowledge and practice. Lack of time, lack of multidisciplinary clinical teams, and lack of clear guidelines were the most frequently reported barriers to practice.ConclusionIn China, nurses have a moderate level of knowledge and practice in promoting physical activity among cancer survivors, but a positive attitude. Numerous barrier factors present challenges in nurses’ clinical practice. Attitude plays a partial mediating role between knowledge and practice.

Voices of Parent-Carers Navigating the Care for Children With Osteogenesis Imperfecta.

Parent-carers of children with rare diseases, including osteogenesis imperfecta (OI), represent a vulnerable and largely invisible population. Despite existing research on familial OI caregiving, the unique experiences, perspectives, and feelings of parent-carers remain poorly understood, prompting this study to delve into these aspects through the subjective lens of voices. The aim of this study was to explore the voices of parent-carers in navigating the complexities of pediatric OI care. Employing a narrative design informed by social constructionism, 15 parent-carers of pediatric OI patients were purposively sampled from a tertiary hospital in Shandong Province, China, between May and August 2021. Individual face-to-face interviews were conducted, and data were analyzed using the voice-centered relational approach followed by thematic analysis. Parent-carers' narratives revealed two overarching themes. The first theme, "the all-encompassing caregiver role," highlighted the profound internal transformation parent-carers underwent, with three key aspects of experiences: "the centrality of care," "life on hold," and "guarded silence." The second theme, "navigating ambivalence," captured the complex psycho-emotional journey of parent-carers as they balanced denial and acceptance, experienced the burden and responsibility of caregiving, navigated uncertainty with hope, and sought to normalize the care recipients' experiences while acknowledging their unique needs. Our findings suggest the need for developing tailored support strategies that address not only practical challenges but also the psychosocial dimensions of caregiving, to effectively assist and empower this marginalized carer population.

Integrating frailty management into cardiac intensive care unit nursing practice: A qualitative study

BackgroundFrailty is prevalent among older patients in intensive care units (ICUs) and poses significant challenges to recovery. Despite its importance, there is limited research on effective nurse-led frailty management strategies in this context. ObjectiveThe purpose of this qualitative study was to explore nurses' perceptions of frailty management in cardiac ICUs through the lens of the Wuli-Shili-Renli (WSR) system approach. MethodsSixteen nurses from two tertiary hospitals in Shandong province, China, participated in semi-structured interviews. Participants were selected based on their involvement in frailty training, educational background, and cardiac ICU work experience. Thematic analysis was conducted to identify key themes and sub-themes. ResultsAnalysis in three categories revealed the need for foundational support, including the need for appropriate screening tools, updated evidence-based practices, and institutional support. Closed-loop management involved frailty screening, personalized program implementation, information management, and follow-up assessment. Personnel training and coordination emphasized enhancing nurses' professionalism, multidisciplinary teamwork, and cooperation from patients and their caregivers. ConclusionThe insights gained can inform evidence-based practices and improve the quality of care provided to frail patients in cardiac ICUs. There is a need for future research to empirically investigate these strategies.

The mediating effects of parenting self-efficacy between readiness for hospital discharge and post-discharge coping difficulty among mothers of preterm infants

Post-discharge coping difficulty presents a significant challenge for mothers of preterm infants. The readiness for hospital discharge and parenting self-efficacy are crucial factors influencing post-discharge coping difficulty. However, the pathways through which these factors impact post-discharge coping difficulty remain unclear. This study aims to investigate the impact of readiness for hospital discharge on post-discharge coping difficulty and the mediating role of parenting self-efficacy among mothers of preterm infants. A prospective study involving 462 mothers of preterm infants from six tertiary hospitals in Shandong Province was conducted. Mothers were evaluated on the day of discharge (using the Baseline characteristics and Readiness for Hospital Discharge Scale) and three weeks post-discharge (utilizing the Parenting Sense of Competence Scale-Efficacy subscale and Post-Discharge Coping Difficulty Scale). Structural equation modeling was employed to analyze the mediating effect. The results of this study revealed that readiness for hospital discharge significantly decreased post-discharge coping difficulty (β = − 0.533, P < 0.001), and parenting self-efficacy also significantly reduced post-discharge coping difficulty (β = − 0.419, P < 0.001). Furthermore, parenting self-efficacy partially mediated the relationship between readiness for hospital discharge and post-discharge coping difficulty, accounting for 25.35% of the total effect. Mothers reported a moderate level of post-discharge coping difficulty. In assisting mothers of premature infants to alleviate post-discharge coping difficulty, nurses could implement strategies focused on enhancing readiness for hospital discharge and parenting self-efficacy.

Knowledge and practices of neonatal intensive care unit nurses concerning hypothermia in preterm infants: Adescriptive cross-sectional study.

To investigate the knowledge level and clinical practice of neonatal intensive care unit nurses on the whole process of hypothermia prevention in preterm infants. A polycentric descriptive cross-sectional study was conducted in 23 hospitals in Shandong province involving 254 neonatal intensive care unit nurses. An evidence-based knowledge and clinical practice questionnaire on hypothermia prevention in preterm infants and a general information questionnaire were used to collect data. SPSS and EXCEL 24.0 database were used for data statistics and analysis. Nearly one-third of nurses were unclear about the definition of mild hypothermia and heat preservation measures during labour management and resuscitation. Knowledge about the correct rate of amniotic fluid evaporation was low. The higher the hospital level and nurses' education level, professional title, work experience, and position, the higher the knowledge level. The clinical practice of nurses differed in terms of body temperature assessment tools, measurement sites, and measurement frequency for premature infants. Nurses in neonatal intensive care units need to apply evidence-based knowledge and carry out practice interventions to ensure preterm infants' safe transition from the delivery room to the neonatal intensive care unit. There have been few studies evaluating neonatal nurses' knowledge and practices with regards to the preventing hypothermia of premature infants from delivery room to neonatal intensive care unit. The study identifies the deficiencies and problems in temperature management that can be attributed to the knowledge level of nurses. The findings will help improve the current curriculum, teaching strategies, and the nurses' knowledge levels, preventing premature hypothermia in infants. This study adhered to the STROBE statement for observational studies and obtained approval (KYLL-2023LW045) from the ethics committee of The Second Hospital of Shandong University. The other 22 third- and second-level hospitals, as our alliance members, recognized our chairperson status within the alliance and were willing to join our academic activities. Mutual responsibility for ethical filing between alliance units. 254 nurses were recruited from 23 tertiary and secondary public hospitals in Shandong province. No public or patient involvement. Members of the research group used the Questionnaire Star platform to prepare the electronic questionnaire, including obtaining informed consent, taking precautions for questionnaire completion, and using the aforementioned measurement tools. The project research team contacted the head nurses of 23 neonatal intensive care units in Shandong Province. After obtaining consent from the head nurses, they were asked to send the requirements and link of the electronic questionnaire to their WeChat management group. The nurses go through each question and make a choice which has two options of 'agree' or 'disagree.' Based on their answers, nurses were evaluated as having 'mastered' or 'not mastered' each item. Each 'mastered' item (correct answer) was given a score of 4; an item 'not mastered' (incorrect answer) was given a score of 0. The total score ranged from 0 to 100.

Developing mapping algorithms to predict EQ-5D health utility values from Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index among patients with Ankylosing Spondylitis

BackgroundPreference-based measures of health-related quality of life (HRQoL), such as the EQ-5D or the SF-6D, are essential for health economic evaluation. However, they are rarely included in clinical trials of ankylosing spondylitis (AS). This study aims to develop mapping algorithms to predict EQ-5D-3L and EQ-5D-5L health utility scores from the Bath Ankylosing Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI).MethodsPatients with AS were recruited from the largest tertiary hospital in Shandong province, China, between December 2019 and October 2020. Patients were selected by convenience sampling method according to the following criteria: (1) diagnosed with AS according to the New York criteria; (2) aged 18 years and above; and (3) without mental disorders; (4) able to understand the questionnaires; (5) without serious complications. There were 243 patients who completed the face-to-face questionnaire survey, and 5 cases with missing values in key variables were excluded. Ordinary least squares, censored least absolute deviations, Tobit, adjusted limited dependent variable mixture model and beta-mixture model (BM) in the direct approach and ordered logit and multinomial logit (Mlogit) model in the response approach were used to develop mapping algorithms. Mean absolute error, root mean square error, Spearman’s correlation coefficient and concordance correlation coefficient were used to access predictive performance.ResultsThe 238 patients with AS had a mean age of 35.19 (SD = 9.59) years, and the majority (74.47%) were male. The observed EQ-5D-3L and EQ-5D-5L health utility values were 0.88 (SD = 0.12) and 0.74 (SD = 0.27), respectively. The EQ-5D-5L had higher conceptual overlap with the BASDAI and BASFI than the EQ-5D-3L did. The Mlogit was the best-performing model for the EQ-5D-3L, and the BM showed better performance in predicting EQ-5D-5L than other direct and indirect mapping models did.ConclusionThis study demonstrates that the EQ-5D-5L, rather than EQ-5D-3L, should be selected as the target outcome measure of HRQoL in patients with AS in China, and the BM mapping algorithm could be used to predict EQ-5D-5L values from BASDAI and BASFI for health economic evaluation.

Colistin Resistance Mechanisms and Molecular Epidemiology of Enterobacter cloacae Complex Isolated from a Tertiary Hospital in Shandong, China.

Enterobacter cloacae complex (ECC), which includes major nosocomial pathogens, causes urinary, respiratory, and bloodstream infections in humans, for which colistin is one of the last-line drugs. This study aimed to analyse the epidemiology and resistance mechanisms of colistin-resistant Enterobacter cloacae complex (ECC) strains isolated from Shandong, China. Two hundred non-repetitive ECC strains were collected from a tertiary hospital in Shandong Province, China, from June 2020 to June 2022. Whole-genome sequencing and bioinformatics analyses were performed to understand the molecular epidemiology of the colistin-resistant ECC strains. The nucleotide sequences of heat shock protein (hsp60) were analyzed by using BLAST search to classify ECC. The gene expression levels of ramA, soxS, acrA, acrB, phoP, and phoQ were assessed using RT-qPCR. MALDI-TOF MS was used to analyse the modification of lipid A. Twenty-three colistin-resistant strains were detected among the 200 ECC clinical strains (11.5%). The hsp60 cluster analysis revealed that 20 of the 23 ECC strains belonged to heterogeneous resistance clusters. Variants of mgrB, phoPQ, and pmrAB, particularly phoQ and pmrB, were detected in the 23 ECC strains. The soxS and acrA genes were significantly overexpressed in all 23 colistin-resistant ECC strains (P < 0.05). Additionally, all 23 ECC strains contained modified lipid A related to colistin resistance, which showed five ion peaks at m/z 1876, 1920, 1955, 2114, and 2158. Among the 23 ECC strains, 6 strains possessed a phosphoethanolamine (pETN) moiety, 16 strains possessed a 4-amino-4-deoxy-L-arabinose (-L-Ara4N) moiety, and one strain had both pETN and -L-Ara4N moieties. This study suggests that diverse colistin resistance existed in ECC, including unknown resistance mechanisms, exist in ECC. Mechanistic investigations of colistin resistance are warranted to optimise colistin use in clinical settings and minimise the emergence of resistance.

Development and validation of a predictive model for double-J stent encrustation after upper urinary tract calculi surgery

The study is aimed to establish a predictive model of double-J stent encrustation after upper urinary tract calculi surgery. We collected the clinical data of 561 patients with indwelling double-J tubes admitted to a hospital in Shandong Province from January 2019 to December 2020 as the modeling group and 241 cases of indwelling double-J tubes from January 2021 to January 2022 as the verification group. Univariate and binary logistic regression analyses were used to explore risk factors, the risk prediction equation was established, and the receiver operating characteristic (ROC) curve analysis model was used for prediction. In this study, 104 of the 561 patients developed double-J stent encrustation, with an incidence rate of 18.5%. We finally screened out BMI (body mass index) > 23.9 (OR = 1.648), preoperative urine routine white blood cell quantification (OR = 1.149), double-J tube insertion time (OR = 1.566), postoperative water consumption did not reach 2000 ml/d (OR = 8.514), a total of four factors build a risk prediction model. From the ROC curve analysis, the area under the curve (AUC) was 0.844, and the maximum Oden index was 0.579. At this time, the sensitivity was 0.735 and the specificity was 0.844. The research established in this study has a high predictive value for the occurrence of double-J stent encrustation in the double-J tube after upper urinary tract stone surgery, which provides a basis for the prevention and treatment of double-J stent encrustation.

Unveiling the multi-dimensional frailty network among older cancer survivors in China: A network analysis study

IntroductionFrailty has a significant impact on the overall quality of life of older cancer survivors, but the relationships among frailty symptoms are not well understood. This study aims to explore the specific associations among multidimensional symptoms of frailty among older cancer survivors by employing network analysis to provide supportive evidence for targeted interventions in the future. Materials and MethodsData were obtained by cluster sampling from three large Grade-A tertiary hospitals in Shandong Province, China, and collected through face-to-face interviews by trained investigators. We included patients who were diagnosed with a solid malignant tumor at the age of 60 years or older. Frailty indicators were measured by the Groningen Frailty Indicator (GFI) and analyzed primarily through network analysis, including network estimation, centrality, and stability analysis. The relative importance of a node in a network was tested by centrality analyses, and Spearman correlations were applied to estimate the relationships between symptom pairs (symptom score) and symptom clusters (standardized symptom score) in the symptom network. In terms of centrality, the indexes of strength, closeness, and betweenness were adopted to measure the importance of nodes. ResultsFive hundred and eight older cancer survivors were included, with an average age of 68.4 years (standard deviation [SD] = 5.4), and a higher proportion were male (n = 307[60.4%]). The prevalence of frailty among older cancer survivors was 58.9% (n = 299), with a mean GFI score of 4.46 (SD = 2.87). The strongest edge was between “dressing and undressing” and “going to the toilet” (r = 0.58). The nodes with the higher strength centrality were “going to the toilet” (rS=1.09), “walking around outside” (rS=0.97), and “part of social network” (rS=0.96); and the nodes with the higher closeness centrality were “mark physical fitness” (rC=0.005), “calm and relaxed” (rC=0.005), and “nervous or downhearted” (rC=0.005). DiscussionThis study demonstrated that older cancer survivors in China have a high prevalence of frailty, with self-care and social participation-related symptoms playing a key role in the multidimensional network of frailty symptoms. Psychological symptoms can rapidly influence other symptoms within this network. Therefore, prioritizing psychological symptoms in the assessment of older adults with cancer is essential for effective frailty management.

Relationship of Demographic Profile to Satisfaction in Interprofessional Collaboration among Medical-Surgical Ward Nurses in Selected Hospitals of Shandong, China: A Cross-Sectional Study

With the spread of the concept of team medicine, active nurse-doctor collaboration is closely related to nursing quality. Nursing standards recognize that collaborative practice is a necessary condition for high-quality patient care, but many nurses are often reluctant to participate in interprofessional teams, indicating that challenges in nurse-doctor collaboration still exist. This study aimed to investigate the relationship between demographic data and nurse interprofessional satisfaction of medical and surgical nurses in tertiary hospitals in Shandong Province, and to provide a reference direction for improving teamwork. Methods: The research method was a cross-sectional study. Medical and surgical nurses in three tertiary hospitals in Shandong Province were surveyed. Medical and surgical nurses who were officially registered in the hospital and had been engaged in internal medicine or surgery for at least one year were selected. They were aged 18 to 45 years. The researchers used SPSS software to analyze the data, and descriptive statistics (frequency percentage distribution, mean score, and standard deviation) were used to present the satisfaction scores. If the data did not follow a normal distribution, nonparametric tests were used. Results: The average scores of the interprofessional collaboration satisfaction scale for the participating nurses were: "overall expectation" 2.67; "perception dimension of professional collaboration" 3.78; "The overall relationship satisfaction of professional cooperation" 3.83; "Communication and tolerance of interprofessional collaboration" 3.80; "Equality of interprofessional collaboration" 3.81; "Satisfaction with interprofessional collaboration" 2.98. The results of non-parametric tests showed that there was a significant difference between marriage and nurses' satisfaction with interprofessional collaboration (P&lt;0.05). Conclusion: The overall satisfaction of nurses with interprofessional collaboration in three tertiary hospitals in Shandong Province was generally average. The three hospitals should improve the management model and care about the mental health of nurses according to factors such as the marital status of nurses. Nurses should make a good distinction and plan between work and life to promote interprofessional collaboration.

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...