STROBE Checklist Research Articles

Relationship Between Geriatric Nurses' Spiritual Care Perceptions and Professional Attitudes, a Cross-Sectional Study.

This study, based on the self-determination theory, aims to explore the current situation of geriatric nurses' perceptions of spiritual care and its relationship with their professional attitude. It was conducted from February to May 2022. As the population ages, it is necessary to actively implement coping strategies. Geriatric nurses are important human resources, so we should pay attention to their perception of spiritual care for the elderly and their attitude towards the nursing profession. A cross-sectional survey was conducted. A total of 488 geriatric nurses engaged in elderly care were recruited from different hospitals in China. An online questionnaire was used to assess geriatric nurses' sociodemographics, their perception of spiritual care and their professional attitude. This study's findings indicate that the overall average score of geriatric nurses' perception of spiritual care was at a medium level (173.64 ± 27.87). Geriatric nurses' professional attitude was positively correlated with spiritual care perception (p < 0.001). The multiple stepwise linear regression model (n = 488) had an explained variance (R2 = 0.216), and three factors such as the need to enhance the ability of spiritual care through lectures and other methods were the main predictors of the perception level of spiritual care among geriatric nurses (p < 0.001). The findings demonstrated that the enhancement of professional attitudes among geriatric nurses can effectively augment their perception and implementation of spiritual care. This study's result is helpful for nursing managers to identify the weak links in the overall nursing services for elderly patients, thereby carrying out relevant intervention measures, improving the perception level of spiritual care of geriatric nurses, optimising the quality of elderly care services and achieving healthy aging. No patient or public contribution. The study focused on the current situation of geriatric nurses' perceptions of spiritual care and its relationship with their professional attitude. Therefore, the involvement of patients or the public was not deemed necessary for achieving the specific research objectives. The reporting of the study was guided by the STROBE checklist.

Factors affecting the unused short peripheral catheters: A neverending debate? A cross-sectional study in hospitalized patients.

Concern about unused vascular access devices has increased, but data on idle short peripherally intravascular catheters in medical-surgical units is still scarce. We aimed to assess the prevalence of unused short peripheral catheters in hospitalized patients and identify risk factors and reasons that lead nurses to maintain them in situ. A cross-sectional observational study was performed in September 2022. Clinical observation (24h) and medical records review were assessed to collect patient demographics and catheter-related information. Nurses were asked the main reason for continuing the use of the unused catheter. The primary outcome was the prevalence of unused short peripheral catheters, which were no longer used for intravenous fluids or medications in the previous 24 h. Multivariate logistic regression has been performed to evaluate risk factors for unused catheters. The STROBE checklist was used to report our study. Seven hundred and sixty-four patients were included; out of the 621 patients with at least one short peripheral catheter, one-third had at least one unused catheter. The risk of having an unused peripherally intravascular catheter was almost double when the catheter was positioned in the emergency department. Catheters of smaller calibers and in situ for fewer days were less likely to be unused. The main reasons for keeping a peripherally intravascular catheter unused in situ were clinical conditions. Unused short peripheral catheters are still quite frequent. While specific clinical needs justified some unused short peripheral catheters, a proportion remained unexplained and potentially avoidable. Nurses and policymakers can use the findings to inform decision-making and protocols to manage peripherally inserted catheters to reduce unused short peripheral catheters and, consequently, complications and costs and improve patient safety and quality of care.

Prediction of Nursing Need Proxies Using Vital Signs and Biomarkers Data: Application of Deep Learning Models.

To develop deep learning models to predict nursing need proxies among hospitalised patients and compare their predictive efficacy to that of a traditional regression model. This methodological study employed a cross-sectional secondary data analysis. This study used de-identified electronic health records data from 20,855 adult patients aged 20 years or older, admitted to the general wards at a tertiary hospital. The models utilised patient information covering the preceding 2 days, comprising vital signs, biomarkers and demographic data. To create nursing need proxies, we identified the six highest-workload nursing tasks. We structured the collected data sequentially to facilitate processing via recurrent neural network (RNN) and long short-term memory (LSTM) algorithms. The STROBE checklist for cross-sectional studies was used for reporting. Both the RNN and LSTM predicted nursing need proxies more effectively than the traditional regression model. However, upon testing the models using a sample case dataset, we observed a notable reduction in prediction accuracy during periods marked by rapid change. The RNN and LSTM, which enhanced predictive performance for nursing needs, were developed using iterative learning processes. The RNN and LSTM demonstrated predictive capabilities superior to the traditional multiple regression model for nursing need proxies. Applying these predictive models in clinical settings where medical care complexity and diversity are increasing could substantially mitigate the uncertainties inherent in decision-making processes. We used de-identified electronic health record data of 20,855 adult patients about vital signs, biomarkers and nursing activities. The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies. Despite widespread adoption of deep learning algorithms in various industries, their application in nursing administration for workload distribution and staffing adequacy remains limited. This study amalgamated deep learning technology to develop a predictive model to proactively forecast nursing need proxies. Our study demonstrates that both the RNN and LSTM models outperform a traditional regression model in predicting nursing need proxies. The proactive application of deep learning methods for nursing need prediction could help facilitate timely detection of changes in patient nursing demands, enabling the effective and safe nursing services.

The impact of nurses' stress situation coping on somatization: a mediated moderation model.

The purpose of this study is to investigate the impact of nurses' stress situation coping levels on somatization symptoms, the mediating effect of depression, and the moderating effect of perceived social support. As a core part of the global healthcare system, nurses are crucial to patient health and rehabilitation outcomes. However, due to heavy workloads, unreasonable staffing structures, and constant exposure to occupational risks in their workplaces, these factors often place nurses in a high-intensity, high-stress environment, which directly affects their physical and mental health and professional burnout. Coping with stress situations is an important means to help individuals effectively manage stress, reduce negative impacts, and maintain mental health. However, research on the impact of nurses' stress situation coping methods on somatization symptoms is limited. This study conducted a cross-sectional survey from December 2022 to April 2023, and finally included 293 nurses working on the front line of tertiary hospitals. Data was collected through questionnaires and analyzed using SPSS 24.0 and the SPSS macro program's Models 7 and 14. This study is an observational study, strictly prepared and presented according to the STROBE checklist. The somatization symptom scores of the nurses were (27.27 ± 7.33) points, the stress situation coping scores were (59.90 ± 9.64) points, the perceived social support scores were (65.64 ± 12.90) points, and the depression scores were (4.42 ± 4.12) points. The somatization symptom scores of the nurses were positively correlated with the stress situation coping scores and depression scores, and negatively correlated with the perceived social support scores, with correlation coefficients of 0.200, 0.851, and -0.302, respectively. The stress coping level of the nurses had a direct positive impact on somatization symptoms (β = 0.081, p = 0.009), and a direct positive impact on nurse depression (β = 0.202, p = 0.001). Depression had a significant positive impact on somatization symptoms (β = 0.823, p = 0.000), and depression played a mediating role. Perceived social support had a significant negative impact on depression (β = -0.383, p = 0.000). Perceived social support had a significant moderating effect on the relationship between the stress situation coping level and depression (β = -0.121, p = 0.003). In this study, the stress situation coping methods of nurses had a positive impact on somatization symptoms, had a complete mediating effect on the depression level of nurses, and perceived social support had a significant moderating effect in the pathway from the stress situation coping methods of nurses to depression-mediated somatization symptoms.

Positive Coping Style and Family Resilience of Caregivers of COPD Patients: The Chain Mediating Roles of Caregiver Burden and Resilience.

To investigate the association between positive coping style and family resilience, considering the mediating factors of burden and individual resilience within caregivers of chronic obstructive pulmonary disease (COPD) patients. A cross-sectional survey. A total of, 204 caregivers of COPD patients were recruited using convenient sampling from April 2023 to May 2024 to investigate general information, family resilience, individual resilience, caregiver burden and positive coping styles on caregivers of COPD patients. Influencing factors were primarily identified using Mann-whitney U test and Kruskal-Wallis H test. Spearman correlation analysis was used to explore the correlation between family resilience, positive coping, caregiver burden and resilience. Linear regression was used to analyse the influencing factors of family resilience of caregiver. Structural equation modelling was used to detect the mediating effects of caregiver burden and resilience. The STROBE checklist was followed. The family resilience of caregivers was positively correlated with positive coping styles and individual resilience, and negatively correlated with caregiver burden. The family resilience of caregivers increased with the improvement positive coping style and individual resilience, and decreased with the increase of caregiver burden. Caregiver burden and resilience played the chain mediating roles between positive coping style and family resilience. Family caregivers of COPD patient with higher education levels also have higher family resilience. Higher positive coping style may lead to higher family resilience of caregivers of COPD patients by reducing caregiver burden and promoting resilience. There are individual differences in the level of family resilience of caregivers of COPD patients, and nurses can provide personalised interventions to different family caregivers by understanding their characteristics and needs. Nurses can improve the family resilience of caregivers by guiding them to adopt positive coping styles, reducing burdens and promoting resilience. This study was conducted with the participation of caregivers of COPD patients who contributed data by completing study questionnaires.

What Are the Predictors of Acute Care Nurses' Stroke Knowledge?: Empirical Research Quantitative.

To examine the predictability of categorical and quantitative study variables on acute stroke knowledge amongst study participants. Non-experimental, descriptive correlational. A convenience sample of registered nurses caring for adult, hospitalized patients recruited from the urban Southeast. A three-part survey was emailed to the nurses: demographics, stroke education and experience, and the Acute Stroke Management Questionnaire. Intensive Care Unit and Emergency Department nurses had the highest level of stroke knowledge. Nurses reporting three or more post-licensure education modalities had higher stroke knowledge scores than those reporting two or less. Practice setting, self-perception of stroke knowledge, self-identified knowledge of acute stroke management and three items related to code stroke were significantly correlated with stroke knowledge. Various methods of training and reinforcement of learning using varying teaching styles are effective in increasing nurses' stroke knowledge. Further stroke education is needed for nurses across the acute care setting. Future studies should explore lived experiences of nurses to gain understanding of nonquantifiable factors that nurses feel have strengthened their stroke knowledge. What Problem Did the Study Address? ○ Addressing the gap in the knowledge of predictors of nurse stroke knowledge. MAIN FINDINGS?: Practice setting, post-licensure stroke education, code stroke familiarity, confidence and understanding were all predictive of the overall stroke knowledge. WHOM WILL THE RESEARCH HAVE AN IMPACT?: Nurses, nurse educators, patients experiencing and at risk for stroke. The STROBE checklist was used to strengthen the reporting of the results. Nurses voluntarily participated in this study by completing the online questionnaire. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Provides predictors of stroke knowledge for nurse leaders to have a better understanding of nurses' educational needs. Provides evidence of a quick, effective measure of nurses' stroke knowledge.

Validation of Spanish Version of the Spirituality and Spiritual Care Rating Scale (SSCRS-Sp) in Nursing Professionals.

To examine the reliability and construct validity of the Spanish adaptation of the Spirituality and Spiritual Care Rating Scale (SSCRS) within the nursing professionals' context. Observational and descriptive cross-sectional study. The sample consisted of N = 325 nursing professionals from various healthcare settings, including hospitals, clinics and community healthcare centres. Following translation and cultural adaption of the SSCRS, the scale underwent psychometric assessment of its construct validity through exploratory and confirmatory factor analysis. Internal consistency analysis was also performed using a McDonald's omega. The reporting in this investigation adhered to the STROBE checklist. The exploratory factor analysis (EFA) revealed a two-factor structure, with one factor closely aligning with one religiosity dimension and the other factor combining the spirituality, spiritual care and personalised care dimensions. The results of the confirmatory factor analysis did not provide an adequate fit to the data for both the two-factor solution found in the EFA and the four-factor solution proposed by McSherry, Draper, and Kendrick (2002). Even though the four-factor solution showed a slightly better fit than the two-factor solution, neither model achieved a satisfactory fit. The lack of formal education and confusion between religion and spirituality among healthcare professionals could have influenced the responses and interpretation of the results. The findings showed that the SSCRS-Sp demonstrated good internal consistency, indicating that the items in the scale are reliably measuring the targeted constructs. Further refinement and validation of the scale are needed to establish a robust factor structure in the target population. The SSCRS-Sp can be used to assess the nurses' perceptions of spirituality and spiritual care. The availability of this tool represents a significant step towards greater integration of the spiritual dimension of care within a holistic nursing care framework in Spanish-speaking countries. Nursing professionals responded to the research scale.

Prognostic Factors Associated With Survival Distribution of Admission to Delayed Rapid Response Team Activation Among Deteriorating Patients: A Retrospective Study.

To investigate the prevalence of rapid response team delays, survival distribution of admission to rapid response team delay and its prognostic factors. A retrospective single-centre study. Data on rapid response team activations from 1 January 2018 to 31 December 2022 were retrieved from electronic medical records at a tertiary hospital in Hangzhou, China. All patients who met the eligibility criteria were included. Multivariable Cox regression analysis was conducted to analyse the data. Out of 636 patients included, 18.4% (117) experienced a delay, with a median (interquartile range) of 8.5 (12) days from admission to rapid response team activation. Six significant prognostic factors were found to be associated with the higher hazard ratio of rapid response team delay, including call time (05:01 PM and 7:59 AM), emergency admission, a higher Modified Early Warning Score, an admission diagnosis of infection, a comorbidity of respiratory failure/Acute Respiratory Distress Syndrome and the absence of lung infection. The prevalence of rapid response team delays was lower, and the days from admission to rapid response team delay was longer than in previous studies. Healthcare providers are suggested to prioritise the care of high-risk patient groups and provide proactive monitoring to ensure timely identification and management. Implementing artificial intelligence in continuous monitoring systems for high-risk patients is recommended. The findings help nurses anticipate potential delays in rapid response team activation, enabling better preparedness. The study highlights the prevalence of rapid response team delays, timing from admission to rapid response team activation and six prognostic factors influencing delays. It could shape patient care and inform future research. Hospital administrators should review staffing, especially during night shifts, to minimise delays. Further qualitative research is needed to explore why nurses may delay rapid response team activation. The STROBE checklist was adhered to when reporting this study. 'No patient or public contribution'.

Operating room radiation safety measures: Awareness, compliance, and perceived risks among nurses and other healthcare workers.

This study evaluates and compares nurses' and other healthcare workers' awareness of and compliance with radiation protection measures in operating rooms and their perceived susceptibility to occupational illness due to radiation exposure. Compliance with radiation safety measures minimises occupational radiation exposure risks. Understanding the role of perceived susceptibility to occupational illness in motivating compliance and awareness can enhance safety interventions. Using a questionnaire-based cross-sectional observational design, this study targeted nurses, physicians, and radiologic technologists working in Saudi Arabian operating rooms. The survey measured awareness of and compliance with radiation protection measures and perceived susceptibility to occupational illness. The STROBE checklist was followed to ensure methodological rigour. Nurses demonstrated the lowest awareness and compliance, and the highest perceived susceptibility to occupational illnesses compared to other healthcare professionals. There was a moderate positive correlation between increased awareness of safety measures and compliance, but a weaker correlation between adherence and perceived risk. Nurses' compliance and awareness did not align with their risk perceptions, suggesting a cognitive-behavioural gap in which stronger risk perceptions among nurses do not lead to proactive protective behaviours. This discrepancy may be attributed to the demanding nature of nursing duties, which often overshadow strict adherence to safety protocols. The study identified significant disparities in radiation safety practices, with nurses demonstrating less awareness and compliance but higher risk perceptions than other healthcare professionals. Interventions are needed to bridge the gap between perceived risk and actual safety behaviours. Role-specific training programmes and continuous education are needed to enhance radiation safety practices among nurses. Policies must support these educational efforts, ensuring that nurses can balance patient care responsibilities with radiation protection measures.

Nursing students' personality traits, sleep quality, social media addiction, and academic performance: A multi-site structural equation model analysis

BackgroundThe associations between personality traits, sleep quality, social media addiction, and academic performance have been well-reported across the literature among university students. However, the interaction among these variables remains understudied among nursing students of underdeveloped countries like the Philippines. PurposeThis study investigated the interrelationships of personality traits, sleep quality, social media addiction, and academic performance among Filipino nursing students. MethodsA correlational, cross-sectional design and convenience sampling was used to recruit nursing students (n = 823) from five nursing colleges in the Philippines. Three standardized instruments (10-item Personality Inventory, 19-item Pittsburgh Sleep Quality Index, and 6-item Bergen Social Media Addiction Scale) were used to collect data from June to August 2023. Covariance-based structural equation modeling (CB-SEM) was employed to analyze the data. STROBE checklist guided in reporting study results. ResultsThe emerging model demonstrated satisfactory model fit parameters. Nursing students reported high levels of extraversion (x̅=6.13, SD = 2.08) with low scores in emotional stability (x̅ =6.76, SD = 2.30) and openness to experiences (x̅ =8.80, SD = 2.09). The majority had poor sleep quality (x̅=8.35, SD = 3.12) and were at low risk for social media addiction (x̅=17.73, SD = 5.61). Conscientiousness (β = −0.13, p = 0.031) and emotional stability (β = −0.35, p = 0.002) inversely influenced sleep quality. Agreeableness (OR = 1.13, p = 0.007) and openness to experiences (OR = 1.11, p = 0.050) had a positive effect, while conscientiousness (OR = 0.84, p = 0.006) had a negative effect on high-risk social media addiction. Conscientiousness (β = 0.12, p = 0.010) significantly and positively influenced academic performance. Conscientiousness and emotional stability were able to measure 15.00 % of sleep quality's total variance. ConclusionPolicymakers, nursing college administrators, and nurse educators could use these findings to evaluate students' personality traits and create programs that will promote better sleep quality and prevent social media addiction. Hence, enhancing academic performance.

The Trajectory and Influencing Factors of Fear of Childbirth in Third Trimester Primiparas: A Prospective Longitudinal Study.

Maternal fear of childbirth fluctuates throughout pregnancy. However, no studies have investigated the changing characteristics and influencing factors of fear of childbirth. This study aimed to identify the trajectory patterns of fear of childbirth in third-trimester primiparas and to examine the factors influencing these patterns. This study followed the STROBE checklist for observational research. A prospective longitudinal design was employed, using the Intolerance of Uncertainty Scale, Childbirth Self-Efficacy Inventory and Childbirth Attitudes Questionnaire as primary measures. Data were collected from 226 primiparous women at 28-29 weeks, 32-33 weeks, 36-37 weeks and 39-41 weeks of gestation. Growth mixture modelling (GMM) was fitted using Mplus 8.3 software to analyse the trajectory of fear of childbirth. Logistic regression was conducted to identify the factors influencing these trajectories. The results revealed heterogeneity in the trajectory of fear of childbirth, which could be categorised into six groups: a normal group without fear, a group with no initial fear but increased fear later, a group with mild fear that decreased, a group with mild fear that worsened, a mild fear stable group and a moderate fear stable group. Logistic regression showed that intolerance of uncertainty, childbirth self-efficacy and childbirth preference were the primary factors influencing these trajectories (p < 0.05). This study highlights the varying trajectories of fear of childbirth in third-trimester primiparas. Different categories of fear emerge, each following a distinct path of change. Healthcare providers can use this information to create individualised interventions, addressing specific concerns and influencing factors at various stages, to support the psychological well-being of primiparas during the perinatal period. Healthcare providers should be vigilant about primiparas' awareness of and response to childbirth fear. This study shows that the fear of childbirth often begins to increase or decrease between 32 and 33 weeks of gestation. Screening and interventions should thus be initiated during this period, with follow-up mechanisms in place. Providers should also assess primiparas' capacity to cope with childbirth fear, offering targeted guidance and education to reduce uncertainty, enhance childbirth self-efficacy and ultimately alleviate fear. No patient or public contribution. This study is of great interest to health care providers, suggesting that health care providers should be vigilant about primiparas' awareness of and response to childbirth fear. This study shows that the fear of childbirth often begins to increase or decrease between 32 and 33 weeks of gestation. Screening and interventions should thus be initiated during this period, with follow-up mechanisms in place. Providers should also assess primiparas' capacity to cope with childbirth fear, offering targeted guidance and education to reduce uncertainty, enhance childbirth self-efficacy and ultimately alleviate fear.

Longitudinal Trajectories of Psychological Distress and Its Influence Factors in Young and Middle-Aged Patients With Colorectal Cancer.

To identify the longitudinal trajectories of psychological distress and to explore the predictive factors of different trajectories among young and middle-aged colorectal cancer patients from diagnosis to 6 months postoperation. A longitudinal study was conducted, guided by the STROBE checklist. A total of 214 patients were recruited from July 2021 to May 2022 at a cancer hospital in Guangzhou, China. Data were collected from diagnosis to 6 months post-surgery, using the Brief Symptom Inventory-18, Distress Disclosure Index, Connor-Davidson Resilience Scale and Social Support Rating Scale. We also collected socio-demographic and clinical characteristics at baseline. General estimation equation (GEE) was used to analyse the overall trend of psychological distress. To identify distinct distress trajectories, growth mixture modelling (GMM) and latent class growth modelling (LCGM) were both used. Longitudinal trajectories of psychological distress: the average score of psychological distress at different time points were 12.02 ± 9.87, 17.40 ± 9.73, 15.91 ± 10.05, 16.28 ± 11.24 and 16.31 ± 11.66. GEE showed four unique trajectories of psychological distress: chronic distress, no distress, steady increase and significantly increased. With reference to resilient group, multinomial logistic regression showed that education level, monthly income, minor offspring, stoma, residence, self-disclosure and psychological resilience were predictive factors of chronic distress class or increase-distress class. From diagnosis to 6 months post-surgery, psychological distress increased at discharge, gradually stabilising thereafter. Meanwhile, results revealed heterogeneity in this population. To effectively alleviate distress, it is crucial to identify high-risk individuals through predictive factors and implement tailored interventions. This study offers the trajectory and predictors of psychological distress in the process of diagnosis and treatment, and can be used in the clinical identification and monitoring of high-risk patients. The findings suggest that healthcare providers should regularly monitored and identified the psychological distress of patients, and took individualised intervention measures. This study is reported using the STROBE guidelines. No patient or public engagement.

Oral Manifestations in Patients in Treatment with Antidepressants: A Systematic Review.

Background/Objectives: The rising use of antidepressants is linked to oral health risks, including xerostomia, caries, and periodontal disease. Recognizing these risks is essential for improving patient care. To systematically review oral manifestations in patients undergoing antidepressant treatment. Methods: This review follows the PRISMA guidelines and includes observational studies published in the last 21 years. A PICO-based question was developed to select relevant studies, which were assessed for quality using a modified STROBE checklist. Results: A total of 11 studies were analyzed, revealing a consistent association between antidepressant use and the increased risk of xerostomia, caries, and periodontal disease. Additional findings included taste dysfunction and oral bleeding complications. Among the antidepressants, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were most commonly associated with xerostomia and caries. However, no significant impact was observed on the chemical composition of saliva or on hemostasis in invasive dental procedures. Conclusions: Antidepressant use may lead to significant oral health issues, notably xerostomia and caries. Further studies are recommended to clarify the influence of specific antidepressants and confounding factors, such as treatment duration, dosage, and hygiene habits, on oral health outcomes.

Association of frailty with functional difficulty in older Ghanaians: stability between women and men in two samples with different income levels

BackgroundResearch to date suggests that frailty is higher in women and is associated with functional difficulty. This study builds on the evidence by examining the association between frailty and functional difficulty between low- and higher-income groups and between older men and women in these income groups.MethodsThis study adopted a cross-sectional design that complied with the STROBE checklist and included steps against confounding and common methods bias. The population was community-dwelling older adults aged 50 years or older in two urban neighbourhoods in Accra, Ghana. Participants were either in the low-income group in a low socioeconomic neighbourhood (n = 704) or the higher-income group in a high socioeconomic neighbourhood (n = 510). The minimum sample necessary was calculated, and the hierarchical linear regression analysis was utilised to analyse the data.ResultsFrailty was positively associated with functional difficulty in the low- and higher-income samples, but this association was stronger in the higher-income sample. Frailty was positively associated with frailty in men and women within the low- and higher-income samples.ConclusionThe association of frailty with functional difficulty was consistent between low- and higher-income samples, although the strength of the relationship differed between these samples. In both income samples, the foregoing relationship was consistent between men and women, although the strength of the relationship differed between men and women.

Musculoskeletal Disorders and Related Risk Factors in Iranian Military Personnel: A Systematic Review and Meta-Analysis.

Work-Related Musculoskeletal Disorders (WRMSDs) are prevalent and costly diseases in military occupations. WRMSDs are prevalent and costly diseases in military occupations. We investigated the exposure to ergonomic risk factors and the prevalence of musculoskeletal disorders (MSDs) among military personnel in the workplace. We aimed to investigate MSDs by conducting electronic searches on Persian databases such as SID, MagIran, and IranMedex, and English databases like PubMed, Web of Sciences, and Scopus. The search was not restricted by time and was conducted until Dec 20, 2021. Two researchers independently extracted the data, and the quality of the research was evaluated using the STROBE checklist. The results of different studies were merged and incorporated into the analysis using Comprehensive Meta-Analysis (CMA) v3 software. Eleven qualitative studies found that 92% of the respondents were men (83% to 96%). The mean age was 34.17 ± 0.16 yr, with a confidence interval (of 95% CI:33.85-34.48). The mean BMI was 25±0.39 with a confidence interval of 95% CI:24.28-25.84. The mean work record was 12.89±0.81 yr with a confidence interval of 95% CI:11.30-11.48. The highest outbreak of MSDs is in the knee at 38.1% (95%CI:32.1-44.4), 37.6% of the neck (95% CI:24.8-52.5), and 32.5% of the shoulder. (95%CI:22.5-44.3) was observed. The wide role of various dimensions of work tasks and repetitive tasks (such as lifting, moving or changing positions, standing for long periods, as well as improper postures) in causing WRMSDs. Additionally, the risk factor in the workplace has financial implications for the military organization. The reduction of physical and psychological demands, as well as the improvement of ergonomic standards in the workplace, should be addressed to decrease MSDs in military centers.

Long Term Outcomes of Endovascular Repair in Blunt Traumatic Aortic Injury: A Twenty Year Multicentre Follow Up Study

This retrospective, multicentre, observational study analysed patients who underwent endovascular repair for blunt traumatic aortic injury at four tertiary trauma referral centres over twenty years. It aimed to determine early and long term survival, analyse aortic and device related complications, and assess the re-intervention rate after endovascular repair for blunt traumatic aortic injury. All patients treated from 1 January 2001 to 31 October 2021 were identified using local hospital registries and two national registries: the Swedish vascular registry (Swedvasc) and Swedish trauma registry (SweTrau). Patient, treatment, and follow up data were extracted from medical records and radiology data by review of congregated imaging. The report was structured according to the STROBE checklist. Ninety five patients were included: 80 were male (84%), median age was 42 years (IQR 27, 64), and median follow up time was 6.1 years (IQR 0.7, 12.4). Thirty day mortality was 16% (15 of 93), 40% of these were caused by traumatic brain injury and 33% of aortic related causes. Estimated overall survival was 57% (SE 6.6) at fifteen years after index treatment. Aortic re-intervention procedures (re-stenting, coiling, or explantation) were performed in 14 of 86 (16%) patients, six of whom underwent stent graft explantation. Seven of the 14 patients (50%) who underwent aortic re-intervention presented with symptoms and six of 14 had a device related complication. All complications that required aortic re-intervention were diagnosed within 18 months after the index procedure. There was no association between injury grade and aortic re-intervention. Thoracic endovascular aortic repair is an effective treatment for patients with blunt traumatic aortic injury needing intervention. It carries low rates of device related complications and mortality, and the long term outcomes are acceptable. As all aortic complications requiring re-intervention were identified during the first two years after index treatment, with half of the patients reporting symptoms, future follow up protocols should be adjusted accordingly.

Abstract 4117868: The Mediation Effect of Self-care Self-efficacy between Illness Perceptions and Self-care Behaviors among People with Heart Failure

Introduction: Heart failure (HF) self-care behaviors are related to patient outcomes. The Common-sense Model of Self-Regulation indicates that illness perceptions and self-care self-efficacy are crucial predictors of self-care behaviors. However, research evidence is limited on these relationships. Aims: To explore the associations among illness perceptions, self-care self-efficacy, and self-care behaviors in people with HF. Methods: A cross-sectional study design was adopted. People with HF were recruited from a tertiary hospital between February and April 2023 in China. All the participants were assessed for illness perceptions, self-care self-efficacy, and self-care behaviors. Data were analyzed using Pearson correlation and mediation analyses. The study was reported following the STROBE checklist. Results: A total of 164 people with HF were enrolled. Pearson analysis reported the negative correlations between the scores of illness perceptions and the scores of self-care maintenance (r=-0.344, p&lt;0.001), symptom perception (r=-0.352, p&lt;0.001), and self-care management (r=-0.519, p&lt;0.001), as well as the positive associations between the scores of self-care self-efficacy and the scores of self-care maintenance (r=0.689, p&lt;0.001), symptom perception (r=0.697, p&lt;0.001), and self-care management (r=0.771, p&lt;0.001). Moreover, a significant negative relationship between the scores of illness perceptions and the scores of self-care self-efficacy was observed (r=-0.527, p&lt;0.001). Mediation analysis reported that the scores of self-care self-efficacy completely mediated the negative relationships between the scores of illness perceptions and the scores of self-care maintenance, symptom perception, and self-care management, and the mediation effect accounted for 71.4%, 72.5%, and 88.2% of the total effect, respectively. Conclusions: Among people with HF, self-care self-efficacy completely mediated the relationships between illness perceptions and self-care behaviors. Interventions targeting improving illness perceptions and self-care self-efficacy may enhance HF self-care behaviors.

The Association of Health Literacy With the Quality of Discharge Planning and Readiness for Hospital Discharge in Jordanian Acute Myocardial Infarction Patients.

To examine the relationship between health literacy with the quality of discharge planning and readiness for hospital discharge in acute myocardial infarction patients in Jordan. Acute myocardial infarction is a major heart disease caused by plaque formation in coronary arteries. Complications after acute myocardial infarction include readmission and physical complications such as chest pain, and limited health literacy increases the risk of complications. Improving the health literacy of patients can improve postdischarge outcomes and decrease complications. This study was conducted using a cross-sectional design. Data were collected from 123 patients who were recruited from three hospitals in Jordan. A demographics questionnaire and three valid and reliable instruments (Health Literacy Questionnaire, Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale) were used to collect the data. The authors adhered to the STROBE checklist during the preparation of this study. The results demonstrated that the Readiness for Hospital Discharge had weak to moderate positive correlations with health literacy scales (r = 0.24-0.36, p < 0.05). The content subscale of the Quality of Discharge Teaching Scale showed weak positive correlations with navigating the healthcare system, finding good health information and understanding health information scales of the Health Literacy Questionnaire. The results reported here indicate that health literacy positively correlates with readiness for hospital discharge and quality of discharge teaching. Improving the health literacy of acute myocardial infarction patients can enhance their discharge planning outcomes. The findings of this study are beneficial for healthcare providers in designing targeted interventions that correspond to health literacy among acute myocardial infarction patients. No patient or public contribution.

Interns' and Junior Nurses' Workplace-Violence Perceptions, Coping Confidence and Attitudes Towards Violence Management: A Structural Equation Model Analysis.

To investigate interns' and junior nurses' perceptions, coping confidence and attitudes towards workplace violence in China. Cross-sectional survey study involving 622 interns or nurses with < 5 years of hospital experience. Data were gathered from the largest tertiary hospital in southwestern mainland China using a general information questionnaire, the Perception of Aggression Scale, the Confidence in Coping with Patient Aggression Instrument and the Management of Aggressive and Violence Attitude Scale. Structural equation modelling was used to understand relationships and pathways between the nurses' perceptions of, confidence in dealing with and attitudes towards managing workplace violence. The average scores for the perception of workplace violence, confidence in coping with workplace violence and attitudes towards violence management were 37.44 (±11.60), 29.84 (±8.23) and 81.87 (±23.72), respectively. Perceptions of workplace violence, confidence in coping with workplace violence and attitudes towards violence management show low to moderate correlations; confidence in coping with workplace violence was the mediating variable in the interactions among the three variables. Interns and junior nurses have weaker perceptions of workplace violence, lower confidence in their ability to cope with violence and more negative attitudes towards violence management. Perceptions of workplace violence affected attitudes towards violence management through the intermediary role of confidence in coping with workplace violence. Nursing managers should increase education and training to improve interns' and junior nurses' awareness and confidence in dealing with workplace violence. Healthcare organisations should prevent and manage workplace violence to develop nurses' positive attitudes towards violence management. The study adhered to the STROBE checklist of cross-sectional studies. Interns and nurses with < 5 years of experience participated by voluntarily completing a paper questionnaire.

Job satisfaction among nurses in Eastern Mediterranean Region hospitals: a systematic review and meta-analysis

BackgroundJob satisfaction is the extent to which an employee feels positively or negatively toward their job. Hospitals with high job satisfaction among nurses provide higher-quality nursing care, resulting in higher patient satisfaction.AimsThis study was conducted to determine job satisfaction among nurses in Eastern Mediterranean Region (EMR) hospitals.MethodsThis research was a meta-analysis of research on job satisfaction among nurses in EMR hospitals. All studies published in three databases (PubMed, Scopus, Web of Science) and Google Scholar search engine were searched, collected, and assessed for quality. The STROBE checklist was used to determine the quality of the studies. Finally, 13 articles were analyzed using the CMA software.ResultsBased on the random effects model, the overall job satisfaction among nurses in EMR hospitals was 17.9% (95% CI (11.9–26.0)). The highest job satisfaction was in hospitals in Palestine. Job satisfaction among nurses was higher in high-income countries than in others. The level of job satisfaction was also higher in private hospitals. Moreover, the results showed that average age and sample size caused heterogeneity between the reviewed studies (p < 0.05).ConclusionAccording to the results of this study, about 18% of nurses in EMR hospitals felt satisfied with their job. Therefore, healthcare managers and policymakers in the EMR region must identify and eliminate the causes of dissatisfaction.