Association of nurse managers' paternalistic leadership and nurses' perceived workplace bullying: The mediating effect of organizational climate.

AIMS: To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association. BACKGROUND: There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational-level solutions to prevent it. METHODS: A cross-sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire-Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis. RESULTS: A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate. CONCLUSION: The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses. IMPACT: This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

Scope and inclination of voluntary service for urban community-living older adults provided by volunteers with nursing background: A qualitative study.

BACKGROUND: With the growing challenge of an aging population, addressing the needs of elderly individuals who face living difficulties and lack family support becomes increasingly difficult. Volunteer services are crucial in this context, yet their effectiveness is hindered by unclear service scopes and uncertain volunteer inclinations. AIM: To explore the role and specific preference of volunteers with nursing backgrounds in support of older adults living in the urban community. DESIGN, SETTING AND PARTICIPANTS: A descriptive qualitative study was conducted between September and October 2022. Twenty-three participants (hospital nurses [10], community nurses [4], nursing teachers [4] and nursing students [5]) were selected. Data analysis followed conventional content analysis. RESULTS: Nine major themes were identified based on interview data. Four themes described the service scope of nursing volunteers: (1) environment domain, (2) physiological domain, (3) psychosocial domain and (4) health-related behaviours domain. Another five themes highlighted the service inclination of these volunteers: (1) service frequency, (2) service duration per person/time, (3) service coverage, (4) service place and (5) service object. CONCLUSION: This study clarifies the service focus and scope of necessary support for volunteers, exploring the potential service capabilities of scarce volunteers to the greatest extent. Meanwhile, the results of this study also provide a foundation for stakeholders to fully exploit the synergy. The important findings of this study will help the government and relevant authorities better understand the service attributes of nursing volunteers, allowing them to develop detailed training plans and provide nursing volunteers with targeted support and assistance to meet the health expectations of urban community-living older adults in need. PATIENT OR PUBLIC CONTRIBUTION: Developing research questions, participation and conduct and provision and interpretation of evidence.

An analysis of the influencing factors of depression in older adults under the home care model.

Objectives: To explore and analyze the influencing factors of depression in older adults living at home, so as to propose suggestions for improving the quality of older adults living at home. Methods: We conducted a cross-sectional study on 498 older adults living at home based on questionnaire survey on the general information, daily living ability, health status, and care perception (including self-care, care for cohabitants, and care for non-cohabitants) of older adults living at home, as well as their willingness to help each other, and analyzed the influencing factors of depression among older adults living at home. Results: The results showed a willingness to help older adults, self-care, and total activities of daily living (ADL), health status was an influential factor for depression in older adults (p < 0.05). Conclusion: It aims to take targeted measures, such as encouraging older adults at home to actively participate in mutual assistance activities for older adults and care for themselves, so as to prevent and reduce the occurrence of depression in older adults.

Factors associated with the perceived need for assistance from voluntary services in home-based older adults in Chinese urban areas: a cross-sectional study.

BACKGROUND: With China's rapidly aging population, meeting the diverse care needs of senior citizens is becoming more challenging. Although voluntary social services have numerous advantages and are popular among older adults, there is little information on the need for assistance from volunteer-based social services, particularly those with a medical background, and influencing factors among urban home-based older adults. This study aimed to assess the need for assistance from voluntary services and related factors among urban home-based older adults in China. METHODS: A cross-sectional study was conducted in 2022 on communities in four cities in China. The 27-item Home-Based Older Adults Assistance Need Scale was used to measure the assistance needs of 498 participants aged 60 and above. Multiple linear regression models were conducted to identify salient variables associated with the need for assistance from voluntary services. RESULTS: The mean score of the need for assistance from voluntary services was 88.60 ± 24.37. The mean scores of the items examining four dimensions, namely, health maintenance, visiting communication, social intercourse, and daily life, were 3.64 ± 1.08, 3.49 ± 1.04, 3.33 ± 1.08, and 2.78 ± 1.08, respectively. The level of depression, willingness to assist older adults, attaching importance to health preservation, ability to self-comfort, desire to accept assistance from others, and the presence of more children or none at all were all positively correlated with the perceived need for assistance from voluntary services. In contrast, social care obtained from visiting medical institutions was negatively correlated. These seven factors explained 28.5% of the total variance. CONCLUSIONS: Urban home-based older adults in China were found to have significant requirements for assistance from volunteer services, and several complex factors were associated with more significant assistance needs. These findings may encourage the extremely limited numbers of social volunteers, particularly those with a medical background, to identify priorities in providing assistance services to the large numbers of urban home-based older adults and thus improve service delivery.

Nurse managers' perceptions and experiences of caring behavior for clinical nurses: a multicenter survey.

BACKGROUND: Humanistic care management is a necessary measure to improve the motivation and initiative of clinical nurses and is the foundation to improve the quality of nursing. Understanding the current status and identifying the influencing factors that promote or hinder humanistic care behaviors is essential. This study investigated the current status and experiences of nurse managers' caring behaviors toward clinical nurses. METHODS: We conducted a mixed-methods study with an explanatory sequential design. A survey on the nurse managers' caring behaviors in 101 hospitals from 23 provinces and four municipalities in China was investigated (n = 2022). Then, semi-structured interviews were conducted to obtain information about the participants' experiences associated with the performance of caring behaviors (n = 27). RESULTS: Survey data demonstrated that the nurse managers' overall caring behaviors were moderately good. The total scoring rate was 88.55%, and the overall score was 161.19 ± 20.68. Qualitative data revealed that the capacity of nurse managers and clinical nurses, opportunity, and motivation to implement humanistic care are key influencing factors of caring behaviors. CONCLUSIONS: The results suggested that intrinsic motivation, organizational support, and the humanistic care capabilities of clinical nurses and nurse managers are vital to implementing care behaviors. Thus, successful humanistic care management requires a concerted effort at the individual and organizational levels.

Patient satisfaction with humanistic nursing in Chinese secondary and tertiary public hospitals: a cross-sectional survey.

Background: Humanistic care pertains to the abilities, attitudes, and behaviors central to patient-centered care, contributing to patients' sense of safety and wellbeing. This study aimed to assess the satisfaction of patients with humanistic nursing care in Chinese secondary and tertiary public hospitals. Methods: A national cross-sectional survey was conducted across 30 provinces and 83 hospitals in China. Patient satisfaction with humanistic care was assessed using the Methodist Health Care System Nurse Caring Instrument (NCI), which encompasses 20 items across 12 dimensions. Each item was rated on a 7-point Likert scale, yielding a total score of 140. Multiple linear regression analysis was employed to identify factors associated with patients' satisfaction. Results: Moderate satisfaction (mean score 91.26 ± 13.14) with humanistic nursing care was observed among the 17,593 participants. Factors significantly associated with patient satisfaction included age, hospital type, presence of children, educational attainment, place of residence, family monthly income, and medical insurance type. Conclusion: The study findings highlight the importance of tailored interventions, evidence-based practice guidelines, and patient-centered care in improving patients' satisfaction with humanistic nursing care. Continuous emphasis on nursing education and professional development is crucial for enhancing humanistic care and patient satisfaction.

Factors influencing parent-child relationships in chinese nurses: a cross-sectional study.

BACKGROUND: With the development of the social economy, the effective coordination of the conflict between work and family has become an urgent problem for most parents. Such conflicts are especially acute in the families of nurses with children. Therefore, a timely understanding of the status quo of the parent-child relationship and associated risk factors among nurses will assist in improving their family harmony and the healthy growth of their children. METHODS: A total of 350 nurses with children at a general tertiary hospital in Sichuan Province, China, were interviewed using a structured questionnaire between June 23 and July 9, 2022. The results were analyzed by multiple linear regression using the stepwise method. RESULTS: The results showed that the parent-child relationship received a middle-level mean score of 77.74 (SD = 10.77). The factors that influenced the parent-child relationship among nurses included the parents' character type (ß = 0.143, P = 0.002), feeling tired due to dealing with patients (ß=-0.150, P = 0.002), the nurse-patient relationship (ß = 0.137, P = 0.004), the age of older children (ß=-0.153, P = 0.001), number of children (ß=-0.093, P = 0.041), sleep quality (ß = 0.116, P = 0.014), and family adaptability (ß = 0.308, P = 0.000); these factors accounted for 31.3% of the variance in parent-child relationships among nurses. CONCLUSION: The findings of this study will help policy makers and nursing managers to better understand parent-child relationships in Chinese nurses. The results highlighted the importance of the creation of a family-oriented work environment while paying more attention to the parent-child relationships of nurses who are introverted and have more or older children. After busy workdays, nurses should also be encouraged to participate more in family decision-making and strategic parent-child interactions to avoid negative effects on children caused by work-related emotional exhaustion, physical and mental fatigue, and other reasons. The development of good parent-child relationships may help maintain both their and their children's mental health while enhancing their enthusiasm for work and their professional identity.

Analysis of Shear Model for Steel-Fiber-Reinforced High-Strength Concrete Corbels with Welded-Anchorage Longitudinal Reinforcement.

According to the shear capacity test results of six steel-fiber-reinforced high-strength concrete (SFHSC) corbels with welded-anchorage longitudinal reinforcement under concentrated load, the effects of shear span ratio and steel fiber volume fraction on the failure mode, cracking load and ultimate load of corbel specimens were analyzed. On the basis of experimental research, the shear transfer mechanism of corbel structure was discussed. Then, a modified softened strut-and-tie model (MSSTM), composed of the diagonal and horizontal mechanisms, was proposed, for steel-fiber-reinforced high-strength concrete corbels. The contributions of concrete, steel fiber and horizontal stirrups to the shear bearing capacity of the corbels were clarified. A calculation method for the shear bearing capacity of steel-fiber-reinforced high-strength concrete corbels was established and was simplified on this basis. The calculation results of the model were compared with the test values and calculation results of the GB50010-2010 code, the ACI318-19 code, the EN 1992-1-1 code and the CSA A23.3-19 code. The results showed that the concrete corbel with small shear span ratio mainly has two typical failure modes: shear failure and diagonal compression failure. With the increase in shear span ratio, the shear capacity of corbels decreases. Steel fiber can improve the ductility of a reinforced concrete corbel, but has little effect on the failure mode of the diagonal section. The calculated values of the national codes were lower than the experimental values, and the results were conservative. The theoretical calculation values of the shear capacity calculation model of the corbels were close to the experimental results. In addition, the model has a clear mechanical concept considering the tensile properties of steel-fiber-reinforced high-strength concrete and the influence of horizontal stirrups, which can reasonably reflect the shear transfer mechanism of corbels.

How work-family conflict influences emergency department nurses' turnover intention: The mediating role of positive and negative affect.

BACKGROUND: Turnover has significant impact on nursing management and nursing safety. Nurses working in the Emergency Department are especially vulnerable to high turnover intention because of their increased risk of work-family conflict associated with the work characteristics. OBJECTIVE: This study aimed to investigate the effects of work-family conflict on emergency nurses' turnover intention and the role of positive and negative affect between work-family conflict and turnover intention. METHODS: A cross-sectional study. Data were collected from 17582 nurses working in emergency department in China. We employed a standardized questionnaire to collect sociodemographic information and target work-family conflict, affect and turnover intention. Mediation analyses were performed for the data analyses. RESULTS: On turnover intention, work-family conflict exerted both direct effect and indirect effect. The results also indicated that positive and negative affect partially mediated the effect of work-family conflict on turnover intention, and that 35.7% of this effect could be explained by mediating effects totally. CONCLUSIONS: The findings highlight positive and negative affect concern during the process of nursing management and nursing managers should take active measures to reduce negative affect and improve positive affect in order to reduce turnover intention and maintain the stability of the emergency nursing workforce.

Experiences and expectations of receiving volunteer services among home-based elderly in Chinese urban areas: A qualitative study.

BACKGROUND: The various complex needs for assistance among home-based older adults have increased dramatically. Thus, it would be advantageous to recruit volunteers with medical knowledge and a better understanding to support and assist the elderly living in urban communities. AIM: This study aimed to explore the experiences and expectations of receiving volunteer services among the home-based elderly in Chinese urban areas. DESIGN, SETTING AND PARTICIPANTS: A descriptive qualitative study was conducted following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. This study was performed in two communities in Wuhan, Hubei Province. A purposive sampling method, which includes criterion and maximum variation sampling, was used to identify and select a diverse range of participants. Semistructured face-to-face interviews with 20 older adults (aged 62-90 years old) were performed. The conventional content analysis method was used for thematic analysis. RESULTS: Three categories with associated subcategories were identified: experiences of receiving volunteer services including negative and positive experiences; specific needs for volunteer services involving physiological, psychosocial, health-related behaviours and environmental domains; characteristics of expected volunteer services including availability, formats, recipients, providers and service strategies. CONCLUSIONS: The volunteer services provided to the home-based elderly were found to be unsatisfactory, and lacking relevance and effectiveness. Due to a lack of family support or difficulty in meeting some high-level needs, the home-based elderly expressed a strong demand for volunteer services involving physiological, psychosocial, health-related behaviours and environmental domains. This finding can provide a basis for developing training plans beneficial to volunteers. Furthermore, the present research clarifies the criteria for selecting volunteers and the necessity of supervising and managing volunteers. Improving the effectiveness and accessibility of urban-community volunteer service may reduce the burden on care institutions and home caregivers while enhancing the quality of life and well-being of the elderly. PATIENT OR PUBLIC CONTRIBUTION: Developing research questions, study design, management and conduct and interpretation of evidence.

A caring leadership model in nursing: A grounded theory approach.

AIM: This study aimed to develop a theoretical model of caring leadership in nursing. BACKGROUND: Nurse leader's role plays an integral part in complex health care institutions. As a common feature of leaders, leaders' caring leadership can positively influence the stakeholders in health care institutions. Still, little is known about caring leadership in nursing, especially in the Chinese cultural background. METHODS: Grounded theory was used to develop the theoretical model of caring leadership. Both semi-structured interviews and open-ended questionnaire surveys were used to collect data for constructing the theory model. Ten nurse leaders and 11 nurse staff were recruited for an interview, and 168 nurse leaders and 286 nurses were recruited for an open-ended questionnaire survey. RESULTS: A theoretical model of caring leadership was developed using five core attributions: benevolent to others, appreciate the uniqueness, facilitate self-actualization, maintain mutual benefit and motivate with charisma. Caring leadership in nurse leaders works through the caring and leading process, resulting in nurses' well-being, patients' healing and organisational excellence. CONCLUSION: A caring leadership model was developed through grounded theory, revealing Chinese nurses' perspectives on caring leadership in Chinese cultural background. According to the model, the concept of caring leadership has been further explained, and it makes contributions to the measurement and leaders' practice in health care institutions. IMPLICATIONS FOR NURSING MANAGEMENT: This caring leadership model developed in our study provides a new perspective and understanding of caring and leadership for nurse leaders. Nurse leaders need to strengthen their responsibilities and personal qualities while caring for nurse staff to improve leadership efficacy based on the theoretical model. And caring leadership can help nurse leaders to balance the interests of stakeholders, leading to positive consequences for nurse staff, patients and health care organisations.

Formally reporting incidents of workplace violence among nurses: A scoping review.

AIM: We aim to describe and synthesize the scientific literature on nurses' formal reporting of workplace violence. BACKGROUND: Research on reporting workplace violence among nurses is increasing annually, but the evidence from such reports has not been summarized or analysed. EVALUATION: A scoping review was conducted using electronic databases including PubMed, Web of Science, Scopus, CINAHL and Ovid-Embase. KEY ISSUES: Forty-nine studies were included in this review, and four significant issues pertinent to reporting of workplace violence was identified: (1) the reporting rate is generally low, and oral report is the most popular medium; (2) nurses are often not satisfied with how the organisation handles their report; (3) the reasons affecting reporting are complex and diverse; and (4) few studies have proposed countermeasures to promote reporting formally. CONCLUSIONS: Scholars are paying increasing attention to workplace violence; however, the reporting of workplace violence in real world situations is not being facilitated to inform improvements in managing violence in the workplace. Therefore, more countermeasures conducive to reporting urgently need to be put forward. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers are in a pivotal position to encourage reporting by their staff, respond pro-actively and advocate for more streamlined and accessible processes. The findings of this review can provide a basis for nursing managers to better manage workplace violence and improve the reporting rate among nurses.

Nurse-to-nurse horizontal violence in Chinese hospitals and the protective role of head nurse's caring and nurses' group behaviour on it: A cross-sectional study.

AIMS: This study aimed to analyse the prevalence of nurse-to-nurse horizontal violence in Chinese hospitals and examine the effects of head nurse's caring and nurse's group behaviour on horizontal violence. BACKGROUND: Horizontal violence is a serious global problem affecting the nursing profession, but little is known of the issue in Chinese hospitals. Increasing evidence has showed that leadership and group factors are important in facilitating horizontal violence. Whether the head nurse's caring and group behaviour perceived by nurses has protective effects against horizontal violence remains unclear. METHODS: A cross-sectional online-based questionnaire study was performed in seven general hospitals in Hubei Province, China. Data related to the demographic information, horizontal violence, head nurse's caring and group behaviour were collected. Descriptive analyses, chi-squared tests and logistic regression were used for data analysis. RESULTS: In total, 1942 valid questionnaires were collected, with a 92.70% effective response rate (1942/2095). Of those, 59.1% (1148/1942) of respondents had experienced horizontal violence at least once in the previous 6 months. Covert negative behaviours were more frequently reported. Compared with the low level, moderate and high levels of the head nurse's caring showed a lower risk of horizontal violence (odds ratio [OR] = 0.400, p < .001; OR = 0.128, p < .001); moderate and high levels of group behaviour also showed a reduced risk (OR = 0.601, p < .001; OR = 0.221, p < .001). CONCLUSION: Horizontal violence is common among Chinese nurses. The head nurse's caring and maintaining a good climate of nurses' group behaviours could serve as protective factors for preventing horizontal violence. IMPLICATIONS FOR NURSING MANAGEMENT: This study helps nursing managers identify which specific negative behaviours occur frequently and require special attention. It suggests that nursing managers attach importance to improving their caring ability towards nurses and to creating an amicable climate of group behaviour to buffer against horizontal violence.

Comparative proteomics analysis of Schistosoma japonicum developed in different Oncomelania snails as intermediate hosts.

Schistosomiasis is a tropical parasitic disease that seriously endangers humans and animals. In this study, two Oncomelania snails, Oncomelania hupensis (O. hupensis) and Oncomelania weishan (O. weishan), were infected with Schistosoma japonicum (S. japonicum) cercariae during the early period, and ICR mice were subsequently infected with two kinds of miracidia that developed in male and female adult worms. In this study, isobaric tags for relative and absolute quantification (iTRAQ) were used to identify four channels: 113, 115, 117, and 119. A total of 2364 adult schistosome proteins were identified, and 1901 proteins were quantitative. Our results revealed 68 differentially expressed proteins (DEPs) in female adult worms, including 24 upregulated proteins and 44 downregulated proteins, and 55 DEPs in male adult worms, including 25 upregulated proteins and 30 downregulated proteins. LC-MS/MS and bioinformatics analysis indicated that these DEPs are mainly concentrated in cellular composition, molecular function, biological function and catabolism pathways. In summary, this proteomics analysis of adult schistosomes that hatched in two intermediate hosts helps to improve our understanding of the growth and developmental mechanisms of S. japonicum.

Corrigendum: Comparative proteomics analysis of Schistosoma japonicum developed in different Oncomelania snails as intermediate hosts.

[This corrects the article DOI: 10.3389/fcimb.2022.959766.].

Expert Consensus on Nurses' Human Caring for COVID-19 Patients in Different Sites.

This study aims to develop the expert consensus on nurse's human caring for Corona Virus Disease 2019 (COVID-19) patients in different sites, and thus provide a guideline on providing whole process and systematic caring for COVID-19 patients. Based on the frontline experiences of human caring for COVID-19 patients and the review of literature, the initial draft of consensus was made and finalized after online meeting and revisions. The experts reached consensus on the following parts: terms and definitions, principles of human caring for COVID-19 patients, and human caring measures for COVID-19 patients in different sites. The expert consensus is practical, concise, and reasonable for guiding the nurses providing human caring for COVID-19 patients, as well as other similar infectious diseases.

Comparing the association of cardiovascular nursing care with blood pressure and length of stay of in-patients with coronary artery disease in Wuhan, China.

BACKGROUND: Coronary artery disease is a leading cause of morbidity and mortality worldwide. Comorbidity-like hypertension has been among the major risks of coronary artery disease. Recent evidence identified multiple benefits of cardiovascular nursing care to coronary patients. However, little has been appraised on benefits regarding patients' blood pressure control and length of hospitalisation. OBJECTIVE: To compare the association of cardiovascular nursing care delivered to coronary artery patients with patients' blood pressure and length of stay. METHODS: Records based retrospective design was applied at a large teaching hospital in Wuhan, China. SPSS 21 version was used for data entry and analysis with univariate and multivariate logistic regression models for comparing study variables. RESULTS: Of 300 patients, 224 (74.7%) were known to be hypertensive and admitted with subnormal blood pressure. Cardiovascular nursing care like "assess to grade pain severity on 1-10 scale" and "counsel patient to cope with stress" were six and three times more likely to contribute improved patients' blood pressure (AOR=5.8; 95%CI: 2.8-12.2, p=0.001) and (AOR=3.1; 95%CI: 1.2-7.8, p=0.015) respectively. No significant difference with length of stay (p>0.05). CONCLUSION: There is a possibility of coronary artery patients to recover with normal blood pressure following reception of evidence-based cardiovascular nursing care.