Comparing the effectiveness of mind-body practices (MBPs) and various psychological methods on occupational stress among healthcare workers: a network meta-analysis of randomized controlled trials.

OBJECTIVES: The purpose of this study is to compare the efficacy of mind-body practices (MBPs) and multiple psychological methods, and identify the optimal method for relieving work-related stress among healthcare workers (HCWs) by network meta-analysis (NMA). METHODS: We applied six electronic databases, namely PubMed, Web of Science, Embase, PsycINFO, Cochrane, and Chinese National Knowledge Infrastructure to identify relevant RCTs from inception to September 16, 2023, and implemented a search strategy based on the PICOS principles. Data selection, extraction, and analysis of bias were carried out independently and in duplicate by separate researchers. State 16.0 was used to conduct NMA for comparing the effectiveness of various therapies. RESULTS: We identified 23 studies including MBPs and three different psychological therapies, namely mindfulness-related therapy (MRT), psychoeducational therapy (PT), and comprehensive therapy (CT), which were divided into eleven specific techniques, namely yoga, meditation techniques (MT), Qigong, muscle relaxation(MR), biofeedback therapy (BT), mindfulness-based interventions (MBIs), modified mindfulness-based stress reduction (MBSR-M), mindfulness-based interventions combined with others (MBIs-C), mindfulness-based awareness(MBA), PT and CT. Our NMA results of MBPs and three psychological therapies showed MBPs (SMD = -0.90, CrI:-1.26, -0.05, SUCRA = 99%) were effective for occupational stress in HCWs, followed by MRT(SMD = -0.48, CrI:-0.87, -0.08, SUCRA = 66.5%). NMA results of eleven specific techniques showed yoga (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 97.5%) was the most effective technique in relieving the stress of HCWs, followed by MR (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 87.3%). CONCLUSIONS: Our study suggested MBPs may be the most effective intervention to improve the occupational stress of HCWs. Furthermore, yoga is likely to be the most optimal of MBPs. Hospital managers should attach importance to yoga in addressing occupational stress among medical workers.

Relationship between moral resilience and secondary traumatic stress among ICU nurses: A cross-sectional study.

BACKGROUND: Since the outbreak of COVID-19, researchers worldwide have focused more on the issue of secondary traumatic stress (STS) experienced by nurses. This stress has an adverse effect on the health of nurses and the quality of nursing care, potentially undermining the stability of the nursing team and hindering the ability to meet the growing demand for nursing services. The impact of the COVID-19 pandemic, and the rise in global demand for ICU nursing, has placed a significant strain on ICU nurses, severely damaging their mental and physical health. Notably, ICU nurses also face high levels of moral distress, and moral resilience can effectively alleviate this distress and improve the quality of care. AIMS: This study aimed to examine the levels of moral resilience and STS among ICU nurses, to explore their relationship and identify the factors influencing STS. STUDY DESIGN: This cross-sectional study involved 229 ICU nurses from two tertiary hospitals in Xi'an, China, who participated between November and December 2023. The data were collected through email using anonymous electronic questionnaires, encompassing a self-designed demographic- and work-life-related characteristic questionnaire; the Rushton Moral Resilience Scale; and the Secondary Traumatic Stress Scale. Descriptive statistics, t-tests, analysis of variance and hierarchical regression analysis were performed to analyse the data. RESULTS: The findings of the study indicated that ICU nurses' moral resilience and STS scores were at an intermediate level. Hierarchical regression analysis indicated that STS was negatively correlated with the subscales of the Rushton Moral Resilience Scale, specifically moral adversity coping (ß, -0.156; 95% CI, -1.241 to -0.039) and relational integrity (ß, -0.245; 95% CI, -1.453 to -0.388), which are significant predictors of STS. Additionally, good sleep quality (ß, -.396; 95% CI, -14.948 to -7.117) and seeking psychological counselling because of work difficulties (ß, .107; 95% CI, 0.237-9.624) emerged as significant predictors of STS among ICU nurses, with the model's explanation of the variance in STS increasing to 45.5%, △R2 = .167, F = 16.482 (p < .001). CONCLUSION: This study found that ICU nurses have moderate levels of moral resilience and STS, which are negatively correlated. This suggests that improving the moral resilience of ICU nurses may help reduce their STS levels. RELEVANCE TO CLINICAL PRACTICE: The study revealed that ICU nurses' moral resilience and secondary traumatic stress levels were at a moderate level, indicative of the need to take measures to enhance their moral resilience and reduce their secondary traumatic stress, as their presence not only affects the health of ICU nurses but also diminishes the quality of care and increases turnover rates.

Global research trends in nursing leadership from 1985 to 2022: a bibliometric analysis.

PURPOSE: Developing nursing leadership has become a key policy priority to achieve universal health coverage. This study aims to explore the current status, developing trends and research frontiers in the field of nursing leadership. DESIGN/METHODOLOGY/APPROACH: In total, 1,137 articles and reviews on nursing leadership from 1985 to 2022 were retrieved from the Web of Science Core Collection database. Trends of publications, journals, countries/regions, institutions, documents and keywords were visualized and analyzed using Microsoft Excel and CiteSpace software. FINDINGS: Nursing leadership research showed an overall increase in number despite slight fluctuations in annual publications. The USA was the leading country in nursing leadership research, and the University of Alberta was the most productive institution. The Journal of Nursing Management was the most widely published journal that focused on nursing leadership, followed by the Journal of Nursing Administration. Keyword analysis showed that the main research hotspots of nursing leadership are improvement, practice and impact of nursing leadership. ORIGINALITY/VALUE: This article summarizes the current state and frontiers of nursing leadership for researchers, managers and policy makers, as well as follow-up, development and implementation of nursing leadership. More research is needed that focuses on the improvement, practice and impact of nursing leadership, which are cyclical, complementary and mutually reinforcing. Longitudinal and intervention studies of nursing leadership, especially on patient prognosis, are also particularly needed.

Construction and application of the core competence course training system for infectious disease specialist nurses.

OBJECTIVES: This study aims to construct and apply a training course system which was scientific and comprehensive to foster the core competence of infectious disease specialist nurses. DESIGN: A two-round Delphi consultation survey was carried out to collect feedback from experts on constructing the training course system of core competence for infectious disease specialist nurses. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the courses. METHODS: This study adopted a series of methods including group discussion, theoretical analysis and Delphi consultation to draft the training course content of core competence of infectious disease specialist nurses. Twenty-one Chinese experts were invited to participate in the Delphi consultation from November 2021 to December 2021. From October 2022 to January 2023, a total of 105 infectious disease specialist nurses from two training bases were selected by the convenience sampling method, of which the nurses in one training base were the control group and the nurses in the other training base were the observation group. The observation group was trained by the constructed core competence training course. Questionnaire evaluation was used to compare the core competence of infectious disease specialist nurses and the training effect. RESULTS: The experts, regarded as the authorities on the subject, were highly motivated in this study. Besides, they reached a consensus on the results. The final training course system of core competence for infectious disease specialist nurses focused on 5 competence modules and was composed of 12 categories of courses with 66 classes and corresponding objectives. The core competence scores of the observation group were significantly higher than those in the control group after training (P < 0.05), which proved the training system can effectively enhance the core competence of infectious disease specialist nurses. CONCLUSIONS: The research methods embodied scientific and precise properties. The course system was comprehensive in content and reliable in results. It could serve as a reference for training infectious disease specialist nurses.

Insomnia and anxiety among COVID-19 patients in China: the chain mediating effect of psychological capital and self-esteem.

BACKGROUND: The outbreak of Corona Virus Disease (COVID-19) in 2019 has continued until now, posing a huge threat to the public's physical and mental health, resulting in different degrees of mental health problems. As a vulnerable segment of the public, anxiety is one of the most common mental health problems among COVID-19 patients. Excessive anxiety aggravates the physical and psychological symptoms of COVID-19 patients, which is detrimental to their treatment and recovery, increases financial expenditure, affects family relations, and adds to the medical burden. OBJECTIVE: This study aimed to explore the role of psychological capital and self-esteem in the relationship between insomnia and anxiety, thereby shedding light on the mechanism of the effect of insomnia on anxiety in COVID-19 patients. METHODS: A cross-sectional study was conducted from April to May 2022 in Fangcang hospital in Shanghai, China. The self-administered questionnaires were distributed to 718 COVID-19 patients via cell phone using the Internet platform "Questionnaire Star", which included Athens Insomnia Scale, Psychological Capital Questionnaire, Self-esteem Scale, Self-Rating Anxiety Scale, gender, age, marital status, education. Data analysis was performed using descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analysis, ordinary least-squares regression, and bootstrap method. RESULTS: Education background had significant impact on anxiety in COVID-19 patients (F = 7.70, P < 0.001). Insomnia, psychological capital, self-esteem and anxiety were significantly correlated, respectively (P < 0.001). And Regression analysis showed that insomnia had a direct negative predictive effect on psychological capital (ß = -0.70, P < 0.001) and self-esteem (ß = -0.13, P < 0.001). Psychological capital had a direct positive predictive effect on self-esteem (ß = 0.12, P < 0.001). Insomnia had a direct positive predictive effect on anxiety (ß = 0.61, P < 0.001). Both psychological capital and self-esteem had significant negative predictive effects on anxiety (ß = -0.06, P < 0.05; ß = -0.72, P < 0.001). The results showed that the mediating effect of psychological capital and self-esteem was significant, and the mediating effect value was 0.21. First, the indirect effect consisting of insomnia - psychological capital - anxiety was 0.04, showing that psychological capital had a significant mediating effect. Second, the indirect effect consisting of insomnia-self-esteem-anxiety had a value of 0.10, indicating that self-esteem had a significant mediating effect. Third, the indirect effect consisting of insomnia-psychological capital-self-esteem-anxiety had a value of 0.06, suggesting that psychological capital and self-esteem had a significant chain mediating effect between insomnia and anxiety. CONCLUSIONS: Insomnia had a significant positive predictive effect on anxiety. Insomnia was first associated with a decrease in psychological capital, followed by a sequential decrease in self-esteem, which in turn was associated with increased anxiety symptoms in COVID-19 patients. Therefore, focusing on improving the psychological capital and self-esteem of patients can help alleviate the anxiety caused by insomnia in COVID-19 patients. It is recommended that patients and health care professionals increase the psychological capital and Self-esteem of COVID-19 patients through various methods to counter the effects of insomnia on anxiety.

Relationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis.

BACKGROUND: Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses. METHOD: A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure. RESULTS: The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability. CONCLUSION: The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.

The biosafety incident response competence scale for clinical nursing staff: a development and validation study.

AIMS: This study was designed to develop a biosafety incident response competence scale and evaluate its validity and reliability among clinical nurses. DESIGN: This study employed a sequential approach, comprising four phases: (1) the establishment of a multidimensional conceptual model, (2) the preliminary selection of the items, (3) further exploration and psychometric testing of the items, (4) the application of the scale among clinical nurses. METHODS: The biosafety incident response competence conceptual model was developed through literature review and the Delphi method. A total of 1,712 clinical nurses participated in the preliminary items selection, while 1,027 clinical nurses were involved in the further psychometric testing from July 2023 to August 2023. The item analysis, exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the construct validity. Reliability was measured using Cronbach's alpha, split-half reliability, and test-retest reliability, while validity analysis included content validity, structural validity, convergent validity, and discriminant validity. From September to November 2023, we conducted a survey using the established scale with a total of 4338 valid questionnaires collected. T-test and variance analysis was employed to determine potential variations in biosafety incident response competence based on participants characteristics. RESULTS: The final scale is composed of 4 factors and 29 items, including monitoring and warning abilities, nursing disposal abilities, biosafety knowledge preparedness, and infection protection abilities. The explanatory variance of the 4 factors was 75.100%. The Cronbach's alpha, split-half reliability and test-retest reliability were 0.974, 0.945 and 0.840 respectively. The Scale-level content validity index was 0.866. The Average Variance Extracted of the 4 factors was larger than 0.5, the Construct Reliability was larger than 0.7, and the Heterotrait-Monotrait ratio were less than 0.9. There were significant differences in the scores of response competence among nurses of different ages, working years, titles, positions, departments, marital status and participation in biosafety training (all P < 0.05). CONCLUSIONS: The biosafety incident response competence scale for nurses exhibits satisfactory reliability and validity, making it a valuable tool for assessing clinical nurses' abilities in responding to biosafety incidents.

Heterogeneity of work alienation and its relationship with job embeddedness among Chinese nurses: a cross-sectional study using latent profile analysis.

OBJECTIVE: To identify the distinct profiles of work alienation among Chinese nurses, examine the demographic factors associated with profile memberships, and then explore the relationship between latent categories of work alienation and job embeddedness. METHODS: A cross-sectional survey of 523 nurses was conducted from July to August 2023. Latent profile analysis (LPA) was performed to identify distinct profiles of nurses based on three aspects: powerlessness, helplessness, and meaningfulness. A multinomial logistic regression analysis was conducted to explore the predictors of profile membership. Hierarchical regression analysis was carried out to examine the association between profile memberships and job embeddedness. RESULTS: Three subgroups of work alienation of nurses were identified: 23.1%, 57.8%, and 19.1% in the low work alienation group (profile 1), the moderate work alienation group (profile 3), and the high work alienation group (profile 2), respectively. Nurses with college degrees were more likely to be grouped into moderate work alienation. Nurses who did not work night shifts were more likely to have low or moderate levels of work alienation. Nurses earning 2,000-3,000 and 3,001-5,000 yuan per month were likely to be in the low work alienation group. The different categories of work alienation significantly predicted job embeddedness among nurses (ΔR2 = 0.103, p < 0.001). CONCLUSIONS: Work alienation has an important impact on clinical nurses' job embeddedness. Nursing managers should pay attention to the differences in individual work alienation status and adopt reasonable management strategies to improve the level of job embeddedness, ensure the quality of care, and reduce nursing turnover.

Patterns of information literacy and their predictors among emergency department nurses: a latent profile analysis based on the person-context interaction theory.

BACKGROUND: With the development of information technology, information has been an important resource in clinical medicine, particularly within the emergency department. Given its role in patient rescue, the emergency department demands a high level of information literacy from nurses to effectively collect, analyze, and apply information due to the urgency and complexity of emergency nursing work. Although prior studies have investigated the information literacy of nursing staff, little has been undertaken in examining the patterns of information literacy and their predictors among emergency department nurses. AIM: To clarify the subtypes of information literacy among nurses in the emergency department and explore the factors affecting profile membership. METHODS: A cross-sectional study was conducted among a convenience sample of 2490 nurses in the emergency department from April to June 2023. The clinical nurses completed the online self-report questionnaires including the general demographic questionnaire, information literacy scale, self-efficacy scale and social support scale. Data analyses involved the latent profile analysis, variance analysis, Chi-square tests and multivariate logistic regression. RESULTS: Four latent profiles were identified: 'Low information literacy (Class 1)', 'Moderate information knowledge (Class 2)', 'High information knowledge and support (Class 3)' and 'High information literacy (Class 4)', accounting for 20.14%, 42.11%, 23.36% and 14.39%, respectively. Each profile displayed unique characteristics representative of different information literacy patterns. Age, years of work, place of residence, hospital grade, title, professional knowledge, using databases, reading medical literature, participating in information literacy training, self-efficacy, and social support significantly predicted information literacy profile membership. CONCLUSIONS: Information literacy exhibits different classification features among emergency department nurses, and over half of the nurses surveyed were at the lower or middle level. Identifying sociodemographic and internal-external predictors of profile membership can aid in developing targeted interventions tailored to the needs of emergency department nurses. Nursing managers should actively pay attention to nurses with low information literacy and provide support to improve their information literacy level. RELEVANCE TO CLINICAL PRACTICE: Insights from the current study of the latent profile analysis are beneficial to hospital managers in understanding the different types of emergency department nurses' information literacy. These insights serve as a reference for managers to enhance nurses' information literacy levels.

The relationship between role ambiguity and anxiety in intensive care unit nurses: The mediating role of emotional intelligence.

BACKGROUND: Role ambiguity is recognized as a significant psychological risk stressor in nursing practice, which undermines the psychological well-being of nurses. Since the well-being of nurses plays a crucial role in ensuring positive patient outcomes, it becomes imperative to identify strategies for improving nurses' psychological well-being. OBJECTIVES: This study aimed to explore the effects of role ambiguity on anxiety in intensive care unit nurses and the mechanisms mediating emotional intelligence. METHODS: In April-June 2023, a convenience sampling method was used to collect data from 360 intensive care unit nurses in a total of 7 hospitals in Shaanxi Province, Hunan Province, Beijing, and Jiangsu Province, China. A linear regression model was used to verify the mediating effect. RESULTS: Role ambiguity was significantly and positively associated with anxiety in ICU nurses (p < 0.01). A mediating mechanism between role ambiguity and anxiety was established for emotional intelligence (p < 0.01). CONCLUSIONS: Role ambiguity has a significant impact on the mental health of intensive care nurses, and emotional intelligence plays a mediating role in reducing role ambiguity and anxiety in nurses. IMPLICATIONS FOR CLINICAL PRACTICE: This study highlights that role ambiguity in the intensive care unit setting increases nurses' anxiety, while emotional intelligence alleviates the anxiety associated with role ambiguity. Creating support systems and improving the environment is a top priority for nursing administrators. This includes, but is not limited to, clarifying the roles of nurses, conducting social-emotional training, and developing emotional intelligence to prevent and regulate nurses' anxiety and maintain mental health.

Factors influencing work engagement among male nurses: A structural equation model.

AIM: To investigate the male nurses' engagement in nursing work and the influencing factors. DESIGN: A cross-sectional study. METHODS: A cross-sectional survey was conducted in 13 hospitals in China to collect data from 328 male nurses from August to October 2021. A structural equation model design was tested with validated measurement instruments. RESULTS: The work engagement of male nurses in China was at a medium level. There was a high correlation of the male nurses' work engagement with career identity (r = 0.764, p < 0.01), career success (r = 0.735, p < 0.01) and social support (r = 0.477, p < 0.01). The linear multivariate regression analysis showed that career satisfaction (ß = 0.393), career identity (ß = 0.392) and subjective support (ß = 0.116) entered regression equation of male nurses' work engagement (all p < 0.05). The structural equation model results showed that career identity and social support were the influencing factors of the male nurses' work engagement and the model explained variation of 66.4% variables. CONCLUSION: To know the male nurses' work engagement and influencing factors in China has certain enlightening significance for male nurses themselves and nursing manager. On the one hand, it is necessary to enhance the male nurses' career recognition to nursing work. On the other hand, the society should provide more aid and support to the male nurses. Therefore, the male nurses could devote more into nursing work and promote the nursing development.

Construction and application on the training course of information literacy for clinical nurses.

DESIGN: A two-round Delphi survey was conducted to seek opinions from experts about the index system for the evaluation of training courses of clinical nursing staff's information literacy. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the training courses. AIMS: This study intended to construct a training course of information literacy for clinical nurses, train nurses in order to improve their information literacy level and provide theoretical reference for the training of information literacy courses for clinical nurses. METHODS: Two rounds of Delphi study were conducted for the study among 26 clinical medical and nursing experts as well as educational experts from 5 different provinces and cities in China. From July 2022 to October 2022, a total of 84 clinical nurses from two hospitals were selected by the convenience sampling method, of which the nurses in one hospital were the control group and the nurses in the other hospital were the observation group. 42 nurses in the observation group were trained by the constructed information literacy training course. Questionnaire evaluation was used to compare the differences in the level of information literacy of nurses and the training effect between the two groups. RESULTS: The results of the Delphi consultation showed that the expert's judgment coefficient was 0.958, the expert's familiarity was 0.946, and the expert's authority coefficient was 0.952. Finally, a training course of information literacy for clinical nurses with 4 course categories and 45 specific course contents was formed. Among them, nursing information awareness included 7 courses, nursing information knowledge 15 courses, nursing information ability 19 courses, and nursing information ethics 4 courses. The results of the empirical study showed that the information literacy level of the nurses in the observation group after the training of the information literacy course was improved, and the scores in nursing information awareness, nursing information knowledge, nursing information ability, and information ethics were significantly higher than those in the control group after training (P < 0.05). CONCLUSIONS: The constructed information literacy training courses for clinical nurses were clearly targeted and systematic. Empirical research showed that the course contents were scientific and reasonable, which could provide reference for the training of clinical nurses' information literacy.

Influencing factors of quality of life among front-line nurses who collected nucleic acid samples during COVID-19: a path analysis.

Aim: The aim of this study is to investigate the quality of life of nurses who collected nucleic acid samples throughout the COVID-19 epidemic's routine management, as well as the factors that may have influenced it. Background: After the outbreak of COVID-19, normalized epidemic prevention and control throughout China were implemented. Nucleic acid testing has become an effective measure for the early detection of virus-infected individuals. Nurses collecting nucleic acid samples undertake important tasks. Their quality of life is significant to maintaining team stability and containing the epidemic. However, research on their quality of life is still limited. Methods: A cross-sectional survey was conducted on 1,292 nurses who collected nucleic acid samples from five tertiary general hospitals in Xi'an through self-reported electronic questionnaires (including general demographic information, the Connor-Davidson Resilience Scale, the Social Support Rating Scale, and the World Health Organization Quality of Life Brief Scale). Descriptive, one-way ANOVA and multiple linear regression were performed using SPSS 26.0. Structural equation modeling was used to analyze the influencing factors. Results: The nurses collecting nucleic acid samples had a modest level of quality of life. Age, marital status, average daily sleep duration, frequency of exercise, psychological resilience, and social support were all influencing factors of quality of life, according to multiple linear regression analysis. Quality of life was found to be significantly related to psychological resilience and social support. Conclusion: Demographic characteristics, psychological resilience, and social support are the factors affecting the quality of life of nurses who collect nucleic acid samples. Nursing managers should focus more on these factors to improve the quality of life for nurses. Relevance to clinical practice: Nursing managers should realize the importance of the quality of life of nurses who collect nucleic acid samples in maintaining a vigorous nursing team and ensuring optimized epidemic control. Social support should also be provided to nurses to improve their psychological resilience, thereby improving their quality of life.

The relationship between role ambiguity, emotional exhaustion and work alienation among chinese nurses two years after COVID-19 pandemic: a cross-sectional study.

BACKGROUND: work alienation is receiving increasing attention as a psychological risk at work, and little is known about the mechanisms of role ambiguity and work alienation in nurses in the context of the COVID-19 pandemic. This article aims to examine how role ambiguity affects work alienation among Chinese nurses during the two years after COVID-19 pandemic and verify emotional exhaustion as mediators. METHODS: A cross-sectional study design was used to recruit 281 Chinese nurses. Nurses completed online questionnaires containing demographic characteristics, role ambiguity, emotional exhaustion, and work alienation, and SPSS 26.0 and AMOS 24.0 were used for data analysis and structural equation modelling. RESULTS: work alienation scores were (34.64 ± 10.09), work alienation was correlated with role ambiguity and emotional exhaustion (r1 = 0.521, r2 = 0.755; p < .01), and role ambiguity was positively correlated with emotional exhaustion (r = 0.512; p < .01). A mediating effect of emotional exhaustion between role ambiguity and work alienation held (mediating effect of 0.288, 95% CI: 0.221-0.369, accounting for 74.8% of the total effect). CONCLUSION: Role ambiguity has a significant direct effect on nurses' feelings of alienation and exacerbates alienation through emotional exhaustion. Clarifying roles at work and being less emotionally drained are effective ways to reduce nurses' feelings of alienation.

Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support.

BACKGROUND: COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship. METHODS: The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses. RESULTS: Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01). CONCLUSION: Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

Characteristics and influencing factors of social isolation in patients with breast cancer: a latent profile analysis.

PURPOSE: The goal of this study is to investigate the social isolation (SI) subtypes of patients with breast cancer (BC) and to explore its influencing factors. METHODS: A sample of 303 BC patients participated in the study from September to December, 2021. Latent profile analysis (LPA) was performed to identify SI clusters based on the three sub-scales of the Chinese version of the Social Anxiety Scale, the Chinese version of the Social Avoidance and Distress Scale, and the Chinese version of the Loneliness Scale. RESULTS: We found that SI can be divided into three categories: high-level (Class 1), middle-level (Class 2), and low-level (Class 3), accounting for 20.46%, 33.00%, and 46.54%, respectively. Compared to Class 3, Class 1, which had the lower average monthly income per family member (RMB) (< 3000: OR = 5.298, P = .021; 3000 ~ 5000: OR = 5.320, P = .018), was more likely to suffer from SI due to occupation (Laborer: OR = 12.023, P = .009). Surgery (OR = 14.138, P < .001; OR = 2.777, P = .020), chemotherapy (OR = 10.224, P = .001; OR = 3.545, P = .001); poorer family functioning (OR = .671, P < .001; OR = .801, P = .002), and lower levels of self-transcendence (OR = .806, P < .001; OR = .911, P < .001) were important influencing factors for SI in Class 1 and Class 2 compared to Class 3. CONCLUSION: SI is classifiably heterogeneous among patients with BC. Strategies that identify characteristics of SI and give targeted intervention focusing on family functioning and improving self-transcendence levels contribute to the prevention of SI among patients with BC.

The relationship between components of hypoglycemia worries and avoiding hypoglycemia behavior in type 2 diabetes mellitus with hypoglycemia: a network analysis.

BACKGROUND: The fear of hypoglycemia in type 2 diabetes mellitus (T2DM) patients with hypoglycemia has seriously affected their quality of life. They are always afraid of hypoglycemia and often take excessive action to avoid it. Yet, researchers have investigated the relationship between hypoglycemia worries and excessive avoiding hypoglycemia behavior using total scores on self-report measures. However, network analysis studies of hypoglycemia worries and excessive avoiding hypoglycemia behavior in T2DM patients with hypoglycemia are lacking. PURPOSE: The present study investigated the network structure of hypoglycemia worries and avoiding hypoglycemia behavior in T2DM patients with hypoglycemia and aimed to identify bridge items to help them correctly treat hypoglycemia and properly deal with hypoglycemia fear. METHODS: A total of 283 T2DM patients with hypoglycemia were enrolled in our study. Hypoglycemia worries and avoiding hypoglycemia behavior were evaluated with the Hypoglycemia Fear Scale. Network analyses were used for the statistical analysis. RESULTS: B9 "Had to stay at home for fear of hypoglycemia" and W12 "I am worried that hypoglycemia will affect my judgment" have the highest expected influences in the present network. In the community of hypoglycemia worries, W17 "I worry about hypoglycemia during sleep" has the highest bridge expected influence. And in the community of avoiding hypoglycemia behavior, B9 "Had to stay at home for fear of hypoglycemia" has the highest bridge expected influence. CONCLUSION: Complex patterns of associations existed in the relationship between hypoglycemia worries and avoiding hypoglycemia behavior in T2DM patients with hypoglycemia. From the perspective of network analysis, B9 "Had to stay at home for fear of hypoglycemia" and W12 "I am worried that hypoglycemia will affect my judgment" have the highest expected influence, indicating their highest importance in the network. W17 "I worry about hypoglycemia during sleep" aspect of hypoglycemia worries and B9 "Had to stay at home for fear of hypoglycemia" aspect of avoiding hypoglycemia behavior have the highest bridge expected influence, indicating they have the strongest connections with each community. These results have important implications for clinical practice, which provided potential targets for interventions to reduce hypoglycemia fear and improve the quality of life in T2DM patients with hypoglycemia.

The relationship between psychosocial job stressors and insomnia: The mediating role of psychological capital.

AIM: This study aimed to examine the association of job-related stressors and insomnia; to determine the association of psychological capital and insomnia; and to explore whether psychological capital mediates the association between job-related stressors and insomnia among Chinese nurses. DESIGN: A cross-sectional questionnaire survey. METHODS: The STROBE statement was utilized to guide the study. A total of 810 nurses from one tertiary grade hospital in Shan Dong Province, China, were recruited for the present study and a total of 658 valid questionnaires were obtained (effective recovery rate: 81.2%). The study survey consisted of demographic variables, psychological capital, job stress and insomnia. Descriptive analysis, independent-samples T-test, one-way analysis of variance, stratified regression analysis, Pearson correlation analyses, ordinary least-squares regression and the bootstrap method were used to analyse data. RESULTS: Findings of the study determined that demographic, work-related, behavioural and work setting (i.e. working hours, chronic disease, negative life events, smoking behaviour and night shift) factors were differentially associated with experiences of insomnia. The empirical study showed that psychological capital had statistically significant mediating effects between job stressors and insomnia. PUBLIC CONTRIBUTION: This study explored the factors associated with nurses' psychological job stressors and insomnia. Some of the associated factors could be used for the prevention and mitigation of psychosocial dysfunction among nurses. This study found nurses in surgery, emergency department, ICU, working >40 h a week, with chronic illness, experiencing negative life events, shift work and high effort, high overcommitment and low reward had higher scores of insomnia respectively. The results of this study also showed that reward was correlated with the increase of psychological capital, and the increase of psychological capital was correlated with the decrease of insomnia in nurses. On the contrary, effort and overcommitment decreased psychological capital, and then increased insomnia among nurses. These findings have important implications for future research and policy interventions to improve sleep quality of nurses and enhance nurses' health and patients' safety. This study significantly suggests that improving nurses' psychological capital is a potential way to help nurses improve sleep quality when psychosocial job stressors are difficult external environment to change.

Knowledge, attitudes and behaviors toward healthy eating among Chinese cancer patients treated with chemotherapy: A systematic review.

Side effects from chemotherapy may disturb healthy eating. There are many food taboos among Chinese patients with cancer treated with chemotherapy; they may be conservative in food intake and seek help from traditional Chinese medicine to adjust to healthy eating. Differences in eating cultures may lead Chinese patients with cancer to generate different knowledge, attitudes, and behaviors toward healthy eating. This systematic review explored the knowledge, attitudes, and behaviors toward healthy eating and summarized influencing factors among Chinese patients with cancer treated with chemotherapy. Two English and three Chinese databases were searched since 2007. The eligibility criteria were quantitative descriptive studies, participants who were adult Chinese patients with cancer who received chemotherapy, and primary outcomes that included knowledge, attitudes, or behaviors toward healthy eating. A total of 12 studies were identified. The 11-item tool from the Agency for Healthcare Research and Quality was used to assess quality. All studies were of moderate quality. Narrative qualitative analysis was considered to summarize the findings, and the results were reported by scores or percentages. Four studies measured knowledge, and the information about what to eat and how much to eat was contradictory and confused patients, with little known about Chinese food therapy. Ten studies involved attitudes, and patients were aware of the importance and willingness for eating guidance before, during, and after chemotherapy. Strategies to relieve vomiting and nausea, engage in healthy food choices, and seek food therapy were the main behaviors. The influencing factors were found only in behaviors, including demographic and psychological factors. Knowledge, attitudes, and behaviors toward healthy eating are not satisfactory and need to be improved. More high-quality studies should regard health behavior as a distal outcome and explore the influences of knowledge and attitudes on behaviors.

Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital.

Aim: COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods: A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results: Three latent profiles were identified-low security (Class 1), moderate security (Class 2), and high security (Class 3)-accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3; Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions: Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.