Mediação de saberes na sobrevivência ao câncer de laringe: a experiência de pessoas Laringectomizadas Totais / Mediation of knowledge in surviving laryngeal cancer: the experience of Total Laryngectomized persons / Mediación del conocimiento en la supervivencia al cáncer de laringe: la experiencia de las personas sometidas a Laringectomía Total

O presente estudo parte de reflexões acerca da sobrevivência ao câncer e da experiência estigmatizante vivenciada por pessoas diagnosticadas com câncer de laringe no Hospital Nacional do Câncer/Instituto Nacional do Câncer, submetidas à cirurgia de Laringectomia Total e participantes do Grupo de Laringec-tomizados Totais. O objetivo foi compreender as mediações de saberes e de informações produzidas pelos participantes do grupo na interface com os profissionais de saúde, considerando a sua dupla condição de estigma: o câncer e a deficiência. Parte-se de uma abordagem socioantropológica de caráter qualitativo e ex-ploratório que empregou os métodos de entrevista narrativa com cinco participantes. A análise foi realizada pelo método hermenêutico-dialético. Nos resultados destacam-se a busca pelo reconhecimento individual e social e a valorização da experiência frente aos saberes oficiais e o quanto as mediações extrapolam o espaço institucional. A mediação de saberes faz emergirem elementos significativos para o enfrentamento de uma cultura informacional dominante.

This study is based on reflections on surviving cancer and the stigmatizing experience of people diagnosed with laryngeal cancer at the Hospital Nacional do Câncer/Instituto Nacional do Câncer, who underwent Total Laryngectomy surgery and participated in the Total Laryngectomy Group. The goal was to understand the mediations of knowledge and information produced by the group participants, in the interface with health professionals, considering their double condition of stigma: cancer and disability. It is based on a socio-anthropological approach, of qualitative and exploratory nature that employed the narrative interview method with five participants. The analysis was carried out through the hermeneutic-dialectic method. The results highlight the search for individual and social recognition and the appreciation of experience in relation to official knowledge, and how the mediations go beyond the institutional space. The mediation of knowledge brings out significant elements to confront a dominant informational culture.

El presente estudio se basa en las reflexiones sobre la supervivencia al cáncer y la experiencia estigmatiza-dora de personas diagnosticadas de cáncer de laringe en el Hospital Nacional do Câncer/Instituto Nacional do Câncer, que se sometieron a una Laringectomía Total y participaron en el Grupo de Laringectomía Total. Objetivo: comprender las mediaciones de conocimiento e información producidas por los participantes del grupo, en la interfaz con los profesionales de salud, considerando su doble estigma: cáncer y discapacidad. Se basa en un abordaje socioantropológico, cualitativo y exploratorio, que utilizó métodos de entrevista narrativa con cinco participantes. El análisis ocurrió a través del método hermenéutico-dialéctico. Los resultados destacan la búsqueda de reconocimiento individual y social y la valorización de la experiencia en relación con el conocimiento oficial y la medida en que las mediaciones van más allá del espacio insti-tucional. La mediación del conocimiento pone de manifiesto elementos significativos sobre una cultura informacional dominante.

El médico de familia como mediador en conflictos vinculados a la salud

Introducción: La mediación adquiere elevada significación social, a partir de su vínculo con la prevención y solución de conflictos. Sin embargo, la revisión bibliográfica y la experiencia profesional de los autores indican que el tema es insuficientemente tratado en relación con el desempeño asistencial del médico de familia. El objetivo del artículo consistió en valorar aspectos asociados a este profesional como mediador en conflictos vinculados a la salud. Métodos: Investigación cualitativa comprendida entre febrero de 2023 y junio de 2023 en el área de salud del Policlínico Docente "René Vallejo Ortiz". Se emplearon métodos teóricos como el análisis y síntesis, el histórico-lógico y la sistematización. En el orden empírico se empleó la revisión de documentos y la encuesta a médicos de familia. Resultados: Fueron develados criterios valorativos sobre aspectos legales, curriculares, metodológicos y asistenciales vinculados al tema. También se obtiene, a partir de la autopercepción del médico de familia, valoraciones sobre la preparación para un desempeño mediador. Discusión: Se valoran integralmente aspectos asociados al médico de familia como mediador en conflictos vinculados a la salud y se revela una correspondencia con estudios precedentes respecto a la necesidad de optimizar en la educación médica la mediación como contenido de enseñanza. Conclusiones: Se enfatiza que el desempeño mediador del médico de familia en los conflictos vinculados a la salud, no se reducen a las posibilidades de intervención reconocidas en el ordenamiento jurídico. Se corrobora la pertinencia del tema y la necesidad de introducir trasformaciones en este sentido.

Introduction: Mediation acquires high social significance, based on its link with the prevention and resolution of conflicts. However, the bibliographic review and the professional experience of the authors indicate that the topic is insufficiently addressed in relation to the care performance of the family doctor. The objective of the article was to assess aspects associated with this professional as a mediator in conflicts related to health. Methods: Qualitative research between february 2023 and june 2023 in the health area of ​​the "René Vallejo Ortiz" Teaching Polyclinic. Theoretical methods such as analysis and synthesis, historical-logical and systematization were used. In the empirical order, the review of documents and the survey of family doctors were used. Results: Evaluative criteria on legal, curricular, methodological and healthcare aspects linked to the topic were revealed. Assessments of preparation for mediation performance are also obtained from the family doctor's self-perception. Discussion: Aspects associated with the family doctor as a mediator in conflicts related to health are comprehensively assessed and a correspondence with previous studies is revealed regarding the need to optimize mediation as teaching content in medical education. Conclusions: It is emphasized that the mediating performance of the family doctor in conflicts related to health is not reduced to the possibilities of intervention recognized in the legal system. The relevance of the topic and the need to introduce transformations in this sense are corroborated.

Estrategia pedagógica para la preparación del profesor de Educación Física como mediador de conflictos

El logro de una educación accesible y de calidad para todos los ciudadanos es, en la actualidad, una de las prioridades para la formación de profesionales, puesto que estos contribuyen al desarrollo de un sistema de educación reconocido, tanto a nivel nacional como internacional. De esta manera, el estudio realizado se propuso como objetico diseñar una estrategia pedagógica para la preparación al profesor como mediador de conflictos en la clase de Educación Física, de las escuelas secundarias básicas del municipio La Habana del Este. Para ello, se utilizó un enfoque mixto, con el fin de agrupar los análisis de documentos y las descripciones cualitativas junto a tablas y figuras para complementar y enriquecer el estudio cualitativa y cuantitativamente. Como principal resultado, se evidenciaron los principios, premisas y el procedimiento metodológico para la integración de influencias educativas. En sentido general, la preparación del profesor como mediador de conflictos da respuesta a los programas priorizados del Ministerio de Educación en su agenda de perfeccionamiento hacia el 2030 y del Instituto Nacional de Deporte, Educación Física y Recreación.

A concretização de um ensino acessível e de qualidade para todos os cidadãos é atualmente uma das prioridades para a formação dos profissionais, uma vez que contribuem para o desenvolvimento de um sistema educativo reconhecido, tanto a nível nacional como internacional. Desta forma, o estudo propôs desenhar uma estratégia pedagógica para preparar o professor como mediador de conflitos nas aulas das escolas secundárias básicas do município de La Habana del Este. Para isso, foi utilizada uma abordagem mista, de modo a agrupar a análise de documentos e descrições qualitativas com tabelas e figuras para complementar e enriquecer o estudo, tanto qualitativo como quantitativo. O principal resultado é a integração das influências educacionais, os fundamentos, princípios, premissas e procedimento metodológico. De um modo geral, é evidente a preparação do professor como mediador de conflitos, respondendo aos programas prioritários do Ministério da Educação em aperfeiçoamento para 2030 e do Instituto Nacional de Esportes, Educação Física e Recreação.

The achievement of accessible and quality education for all citizens is, currently, one of the priorities for the training of professionals, since they contribute to the development of a recognized education system, both nationally and internationally. In this way, the objective of the study carried out was to design a pedagogical strategy to prepare the teacher as a conflict mediator in the Physical Education class, in the basic secondary schools of the municipality of La Habana del Este. For this purpose, a mixed approach was used, in order to group document analyzes and qualitative descriptions together with tables and figures to complement and enrich the study qualitatively and quantitatively. As the main result, the principles, premises and methodological procedure for the integration of educational influences were evident. In a general sense, the preparation of the teacher as a conflict mediator responds to the prioritized programs of the Ministry of Education in its improvement agenda towards 2030 and of the National Institute of Sports, Physical Education and Recreation.

Orientação sexual e sintomas depressivos: papel mediador da autoestima e satisfação com a vida / Sexual orientation and depressive symptoms: mediating role of self-esteem and life satisfaction / Orientación sexual y síntomas depresivos: papel mediador de la autoestima y la satisfacción con la vida

Objetivo: verificar se autoestima e satisfação com a vida exercem efeitos mediadores na relação entre orientações sexuais minoritárias e sintomatologia depressiva em amostra de pós-graduandos stricto sensu. Método: estudo analítico, transversal, conduzido com 321 pós-graduandos stricto sensu entre março/abril de 2021. Utilizou-se o Patient Health Questionnaire-9 para avaliação de sintomas depressivos, Escala de Autoestima de Rosemberg e Escala de Satisfação com a Vida. Análises de mediação simples foram conduzidas por meio da macro PROCESS. Resultados: pós-graduandos de orientações sexuais minoritárias apresentaram maior severidade de sintomas depressivos e menores indicadores de autoestima e satisfação com a vida do que seus pares heterossexuais. Autoestima e satisfação com a vida mediaram parcialmente a relação entre orientação sexual e severidade de sintomas depressivos em uma proporção de, respectivamente, 48,26% e 37,54%. Conclusão: autoestima e satisfação com a vida apresentaram-se como importantes mediadores da relação entre orientações sexuais minoritárias e sintomas depressivos entre pós-graduandos.

Objective: to verify whether self-esteem and satisfaction with life exert mediating effects on the relationship between minority sexual orientations and depressive symptoms in a sample of graduate students. Method: analytical, cross-sectional study conducted with 321 Brazilian graduate students between March/April 2021. The Patient Health Questionnaire-9 was used to assess depressive symptoms, was used too, Rosemberg´s Self-Esteem Scale and the Life Satisfaction Scale. Simple mediation analyzes were conducted using the PROCESS macro. Results: graduate students with minority sexual orientations had more severe depressive symptoms and lower indicators of self-esteem and life satisfaction than their heterosexual peers. Self-esteem and satisfaction with life partially mediated the relationship between sexual orientation and severity of depressive symptoms in a proportion of, respectively, 48.26% and 37.54%. Conclusion: self-esteem and life satisfaction were important mediators of the relationship between minority sexual orientations and depressive symptoms among graduate students.

Objetivo: verificar si la autoestima y la satisfacción con la vida ejercen efectos mediadores en la relación entre las orientaciones sexuales minoritarias y la sintomatología depresiva en una muestra de estudiantes de posgrado stricto sensu. Método: estudio transversal analítico realizado junto a 321 estudiantes de posgrado stricto sensu entre marzo y abril de 2021. Para evaluar los síntomas depresivos, se utilizó el Patient Health Questionnaire-9, la Escala de Autoestima de Rosemberg y la Escala de Satisfacción con la Vida. Los análisis de mediación simple se realizaron utilizando la macro PROCESS. Resultados: los estudiantes de posgrado con orientaciones sexuales minoritarias presentaron síntomas depresivos más severos y menores indicadores de autoestima y satisfacción con la vida que sus pares heterosexuales. La autoestima y la satisfacción con la vida mediaron parcialmente la relación entre la orientación sexual y la severidad de los síntomas depresivos en una proporción de, respectivamente, 48,26% y 37,54%. Conclusión: la autoestima y la satisfacción con la vida fueron importantes mediadores de la relación entre la orientación sexual minoritaria y los síntomas depresivos entre estudiantes de posgrado.

Uso pasivo de redes sociales y malestar psicológico. El rol de la comparación social / Passive use of social media sites and psychological distress. The role of social comparison

Resumen La presente investigación se focalizó en los diferentes tipos de uso (activo/pasivo) que hacen los usuarios de redes sociales y los efectos psicológicos que esto puede conllevar, sobre todo en aquellos sujetos tendientes a compararse con los demás. Por un lado, se examinó el poder predictor de variables relacionadas al uso de redes sociales (i. e., tiempo de conexión, tipo de uso -pasivo/activo-, motivaciones de uso) y la comparación social, sobre el malestar psicológico percibido (i. e., depresión, ansiedad, estrés). Por otro lado, se analizó el rol mediador de la comparación social en la relación entre el uso pasivo de redes sociales y la percepción de malestar psicológico percibido. La muestra fue de conveniencia y estuvo compuesta por 420 sujetos de población general (211 hombres, 209 mujeres), con una media de edad de 40.29 años (DE = 14.93). Se utilizaron los siguientes instrumentos de recolección de datos: Motives for SMSs use Scale; Iowa-Netherlands Comparison Orientation Measure (INCOM-E), Depression, Anxiety and Stress Scale (DASS-21) y una escala diseñada ad-hoc para evaluar el uso activo y pasivo que se hace de redes sociales. Los resultados obtenidos mostraron que la comparación social es el principal predictor de malestar psicológico junto con el motivo de uso relacionado con pasatiempo/exhibicionismo. Además, se pudo comprobar un efecto indirecto del uso pasivo sobre el malestar psicológico considerando a la comparación social como variable mediadora. Por lo tanto, usar pasivamente las redes generaría mayor malestar si el usuario tiende a compararse con quienes realizan las publicaciones.

Abstract The present investigation is framed in the field of cyberpsychology. It aimed to analyze the predictive power of variables related to the use of social media sites -SMSs- (i. e., connection time, type of use -passive / active-, motivations for use) and social comparison, on perceived psychological distress (i. e., depression, anxiety, stress). Furthermore, the mediating role of social comparison in the relationship between the passive use of SMSs and the perceived psychological distress, was also analyzed. It is important to study these topics since different international studies have shown inconsistent and contradictory results regarding the effects of SMSs use on individuals' well-being (e. g., Frison y Eggermont, 2015; Kraut et al., 2002; Nie et al., 2015). Consequently, some studies have focused on understanding whether the manner in which people use the networks, whether actively or passively, explains how technology impacts on users' well-being and/or psychological distress (Verduyn et al., 2015). The negative impact of passive use of SMSs can be explained by the Social Comparison Theory (Festinger, 1954), which suggests that people tend to evaluate themselves in comparison with others. These comparisons might generate negative effects on the individual (Giagkou et al., 2018) and, according to Lup et al. (2015), social comparison may be a mediating variable in this association. Regarding participants of the study, a convenience sample of 420 subjects of general population was studied (211 men, 209 women). The mean age was 40.29 years old (SD = 14.93). The majority of the participants (n = 278) lived in Buenos Aires City and surroundings. In terms of variables related to the use of SMSs, when asked about type of SMSs, most participants reported using more than one SMS, mainly Facebook (72 %) and Instagram (57 %). Regarding time spent on SMSs, 60 % of the respondents used their favorite SMS more than three times a day. The mean daily time engaged on all the SMSs exceeded five hours. Data were gathered using the Motives for SMSs use Scale (Lupano Perugini y Castro Solano, 2021a), the Iowa-Netherlands Comparison Orientation Measure (INCOM-E) (Buunk et al., 2005; Gibbons y Buunk, 1999), the Depression, Anxiety and Stress Scale (DASS-21) (Antúnez y Vinet, 2012; Lovibond y Lovibond, 1995). Furthermore, a survey to assess individuals' use of social networks was designed. The first part explored the most frequently used SMSs, the number and type of friends/followers, and the time spent on SMSs. The main SMSs were listed and participants were asked to indicate whether they used them or not, and if they did, they rated the amount of time spent on SMSs daily. The total amount of time per day was also surveyed. The second part of the survey was designed based on The Passive Active Use Measure (PAUM, Gerson et al., 2017) and some users' suggestions. This instrument assesses the frequency of certain activities performed on the networks to find out if participants make active use (e. g., posting information, commenting) or passive use (e. g., viewing profiles and posts, scrolling). The obtained results showed that social comparison is the main predictor of psychological distress. The motivation for use related to pass time / exhibitionism was also a significant predictor. In addition, an indirect effect of passive use on perceived psychological distress could be verified, considering social comparison as a mediating variable. Therefore, using the social networks passively would generate greater discomfort if the user tends to compare themselves with those who make the publications. The results of this study allow both users and healthcare and education providers to have greater knowledge of the consequences of using social media on individuals' overall well-being, and to promote their proper use.

Revisão sistemática sobre resolução de problema e mediação de conflito pela terapia cognitivo-comportamental / Systematic review on problem solving and conflict mediation by cognitive-behavioral therapy

RESUMO Objetivo: Na prática clínica, é importante diferenciar problema e conflito, porque os passos sugeridos na técnica de resolução de problemas costumam não ser suficientes para auxiliar o cliente a lidar com conflitos. Esta revisão sistemática teve como objetivos: investigar como a terapia cognitivo-comportamental (TCC) pode auxiliar na resolução de problemas e na mediação de conflito; sugerir uma estratégia que favoreça a melhor capacidade de mediar conflitos (QPD). Métodos: Foi realizada uma busca nas bases de dados: PubMed, PsycINFO, Web of Science (ISI) e Scopus. O método prisma foi utilizado, e foram selecionados para leitura na íntegra artigos experimentais. Resultados: Trezentos e sessenta e quatro ensaios clínicos aplicaram a resolução de problemas, apontando a eficácia dessa técnica juntamente com outras estratégias/intervenções da TCC. Livros-guias de TCC: não diferenciam problema e conflito; descrevem detalhadamente passos para resolução de problemas, focando na perspectiva do cliente, no momento presente e no uso da razão lógica; não abordam a mediação de conflitos pela TCC. Sugerimos uma estratégia que pode ajudar na mediação de conflitos: auxiliando na coleta/organização de informações; melhorando a comunicação - empática e assertiva; favorecendo escolhas com o intuito de causar o menor dano possível a todas as partes envolvidas no conflito. Conclusões: Para treinar terapeutas para aplicarem a resolução de problemas, há descrição detalhada dos passos a serem seguidos. Entretanto, para capacitar os terapeutas para mediarem conflitos, práticas clínicas que têm sido frequentemente descritas/utilizadas nas terapias cognitivas contextuais podem ser necessárias: aceitação psicológica, mindfulness , entender valores individuais, vivenciar/considerar a emoção em tomadas de decisão, ativar a compaixão/autocompaixão.

ABSTRACT Objective: It is important to differentiate between problem and conflict in clinical practice, because the steps suggested in the problem-solving technique are usually not enough to help patients deal with conflicts. This systematic review aimed to: investigate how cognitive-behavioral therapy (CBT) can help in problem solving and conflict mediation; suggest a strategy that can improve conflict mediate skills (QPD). Methods: A search was performed in the following databases: PubMed, PsycINFO, Web of science (ISI) and Scopus. Prisma flow diagram was used and experimental articles were selected for full reading. Results: Three hundred and sixty four clinical trials applied problem solving, showing the effectiveness of this technique with other CBT strategies/interventions. CBT guide books: do not differentiate between problem and conflict; describe in detail problem solving steps, focusing on the customer's perspective, the present moment and the use of logical reason; do not explore conflict mediation in the CBT. We suggest a strategy that can help in the mediation of conflicts: assisting in the collection/organization of information; improving communication - empathic and assertive; favoring choices that can cause the least possible harm to all parties in the conflict. Conclusions: There is detailed description of the steps to train therapists to apply problem solving. However, to improve therapeutic skills to mediate conflicts, clinical practices that have been frequently described/used in the contextual cognitive behavioral therapies may be necessary: psychological acceptance, mindfulness, understanding personal values, experiencing/considering emotion in decision making, activating compassion/self-compassion.

Mediating role of family function between coping strategies and emotional behavior in children with chronic superficial gastritis / 四川精神卫生

BackgroundChronic superficial gastritis （CSG） is a common clinical disease in children. The emotional behavior of CSG children is susceptible due to them suffering from such disease at young age. ObjectiveTo explore the impact of coping strategies on emotional behavior and the effect of family function in children with CSG， and to provide references for clinical intervention in CSG children with emotional behavior problems. MethodsA total of 177 children with CSG admitted to Anhui Children's Hospital from June 2019 to January 2023 were selected as the research subjects. Investigation on family function， emotional and behavioral problems and coping strategies of children was conducted by employing the Family APGAR index （APGAR）， the Strengths and Difficulties Questionnaire （SDQ） and Coping Strategies Questionnaire （CSQ）. The structural equation model was used to test the mediating effect of family function between coping strategies and emotional behaviors. ResultsThe APGAR score was negatively correlated with both SDQ score and negative coping strategies score （r=-0.507， -0.551， P<0.01）， but was positively correlated with positive coping strategy score （r=0.579， P<0.01）. The positive coping strategy score was negatively correlated with SDQ score （r=-0.539， P<0.01）， while the negative coping strategy score was positively correlated with SDQ score （r=0.543， P<0.01）. The result showed that family function played a partial mediating role between positive coping strategies and emotional behavior ［indirect effect was -0.133 （95% CI： -0.256~-0.079， P<0.01）， accounting for 29.40% of the total effect］. The same mediating effect happened between negative coping strategies and emotional behavior ［indirect effect was 0.093 （95% CI： 0.198~0.045， P<0.01）， accounting for 28.50% of the total effect］. ConclusionCoping strategies of CSG children can affect emotional behavior directly and indirectly with family function playing a partial intermediary effect.

Physical growth and dietary characteristics of children with attention deficit hyperactivity disorder: a cross-sectional study / 中国当代儿科杂志

OBJECTIVES@#To investigate the physical growth and dietary characteristics of children with attention deficit hyperactivity disorder (ADHD), and to analyze their relationship with core symptoms of ADHD.@*METHODS@#A total of 268 children who were newly diagnosed with ADHD in Children's Hospital of Nanjing Medical University from June to December 2020 were included in the ADHD group, and 102 healthy children who underwent physical examination during the same period were selected as the control group. Physical evaluations and dietary surveys were conducted for both groups. ADHD diagnosis and scoring were performed according to the Diagnostic and Statistical Manual of Mental Disorders (5th edition). Factor analysis, Spearman correlation analysis, and mediation analysis were used to study the relationship between core symptoms of ADHD, dietary patterns, and physical growth.@*RESULTS@#The rate of overweight/obesity in the ADHD group was significantly higher than that in the control group (35.8% vs 21.6%, P<0.05). Three dietary patterns were extracted from the food frequency questionnaire: vegetarian dietary pattern, traditional dietary pattern, and snack/fast food pattern. The factor score for the snack/fast food pattern in the ADHD group was higher than that in the control group (P<0.05). There was a significant positive correlation between ADHD symptom scores, snack/fast food pattern factor scores, and body fat percentage (P<0.05). The mediation analysis showed that the snack/fast food pattern played a partial mediating role in the relationship between ADHD symptom scores and body fat percentage, with a mediation proportion of 26.66%.@*CONCLUSIONS@#The rate of overweight/obesity in children with ADHD is higher than that in non-ADHD children. Core symptoms of ADHD are related to dietary patterns and physical growth, with the snack/fast food pattern playing a partial mediating role in the relationship between core symptoms of ADHD and physical growth.

Fear of Covid-19 and Burnout Among Healthcare Providers in Malaysia: Is Resilience a Missing Link?

@#Introduction: During the COVID-19 pandemic, healthcare providers have been in great fear due to the high risk of contracting COVID-19 infection at any time. This study aimed to determine the mediating role of resilience on the relationship between fear of COVID-19 and burnout in primary care healthcare providers in Malaysia. Methods: This was an online cross-sectional study involving 1280 healthcare providers aged 18 years and older from 30 government primary care clinics in Malaysia. We used the COVID-19 Fear Scale, the Copenhagen Burnout Inventory Scale, and the Short Brief Resilience Scale to collect data from the respondents. Smart-PLS was used to perform mediation analysis. Results: The mean age of the respondents was 36 years old and mean duration of working experience was 11 years. The majority of the respondents were female (82.4%) and Malays (82.3%). The study population consisted of nurses (47.4%), doctors (26%), medical assistants (11.9), healthcare assistant (7.1%), medical laboratory technicians (6.4%) and drivers(1.3).The results show that fear of COVID-19 positively predicts burnout. According to the results, resilience mediates the relationship between fear of COVID-19 and all the three burnout domains, namely personal burnout (β=0.175,p<0.001), work-related burnout (β=0.175,p<0.001) and client-related burnout (β=0.172,p<0.001). Additionally, resilience reduces the impact of COVID-19 fear on the three domains of burnout. Conclusion: Our study has reported a mediating effect of resilience on the relationship between fear of COVID-19 and burnout.

Effect of diabetes on sepsis in patients with pyogenic liver abscess / 中华肝胆外科杂志

Objective:To study the effect of diabetes mellitus (DM) on sepsis in patients with pyogenic liver abscess (PLA).Methods:The clinical data of 116 patients with PLA treated in the Affiliated Hospital of Jiangnan University from January 2021 to May 2022 were retrospectively analyzed, including 64 males and 52 females, aged (62.3±12.6) years old. Patients were divided into DM group ( n=56) and non-DM group ( n=60), which were also divided into the sepsis group ( n=29) and the non-sepsis group ( n=87). The clinical features were compared among the groups, the risk factors of PLA complicated with sepsis were analyzed by multivariate logistic regression. Mediation model was used to analyze how DM affects the development of sepsis. Results:Compared with the non-DM group, patients in DM group had higher incidences of hypertension and acute physiology and chronic health evaluation II, a higher proportion of blood neutrophil count, a higher serum levels of triglyceride, urea nitrogen, fasting blood glucose and glycated hemoglobin at admission. The DM group also higher incidences of hypoproteinemia, pleural effusion, and sepsis, with longer hospital stay and higher hospitalization cost (all P<0.05). The levels of hemoglobin, albumin and hematocrit were lower in DM group (all P<0.05). Multivariate logistic regression analysis showed that comorbidity of DM ( OR=3.431, 95% CI: 1.245-9.455) and abscess with a larger diameter ( OR=1.664, 95% CI: 1.258-2.220) were associated with a higher risk of developing sepsis (all P<0.05). Mediation model showed that neutrophil count and triglyceride were the mediating variables of sepsis in patients with PLA. Conclusion:Comorbidity of diabetes is an independent risk factor of developing sepsis in patients with pyogenic liver abscess. Diabetes may induce sepsis by affecting the neutrophils and triglyceride.

The effect of disease uncertainty on caregiving burden in major caregivers of stroke:an intermediary model with regulation / 中国实用护理杂志

Objective:To investigate the relationship and intrinsic mechanism between disease uncertainty, coping style, social support and caregiver burden of primary caregivers of stroke, in order to provide a theoretical basis for reducing the burden of care and improving the quality of care for stroke caregivers.Methods:In this study, the main caregivers of 314 stroke patients hospitalized in Xinjiang Uygur Autonomous Region People's Hospital from December 2021 to May 2022 were selected by convenience sampling method, and cross-sectional surveys were conducted using the general data questionnaire, the Family Scale of Disease Uncertainty, the Simple Coping Style Questionnaire, the Social Support Rating Scale, and the Caregiver Burden Scale. Model 4 in Hayes′ SPSS-Process program was used to test the mediation effect, and Model 15 was used to test the mediation effect of social support.Results:The positive predictive effect of disease uncertainty in the primary caregiver of stroke patients on the burden of caregivers was significant ( β=0.665, P<0.01). Active coping played a partial mediating role between disease uncertainty and caregiver burden, with a mediating effect of 0.306 and a mediating effect of 31.8%. The interaction between disease uncertainty and social support had a significant predictive effect on caregiver burden ( β=-0.033, P<0.05), and the interaction item between active response and social support had a significant predictive effect on caregiver burden ( β=-0.019, P<0.05). Conclusions:Positive coping is an important psychological mechanism between disease uncertainty and caregiver burden, and social support can alleviate the influence of disease uncertainty on caregiver′s burden, and can also strengthen the weakening effect of positive coping on caregiver′s burden.

The mediating effect of interdisciplinary cooperation ability on the level of hospice care practice and the degree of difficulty of medical staff / 中国实用护理杂志

Objective:To explore the mediating role of interdisciplinary cooperation ability between the level of hospice care practice and difficulty degree of hospice care for medical staff, in order to improve the quality of hospice care services for medical staff, and to provide evidence for relevant managers to formulate effective measures to reduce the implementation of hospice care difficulties.Methods:This study was a cross-sectional survey. Using convenience sampling method, the general data questionnaire, Palliative Care Difficulties Scale (PCDS), Palliative Care Self-Report Practice Scale (PCPS) and Modified Index of Interdisciplinary Collaboration (MIIC) were used to investigate 362 medical staff in all hospice care institutions of Shiyan City from July to August 2022.Results:The total score of PCDS in 362 medical staff was (40.58±13.44) points, (67.47 ± 12.50) points for PCPS and (108.36 ± 21.46) points for MIIC. There was a positive correlation between the total score of MIIC and PCDS ( r=0.500, P<0.01). The total score of PCPS was negatively correlated with the total score of MIIC ( r=-0.337, P<0.01) and the total score of PCDS ( r=-0.189, P<0.01). The interdisciplinary cooperation ability of medical staff in hospice care had a complete mediating effect between the level of practice and the degree of difficulty (Effect value=-0.190, 95% CI-0.274 to -0.126), and the mediating effect accounted for 98.5% of the total effect value. Conclusions:The practice level of hospice care can not directly affect the implementation of the difficulty degree, but by taking active measures to improve the interdisciplinary cooperation ability, so as to enhance the practice level, and then reduce the implementation of hospice care difficulty degree.

Intermediary effect of benefit finding in the mindfulness level and coping style of acute cerebral infarction patients who received interventional therapy / 中国实用护理杂志

Objective:To observe the level of mindfulness and coping style in patients with acute cerebral infarction (ACI) after interventional therapy, and analyze the intermediary effect of benefit finding between them, so as to provide a theorectical basis of implement mindfulness intervention in clinical practice.Methods:The 130 patients with ACI after interventional treatment in the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were included in this cross-sectional survey study. The general data questionnaire, Five-factor Mindfulness Scale (FFMQ), Benefit Finding Rating Scale (BFS), and Simple Coping Style Questionnaire (SCSQ) were used to analyze the relationship between benefit finding, mindfulness level and coping style, and the intermediary effect of benefit finding between them.Results:The total FFMQ score of 130 ACI patients after interventional therapy was (123.34 ± 5.14) points. The BFS score, positive coping score and negative coping score were (49.73 ± 3.41), (20.35 ± 2.25), (13.18 ± 1.45) points, respectively. The level of mindfulness and benefit were positively correlated with positive coping ( r=0.687, 0.737, both P<0.05). The level of mindfulness and benefit were negatively correlated with negative coping( r=-0.654, -0.779, both P<0.05). It was found that mindfulness level played a partial intermediatory effect on positive coping and negative coping in ACI patients after interventional therapy, with contribution rates of 49.71% and 64.58%, respectively. Conclusions:Benefit finding plays a partial intermediary effect on the level of mindfulness and coping style of patients with ACI after interventional therapy.

Mediating effect of cognitive emotion regulation strategy on stress overload and stress response of palliative care nurses / 中国实用护理杂志

Objective:To explore the current status and correlation between stress overload, different cognitive emotion regulation strategies and stress response in palliative care nurses, and to provide reference for reducing stress reaction of hospice nurses.Methods:A total of 448 palliative care nurses from Beijing City, Jiangsu Province, Hunan Province and Anhui Province were selected as subjects by convenience sampling method in February 2022. The general information questionnaire, Stress Overload Scale, Cognitive Emotion Regulation Questionnaire and Stress Response Questionnaire were used to conduct a cross-sectional survey. After analyzing their scores, correlation analysis and mediating effect analysis were conducted.Results:The stress overload score of palliative care nurses was 66.00 (55.00, 67.00), and the stress response score was 80.00 (63.00, 84.00). The stress overload was positively correlated with the stress response ( r=0.735, P<0.05), and the positive emotion regulation strategy was negatively correlated with the stress response ( r=-0.440, P<0.05), negative emotion regulation strategy was positively correlated with stress response ( r=0.747, P<0.05). The cognitive emotion regulation strategy had a partial mediating effect between the stress overload and the stress response, accounting for 29.6% of the total effect. Conclusions:Cognitive emotion regulation is the mediating variable between stress overload and stress response of palliative care nurses. Managers should pay more attention to the stress level and mental health status of palliative care nurses, and guide them to choose appropriate emotional regulation strategies, so as to reduce stress response and maintain physical and mental health.

The level of mindfulness and fear of recurrence in patients after radical gastrectomy for gastric cancer: the chain mediating effect of illness uncertainty and negative coping styles / 中国实用护理杂志

Objective:To explore the relationship between the level of mindfulness, illness uncertainty, negative coping style and fear of recurrence in patients after radical resection of gastric cancer, and to understand the internal mechanism of how mindfulness affects the fear of recurrence.Methods:This was a cross sectional survey. From January 2019 to March 2021, the convenience sampling method was used to select 227 patients undergoing radical gastric cancer surgery in the Affiliated Hospital of Naval Medial University of Chinese PLA as the research objects. The general information questionnaire, Mindfulness Attention and Awareness Scale, Fear of Disease Progression Simplified Scale, Mishel′s Illness Uncertainty Scale and Simplified Coping Style Questionnaire were used for questionnaire surveys. The relationship between the level of mindfulness, illness uncertainty, negative coping style and fear of recurrence was explored and the model was tested.Results:The returned questionnaires were 207 with a recovery rate of 91.19%(207/227). Pearson correlation analysis showed that the level of mindfulness was negatively correlated with illness uncertainty, negative coping style, and fear of recurrence ( r=-0.176, -0.269, -0.480, all P<0.01). Illness uncertainty, negative coping styles were positively correlated with fear of recurrence ( r=0.433, 0.420, both P<0.01). The mediation model test showed that mindfulness had a significant direct effect on fear of relapse (effect value was -0.220), illness uncertainty and negative coping styles had significant partial mediating effect between mindfulness level and fear of recurrence (effect value were -0.036, -0.030). And the chain mediating effect of illness uncertainty and negative coping style was also significant (effect value was -0.006). Conclusions:The level of mindfulness can not only have a direct impact on the fear of recurrence in patients after radical gastrectomy, but also indirectly affect the fear of recurrence through the chain mediating effect of illness uncertainty, negative coping style, and disease uncertainty→negative coping style.

Mediating role of innovation self-efficacy in the relationship between sense of organizational fairness and innovation behavior in nurses / 中国职业医学

Objective To study the relationship among the sense of organizational fairness, innovative self-efficacy (ISE) and innovative behavior in nurses. Methods A total of 392 nurses from a grade A tertiary hospital were selected as the research subjects using convenience sampling method. The Organizational Fairness Scale, Innovation Self-efficacy Scale, and Innovation Behavior Scale were used to evaluate the sense of organizational fairness, ISE, and innovation behavior, respectively. The mediate equation model was constructed, and Bootstrap analysis was applied for validation. Results The scores for organizational fairness, ISE, and innovative behavior among the nurses were (67.8±15.2), (23.9±3.5), and (30.5±6.7) points, respectively. Organizational fairness score was positively correlated with both innovative behavior and ISE scores ［correlation coefficients (r) were 0.38 and 0.36, respectively, both P<0.01］. ISE score was positively correlated with innovative behavior total score (r=0.51, P<0.01). The results of the mediation analysis indicated that the total effect of organizational fairness on innovation behavior was 0.34 (P<0.01),with a direct effect of 0.17 (P<0.01). ISE plays a mediating role between organizational fairness and innovation behavior among nurses(P<0.01) with standardized mediation effect of 0.17, accounting for 50.0% of the total effect. Conclusion Organizational fairness can influence the ability of innovative behavior directly or through the mediating role of ISE.

Mediating effect of emotion regulatory self-efficacy in the relationship between musculoskeletal disorders and turnover intention among operating room nurses / 中国职业医学

Objective To explore the mediating effect of emotion regulatory self-efficacy (ERSE) in the relationship between musculoskeletal disorders and turnover intention in operating room nurses. Methods A total of 372 operating room nurses from five hospitals in Shenyang City were selected as the research subjects using covenient sampling method. The Musculoskeletal Disorders Questionnaire, Turnover Intention Scale, and Emotional Self-Regulation Efficacy Scale were used to study the prevalence of work-related musculoskeletal disorders (WMSDs), turnover intention, and ERSE among the study subjects. The Bootstrap method was used for mediation effect analysis of ERSE. Results The prevalence of WMSDs among operating room nurses was 69.9%. The scores for turnover intention and ERSE among operating room nurses were (13.6±6.3) and (34.7±16.2), respectively. ERSE played a partial mediating role in the relationship between WMSDs and turnover intention among operating room nurses, with an effect value of 0.04 and the 95% confidence interval of 0.01 to 0.08, accounting for 8.1% of the total effect. Conclusion WMSDs and ERSE directly influence turnover intention among operating room nurses. WMSDs can indirectly increase turnover intention by reducing ERSE among operating room nurses.

Relationship between job stress/sleep quality and job satisfaction among programmers in a Shanghai Internet enterprise / 上海预防医学

ObjectiveTo study the relationship between occupational stress/sleep quality and job satisfaction of internet enterprise programmers， to explore the mediating effect of sleep quality between occupational stress and job satisfaction， and to provide a theoretical basis for taking effective measures to improve job satisfaction. MethodsA total of 271 programmers from an Internet company in Shanghai were investigated by job content questionnaire， Pittsburgh Sleep Index Scale and the third part of the McLean occupational stress questionnaire. The results were statistically analyzed ResultsThe positive rate of occupational stress of programmers in this enterprise was 66.7%， 34.3% of them had average sleep quality， 28.0% had poor sleep quality， and the score of job satisfaction was 47.70±6.78. Correlation analysis showed that the higher the occupational stress， the worse the sleep quality and the lower the job satisfaction. Effects of occupational stress and sleep quality on job satisfaction were both statistically significant. The total effect of occupational stress on job satisfaction was -0.35， and the mediating effect of sleep quality between occupational stress and job satisfaction was -0.04， accounting for 12.0% of the total effect. ConclusionSleep quality of internet enterprise programmers plays a partial mediating role between occupational stress and job satisfaction， and a series of measures such as improving sleep can be taken to improve programmer’s job satisfaction.

Study on the influence of job burnout and anxiety symptoms on work ability of biosafety laboratory staff in Xinjiang Uygur Autonomous Region / 中国职业医学

{L-End}Objective To understand the influence of job burnout and anxiety symptoms on work ability of biosafety laboratory (BSL) workers in Xinjiang Uygur Autonomous Region. {L-End}Methods A total of 5 808 BSL workers in Xinjiang Region were selected as the research subjects using cluster sampling method. The Job Burnout Questionnaire, Anxiety Self-rating Scale and Work Ability Index Questionnaire were used to evaluate their job burnout, anxiety symptoms and work ability. The mediation effect of anxiety symptoms on the relationship between job burnout and work ability was tested by stepwise regression analysis. {L-End}Results The detection rate of job burnout, anxiety symptoms and poor working ability was 83.1% (4 829/5 808), 37.2% (2 160/5 808) and 5.8% (339/5 808), respectively. There was a positive correlation between job burnout and anxiety symptoms score in BSL workers ［correlation coefficient (r) was 0.48, P<0.01］. The score of job burnout and anxiety symptoms was negatively correlated with the work ability score (r were -0.58, -0.51, both P<0.01). The results of mediation effect analysis show that the total effect of job burnout on work ability was -0.31, with the direct effect of -0.15. The mediation effect of anxiety symptoms on the relationship between job burnout and work ability was -0.16, accounting for 51.6% of the total effect. {L-End}Conclusion The detection rates of job burnout and anxiety symptoms among BSL workers in Xinjiang Region are relatively high. Anxiety symptoms show a mediate effect on the relationship between job burnout and work ability. The work ability of BSL workers can be improved by improving job burnout and anxiety symptoms.

Mediating effect of self-efficacy on self-management ability and self-management behavior in patients with type 2 diabetes mellitus / 北京大学学报(医学版)

OBJECTIVE@#To investigate the mechanism of self-efficacy between self-management ability and self-management behavior and its differences among patients with different disease courses through mediation tests.@*METHODS@#In the study, 489 patients with type 2 diabetes who attended the endocrinology departments of four hospitals in Shanxi Province and Inner Mongolia Autonomous Region from July to September 2022 were enrolled as the study population. They were investigated by General Information Questionnaire, Diabetes Self-Management Scale, Chinese version of Diabetes Empowerment Simplified Scale, and Diabetes Self-Efficacy Scale. Mediation analyses were performed using the linear regression model, Sobel test, and Bootstrap test in the software Stata version 15.0 and divided the patients into different disease course groups for subgroup analysis according to whether the disease course was > 5 years.@*RESULTS@#In this study, the score of self-management behavior in the patients with type 2 diabetes was 6.16±1.41, the score of self-management ability was 3.99±0.74, and the score of self-efficacy was 7.05±1.90. The results of the study showed that self-efficacy was positively correlated with self-management ability (r=0.33) as well as self-management behavior (r=0.47) in the patients with type 2 diabetes (P < 0.01). The mediating effect of self-efficacy accounted for 38.28% of the total effect of self-management ability on self-management behaviors and was higher in the behaviors of blood glucose monitoring (43.45%) and diet control (52.63%). The mediating effect of self-efficacy accounted for approximately 40.99% of the total effect for the patients with disease course ≤ 5 years, while for the patients with disease course > 5 years, the mediating effect accounted for 39.20% of the total effect.@*CONCLUSION@#Self-efficacy enhanced the effect of self-management ability on the behavior of the patients with type 2 diabetes, and this positive effect was more significant for the patients with shorter disease course. Targeted health education should be carried out to enhance patients' self-efficacy and self-management ability according to their disease characteristics, to stimulate their inner action, to promote the development of their self-management behaviors, and to form a more stable and long-term mechanism for disease management.