Reflective based learning for nursing ethical competency during clinical practices.

BACKGROUND: A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. AIM: To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. RESEARCH DESIGN: Qualitative study with a content analysis according to Elo and Kinglas framework. PARTICIPANTS AND RESEARCH CONTEXT: Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. METHODOLOGY: The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. ETHICAL CONSIDERATIONS: Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. FINDINGS: Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. CONCLUSION: All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.

Moral resilience in registered nurses: Cultural adaption and validation study.

BACKGROUND: Healthcare professionals, especially professional nurses, experience various types of moral suffering due to inevitable ethical conflicts. Moral resilience is recently proposed as a resource to address moral suffering. However, there is no tool to measure moral resilience in Chinese professional nurses. AIM: This study aimed to translate the Rushton Moral Resilience Scale (RMRS) into Chinese and evaluate the psychometric properties of the Chinese version of RMRS (Chi-RMRS). RESEARCH DESIGN: A methodological and descriptive research design. PARTICIPANTS AND RESEARCH CONTEXT: A convenience sample of 411 Chinese professional nurses was recruited through an online survey platform between February and March 2023. ETHICAL CONSIDERATIONS: This study was approved by the Research Ethics Committees of the University and hospitals involved. RESULTS: The RMRS was translated and culturally adapted into a Chinese version. Neither floor nor ceiling effects were observed. The scale-level content validity index (CVI) was 0.922 with the item-level CVIs ranging from 0.833 to 1.000. The explanatory factor analysis (EFA) generated a three-factor structure for the Chi-RMRS, and the confirmatory factor analysis (CFA) demonstrated the three-factor structure with factor loadings for each item ranging from 0.42 to 0.80. The scale-level Cronbach's α coefficient was 0.811 with each dimension ranging from 0.717 to 0.821, and composite reliability (CR) coefficient for the overall scale was 0.920, with each dimension varying from 0.739 to 0.824. The standard error of measurement (SEM) and smallest detectable change (SDC) were 3.522 and 9.763, respectively. DISCUSSION: The Chi-RMRS is able to measure moral resilience of Chinese professional nurses, and has good validity and reliability. It can be used in research and practice to determine the level of moral resilience, thus helping nursing managers to monitor the status of Chinese professional nurses, then develop interventions to maintain the well-being of professional nurses and to ensure quality of care.

Network meta-analysis of the optimal time of applying enteral immunonutrition in esophageal cancer patients receiving esophagectomy.

BACKGROUND: Enteral immunonutrition (EIN) has been extensively applied in cancer patients; however, its role in esophageal cancer (EC) patients receiving esophagectomy remains unclear. We performed this network meta-analysis to investigate the impact of EIN on patients undergoing surgery for EC and further determine the optimal time of applying EIN. METHODS: We searched PubMed, EMBASE, Cochrane library, and China National Knowledgement Infrastructure (CNKI) to identify eligible studies. Categorical data was expressed as the odds ratio with 95% confidence interval (CI), and continuous data was expressed as mean difference (MD) with 95% CI. Meta-analysis with head-to-head approach and network meta-analysis was performed to evaluate the impact of EIN on clinical outcomes using RevMan 5.3 and ADDIS V.1.16.8 software. The surface under the cumulative ranking curve (SUCRA) was calculated to rank all nutritional regimes. RESULTS: Total 14 studies involving 1071 patients were included. Meta-analysis with head-to-head approach indicated no difference between EIN regardless of the application time and standard EN (SEN); however, subgroup analyses found that postoperative EIN was associated with decreased incidence of total infectious complications (OR = 0.47; 95%CI = 0.26 to 0.84; p = 0.01) and pneumonia (OR = 0.47; 95%CI = 0.25 to 0.90; p = 0.02) and shortened the length of hospitalization (LOH) (MD = - 1.01; 95%CI = - 1.44 to - 0.57; p < 0.001) compared to SEN, which were all supported by network meta-analyses. Ranking probability analysis further indicated that postoperative EIN has the highest probability of being the optimal option in terms of these three outcomes. CONCLUSIONS: Postoperative EIN should be preferentially utilized in EC patients undergoing esophagectomy because it has optimal potential of decreasing the risk of total infectious complications and pneumonia and shortening LOH. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/KJ9UY.

Clinical outcomes and safety of passive leg raising in out-of-hospital cardiac arrest: a randomized controlled trial.

BACKGROUND: There are data suggesting that passive leg raising (PLR) improves hemodynamics during cardiopulmonary resuscitation (CPR). This trial aimed to determine the effectiveness and safety of PLR during CPR in out-of-hospital cardiac arrest (OHCA). METHODS: We conducted a randomized controlled trial with blinded assessment of the outcomes that assigned adults OHCA to be treated with PLR or in the flat position. The trial was conducted in the Camp de Tarragona region. The main end point was survival to hospital discharge with good neurological outcome defined as cerebral performance category (CPC 1-2). To study possible adverse effects, we assessed the presence of pulmonary complications on the first chest X-rays, brain edema on the computerized tomography (CT) in survivors and brain and lungs weights from autopsies in non-survivors. RESULTS: In total, 588 randomized cases were included, 301 were treated with PLR and 287 were controls. Overall, 67.8% were men and the median age was 72 (IQR 60-82) years. At hospital discharge, 3.3% in the PLR group and 3.5% in the control group were alive with CPC 1-2 (OR 0.9; 95% CI 0.4-2.3, p = 0.91). No significant differences in survival at hospital admission were found in all patients (OR 1.0; 95% CI 0.7-1.6, p = 0.95) and among patients with an initial shockable rhythm (OR 1.7; 95% CI 0.8-3.4, p = 0.15). There were no differences in pulmonary complication rates in chest X-rays [7 (25.9%) vs 5 (17.9%), p = 0.47] and brain edema on CT [5 (29.4%) vs 10 (32.6%), p = 0.84]. There were no differences in lung weight [1223 mg (IQR 909-1500) vs 1239 mg (IQR 900-1507), p = 0.82] or brain weight [1352 mg (IQR 1227-1457) vs 1380 mg (IQR 1255-1470), p = 0.43] among the 106 autopsies performed. CONCLUSION: In this trial, PLR during CPR did not improve survival to hospital discharge with CPC 1-2. No evidence of adverse effects has been found. Clinical trial registration ClinicalTrials.gov: NCT01952197, registration date: September 27, 2013, https://clinicaltrials.gov/ct2/show/NCT01952197 .

The chain mediating role of social support and stigma in the relationship between mindfulness and psychological distress among Chinese lung cancer patients.

PURPOSE: Psychological distress greatly impaired the psychological and physical well-being of lung cancer patients. Identification of protective and risk factors is a prerequisite of developing effective psychological treatment protocol. The study aims to determine the relationship of mindfulness and psychological distress and further clarify the mechanism of mindfulness against psychological distress through perceived stigma and social support among Chinese lung cancer patients. METHOD: A cross-sectional survey study involving 441 valid Chinese lung cancer patients was conducted from September 2018 to August 2019. After all validated questionnaires that measured psychological distress, level of mindfulness, social support, and perceived stigma were returned by patients, we firstly performed correlation analysis to assess the associations between mindfulness, social support, perceived stigma, and psychological distress. Then structural equation modelling analysis was conducted to further clarify the mediating effects of perceived stigma and social support on the relationship between mindfulness and psychological distress. RESULTS: According to our hypothesis and further modification, our revised model adequately fits to data. Mindfulness (ß = - 0.107, p = 0.008) and social support (ß = - 0.513, p < 0.001) had a direct effect on psychological distress. Meanwhile, mindfulness had a direct effect on perceived stigma (ß = - 0.185, p < 0.001), and perceived stigma had a direct effect on social support (ß = - 0.373, p < 0.001). Furthermore, mindfulness had also the indirect effect on psychological distress through the chain mediating role of stigma and social support among lung cancer patients. CONCLUSIONS: Mindfulness has direct negative effect on psychological distress and has also indirectly negative psychological distress through impacting social support and perceived stigma.

Comparative Effectiveness of Enhanced Patient Instructions for Bowel Preparation Before Colonoscopy: Network Meta-analysis of 23 Randomized Controlled Trials.

BACKGROUND: Various enhanced patient instructions (EPIs) have been used for bowel preparation (BP) and our previous meta-analysis also demonstrated the efficacy of EPIs in increasing the colonic polyp and adenoma detection rates; however, the optimal method for adequate BP has not yet been developed. OBJECTIVE: We performed a network meta-analysis to determine the optimal instructions. METHODS: We searched for randomized controlled trials (RCTs) comparing the effectiveness of EPIs with each other or standard patient instructions (SPIs) for BP. We performed direct and Bayesian network meta-analyses for all instructions and used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria to appraise the quality of evidence. RESULTS: We included 23 RCTs (7969 patients) comparing 10 different instructions. In direct meta-analyses, most of the EPIs, except visual aids and mobile apps, increased the adequate preparation rate (APR). Network meta-analyses showed that additional explanations were superior to visual aids (odds ratio [OR] 0.35, 95% CI 0.19-0.59), telephone calls (OR 0.62, 95% CI 0.37-0.99), educational videos (OR 0.79, 95% CI 0.5-0.77), and mobile apps (OR 0.33, 95% CI 0.14-0.68) with low-to-high-quality evidence; newly designed booklets (OR 3.28, 95% CI 1.59-6.16), SMS text messaging (OR 2.33, 95% CI 1.28-3.91), telephone calls (OR 1.86, 95% CI 1.03-1.78), educational videos (OR 2.33, 95% CI 1.40-3.65), and social media applications (OR 2.42, 95% CI 1.4-3.93) were superior to visual aids and mobile apps with low-to-high-quality evidence. SMS text messaging, telephone calls, and social media applications increase adherence to and satisfaction with the BP regime. Social media applications reduce the risk of adverse events (AEs). Telephone calls and social media applications increase the polyp detection rate (PDR). CONCLUSIONS: Newly designed booklets, telephone calls, educational videos, and social media applications can improve the quality of BP. Telephone calls and social media applications improve adherence to and satisfaction with the BP regime, reduce the risk of AEs, and increase the PDR. TRIAL REGISTRATION: INPLASY (International Platform of Registered Systematic Review and Meta-analysis Protocols) INPLASY2020120103; https://inplasy.com/inplasy-2020-12-0103/.

Emotions and feelings in critical and emergency caring situations: a qualitative study.

BACKGROUND: Moral emotions are a key element of our human morals. Emotions play an important role in the caring process. Decision-making and assessment in emergency situations are complex and they frequently result in different emotions and feelings among health-care professionals. METHODS: The study had qualitative deductive design based on content analysis. Individual interviews and focus groups were conducted with sixteen participants. RESULTS: The emerging category "emotions and feelings in caring" has been analysed according to Haidt, considering that moral emotions include the subcategories of "Condemning emotions", "Self-conscious emotions", "Suffering emotions" and "Praising emotions". Within these subcategories, we found that the feelings that nurses experienced when ethical conflicts arose in emergency situations were related to caring and decisions associated with it, even when they had experienced situations in which they believed they could have helped the patient differently, but the conditions at the time did not permit it and they felt that the ethical conflicts in clinical practice created a large degree of anxiety and moral stress. The nurses felt that caring, as seen from a nursing perspective, has a sensitive dimension that goes beyond the patient's own healing and, when this dimension is in conflict with the environment, it has a dehumanising effect. Positive feelings and satisfaction are created when nurses feel that care has met its objectives and that there has been an appropriate response to the needs. CONCLUSIONS: Moral emotions can help nurses to recognise situations that allow them to promote changes in the care of patients in extreme situations. They can also be the starting point for personal and professional growth and an evolution towards person-centred care.

Nurses' emotions on care relationship: A qualitative study.

AIMS: To describe nurses' experiences regarding the care relationship built with medical-surgical patients in acute hospitalization units and the association with their clinical practice. BACKGROUND: Nurses' commitment to care and their relationships as well are the core of quality of care. Nurses consider that the emotional commitment is essential to the profession, thus accepting to be exposed to emotional distress. METHODS: In-depth interviews were conducted to explore the experience of 23 nurses from seven Spanish hospitals. Taped interviews were transcribed verbatim and analysed according to inductive content analysis. RESULTS: Six subcategories emerged from the data analysis: Fulfilling experiences, Feeling the pain of others, Emotional distress, Stepping back, Seeking professional support, and Evolution of emotions, which were combined in two main categories: Nurses' emotions and Nurses' coping strategies. Patient's suffering, work environment and interprofessional relations influence the care relationship. CONCLUSIONS: Positive and negative emotions emerge spontaneously in professional relationships of experienced nurses. Lack of time and high workloads are factors that hinder the nurse-patient relationship. This care relationship is often the reason that fulfils them. Despite their level of expertise and having coping strategies, these are not always effective and, sometimes, nurses need professional help. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses will continue performing their job with commitment; therefore, nursing managers should take care of their staff and pay attention to the emotional competence related to patients' relationships. Promoting self-care and a good working environment could improve their coping mechanisms.

Impact of training on intensive care providers' attitudes and knowledge regarding limitation of life-support treatment and organ donation after circulatory death.

The limitation of life-sustaining treatment is common practice in critical care units, and organ donation after circulatory death has come to be included as an option within this care plan. Lack of knowledge and misunderstandings can raise barriers between health-care providers (e.g., confusion about professional roles, lack of collaboration, doubts about the legality of the process, and not respecting patients' wishes in the decision-making process). The aim of the present study was to determine the knowledge and attitudes of intensive care physicians and nurses before and after a multidisciplinary online training program. A cross-sectional study was performed, and comparisons between the two groups were made using a χ2 -test for categorical data and unpaired t-test or Mann-Whitney rank sum test for continuous data according to its distribution. Training benefited both professional categories, helping nurses to be more open-minded and willing to collaborate, while physicians became more aware of nurses' presence and the need to collaborate with them.

Nurses' attitudes and knowledge regarding organ and tissue donation and transplantation in a provincial hospital: A descriptive and multivariate analysis.

The attitudes and knowledge of nursing personnel regarding organ and tissue donation can influence the decision to donate. This study aimed to determine these two factors among nurses at a district hospital in Barcelona, Spain. A survey was carried out using a 35 item questionnaire. Results were subjected to descriptive and comparative statistical analyses using bivariate and multivariate analyses to examine the relation between demographic data and attitudes toward donation. The completion rate was 68.2%, with 98.6% of those responding stating that they were in favor of organ donation. The respondents were unsure as to whether the criteria for inclusion in transplant waiting lists were appropriate (57.5%), whereas 72.2% agreed that brain death is equivalent to death. The bivariate analysis revealed a significant association between a positive attitude toward donation and working on permanent night shift no religious beliefs. Attitudes toward donation among nurses were generally positive; a negative attitude, although attitudes towards donation among the nurses participating in the study were generally positive, it should be pointed out that when a negative attitude does exist this affects significant aspects such as belief in the diagnosis of brain death or the criteria for inclusion on the waiting list, amongst others, which reflects that specific training in donation focused on nurses continues to be needed.

Emergency Nurse Competence in Electrocardiographic Interpretation in Spain: A Cross-Sectional Study.

INTRODUCTION: Electrocardiographic interpretation skills are key to provide a fast attention to patients with thoracic pain. The aim of the study was to determine the current level of competence in electrocardiographic interpretation of nurses in emergency departments. METHODS: Cross-sectional, multicenter study via an ad hoc questionnaire. Subjects were nurses from three Spanish emergency departments with at least a year experience in this area. A two-part questionnaire was created consisting of a professional profile, and 12 questions (2 theoretical questions and 10 questions on practical cases with electrocardiographic register [readout]). A pilot test was carried out to evaluate the validity of the questionnaire, the content validity index. The reliability of the questionnaire was also tested on a subsample through intraclass correlation coefficient with a value of 0.869 (CI 95% 0.712-0.941). Descriptive and bivariate analyses were conducted using an independent t-test or one-way ANOVA as appropriate. A statistical significance of P < .05 was assumed. RESULTS: Fifty-seven usable questionnaires were obtained (47.2% response rate). Women comprised 84.2% of the sample and the mean age of the sample was 40.5 (SD = 9.3) years. Slightly more than 91% had taken electrocardiographic interpretation training courses, the main modality for which was face-to-face (84.2%). The average score on our questionnaire was 8.6 (SD=1.1) points. No significant differences between nursing experience and hospitals were observed. Nurses who had received training within the previous five years scored significantly higher than those who had not (P = .031). DISCUSSION: The electrocardiographic knowledge of emergency nurses is high. Level of knowledge was not influenced by experience or hospital but was influenced by training when provided in the previous 5 years. Therefore, refreshing courses should be taken at least every 5 years. Contribution to Emergency Nursing Practice.

Some ethical conflicts in emergency care.

BACKGROUND: Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals. AIM: To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations. METHODS: Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group. ETHICAL CONSIDERATIONS: Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research. RESULT/CONCLUSION: Two categories emerged: one in 'ethical issues' and one in 'emotions and feelings in caring'. The four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse's ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients' care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with 'end-of-life' care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient's 'previous wishes' in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient's advocate. The nurses express feelings of distress, suffering, anger and helplessness.

Passive leg raise (PLR) during cardiopulmonary (CPR) - a method article on a randomised study of survival in out-of-hospital cardiac arrest (OHCA).

BACKGROUND: It is estimated that about 275,000 inhabitants experience an out-of-hospital cardiac arrest (OHCA) every year in Europe. Survival in out-of-hospital cardiac arrest is relatively low, generally between five per cent and 10%. Being able to explore new methods to improve the relatively low survival rate is vital for people with these conditions. Passive leg raise (PLR) during cardiopulmonary resuscitation (CPR) has been found to improve cardiac preload and blood flow during chest compressions. The aim of our study is to evaluate whether early PLR during CPR also has an impact on one-month survival in sudden and unexpected out-of-hospital cardiac arrest (OHCA). METHOD/DESIGN: A prospective, randomized, controlled trial in which all patients (≥18 years) receiving out-of hospital CPR are randomized by envelope to be treated with either PLR or in the flat position. The ambulance crew use a special folding stool which allows the legs to be elevated about 20 degrees. Primary end-point: survival to one month. Secondary end-point: survival to hospital admission to one month and to one year with acceptable cerebral performance classification (CPC) 1-2. DISCUSSION: PLR is a simple and fast maneuver. We believe that the greatest benefit with PLR is when performed early in the process, during the first minutes of CPR and before the first defibrillation. To reach power this study need 3000 patients, we hope that this method article will encourage other sites to contact us and take part in our study. TRIAL REGISTRATION: ClinicalTrials.gov NCT01952197.

Efficacy and mechanisms of 4-week MBSR on psychological distress in lung cancer patients: A single-center, single-blind, longitudinal, randomized controlled trial.

Objective: This study aimed to evaluate the efficacy of a 4-week mindfulness-based stress reduction (MBSR) program on psychological distress in patients with lung cancer and elucidate its mechanisms. Methods: This single-center, single-blinded, longitudinal, randomized controlled trial was conducted on 175 patients with lung cancer randomly allocated to a 4-week MBSR or a waiting-list group. The efficacy and mechanisms of the 4-week MBSR program were evaluated by outcome measures at preintervention (T0), the immediate postintervention (T1), 1 month (T2), and 3 months (T3). We analyzed the collected data using the per-protocol set principle, independent sample t-test, repeated measure analysis of variance, and structural equation modeling. Results: The 4-week MBSR program significantly alleviated psychological distress (F â€‹= â€‹15.05, P â€‹< â€‹0.001), decreased perceived stigma (F â€‹= â€‹8.260, P â€‹= â€‹0.005), improved social support (F â€‹= â€‹16.465, P â€‹< â€‹0.001), and enhanced mindfulness (F â€‹= â€‹17.207, P â€‹< â€‹0.001) compared with usual care at T1, T2, and T3. All variables significantly changed over time except for copying style (P â€‹= â€‹0.250). The changes in social support, mindfulness, and perceived stigma mediated the efficacy of the 4-week MBSR program on psychological distress (ߠ​= â€‹-0.292, P â€‹= â€‹0.005; ߠ​= â€‹-0.358, P â€‹= â€‹0.005). Conclusions: This study shows the benefits of the MBSR program for psychological distress, social support, mindfulness, and perceived stigma in patients with lung cancer. Also, it elucidates the mechanisms by which the MBSR program alleviates psychological distress by improving social support, enhancing mindfulness, and decreasing perceived stigma. The findings provide insights into applying the MBSR program to reduce psychological distress among patients with lung cancer.

Patients' lived experiences of breathlessness prior to prehospital care - A phenomenological study.

AIMS AND OBJECTIVES: The study aimed to describe how breathlessness is experienced by patients prior to prehospital care. DESIGN: A qualitative phenomenological design. METHODS: Lifeworld interviews were conducted with 14 participants. The analysis was carried out within the descriptive phenomenological framework. RESULTS: The essential meaning of the breathlessness phenomenon is described as an existential fear in terms of losing control over one's body and dying, which involves a battle to try to regain control. This is further described by four constituents: being in an unknown body, striving to handle the situation, the ambiguity of having loved ones close and reaching the utmost border. CONCLUSIONS: Patients describe a battling for survival. It is at the extreme limit of endurance that patients finally choose to call the emergency number. It is a challenge for the ambulance clinician (AC) to support these patients in the most optimal fashion.

Mindfulness Affects the Level of Psychological Distress in Patients With Lung Cancer via Illness Perception and Perceived Stress: A Cross-Sectional Survey Study.

Purpose: The aims of the study were first to investigate the association between illness perception and psychological distress and second to determine whether mindfulness affects psychological distress via illness perception and perceived stress in patients with lung cancer. Methods: Among 300 patients with lung cancer who participated in this cross-sectional study, 295 patients made valid responses to distress thermometer (DT), the Five Facet Mindfulness Questionnaire (FFMQ), the Brief Illness Perception Questionnaire (B-IPQ), and the Perceived Stress Scale (PSS) between January and July 2021. The possible pathways of mindfulness affecting psychological distress were analyzed based on the structural equation modeling analysis. Results: A total of 24.4% patients with lung cancer had DT > 4. Illness perception (ß = 0.17, p = 0.002) and perceived stress (ß = 0.23, p < 0.001) had a direct effect on psychological distress. Mindfulness had a direct effect on illness perception (ß = -0.16, p = 0.006) and mindfulness indirectly influenced psychological distress (ß = -0.04, p = 0.009) through affecting illness perception alone or simultaneously affecting both the illness perception and perceived stress in patients with lung cancer. Conclusion: Lung cancer suffered from varying levels of psychological distress. Mindfulness may alleviate psychological distress by reducing the level of illness perception and perceived stress. We suggest developing a comprehensive factor model to clarify potential mechanisms of mindfulness on psychological distress due to the very low effect of mindfulness on psychological distress via illness perception and perceived stress.

The Impact of Mindfulness-Based Stress Reduction (MBSR) on Psychological Outcomes and Quality of Life in Patients With Lung Cancer: A Meta-Analysis.

Objective: The impact of the mindfulness-based stress reduction (MBSR) program on psychological outcomes and quality of life (QoL) in lung cancer patients remains unclear. This meta-analysis aimed to evaluate the effectiveness of the MBSR program on psychological states and QoL in lung cancer patients. Methods: Eligible studies published before November 2021 were systematically searched from PubMed, EMBASE, Cochrane Library, PsycINFO, China National Knowledge Infrastructure (CNKI), and Wanfang databases. The risk of bias in eligible studies was assessed using the Cochrane tool. Psychological variables and QoL were evaluated as outcomes. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to grade the levels of evidence. Statistical analysis was conducted using RevMan 5.4 and STATA 14.0. Results: A total of 17 studies involving 1,680 patients were included for meta-analysis eventually. MBSR program significantly relieved cancer-related fatigue (standard mean difference [SMD], -1.26; 95% confidence interval [CI], -1.69 to -0.82; moderate evidence) and negative psychological states (SMD, -1.35; 95% CI, -1.69 to -1.02; low evidence), enhanced positive psychological states (SMD, 0.91; 95% CI, 0.56-1.27; moderate evidence), and improved quality of sleep (MD, -2.79; 95% CI, -3.03 to -2.56; high evidence). Evidence on MBSR programs' overall treatment effect for QoL revealed a trend toward statistical significance (p = 0.06, low evidence). Conclusion: Based on our findings, the MBSR program shows positive effects on psychological states in lung cancer patients. This approach should be recommended as a part of the rehabilitation program for lung cancer patients. Systematic Review Registration: https://archive.org/details/osf-registrations-mwvbq-v1, identifier: 10.17605/OSF.IO/MWVBQ.

Prevalence of Compassion Fatigue and Its Association with Professional Identity in Junior College Nursing Interns: A Cross-Sectional Study.

Background: The issue of compassion fatigue among clinical nurses has received considerable attention, particularly during the COVID-19 pandemic. Yet, the current status of compassion fatigue among junior college nursing interns remains unclear. Additionally, professional identity can modulate the impact of compassion fatigue or burnout on psychological well-being; however, whether professional identity still works in this group is also unclear. This study aimed to reveal the current status of compassion fatigue among nursing interns in junior colleges and also investigate the association between compassion fatigue and professional identity. Methods: This cross-sectional survey evaluated the levels of participants' compassion fatigue (The Compassion Fatigue Short Scale) and professional identity (Professional Identity Scale) in 2256 nursing interns. Results: The mean score of compassion fatigue was 44.99, and 19.5% of the participants scored above The Compassion Fatigue Short Scale median scores for compassion fatigue. A moderate negative correlation was detected between compassion fatigue and professional identity. Conclusions: The level of compassion fatigue among nursing interns is low but nearly one in five nursing students is at risk of compassion fatigue. More attention should be paid to nursing interns with a high risk of compassion fatigue. Future studies are warranted to explore which pathways could mediate the relationship between professional identify and comparison fatigue.

A Bibliometric Analysis of the Association Between Compassion Fatigue and Psychological Resilience From 2008 to 2021.

Aims: A negative association between the lower level of psychological resilience (PR) and increased risk of compassion fatigue (CF) and higher Coronavirus disease 2019 (COVID-19) stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic. Methods: We identified relevant literature from the Web of Science Core Collection® database using "resilience" and "compassion fatigue" on September 30, 2021. All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1. Results: A total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19. Conclusion: The results of the present study help us understand the status of the CF and PR field and its recent developments.