Measuring care-related regret intensity: Reliability and validation of a 10-item scale among Chinese nursing interns.

AIM: The 10-item care-related regret intensity scale (RIS-10) assesses the experience and intensity of care-related regrets. The aim of this study was to validate a Chinese version of the RIS and examine its reliability and validity when applied to Chinese nursing interns. BACKGROUND: Nursing students, the future healthcare workforce, often face clinical errors and adverse events due to limited knowledge and experience. Assessing care-related regret during their internships is crucial for their development. METHODS: Through a process involving translation, back-translation and cross-cultural adaptation, a Chinese version of the RIS-10 was developed. A convenience sampling method was employed to survey 529 nursing interns to validate the reliability and validity of the scale. RESULTS: The Chinese version of the scale, consisting of 10 items, demonstrated a single dimension, explaining 66.77% of the total variance according to exploratory factor analysis. Content validity for the 10 items ranged from 0.800 to 1.000, with a scale-level content validity of 0.980. Confirmatory factor analysis indicated a well-fitting model (CFI = 0.968, GFI = 0.921, NFI = 0.952, IFI = 0.969, TLI = 0.957, RMSEA = 0.088). Convergent validity was supported by an Average Variance Extracted of 0.636 and a Composite Reliability of 0.946. The scale also exhibited strong reliability with a Cronbach's α coefficient of 0.945, a split-half reliability coefficient of 0.903 and a test-retest reliability of 0.901. CONCLUSIONS: This comprehensive translation and validation process confirms the suitability of the Chinese version of the RIS-10 for use among Chinese nursing interns.

Impact of the transforming growth factor-ß pathway on vascular restenosis and its mechanism. / è½¬åŒ–ç”Ÿé•¿å› å­ßé€šè·¯å¯¹è¡€ç®¡å†ç‹­çª„çš„å½±å“åŠå ¶æœºåˆ¶.

As a crucial regulatory molecule in the context of vascular stenosis, transforming growth factor-ß (TGF-ß), plays a pivotal role in its initiation and progression. TGF-ß, a member of the TGF-ß superfamily, can bind to the TGF-ß receptor and transduce extracellular to intracellular signals through canonical Smad dependent or noncanonical signaling pathways to regulate cell growth, proliferation, differentiation, and apoptosis. Restenosis remains one of the most challenging problems in cardiac, cerebral, and peripheral vascular disease worldwide. The mechanisms for occurrence and development of restenosis are diverse and complex. The TGF-ß pathway exhibits diversity across various cell types. Hence, clarifying the specific roles of TGF-ß within different cell types and its precise impact on vascular stenosis provides strategies for future research in the field of stenosis.

Purinergic receptor P2X7 contributes to abdominal aortic aneurysm development via modulating macrophage pyroptosis and inflammation.

The purinergic receptor P2X7 has been established as an important mediator of inflammation and participates in a variety of cardiovascular diseases including atherosclerosis, however, its role in abdominal aortic aneurysms (AAA) remains unclear. In this study, we demonstrate that P2X7 plays essential roles in AAA development via modulating macrophage pyroptosis and inflammation. P2X7 is highly expressed in human AAA specimen, as well as in experimental murine AAA lesions (both CaCl2- and Angiotensin II-induced AAA models), and it mainly confines in macrophages. Furthermore, P2X7 deficiency or pharmacological inhibition with its antagonist could significantly attenuate aneurysm formation in experimental murine AAA models, while P2X7 agonist could promote AAA development. The caspase-1 activity, matrix metalloproteinase (MMP) activity, reactive oxygen species (ROS) production and pro-inflammatory gene expression were significantly reduced in experimental AAA lesions in mice with P2X7 deficiency or inhibition. Mechanistically, macrophage P2X7 can mediate the activation of NLRP3 inflammasome and activate its downstream caspase-1 to initiate the pyroptosis pathway. After caspase-1 activation, it further cleaves pro-interleukin (IL)-1ß and gasdermin D (GSDMD). Consequently, the N-terminal fragment of GSDMD forms pores on the cell membrane, leading to macrophage pyroptosis and release of the pro-inflammatory factor IL-1ß. The resulting vascular inflammation further leads to the upregulation of MMP and ROS, thereby promoting AAA development. In summary, these data identify P2X7-mediated macrophage pyroptosis signaling pathway as a novel contributory mechanism of AAA formation.

Nonlinear relationship between early postnatal weight gain velocity and neurodevelopmental outcomes in very-low birth weight preterm infants: A secondary analysis based on a published prospective cohort study.

Background: Extrauterine growth restriction among the very-low birth weight preterm infants (VLBWPIs) is associated with poorer cognitive development outcome, while the rapid weight gain in infancy increases the long-term risk of obesity and noncommunicable disease among VLBWPIs. However, the results of research on the association between early postnatal growth velocity and neurodevelopmental outcomes in VLBWPIs are still limited and controversial. Objective: We aimed to explore the association between the growth velocity in early postnatal and neurodevelopmental impairment (NDI) among VLBWPIs. Methods: This study was a secondary analysis of a previously published prospective cohort. It was based on data on 1,791 premature infants with a birth weight of less than 1500 g, registered in the database of the Premature Baby Foundation of Taiwan between 2007 and 2011. A binary logistic regression model was used to evaluate the association between the weight gain velocity in different periods [from birth to 6 months corrected age (CA), 6 to 12 months CA, and 12 to 24 months CA] and NDI, respectively. The generalized additive model and the smooth curve fitting (penalized spline method) were used to address nonlinearity, and a two-piece-wise binary logistic regression model was added to explain the nonlinearity further. Results: Nonlinearities were observed between NDI and the weight gain velocity from birth to 6 months CA [inflection point 20.36, inflection point: OR = 1.01, 95% CI 0.97-1.05], 6-12 months CA [inflection point 9.44, inflection point: OR = 1.05, 95% CI 1.05-(1.00, 1.11)], and 12-24 months CA [inflection point 16.00, inflection point: OR = 1.75, 95% CI 1.05-(0.96, 3.08)]. Conclusion: The neurodevelopmental benefits from a rapid weight gain velocity from birth to 24 months CA might be limited once the growth pace reaches an optimum level. It would help find a pattern of growth that facilitates optimal neurodevelopment, yet minimizes negative health consequences associated with overnutrition further.

Competency-based construction of a comprehensive curriculum system for undergraduate nursing majors in China: an in-depth interview and modified Delphi study.

BACKGROUND: The traditional nursing undergraduate curriculum is deeply influenced by the medical curriculum, and there are problems such as uneven distribution of theoretical and practical class hours, and a high proportion of subject-related knowledge points. The lack of nursing characteristics is not conducive to improving the competency of nursing students. After two rounds of Delphi consultation, the opinions of the expert group tended to be concentrated, and finally a comprehensive curriculum system for undergraduate nursing was constructed according to the future development trend of nursing in China. METHODS: The research is carried out in three stages: (I) the literature on comprehensive nursing undergraduate comprehensive curriculum construction at home and abroad in the past 5 years is reviewed to understand the current situation of domestic and foreign nursing undergraduate comprehensive curriculum construction; (II) conduct semi-structured interviews with nursing education experts and nursing professional teachers to preliminarily determine the indicators of the comprehensive curriculum system for nursing undergraduate majors based on competency; (III) experts who are proficient in nursing undergraduate education knowledge are invited to conduct two rounds of modified Delphi surveys, and finally complete the construction of the curriculum system of this research. RESULTS: On the basis of interviews with experts and teachers, 5 course groups (first-level indicators) and 16 professional comprehensive courses (second-level indicators) were finally constructed after two rounds of expert consultation. The coefficient of variation of index was 0.000-0.112. The effective recovery rate of the two rounds of expert consultation questionnaires was 100%, the expert authority coefficients was 0.940 and 0.961, the expert opinion coordination coefficient was 0.263 and 0.275, P<0.001. The highest weight of the first-level indicators in this study is the professional core course group (0.333). Among the secondary indicators, nursing humanistic cultivation and professionalism (0.750) and nursing education theory and practice (0.528) accounted for a relatively high proportion. CONCLUSIONS: Correspondence experts in this study are highly motivated, coordinated, and authoritative, and the indicators constructed are scientific and reliable. This study is expected to provide a curriculum framework for the construction of a comprehensive curriculum system for undergraduate nursing in China.

Negative silence in the classroom: A cross-sectional study of undergraduate nursing students.

OBJECTIVE: To investigate the concept of negative silent behavior of undergraduate nursing students and its influencing factors. METHODS: A cross sectional study was conducted by using convenience sampling, and 269 nursing students enrolled from August-September 2021 in a higher medical institution in Guizhou Province were selected for the study and surveyed using the general information questionnaire, the degree of negative classroom silence scale, and a questionnaire on the factors influencing negative classroom silence. Multiple linear regression was used to analyze the influencing factors of classroom negative silence among nursing students. RESULTS: The degree of negative silence in the nursing students' classroom was (2.75 ± 0.50), which was at a relatively active level. Multiple linear regression showed that teacher pedagogy and student literacy were influential factors in the degree of negative silence in nursing students' classrooms (p < 0.05). CONCLUSIONS: The level of negative silence in nursing students' classrooms is at a relatively active level, and teacher pedagogy and student literacy are the main influencing factors. Nurse educators should pay attention to the problem of negative silence of students in the classroom and prevent and intervene early to ensure the quality and effectiveness of classroom teaching and learning.

Diagnostic potential of trace metals concentration in expressed prostatic secretion and serum of patients with category IV prostatitis.

BACKGROUND: The National Institutes of Health (NIH) category IV prostatitis is a painless prostate gland inflammation, just as its name implies, this type of prostatitis is related with inflammation of the prostate, but most men are not conscious of it. However, category IV prostatitis is fairly common in general populations and reported having indirect relationships with prostate cancer. METHOD: We analyzed the concentration of zinc (Zn), copper (Cu), calcium (Ca) and magnesium (Mg) in expressed prostatic secretion (EPS) and serum of patients with category IV prostatitis and healthy controls, investigating the diagnostic potential of different metals in category IV prostatitis using a flame atomic absorption spectrometer (FAAS). RESULTS: Metal concentration combined clinical characteristics analysis suggested that average level of Zn, Ca, Mg were significantly lower in the EPS of patients with category IV prostatitis (P-value< 0.000), while Cu level raised obviously (P-value< 0.000). And in the serum, mean concentrations of Ca was also found to increase significantly in the patients with category IV prostatitis compared to healthy controls. Moreover, the correlation analysis indicated that age showed a positive correlation with EPS Zn, Ca, Mg concentration (P-value< 0.05), while albumin correlates with EPS Zn, Ca, Mg concentration reversely (P-value< 0.05) in patients with category IV prostatitis. CONCLUSION: Our report revealed that determination of the metal elements zinc, copper, calcium and magnesium in the serum and EPS could be a new and promising strategy for the rapid diagnosis of category IV prostatitis.

A survey of coping strategies among clinical nurses in China during the early stage of coronavirus disease 2019 pandemic: A cross-sectional study.

AIMS: To investigate coping strategies and identify their associated factors among Chinese clinical nurses during the early stage of coronavirus disease 2019 pandemic. DESIGN: A cross-sectional study. METHODS: This study was conducted in seven designated hospitals involved in the diagnosis and treatment of the coronavirus disease 2019 in the southwest of China between 1 February and 31 March, 2020. Multiple linear regression was conducted to explore the association of different factors with the coping strategies of nurses. RESULTS: Nurses' positive coping was associated with higher psychological capital (B = 0.185, 95% CI 0.158-0.213), social support (B = 0.292, 95% CI 0.244-0.340) and lower frustration (B = -0.065, 95% CI -0.123 to -0.007). In contrast, higher frustration (B = 0.091, 95% CI 0.044-0.139), lower performance (B = -0.054, 95% CI -0.101 to -0.007) and psychological capital (B = -0.035, 95% CI -0.055 to -0.014) were associated with negative coping.

Obstetricians' perspectives on trial of labor after cesarean (TOLAC) under the two-child policy in China: a cross-sectional study.

BACKGROUND: As the birth policy has been adjusted from one-child-one-couple to universal two-child-one-couple in China, there is an increasing number of women undergoing a second pregnancy after a previous cesarean section (CS). Undertaking an elective repeat CS (ERCS) has been taken for granted and has thus become a major contributor to the increasing CS rate in China. Promoting trial of labor after CS (TOLAC) can reduce the CS rate without compromising delivery outcomes. This study aimed to investigate Chinese obstetricians' perspectives regarding TOLAC, and the factors associated with their decision-making regarding recommending TOLAC to pregnant women with a history of CS under the two-child policy. METHODS: A cross-sectional survey was carried out between May and July 2018. Binary logistic regression was used to determine the factors associated with the obstetricians' intention to recommend TOLAC to pregnant women with a history of CS. The independent variables included sociodemographic factors and perceptions regarding TOLAC (selection criteria for TOLAC, basis underlying the selection criteria for TOLAC, and perceived challenges regarding promoting TOLAC). RESULTS: A total of 426 obstetricians were surveyed, with a response rate of ≥83%. The results showed that 31.0% of the obstetricians had no intention to recommend TOLAC to pregnant women with a history of CS. Their decisions were associated with the perceived lack of confidence regarding undergoing TOLAC among pregnant women with a history of CS and their families (odds ratio [OR] = 2.31; 95% CI: 1.38-1.38); obstetricians' uncertainty about the safety of TOLAC for pregnant women with a history of CS (OR = 0.49; 95% CI: 0.27-0.96), and worries about medical lawsuits due to adverse delivery outcomes (OR = 0.14; 95% CI: 0.07-0.31). The main reported challenges regarding performing TOLAC were lack of clear guidelines for predicting or avoiding the risks associated with TOLAC (83.4%), obstetricians' uncertainty about the safety of TOLAC for women with a history of CS (81.2%), pregnant women's unwillingness to accept the risks associated with TOLAC (81.0%) or demand for ERCS (80.7%), and the perceived lack of confidence (77.5%) or understanding (69.7%) regarding undergoing TOLAC among pregnant women and their families. CONCLUSION: A proportion of Chinese obstetricians did not intend to recommend TOLAC to pregnant women with a history of CS. This phenomenon was closely associated with obstetricians' concerns about TOLAC safety and perceived attitudes of the pregnant women and their families regarding TOLAC. Effective measures are needed to help obstetricians predict and reduce the risks associated with TOLAC, clearly specify the indications for TOLAC, improve labor management, and popularize TOLAC in China. Additionally, public health education on TOLAC is necessary to improve the understanding of TOLAC among pregnant women with a history of CS and their families, and to improve their interactions with their obstetricians regarding shared decision making.

Hospice care self-efficacy among clinical medical staff working in the coronavirus disease 2019 (COVID-19) isolation wards of designated hospitals: a cross-sectional study.

BACKGROUND: The COVID-19 pandemic has caused more than 462,417 deaths worldwide. A large number of patients with severe COVID-19 face death in hospital. Hospice care is truly a philosophy of care that delivers patient-centred care to the terminally ill and their families. Hospice care could provide many benefits for patients, families, and for hospice caregivers. The aim of this study is to investigate hospice care self-efficacy and identify its predictors among Chinese clinical medical staff in COVID-19 isolation wards of designated hospitals. METHODS: A cross-sectional design was used. The Hospice Care Self-Efficacy, Self-Competence in Death Work Scale, Positive Aspects of Caregiving, and Simplified Coping Style Questionnaires were administered between February and April 2020. A total of 281 eligible medical staff responded to the questionnaires, with a response rate of ≥78.9%. RESULTS: The mean score of hospice care self-efficacy was 47.04 (SD = 7.72). Self-efficacy was predicted by self-competence in death work (B = 0.433, P < 0.001), positive aspects of caregiving (B = 0.149, P = 0.027), positive coping (B = 0.219, P < 0.001), giving hospice care to dying or dead patients before fighting against COVID-19 (B = -1.487, P = 0.023), occupational exposure while fighting against COVID-19 (B = -5.244, P = 0.004), holding respect for life and professional sentiment as motivation in fighting against COVID-19 (B = 2.372, P = 0.031), and grade of hospital employment (B = -1.426, P = 0.024). The variables co-explained 58.7% variation of hospice care self-efficacy. CONCLUSION: Clinical nurses and physicians fighting COVID-19 reported a moderate level of hospice care self-efficacy during this pandemic. Exploring the traditional Chinese philosophy of life to learn from its strengths and make up for its weaknesses and applying it to hospice care may provide a new framework for facing death and dying during the COVID-19 pandemic. Continuous hospice care education to improve self-competence in death work, taking effective measures to mobilize positive psychological resources, and providing safer practice environments to avoid occupational exposure are also essential for the improvement of the hospice care self-efficacy of clinical nurses and physicians. These measures help caregivers deal effectively with death and dying while fighting against the COVID-19 pandemic.

Challenge of parents caring for children or adolescents with early-stage schizophrenia in China: A qualitative study.

PURPOSE: To explore the challenges of parents caring for early-stage schizophrenia (ESS) children/adolescents in China. DESIGN AND METHODS: Thirteen parents of ESS subjects completed semi-structured interviews. Thematic analysis was used to analyze data. FINDINGS: Seven themes emerged from the data: psychological shock and emotional burden; lack of disease knowledge and care skill; poor treatment compliance of the patient; difficulty getting along with the patient; conflict within the family or in the workplace; financial burden; and need sufficient social support. Each challenge was produced and influenced under the Chinese special social context. PRACTICE IMPLICATIONS: Professional support was needed to help patients with schizophrenia to cope with their situation promptly. Education initiatives should focus on mental health to prevent discrimination from society and enable people to recognize the early symptoms of schizophrenia in children. Telemedicine should be explored for application in the treatment of mental illness. Also, a broader nationwide healthcare policy would be needed to help to reduce the individual and societal financial burdens associated with schizophrenia.

Maternal age at menarche and offspring body mass index in childhood.

BACKGROUND: Earlier age of menarche has been associated with an increased risk of chronic diseases during adulthood, but whether early menarche has intergenerational effect is not clear. METHODS: In this population-based cross-sectional study, we recruited children from 26 primary schools using cluster random probability sampling in Shanghai, China, in 2014. We used multiple linear regression models to estimate the adjusted associations of maternal age of menarche (MAM) with offspring body mass index (BMI). We also used the mediation analysis to examine the contribution of maternal BMI and gestational diabetes to offspring BMI. RESULTS: A total of 17,571 children aged 6-13 years were enrolled, of whom 16,373 had their weight and height measured. Earlier MAM was associated with higher child BMI in boys (- 0.05 z-score per year older MAM, 95% CI - 0.08 to - 0.02) and in girls (- 0.05 z-score per year older MAM, 95% CI - 0.07 to - 0.02). Maternal BMI positively mediated the association of MAM with offspring BMI in both sexes, with mediation effects of 37.7 and 19.4% for boys and girls, respectively. CONCLUSION: Early maternal menarche was associated with greater offspring BMI. This study provides evidence for the intergenerational effect in the development of BMI in offspring.

Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers.

BACKGROUND: This study aimed to describe the intentions of and barriers to the use of long-acting reversible contraceptives (LARCs) in the post-abortion period among women seeking abortion in mainland China. METHODS: A cross-sectional study was conducted from July 2015 to December 2015 using a waiting room questionnaire. A total of 381 women seeking abortions were recruited at a public hospital abortion clinic. The outcome variable was an 'intention-to-use' LARCs in the immediate post-abortion period. Chi-square tests were used to assess associations between categorical variables. Statistically significant variables (p ≤ 0.05) were then further analyzed by logistic regression. RESULTS: Among 381 respondents, 42.5% intended to use LARCs in the immediate post-abortion period; 35.2% intended to use intra-uterine devices (IUDs); and 13.9% intended to use implants. Previous use of LARC was a predictor for an intention to use LARCs (odds ratio [OR] = 2.41; 95% confidence interval [CI]: 1.06-5.47). Participants with one or no child had reduced odds for an intention to use LARC (OR = 0.32, 95% CI: 0.15-0.47 and OR = 0.29, 95% CI: 0.13-0.68, respectively). Women with a higher sex frequency (at least once per week) showed increased odds for LARC use (OR = 3.34; 95% CI: 1.03-10.78) and married women were more likely to use LARC than single women (OR = 1.57; 95% CI:1.00-2.47). Women who planned to have another baby within two years were more likely not to use LARCs in the immediate post-abortion period (OR = 0.97; 95% CI: 0.43-2.12). Barriers to the use of LARCs were anxiety relating to impaired future fertility (56.2%), LARCs being harmful to health (45.2%), irregular bleeding (44.3%), risk of IUD failure (41.6%) and lack of awareness with respect to LARCs (36.1%). CONCLUSIONS: Intention to use LARCs was predicted by marital status, frequency of sexual activity, number of children, planned timing of next pregnancy, and previous LARC use. Impaired future fertility, being harmful to health, irregular bleeding, risk of complications, and lack of awareness with regards to LARCs were the main barriers in their potential use.

Career intentions of PhD students in nursing: A cross-sectional survey.

BACKGROUND: Despite the rapid growth of Chinese nursing PhD programs, little is known about the career intentions of students in this field. OBJECTIVE: To investigate the career intentions of nursing PhD students. DESIGN: Online cross-sectional survey. PARTICIPANTS: Nursing PhD students at Chinese universities. METHODS: An online questionnaire was designed and the data were analyzed using SPSS. RESULTS: The mean age of the participants was 31.53 ±â€¯4.92 years, and most were female (89.9%), married (74.2%), and had been employed previously (69.7%). Most intended to work in the city where their family lived (34.8%) or near their previous workplace (32.6%). Most (60.7%) desired to work in an educational institution (e.g., a university or college). The most common expected salary was 8000-11,999 RMB/month. The work benefits perceived as indispensable were "Five Insurances and One Fund" (77.5%), good educational resources for children (59.6%), financial allowances for PhD graduates (52.8%), staff dormitories/housing subsidies (50.6%), and tenure (50.6%). Nursing education (75.3%) and research (70.8%) were the most favored fields. The key job characteristics were the opportunity to put strengths to fullest use (79.8%), time to conduct research (60.7%), and work-life balance (51.7%). The key research conditions included a good research incentive mechanism (77.5%), a Basic Scientific Research Foundation (68.5%), opportunity to apply to conduct research projects (66.3%), and the nursing team's atmosphere regarding research (64.0%), and 91.0% were eager to study abroad (e.g., as part of an international exchange). CONCLUSIONS: Nursing PhD students would like to work in their hometown or near their previous workplace. Most preferred working in an educational institution, and the most popular fields were nursing education and research (rather than clinical care), despite the high demand of hospital management for nursing PhD graduates. Flexible work, high-quality research conditions, a certain salary, work benefits, and training were key expectations.