BackgroundBullying experiences during clinical practice threaten nursing students' learning and professional development. However, existing studies mainly focused on variable-centered associations, with limited exploration of heterogeneous subgroups from a person-centered perspective. This study aimed to examine the mediating role of perceptions of clinical stressors (PCS) in the relationship between psychological capital (PsyCap) and bullying experiences, while identifying latent profiles of bullying experiences. Recognizing distinct subgroups and clarifying influencing mechanisms can help provide tailored educational interventions.MethodsA multicenter cross-sectional study was conducted from September 2024 to May 2025. A total of 578 nursing students undergoing clinical internships at six general hospitals in Gansu Province, China, were enrolled in the survey. This study included general information questionnaires, the Psychological Capital Questionnaire, the Perceptions of Clinical Stressors Scale, and the Bullying Behaviors in Nursing Education Scale. Mediation analysis and latent profile analysis were carried out.Results(1) Three distinct latent bullying experiences profiles were identified: the low bullying group (29.2%), the high bullying group (27.9%), and the moderate bullying group (42.9%). (2) PsyCap was significantly negatively associated with bullying experiences (r = −0.635, p < 0.001). (3) PCS partially mediated the relationship (ab= −0.248, p < 0.001) between PsyCap and bullying experiences, with a proportion mediated of 43.12%.ConclusionsBullying experiences among nursing students are heterogeneous and embedded in stressful clinical learning environments. PCS and PsyCap are key factors associated with this heterogeneity, with PCS acting as a partial mediator. Nursing educators should implement targeted, profile-specific interventions to mitigate the impact of bullying experiences.

BACKGROUND:Cardiovascular (CVD) and cerebrovascular diseases (CeVD) are leading causes of mortality. The Pooled Cohort Equations (PCE) are widely used for ASCVD risk prediction, but face calibration concerns, particularly in diverse populations. The Revised Pooled Cohort Equations (RPCE) were developed to address these limitations. While prior research has evaluated these models for ASCVD, less is known about their performance for CVD and CeVD mortality outcomes. OBJECTIVE:This study aimed to comprehensively compare the association of PCE and RPCE with CVD mortality and combined CVD and CeVD mortality, including subgroup analyses by race and gender, within a nationally representative US adult population. METHODS:We analyzed 16,584 primary prevention participants (aged 40-79 years) from National Health and Nutrition Examination Survey (1999-2018), linked to National Death Index mortality data. We calculated 10-year ASCVD risk using both PCE and RPCE. Bland-Altman plots assessed score agreement. Cox proportional hazards models evaluated the association of standardized PCE and RPCE scores with CVD and combined CVD and CeVD mortality, adjusting for confounders and stratifying by race and gender. RESULTS:Both PCE and RPCE were significantly associated with CVD mortality (adjusted hazard ratio (HR) for PCE: 1.91 [95% CI: 1.82-2.01]; RPCE: 1.65 [95% CI: 1.59-1.72]) and combined CVD and CeVD mortality (adjusted HR for PCE: 1.91 [95% CI: 1.82-2.00]; RPCE: 1.65 [95% CI: 1.60-1.72]). Bland-Altman analyses revealed PCE consistently overestimated risk compared to RPCE, with differences increasing at higher risk levels. RPCE demonstrated improved calibration, especially in racially diverse populations, where PCE overestimation was more pronounced. CONCLUSION:Both PCE and RPCE are robust prognostic tools for vascular mortality. However, RPCE offers improved calibration, particularly in racially diverse populations, by providing more conservative yet comparably predictive risk estimates. These findings highlight the importance of selecting risk models tailored to target populations to optimize prevention and avoid potential overtreatment.

Current benign prostatic hyperplasia (BPH) management prioritizes urological symptoms while neglecting psychological impacts on subjective well-being (SWB). Although chronic disease-SWB associations are established, limited evidence exists regarding interactive effects of psychosocial factors (sleep, anxiety, self-management) in BPH populations. This multicenter cross-sectional study enrolled 412 BPH patients from 6 tertiary hospitals in Northwest China. Validated instruments assessed key variables: Pittsburgh Sleep Quality Index for sleep quality, Self-Rating Anxiety Scale for psychological distress, Memorial University of Newfoundland Happiness Scale for SWB, and Chinese Self-Management Ability Scale for behavioral competencies. Structural equation modeling elucidated pathway relationships. Of the patients, 72.5% experienced sleep disorders, and 79.0% reported anxiety. Regression analysis indicated that income (β = 1.378, P < .01) and self-management abilities (β = 0.074, P < .01) positively impacted SWB, while anxiety (β = −0.155, P < .01) and sleep disorders (β = −0.581, P < .01) negatively affected it. The structural equation model revealed a direct effect of self-management abilities on SWB of 0.20 and an indirect effect of 0.16. This study contributes to the field by proposing a comprehensive, patient-centered model of care that can improve both the quality of life and long-term outcomes for BPH patients.

Kidney dialysis patients often experience intensified depression after prolonged maintenance dialysis, which may diminish family resilience. Conversely, family functioning and self-efficacy might bolster resilience by serving as crucial internal resources. The mechanisms through which depression impact family resilience via these resources remain unclear. The present study used a cross-sectional design and included 211 kidney dialysis patients. The study was conducted in Lanzhou, China. The participants were selected through convenience sampling from September 2023 to January 2024. General Information Questionnaire, Depression subscale of the Hospital Anxiety and Depression Scale (HADS), Family Resilience Rating Scale (FRRS), Family APGAR Index (APGAR) and Simplified Coping Style Questionnaire (GSES), were used for data collection. Independent-sample t-tests and one-way ANOVA determined the influential factors using SPSS 27.0. Structural equation modeling, executed with AMOS 24.0 software, validated the mediating effects of family functioning and self-efficacy between depression and family resilience. Family resilience levels among kidney dialysis patients differed significantly by education level, marital status and per capita monthly income. Depression were inversely associated with family resilience. Family functioning (β = 0.22, p < 0.01) and self-efficacy (β = 0.04, p < 0.01) mediated the relationship between depression and family resilience, respectively. This study provides further insights into the psychological mechanism of depression and family resilience in kidney dialysis patients. Caregivers can actively help kidney dialysis patients to reduce depression and improve the family functioning, so as to enhance the family resilience.

Background Nursing students bullying remains a key issue affecting their career preparation and development in healthcare. It is necessary to analyze research hotspots, trends through bibliometric statistics in order to identify the future research directions and provide targeted interventions. Aim The researchers conducted a bibliometric review on the bullying of nursing students. Methods We used the Web of Science Core Collection database to determine the most frequently cited studies on the bullying of nursing students. VOSviewer and CiteSpace were used to conduct bibliometric analysis. Results A total of 152 documents were retrieved from the WOSCC database, and we observed an increasing trend in publications over time. The United States was the leading contributor for research productivity. The author with the highest number of publications and the most cited author was Birks M. Nurse Education Today was the top journal in this area. ‘Bullying in the Nursing Profession’ by Randle J. was the most cited article. The research hotspots include three main areas: the types of bullying behaviors, experiential dimensions, and intervention. The burst vocabulary showed that the health, harassment, and intention of bullying of nursing students have a significant potential to become an emerging hotspot. Conclusion There is a growing body of research examining the bullying of nursing students. These findings provide invaluable insights for nursing education.

Teaching aims to improve the learning and all-round abilities of college students. However, the prevalent phenomenon of psychological truancy among college students is a major impediment to achieving the outcomes of teaching. Academic self-concept is a positive psychological feature that affects the academic activities of students. In this study, we explored the effect of academic motivation and school climate on the relationship between academic self-concept and psychological truancy. This is a descriptive cross-sectional study. A total of 628 students from 8 Chinese medical colleges were enrolled. Four questionnaires of Academic Self-Concept Scale (44-item; α = 0.84), the Psychological Truancy Scale (28-item; α = 0.84), the Delaware School Climate Survey-Student (Chinese adaptation, 31-item; α = 0.89) and the academic motivation questionnaire (34-item; α = 0.93) were used to collect data. Data analysis was conducted using SPSS Statistics (version 25.0) and AMOS (version 24.0) software, with a significance level set at 0.05. The findings of the study indicated that academic self-concept not only directly affect psychological truancy (β = -0.110, 95

Background Elder abuse is a global public health and human rights concern that is predicted to increase with the rapid increase in the elderly population in China. Objectives To investigate the incidence of elder abuse tendency and factors related to such a tendency among caregivers working in nursing homes. Methods A cross-sectional study comprising 412 caregivers from nursing homes was conducted. Results The results indicated that the prevalence of elder abuse tendency among caregivers working in nursing homes was 73.5%. This rate was influenced by gender, marital status, work experience, employment modes, whether one had participated in relevant training, caregiver burden and the level of perceived social support (P < 0.05). Conclusion The study revealed the factors influencing elder abuse tendency among caregivers working in nursing homes and the relationships between elder abuse tendency, caregiver burden, and perceived social support.

ObjectiveThe aim of this network meta-analysis was to compare the improvement effects of various exercise interventions and mindfulness-based interventions to determine the best interventions for the improvement of cognitive impairment.DesignSeven databases were searched to screen randomized controlled trials of exercise interventions and mindfulness-based interventions to improve cognitive impairment. The network meta-analysis was performed using Revman 5.3, R 4.2.1 and ADDIS 1.16.8 software.ResultsThirty-four randomized controlled trials involving 14 interventions were included in the study. In terms of cognitive function, except for mindfulness-based stress reduction, all interventions showed significantly greater improvement in cognitive function compared with conventional therapy. Physical activity and Qigong showed better effect in improving executive function. In terms of improving verbal memory, compensatory cognitive training, neurofeedback training, Qigong, and sham Qigong were more effective than other interventions. On performing surface under the cumulative ranking curve analysis, acceptance and commitment therapy, neurofeedback training, Qigong, and mediation had the best effects on cognitive function, quality of life, executive function, and processing speed, respectively.ConclusionsMindfulness-based interventions were found to be more effective than exercise interventions for alleviating cognitive impairment. More robust randomized controlled trials focusing on acceptance and commitment therapy for cognitive impairment are required to support the current evidence.

This study aimed to explore the relationship between caregiver burden and anticipatory grief among caregivers of elderly cancer patients, and to examine the chain mediation effects of family functioning and resilience. A total of 624 valid questionnaires were collected. The Structural Equation Model was established to test the mediating effects of family functioning and resilience. Results showed that caregiver burden has a direct positive effect on anticipatory grief, both family functioning and resilience have negative effects on caregiver burden and anticipatory grief, and that resilience moderates the mediating effect of family functioning. Our findings suggest that reducing the caregiver burden among caregivers of elderly cancer patients, improving family functioning, and enhancing resilience have important effects in alleviating the anticipatory grief of caregivers. Our findings provide some references for further research. Medical staff should better understand the grief experience of caregivers and implement interventions to enable caregivers to better cope with anticipatory grief and psychological stress, so as to promote the quality of care for elderly cancer patients.

AbstractAimTo examine how the effects of hardiness, self‐efficacy and positive academic emotion related to the SRL ability of undergraduate nursing students.DesignA cross‐sectional survey was designed.MethodsA total of 395 Chinese undergraduate nursing students from two undergraduate colleges filled out the questionnaires from May to June 2019. The relationships between hardiness, self‐efficacy, positive academic emotion and SRL ability were analysed by structural equation modelling.ResultsThe response rate was 94.05%. SRL ability was significantly positive correlated with hardiness, self‐efficacy and positive academic emotion in undergraduate nursing students. Self‐efficacy (β = 0.417, p < 0.001) and positive academic emotion (β = 0.232, p < 0.001) showed a direct effect on the SRL ability. Although hardiness showed no direct effect on the SRL ability, it affected SRL ability through three indirect ways: self‐efficacy (77.778%), positive academic emotion (14.184%) and the chain mediating effect from self‐efficacy to positive academic emotion (8.038%).ConclusionsNursing students with a higher level of hardiness would have higher self‐efficacy, and more positive and stable academic emotions to obtain the better SRL ability. The produced model provides insights into several factors associated with SRL ability of nursing students. Hardiness, self‐efficacy and positive academic emotion should be emphasized in the education of nursing students because these factors could improve their SRL ability and promote their life‐long learning.

Background The infertility prevalence of married couples in China is increasing gradually. The dyadic coping level and its influencing factors of infertile women in China are poorly reported. The relationship between dyadic coping and the family cohesion and adaptability in infertile women was investigated. Methods A total of 482 infertile women in the reproductive clinics of three affiliated hospitals of the Lanzhou University were selected by the convenience sampling method. The self-made general information questionnaire, family adaptability and cohesion evaluation scale, and dyadic coping questionnaire were used in this study. Results The average age of infertile women was 31.73 ± 4.57 years, the duration of infertility was 28.66 ± 27.99 months, the total score of dyadic coping was 132.66 ± 25.49, the total score of family cohesion and adaptability was 101.48 ± 20.96. A significant positive correlation between dyadic coping and family cohesion and adaptability was observed (r = 0.74, p < 0.01). The multiple linear regression analysis showed that religious belief, number of miscarriages, relationship between family members, family intimacy, and adaptability were the influencing factors of dyadic coping level in the family of infertile women (R2 = 0.566, p < 0.01). Conclusions The dyadic coping level of infertile women is in the medium level, which is significantly positively correlated with family intimacy and adaptability. In clinical nursing, nurses try to improve the family relationship of patients to increase the level of dyadic coping of infertile women.

Objective To investigate the research hotspots and trends in the field of elderly care staff’s job satisfaction, and provide references for the relevant research in China. Methods The CiteSpace 5.8.R1 software was used to visually analyze the number of publications, country of publication, keywords, co-citation and outburst words of related literatures in the field of job satisfaction of elderly caregivers collected from January 1, 1993 to December 14, 2021 in the core collection database of Web of Science. Results A total of 304 studies were included, and the number of publications showed an overall upward trend. The related outcomes, influencing factors and intervention measures of job satisfaction of elderly caregivers were the research hotspots, and turnover intention was the research trend. Conclusion Research on job satisfaction of elderly caregivers in China is at the beginning stage. It is suggested that relevant scholars strengthen the theoretical study, strengthen the model construction, and expand the research perspective.

AIM:To assess the influence of professional identity on work engagement among nurses working in nursing homes in China.BACKGROUND:China is faced with an increasingly ageing population. There is a shortage of adequately trained nursing personnel and a high turnover rate among nurses. Work engagement is a key factor in improving nurses' performance and improving professional identity is critical to increase work productivity and satisfaction.METHODS:We conducted a cross-sectional survey of 272 nurses working in nursing homes. And the data were analysed by descriptive analyses, univariate analysis and Multiple regression analyses.RESULTS:The overall average work engagement score was 3.99 ± 1.04. Professional identity was the only factor that significantly influenced the 'vigour' and 'absorption' of nurses. Age, ethnicity and professional identity were significant predictors of 'dedication'.CONCLUSIONS:A positive professional identity can lead to a better work engagement among nurses working in nursing homes in China.IMPLICATIONS FOR NURSING MANAGEMENT:To enhance the work engagement of nurses working in nursing homes, nursing leaders should create a respectful and equal work environment, create a favourable image of the industry and the profession and strengthen training to improve the professional identity.

目的 探讨BOPPPS教学模式在《临床综合护理技能》课程中的应用效果.方法 将2016级81名护理本科生和2017级98名护理本科生分别作为对照组和观察组.对照组采用传统教学法,观察组采用BOPPPS教学模式开展教学.教学评价包括过程性评价、终结性考核和问卷调查,问卷采用护理临床决策意识量表、中文版护生问题解决能力问卷.结果 观察组学生过程性评价、终结性考核、综合成绩评分及护理临床决策意识评分、问题解决能力评分显著高于对照组(均P＜0.05).结论 BOPPPS教学模式在《临床综合护理技能》课程中的设计及应用可以增强学生课堂参与度,有效提高整体教学成绩,且可提升学生问题解决能力和护理临床决策意识.

Background A key outcome in coronary heart disease (CHD) is Health Related Quality of Life (HRQoL), and family functioning is important in the management of CHD. But few studies have examined both together, and little is known about them among inpatients with CHD in less developed areas of China. Therefore, this study aimed to assess the HRQoL and family functioning status of inpatients with CHD in Lanzhou from Northwest China, and identify the factors that affect their HRQoL. Methods A cross‑sectional study was conducted in 224 CHD inpatients at one major hospital. Sociodemographic data and disease information of CHD inpatients were collected by face-to-face using a structured questionnaire and data were also obtained from patient medical records. HRQoL was measured using the Sickness Impact Profile (SIP). Family functioning was measured using the family APGAR index. Multiple binary logistic regression analysis (MBLRA) was used to explore potential risk factors associated with HRQoL, and Pearson’s correlations were used to assess the relationship between family functioning and HRQoL. Results The overall, physical and psychosocial SIP scores were 25.03 ± 8.52, 18.61 ± 9.90 and 28.08 ± 9.64, respectively. The total family APGAR score was 6.11 ± 2.45. MBLRA found older age, poorer cardiac function and more severe disease were associated with poorer HRQoL, while better family functioning, higher monthly income, and urban living were associated with better HRQoL. Family functioning was weakly to moderately correlated with total and psychosocial HRQoL. Conclusions Older and less affluent inpatients with lower educational level, less family support and more severe CHD have poorest quality of life, and health care providers should consider interventions to support them.

Objective To explore the construction method and teaching effect of Hospice Nursing course for nursing undergraduates. Methods Based on surveys and expert consensus,the specialized and optional course of Hospice Nursing was set up and improved. The teaching objective of the course was to guide students to establish correct attitude to life and death,master the knowledge and skills of hospice nursing,and improve their attitudes and abilities in hospice care. The teaching contents included death education,quality of life evaluation,common symptom management,psychological care of dying patients and their families,etc. Diverse teaching methods were adopted,such as case teaching,scenario simulation teaching,debate and etc. Formative evaluation was used for assessment. A total of 35 nursing undergraduates of 2018 Class were selected as the participants,and the teaching effect was evaluated by the course scores,the interview of students’ teaching satisfaction,and the surveys of students’ attitude toward death anxiety and hospice care. Results The course scores of 35 students were 87.43 ±0.84. In interview,18 students were satisfied with the content,method,assessment and experience of teaching,and put forward suggestions to increase teaching hours and carry out clinical practice. After taking the course,the total score of death anxiety among students was lower（Z=3.248,P＜0.001）,and the total score of hospice attitude was higher（t=5.284,P＜0.001）than before. Conclusion These students passed the Hospice Nursing course examination smoothly and were satisfied with the teaching effect. Besides,their death anxiety got reduced with improved attitude toward hospice care.

目的 了解前列腺增生症患者的主观幸福感水平及影响因素,为提高患者的主观幸福感水平提供对策依据.方法 采用一般人口学资料调查表、纽芬兰大学幸福度量表、匹兹堡睡眠质量指数量表、焦虑自评量表及自我管理能力量表调查412例前列腺增生症患者.结果 前列腺增生症患者主观幸福感得分为(21.17±8.36)分;前列腺增生症患者主观幸福感得分与自我管理能力总分呈正相关(P<0.01,r=0.380),与焦虑总分、匹兹堡睡眠质量总分呈负相关(P<0.01,r=-0.536;P<0.01,r=-0.553);多元线性回归分析显示,家庭人均月收入、自我管理能力、焦虑、睡眠障碍是主观幸福感的主要影响因素(P<0.01),可解释总变异的38.9％.结论 前列腺增生症患者主观幸福感处于中等水平,建议医护人员应注重患者自我管理能力提升,睡眠质量改善及加强心理健康教育,从而提高患者的主观幸福感水平.

Objective. The core-shell chlorhexidine/amorphous calcium phosphate (CHX/ACP) nanoparticles were synthesized and used to modify the dental resin composite, aiming to improve its remineralized and antibacterial properties. Methods. The core-shell CHX/ACP nanoparticles were synthesized by vesicle-templating technology and characterized, and their sustained release and antibacterial properties were also evaluated. Subsequently, the synthesized nanoparticles were incorporated into the dental resin composite at 1 wt.%, 5 wt.% or 10 wt.% to obtain different experimental groups. The physical properties, including curing depth, double bond conversion rate, water absorption and solubility, the sustained-release effects, and mechanical properties of the modified resin composite were evaluated. The remineralization ability was also measured by SEM. The antibacterial experiment of the modified resin composite with fresh preparation or aging in water for 28 days was carried out by a plate count method. Results. The physical and chemical characterizations showed that the synthesized nanoparticles presented a core-shell structure, and their diameter was about 98.5 nm. The shell was composed of ACP with the core full of CHX. These nanoparticles had a release effect on calcium, phosphate ions, and CHX. The nanoparticles could effectively inhibit the growth of S. mutan at a lower concentration (>= 50 & micro;g/mL). The curing depth, the double bond conversion, the water absorption, the solubility, the flexural strength, the flexural modulus, and the compressive strength of the modified resin composite were 3.86-4.88 mm, 62.32-73.61%, 1.47-2.84%, 0.21 & minus;0.48%, 45.83-109.46 MPa, 2.57-4.91 GPa, and 66.43-160.38 MPa, respectively. The modified resin composite containing 5 wt.% and above CHX/ACP nanoparticles could effectively inhibit the growth of S. mutans regardless of aging in water, with immediate and aging antibacterial rate of more than 92%. In addition, the modified resin composite had a certain remineralization property in the SBF solution verified by SEM. Significance. The core-shell CHX/ACP nanoparticles were successfully prepared and used to modify the resin composite. The modified dental resin composite with 5 wt.% CHX/ACP nanoparticles had excellent mechanical, antibacterial, and remineralization properties. It is expected to be an ideal restorative filling material for clinical application. (c) 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

目的 探讨农村老年冠心病患者的家庭关怀度与生活质量的关系以及自我效能感和自我管理能力在其中的链式中介作用.方法 2020年7-11月,便利抽样选取郑州市郊县某自然村530名农村老年冠心病患者,采用健康状况调查简表、家庭关怀度指数问卷、冠心病自我效能感量表和冠心病自我管理行为量表对其进行调查,并建立结构方程模型.结果 农村老年冠心病患者的家庭关怀度、自我效能感、自我管理能力和生活质量得分分别为(4.25±1.05)分、(32.15±11.28)分、(54.64±15.08)分和(55.38±10.65)分;且相互间呈两两正相关(r为0.489～0.935,均P＜0.01);家庭关怀度可正向预测生活质量(β = 0.319,P＜0.01);家庭关怀度通过自我效能感、自我管理能力对生活质量的中介效应显著(均P＜0.01);自我效能感及自我管理能力在农村老年冠心病患者的家庭关怀度与生活质量之间发挥链式中介作用(β = 0.150,P＜0.01).结论 提高农村老年冠心病患者的家庭关怀度,增强自我效能感和自我管理能力,对改善其生活质量有重要意义.