Although previous evidence indicates that the composite dietary antioxidant index (CDAI) is negatively associated with health outcomes, no studies have explored the association between CDAI and premature death. This research utilized a cohort study design with 37,301 participants from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. Cox proportional hazard regression was employed to analyze the association between CDAI and premature death and all-cause mortality. Restricted cubic spline (RCS) analysis was performed to examine the nonlinear relationship between variables, and Kaplan-Meier analysis was used to evaluate survival outcomes over time. Sensitivity and subgroup analyses were conducted to assess the reliability of the findings. During a median follow-up period of 8.25 years, 4487 deaths were recorded, with 1671 classified as premature. The study revealed a negative correlation between CDAI and premature death (Per-SD hazard ratio [HR] 0.91, 95% CI 0.85-0.97; quartiles [Q4:Q1] HR 0.83, 95% CI: 0.70, 0.98) as well as all-cause mortality (Per-SD HR 0.96, 95% CI 0.92-1.00; quartiles [Q4:Q1] HR 0.91, 95%CI: 0.82, 1.01). The RCS analyses indicated a 'U' shaped relationship between CDAI and premature death and all-cause mortality. The threshold effect analysis pinpointed the inflection points for CDAI relative to premature death and all-cause mortality at 1.42 and 1.48, respectively. Kaplan-Meier curves illustrated that the likelihood of individual survival increases with higher CDAI quartiles. The results highlight the significance of dietary antioxidant intake in enhancing extending lifespan. Further research is needed to investigate the underlying mechanisms and determine optimal intake levels for improving health outcomes.

Objectives: The study aimed to survey the current situation and explore the factors that influence the ability of palliative care practice among oncology nurses. Methods: A multicenter cross-sectional study was conducted using stratified random sampling to select 26 tertiary hospitals' oncology departments in Hubei Province, China. A total of 1,198 nurses were included and finished the questionnaire consisting of social demographic characteristics, Palliative Care Self-Report Practice Scale (PCPS), End-of-life Professional Caregiver Survey (EPCS), and Self-Perceived Pain Assessment Knowledge and Confidence Scale (Self-PAC) through the online platform. Data were analyzed using t-test, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis in SPSS 26.0. Results: The total score for PCPS was 67.17 +/- 12.57, the three dimensions' scores were: physical symptom care (32.50 +/- 6.10), spiritual and psychological care (23.35 +/- 4.97), communication (11.58 +/- 2.48). There are significant positive correlations between the palliative care practice ability and core competence (r = 0.77, P < 0.01), as well as pain assessment ability (r = 0.56, P < 0.01). Multiple regression analysis identified female, with high education background (bachelor's degree and master's degree or above), interest in palliative care, pain assessment ability, and core competence were positive predictors of palliative care practice ability (Adjusted R-2 = 0.668, P < 0.05). Conclusions: The overall ability of the oncology nurses to practice palliative care was relatively high, but the palliative nurses reported suboptimal performance in the communication dimension of palliative nursing practice ability. To comprehensively improve oncology nurses' palliative care practice ability, managers must consider the gender structure, educational background, enthusiasm for palliative care work, core competence, and pain assessment ability.

Background:Nursing interns play a crucial role in shaping the future nursing workforce, as their professional identity is closely linked to workplace retention rates and patient outcomes. Thus, investigating the factors that influence nursing interns' professional identity is important. Objective:To evaluate the relationship between psychological capital, stress, micro-learning environment, and professional identity among nursing interns. Methods:This was a cross-sectional study. The sample consisted of 388 nursing interns from 8 comprehensive teaching hospitals across five cities in Hubei Province between March and April 2024. Data were collected using a Descriptive Information Questionnaire, the Psychological Capital Questionnaire, the Student Nurse Stress Index scale, the Healthcare Education Micro Learning Environment Measure, and the Professional Identity Scale. The structural equation model was applied to explore the influencing factors of nursing interns' professional identity. Results:The mean total score for professional identity was 35.57 ± 7.47. Psychological capital positively influenced professional identity directly (β = 0.16, P < 0.01), while stress as measured using the student nurse stress index had a negative impact (β = -0.20, P < 0.01). High scores on the healthcare education micro-learning environment measure positively contributed to the development of professional identity (β = 0.69, P < 0.001). Furthermore, psychological capital was identified as a mediator in the association between the healthcare education micro learning environment and professional identity, as well as between the student nurse stress index scores and professional identity. Conclusion:The study suggests that a higher level of psychological capital, low stress levels, and a satisfied micro-learning environment are essential in fostering professional identity among nursing interns. It recommends collaboration between nursing schools and clinical departments to enhance nursing interns' psychological capital and stress management skills, creating a positive and safe working environment, thereby fostering professional identity among nursing interns.

The stress hyperglycemia ratio (SHR) is recognized as a significant indicator of relative hyperglycemia that has demonstrated to correlate with poor outcomes, including elevated mortality rates in individuals facing severe acute conditions. However, the connection between SHR and all-cause mortality and premature death in individuals with cardiovascular disease (CVD) remains insufficiently investigated. This research intended to investigate the relationship between SHR and all-cause mortality and premature death among individuals with CVD. This cohort study involved data extracted from 2,714 follow-up cohorts sourced from the National Health and Nutrition Examination Survey (NHANES). Participants were categorized based on SHR quartiles. The relationship between SHR and all-cause mortality and premature death in CVD patients was analyzed using Kaplan-Meier survival curves, restricted cubic splines (RCS), Cox proportional hazards models, threshold effect analysis, and subgroup analyses. Over an average follow-up duration of 88.38 months, 1,201 deaths were documented, of which 351 were classified as premature. The Kaplan-Meier curves illustrated that individuals in quartile 2 of SHR exhibited highest survival probability compared to other quartiles. Cox proportional hazards regression revealed a positive association between SHR (for continuous) and all-cause mortality (HR 1.57, 95

Post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are inspiratory areas of psychological research in which deliberate rumination has important implications. However, these relationships have not yet been assessed in the COVID-19 pandemic using longitudinal designs. In this study, measures of PTSD, PTG, and deliberate rumination were collected from 2,292 healthcare staff members at two-time points six months apart in 2022–2023 from two general hospitals in Hubei Province, China. A cross-lagged analysis was used to simultaneously determine the directional relationships between these three variables. The results suggest that the relationship between PTG and deliberate behavior is bidirectional and mutually reinforcing (β = 0.133, P < 0.001; β = 0.129, P < 0.001). Significant prospective relations were observed between PTG and PTSD (β = 0.054, P < 0.01), and PTSD prospectively predicted changes in deliberate rumination (β = 0.204, P < 0.001). In addition, significant sex differences were observed in the cross-lagged models. These findings highlighted the noteworthy cross-lagged relationship between PTSD, PTG, and deliberate rumination two years after the COVID-19 pandemic in Hubei Province, China. Therefore, interventions to reduce PTSD, promote PTG, and improve well-being among healthcare staff are important.

Currently, the physical and mental health of nursing staff in China is not optimistic and cannot be ignored. Meanwhile, the tense nurse-patient relationship imposes higher demands on the emotional labor of nursing staff. How to maintain a balance between the contributions and rewards of nursing staff, guide them to engage in moderate emotional labor, and improve their physical and mental health has become an important and urgent issue that medical institutions and the entire society need to address. The purpose of this study was to explore the effect of effort-reward imbalance on the physical and mental health of nurses, focusing on the mediating role of emotional labor and nurse-patient relationship, and to provide a basis for formulating strategies and measures to improve the health status of nursing staff. A cross-sectional design was employed.Using convenience sampling methods, 2191 new nurses were surveyed in 7 hospitals in Hubei Province, China, from June to October 2024. Data were collected using demographic characteristics questionnaire, the Short Form-12(SF-12) scale, the Effort-reward imbalance Scale, the Emotional labour Scale for Nurses, while the nurse-patient relationship was assessed using single items. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 26.0 was used for data analysis. The mediation model shows a good fit (χ2/df = 2.747, CFI = 0.981, AGFI = 0.971, IFI = 0.982, GFI = 0.990, TLI = 0.961, and RMSEA = 0.056). In this study, we found emotional labour is a mediating variable between effort-reward imbalance and physical and mental health of nurses (β = 0.009, P = 0.019), nurse-patient relationship is a mediating variable between effort-reward imbalance and physical and mental health of nurses (β = 0.126, P < 0.01) and emotional labour and nurse-patient relationship play a chain mediating role in effort-reward imbalance and physical and mental health (β = 0.011, P = 0. 023). The study emphasizes the significance of enhancing the physical and mental health of nurses. Policymakers and hospital administrators should devise policies and strategies that encourage nurses to demonstrate an appropriate level of dedication, balance effort and reward, establish a safe working environment, and improve emotional labor to promote harmonious nurse-patient relationships, thereby improving the physical and mental health of nurses.

The impaired healing of diabetic wounds is a key factor leading to foot ulcers, wound gangrene, and even amputations in patients. Mesenchymal stem cell exosomes offer a novel therapeutic strategy for diabetic wound repair; however, exosomes are easily cleared by the immune system in vivo and have a short retention time in tissues, resulting in suboptimal therapeutic efficacy. Polysaccharide-based hydrogels are ideal delivery carriers for exosomes. This article analyzes the causes of difficult diabetic wound healing, provides a brief overview of the applications of mesenchymal stem cell-derived exosomes and polysaccharide-based hydrogels in diabetic wound healing, and discusses the role of polysaccharide-based hydrogels loaded with exosomes in promoting diabetic wound healing. This work aims to provide a reference for the application of exosome-loaded polysaccharide-based hydrogels in diabetic wound repair.

The purpose of this study was to develop a specific instrument to assess the discharge readiness among Chinese adults following brain tumour surgery and evaluate its psychometric properties. The construction of this measurement tool from March 2022 to April 2024 comprised two stages: the development of the scale (Stage I) and a cross-sectional survey involving 413 post-operative brain tumour patients to test its psychometric properties (Stage II). The final scale had 24 items with 4 domains. The item-level content validity index ranged from 0.850 to 1.000, and the scale-level content validity index was 0.926. Exploratory factor analysis showed a four-factor structure of the 24-item scale, accounting for 63.319% of the variance. The structures of confirmatory factor analysis formed validated acceptable fit indices after modification, which further confirmed the fit of the scale to the model. The scale showed an acceptable concurrent validity when compared with the RHDS (r = 0.456-0.875, p < 0.001). The Cronbach's α and split-half reliability of the total scale was 0.894 and 0.813, respectively. The scale has good reliability and validity and can be used to assess the discharge readiness of Chinese adults following brain tumour surgery.

ObjectiveThis study aims to investigate the factors that influence fatigue in hemodialysis (HD) patients and to develop and validate a nomogram to estimate the probability of fatigue in this population.MethodsThis cross-sectional study collected 453 patients who underwent HD at the tertiary hospital in Hubei, China, from April to December 2023. They were randomly divided into a 70% training group (n = 316) and a 30% validation group (n = 137). In the training set, factors influencing fatigue were screened using multivariate logistic regression analysis, and a nomogram was developed to estimate fatigue probability in HD patients. The discrimination and calibration of the nomogram were validated in both the training and validation sets through the area under the receiver operating characteristic (ROC) curve (AUC) and the Hosmer-Lemeshow (H-L) test.ResultsIn the training group, logistic regression showed that age, dialysis vintage, inter-dialysis weight gain, hemoglobin, depression, insomnia, and social support were variables associated with fatigue in HD patients. Based on these factors, a nomogram for assessing fatigue probability in HD patients was developed. The AUC was 0.955 (95% CI: 0.932-0.977) and 0.979 (95% CI: 0.961-0.997) in the training and validation sets. The results from the H-L test indicated a good fit.ConclusionThe nomogram can evaluate fatigue probability in HD patients and may serve as a convenient clinical tool.

To investigate clinical nurses’ perception of adverse event risk and to analyze its influencing factors. A proportional stratified random sampling method was applied to recruit nurses from a hospital in Shiyan City, Hubei Province, China. The Nursing Adverse Event Risk Perception Scale, Organizational Support Questionnaire, Nurse Manager Leadership Behavior Questionnaire, Nursing Safety Behavior Questionnaire, and Burnout scale was used to investigate 1084 nurses. Univariate analysis, Pearson correlation analysis, and multiple linear regression analysis were used to analyze the influencing factors. The scores of the Nurses’ Risk Perception of Adverse Nursing Event Scale, Organizational Support Questionnaire, Nurse Manager Leadership Behavior Questionnaire, Nursing Safety Behavior Questionnaire, and Burnout Scale were 14.98 ± 5.39, 52.57 ± 10.00, 88.98 ± 21.08, 56.42 ± 5.03, 30.90 ± 21.49, respectively. According to the correlation analysis, nurses’ perception of adverse nursing events was positively correlated with the sense of organizational support (r = .457, P < .01), head nurses’ leadership behavior (r = .348, P < .01), and nurse safety behavior (r = .457, P < .01), and negatively correlated with the level of burnout (r = −.384, P < .01). According to the Regression analysis, nurses’ departments (β = .226, P < .001), daily working hours (β = 1.122, P < .001), adverse events experience (β = −1.505, P < .001), organizational support (β = .105, P < .001), head nurses’ leadership behavior (β = .072, P < .001), and burnout (β = −.052, P < .001) held an influence on nurses’ risk perception of adverse nursing event. These factors explained 42.5% of the total variation. Nurses’ risk perception of adverse nursing events needs to be improved. Nursing managers need to strengthen organizational support for nurses, change the leadership behavior of nurse managers, reduce nurses’ burnout, improve nurses’ risk perception of adverse nursing events, prevent adverse events, and ensure patient safety.

The study was to survey the current situation and explore the relationship between pain assessment ability, palliative care core competence and palliative care practice ability among oncology nurses in mainland China. A multicenter cross-sectional study design was employed. Study data were collected in 26 tertiary hospitals among 1198 registered oncology nurses in the oncology department in Hubei province, China. A web-based survey was conducted using a stratified random integral sampling method to obtain data. All variables were measured using standardized instruments. Data was analyzed using SPSS 26.0 and AMOS 26.0 statistical software. All statistical tests were two-sided, with the significance level set at P < 0.05. The structural equation model was utilized to test the mediation effect of pain assessment ability on the pathway from palliative care core competence to palliative care practice ability. The mean scores for pain assessment, core competence and practice ability were 125.68 (SD = 31.16), 76.67 (SD = 19.59) and 67.17(SD = 12.57), respectively. Pearson correlation analysis revealed significant positive correlations among the PCPS, EPCS, and Self-PAC scores of the oncology nurses (P < 0.01). The association between core competence and palliative care practice ability was mediated by pain assessment ability (ES = 0.125, 95

To identify and evaluate the psychometric properties of available patient-reported outcome measures (PROMs) of psychological birth trauma (PBT) in postpartum women. A literature search was carried out across eight databases—PubMed, Embase, Web of Science, CINAHL, PsycINFO, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese Technical Periodicals—covering studies published from the inception of each database up to 21 May 2024. English and Chinese language studies employing any research design and reporting at least one psychometric property of PBT in puerperae were included. Independent reviewers extracted data and followed the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines to evaluate three aspects of the included instruments: methodological quality, psychometric properties, and level of evidence assessed using the modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Thirty-one studies with twelve PROMs were included, measurement error, cross-cultural validity, and responsiveness were not reported for most PROMs. Nine PROMs received a Class B recommendation, based on their measurement attribute ratings and overall evidence quality. In contrast, the CTI, IES-R, and PBTAS with high-quality evidence for insufficient measurement properties, so received a Class C recommendation. This systematic review provisionally recommends the City BiTS as credible tool for assessing PBT in both clinical practice and research involving puerperae. However, further comprehensive studies are needed to conduct more comprehensive validations of the psychometric properties of existing PROMs.

目的 通过了解在校小学四年级到高三年级中小学生的心理健康总体现状,评估学生心理健康水平.方法 采用中国中学生心理健康量表(MSSMHS)对全市小学四年级以上学生,初中生(职业技术学校学生)及高中生进行大样本心理健康筛查.结果 总体测评结果显示,学生心理健康正常人数为 124 749 名(73.70%),异常人数为 44 521 名(26.30%).异常人数中存在轻度心理健康问题为 35 215 名(20.80%),中等程度心理健康问题为 8 178 名(4.83%),存在较重心理健康问题为1 053 名(0.52%),存在严重心理健康问题为75 名(0.04%).不同学习阶段、不同年级、不同学段公立私立学校学生心理健康状况分布均有差别.女生MSSNHS总分及各因子分均高于男生(P＜0.01).结论 通过测评,可以帮助学校老师、家长和学生本人了解存在的问题,从心理和行为等方面进行疏导、干预,甚至药物有效治疗;建立学生心理健康档案,提升该市学生整体心理健康水平.

文章总结了 1 例暴发性心肌炎合并感染性休克新生儿行体外膜肺氧合(extracorporeal membrane oxygen-ation,ECMO)的护理经验.在多学科团队协作下,对患儿实施 ECMO 精细化管理,包括管道及参数管理、出入量管理、抗凝管理、血管活性药物的动态使用,同时做好营养支持、镇痛镇静管理、个性化基础护理以及感染的防控等.经过精心治疗和护理,患儿成功撤离 ECMO,康复出院.

目的 探讨产褥期产妇及配偶的二元应对与育儿胜任感的主客体效应,为制定针对性的护理干预提供参考.方法 采用便利抽样法,选取产后42 d复查的274对产妇及其配偶,运用一般资料调查表、二元应对量表、育儿胜任感量表进行调查,构建产妇及其配偶的二元应对与育儿胜任感的主客体互倚模型.结果 产妇与配偶的二元应对总分分别为(128.96±16.23)分、(129.62± 15.56)分;育儿胜任感总分分别为(72.32±9.59)分、(73.15±8.22)分.产妇及配偶的二元应对均能正向影响自身的育儿胜任感(β=0.314、0.299,均P＜0.05),即主体效应显著;产妇及配偶的二元应对均可正向影响对方的育儿胜任感(β=0.240、0.325,均P＜0.05),即客体效应显著.结论 产妇及配偶的育儿胜任感、二元应对均处于中等水平,育儿胜任感受 自身和对方二元应对的交互影响.为提升产后积极育儿体验,医护人员可将产妇配偶纳入进来,制定以夫妻为中心的共同育儿干预方案.

Objective: This paper aims to explore the influence of family function, work engagement, and sleep on the mental health of nurses in China’s top three hospitals. Methods: The convenience sampling method was adopted to select 1147 clinical nurses from Taihe Hospital Affiliated to Hubei University of Medicine, during the period of August- September 2018 as the survey subjects. Correlation analysis was performed to explore the relationship between clinical nurses’ mental health and family function, work engagement, and sleep quality. Results: The result demonstrated that the main influencing factors of clinical nurses’ mental health include the length and emotional degree of family function, sleep quality, and the vitality dimension in work engagement. Conclusion: The clinical nurses have good family function, sleep quality, and mental health status, and the level of work engagement is average. Besides, work engagement is closely related to mental health.

Abstract Aim This study aimed to undertake a bibliometric analysis to provide comprehensive information in demonstrating the current status and outline the overall trends in the area of readiness for hospital discharge (RHD). Design A bibliometric and visual analysis of RHD literature was undertaken. Methods Articles were retrieved from the Web of Science network from 2002 to 2021. VOSviewer was used to identify the co‐authorship network of countries/institutions, co‐authorship and co‐citation analysis of authors, and co‐citation analysis of references and citation analysis of documents. CiteSpace was used to identify the keyword co‐occurrence network and perform cluster analysis, detecting the keywords with citation bursts and speculated frontiers in this research field. Results A total of 512 articles were included in the final analysis. Key findings are: (1) There has been a continuous but somewhat fluctuating rise in the number of publications. (2) 56.05% of publications come from the USA with Marquette University making the highest contribution. (3) Most publications (17, 3.32%) in RHD research were from the Journal of Clinical Nursing, and Anaesthesia and Analgesia had the highest number of citations (584 citations). (4) Weiss ME (25, 4.88%) was the most productive author whose articles have been the most highly cited (646 citations). (5) Cited references from Weiss ME (2007) also made the largest contribution to co‐citations, and the most cited reference was from Jack BW (2009) (1022 citations). (6) The 20 most frequent keywords and keywords with the strongest citation bursts were retrieved. There were seven research hotspots, and three emerging research frontiers were explored. Conclusions The bibliometric analysis of material published in the last 20 years indicates that there have been statistically significant gains in comprehensive information on RHD, including the knowledge mapping of the countries, institutions, authors, references and keywords. The hotspots and frontiers, which have been explored can give guidance to researchers as to new angles and directions to take. Implications for Nursing Management The effects of the implementation of ERAS on RHD‐related risk for adverse post‐discharge outcomes in surgical patients will be of increasing concern for healthcare professionals. It is important for patients and their relatives to be confident that on discharge they are sufficiently ready for hospital discharge to enable them to safely and smoothly make the transition to home. Improving the level of RHD in discharged patients can help nurse managers and researchers measure the effectiveness of discharge planning services.

目的:了解临床护士护理不良事件风险感知现状及影响因素,并探讨其对护士安全行为的影响.方法:采用方便抽样法选取十堰市某三级甲等医院 1 084 名临床护士为研究对象,采用一般资料问卷、临床护士不良事件风险感知量表、组织支持感问卷、护士长领导行为问卷、护士安全行为问卷、职业倦怠量表进行调查,采用结构方程模型分析临床护士不良事件风险感知的影响因素及其对护士安全行为的作用路径.结果:临床护士护理不良事件风险感知得分为(14.98±5.39)分,护士安全行为得分为(56.42±5.03)分.相关分析显示,临床护士护理不良事件风险感知与组织支持感、护士长领导行为及护士安全行为呈正相关(均P<0.01),与职业倦怠呈负相关(P<0.01).结构方程模型显示,组织支持感、护士长领导行为正向影响临床护士不良事件风险感知(β值分别为 0.373,0.116,均P<0.001),职业倦怠负向影响临床护士不良事件风险感知(β=-0.263,P<0.001),不良事件风险感知正向影响护士安全行为(β=0.244,P<0.001).结论:临床护士护理不良事件风险感知水平有待提高且对护士安全行为有正向影响作用,护理管理者应采取措施提高临床护士的组织支持感、转变护士长领导行为、降低临床护士的职业倦怠感、提高临床护士护理不良事件风险感知水平、规范护士安全行为,从而降低护理不良事件发生率.

新生儿的疼痛敏感性较成人高,疼痛刺激不仅会给患儿带来不舒适的感受,还会引发患儿生理紊乱、发育迟缓等一系列近期和远期的不良影响[1] .相关研究显示[2-3] ,新生儿科护士的疼痛管理知识掌握不足,导致临床疼痛管理效果不佳,开展有效的培训可以改变护士的实践行为[4] . 直播培训是依托移动技术和直播平台开展的学与教活动,是实现知识共享与创造的培训新模式[5] ,其设计和思路依然在探索中[6]. ADDIE是指包括分析(analysis)、设计(design)、发展(develop)、执行(implement)及评价(evaluate)五个阶段为一体的理论模型,已被广泛应用于国内外护理专业网络培训项目的开发与实践[7-8] . 我院基于ADDIE理论模型,借助第三方直播平台,对56 名新生儿科护士进行疼痛管理培训取得了良好效果,现报道如下.