Abstract Background Career maturity is a crucial indicator of career preparedness and unpreparedness can cause the turnover of new nurses. Considerable empirical work demonstrates the potential associations between specialty identity, self-efficacy, study engagement, and career maturity. This study aimed to explore the mediation role of self-efficacy and study engagement on the relationships between specialty identity and career maturity among Chinese nursing students. Methods Four hundred twenty-six Chinese nursing students were recruited between September 11 and October 30, 2022. The online survey was conducted following the CHERRIES checklist. Electronic questionnaires assessed their perceived specialty identity, self-efficacy, study engagement, and career maturity. The descriptive analysis, Harman single-factor analysis, Pearson correlation tests, structural equation modeling, and the bootstrap method were employed in data analysis. Results Bivariate correlation analysis identified a positive correlation between specialty identity, self-efficacy, study engagement, and career maturity (r = 0.276–0.440, P < 0.001). Self-efficacy and study engagement partially mediated the relationship between specialty identity and career maturity. Self-efficacy and study engagement played a chain mediating role between specialty identity and career maturity. Conclusions The underlying mechanism can explain the relationships between specialty identity and career maturity: a direct predictor and an indirect effect through self-efficacy and study engagement. Policymakers and educators should emphasize the importance of specialty identity and provide tailored strategies for improving care maturity depending on nursing students’ specialty identity, self-efficacy, study engagement in the early stages of career development.

BACKGROUND:A growing body of literature has shown a higher risk of suicide in cancer patients compared with the general population. Early detection of factors related to suicide resilience in cancer patients could prevent loss of life.OBJECTIVE:The study aimed to investigate the serial-multiple mediation of self-care self-efficacy and meaning in life in the relationship between social support and suicide resilience among Chinese cancer patients.METHODS:A cross-sectional investigation of 287 cancer patients using a battery of self-reported questionnaires was performed. For preliminary analyses, descriptive, univariate, and Pearson correlation analyses were performed. Mediation analyses were tested using a serial-multiple mediation model (PROCESS model 6).RESULTS:Mediation analysis indicated the indirect effects of social support on suicide resilience mediated solely by either self-care self-efficacy (point estimate = 0.20; 95% confidence interval [CI], 0.12-0.30), or by meaning in life (point estimate = 0.06; 95% CI, 0.01-0.12), or by the multiple mediation of self-care self-efficacy to meaning in life (point estimate = 0.03; 95% CI, 0.01-0.06).CONCLUSIONS:The findings demonstrated the crucial direct or indirect effects of social support, self-care self-efficacy, and meaning in life on facilitating cancer patients' suicide resilience.IMPLICATIONS FOR PRACTICE:Oncology nurses, as 24-hour care providers for cancer patients, may interact with and be important sources for the psychosocial care of cancer patients at risk of suicide. Prevention and intervention efforts must be directed at assisting cancer patients, improving self-care self-efficacy, and finding meaning in life after a cancer diagnosis.

Background: Novel-fosfamides (NFOs) belong to active metabolites of ifosfamide that bypass the generation of toxic byproducts. In this analysis, we aimed to comprehensively assess the benefits and risks of NFO monotherapy or in combination with doxorubicin (DOX) versus single-drug DOX in previously untreated patients with advanced soft-tissue sarcoma (ASTS). Methods: Online PubMed, Web of Science, Embase, and Cochrane CENTRAL databases were systematically searched on April 26, 2022. Objective response rate and disease control rate were primary outcomes. Overall survival (OS), progression-free survival (PFS), and grade ≥ 3 treatment-related adverse events were secondary outcomes. Results: In all, 3 randomized clinical trials with a total of 1207 ASTS patients were eligible. DOX plus NFO combination therapy showed higher risk ratios of objective response rate (1.50, 95% CI 1.20–1.68, P = .0003) and disease control rate (1.15, 95% CI 1.05–1.27, P = .0030) compared with DOX monotherapy. Nevertheless, NFO-based monotherapy and combination therapy were found no improvements on OS (hazard ratio 0.93, 95% CI 0.52–1.65, P = .8050) and PFS (hazard ratio 0.88, 95% CI 0.54–1.43, P = .6088) against DOX. More incidences of grade 3 or worse anemia, thrombocytopenia, stomatitis, diarrhea, constipation, and febrile neutropenia were observed in NFO-based treatments. Conclusion: Adding NFO to DOX as first-line therapy improved the responses in ASTS patients but did not prolong OS and PFS. Grade 3 or worse treatment-related adverse events should be treated with caution during the NFO-based therapies.

Objective To construct an evaluation index system of clinical nursing teaching quality suitable for teaching hospitals. Methods An evaluation index system draft for clinical nursing teaching quality was formed based on CIPP evaluation model, literature review and semi-structured interviews, and then a two-round Delphi study was conducted among 29 experts to improve the draft. Results The response rates of the 2 rounds expert consultations were 96.67% and 100%, the expert authority coefficients were 0.894 and 0.897, and the Kendall coordination coefficients were 0.331 and 0.415（P＜0.01）. The final evaluation index system for nursing clinical teaching quality consisted of 4 first-level indexes（teaching context evaluation, teaching resource evaluation, teaching process evaluation, teaching result evaluation）, 13 second-level indexes and 43 third-level indexes. Conclusion The constructed evaluation index system for nursing clinical teaching quality based on CIPP evaluation model can be used as an evaluation tool for teaching hospitals.

BACKGROUND:Sacituzumab govitecan (SG) is an antibody-drug conjugate that targets the human trophoblast cell-surface antigen 2 to deliver SN-38 to cancer cells. In this study, we assessed the efficacy and safety of SG in patients with relapsed or refractory metastatic triple-negative breast cancer (RM-TNBC). METHODS:For this integrated analysis, from inception to January 2, 2023, we searched PubMed, Web of Science, Embase, and Cochrane library databases for prospective studies that evaluated SC in RM-TNBC patients. Primary endpoints were survival outcomes and responses. Secondary endpoints were all grade and grade ≥ 3 toxicities. RESULTS:Six hundred potentially relevant records were screened. Our analysis included 3 trials (412 patients). Median overall survival was 12.9 months (95% confidence interval [CI], 11.5-14.4), progression-free survival was 5.7 months (5% CI, 5.1-6.3), and duration of objective response was 7.4 months (5% CI, 5.8-9.0). The objective response rate was 34%, and the disease control rate was 71%. Key grade ≥ 3 toxicities (in over 10% of the patients) included neutropenia (46%), leukopenia (12%), febrile neutropenia (11%), diarrhea (11%), and anemia (10%). Four treatment-related deaths were reported. CONCLUSION:SG was associated with effectiveness in patients with RM-TNBC. Myelosuppression and diarrhea were the primary treatment-related adverse events.

To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %-47.01 %) and 24.95 % (95 % CI 10.96 %-38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression.

BACKGROUND:Adaption to clinical work during the internship can induce several stressors among medical students, especially in the context of the coronavirus disease 2019 (COVID-19) pandemic. Particularly, job stress could be linked to the development of psychological traits and the formation of the professional identity of medical interns.OBJECTIVE:This study aimed to explore the relationship between job stress, psychological capital, and professional identity through a mediation analysis of Chinese medical interns.METHODS:A descriptive cross-sectional study was conducted in 30 hospitals and clinics in China from June 2021 to March 2022. A total of 665 medical interns filled out questionnaires related to demographic questions, psychological capital, job stress, and professional identity. Data analysis was executed using the IBM SPSS version 22.0 software and its add-in PROCESS Windows version 4.0.RESULTS:The findings indicated a statistically significant mediating effect of psychological capital between job stress and professional identity. Job stress and job stress combined with psychological capital accounted for 5.3% and 37.9%, respectively, of the variance in professional identity. The bootstrapping method corroborated the significance of the indirect effect of job stress through psychological capital (95% bootstrap CI = -4.7921, -2.4345).CONCLUSION:The current findings underscore the need for increased attention on improving the psychological capital of medical interns.

Objective:Several studies reported that adverse reactions to treatment, neuroticism, marital relations, and quality of life may impact the development of depression in cervical cancer patients treated with radiotherapy and/or chemotherapy, but the associations between them remained unclear. This study investigated the associations between these factors using moderated mediation models.Methods:Data were extracted from a survey involving cervical cancer patients treated with radiotherapy and/or chemotherapy at five tertiary hospitals in Hubei Province, China, from June to December 2022. The SPSS-PROCESS program was used to develop a moderated mediation model to study the roles of neuroticism, quality of life, and marital relations in the association between adverse reactions and depression in the study population.Results:A total of 802 cervical cancer patients treated with radiotherapy and/or chemotherapy (54.84 ± 9.68 years) were recruited. The prevalence of depression among these patients was 72.72%, with four symptom clusters of dizziness-ringing in the ears, digestive system-related symptoms, skin dryness and itching, and urinary frequency-urgency-leakage. Adverse reactions directly and positively affected the occurrence of depression, neuroticism mediated the association between adverse reactions and depression, while this association varied according to the quality of life and marital relations.Conclusion:Our findings suggest that depression is common among cervical cancer patients receiving radiotherapy and/or chemotherapy. Intervention targets for depression in cervical cancer patients should be precisely selected and targeted according to the quality of life and marital relations differences in patients, taking into account the cost of the intervention and the benefit to the patient.

Suicidal individuals rarely seek help and receive professional psychological intervention on their initiative. Internet-based cognitive behavioral therapy(iCBT) can increase availability and reduce stigma compared to face-to-face interventions for suicide.However, conclusions about the effectiveness of iCBT on suicide are controversial. The review aimed to determine the effectiveness of iCBT on reducing suicidal ideation (primary outcomes) and other outcomes related to suicide like suicide attempts(secondary outcomes). PubMed, the Cochrane Library, EMBASEwere searched up to March 2020 for RCTs of iCBT which aimed to reduce suicide.The potential bias was assessed by the Cochrane risk of bias tool. Data analyses wereperformed by RevMan5.3.Four studies meeting the eligibility criteria were included which reported data on a total of 1225 participants. We found iCBT was associated with reducing an individual's suicidal ideation, and first indications suggest that the treatment effect might be even more pronounced in the short term and in adults.Additionally, there was insufficient evidence to prove its effectiveness in reducing suicide attempts and suicide death.Overall, iCBT can overcome the disadvantages of traditional interventions and show promise on suicidal ideation. While ensuring safety and ethics, further studies are warranted, focusing on suicide specific behavior like suicide attempts.

目的 了解恩施土家族苗族自治州医院护士人文关怀品质现状及影响因素,为实现当地护理人文关怀同质化提供参考.方法 采用护士人文关怀品质量表对恩施土家族苗族自治州33所医院的334名护士进行调查.结果 恩施土家族苗族自治州医院护士人文关怀品质总分(121.60±13.16)分;同事关怀程度、工作科室是护士人文关怀品质的影响因素(P＜0.05,P＜0.01).结论 恩施土家族苗族自治州医院护士人文关怀品质处于中等水平,同事关怀程度高的护士及儿科护士人文关怀品质相对较高.需对护士加强系统的人文关怀培训,以提升其人文关怀品质.

The Brief Symptom Inventory-18 (BSI-18) is widely used to assess psychiatric distress but has not been verified in the Chinese population. From March to April 2019, 293 hospitalized cancer patients, aged 20–87, completed the cross-sectional survey with demographics questionnaire, BSI-18, and PHQ-9. We analyzed the single suicide-related item of PHQ-9 with the full score clinical outpoint for BSI-18 and PHQ-9 using SPSS 22.0 and R 2.15, including Pearson's χ2 test and ROC curve analyses. A Pearson's χ2 test was carried out to compare the three different methods with the gold screening criteria. The p-value was correspondingly to .006, .066, .838. When the PHQ-9 ≥ 10 criteria for the BSI-18, receiver operating characteristic analysis revealed that AUC values were 0.839, optimal cut-off points for both BSI-18 ≥ 50, the sensitivity of 85.8%, and 62.5%, respectively. The BSI-18 is suitable for a screening tool for psychological distress and could also be used in clinical settings for preliminary screening of hospitalized cancer patients.

目的 了解肺癌患者不同化疗周期化疗相关性症状变化及与患者功能状况的相关性.方法 采用一般资料调查表、治疗相关性症状列表(TRSC)、卡氏评分量表于第1周期化疗后(T1)、第3周期化疗后(T2)、第5周期化疗后(T3)对肺癌患者进行调查.采用广义估计方程分析比较各时间点TRSC总分及卡氏评分,采用Kruskal-Wallis秩和检验比较25种化疗相关性症状各时间点评分差异,采用Pearson相关性分析各时间点TRSC总分及卡氏评分的关系.结果 T1、T2、T3分别调查246例、221例、209例肺癌化疗患者,TRSC总分分别为(17.61±9.62)分、(19.47±7.99)分和(22.93±9.02)分,卡氏评分分别为(79.13±14.22)分、(76.98±13.85)分和(72.85±13.45)分;T3的TRSC评分显著高于T1、T2评分,T3卡氏评分显著低于T1评分(均P＜0.05).25种化疗相关性症状中,14种严重度评分在3个时间点存在显著差异.T1、T2、T3时TRSC总分与卡氏评分呈负相关(均P＜0.05).结论 肺癌患者各周期化疗均承担较严重的化疗相关性症状负荷,症状严重度随化疗周期呈增加趋势,功能状况呈降低趋势,各个治疗阶段治疗相关性症状负荷越严重者,功能状况越差.

目的 探讨基于儿科护士需求分析的人文关怀分层培训的应用效果.方法 采用访谈法了解不同层级儿科护士的人文关怀培训需求,根据培训需求对142名儿科护士实施人文关怀分层培训6个月,比较培训前及培训后各层级儿科护士关怀能力和培训满意度.结果 培训后不同层级儿科护士关怀能力及对人文关怀培训满意度显著高于培训前(P＜0.05,P＜0.01).结论 采用基于需求的人文关怀分层培训有利于提高各层级儿科护士的人文关怀能力,提高培训满意度.

目的 分析肺癌患者治疗相关性症状与生活质量及功能状况的关系,为肿瘤患者症状管理提供参考.方法 采用治疗相关性症状列表、卡氏评分量表及肺癌治疗功能评价表对302例肺癌患者进行调查.结果 肺癌患者治疗相关性症状总分为(20.62±9.10),生活质量总分为(91.17±16.08),卡氏评分为(76.32±13.84).超过20％患者自评为"严重/非常严重"的治疗相关性症状包括食欲下降、脱发、恶心、呕吐、感觉疲乏、味觉改变6种.治疗相关性症状总分与生活质量总分,生理状况、社会/家庭状况、情感状况、功能状况、肺癌附加关注维度评分及卡氏评分的相关系数r为-0.617、-0.183、-0.379、-0.194、-0.584、-0.516、0.374(均P＜0.01).结论 肺癌患者存在较严重的治疗相关性症状负荷,尤其是治疗引起的食欲下降、脱发、恶心、呕吐、感觉疲乏、味觉改变,且治疗引起的症状负荷越严重者,生活质量及功能状况越差.

Review question / Objective: The prevalence of suicidial ideation among hospitalized cancer patients in China.Condition being studied: To our knowledge, this will be the first meta-analysis to evaluate the suicidal ideation among hospitalized cancer patients in China.

Objective To explore the experiences of front-line nurses combating the coronavirus disease-2019 epidemic. Design and Sample Fifteen front-line nurses caring for COVID-19 patients were recruited from two hospitals in Wuhan, China from January 26 to February 5, 2020. Data were collected through semi-structured individual interviews and analyzed using standard qualitative methods. Results Four theme categories emerged from the data analysis: (a) "Facing tremendous new challenges and danger"; (b) "Strong pressure because of fear of infection, exhaustion by heavy workloads and stress of nursing seriously ill COVID-19 patients"; (c) "Strong sense of duty and identity as a healthcare provider"; (d) "Rational understanding of the epidemic-the nurses believed that the epidemic would soon be overcome and would like to receive disaster rescue training." Conclusions Although the intensive rescue work drained front-line nurses, both physically and emotionally, they showed a spirit of dedication and felt a responsibility to overcome this epidemic. Their experiences provide useful insights into implementing a safer public health emergency rescue system in preparation for future outbreaks of infectious diseases. Specifically, psychological support and humanistic care should be provided to front-line nurses to maintain their well-being, and nationwide emergency rescue training and disaster education should be implemented.

This study describes a psychometric scale, the Inpatient Suicide Second Victim Experience and Support Tool, for evaluating physical and psychological distress with a focus on resources for supporting the needs of nursing professionals. Our study defines "second victim" as a nurse who experiences inpatient suicide while on shift. We conducted a cross-sectional study among non-psychiatric nurses to examine the psychometrics of the scale. A total of 731 participants were recruited from eight Chinese general hospitals for this research. Data were analyzed by exploratory factor analysis and confirmatory factor analysis to examine the reliability and validity of the scale. The results indicated adequate indices resulting in 21 items. The final structure for the scale was categorized into five domains: psychosomatic distress, support from family and friends, work-related support, organizational support, and professional self-efficacy. The total variance explained was 69.06%. Cronbach's alpha was 0.869 overall, and ranged from 0.626 to 0.914 for the five dimensions. The test-retest reliability of 0.792 for the entire scale was also acceptable. The scale shows promise for use by healthcare organizations to identify second victims and promote necessary organizational support interventions in Chinese hospitals.

Objective: This was a large-scale epidemiological survey of non-psychiatric inpatient attempted suicides/suicides in general hospitals in China, allowing a detailed quantitative analysis of the characteristics of inpatient attempted suicides/suicides. Methods: The incidence, inpatient demographic and behavioral characteristics, and risk factors for attempted suicide/suicide were explored through a survey of non-psychiatric inpatients admitted to 48 general hospitals, between 2015 and 2017. A Vector Error Correction model was established to explore hospital variables as predictors of inpatient attempted suicide/suicide using the annual numbers of inpatient attempted suicides/suicides, undergraduate or above nurses per total number of nurses, and number of beds per nurse in a tertiary general hospital, between 1998 and 2017. Results: The incidence of attempted suicide/suicide among inpatients in general hospitals was 3.26/100,000 admissions. 180 inpatient attempted suicides/suicides were reported, which were associated with particular inpatient demographic and behavioral characteristics and a specific temporal and spatial distribution. Incidence of attempted suicide/suicide was higher in inpatients aged >= 60 years, with junior high school or lower level of education, in secondary general hospitals, suffering from malignant tumors or chronic diseases. Number of beds/nurse had a significant impact on the incidence of inpatient attempted suicide/suicide. Conclusion: We recommend that general hospital administrators establish a targeted approach to inpatient suicide prevention efforts in their hospitals.

目的 调查肺癌患者放化疗引起的各种症状及有效缓解各种症状的自我护理方法.方法 采用治疗相关性症状列表及缓解症状的自理方法量表调查302例肺癌患者.结果 患者自评发生率前5位的治疗相关性症状依次为感觉疲乏(94.70％)、食欲下降(91.39％)、恶心(78.48％)、脱发(74.17％)和呕吐(69.21％);患者还承受29种其他症状困扰.共收集400多种患者认为有效缓解各种症状的自我护理方法,可归纳为饮食/营养/生活方式改变,心境/身体控制,生物治疗,中医治疗,处方药及其他6类.结论 肺癌患者承受着较严重的治疗相关性症状负担,多种自我护理方法可缓解肺癌患者治疗引起的症状.护士应基于循证收集各类缓解症状的替代疗法,以有效管理症状,减轻患者的症状困扰.

ObjectiveTo probe into the effects of integrative physician⁃nurse collaboration based on therapy⁃related symptoms checklist(TRSC) assessment on alleviating chemotherapy⁃related symptoms among lung cancer patients.MethodsA total of 67 patients with non⁃small cell lung cancer,who planned to receive the second cycle of chemotherapy,were divided into the control group(n=32) and the observation group(n=35).Patients in both groups received routine chemotherapy and chemotherapy⁃related nursing.In addition,patients in observation group needed to receive intervention charactered by integrative physician⁃nurse collaboration based on TRSC assessment,so as to manage multiple symptoms induced by the chemotherapy.Patients' status was evaluated by nurses using TRSC before the second,third and fourth cycle of chemotherapy.And the patients were guided to use complementary and alternative medicine methods to alleviate symptoms.And physicians adjusted chemotherapeutic scheme or dosage of drugs according to assessment results.Furthermore,physicians could adopt therapeutic or preventive medication schemes in accordance with the actual situation.The scores of TRSC between the two groups were compared before and after intervention,namely before the second cycle of chemotherapy and one month after the fourth cycles of chemotherapy or before the fifth cycle of chemotherapy.ResultsAfter intervention,total score of TRSC in observation group group was significantly lower than that in the control group.And the scores of taste alteration,loss of appetite,nausea,vomiting and feeling fatigue in the observation group were significantly lower than those in the control group（P<0.05 or P<0.01）.ConclusionsIntervention charactered by integrative physician⁃nurse collaboration based on TRSC assessment was conductive to alleviate chemotherapy⁃related symptoms among lung cancer patients.Nurses in oncology department should systematically and precisely assess chemotherapy⁃related symptoms by using specific instruments,thus to provide reference for targeted symptom management.