Background Clinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses. Methods A total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson’s or Spearman’s correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue. Results The results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%. Conclusions Our findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses’ social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

ObjectiveSchool age is a critical period for the development of individual gender equality consciousness. The purpose of this study was to explore the potential classes of school-age children’s gender equality consciousness, influencing factors and their differences in gender role, thus providing targeted guidance for the formulation and implementation of gender equality education strategies.MethodsA cross-sectional survey was conducted among 1846 school-age children using the demographic information questionnaire, gender equality consciousness questionnaire and Bem Sex Role Inventory. A latent class analysis was performed to explore gender equality consciousness latent classes. Multinomial logistic regression analysis was conducted to examine the predictors of class membership, and chi-square test was used to compare the gender role of each latent class.ResultsThe average age of the included 1846 participants was 10.10 ± 1.82 years old. The proportion of boy, grade 6 and living in urban area, respectively, were 50.8, 25.3, and 60.2%. The only children was 16.3% and left-behind children was 22.5%. 60.5% of all children thought their parents had a good relationship. The core family structure in all participants was 54.1%. Mothers were the caregivers of most children (63.6%). The same-sex friends more than 3 was 73.5%, while opposite-sex friends ranged from 0 to 1 was 41.7%. Three latent classes were identified and labeled “high gender equality consciousness” class (20.6%), “moderate gender equality consciousness” class (42.3%) and “low high gender equality consciousness” class (37.1%). Factors affecting the different types of school-age children’s gender equality consciousness include gender, grade, caregiver, place of residence, whether they are left-behind children and parental relationship. Rural and left-behind children are more likely to enter the “low gender equality consciousness” group. Children in the “low gender equality consciousness” group had a lower proportion of androgynous gender role.ConclusionRural children and left-behind children are the priority groups for gender equality education. Gender role is the important predictors and intervention targets of children’s gender equality consciousness. Educators or policy makers can formulate targeted intervention measures according to the influencing factors of potential classes.

Abstract Objective The purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables. Methods The Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG. Results The Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett’s test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach’s α = 0.951), with dimensions’ Cronbach’s α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG. Conclusion The Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.

OBJECTIVE:Relational job characteristics include perceived social worth and perceived social influence. Good relational job characteristics mean that nurses have high prosocial behavior. The purpose of this study was to explore the potential profile of nurses' relational job characteristics, influencing factors and their differences in turnover intention and subjective well-being, thus finding the most suitable clinical relationship job characteristics. METHODS:A cross-sectional survey was conducted among 1013 clinical nurses using the general demographic data questionnaire, Relational Job Characteristics scale, Turnover Intention Questionnaire and Campbell index of well-being. A latent profile analysis was performed to explore relational job characteristics latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the turnover intention and subjective well-being in each latent profile. RESULTS:Five latent profiles were identified and labeled 'High prosocial job characteristics' profile (20.7%), 'Moderate prosocial job characteristics' profile (41.7%), 'High social worth-low social impact perceived' profile (6.3%), 'Low social worth-high social impact perceived' profile (18.8%) and 'Low prosocial job characteristics' profile (12.5%). Factors affecting the different types of nurse relationship job characteristics include age, marital status, hospital department, nursing years, professional title and hospital position. Among them, chief nurse, nurses with more than 20 years of nursing experience and obstetrics and gynecology nurses were more likely to be 'high prosocial job characteristics' profile. The turnover intention of nurses in 'high prosocial job characteristics' profile was significantly lower than that of other profiles, and their subjective well-being was significantly higher than that of other profiles. CONCLUSION:Improving nurses' perception of social worth and social impact on clinical work can improve nurses' prosocial behavior and subjective well-being, and reduce their turnover intention. Nursing managers or policy makers can formulate targeted intervention measures according to the influencing factors of potential profiles.

BackgroundThe relationship between secondary traumatic stress (STS), empathy, and vicarious post-traumatic growth (VPTG) in oncology nurses is unclear. Understanding these links is crucial for improving nurse well-being and patient care quality.ObjectiveThis study aimed to investigate the relationships between STS, empathy, and VPTG among oncology nurses.MethodsThis cross-sectional study was conducted in a multicentric setting. Data collection involved oncology nurses completing questionnaires assessing STS, empathy, and VPTG levels. Data analysis included correlation analyses, multiple stepwise regression analysis, and structural equation modeling (SEM) to examine the interrelationships between these variables. The study adhered to the STROBE checklist.ResultsA total of 391 oncology nurses participated in the study. They showed moderate to low levels of VPTG and high levels of STS. STS exhibited a negative association with VPTG, while empathy demonstrated a positive direct association with both VPTG and STS. Moreover, SEM indicated that empathy mediated the relationship between STS and VPTG, with a partial mediating effect of 0.127. Factors such as receiving psychological training, educational attainment, STS, and empathy collectively explained 24% of the variance in VPTG.ConclusionOur findings highlighted the negative correlation between STS and VPTG among oncology nurses. Additionally, empathy was found to mediate the relationship between STS and VPTG, suggesting it plays a significant role in influencing VPTG.Implications for practiceTo aid oncology nurses, interventions should focus on reducing STS and enhancing empathy. Strategies like resilience workshops, peer support, and stress management can foster VPTG. Creating a supportive work environment is crucial for nurses’ well-being and quality patient care.

Objective This study aimed to understand the consciousness of gender equality among school-aged children in China and its influencing factors using structural equation modeling to explore the pathways, intensity and group differences among these factors.Methods A cross-sectional survey was conducted using stratified random whole-group sampling of primary school students in grades 1-6 and their parents who met the inclusion and exclusion criteria. In this study, 1,312 valid questionnaires were collected from a total of 1,500 school-aged children in Hunan Province, China (effective response rate of 87.5%). Statistical analysis was conducted using SPSS 26.0 and AMOS 24.0 software. Statistical inference consisted of t-tests, analysis of variance, the LSD test, Pearson correlation analysis, multiple stepwise linear regression analysis and structural equation modeling.Results School-aged children had the lowest consciousness of gender equality in the area of occupation and relatively higher consciousness in the areas of family and school. Children's age, gender, gender role, parent-child relationship, teacher-student relationship and parents' gender equality consciousness had predictive effects on children's consciousness of gender equality. The structural equation model constructed in this study is applicable to school-aged children of different genders. There was a significant difference in the structural equation modeling for children in different study period groups.Conclusion In the education process, parents and teachers should attempt to improve their own consciousness of gender equality, integrate the concept of androgynous education, enhance close relationships with children, and adopt appropriate education methods according to the characteristics of different groups of children.

IntroductionWithout parental support, left-behind adolescents are more likely than their peers to experience negative emotions and demonstrate aggressive behavior in the same frustrating situation. However, research on this subject has been sparse. To fill this gap and identify potential targets for intervention, this study sought to examine the relationships among factors influencing left-behind adolescents’ aggressive behavior.MethodsA total of 751 left-behind adolescents were enrolled in a cross-sectional survey, with data collected using the Adolescent Self-Rating Life Events Checklist, Resilience Scale for Chinese Adolescents, Rosenberg Self-Esteem Scale, Coping Style Questionnaire, and Buss–Warren Aggression Questionnaire. The structural equation model was used for data analysis.ResultsThe results showed that left-behind adolescents reported higher levels of aggression. Further, the factors found to have a direct or indirect effect on aggressive behavior included life events, resilience, self-esteem, positive coping, negative coping, and household income. The results of confirmatory factor analysis indicated goodness of fit. In the face of negative life events, left-behind adolescents with high resilience, self-esteem, and positive coping were less likely to exhibit aggressive behavior (P < 0.05).DiscussionLeft-behind adolescents can reduce their aggressive behavior by assuaging the adverse effects of life events via increased resilience and self-esteem as well as the adoption of positive coping strategies.

AimsThis study aimed to examine and compare different psychological intervention effects on the quality of life (QoL) and remission rates of patients with acute leukemia receiving chemotherapy.MethodsA total of 180 participants were randomly divided into a cognitive intervention group, a progressive muscle relaxation (PMR) group, a cognitive intervention plus PMR group, and a usual care control group. QoL via the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and remission rate were assessed at baseline and immediate post-intervention. A Generalized Linear Mixed Model was used for statistical analysis. Cost-effectiveness analysis with the value of the Incremental Cost-effectiveness Ratio was conducted to realize the economic evaluation of psychological interventions.ResultsThe total score of QoL and its most dimensions were significantly improved for participants in the intervention groups compared with the control group. The cognitive intervention plus PMR intervention was the most effective concerning QoL with cost-effectiveness. No significant improvements were indicated in participants’ remission rates among the groups.ConclusionThe cognitive intervention plus PMR intervention is the most effective in improving QoL with cost-effectiveness among patients with acute leukemia receiving chemotherapy. More rigorous randomized controlled trials with multiple follow-up points are suggested to clarify the psychological interventions on remission rates in this population.

Abstract Background Left-behind adolescents (LBAs) are adolescents aged 11–18 years who are separated from their parents and left behind in local cities by one or both parents for a period of more than 6 months. LBAs in rural areas are likely to engage in aggressive behavior, which can affect interpersonal relationships, reduce academic performance, and even lead to anxiety and depression. To our knowledge, no studies have examined the mediating effect of resilience and self-esteem on the relationship between negative life events and aggression among Chinese rural LBAs. Therefore, this study aimed to explore the relationship between negative life events and aggression among Chinese rural LBAs and how self-esteem and resilience mediate the association. Methods Using a stratified random sampling method, 1344 LBAs in Hunan Province of China were investigated. Information was collected by a self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale and Aggression Scales to assess the psychology of LBAs. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results Negative life events were significantly related to self-esteem (r = − 0.338), resilience (r = − 0.359), and aggression (r = 0.441). Aggression was directly affected by self-esteem (β = − 0.44) and resilience (β = − 0.34). Negative life events were not only directly related to aggression (β = 0.34, 95% CI: 0.275 ~ 0.398) but also showed an indirect effect on aggression through self-esteem and resilience. The direct effect, total effect and indirect effect of negative life events on aggression through self-esteem and resilience were 0.3364, 0.4344 and 0.0980, respectively. The mediating effect of self-esteem and resilience accounted for 22.56% of the relationship between negative life events and aggression. Conclusions We found that self-esteem and resilience mediated most negative life events on aggression. It is imperative for educators and families to improve LBAs’ self-esteem and resilience to reduce the occurrence of aggression. Future intervention studies should be designed to strengthen self-esteem and resilience.

The objective of this study was to investigate and analyze the status and influential factors of gender equality awareness, self-esteem, and subjective well-being in school-age boys and girls. The results can help schools and teachers provide more effective gender equality and mental health education. In the study, 284 valid questionnaires were collected from a total of 323 school-age boys and girls in the Hunan Province, China (effective response rate of 87.93%). The questionnaire covered gender equality awareness, self-esteem, and subjective well-being, with the influencing factors analyzed through multiple linear regression. There was a significant correlation among children’s gender equality awareness in all areas examined (family, occupation, and school), with both boys and girls having the lowest awareness of gender equality in occupational fields. The children’s self-esteem and subjective well-being were significantly correlated as well. Gender equality awareness, self-esteem, and subjective well-being among boys and girls reflected different influential factors. Androgynous traits (neither feminine nor masculine) were conducive to the development of gender equality awareness and self-esteem among the children. Therefore, schools and teachers need to provide gender equality and mental health education according to the specific psychological characteristics of each boy and girl.

ObjectiveThis study explored gender differences in anxiety, depression, and nursing needs among isolated Coronavirus Disease 2019 (COVID-19) patients, with a particular focus on the influencing factors. The main goal was to elucidate breakthrough points and intervention targets for psychological counseling aimed at the promotion of overall health during isolation treatment.MethodsA survey was conducted to obtain information about the nursing needs of COVID-19 patients, with mental health assessed via the Hospital Anxiety and Depression Scale (HADS). Participants included 219 isolated COVID-19 patients at a Wuhan module hospital in Hubei province, China.ResultsA total of 216 valid questionnaires were collected (98.63% retrieval rate). Of these participants, 21.76% had anxiety symptoms, while 17.59% had depression symptoms. Colleagues infected with COVID-19 (OR = 3.896, 95%CI: 1.555–9.764, P = 0.004) were the main influencing factors for anxiety symptoms, while marital status (OR = 2.700, 95% CI: 1.033–7.055, P = 0.043) and family members infected with COVID-19 (OR = 2.969, 95% CI: 1.243–7.095, P = 0.014) were the main influencing factors for depression symptoms. As for gender, male patients were generally more prone to depression and anxiety than female patients, especially those who were infected with colleagues. On the other hand, female patients reported greater concerns about safe treatment environments and communication with medical staff.ConclusionThis study found gender-based differences regarding the factors influencing anxiety and depression in isolated COVID-19 patients, with males reporting a greater general tendency for symptoms. On the other hand, female patients reported greater overall psychological nursing needs than males. Targeted nursing should thus be implemented to address specific psychological characteristics and nursing needs.

目的 调查国内临床护士的知信行现状,分析其延续性护理实践行为的影响因素,为相关实践培训提供参考.方法 采用便利抽样法,对国内964名临床护士进行延续性护理知识、态度、行为问卷调查.结果 国内护士的延续性护理知信行总分为(72.02±13.09)分,处于中等水平,其中知识(72.06±15.93)分、态度(81.95±13.07)分、行为(62.54±21.40)分.多重线性回归分析得出,影响护士延续性护理实践行为的因素有:知识、态度得分、学历和是否接受延续性护理相关培训.结论 国内临床护士延续性护理知识掌握相对不足,态度较为积极,实践行为亟待加强,提示管理者需要加强延续性护理培训,完善医院-社区沟通渠道,以提高临床护士延续性护理能力,促进延续性护理的实施.

AIM:To measure the prevalence of compassion fatigue among Chinese clinical nurses and to examine the effects of resilience and self-efficacy on compassion fatigue.DESIGN:A cross-sectional descriptive survey was conducted in accordance with the STROBE guidelines.METHODS:Participants were recruited from three tertiary hospitals in central China from October 3 to December 15, 2019, using convenience sampling. Clinical nurses (n = 992) from different nursing departments completed the General Information Questionnaire, Professional Quality of Life Scale, Connor-Davidson Resilience Scale, and General Perceived Self-Efficacy Scale. Descriptive statistics, t-tests, one-way analysis of variance, Pearson or Spearman's correlation analyses, and multiple linear regression models were used.RESULTS:Nurses experienced moderate levels of compassion fatigue (burnout and secondary traumatic stress). Resilience and self-efficacy were significantly negatively correlated with burnout but not with secondary traumatic stress. Linear regression analysis showed that resilience, self-efficacy, exercise, and physical conditions were the main predictors of burnout. Only physical conditions and marital status significantly predicted secondary traumatic stress.CONCLUSION:Nurses are vulnerable to compassion fatigue in China. Resilience and self-efficacy significantly negatively predicted nurses' compassion fatigue. Physical conditions, healthy lifestyles, and social support are also important factors for compassion fatigue.IMPACT:Our findings can be used to generate targeted intervention and coping strategies for nurses to improve their resilience and self-efficacy to alleviate compassion fatigue.

Objective: This study aims to explore the association between life events and coping styles, and how resilience and self-esteem mediate the association. Methods: A cross-sectional study was conducted among 981 left-behind adolescents (LBAs) in five junior high schools in Hunan Province, China, from April 13 to April 20, 2020. We utilized self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale, and Simplified Coping Style Questionnaire to assess the mental health of LBAs. Statistic description, Pearson correlation analysis, and structural equation model were adopted to analyze the data. Results: Results revealed that life events could negatively predict resilience (β = −0.29, P < 0.001) and self-esteem (β = −0.39, P < 0.001) and positively predict LBAs' positive coping style (β = 0.28, P < 0.001) and negative coping style (β = 0.21, P < 0.001). Self-esteem could also positively predict the resilience of LBAs (β = 0.62, P < 0.001); resilience could negatively predict the negative coping style (β = −0.21, P < 0.001) and positively predict the positive coping style (β = 0.79, P < 0.001). Life events not only have direct effects on negative coping style (β = 0.21) and positive coping style (β = 0.28) but also have indirect effects on coping styles by affecting resilience (β = −0.29) and self-esteem (β = −0.39). The total effect of life events on coping styles was 0.32, where 34.37% was mediated by resilience and self-esteem. Conclusion: We proved that resilience and self-esteem mediated most of the effects of life events on coping styles. The findings had important implications for interventions to promote mental health of LBAs, particularly the enhancement of resilience and self-esteem.

AbstractAimsTo determine psychological symptoms of patients with mild symptoms of coronavirus disease 2019 in China and to explore the influencing factors.DesignA cross‐sectional study.MethodsA convenience sample of 296 mild coronavirus disease 2019 patients were recruited from a Fangcang hospital in Wuhan, Hubei Province, from 3–5 March, 2020. Participants were assessed using a sociodemographic and clinical characteristics questionnaire, and Symptom Check List 90. The binary logistic regression was utilized to explore the influencing factors of psychological symptoms of patients with mild symptoms of coronavirus disease 2019.ResultsIn total, 296 of 299 patients with mild symptoms of coronavirus disease 2019 participated in the study (response rate: 99.0%). The findings revealed that 12.8% patients with mild symptoms have mental health problems; the most common psychological symptoms are phobic anxiety (58.4%), paranoid ideation (50.7%) and psychoticism (40.2%). Female patients [OR = 3.587, 95% CI (1.694–7.598)] and those having physical symptoms currently [OR = 2.813, 95% CI (1.210–6.539)] are at higher risk, while those in the middle duration of hospitalization [OR = 0.278, 95% CI (0.121–0.639)] protect against mental‐health problems.ConclusionsThe minority of patients with mild symptoms of coronavirus disease 2019 were still suffering from psychological symptoms. Healthcare providers are recommended to pay particular attention to screening these high‐risk groups (women, those in the initial stages of hospitalization and those with physical symptoms currently) and implement targeted psychological care as required.ImpactThis study found that most patients of coronavirus disease 2019 in Fangcang hospital exhibited normal mental health at par with the general Chinese norm and the minority of them were suffering from psychological symptoms. The findings can provide a reference for healthcare providers to screen high‐risk psychological symptoms groups and implement targeted psychological intervention for patients with coronavirus disease 2019.

Abstract Background High aggressive behavior will harm the physical and mental health of children, and the probability of aggressive behaviors among left-behind junior high school students is significantly higher than that of non-left-behind ones, but the systematic research and intervention measures concerning the aggressive behavior of the left-behind junior high school students quite deficient at present. This study adopts the structural equation model to analyze the interrelationship and action modes of various factors affecting the aggressive behavior of the left-behind junior high school students to provide scientific basis for the mitigation and prevention of their aggressive behavior. Methods A structural equation model was constructed based on data from a cross-sectional survey of 751 left-behind junior high school students using Adolescent Self-rating Life Events Checklist, Rosenberg Self-Esteem Scale, Resilience Scale for Chinese Adolescents, Coping Style Questionnaire, and Buss-Warren Aggression Questionnaire. Results Self-esteem, resilience, positive coping, negative coping and household income have different direct or indirect effects on the aggressive behavior of left-behind junior high school students. Among them, self-esteem, resilience, positive coping and negative coping are the important mediating factors between life events and aggressive behavior of left-behind junior high school students. Conclusions Parents, teachers and temporary guardians in the care of left-behind children should try to avoid possible adverse effects that the life events have on the children, meanwhile should also through effective psychological intervention and social support, improving the self-esteem, psychological resilience and positive coping tendencies of left-behind children, in order to reduce or prevent their aggressive behaviors.

AIMS AND OBJECTIVES:To explore the role of resilience in anxiety and depression and to clarify their relationships among patients with mild symptoms of coronavirus disease 2019 (COVID-19) in Wuhan, China. BACKGROUND:The outbreak of COVID-19 has negatively affected some individuals, but resilience plays a decisive role in the response of individuals under pressure and can help them deal with pressure more effectively. DESIGN:The cross-sectional descriptive correlational survey was reported in line with the STROBE guidelines. SUBJECT AND SETTING:In total, 296 patients from FangCang Hospital in Wuhan, Hubei, China, with mild symptoms of COVID-19 were recruited. METHODS:Participants were recruited through convenience sampling. The data collected included their demographic information, the Connor-Davidson Resilience Scale and Hospital Anxiety and Depression Scale. RESULTS:A small number of patients in this study had above threshold anxiety (subthreshold anxiety and major anxiety) and depression (subthreshold depression and major depression). The mean total resilience score of the participants was slightly below the normal level of ordinary Chinese adults. Resilience was inversely associated with and was a protective factor for both anxiety and depression in our samples. Risk factors for anxiety include being female and having colleagues with COVID-19, while a risk factor for depression was having family members with COVID-19. CONCLUSIONS:This study shows that after taking the general demographics into consideration, higher levels of resilience were associated with lower anxiety and depression among mild COVID-19 patients in Wuhan, China. RELEVANCE TO CLINICAL PRACTICE:Health professionals, especially clinical nurses, need to be aware of the psychological status of COVID-19 patients and promote resilience to improve their mental health.