Objectives To explore the relationships between moral courage, moral resilience, and ethical behavior among pediatric nurses, and to examine the mediating effects of moral resilience in the relationship between moral courage and ethical behavior. Design A quantitative, multicenter, cross-sectional study. Methods A total of 327 Chinese pediatric nurses from 13 public hospitals completed an online survey. They completed the Nurses' Moral Courage Scale (NMCS), the Rushton Moral Resilience Scale (RMRS), and the Ethical Behavior Scale for Nurses (EBSN). The mediating effect of moral resilience was assessed using the bootstrap method through IBM SPSS Amos 26.0. Results Pediatric nurses' moral courage was positively associated with moral resilience (r = 0.485, p < 0.001) and ethical behavior (r = 0.448, p < 0.001); both moral courage and moral resilience were directly associated with ethical behavior, with moral resilience mediating this relationship. Conclusion Moral courage has a positive effect on ethical behavior among pediatric nurses, and this relationship is further strengthened through moral resilience. These findings underscore the importance of integrating ethics education and resilience-building strategies into nursing management and professional development programs to promote sustained, high-quality ethical practice. Practice implications This study provides a practical basis for strengthening ethical practice among pediatric nurses. It highlights the need for targeted strategies to enhance nurses' moral courage and moral resilience, particularly through structured ethics education and resilience-building programs. Future longitudinal studies with larger and more diverse samples are needed to examine the pathways through which moral courage and moral resilience influence ethical behavior.

Mild cognitive impairment (MCI) and dementia are still global public health challenges, with an increased prevalence in sub-Saharan Africa (SSA) due to an increase in aging population. Despite different studies estimating the prevalence, there is still a lack of current and updated reviews that have provided the estimated proportions in SSA. Therefore, this protocol will help in developing the review that will help in understanding the epidemiological trends of MCI and dementia in this region, which is crucial for informing and adding knowledge, setting interventions, and planning healthcare. This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis of Observational Studies in Epidemiology (MOOSE). We will search studies from an electronic database and manually search from listed references published after 2010 reporting on the prevalence of MCI and dementia among older adults. Two independent reviewers will extract data, and the quality will be assessed using a standardized checklist. Statistical analysis will be performed using Stata version 18 to present descriptive findings, forest plots, subgroup analysis, and meta-regression. This study’s findings will provide updated estimates of MCI and dementia prevalence, filling a gap in the current literature essential for developing context-based interventions and health policies tailored to the needs of older adults. CRD42024542596 Establishes a comprehensive understanding of mild cognitive impairment and dementia prevalence in sub-Saharan Africa.​ Identifies gaps in current research for epidemiological surveys, targeted interventions and public health strategies. Aims to enhance the importance and need for early detection methods and improve care for affected older adults.

BACKGROUND:Depression among nurses is an important occupational health concern, but identifying nurses at higher risk remains challenging because work-related exposures are heterogeneous and often measured separately. Occupational trauma-related experiences, including adverse clinical events, workplace violence, bullying, threats and sexual harassment, may differ in frequency and severity, and simple event counts may not adequately capture their relevance to mental health risk. OBJECTIVE:To derive a weighted occupational trauma exposure burden score among female nurses and examine its association with moderate-to-severe depressive symptoms. DESIGN:Large-scale, cross-sectional analysis using baseline data from the Nurses' Mental Health Study in China. SETTING:67 tertiary hospitals across 31 provincial-level regions in China. PARTICIPANTS:90,196 registered female nurses. METHODS:Fourteen occupational trauma exposure indicators were analysed using item response theory to derive a weighted trauma exposure load index. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire, with scores of 10 or higher indicating moderate-to-severe depressive symptoms. Logistic regression and Light Gradient Boosting Machine models were developed using a stratified 7:3 training-testing split. RESULTS:The derived trauma exposure load index summarised heterogeneous occupational trauma exposures, with workplace violence and sexual harassment emerging as highly informative indicators of the overall exposure burden. The index showed greater variation across occupational contexts than across most demographic characteristics, with higher burden observed among psychiatry and emergency nurses. In the prediction model, the trauma exposure load index was the highest-ranking predictor, and higher scores were associated with greater predicted risk of moderate-to-severe depressive symptoms. The calibrated Light Gradient Boosting Machine model showed acceptable discrimination in the independent testing set, with an area under the receiver operating characteristic curve of 0.830 (95% confidence interval 0.824-0.836). CONCLUSIONS:The trauma exposure load index provided an empirically weighted summary of heterogeneous occupational trauma exposures among female nurses and was associated with moderate-to-severe depressive symptom status. These findings support further evaluation of weighted exposure measures to examine the relationship between complex occupational trauma exposure and nurses' mental health. Longitudinal studies are needed to assess temporal relationships and the generalisability of the index. REGISTRATION:The Nurses' Mental Health Study was registered prospectively with the Chinese Clinical Trial Registry (ChiCTR2300072142) on 5 June 2023; participant recruitment began in December 2023.

Background Intimate partner violence (IPV) is a major global social issue that poses severe threats to both physical and mental health. However, the prevalence and associated factors of IPV among nurses in China remain insufficiently studied. Existing evidence indicates that women are more likely to be victims of IPV. More specifically, as a predominantly female workforce group, nurses may constitute a vulnerable population at risk of IPV. Nevertheless, evidence regarding the prevalence of IPV among nurses working in tertiary hospitals in China remains limited, and the risk factors and correlates of IPV in this population have not been comprehensively examined. Methods We conducted a nationwide survey using a self-designed structured questionnaire to collect data on demographics, socioeconomic characteristics, lifestyle and childhood experiences, mental health conditions, burnout, and IPV. Depression, anxiety, and burnout levels were assessed using validated scales. Binary logistic regression was applied to identify factors associated with IPV. Results Among 97,867 nurses, the prevalence of IPV in the past year was 7.90%, with emotional violence (7.63%) being the most common subtype. Logistic regression analysis showed that male gender, 31–40 years old, postgraduate degree, partner occupation as a nurse, smoking status (> 1 cigarette/day), alcohol use (> 4 times/week), and adverse childhood experience were significantly associated with IPV. Furthermore, IPV exposure is closely related to the high risk of depression, anxiety, and burnout. Conclusion IPV among nurses in China is an important issue associated with population, educational and lifestyle factors. Since it is closely associated with poor mental health outcomes, targeted prevention and intervention strategies should be implemented to protect nurses' well-being, occupational stability, and the quality of medical service.

OBJECTIVE:This study aimed to identify heterogeneous longitudinal trajectories of sense of coherence (SOC) among newly diagnosed HIV-positive men who have sex with men (MSM) and examine associated characteristics and factors across different trajectories. METHODS:A prospective cohort study was conducted by recruiting newly diagnosed HIV-positive MSM from a tertiary hospital and a social work service center in Changsha, China. Follow-up surveys were administered at baseline (T1), 3 months (T2), and 6 months (T3). Data were collected on SOC, HIV stigma, perceived stress, depression, internalized homophobia, antiretroviral therapy (ART) adherence, comfort in accessing healthcare services, coping strategies, social support, and sociodemographic and sexual behavior characteristics. A latent class mixed model (LCMM) was fitted in R to identify SOC trajectories. Multinomial logistic regression was used to examine predictors of trajectory class membership, and psychosocial correlates of SOC were analyzed within each trajectory class. RESULTS:A total of 313 participants were included. Overall SOC declined significantly over the 6-month follow-up (F = 38.78, P < 0.001). LCMM identified four SOC trajectories: Continuously Low (13.10 %), Slow Decline (48.24 %), Rapid Decline (25.24 %), and Active Transition (13.42 %). Significant between-trajectory differences were observed in household registration (P = 0.016), educational level (P = 0.025), monthly income (P = 0.021), age at first sexual activity (H = 7.11, P = 0.041), and condom use during anal intercourse (P = 0.008). Using the Active Transition group as the reference, rural household registration increased the likelihood of belonging to the Slow Decline group (Coef = 1.02, P = 0.001). A lower educational level increased the likelihood of belonging to the Continuously Low group (Coef = -0.84, P = 0.026). Earlier age at first sexual activity (Coef = -0.24, P = 0.025) and a greater number of male partners (Coef = 0.37, P = 0.028) were associated with the Continuously Low group. Across trajectories, HIV stigma, perceived stress, and depression were negatively associated with SOC, with perceived stress showing a relatively stronger negative association. Social support was positively associated with SOC in the Continuously Low group (Coef = 0.78, P = 0.013). In the Slow Decline group, ART adherence (Coef = 0.76, P < 0.001) and comfort in accessing healthcare services (Coef = 0.88, P < 0.001) were positively associated with SOC. CONCLUSION:SOC among newly diagnosed HIV-positive MSM declined significantly during the early post-diagnosis period and exhibited marked trajectory heterogeneity. Early trajectory-stratified interventions are warranted, particularly for the Continuously Low and Rapid Decline groups, to help sustain psychological resources and improve health outcomes.

The global shortage of nursing professionals is a pressing issue that requires immediate attention. Previous studies have shown that the turnover intention rate of nurses is high, which varies across different countries due to various influencing factors. This study aims to investigate the current state, characteristics, and associated factors of turnover intention among nurses in tertiary hospitals in China. This is a large-sample cross-sectional study, and the included sample involved a total of 67 tertiary hospitals in 31 provinces in China. A validated questionnaire was used to measure the basic situation of nurses and the factors that may lead to nurses’ turnover intention. Data were analyzed using one-way analysis of variance and binary logistic regression. Approximately 13.7

BACKGROUND:The parental acceptance questionnaire (6-PAQ) is a user-friendly and contextually sensitive scale of psychological flexibility. OBJECTIVE:This research aimed to translate the original English version of the 6-PAQ into Chinese and to test its psychometric properties among Chinese parents of children with or without hearing loss (HL). METHODS:Two phases were conducted: (1) translation from English to Chinese (6-PAQ-C), followed by a semantic equivalence evaluation between two versions, a pre-test and face validity with 40 parents of children with or without HL, and content validity with 15 experts; (2) A cross-sectional study was conducted for providing empirical support among two samples: parents of children with (n = 204) or without (n = 336) HL. All participants were assessed for test-retest reliability over an 8-week interval. RESULTS:The 6-PAQ-C showed satisfactory semantic equivalence with the original version, excellent internal consistency, and good 8-week test-retest stability. Exploratory factor analysis and parallel analysis confirmed a six-factor structure consisting of 18 items. Confirmatory factor analysis supported both the original six-factor structure and a bifactor model (one general factor plus six specific factors), both demonstrating excellent fit. Bifactor indices indicated a strong general factor (omega = 0.95; omega hierarchical = 0.80; proportion of uncontaminated correlations = 0.88) and more modest independent specific-factor reliability (omega hierarchical subscale = 0.41-0.49; specific explained common variance = 0.08-0.10), supporting use of the total score as the primary metric and subscale scores as supplementary indicators. The scale also exhibited significant mean score differences between parents with high and low parenting stress in both samples and correlated with measures of psychological flexibility, symptomatology, and mental well-being. CONCLUSIONS:These findings suggest that the 6-PAQ-C is a reliable and valid instrument for measuring psychological flexibility among parents of children with or without HL. In practice, the total score should be treated as the primary scoring metric, whereas the six subscale scores may be used cautiously to describe ACT process profiles rather than as fully independent dimensions. Future research should test the 6-PAQ-C with diverse samples across cultures/contexts to improve its generalizability.

Background:Sleep disturbance is a critical occupational health issue among nurses, jeopardizing their well-being and patient safety. Identifying its prevalence and modifiable factors is essential for developing effective interventions. Objectives:This study aimed to determine the national prevalence of sleep disturbance and explore associated demographic, occupational, and behavioral factors among Chinese nurses. Methods:In this nationwide cross-sectional study, we analyzed baseline data from the Nurses' Mental Health Study (NMHS), a primary database established and maintained by the authors. A total of 132,910 nurses from 67 tertiary public hospitals in China were included between December 2023 and January 2024. Data were collected electronically via a structured questionnaire. Chi-square tests and binary logistic regression were used to identify factors associated with sleep disturbances. Results:The overall prevalence of sleep disturbances was 24.1%. Difficulty initiating sleep (13.3%), difficulty maintaining sleep (15.5%), and early morning awakening (15.4%) were most common, with higher rates in critical care, emergency, pediatrics, and obstetrics. Factors associated with increased odds of sleep disturbance included age (30-39 years), female sex, intermediate professional title, lower education, longer working experience, night shift work, smoking, alcohol use, and physical inactivity. Conclusion:Sleep disturbance is prevalent among Chinese nurses and associated with scheduling patterns and health behaviors. To mitigate risk, healthcare organizations should optimize shift schedules, enhance support for high-risk nurses, and allocate resources to high-burden clinical departments. Nurses are also encouraged to adopt healthier lifestyles to improve sleep quality and occupational safety. Clinical trial registration:Identifier ChiCTR2300072142.

Background The behavioral characteristics of nurses' unhealthy lifestyles and their anxiety and depression have become important public health issues.High-intensity occupational stress and irregular shift work lead to the coexistence of various unhealthy lifestyle behaviors among the nurse population, and their relatively high incidence rate may have adverse effects.However, existing studies analyze these behavioral characteristics in isolation and do not evaluate different patterns.This study aims to identify the potential categories of lifestyle behavior patterns among clinical nurses, analyze their influencing factors, and explore their relationships with anxiety and depression. Methods The present national cross-sectional study used data on 132,863 RNs who were participants of the Nurses' Mental Health Study (NMHS). We performed latent class analysis (LCA) based on nine life-style factors including sleeping quality,circadian rhythm profiles, food intake, and Two binomial logistic regression models were used to examine associations between anxiety and depression, Adjust for demographic and work-related covariates.To assess the robustness of the results, we conducted interaction analysis and sensitivity analysis ,Interaction analysis is conducted by incorporating lifestyle behavior patterns and product interaction terms into the regression model.Participants with uncertain category attribution (maximum posterior probability < 0.70) were excluded, and sensitivity analysis was conducted by gender and night shift exposure stratification to determine whether the results were consistent with those of the main analysis. Results Three distinct latent classes were identified : the "Restorative Lifestyle Pattern" (33.9%), the "Strained Lifestyle Pattern" (52.6%), and the "Depleted Lifestyle Pattern" (13.5%).Compared to the Strained pattern (reference), nurses in the Depleted pattern exhibited a significantly higher risk of depression (OR = 2.96, 95% CI: 2.67–3.29) and anxiety, whereas the Restorative pattern showed a strong protective effect (OR = 0.17, 95% CI: 0.17–0.18). The interaction between lifestyle behavior phenotypes and moderating variables showed that gender was statistically significant (P < 0.05).In the subgroups of different genders and night shift exposure statures, the association direction, effect size and statistical significance of the sensitivity analysis results were consistent with those of the main analysis. Conclusion This study identified three distinct core axes of lifestyle clustering among nurses in top-tier hospitals in China and verified the relationship between three phenotypes and anxiety and depression, especially when the sleep-wake rhythm was disrupted, which was significantly associated with the risk of anxiety and depression.Precise intervention targeting specific lifestyle behavioral patterns may help reduce the occurrence of anxiety and depression in such groups of people.

Hospital workplace violence is a significant global public health concern, impacting nurses' mental well-being and their likelihood of leaving their jobs. Previous research explored the associations between workplace violence, mental health, and turnover intention among nurses, which yielded inconsistent results due to smaller sample sizes, thus highlighting the need for a more comprehensive investigation with a large sample of a representative population. This study, drawing on a large dataset of 116,345 nurses from 67 tertiary hospitals across 31 provinces in China, aimed to assess the relationship between workplace violence and nurses' mental health and turnover intentions between October and December 2023. Data were analyzed using multilevel regression models. The study assessed the varying levels of workplace violence (low, moderate, and high), mental health outcomes, and turnover intention. The study found that a substantial number of nurses, 30,987 (26.6%), experienced workplace violence in the year prior to the survey, with varying levels of severity. Specifically, 27,225 (23.4%) encountered low-level violence, 3519 (3%) moderate violence, and 243 (0.2%) high-level violence. After controlling for sociodemographic and work-related variables, workplace violence was significantly associated with depressive symptoms (p < 0.001), stress (p < 0.001), anxiety symptoms (p < 0.001), burnout (p < 0.001), and turnover intention (p < 0.001). These findings underscore the critical need for policymakers, hospital administrators, and supervisors to take proactive measures. It is essential to implement strategies that both reduce the incidence of workplace violence and provide robust psychological support and interventions for nurses who have been affected. This collaborative effort will be crucial in protecting the mental health of nursing professionals and fostering a safer, more supportive work environment. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2300072142.

BACKGROUND:Suicidal ideation (SI) is a major mental health concern among nurses. Disclosure of SI is considered a key step toward accessing care, but limited research has explored how SI disclosure influences future help-seeking behaviors, especially in nurses. This study aims to examine whether SI disclosure predicts nurses' professional help-seeking intentions and behaviors at a one-year follow-up. METHODS:This nationwide one-year cohort study used data from 5075 Chinese nurses who endorsed SI via PHQ-9 from the Nurses' Mental Health Study. SI disclosure was defined using responses to a direct question on SI and PHQ-9 item 9. Logistic regression models examined whether SI disclosure predicted professional help-seeking intentions and behaviors at follow-up, adjusting for sociodemographic, psychosocial, and clinical covariates. Interaction terms and stratified models explored moderation by sex, age, and depression status. Two sensitivity analyses tested the robustness of findings. RESULTS:Only 46 % of nurses disclosed SI, indicating that more than half of nurses with SI did not acknowledge their ideation directly despite reporting it on a validated symptom measure. Compared to non-disclosers, disclosers had significantly higher odds of endorsing professional help-seeking intentions (AOR = 1.17, 95 % CI: 1.04-1.31) and engaging in professional support (AOR = 1.18, 95 % CI: 1.01-1.37). These associations were significant for both mental health service use and participation in promotion programs. Age significantly moderated these associations, which were only observed among nurses aged ≤35 years. Sensitivity analyses confirmed the primary findings. CONCLUSIONS:SI disclosure significantly predicts subsequent professional help-seeking among Chinese nurses, particularly in younger adults. Ambiguous responses, such as "Prefer not to answer," should not be overlooked in suicide prevention. These findings underscore the importance of improving early detection and reducing barriers to care for nurses experiencing SI.

Aim:To develop and conduct a preliminary evaluation of a digital salutogenic intervention-"Towards the Sun"-aimed at enhancing sense of coherence (SOC) and improving health outcomes among newly diagnosed HIV-positive men who have sex with men (MSM). Methods:The initial intervention draft was developed using the systematic Intervention Mapping (IM) process, informed by preliminary research, literature review, and evidence-based needs assessment. Two rounds of expert panel review were then conducted to refine the draft, followed by a feasibility assessment among newly diagnosed HIV-positive MSM. Results:The final digital intervention consisted of a five-stage, eight-week program, focusing on stress management, resource activation, and meaning exploration to strengthen the three dimensions of SOC. After review by 8 experts, the mean importance ratings of the intervention items were all above 4 and the coefficients of variation (CV) were less than 0.20, indicating consensus. A pilot study involving 7 newly diagnosed MSM demonstrated feasibility: SOC-13 scores increased, levels of stress and depression decreased, and participants reported high satisfaction with the overall content, especially the modules on self-acceptance and resource orientation. Conclusion:This digital salutogenic intervention demonstrated good feasibility, user acceptance, and preliminary effectiveness among newly diagnosed HIV-positive MSM. As a strengths-based and innovative digital solution, it warrants further validation and dissemination in larger samples and randomized controlled designs. Reporting Guidelines:The study followed the TIDieR (Template for Intervention Description and Replication) Checklist.

Musculoskeletal pain is common among nurses and can lead to absenteeism, reduced productivity and impaired physical and mental health. Long-term pain may develop into chronic pain, which is a more serious and longer-lasting condition that will cause further harm to nurses’ health. Therefore, this study aims to investigate the prevalence and characteristics of chronic pain and its associated factors among nurses in tertiary hospitals in China. This was a multicentre cross-sectional study of 147,832 nurses from 67 tertiary hospitals in China between December 2023 and January 2024, using cluster sampling and online methods. This study was a secondary analysis of the Nurses’ Mental Health Study. The variables included sociodemographic information (sex, age, ethnicity, etc.), work-related information (professional title, years of working, department, etc.), and chronic pain characteristics (presence of chronic pain and site of pain). The study followed the STROBE guidelines. Statistical analyses included descriptive, chi-square test and binary logistic regression. The prevalence of chronic pain among the participants was 8.2

Many elements in the workplace contribute to nurses’ burnout experiences, affecting patient safety and the healthcare organizations’ efficiency. Leaders’ presence and conduct are the most potent “master” factors in every work setting. Although previous studies have shown that head nurse leadership, job demands, job resources, and job burnout are significantly related, the interaction mechanism remains unclear. This study investigates the parallel mediating roles of job demands and job resources between head nurse leadership and job burnout in nursing staff. A cross-sectional, anonymous, and confidential online survey was conducted from March to June 2024 to collect data from 579 registered nurses in four hospitals in Hunan provinces. The independent variable was head nurse leadership, the mediating variables were job demands and resources, and the dependent variable was job burnout. Parallel mediation analysis was performed using the PROCESS macro in SPSS. This study found that head nurse leadership negatively relates to nurses’ burnout. The parallel mediation analysis suggests that job resources and job demands play parallel roles in the relationship between head nurse leadership and job burnout. As predicted, head nurse leadership weakened job burnout through job resources and contributed to job burnout through job demands. This study finding highlights the importance of head nurse leadership in decreasing nurses’ job burnout and reveals two potential mechanisms through which head nurse leadership is related to nurses’ burnout. By understanding the role of head nurse leadership, job demands, and job resources, interventions can be targeted to improve nurses’ mental health.

BACKGROUND:Owing to the special nature of work and practice environment, nurses face relatively higher mental health risks. The mental health problems of nurses in China's tertiary hospitals are particularly prominent. However, nationally representative longitudinal data on nurses' mental health in China are lacking. The present paper describes the design and initial findings of the Nurses' Mental Health Study (NMHS). METHODS:The study population comprised registered nurses employed at 67 tertiary hospitals across 31 provinces in mainland China. Survey content covers sociodemographic information, work-related factors, health status, lifestyle habits, objective experiences, family and social relationships, current affairs opinions, overall evaluation, and identity information. Data are collected annually and have been collected twice to date, with an initial follow-up period of five years. RESULTS:The baseline survey (December 2023-January 2024) collected 132,910 valid questionnaires (effective response rate 89.9%, 93.5% female, ages 18-65 years), and the first follow-up (December 2024-January 2025) collected 131,713 valid questionnaires (effective response rate 90.8%, 92.9% female, ages 18-66 years). A total of 84,252 questionnaires were successfully matched between baseline and the first follow-up (matching rate 63.4%). Among the participants, 55.2% of participants reported depressive symptoms, 39.3% reported anxiety symptoms, and 45.0% reported insomnia symptoms. It should be noted that severity bands (e.g., mild) reflect symptom burden rather than clinical diagnoses. Suicidal ideation and self-harm behaviors were reported by 3.1% and 1.2% of participants, respectively. In the past year, 6.9% of nurses sought help from psychiatric or psychological services, and 15.4% participated in mental health promotion activities. CONCLUSION:Our findings suggest that a substantial proportion of NMHS participants reported experiencing mental and psychological symptoms. However, the mental health service use rate was low. These findings highlight the necessity of routine psychological screening and the optimization of mental health promotion services.

Despite its widespread use and acceptance, there is still a significant need for a comprehensive understanding of the safety profile of deep brain stimulation (DBS) for Parkinson’s Disease. This study investigates the surgical and psychological complications associated with DBS surgery for movement disorders, aiming to quantify patient risk and promote broader acceptance of the procedure. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It focused on a substantial population of 3,599 patients from various studies who underwent DBS between 2000 and 2024. A thorough literature search was carried out to identify studies on the safety profile of DBS in Parkinson’s Disease (PD) across multiple electronic databases. Two reviewers extracted data and independently assessed the risk of bias, and all authors resolved any discrepancies collectively. This review identified 17,453 studies, but only 26 were thoroughly reviewed after fulfilling all inclusion criteria. DBS showed both therapeutic benefits and significant risks, with complications including neurological deficits, infections, cognitive and psychiatric symptoms, surgical or device-related issues, motor dysfunction, and mortality. Overall, the findings support the cognitive safety of DBS, revealing limited adverse effects on cognitive functions. This review confirms therapeutic advantages and significant risks during and after surgery, including intraoperative and long-term adverse events. Additional reviews are required to evaluate the long-term impact of these complications, thereby enhancing patient safety and quality of life. Not applicable.

BACKGROUND:Nurses in China are disproportionately exposed to workplace violence. Rates of psychological symptoms and adverse events among Chinese nurses have increased in recent years. To evaluate whether workplace violence is associated with psychological symptoms and adverse events among nurses. METHODS:This study is a cross-sectional analysis using baseline data from the Nurses' Mental Health Study (NMHS), conducted across 67 tertiary hospitals in 31 regions of China to assess the mental health of nurses. Workplace violence (WPV) from patients and their relatives was assessed using the Workplace Violence Scale (WVS). Outcomes included depressive symptoms (PHQ-9), anxiety (GAD-7), obsessive-compulsive symptoms (SCL-90-R), burnout, insomnia, and adverse events. To reduce selection bias, propensity score matching was applied, followed by multivariable logistic regression to examine associations between WPV, psychological symptoms, and adverse events. RESULTS:A total of 105,614 nurses participated, with 93.1 % female and 66.0 % married. WPV was reported by 30.3 % (n = 32,027). Before matching, the prevalence of depression, anxiety, obsessive-compulsive symptoms, burnout, and insomnia was 53.0 %, 36.5 %, 74.2 %, 42.4 %, and 22.1 %, respectively. Adverse events were reported by 32.3 % of nurses. Nurses exposed to WPV were significantly more likely to report psychological symptoms and adverse events than those who were not. CONCLUSIONS:WPV from patients and their relatives was significantly associated with increased psychological symptoms and adverse events among Chinese nurses. Reducing WPV in healthcare settings may improve both nurse well-being and patient safety.

Workplace violence (WPV) is a major issue for nurses worldwide, causing both physical and mental harm, and impairing their ability to work effectively. Several researches reported on the prevalence of WPV among nurses in China, ranging from 56.4 to 71

BACKGROUND:Physicians and nurses experience a high prevalence of non-specific neck-shoulder pain (NNSP) and are exposed to multiple risk factors. However, no targeted tools comprehensively assess these risk factors. OBJECTIVE:This study aimed to develop assessment indicators for evaluating risk factors contributing to NNSP among physicians and nurses. DESIGN:A systematic literature review and Delphi method, guided by a theoretical framework, were employed to develop the index system. METHODS:This study utilized a theoretical framework based on ergonomics and the biopsychosocial pain model to collect multi-source data for developing a risk assessment index system. Initially, candidate indicators were identified through literature reviews, theoretical analysis, expert interviews, and consultations. Three rounds of the e-Delphi technique were conducted to identify indices potentially affecting neck-shoulder pain. Finally, the analytic hierarchy process (AHP) method was employed to calculate the relative weight of each indicator. RESULTS:After two rounds of expert consultation, the risk assessment index system reached a consensus, comprising six first-level indicators: workload factors, individual factors, work facilities and equipment factors, workspace and environment factors, organization management factors, and psychological factors. These were further divided into 14 second-level indicators and 82 third-level indicators. Among these, workload factors had the highest weight (0.2484), while psychological factors had the lowest (0.1019). CONCLUSION:The risk assessment index system achieved expert consensus, confirming its scientific validity and practical applicability. It provides a structured approach to identifying risk factors and high-risk individuals for neck-shoulder pain among physicians and nurses.

BACKGROUND:Bubble tea has emerged as an essential beverage in the daily lives of many individuals, which is particularly pronounced among nurses. However, few studies have investigated the potential effects of bubble tea consumption on mental health among nurses. In this study, we aimed to investigate the association between bubble tea consumption and mental health among nurses. METHODS:A cross-sectional analysis using baseline data from the Nurses' Mental Health Study (NMHS), a national cohort study. Odds ratios (ORs) were employed to evaluate the relationship between bubble tea consumption and mental health. RESULTS:A total of 132,910 participants were enumerated nationwide in our survey. 8666 (6.52 %) were male and 124,244 (93.48 %) were female. The median age of participants was 34 years. After adjusting for potential confounders, the odds ratios (ORs) for depressive symptoms, anxiety symptoms, psychiatric diagnosis, fatigue, burnout, loneliness, and well-being trend changed across categories of bubble tea consumption. Low frequency of bubble tea consumption was associated with a lower risk of suicidal ideation, while high frequency of consumption was related to an increased suicidal risk. The relation between bubble tea and mental health varies with gender and age. CONCLUSIONS:This large-sample cross-sectional study found that consumption of bubble tea was significantly associated with increased anxiety, depression, psychiatric diagnosis, fatigue, job burnout and loneliness, and decreased well-being among nurses. Moreover, research indicates that limited consumption of bubble tea may be correlated with a reduction in suicidal ideation, whereas excessive consumption may be linked to an increase in such ideation.