Previous studies have established a positive link between nurse managers’ caring leadership and nurses’ work engagement, but the processes and conditions through which this leadership style influences positive work behaviors remain largely unexplored. To address this gap and contribute to the existing body of knowledge, we developed a chain-mediated effects model to elucidate the impact of caring leadership on nurses’ work engagement and the underlying mechanisms. In this model, we identified professional mission and affective organizational commitment as the mediating variables, offering a novel perspective on the relationship between caring leadership and work engagement. A robust multi-center and large-sample cross-sectional survey was conducted, involving 2502 first-line nurses from six general tertiary hospitals across the eastern, central, and western regions of China. The data collection instruments included a comprehensive questionnaire covering demographic information, the caring leadership scale, the Chinese calling scale, the affective organizational commitment scale, and the Utrecht work engagement scale. Data were meticulously screened and analyzed, employing descriptive analysis to summarize the demographic information, correlation analysis to test the relationship among the variables, stepwise regression analysis to explore the mediating role of calling and affective organization commitment, and the bootstrap method to test the chain mediating effect. This rigorous methodology not only ensures the reliability and validity of research findings but also instills confidence in the robustness of this research. The results indicated a positive relationship among caring leadership, calling, affective organizational commitment, and nurses’ work engagement (p < 0.001). Specifically, caring leadership was significantly associated with nurses’ calling (β = 0.55, p < 0.001), affective organizational commitment (β = 0.21, p < 0.001), and work engagement (β = 0.05, p < 0.001). And the analysis further revealed that calling and affective organizational commitment mediate the process between caring leadership and work engagement(Effect: 0.17, 0.03, 0.05), with a relative effect size of 89.3

AIMS:To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association. BACKGROUND:There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational-level solutions to prevent it. METHODS:A cross-sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire-Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis. RESULTS:A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate. CONCLUSION:The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses. IMPACT:This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

Abstract Background With the growing challenge of an aging population, addressing the needs of elderly individuals who face living difficulties and lack family support becomes increasingly difficult. Volunteer services are crucial in this context, yet their effectiveness is hindered by unclear service scopes and uncertain volunteer inclinations. Aim To explore the role and specific preference of volunteers with nursing backgrounds in support of older adults living in the urban community. Design, Setting and Participants A descriptive qualitative study was conducted between September and October 2022. Twenty‐three participants (hospital nurses [10], community nurses [4], nursing teachers [4] and nursing students [5]) were selected. Data analysis followed conventional content analysis. Results Nine major themes were identified based on interview data. Four themes described the service scope of nursing volunteers: (1) environment domain, (2) physiological domain, (3) psychosocial domain and (4) health‐related behaviours domain. Another five themes highlighted the service inclination of these volunteers: (1) service frequency, (2) service duration per person/time, (3) service coverage, (4) service place and (5) service object. Conclusion This study clarifies the service focus and scope of necessary support for volunteers, exploring the potential service capabilities of scarce volunteers to the greatest extent. Meanwhile, the results of this study also provide a foundation for stakeholders to fully exploit the synergy. The important findings of this study will help the government and relevant authorities better understand the service attributes of nursing volunteers, allowing them to develop detailed training plans and provide nursing volunteers with targeted support and assistance to meet the health expectations of urban community‐living older adults in need. Patient or Public Contribution Developing research questions, participation and conduct and provision and interpretation of evidence.

目的 了解病区护士长对患者实施人文关怀的体验,为制定关怀改进策略提供参考.方法 采用现象学研究方法,对7所医院的17名护士长进行半结构深入访谈,采用Colaizzi 7步分析法分析资料.结果 提炼出5个主题:重要性感知、关怀措施丰富、多层面获益、存在阻碍因素、期望关怀与支持.结论 病区护士长对患者实施人文关怀的体验中有收获、有困难,医院管理层应针对现况完善管理机制,促进病区护士长更全面、更深入地开展患者人文关怀.

Background With the development of the social economy, the effective coordination of the conflict between work and family has become an urgent problem for most parents. Such conflicts are especially acute in the families of nurses with children. Therefore, a timely understanding of the status quo of the parent-child relationship and associated risk factors among nurses will assist in improving their family harmony and the healthy growth of their children. Methods A total of 350 nurses with children at a general tertiary hospital in Sichuan Province, China, were interviewed using a structured questionnaire between June 23 and July 9, 2022. The results were analyzed by multiple linear regression using the stepwise method. Results The results showed that the parent-child relationship received a middle-level mean score of 77.74 (SD = 10.77). The factors that influenced the parent-child relationship among nurses included the parents’ character type (β = 0.143, P = 0.002), feeling tired due to dealing with patients (β=-0.150, P = 0.002), the nurse-patient relationship (β = 0.137, P = 0.004), the age of older children (β=-0.153, P = 0.001), number of children (β=-0.093, P = 0.041), sleep quality (β = 0.116, P = 0.014), and family adaptability (β = 0.308, P = 0.000); these factors accounted for 31.3% of the variance in parent-child relationships among nurses. Conclusion The findings of this study will help policy makers and nursing managers to better understand parent-child relationships in Chinese nurses. The results highlighted the importance of the creation of a family-oriented work environment while paying more attention to the parent-child relationships of nurses who are introverted and have more or older children. After busy workdays, nurses should also be encouraged to participate more in family decision-making and strategic parent-child interactions to avoid negative effects on children caused by work-related emotional exhaustion, physical and mental fatigue, and other reasons. The development of good parent-child relationships may help maintain both their and their children’s mental health while enhancing their enthusiasm for work and their professional identity.

Objective:To investigate the current situation and influencing factors of patients′ satisfaction with nursing humanistic care, and to provide reference for improving the quality of such care provided by hospitals.Methods:From July to August 2022, outpatients and inpatients in 30 provinces were selected by multi-stage stratified sampling as the survey objects. A cross-sectional survey was conducted on an online platform, using the general information questionnaire and Chinese version of methodist health care system nurse caring instrument revised by the research group. The latter instrument consists of 12 dimensions. namely care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family engagement, physical environment, spiritual environment and outcomes. Descriptive analysis was performed on the data collected by the questionnaires, and independent sample t-test and one-way ANOVA were used to analyze the influencing factors of patient satisfaction. Results:A total of 107 hospitals were selected for questionnaire survey, including 86 tertiary hospitals and 21 secondary hospitals, and 29 108 valid questionnaires were recovered. The patient satisfaction with nursing humanistic care scored (5.40±0.86); the top three dimensions were competence (5.50±0.89), emotional support (5.47±0.88) and helping/trusting relationship (5.46±0.86); the lowest scoring dimensions were teaching/learning (5.38±1.01), spiritual environment (5.36±1.04) and patient/family engagement (5.11±1.28). Differences with gender, age, marital status, child status, educational level, occupation, place of residence, economic region, per capita monthly income of the family, type of medical insurance, medical department visited and surgery or not presented significant differences on the patient satisfaction with nursing humanistic care scores ( P<0.05). Conclusions:The satisfaction of patients with hospital′s nursing humanistic care in China was at the middle to upper level. In the future, health education for patients should be strengthened, and a mode of family-engaged nursing humanistic care should be constructed in line with the Chinese cultural background. In the process of nursing services, the particularity of patient groups should be considered to better meet their needs.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

BACKGROUND:Turnover has significant impact on nursing management and nursing safety. Nurses working in the Emergency Department are especially vulnerable to high turnover intention because of their increased risk of work-family conflict associated with the work characteristics.OBJECTIVE:This study aimed to investigate the effects of work-family conflict on emergency nurses' turnover intention and the role of positive and negative affect between work-family conflict and turnover intention.METHODS:A cross-sectional study. Data were collected from 17582 nurses working in emergency department in China. We employed a standardized questionnaire to collect sociodemographic information and target work-family conflict, affect and turnover intention. Mediation analyses were performed for the data analyses.RESULTS:On turnover intention, work-family conflict exerted both direct effect and indirect effect. The results also indicated that positive and negative affect partially mediated the effect of work-family conflict on turnover intention, and that 35.7% of this effect could be explained by mediating effects totally.CONCLUSIONS:The findings highlight positive and negative affect concern during the process of nursing management and nursing managers should take active measures to reduce negative affect and improve positive affect in order to reduce turnover intention and maintain the stability of the emergency nursing workforce.

Objective To investigate the status quo of nurse-to-nurse lateral violence（LV） and nurses′ perceived managerial caring from head nurses in general hospitals, and to analyze the influence of nurses′ perception of head nurses′ managerial caring on nurse-to-nurse LV.Methods Clinical nurses were conveniently selected from six general hospitals in Hubei province, and a cross-sectional survey was conducted by using the general demographic questionnaire, the Caring Assessment Tool-administration, and the Ne-gative Acts Questionnaire.Results A total of 1 905 valid questionnaires were collected.Of the 1 905 participants, 59.11%（1 126/1 905） reported they had experienced LV at least once in the past 6 months.The median total score of nurse-to-nurse LV was 20（IQR:19-26） points, and the total score of nurses′ perceived managerial caring from head nurses averaged（147.24±25.78） points.Multivariate logistic regression analysis showed that high level of shared decision making, and moderate to high levels of respect were protective factors of nurse-to-nurse LV, while moderate to high levels of non-caring were risk factors（all P＜0.05）.Conclusion Nurse-to-nurse LV is common.Nurses perceive high level of managerial caring from head nurses.Head nurses′ caring for nurses is a protective factor for nurse-to-nurse LV.Nursing managers are recommended to reduce the prevalence of nurse-to-nurse LV by increasing their caring for nurses.

BackgroundHumanistic care pertains to the abilities, attitudes, and behaviors central to patient-centered care, contributing to patients' sense of safety and wellbeing. This study aimed to assess the satisfaction of patients with humanistic nursing care in Chinese secondary and tertiary public hospitals.MethodsA national cross-sectional survey was conducted across 30 provinces and 83 hospitals in China. Patient satisfaction with humanistic care was assessed using the Methodist Health Care System Nurse Caring Instrument (NCI), which encompasses 20 items across 12 dimensions. Each item was rated on a 7-point Likert scale, yielding a total score of 140. Multiple linear regression analysis was employed to identify factors associated with patients' satisfaction.ResultsModerate satisfaction (mean score 91.26 ± 13.14) with humanistic nursing care was observed among the 17,593 participants. Factors significantly associated with patient satisfaction included age, hospital type, presence of children, educational attainment, place of residence, family monthly income, and medical insurance type.ConclusionThe study findings highlight the importance of tailored interventions, evidence-based practice guidelines, and patient-centered care in improving patients' satisfaction with humanistic nursing care. Continuous emphasis on nursing education and professional development is crucial for enhancing humanistic care and patient satisfaction.

目的 编制临床护士整体人文关怀感知量表,并检验其信效度.方法 在文献分析和半结构式访谈的基础上,通过德尔菲法构建量表初稿.2022年4月在武汉市某三级甲等医院选取20名临床护士进行预调查,检验量表可读性.2022年4月—5月选取咸宁市和泰安市2所医院的501名临床护士作为调查对象,对量表进行项目分析和信效度检验.结果 临床护士整体人文关怀感知量表包括6个维度、40个条目.探索性因子分析共提取6个公因子,累计方差贡献率为79.05％;验证性因子分析结果显示,量表结构模型的拟合指数良好.量表水平的内容效度指数为0.94,条目水平的内容效度指数为0.78～1.00;量表总的Cronbach'sα系数为0.98,重测信度为0.87.结论 临床护士整体人文关怀感知量表信效度良好,可用于测量护士感知的整体人文关怀情况.

目的 编制带教老师对预防与应对实习护生遭受工作场所暴力的知信行量表,并检验信效度.方法 以知信行理论为指导,在文献回顾基础上,结合半结构访谈法及德尔菲法初步形成带教老师对预防与应对实习护生遭受工作场所暴力的知信行量表.对302名临床护理带教老师进行调查,检验量表信效度.结果 量表包含知、信、行3个Ⅰ级维度,8个Ⅱ级维度,共44个条目.条目水平的内容效度指数为0.889～1.000,量表水平内容效度指数为0.941.探索性因子分析中,知、信、行维度分别提取4、2、2个公因子,累积方差贡献率分别为73.897％、75.388％、82.052％;验证性因子分析显示模型的适配度较好.量表的Cronbach's α系数为0.961,各维度Cronbach's α系数为0.920、0.904、0.977;量表折半信度为0.987,各维度折半信度为0.965、0.950、0.989;量表重测信度为0.927.结论 量表具有良好的信效度,可作为测评带教老师预防与应对实习护生遭受工作场所暴力的有效工具.

Abstract Background With China's rapidly aging population, meeting the diverse care needs of senior citizens is becoming more challenging. Although voluntary social services have numerous advantages and are popular among older adults, there is little information on the need for assistance from volunteer-based social services, particularly those with a medical background, and influencing factors among urban home-based older adults. This study aimed to assess the need for assistance from voluntary services and related factors among urban home-based older adults in China. Methods A cross-sectional study was conducted in 2022 on communities in four cities in China. The 27-item Home-Based Older Adults Assistance Need Scale was used to measure the assistance needs of 498 participants aged 60 and above. Multiple linear regression models were conducted to identify salient variables associated with the need for assistance from voluntary services. Results The mean score of the need for assistance from voluntary services was 88.60 ± 24.37. The mean scores of the items examining four dimensions, namely, health maintenance, visiting communication, social intercourse, and daily life, were 3.64 ± 1.08, 3.49 ± 1.04, 3.33 ± 1.08, and 2.78 ± 1.08, respectively. The level of depression, willingness to assist older adults, attaching importance to health preservation, ability to self-comfort, desire to accept assistance from others, and the presence of more children or none at all were all positively correlated with the perceived need for assistance from voluntary services. In contrast, social care obtained from visiting medical institutions was negatively correlated. These seven factors explained 28.5% of the total variance. Conclusions Urban home-based older adults in China were found to have significant requirements for assistance from volunteer services, and several complex factors were associated with more significant assistance needs. These findings may encourage the extremely limited numbers of social volunteers, particularly those with a medical background, to identify priorities in providing assistance services to the large numbers of urban home-based older adults and thus improve service delivery.

Abstract Background Humanistic care management is a necessary measure to improve the motivation and initiative of clinical nurses and is the foundation to improve the quality of nursing. Understanding the current status and identifying the influencing factors that promote or hinder humanistic care behaviors is essential. This study investigated the current status and experiences of nurse managers' caring behaviors toward clinical nurses. Methods We conducted a mixed-methods study with an explanatory sequential design. A survey on the nurse managers' caring behaviors in 101 hospitals from 23 provinces and four municipalities in China was investigated (n = 2022). Then, semi-structured interviews were conducted to obtain information about the participants’ experiences associated with the performance of caring behaviors (n = 27). Results Survey data demonstrated that the nurse managers' overall caring behaviors were moderately good. The total scoring rate was 88.55%, and the overall score was 161.19 ± 20.68. Qualitative data revealed that the capacity of nurse managers and clinical nurses, opportunity, and motivation to implement humanistic care are key influencing factors of caring behaviors. Conclusions The results suggested that intrinsic motivation, organizational support, and the humanistic care capabilities of clinical nurses and nurse managers are vital to implementing care behaviors. Thus, successful humanistic care management requires a concerted effort at the individual and organizational levels.

概述了人文护理临床实践对象、范畴,从实践主题、实践内涵、实践理念、实践标准、实践目标5个方面阐述了人文护理临床实践的基本要素,提出人文护理实践程序包括人文护理评估、计划、实施与评价,以期为人文护理临床实践规范落实提供借鉴与参考.

ObjectivesTo explore and analyze the influencing factors of depression in older adults living at home, so as to propose suggestions for improving the quality of older adults living at home.MethodsWe conducted a cross-sectional study on 498 older adults living at home based on questionnaire survey on the general information, daily living ability, health status, and care perception (including self-care, care for cohabitants, and care for non-cohabitants) of older adults living at home, as well as their willingness to help each other, and analyzed the influencing factors of depression among older adults living at home.ResultsThe results showed a willingness to help older adults, self-care, and total activities of daily living (ADL), health status was an influential factor for depression in older adults (p < 0.05).ConclusionIt aims to take targeted measures, such as encouraging older adults at home to actively participate in mutual assistance activities for older adults and care for themselves, so as to prevent and reduce the occurrence of depression in older adults.

目的 对胰腺癌患者运动干预相关研究进行范围综述,为胰腺癌患者标准化运动方案的制定提供参考.方法 基于Arksey和O'Malley的范围综述框架,系统检索PubMed、Embase、Web of Science、CIN AHL、中国知网、万方数据库和中国生物医学文献数据库,检索建库至2023年2月15日的文献,并对检索出的文献进行筛选和信息提取.结果 共纳入17篇文献,胰腺癌患者运动干预的内容包括干预时机、干预者、运动类型、运动场所、运动时间、运动频率及强度、干预周期、是否合并营养支持和结局指标等.结论 运动干预对胰腺癌患者是可行、可靠且有效的,有助于改善患者的躯体成分、躯体功能及健康结局,提高患者生活质量,但运动干预的具体内容尚存在较大差异,有待更多证据以制定最佳运动干预方案.

Abstract Background With a rapidly aging population in China, it is becoming increasingly challenging to meet the growing diversified care needs of the elderly. Although social voluntary services has numerous advantages and is popular among the elderly, little information is available on the assistance requirements of the volunteer-based social service, particularly those with a medical background and influencing factors among the urban home-based elderly. Methods A cross-sectional study was conducted in four urban communities in Wuhan, Ezhou, Xinxiang, and Zhengzhou. Assistance needs was assessed using the 27-item Home-based Elderly Assistance Need Scale in 498 participants, aged 60 years and over. Multiple linear regression models were conducted to identify salient variables associated with assistance needs for social voluntary services. Results The mean score of assistance needs was 88.60 +/- 24.37. The item mean scores examining 4 dimensions, namely, health maintenance, visiting communication, social intercourse, and daily life were 3.64 +/- 1.08, 3.49 +/- 1.04, 3.33 +/- 1.08, and 2.78 +/- 1.08, respectively. The level of depression, willingness to help other elderly people, attaching importance to health preservation, willingness to seek help from others, existence of more children, and living parents were positively associated with assistance needs for social voluntary services, while social care from government departments was a negative factor. The aforementioned seven factors explained 28.4% of the total variance. Conclusions The urban home-based elderly population exhibited a high assistance demand for social volunteer services in China, and several complex factors were associated with an elevated assistance need. Our findings are beneficial for the extremely limited social volunteers, particularly, those with a medical background, to identify the priority of providing assistance services to the huge urban home-based elderly population, and improve service behavior.

Human caring is regarded as the essence and core of nursing.Based on Dr.Watson's human caring science theory,nursing staff in Wuhan Union Hospital and other healthcare institutions have delivered warm human caring service in patients'daily care.During the outbreak of major infectious disease-pandemic of COVID-19,patients are suffering from great psychological dis-tress and pressure.Like nursing professionals around the world,nurses in Wuhan,Hubei,China,along with the colleagues from the National Aid Medical Team,used entire of themselves to conduct diversity human caring measures to patients suffering from the major infectious disease with love and responsibilities,which greatly demonstrated the essence and value of nursing care,and has wide implications for further development of nursing.

AIM:This study aimed to develop a theoretical model of caring leadership in nursing. BACKGROUND:Nurse leader's role plays an integral part in complex health care institutions. As a common feature of leaders, leaders' caring leadership can positively influence the stakeholders in health care institutions. Still, little is known about caring leadership in nursing, especially in the Chinese cultural background. METHODS:Grounded theory was used to develop the theoretical model of caring leadership. Both semi-structured interviews and open-ended questionnaire surveys were used to collect data for constructing the theory model. Ten nurse leaders and 11 nurse staff were recruited for an interview, and 168 nurse leaders and 286 nurses were recruited for an open-ended questionnaire survey. RESULTS:A theoretical model of caring leadership was developed using five core attributions: benevolent to others, appreciate the uniqueness, facilitate self-actualization, maintain mutual benefit and motivate with charisma. Caring leadership in nurse leaders works through the caring and leading process, resulting in nurses' well-being, patients' healing and organisational excellence. CONCLUSION:A caring leadership model was developed through grounded theory, revealing Chinese nurses' perspectives on caring leadership in Chinese cultural background. According to the model, the concept of caring leadership has been further explained, and it makes contributions to the measurement and leaders' practice in health care institutions. IMPLICATIONS FOR NURSING MANAGEMENT:This caring leadership model developed in our study provides a new perspective and understanding of caring and leadership for nurse leaders. Nurse leaders need to strengthen their responsibilities and personal qualities while caring for nurse staff to improve leadership efficacy based on the theoretical model. And caring leadership can help nurse leaders to balance the interests of stakeholders, leading to positive consequences for nurse staff, patients and health care organisations.