To identify dyadic patterns of family resilience among adolescents and young adults (AYAs) with cancer and their caregivers, and to explore associated factors and their relationships with quality of life (QoL) in both parties. This cross-sectional study recruited 202 AYA patient-caregiver dyads from four tertiary hospitals in Wuhan and Taiyuan between July 2022 and March 2024. Data were collected through a self-designed general information questionnaire and validated instruments assessing family resilience, individual resilience, social support, and QoL. Family resilience clusters were identified using K-means clustering in R 4.4.3, followed by regression analyses in SPSS 20.0. Two family resilience clusters were identified: the low and high family resilience clusters. High resilience clusters were characterized by having an only child, a shorter disease course (1 3 months), having a smaller family size (≤ 3 family members), and shorter daily caregiving hours. Caregiver QoL was associated with family resilience cluster, caregiver employment changes, and social support, whereas patient QoL was primarily influenced by their individual resilience. This study identified heterogeneity in family resilience among AYA patient-caregiver dyads, with smaller family size, a shorter disease course, and shorter caregiving hours associated with membership in the high resilience cluster. Caregiver well-being was closely linked to family resilience and social-contextual factors, while patient QoL depended more on individual resilience. These findings advance understanding of family resilience in AYA oncology and underscore the importance of family-centered psychosocial support to strengthen family functioning, alleviate caregiver burden, and foster patient resilience.

Anhedonia is a common problem among patients with depression. Negative life events have been associated with the severity of anhedonia, potentially through insomnia and dysfunctional attitudes. This study aimed to investigate whether insomnia and dysfunctional attitudes mediate the relationship between negative life events and anhedonia among patients with major depressive disorder (MDD). This study involved 979 participants with MDD in a public hospital from December 2019 to December 2021. The Life Events Scale (LES), Insomnia Severity Index (ISI), Dysfunctional Attitude Scale (DAS), Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess participants’ negative life events, insomnia, dysfunctional attitudes and anhedonia. Five hundred and twenty-three participants reported symptoms of anhedonia (SHAPS > 33, 53.4

BackgroundExtensive research has focused on the top-down intergenerational transmission of psychopathological symptoms (ITP). However, little is known about the bidirectional and transactional dynamics of ITP between primary caregivers and their adolescent offspring in community-based samples. In particular, the moderating roles of caregiver and adolescent gender in these intergenerational associations remain underexplored.MethodsBetween 2021 and 2022, a total of 1414 primary caregiver-adolescent dyads completed two waves of surveys assessing sociodemographic characteristics, as well as depressive and anxiety symptoms. The actor-partner interdependence model (APIM) was applied to examine the bidirectional transactional patterns of psychopathological symptoms within these dyads. Multiple-group comparison tests were conducted to evaluate the moderating effects of caregiver and adolescent gender on these associations.ResultsAdolescents' depressive and anxiety symptoms significantly predicted subsequent depressive and anxiety symptoms in their primary caregivers. In contrast, only caregivers' anxiety symptoms were found to predict subsequent adolescents' depressive and anxiety symptoms. Multiple-group comparison tests indicated no significant moderating effects of caregiver or adolescent gender on the ITP.ConclusionThese findings suggest that depressive and anxiety symptoms may be mutually reinforced between adolescents and primary caregivers over time. A family-based approach to early identification and prevention could be a promising direction for interrupting escalating cycles of negative emotions across generations.

PurposeThis study aims to understand healthcare providers' (HCPs) perspective and clinical practices regarding fertility preservation in young hematologic patients, particularly from hematology, reproductive medicine, and ethics committee professionals.MethodsAn empirical phenomenological approach was employed. HCPs were recruited from the hematology, reproductive medicine, and ethics committee professionals of eight tertiary hospitals in China using purposive sampling. They participated in semi-structured, in-depth face-to-face individual interviews. Interviews were transcribed verbatim and analyzed using Colaizzi's phenomenological method.ResultsA total of 33 HCPs were recruited, including 12 hematology physicians, two pediatric hematology physicians, six hematology nurses, nine reproductive medicine physicians, two reproductive medicine nurses, and two ethics committee members. The analysis revealed three major themes and associated subthemes: (1) HCPs' overall perspectives of fertility preservation: all recognized its importance and feasibility in young patients with hematologic diseases, though interdepartmental differences; (2) Fertility preservation practice status: still in its early stages, communication strategies are crucial, and balancing the urgency of disease treatment with fertility preservation remains a challenge; and (3) Multi-level challenges and recommendations: challenges exist across the medical system, patient-related factors, and sociocultural levels, with recommendations proposed to address some barriers.ConclusionsHCPs recognized the importance and feasibility of fertility preservation for hematologic patients. However, its implementation faces challenges at multiple levels, including the medical system, patient-related factors, and sociocultural influences. To facilitate early discussions and informed decision-making about fertility preservation, it is crucial to enhance multidisciplinary collaboration, provide better support for patients and their families, and strengthen legal and policy frameworks.

The intergenerational transmission of psychopathology has been well documented, but limited studies have examined the link at the symptomatic level accounting for these associations. This study aimed to identify the central symptoms that bridge adolescents and parental psychopathological symptoms and the specific symptom pathways by using a novel network approach. From September to October 2021, a cross-sectional study was conducted in Wuhan, China. A total of 8,032 adolescent-primary caregiver dyads completed a questionnaire reporting their depression and anxiety symptoms. Network analysis was used to identify central symptoms and the network pathways between adolescents' and parental psychopathological symptoms. Three robust networks were identified in this study: adolescent, parent, and integrated network. The nervous was the most central symptom in the adolescent network, while the parental fatigue was the most central symptom in both the parent and integrated network. Adolescents' suicidal ideation and parental fatigue had the most bridge strength that linked the adolescents' and caregivers' psychopathological symptoms. Parental and adolescents' suicidal ideation had the strongest association in the integrated network. Significant gender differences were found in the link between adolescents' and caregivers' psychopathological symptoms. Network analysis revealed the distinctive core psychopathological symptoms across each network and the specific pathways between adolescents' and caregivers' psychopathological symptoms. Family-based interventions or therapies targeting the resolution of central and bridge symptoms may have potential to reduce the co-occurrence of psychopathological symptoms within families. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

BACKGROUND:Existing studies primarily examine the relationship between childhood maltreatment (CM) and bullying behaviors from an accumulative perspective. However, there is limited understanding of this relationship when adolescents experience combined forms of childhood maltreatment, particularly in the context of varying residential environments. OBJECTIVES:This study aimed to identify latent patterns of childhood maltreatment and examine their association with bullying behaviors among Chinese adolescents. Additionally, residential area differences in these associations were explored. PARTICIPANTS:There were 13,029 Chinese adolescents (mean age = 14.4 years) who completed self-report questionnaires between October and November 2023. METHODS:Data on childhood maltreatment and school bullying were collected through self-report measures. Latent class analysis (LCA) was employed to identify distinct patterns of maltreatment. Multiple logistic regression was employed to explore the relationship between maltreatment patterns and bullying behaviors, with stratified analysis conducted by residential areas after propensity score matching (PSM). RESULTS:Three childhood maltreatment patterns were identified: low-abuse-low-neglect (class 1, 75.7 %), low-abuse-high-neglect (class 2, 20.9 %), and high-abuse-high-neglect (class 3, 3.5 %). Compared to class 1, class 2 was associated with elevated risks for being an only victim (OR = 1.68), only bully (OR = 1.57), or bully-victim (OR = 1.85). Class 3 showed even higher risks (only victim: OR = 3.71; only bully: OR = 4.79; bully-victim: OR = 7.95), with a clear gradient in risk severity. Stratified analyses revealed that adolescents in rural areas who primarily experienced neglect were more likely to be both bullies and victims compared to the urban adolescents (OR = 2.05, 95 % CI = 1.17-3.58, p < 0.05). CONCLUSIONS:Childhood maltreatment influences bullying behaviors among adolescents significantly, with distinct maltreatment patterns providing critical insights for risk stratification. Residential area differences further modulate these associations. Intervention strategies should account for diverse maltreatment patterns and contextual factors such as rural-urban disparities to effectively address bullying behaviors.

BACKGROUND:Adolescents' mental health is shaped by their coping strategies and the broader family context in which they live. However, few studies have examined psychological distress and help-seeking patterns jointly, especially from a person-oriented perspective. Understanding distinct adolescent risk profiles and how family and parental factors influence them may inform more effective prevention strategies. This study aimed to: (1) identify latent profiles of adolescents based on their psychological distress and help-seeking intentions; and (2) explore how family and parental factors predict profile membership and self-harm risk. METHODS:A cross-sectional study was conducted in 2021 with 7,934 Chinese secondary school students and one parent per adolescent. Adolescents completed validated measures of depression, anxiety, and help-seeking intentions; parents reported on family income, family function, mental health symptoms, and mental health stigma. Latent profile analysis and the BCH three-step method were used to identify subgroups and examine predictors and outcomes. RESULTS:Five profiles were identified: normative, safe, distress, high-risk, and aware. The high-risk profile (5.98%) showed high distress, low help-seeking, and the highest self-harm rate (48.7%). Lower family functioning and higher parental distress predicted higher-risk profiles. Professional help-seeking intentions were associated with reduced self-harm risk among distressed adolescents. CONCLUSIONS:Family and parental factors significantly shape adolescent coping profiles and mental health risks. Findings underscore the value of early screening and family-focused interventions to reduce self-harm.

The high prevalence of recurrent depressive episodes (RDE) among patients with major depressive disorder (MDD) has resulted in substantial personal, societal, and financial burdens. Although many studies have explored the factors associated with RDE, most have important methodological limitations. This study aims to examine the factors associated with RDE within two years among young adults with first-episode MDD. A total of 324 patients aged 18 to 30 years with a first episode of MDD completed both the baseline assessment and the two-year follow-up. Personal, psychosocial, and illness-related variables were assessed at baseline. The status of RDE and medication use were evaluated at follow-up. Network analysis and logistic regression were performed to examine variables associated with RDE. The two-year prevalence of RDE among patients with first-episode MDD was 42.28

Introduction: Major depressive disorder (MDD) is a mental disorder with a high prevalence rate and a high recurrence rate. Therefore, identifying and intervening in the core symptoms of MDD patients is of great significance. Anhedonia is manifested as an individual losing interest in activities or experiencing a significant decrease in the sense of pleasure, which is one of the two core symptoms of MDD. Episodic Future Thinking (EFT) training refers to the process of stimulating individuals’ hope for positive future scenarios and encouraging them to take purposeful actions, which may have an effect in alleviating anhedonia. However, the perception of anhedonia of MDD patients among Chinese healthcare professionals is still unclear, and there has been no exploration of the views of healthcare professionals regarding the implementation of EFT training for MDD patients led by psychiatric nurses in a clinical setting. Aim: This study aimed to understand the attention paid by Chinese healthcare professionals to the symptom of anhedonia in patients with MDD, as well as their previous coping strategies. This study further explored the views of healthcare professionals regarding the implementation of EFT training for MDD patients led by psychiatric nurses with a psychological therapist certificate in China, as well as suggestions for future implementation. Methods: This qualitative descriptive study adopted a phenomenological approach. Using purposive sampling, 15 healthcare professionals (psychiatrists, psychiatric nurses and psychological counselors) were recruited from the psychiatry department of a public tertiary hospital in Wuhan, Hubei Province, China. Using the NVivo 12 Plus software, the semi-structured interviews and analyses were conducted by applying Colaizzi’s seven-step phenomenological method. Rigor was ensured through checks of credibility, dependability, and confirmability during data collection and analysis. Results: A thematic analysis revealed that, while psychia-trists and psychological counselors viewed anhedonia as a significant treatment target, nurses were more focused on immediate patient safety concerns. Participants recognized the potential of EFT training to alleviate anhedonia but identified several implementation challenges, including patient resistance, cognitive limitations, and the need for tailored interventions. Conclusions: The research results indicated that psychiatric nurses had relatively poor ability to identify anhedonia. Therefore, it is necessary to enhance the awareness of psychiatric nurses regarding the clinical significance of anhedonia, and incorporate knowledge related to anhedonia into routine nursing training. It is suggested that communication and collaboration among psychiatrists, psychiatric nurses and psychological counselors should be strengthened, and an assessment and feedback process for the lack of anhedonia in patients with MDD should be established, so as to assist these patients in achieving faster psychological recovery. Given the sufficient staffing conditions in the field of psychiatry nursing in China, the design concept and curriculum of EFT training for psychiatry nurses with a psychological therapist certificate should be promoted. Encourage psychiatry nurses with a psychological therapist certificate to conduct offline and online group EFT training intervention forms for MDD patients in the hospital wards during their hospitalization periods, as well as after discharge at home.

BackgroundThe decision-making process between autologous hematopoietic stem cell transplant (autoHSCT) and less-intensive treatments necessitates shared decision-making between older patients with hematological malignancies and healthcare providers. However, there is limited knowledge from both perspectives. This qualitative study aimed to comprehensively understand the experiences of shared decision-making regarding autoHSCT among older patients with hematological malignancies and physicians.MethodsOlder patients and physicians were recruited from the hematology department at one of the affiliated general hospitals of Wuhan University. They participated in semi-structured, in-depth face-to-face individual interviews from August 2022 to March 2023. The interviews explored their experiences with shared decision-making about autoHSCT. Interviews were transcribed verbatim and analyzed using Colaizzi's phenomenological method.ResultsThirteen older patients and eight physicians were recruited. Two themes were identified: (1) Factors influencing AutoHSCT recommendations and decision-making: Seven factors were categorized into three groups: physician-driven factors (pretransplant assessments, experience-based judgment, and communication approaches), patient-driven factors (perceived benefits and risks, financial challenges, and family involvement), and mutual trust between patients and physicians, which is a bidirectional factor relying on both physicians' trust and the active participation of patients in the decision-making process. (2) Treatment planning and outcome expectations: Regardless of treatment choices, patients focused on engaging in self-management and prioritizing quality of life, and maintaining hope for positive outcomes.ConclusionsThe shared decision-making process for autoHSCT between older patients with hematological malignancies and physicians is shaped by physician-driven factors, patient-driven factors, and mutual trust. These findings provide a foundation for developing patient-centered care strategies, including decision aids and enhanced communication training for physicians, aimed at improving outcomes for older patients facing complex treatment choices. Future research should explore how these factors interact over time, through longitudinal studies, to assess their long-term impact on patient outcomes and quality of life.

BackgroundAdolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI.MethodsUsing a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value.ResultsThe top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively.LimitationsThe key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal.ConclusionsThese findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.

AIM:To explore the individual and interpersonal association between mental health knowledge (MHK) and depression in adolescents and one of their parents, and to explore whether gender differences exist between fathers and mothers in these associations. METHODS:Participants were 3456 father-adolescent dyads and 4478 mother-adolescent dyads, recruited from eight middle schools in Wuhan, who completed self-report assessments of MHK and depression from September to October 2021. RESULTS:With the application of the actor-partner interdependence model, A positive actor effect between MHK and depression in adolescents was found. Adverse partner effects from fathers' MHK and mothers' MHK to adolescent depression were noted and showed no significant difference. Adolescents' depression was significantly associated with parental depression in both fathers and mothers. CONCLUSION:It is implied that milder adolescent depression was associated with lower levels of adolescent MHK, along with higher levels of MHK in both fathers and mothers. For parents, it is important to emphasise the improvement of their own MHK and increase their attention to adolescent mental health problems, as this may contribute to enhancing the mental health of adolescents. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:This study is instructive and related to family-based nursing interventions for mental health, emphasising the potential influence of parents in the family on adolescent depressive symptoms. The findings suggest that parental involvement should be encouraged and that the family's role in supporting the child's mental health should be recognised, contributing to the development of relevant policies. IMPACT:This study highlights that higher parental MHK is associated with lower levels of adolescent depression, with no gender differences between fathers and mothers. Family-based nursing interventions that emphasise mental health education for parents may have an impact on improving depression in adolescents. REPORTING METHOD:Guidelines were followed using the STROBE reporting method. PATIENT OR PUBLIC CONTRIBUTION:None.

The objective of this study was to examine the association between dietary diversity and sleep quality among Chinese middle-aged and older adults. The Lifestyle and Healthy Aging of Chinese Square Dancer Study is a prospective, community-based cohort study that enrolled participants aged 45 years and above from 2020 to 2021. Using the semiquantitative food frequency questionnaire to investigate the diets of study participants, and using the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Dietary diversity was assessed using two scoring methods covering ten food groups and 66 food items, respectively: the dietary diversity score (DDS) and the food variety score (FVS). The higher scores of DDS and FVS indicated greater dietary diversity and higher dietary quality. Logistic regression analysis explored the associations between these scores and sleep quality. A total of 2409 individuals with completed information on PSQI and FFQ were included in this study, of whom 767 (31.8

Background: Adolescents with a history of suicide exposure, defined as experiencing the suicide death of a family member, friend, or other acquaintances, are more likely to experience mental health issues such as depression or anxiety.Aims: This study aimed to explore prevalence rates and the network of adolescents' suicide exposure, depression, and anxiety symptoms, and to clarify the correlations between suicide exposure and symptoms of depression and anxiety.Method: A total of 8,957 adolescents were included in this cross-sectional study. Data regarding general information, symptoms of depression and anxiety, and suicide exposure were collected from mid-September to early October 2021. Network analysis was employed to assess relationships between suicide exposure and individual symptoms of both depression and anxiety. Central symptoms were identified by strength; the flow network was visualized to identify symptoms directly related to suicide exposure.Results: The prevalence rates of suicide exposure, depression, and anxiety were 5.28%, 12.87%, and 10.48%. Results indicated that suicide exposure was associated with both depression and anxiety, and had the strongest positive association with suicidal ideation. Central symptoms of the network were sad mood, nervousness, fatigue, irritability, and uncontrollable worry. Bridge symptoms were suicidal ideation and irritability. Appetite changes, suicidal ideation, uncontrollable worry, sleep difficulties, and irritability were symptoms directly related to suicide exposure.Conclusions: There were significant inter-symptom associations between suicide exposure, depression, and anxiety in adolescents. It is recommended that future studies explore whether targeted interventions and long-term monitoring concerning these inter-symptom associations can protect adolescents with suicide exposure.

Background: Non-suicidal self-injury (NSSI) among adolescents represents an alarming public health concern worldwide. Both family function and family socioeconomic status (SES) were found to play important roles in adolescent NSSI engagement. However, the effects of family function on NSSI among adolescents in different family SES are not well evidenced. Aims: This study aimed to explore how family functions (adaptation, partnership, growth, affection, and resolve) affect NSSI among adolescents in different family SES levels. Methods: Data used in this study was derived from the Students’ Mental Health Network Project (SMHN), a survey conducted among 8,872 pairs of adolescent-caregivers in a city in central China. Socio-demographic characteristics, family function, NSSI, adverse life events, and depressive symptoms were measured among adolescents. Family SES were generated from caregivers self-reported information using principal component analysis. Chi-square test and multivariate binary logistic regression analyses were adopted to analyze the effects of family function on NSSI. Results: It revealed that 10.2% of adolescents reported engaging in NSSI in the past 12 months. Poor family function and high family SES were positively associated with NSSI. Partnership, both adaptation and affection, resolve were NSSI-protective factors for adolescents in low, middle, high family SES, respectively. Conclusions: Efforts to address NSSI should acknowledge the association between family function and NSSI among adolescents in different family SES levels.

OBJECTIVE:To explore the dynamic changes, influencing factors, and relationships between resilience and social function in patients with colorectal cancer (CRC) and stomas at different postoperative stages, and to inform precise psychosocial rehabilitation interventions. METHODS:A longitudinal study was conducted at a tertiary hospital in eastern China from January 2021 to June 2023. Patients completed a self-designed socio-demographic questionnaire one month post-surgery, and the Connor and Davidson Resilience Scale (CD-RISC) and Social Dysfunction Screening Scale (SDSS) at 1, 3, and 5 months post-surgery. Data were analyzed using repeated measures ANOVA, Spearman correlation, group-based trajectory modeling, and binary logistic regression. RESULTS:A total of 131 patients were included in the analysis. Resilience showed an initial increase followed by a decline, while social function consistently improved. A moderate negative correlation between social dysfunction and resilience was observed at all time points. Influencing factors for resilience and social function varied across different postoperative stages. Significant differences in resilience trajectories were observed based on education and family income. Resilience trajectories significantly impacted social function trajectories (OR 19.39, 95 % CI 2.46-152.91, P < 0.05). CONCLUSIONS:This study identifies distinct trajectories of resilience and social function in patients with colorectal cancer and stomas. Low resilience is linked to severe social function deficits. Stage-specific interventions are crucial to enhance social adaptation and improve overall quality of life. Tailored support is needed throughout recovery to address the unique challenges faced by these patients.

Background: Insomnia is a common problem among patients with major depressive disorder (MDD). According to previous studies, the development and severity of Insomnia are influenced by childhood trauma experience. Furthermore, negative life events and dysfunctional attitudes may also mediate the impact. So, this study aimed to examine the association between childhood trauma, negative life events, dysfunctional attitudes and insomnia and investigate how negative life events and dysfunctional attitudes mediate the relationship between childhood trauma and insomnia in MDD.Method: This cross-sectional study recruited 621 college students with MDD. The Childhood Trauma Questionnaire (CTQ), Life Event Scale (LES), Dysfunctional Attitude Scale (DAS), Insomnia Severity Index (ISI), and Hamilton Depression Scale-17 (HAMD-17) were used to assess participants' psychosocial factors. Descriptive analysis, Chi-square test, t-test, Pearson correlations, and serial mediation analyses were used in data analysis. In order to eliminate the influence of the severity of depression symptoms, severity of depression symptoms was used as a control variable in this study. Results: There were 166 (26.7%) participants having clinical insomnia (ISI score > 14). After controlling for the effect of severity of depression symptoms, results of serial mediation analyses determined that childhood trauma has a direct (Estimate = 0.109, 95%CI: 0.023,0.190) and indirect (Estimate = 0.090, 95%CI: 0.054,0.137) impact to insomnia. The indirect impact of childhood trauma on insomnia through the pathways of negative life events alone (Estimate = 0.050, 95%CI: 0.024,0.093), dysfunctional attitudes alone (Estimate = 0.027, 95%CI: 0.008,0.050), and negative life events to dysfunctional attitudes (Estimate = 0.013, 95%CI: 0.006,0.024) were significant. Conclusions: This study demonstrates that screening for childhood trauma should be considered when treating insomnia in college students with MDD. Managing negative life events and dysfunctional attitudes may mitigate the negative impact of childhood trauma on insomnia in college students with MDD.

Objective:To explore the relative importance of palliative care knowledge, attitude towards palliative care and healthy work environment of emergency care nurses in predicting perceived self-competence in palliative care based on dominance analysis, and to provide empirical evidence for formulating the optimal training course to improve perceived self-competence in palliative care.Methods:Totally 415 emergency care nurses from 22 tertiary hospitals in Hubei province were conducted a cross-sectional survey to complete the general information questionnaire, the Palliative Care Nursing Self-Competence Scale, the Hospice Knowledge Quiz for Nurses, the Frommelt Attitudes Toward Care of the Dying Scale Form B, and the American Association of Critical Care Nurses Healthy Work Environment Assessment Tool from January to March 2021 using convenient sampling method. Dominance analysis was used for statistical analysis.Results:The total score of perceived self-competence in palliative care of 415 emergency care nurses was (225.48 ± 60.61) points, the total score of palliative care knowledge was (12.44 ± 3.83) points, the total score of palliative care attitude was (97.35 ± 9.07) points and the total score of healthy work environment was (72.00 ± 11.99) points. Perceived self-competence in palliative care was positively associated with palliative care knowledge ( r=0.181, P < 0.01), attitude towards palliative care ( r=0.232, P<0.01) and healthy work environment ( r=0.393, P<0.01). Dominance analysis revealed that the healthy work environment, palliative care attitude and palliative care knowledge accounted for 74.15%, 14.97% and 10.88% of the variance of perceived self-competence in palliative care, respectively. Conclusions:The largest degree of prediction for emergency care nurses′ perceived self-competence in palliative care is healthy work environment, attitude next and the third is knowledge. It suggests that promoting a healthy work environment is an important way to improve nurses′ perceived self-competence in palliative care, and improving knowledge level and cultivating positive attitudes also will be better.

Background: Due to the increasing burden of life-limiting illnesses, the need for palliative care has increased. Nurses’ palliative care competence is a vital factor in improving its accessibility. A reliable instrument is needed to measure nurses’ competence in providing palliative care. Objective: Our aim was to translate and culturally adapt the Palliative Care Nursing Self-Competence Scale (PCNSC) into the Palliative Care Nursing Self-Competence Scale–Simplified Chinese (PCNSC-SC). Methods: Two cross-sectional studies were conducted after content validity had been confirmed during the instrument’s translation and adaption. The convergent validity, construct validity, internal consistency, and homogeneity were evaluated in both the first and second studies. Test-retest reliability was assessed only in the first study. Clinical nurses who had a registered nurse qualification certificate and at least 12 months of work experience from a tertiary hospital in Hubei, China participated in the 2 studies. Results: The PCNSC-SC contains 8 dimensions and 34 items, based on goodness-of-fit indices and confirmatory factor analysis. The Cronbach’s alpha of the PCNSC-SC was .984 and .990 in the 2 studies, respectively. The test-retest reliability of the PCNSC-SC after 2 weeks was .717. Conclusion: The PCNSC-SC can be used to evaluate perceived self-competence in palliative care of Chinese nurses with good reliability and validity.