BMC Nursing最新文献

Background: Nursing students exhibit a higher incidence of mental disorders. Studies have identified psychological stress contributes to elevated depression symptoms through reappraisal cognitive in nursing students. However, there is little research exploring the knowledge regarding the role of ruminative thinking in mediating the associations between psychological stress and depression symptoms. Guiding by the non-hemostatic model and cognitive control theory, the study aims to investigate the chained mediation of cognitive reappraisal and ruminate thinking between psychological stress and depression symptoms among nursing undergraduates.

Methods: A total of 1,220 nursing undergraduates were carried out by stratified sampling from July to December of 2023 via online survey. The investigation adopted the Perceived Stress Scale (PSS-10), Emotion Regulation Questionnaire (ERQ), Ruminative Response Scale (RRS), and the Center for Epidemiologic Studies Depression Scale (CES-D) to measure the level of psychological stress, cognitive reappraisal, ruminative thinking and depression symptoms, respectively. Pearson's r was utilized to investigate the interrelationships, and the structural equation model (SEM) was used to clarify the mediation effects among the four variables.

Results: The mean total score of CES-D was 21.57 ± 10.79. SEM analysis proved that psychological stress had a direct positive effect on depression symptoms (β = 0.388). accounting for a substantial 51.52% of the total effect. Cognitive reappraisal and ruminate thinking partially mediated the association between psychological stress and depression symptoms (95% CI: 0.094-0.210), and the mediating effect accounted for 48.48% of the total effect.

Conclusions: Nursing students exhibited a high prevalence of depression, and cognitive reappraisal and ruminate thinking partially mediated the correlations between psychological stress and depression symptoms. Interventions targeting at consolidating cognitive reappraisal and ruminate thinking are imperative for improving depression.

Background: Professional ethics is a cornerstone of the nursing profession, with its observance closely linked to the enhancement of nursing services and the satisfaction of service recipients. This study aimed to assess nurses' compliance with professional ethical codes and its relationship with factors that facilitate such compliance.

Methods: This descriptive-analytical, cross-sectional study was conducted in 2021 in a hospital located in southern Iran. A total of 312 nurses were selected using the census method and participated in the study. Data were collected through researcher-designed questionnaires that assessed compliance with professional ethical codes and factors facilitating such compliance. Data analysis was conducted using SPSS software version 23, employing t-tests, ANOVA, Pearson's correlation coefficient, and multiple linear regression.

Results: The mean scores for compliance with professional ethical codes and factors facilitating compliance were 127.94 ± 8.52 (out of 170) and 98.31 ± 6.22 (out of 180), respectively. Nurse-related factors (β = 0.323, p < 0.001), patient-related factors (β = 0.286, p = 0.002), and management factors (β = 0.277, p = 0.003) emerged as significant predictors of compliance with professional ethical codes. Significant differences in compliance scores were observed based on gender (p = 0.01), marital status (p = 0.02), level of education (p = 0.04), and the number of patients under observation per work shift (p = 0.03). Additionally, the mean score of factors facilitating compliance with ethical codes was higher among female nurses (p = 0.03) compared to male nurses.

Conclusion: Compliance with professional ethical codes was rated as acceptable, while the factors facilitating compliance were rated as moderate. Given the predictive role of facilitating factors, targeted improvements in these areas could significantly enhance nurses' adherence to professional ethical codes.

Background: Oncology nurses have a vital role in providing care for individuals with cancer. Ethical dilemmas arise for oncology nurses caring for these patients. Nurses experience moral distress when work conflicts with personal beliefs, leading to inappropriate responses or uncertainty about ethics. The ethical climate might influence nurses' response to moral distress. Moral distress in nurses can lead to work-related stressors like compassion fatigue.

Research objectives: This study examined the relationship between moral distress, ethical climate, and compassion fatigue in oncology nursing. Moreover, the role of moral distress as a mediator in the link between ethical climate and compassion fatigue was examined.

Method: A descriptive correlational design was recruited. One hundred twenty-two participants were recruited using the convenience sampling method. The study data were collected using a demographic information form, Corley's Moral Distress Questionnaire, Revised Victor and Cullen's Ethical Climate Questionnaire, and the Professional Quality of Life questionnaire. The Ethics Research Center of Shahid Beheshti University of Medical Sciences approved the study.

Findings: The overall moral distress, compassion fatigue, and ethical climate mean scores were 125.54 ± 37.50, 31.50 ± 9.23, and 49.03 ± 7.49, respectively. The analysis showed that among the dimensions of ethical climate (including egoism, benevolence and principled climate), egoism directly (p=0.03) and indirectly (p<0.001) and benevolence indirectly (p<0.001) (through moral distress) were significantly related to compassion fatigue. The principled ethical climate did not show any direct or indirect impact (p=0.72 and p=0.64, respectively).

Conclusions: Our findings showed moderate moral distress and low compassion fatigue among oncology nurses. In the examined oncology wards, the prevailing ethical climate was benevolent. Moral distress acts as a mediator between egoistic and benevolence ethical climate and compassion fatigue.

Background: At the beginning of 2022, Central Europe entered a state of emergency due to the Russian invasion of Ukraine. Nurses were particularly vulnerable to a decline in their professional quality of life, facing repeated exposure to military trauma, ethical dilemmas, prolonged working hours, and increased stress and fatigue. This study aimed to contribute to our understanding of the potential mediating effect of war-related continuous traumatic stress on the association between moral distress and professional quality of life, including compassion satisfaction and compassion fatigue, represented by burnout and secondary traumatic stress.

Methods: This study used the Professional Quality of Life (ProQOL) Scale to assess compassion fatigue, including burnout, secondary traumatic stress, and compassion satisfaction; the Moral Distress Questionnaire for Nurses to examine everyday moral distress in healthcare facilities and everyday ethical dilemmas of nurses; and the Continuous Traumatic Stress Response (CTSR) Scale to assess ongoing threats, resulting in exhaustion/rage, and fear/betrayal. The sample consisted of 130 female nurses (mean age 40.20 ± 12.15 years) from general surgery, neurosurgery, trauma and orthopaedic surgery, and urgent care who had been undergoing advanced training to work with injured military personnel at the Volyn Medical Institute (Ukraine) from March to May 2023. All nurses had experienced direct and indirect exposure to military trauma, and 105 participants were working with injured military personnel.

Results: The results of the mediation analysis indicated that war-related continuous traumatic stress fully mediated the relationship between moral distress and different components of professional quality of life, namely, compassion fatigue, including burnout and secondary traumatic stress, and compassion satisfaction.

Conclusion: Research has shown that continuous traumatic stress has a significant effect on the relationship between moral distress and various aspects of professional quality of life, underscoring the need for targeted interventions for nurses facing war-related trauma.

Background: Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implementation science, and how confident nurses, other health professionals, and leaders are completing steps in the implementation process. We aimed to understand Ontario maternal-newborn teams' (1) approaches to implementing practice changes and the extent to which their implementation processes aligned with an implementation science planned-action framework; and (2) perceptions of importance and confidence completing implementation activities.

Methods: We conducted a cross-sectional survey between September-November 2023. Using purposive sampling, we invited Ontario maternal-newborn nurses, other healthcare professionals, and leaders who had experience participating in or leading implementation projects to complete an online questionnaire. The questionnaire was informed by an implementation science framework, which includes three core phases (identify issue; build solutions; implement, evaluate, sustain). The questions probed respondents' perceptions of frequency of completion, importance, and confidence for each of the 28 implementation activities. We used descriptive statistics for the closed-ended questions and grouped the written responses into categories.

Results: We received 73 responses from 57 Ontario maternal-newborn hospitals, the majority being nurses in point-of-care and leadership roles. Nearly all respondents agreed that each of the 28 implementation activities were important. Respondents reported always completing a median of 8 out of 28 activities, with the number of activities completed declining from phase 1 through to 3. Most respondents indicated they were somewhat confident completing the implementation activities and agreed their teams would benefit from increasing their knowledge and skills to use an evidence-informed approach to implementing practice changes.

Conclusions: Despite viewing implementation activities as important, many teams are not consistently doing them and lack confidence, particularly in later phases of the implementation process. These findings inform where further capacity-building and supports may be needed to enable maternal-newborn nurses, other healthcare professionals, and leaders to apply implementation science to their change initiatives.

Background: A lung cancer diagnosis has a huge impact on the psychological well-being of both patients and family caregivers. However, the current psychological stress status among dyads remains unclear. We aimed to determine the prevalence of anxiety and depression and identify the factors that influence patients with lung cancer and their caregivers.

Methods: We conducted a cross-sectional study of 254 dyads of lung cancer patients and family caregivers from four tertiary hospitals in Hunan Province, China from January 2021 to June 2021. Besides, we used several instruments to collect data on depression, anxiety, illness perception, mindfulness, self-compassion, and dyadic coping. The independent samples t-test, analysis of one-way variance, Spearman's correlation analysis, and multiple linear regression analysis were employed.

Results: Results showed that 21.3% of patients and 29.5% of caregivers experienced depression, while 22.0% of patients and 33.5% of caregivers reported anxiety. For lung cancer patients, patients' illness perception positively predicted their depression scores and patients' level of mindfulness and level of self-compassion negatively predicted their depression scores; patients' illness perception positively predicted their anxiety scores, and only living with children, patients' mindfulness and self-compassion levels were negatively predicted their anxiety scores. For caregivers, caregivers' level of illness perception and the number of other caregivers positively predicted their depression and anxiety scores, and caregiver's dyadic coping level, residence (county or town, and city), and caregiver's self-compassion level, were negatively predicted their depression and anxiety scores.

Conclusion: The prevalence of psychological stress response of lung cancer patients and caregivers was high and influenced by family living situation, number of persons assisting in care, place of residence, patient-caregiver relationship, levels of illness perception, mindfulness, self-compassion, and dyadic coping.

Trial registration: ClinicalTrial.gov NCT06746948.

Background: Compassion Competence and the ability to strive to understand the suffering of patients in psychiatric ward is essential for nurses to establish effective therapeutic communication in the process of their recovery. Patient Safety Competency is of great importance for nurses to prevent adverse events and minimize errors. This study aimed to investigate the relationship between Compassion Competence and Patient Safety Competency in nurses working in psychiatric wards of Shiraz University of Medical Sciences affiliated hospitals in 2024.

Method: This descriptive-analytical study was conducted on 184 nurses working in the psychiatric wards of Shiraz University of Medical Sciences affiliated hospitals from January 2024 to April 2024 as a census. Data were collected using the Compassion Competence, Patient Safety Competency and Demographic Survey questionnaires and were then analyzed using descriptive and analytical statistics. The analyses were performed using SPSS 22 statistical software.

Results: The results showed that the compassion competence score of psychiatric nurses was 3.98 ± 0.46, with subscales of sensitivity (4.05 ± 0.56), insight (3.79 ± 0.62), and communication (4.04 ± 0.48). Additionally, the patient safety competency score of psychiatric nurses was 3.56 ± 0.44, with subscales of attitude (3.67 ± 0.34), knowledge (3.06 ± 0.77), and skill (3.63 ± 0.58). A statistically significant correlation was also found between Compassion Competence and Patient Safety Competency (r = 0.458, p < 0.001). Regression results showed that the sensitivity (p = 0.012) and insight (p = 0.026) dimensions predict Patient Safety Competency. Among the demographic variables, only the completion of a communication skills course was significantly associated with both Compassion Competence (p = 0.04) and Patient Safety Competency (p = 0.02).

Conclusion: The findings of this study revealed a statistically significant correlation between Compassion Competence and Patient Safety Competency among psychiatric nurses. It is recommended that educational programs be designed to consider these two components and their dimensions to help enhance the competencies of nurses.

Clinical trial number: Not applicable.

Background: Disaster nursing involves systematic and professional care provided to communities affected by natural or man-made disasters. With limited resources in global disaster settings, nurses play a crucial role in disaster management. The aim of this study is to investigate the impact of integrating 'Disaster Nursing' into nursing curricula on nursing students' perceptions of disaster literacy and preparedness.

Methods: This quasi-experimental one-group pretest-posttest study was conducted at a public university in Izmir, Turkey. The pre-test took place on September 27, 2021, and the post-test on January 7, 2022. The study population comprised 66 nursing students enrolled in the elective "Disaster Nursing" course, with 62 volunteering for participation. Data collection tools included an individual introduction form, the Disaster Literacy Scale, and the Perception of Disaster Preparedness in Nurses Scale. The 14-week "Disaster Nursing" course served as the intervention. Data were collected online and analyzed using descriptive statistics, paired sample t-tests, and Pearson correlation.

Results: Of the students, 51.6% were aged 22-23, and 62.9% were female. Additionally, 54.8% reported previous disaster experience. The mean pre-test score on the Disaster Literacy Scale was 32.97 ± 6.47, which increased significantly to 40.58 ± 5.95 post-test (p < 0.05). The mean pre-test score on the Perception of Disaster Preparedness in Nurses Scale was 81.66 ± 4.61, rising significantly to 90.64 ± 6.25 post-test (p < 0.05). A statistically significant positive correlation was found between the total scores of the Disaster Literacy and Disaster Preparedness in Nurses scales (r = 0.79).

Conclusions: The integration of "Disaster Nursing" into nursing curricula positively enhanced the disaster literacy and preparedness perceptions of nursing students. The results demonstrated that higher levels of disaster literacy were associated with increased disaster preparedness among nurses. These findings can inform the development of educational policies for disaster nursing education in Turkey.

Background: Nurses serving in infectious disease ward represent a distinct occupational group that has attracted considerable attention following epidemic outbreaks. However, prior to this study, no research had delved into the underlying mechanism linking anxiety to burnout symptoms among infectious disease nurses. This study aimed to explore investigate the association between anxiety and burnout among nurses working in such environments and scrutinized the mediating role of perceived stress and the moderating influence of resilience on the principal relationship.

Methods: Employing a cross-sectional study using a web-based design, data were collected from 1,579 clinical nurses working in infectious disease ward across 50 hospitals in China. Participants responded to questionnaires assessing anxiety, perceived stress, resilience and burnout. Statistical analyses encompassed descriptive statistics, one-way analyses of variance, independent-samples t-tests, Pearson correlations, and bootstrapping techniques to evaluate the indirect and moderating effects.

Results: The study revealed that 62.13% of the respondents reported high levels of burnout, and 55.92% experienced moderate to high degrees of emotional exhaustion among infectious disease nurses. Significant correlations were observed between anxiety, perceived stress, resilience, and each component of burnout (P < 0.05). Notably, the mediating effect of perceived stress was accounting for 30.61% of the relationship between anxiety and burnout. Simple slope analysis demonstrated that perceived stress significantly predicted emotional exhaustion at both low (B = 0.854, t = 16.586, and P < 0.001) and high (B = 0.498, t = 9.503, and P < 0.001) levels of resilience. The perceived stress and emotional exhaustion were more serious when resilience levels were lower.

Conclusion: Anxiety was identified as a critical risk factor for burnout among nurses in infectious disease units. The relationship between anxiety and burnout was markedly affected by the levels of perceived stress and resilience. Specifically, the deleterious impact of perceived stress on burnout was amplified in nurses with diminished resilience relative to those with heightened resilience. Based on these findings, it is imperative to allocate resources for stress management programs and resilience training. Such initiatives would bolster support for nurses in infectious disease wards, ultimately enhancing their job satisfaction and well-being.

Background: Self-neglect is a significant global public health issue, compromising the health, safety, and well-being of older adults. Despite extensive research on the prevalence and risk factors of self-neglect, the underlying psychosocial mechanisms remain underexplored. Social isolation and aging attitudes have been identified as important correlates of self-neglect; however, the precise interplay between these variables, particularly the mediating role of aging attitudes, has yet to be fully examined in the context of rural older adults.

Objectives: This cross-sectional study aims to investigate the relationships among social isolation, aging attitudes, and self-neglect, focusing on how aging attitudes mediate the association between social isolation and self-neglect among rural older adults living alone in China.

Methods: Using convenience sampling, we conducted a survey from December 2022 to February 2023 among rural older adults living alone across eight cities in Guizhou Province, Southwest China. Data were gathered using the General Information Questionnaire, Attitudes to Ageing Questionnaire, Lubben Social Network Scale-6, and Scale of the Elderly Self-Neglect. Data were analyzed using SPSS 27.0 and the PROCESS macro tool.

Results: The scores for aging attitude, social isolation, and self-neglect among older adults living alone in rural areas were 75.00 (69.00-82.00), 16.00 (12.00-21.00), and 10.00 (8.00-14.00), respectively. Social isolation was positively associated with aging attitude (r = 0.353, P < 0.05) and negatively correlated with self-neglect (r = -0.371, P < 0.05). Self-neglect was also negatively correlated with aging attitude (r = -0.367, P < 0.05). Aging attitude partially mediated the relationship between social isolation and self-neglect among older adults living alone in rural areas, with a mediation effect of -0.077, accounting for 28.20% of the total effect.

Conclusion: The findings suggest that aging attitudes and social isolation among rural older adults living alone are associated with self-neglect. Furthermore, social isolation may be linked to self-neglect indirectly through its association with aging attitudes. Healthcare professionals should develop strategies to promote positive aging attitudes and enhance social networks of this vulnerable population, contributing to prevent or alleviate their self-neglect behaviours.