Journal of Advanced Nursing最新文献

Conflicts of Interest

The author declares no conflicts of interest.

Hong Kong is widely regarded as an extremely modern metropolis, renowned for its advanced technological infrastructure and highly developed urban environment. Against this backdrop, the catastrophic fire that erupted at Wang Fuk Court, a public housing complex in Tai Po, on 26 November 2025, appears profoundly incongruous. The blaze engulfed seven of the estate's eight high-rise residential tower blocks and persisted for 43 h, resulting in 168 fatalities and making nearly 2000 households homeless. This tragedy stands as the worst disaster to have struck Hong Kong in half a century, and the site of the fire now represents a deep wound for the territory and inhabitants.

At the time of the incident, Wang Fuk Court had been undergoing extensive renovation work for over 18 months, and all eight buildings were sheathed in bamboo scaffolding and protective netting, with window openings covered by polystyrene foam boards. Although an independent investigation is currently underway in Hong Kong to ascertain the precise cause of the fire, preliminary findings indicate that the presence of protective netting combined with the use of flammable polystyrene foam boards may have significantly contributed to the rapid spread of the blaze and its intensity. The situation is reminiscent of the Grenfell Tower fire in London in 2017, which resulted from various systemic failures in building design, regulation and maintenance, and its aftermath highlights comparable issues of safety, justice, mental health of survivors, first responders, and others, and long-term community rebuilding. Although the blaze in Hong Kong has long since been extinguished, the profound trauma it inflicted will take considerably longer to overcome.

Scenes of scorched ruins, grieving residents, and the sea of flowers and paper cranes at Wang Fuk Recreation Ground. These paper cranes serve as potent symbols of hope, commemoration, and resilience within East Asian culture and have been featured in countless news bulletins that continue to bear witness to the tears and farewells of Hong Kong people.

Aims: To examine the relationship between ethical conflicts and ethical decision-making ability, ethical sensitivity and demographic factors as mediator/moderator roles.

Design: A cross-sectional survey was conducted from June to December 2024.

Methods: This study involved 503 intensive care unit nurses from eight tertiary hospitals across Zhejiang, Guangdong and Guangxi provinces. Participants completed validated instruments including the Ethical Conflict Nursing Questionnaire-Critical Care Version, the Chinese Moral Sensitivity Questionnaire-Revised version and the Chinese Version of Judgement About Nursing Decision. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation and moderation analysis.

Results: The relationship between ethical conflict and decision-making ability was significantly mediated by both moral responsibility/strength and burden, with the latter demonstrating a stronger indirect effect. Furthermore, exploratory moderated mediation analysis showed that this mediation model varied significantly across different levels of work experience and types of intensive care unit. Given the exploratory nature of these findings, they require verification in future confirmatory studies.

Conclusions: The association between ethical conflict and decision-making ability was mediated by ethical sensitivity. This pathway was moderated by work environment and qualifications, indicating the need for tailored interventions.

Implications for the profession and/or patient care: Developing nurses' ethical sensitivity is a key strategy for managers aiming to improve ethical decision-making when nurses face ethical conflicts.

Impact: This study addressed ambiguous findings regarding the relationship between ethical conflict and nurses' decision-making ability. For nurse managers, fostering ethical sensitivity among staff represents a key strategy for mitigating the ethical conflicts that are negatively associated with decision-making ability.

Reporting method: The strengthening the reporting of observational studies in epidemiology statement (STROBE) was followed.

Patient or public contribution: No patient or public contribution.

Trial registration: Chinese Clinical Trial Registry (ChiCTR): MR-33-24-032956.

Aim(s): To translate, culturally adapt and validate the first Spanish version of the Person-centred Practice Inventory-Care (PCPI-C) instrument.

Design: Cross-cultural adaptation and psychometric validation.

Methods: Two-phase research design: (1) the PCPI-C's translation and cultural adaptation from English to Spanish following the 'Translation and Cultural Adaptation of Patient-Reported Outcomes Measures-Principles Guide of Good Practice' tool; and (2) a cross-sectional quantitative survey to assess the Spanish version's psychometric properties.

Results: A sample of 200 patients participated to obtain the PCPI-C's Spanish version. No significant issues arose during the translation process or the consulting sessions. No item exhibited an inadequate value following adjustment via the weighted kappa index (-scale-level content validity average of 0.95 for clarity and 0.97 for relevance). Psychometric evaluation revealed acceptable internal consistency (Cronbach's alpha from 0.67 to 0.84) and strong construct validity. Exploratory and confirmatory factor analyses supported a five-dimensional structure consistent with the domain Person-Centred Processes. Fit indices improved after model refinements, achieving CFI = 0.92, SRMR = 0.05 and RMSEA = 0.07. This study's observed psychometric properties confirm that the PCPI-C's Spanish version retains the original instrument's theoretical integrity, while showing strong reliability and validity in the new context.

Conclusion: The PCPI-C's Spanish translation was psychometrically valid when tested with Spanish patients, thus providing a culturally appropriate, psychometrically sound tool to evaluate Spanish-speaking patients' perception of person-centred care.

Impact: This study provides a validated instrument that allows for the assessment of person-centred practice in Spanish-speaking clinical environments. It enables healthcare professionals to measure patients' perceptions, track the implementation of person-centred principles and supports international comparative studies, contributing to the development of more ethical and responsive models of care.

Patient or public contribution: Patients participated in cognitive consultations and completed the survey for psychometric testing, ensuring that the translated items were understandable, culturally appropriate and reflective of their experiences of person-centred care.