Valuation of the cultural adaptation and psychometric properties of the Chinese version of the hidden curriculum evaluation scale in nursing education.

BACKGROUND: The hidden curriculum in baccalaureate nursing programs is a means of moral education. Evaluation of the curriculum by students and faculty can increase awareness of its characteristics, which could be useful for planning and further development. OBJECTIVES: This study's aim was to translate the Hidden Curriculum Evaluation Scale in Nursing Education (HCES-N) to Chinese, adapt the scale to the Chinese culture and evaluate its validity and reliability in a sample of undergraduate nursing students. DESIGN: Psychometric assessment of a tool using two cross-sectional surveys. SETTINGS: University-based schools of nursing in seven provinces and cities of China. PARTICIPANTS: Undergraduate nursing students in a baccalaureate program. METHODS: The English version of the HCES-N was translated to Chinese using the Brislin translation model. The test-retest, internal consistency and split-half reliabilities of the HCES-N were examined in a sample of 1016 undergraduate nursing students. Exploratory factor analysis and confirmatory factor analysis were conducted to examine the scale's content validity. RESULTS: The exploratory factor analysis of the final 44-item HCES-N revealed three common factors and a cumulative variance contribution rate of 73.535%. The results of the confirmatory factor analysis showed that the final 44-item, 3-factor model was adequate for the s cale's structure (Chi-square/df = 6.59, RMSEA = 0.074, SRMR = 0.040, CFI = 0.911 and TLI = 0.905). The results confirmed that the Chinese version of HCES-N had good internal consistency (Cronbach α = 0.945); the scale's split-half-reliability was 0.794 and its test-retest reliability after two weeks was 0.894. CONCLUSION: The Chinese version of the HCES-N has good reliability and validity and it can be used to assess the hidden curriculum in baccalaureate nursing programs.

Prevalence and factors associated with depression and anxiety in living liver donors: A systematic review and meta-analysis.

OBJECTIVE: This study aimed to systematically review the prevalence and factors associated with depression and anxiety in living liver donors after liver transplantation. METHODS: Five English language electronic databases and four Chinese language electronic databases were searched from inception to February 2023. Two investigators independently extracted the data and assessed the study quality. The pooled prevalence was calculated using STATA software (version 14.0). We performed a narrative review to summarize the factors associated with depression and anxiety in living liver donors after liver transplantation. The protocol of this study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number: CRD42021290071. RESULTS: This study included 39 articles involving 18,577 participants. The pooled prevalence was 6.3% [95% confidence interval (CI) (4.1-8.9%)] for depression in living liver donors, and 10.0% [95% CI (4.0-18.1%)] for anxiety. Prevalence of clinically significant depressive or anxiety symptoms was higher (15.7% and 17.4%) compared with disorders (2.7% and 2.2%). The prevalence of depression and anxiety was highest within 3 months post-donation. Specifically, female donors, serious postoperative complications, and recipients' poor health/death have been reported as factors having a negative influence on depression and anxiety. CONCLUSIONS: Collected evidence showed that the overall prevalence of depression or anxiety of living liver donors was high. Therefore, early detection and timely treatment of psychological disorders are crucial to promote positive psychiatric health outcomes and ensure the quality of life of living liver donors.

Living well or not? Quality of life of parental living liver donors: A cross-sectional study.

AIM: The aim of this study was to gain comprehensive insight into the quality of life of parental living liver donors after liver donation. BACKGROUND: Several studies reported good quality of life of living liver donors with the SF-36 scale. Care demand from the recipient and responsibility of being parent might make a difference in parental donors' personal experienced quality of life after transplantation surgery. METHODS: It is a cross-sectional study. The parental donors' demographics, clinical data and post-donation complications were obtained. Quality of life was assessed using the Medical Outcomes Study SF-36 and the Quality of Life Scale of Living Organ Donors-Common Module. PATIENT OR PUBLIC CONTRIBUTION: The enrolled participants were contacted by electronic questionnaires and telephonic interview. RESULTS: A total of 345 parental donors were included, with recruited period ranging from 3 to 85 months post-donation. 8.1% of donors had post-operative complications, mostly classified as Clavien grade II. Donors' general quality of life was higher than the Chinese general norm. Issues related to surgical incision, fatigue, worries about income and personal health, effects on work capability, increased medical expenses and difficult reimbursement and suspected donation decision were the prominent problems among donors. Mother-son relationship (OR = 1.87) and equal or less than 2 years after donation (OR = 3.08) were the influencing factors for poor physical quality of life, while unmarried status (e.g. divorced or widowed) was found negatively associated with mental quality of life (adjusted OR = 3.61). CONCLUSIONS: General health among parental donors is good but those female, unmarried and near post-donation might in low life quality. Incision, fatigue, finance, reimbursement and donation decision are prominent problems. RELEVANCE TO CLINICAL PRACTICE: Post-donation care of living donors should cover social and financial domain besides physical and mental dimension. Providing follow-up care and counselling is necessary to ensure their life quality.

A longitudinal study of perinatal depression and the risk role of cognitive fusion and perceived stress on postpartum depression.

AIMS AND OBJECTIVES: To explore fluctuations in perinatal depression based on physiological, psychological and interpersonal dimensions to analyse risk factors across three time points: in the third trimester and at weeks 1 and 6 postpartum. BACKGROUND: Pregnant women experience depression at multiple time points and require screening. Studies have shown protective and negative factors related to postpartum depression. Cognitive fusion refers to an individual's emotions and behaviours that are regulated and influenced by that individual's own cognitive overregulation, especially when facing stress. This is an important psychological factor related to depression, but little is known about it in pregnant women. DESIGN: A longitudinal study was conducted from June 2019-July 2020, and the findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: Pregnant women (n = 207) were recruited, and a questionnaire survey was performed at 32-34 weeks of pregnancy and at weeks 1 and 6 postpartum. Repeated-measures analysis of variance was performed to analyse the changes in depression over time. Regression analysis and linear mixed modelling were used to identify risk factors. Pearson's correlation analysis was performed to analyse the relationships between variables. RESULTS: Of the pregnant women, 36.70% experienced antenatal depression and prolonged depression with the onset of postpartum depression (12.21%). Some depressive moods disappeared spontaneously after delivery (47.37%). Perceived stress was the highest risk predictor of postpartum depression (ß = 0.332), followed by cognitive fusion (ß = 0.178), which remained stable over time and might have been positively related to having a vulnerable personality (0.2 < r < 0.4). Social support plays a positive role in lowering postpartum depression (ß = -0.027). CONCLUSIONS: Changes in depression were influenced by multiple factors with stability and predictability across time. Psychological dimensions, such as perceived stress and cognitive fusion, are risk factors for developing postpartum depression and antenatal depression. RELEVANCE TO CLINICAL PRACTICE: Pregnant women can be divided into depressive cohorts according to screening at different time points to provide targeted interventions.

Anxiety, depression, psychological stress and coping style in medical postgraduates in southeastern China when restricted to commuting between the campus and hospital during the COVID-19 pandemic.

Background: As the COVID-19 epidemic was gradually brought under control, a new autumn semester began in 2020. How was the mental health of postgraduates as they experienced quarantine at home, only commuting between the school and hospital? Methods: The research was conducted in a cross-sectional online survey in October 2020. The data were collected from 1,645 medical postgraduates (master's and doctoral students) by using the demographic information questionnaire, the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), the Questionnaire on Psychological Stressors of Postgraduates (QPSP), the Simplified Coping Style Questionnaire (SCSQ) and the Social Support Rate Scale (SSRS). One-way ANOVA and Pearson correlation were used to explore the relationships among anxiety, depression, psychological stressors, social support and coping style. Structural equation modeling (SEM) was conducted to assess the mediation model. Results: Among the total of 1,645 medical postgraduates, 21.6% (n = 356) had self-rated depression symptoms, and 9.4% (n = 155) had self-rated anxiety symptoms. The main disturbances they experienced were employment, academic and interpersonal pressure. The master of third grade students had the highest employment pressure, and the master of second grade students had the highest academic and interpersonal pressure. Negative coping played a negative mediating role and social support played a positive mediating role in the relationships between perceived stress and anxiety (ß = 0.027, P < 0.01; ß = 0.124, P < 0.01) and depression (ß = 0.016, P < 0.01; ß = 0.193, P < 0.01). Conclusion: Medical postgraduates in China restricted to studies on campus and in the hospital experienced psychological distress. Our results suggest that providing employment and learning guidance, while strengthening social support and guiding positive coping may be effective at improving the mental health of the medical graduate students, mediating their perceived stress and negative emotions.

Nurses' experiences of the effects of mindfulness training: A narrative review and qualitative meta-synthesis.

OBJECTIVE: To explore nurses' experiences of the effects of undertaking mindfulness training. DESIGN: Qualitative meta-synthesis. DATA SOURCES: Qualitative literature from seven scientific databases: Pubmed, Cochran Library, Science Direct, EBSCO, Web of Science, Scopus and PsycINFO were searched. REVIEW METHODS: The PRISMA flow diagram was used to report the phases of the literature search. The Critical Appraisal Skills Program (CASP) qualitative research checklist, and the Mixed-Methods Appraisal Tool (MMAT) for mixed method studies were used as appraisal framework. Data synthesis was conducted using Thematic synthesis. The review steps were guided by Adams, Chamberlain, & Giles, 2019 and Whittemore & Knafl, 2005. RESULTS: 4 qualitative studies and 3 mixed-methods studies were included in the review. Four interpretive themes were generated to show how nurses experience of the effects of mindfulness training: 1. Stress conceptualisation and management; 2. Nurses' valued aspects of mindfulness training strategies; 3. Self-care awareness and strategies; 4. Challenges of mindfulness training. CONCLUSION: Conducting mindfulness-based interventions among nursing professionals helps to reduce work-related stress and has positive effects on work and life.

The association between diabetes-related distress and fear of hypoglycaemia in patients with type 2 diabetes mellitus: A cross-sectional descriptive study.

AIM: The study aimed to explore the association between diabetes-related distress as a dependent variable and fear of hypoglycaemia as a independent variable in Chinese individuals with type 2 diabetes, which can provide a basis for the development of effective nursing interventions. DESIGN: A cross-sectional descriptive study. METHODS: Pre-piloted scales were used to determine whether they experienced fear of hypoglycaemia and whether this impacted upon their management of the disease. From June-October 2019, participants were asked to complete the "hypoglycaemia fear survey" and "diabetes distress scales" to assess levels of fear and distress. Stepwise multivariate regression analysis was applied to reveal relationship between distress as a dependent variable and fear as a independent variable. Covariates included demographic, clinical or lifestyle factors. RESULTS: A total of 258 participants were recruited for the survey, and they were characterized by little or no distress (39.53%), moderate distress (45.35%) and high distress (15.12%). The prevalence of moderate to severe distress in patients was 60.47%. Increased diabetes-related distress was strongly correlated with increased fear of hypoglycaemia and closely associated with the scores of the worry and behaviour subscales. These results indicated that 62.3% of diabetes-related distress may be explained by fear of hypoglycaemia. CONCLUSION: Increased diabetes-related distress is associated with increased fear of hypoglycaemia in individuals with type 2 diabetes.

Association of Peroxiredoxin 1 and brain-derived neurotrophic factor serum levels with depression and anxiety symptoms in patients with irritable bowel syndrome.

BACKGROUND: Oxidative stress is considered a possible mechanism of irritable bowel syndrome (IBS) and depression. This study determined the possible association of serum peroxiredoxin 1 (PRDX1; a key antioxidant enzyme) and brain-derived neurotrophic factor (BDNF) with anxiety and depression symptoms in IBS patients. METHODS: According to the Rome IV diagnostic criteria, 177 IBS patients from February 2019 to July 2019 were included. Serum levels of PRDX1, BDNF, and TNFα were detected by enzyme-linked immunosorbent assay. Levels of anxiety and depression were assessed with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). RESULTS: Compared with normal IBS patients, patients with anxiety and depression symptoms had significantly higher serum PRDX1 (p<0.001; p=0.002) and TNFα (p<0.001; p = 0.002) and significantly lower BDNF (p < 0.001; p = 0.002). Serum PRDX1 (r = 0.659, p < 0.001; r = 0.466, p < 0.001) and TNFα (r = 0.531, p < 0.001; r = 0.449, p < 0.001) were positively correlated with SAS and SDS, respectively, whereas BDNF was negatively correlated with SAS (r = 0.594, p < 0.001) and SDS (r = 0.534, p < 0.001). Multivariable regression analysis revealed that IBS severity, BDNF, and PRDX1 were significant predictors of anxiety. BDNF was also a significant predictor of depression. CONCLUSION: Elevated PRDX1 and decreased BDNF in serum may be closely related to psychological symptoms in IBS. Results of this study suggested that PRDX1 may be an important target for IBS treatment in fighting against intestinal and psychological symptoms.

Fear of hypoglycemia in patients with type 1 and 2 diabetes: a systematic review.

AIMS AND OBJECTIVES: To summarize and thematize fear of hypoglycemia (FOH) in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) to provide a theoretical basis for the development of effective interventions. BACKGROUND: FOH is common in this population and can reduce quality of life(QOL) and adversely impact upon diabetes self-care management. DESIGN: a systematic review METHODS: Articles published between 2000 and 2019 were searched in PubMed, MEDLINE, EMBASE, Web of Science and three Chinese databases (CNKI, Wan-fang data and VIP). Eligible articles were selected using the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. The quality of all articles finally included was evaluated by the Joanna Briggs Institute (JBI) Critical Appraisal tools. RESULTS: Eighteen studies from 8654 papers were included. The sample size of each study ranged from 48 to 3812 subjects. FOH negatively impacted QOL, particularly psychosocial functioning, daily life and sleep quality. CONCLUSIONS: FOH is a common and serious problem for patients, leading to poor QOL. It has been suggested that psychological concerns, QOL and effective countermeasures in individuals with T1D and T2D should be taken seriously. Advanced technology should be evaluated for its benefits before being used by patients. RELEVANCE TO CLINICAL PRACTICE: The review highlights that FOH negatively impacts QOL, including psychosocial factors, daily life and sleep quality. Healthcare providers should develop targeted and professional assessment tools for FOH and QOL for patients with T2D, especially for patients who are about 60 years old. Advanced technology should be evaluated for its benefits before being used by patients.

Positive spiritual climate supports transformational leadership as means to reduce nursing burnout and intent to leave.

AIM: To explore the relationship between spiritual climate and transformational leadership, and examine their impact on nurses perceived emotional exhaustion and intentions to quit. BACKGROUND: Transformational leadership is known to have a significant positive effect on work environment and job satisfaction. Additionally, promoting spiritual climate amongst staff can benefit workers by increasing self-worth. The relationship between the two is unknown. METHODS: Nurse clinicians from 2 sites in the Jiangsu Province of China completed self-report questionnaires based on spiritual climate, emotional exhaustion, clinical leadership and Turnover Intention Scales. Mediation analysis was applied to evaluate impact of spiritual climate. RESULTS: Perceived positive spirituality amongst nurse clinicians reinforces transformational leadership to reduce emotional exhaustion (indirect effect of -0.089, p < .01). Burnout and intention to leave showed significantly positive correlation with lower levels of perceived spirituality (r = .545, p < .01). CONCLUSION: Transformational leadership in the workplace can reduce nurses' burnout, and a positive spiritual climate increases meaningfulness in their work. This may help in nurse retention. IMPLICATIONS FOR NURSING MANAGEMENT: Health care leaders must look beyond transformational leadership to maintain a positive and supportive clinical climate, and this may involve acknowledgement of nurses' spiritual needs.

Peroxiredoxin 1 as an inflammatory marker in diarrhea-predominant and postinfectious irritable bowel syndrome.

BACKGROUND: Low-grade inflammation occurs in some patients with irritable bowel syndrome (IBS). However, the exact inflammatory markers of IBS and the relationship of these markers with IBS subtypes and symptoms are poorly defined. Peroxiredoxin 1 (PRDX1) plays an important role in inflammatory responses, including intestinal inflammation. We investigated whether PRDX1 is associated with the diagnosis, subtypes, and symptom severity of IBS. METHODS: A total of 177 IBS patients and 174 sex- and age-matched healthy controls (HCs) were recruited. The PRDX1 levels in the sera and colonic mucosa of the participants were detected by enzyme-linked immunosorbent assays and immunohistochemistry. The severity of IBS symptoms was assessed using the IBS Severity Scoring System (SSS) questionnaire. RESULTS: The PRDX1 levels in the sera (F = 71.81, P < .001) and colonic mucosa (F = 5.359, P < .001) of postinfectious (PI-IBS) and diarrhea-predominant IBS (IBS-D) groups were significantly higher than those of the other three IBS subtypes and HC group. The PRDX1 level in the serum and colonic mucosa of IBS-D (serum, P < .01, mucosa, P < .001) and PI-IBS (serum, P < .05, mucosa, P < .001) groups with the most severe symptoms was significantly higher than that in the groups with mild and moderate symptoms. Correlation analysis revealed that in patients with IBS-D (P < .001) and PI-IBS (P < .05), the levels of PRDX1 and TNF-α in sera had a significant positive correlation with IBS-SSS. CONCLUSION: Elevated PRDX1 in the serum and colon mucosa may be closely related to the progression of IBS (especially IBS-D and PI-IBS) and the expression of gastrointestinal symptoms.

Relationship between burnout and intention to leave amongst clinical nurses: The role of spiritual climate.

AIM: This study aims to identify the role that spiritual climate has in reducing burnout and intentions to leave amongst clinical nurses. BACKGROUND: Both shortages and the high turnover of nurses are challenging problems worldwide. Enhancing the spiritual climate amongst nurses can enhance teamwork, organisational commitment and job satisfaction and can play a role in reducing burnout and turnover intention. METHODS: A total of 207 clinical nurses working at a tertiary university hospital were included in this cross-sectional, single-site study. Independent-samples t test and ANOVA, Pearson correlation analysis and hierarchical regression analysis were used to explore the relationships amongst related factors. RESULTS: Most clinical departments showed a moderate spiritual climate (60.24 ± 0.82) with high job burnout (33.62 ± 0.28) and turnover intention (2.37 ± 0.57). A good spiritual climate was correlated with high job satisfaction (r = 0.412, p < 0.01), low burnout and turnover intention (r = -0.423, p < 0.01 and r = -0.292, p < 0.01, respectively). Spiritual climate could also indirectly influence nurses' job burnout and turnover intention (R2  = 10.31%). CONCLUSIONS: Different departments have different spiritual climates. The findings from this study indicate that spiritual climate may impact nursing burnout and turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Using a spiritual climate scale provides health care decision-makers with clear information about staff spirituality well-being. Interventions to improve spiritual climate can benefit teamwork in clinical departments.

Decreased expression of microRNA-510 in intestinal tissue contributes to post-infectious irritable bowel syndrome via targeting PRDX1.

OBJECTIVE: Post-infectious irritable bowel syndrome (PI-IBS) is a common functional gastrointestinal (GI) disorder that occurs after acute GI infection. Recent studies showed that microRNAs were involved in the occurrence and development of IBS. Here, we elaborated the role of miR-510 in the occurrence of PI-IBS and analyzed its mechanism. METHODS: We detected the expressions of miR-510 and PRDX1 in colonic mucosal tissues by qRT-PCR, Western blot and immunohistochemistry. Furthermore, we transfected Caco-2 cells with miR-510 mimic, anti-miR-510, si-PRDX1, and control, then evaluated the cell viability and apoptosis by CCK8 assay and flow cytometry, assessed expression levels of PRDX1 by qRT-PCR and Western blot analysis, and pro-inflammatory cytokines by qRT-PCR and ELISA. RESULTS: MiR-510 expression was downregulated and negatively correlated with TNF-α, whereas PRDX1 expression was upregulated in PI-IBS colonic mucosal tissues. LPS at concentrations of 5 and 10 µg/ml can significantly induce inflammatory injury in Caco-2 cells. MiR-510 overexpression aggravated the injury induced by LPS, as reflected by increased cell viability, decreased apoptosis, and less production of pro-inflammatory cytokines. miR-510 mimic transfection in cells significantly suppressed the mRNA and protein expression levels of PRDX1. Furthermore, the inflammatory injury induced by LPS was exacerbated by upregulating PRDX1 expression when miR-510 was knocked down. CONCLUSION: MiR-510 downregulation in intestinal tissue might contribute to PI-IBS via targeting PRDX1. The results of this study will not only enrich the pathogenesis of PI-IBS but also make us understand the biological activity of miR-510 and provide important experimental basis for PI-IBS clinical treatment targeting miR-510.