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The medical field is facing a physician-scientist shortage, threatening future medical research and development. Medical institutions can contribute to developing physician-scientists by stimulating students' involvement in research. In this study, a medical undergraduate teaching module to develop research skills and encourage interest in research was held in Chongqing, China. Undergraduate medical students at Chongqing Medical University completed research skills training. Before and after the training, an online, anonymous, self-reported questionnaire was administered. The self-reported questionnaire investigated students' demographic characteristics, students' perception of attitudes toward conducting research, research skills (e.g., identifying and utilizing information, critical appraisal of literature, paper writing, and understanding of research), and feedback on scientific research training. The module was implemented with 25 students from July 2019 to October 2019, and 96.0% (N = 24) of participants responded to the questionnaire both prior to and after the training. In the evaluation of research skills, results showed that use of appropriate tools for research (Z = -3.340, p < 0.01), students' ability to undertake a focused literature search (Z = -3.40, p < 0.01), identifying and utilizing information (Z = -3.34, p < 0.01), and paper-writing skills (Z = -3.49, p < 0.01) were significantly improved after the undergraduates participated in the scientific research training. A qualitative analysis of the feedback showed that students found that the training helped to enhance their knowledge, improve their study scores, and motivate them to conduct research in the future. Early scientific research ability training strengthened the research skills of medical undergraduates and motivated them to pursue research.

Family income questions in general purpose surveys are usually collected with either a single-question summary design or a multiple-question disaggregation design. It is unclear how estimates from the two approaches agree with each other. The current paper takes advantage of a large-scale survey that has collected family income with both methods. With data from 14,222 urban and rural families in the 2018 wave of the nationally representative China Family Panel Studies, we compare the two estimates, and further evaluate factors that might contribute to the discrepancy. We find that the two estimates are loosely matched in only a third of all families, and most of the matched families have a simple income structure. Although the mean of the multiple-question estimate is larger than that of the single-question estimate, the pattern is not monotonic. At lower percentiles up till the median, the single-question estimate is larger, whereas the multiple-question estimate is larger at higher percentiles. Larger family sizes and more income sources contribute to higher likelihood of inconsistent estimates from the two designs. Families with wage income as the main income source have the highest likelihood of giving consistent estimates compared with all other families. In contrast, families with agricultural income or property income as the main source tend to have very high probability of larger single-question estimates. Omission of certain income components and rounding can explain over half of the inconsistencies with higher multiple-question estimates and a quarter of the inconsistencies with higher single-question estimates.

This study uses questionnaire surveys to examine the real impact of incorporating traditional cultural elements into the practice of ideological and political education in colleges and universities. The integration of traditional cultural elements into these practices is the research object of this paper. It realizes the sharing of teaching resources for the integration of traditional culture into the practice of ideological and political education in colleges and universities and examines the impact of network distance education on students' learning interests using SQLServer development tools and network distance education technology. The study's conclusions demonstrate that students can enjoy the allure of traditional culture virtually by setting up a network distance education platform and implementing resource sharing. The study's findings offer theoretical evidence in favor of using network distant education to incorporate traditional cultural components into the practice of teaching politics and ideologies in higher education institutions.

The aim: To explore and describe workplace stress levels and health‐promoting behaviours reported by emergency nurses in China, and to investigate factors associated with workplace stress and health‐promoting lifestyle behaviours among emergency nurses. Methods: A cross‐sectional study was conducted between October 2019 and January 2020. Nurses (n = 1565) were recruited from the emergency departments of 54 hospitals within the Sichuan Province of West China. Each subject completed the Chinese versions of the Nurse Workplace Stress Scale, the Health‐Promoting Lifestyle Profile (HPLP‐II) and demographic questions. Linear regression analyses were used to identify associations between workplace stress and the health‐promoting lifestyle and risk factors correlated with these two measurements. Results: Workplace stress was negatively associated with health‐promoting behaviours. Linear regression analysis showed that gender, marital status, whether wages met expected standards and professional rank were found to be associated with health promotion behaviours; marital status, whether income met expected standards, the number of night shifts per month and health promotion behaviours were found to be associated with workplace stress. Conclusion: Higher levels of workplace stress are associated with lower levels of engagement in health‐promoting behaviours, suggesting the potential for reducing workplace stress through the adoption of healthier habits. Policies should prioritize workplace stress by promoting healthy lifestyle initiatives. Summary statement: What is already known about this topic? Emergency nurses experience high levels of workplace stress. Excessive long‐term stress may result in physical and mental illnesses.The health and quality of life of emergency nurses are profoundly affected by these stressors, and their health status is directly related to the efficiency and quality of their nursing work.Very little research has been conducted on the relationship between workplace stress and health‐promoting lifestyle behaviours in emergency nurses. What this paper adds? Workplace stress was negatively associated with health‐promoting behaviours.Married female nurses, those who did not receive the expected income, and those with lower professional ranks were found to be less likely to engage in health‐promoting behaviours.Interventions to reduce nurses' workplace stress should prioritize the promotion of health‐promoting behaviours. The implications of this paper: Hospital managers should implement active and effective measures in the nursing management of emergency departments to alleviate work pressure on nurses and encourage their healthy lifestyles.The introduction of a flexible scheduling system, taking into account night shift arrangements, can significantly reduce workplace stress caused by the number of night shifts per month.Improving the working environment for emergency nurses by providing easy access to affordable and nutritious meals and snacks and organizing physical activity can reduce stress. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the relationship between coping styles, social support and quality of life among disabled older adults and to examine the mediating role of coping styles in the relationship between social support and quality of life. Methods: Using a purposive sampling method, three investigators conducted a face‐to‐face questionnaire survey of eligible participants in the geriatric department of a tertiary care hospital in one of the largest cities in southern China between August 2021 and March 2022. A total of 187 questionnaires were collected, of which 176 were valid, with an effective response rate of 94.1%. Results: Social support and positive coping were positively related to disabled older adults' quality of life, while negative coping was negatively related to both social support and disabled older adults' quality of life. According to the mediating effect analysis after covariate adjustment, positive coping completely mediated the relationship between social support and older adults' quality of life (p < 0.01), with the mediating effect size accounting for 76.9% of the total effect. Negative coping had some mediating effect on the relationship between social support and older adults' quality of life (p < 0.01), with the mediating effect size accounting for 13.0% of the total effect. Conclusion: The quality of life of disabled older adults is low, which is closely related to their social support and coping styles. Therefore, it is important to recognize and emphasize the key role that social support systems play in improving the quality of life of this population, broaden their access to social support and guide them to adopt positive coping styles. Summary statement: What is already known about this topic? Disability has become a serious public health problem with a high incidence in the elderly population.As the population ages, the number of people with disablilities is gradually increasing.Disability can seriously affect the quality of life of older adults while increasing the burden of care for families and healthcare workers. What this paper adds? Social support, coping style and quality of life of disabled older adults are closely related.Good social support can improve the coping style of disabled older adults, thus improving the quality of life of disabled older adults. The implications of this paper: From a practical perspective, by studying the relationship between coping styles, social support and quality of life, we can gain a more comprehensive understanding of the challenges and needs faced by disabled older adults, which can help to develop more specific and effective interventions to improve the overall quality of life of disabled older adults.From an academic perspective, this study will fill the research gap on this specific topic in the existing literature and provide a foundation and inspiration for future research in related fields. [ABSTRACT FROM AUTHOR]

Background: Illness perceptions are an important factor affecting the prognosis of stroke patients. Evaluating the illness perceptions of stroke patients is of great importance for predicting their health behaviour and rehabilitation outcomes. However, there is no specific tool for assessing illness perceptions in stroke patients in China. Objectives: The objective of this study is to translate the Stroke Illness Perception Questionnaire‐Revised (SIPQ‐R) into Chinese and to psychometrically test the Chinese version of the scale in the population of Chinese stroke patients. Methods: This was a methodological study. We investigated 593 stroke patients in the neurology department of a hospital in China from March to September 2021. We translated the SIPQ‐R and adapted it to the cultural context, after which we evaluated the reliability and validity of the Chinese version of SIPQ‐R. Results: Exploratory factor analysis identified eight common factors that accounted for 71.74% of the total variance, and the factor loadings ranged from 0.530 to 0.933. Confirmatory factor analysis confirmed the eight‐factor structure (χ2/df = 1.765, root mean square error of approximation = 0.053, incremental fit index = 0.906, comparative fit index = 0.905 and Tucker–Lewis index = 0.900). Internal consistency was confirmed by a Cronbach's alpha coefficient of 0.982. The test–retest reliability was 0.762. The results showed good content validity (the scale level content validity index was 0.940, and the item level content validity index values ranged from 0.860 to 0.960). There were no missing responses and floor or ceiling effects. The standard error of measurement and the smallest detectable change for the SIPQ‐R were 45.49 and 126.10, respectively. Conclusions: The results of this study provide empirical evidence for the reliability and validity of the Chinese version of the SIPQ‐R for stroke patients. Summary statement: What is known about this topic? Illness perceptions are an important factor affecting the prognosis of stroke patients. Evaluating the illness perceptions of stroke patients is of great importance for predicting their health behaviour and rehabilitation outcomes.Currently, there is no specific illness perception scale for stroke patients in China.SIPQ‐R is a stroke‐specific version of the illness perception questionnaire. What this paper adds? The Chinese version of the SIPQ‐R has the same factor structure as the English version using confirmatory factor analysis.The scale was adjusted to reduce the number of items, which may have improved its clinical applicability and compatibility.All the indexes verified by the model reached the standard. Implications of this paper: The results of this study provide empirical evidence for the reliability and validity of the Chinese version of the SIPQ‐R for stroke patients.This study translated the SIPQ‐R into Chinese and tested its reliability and validity to provide a reliable tool for assessing illness perception in a group of Chinese stroke patients.SIPQ‐R can be used as a measure of the illness perceptions of stroke patients in the clinic to provide a basis for patients' rehabilitation. [ABSTRACT FROM AUTHOR]

With the aging population, the financial burdens associated with chronic diseases continue to escalate. Among various management strategies, family physician contracting stands out as a significant initiative aimed at addressing this challenge, officially introduced in China in 2016. However, current research has given relatively little attention to the economic benefits of family physician contracting in developing countries. This paper evaluates the economic effect of family physician contracting by employing microdata of patients with chronic diseases at the Yuyuantan Community Health Service Center, Haidian District, Beijing, from January 2019 to May 2021. This research contributes to the theoretical discourse in healthcare services by introducing a modified Anderson model. The empirical findings demonstrated that family physician contracting effectively reduced healthcare costs for patients with chronic diseases. Notably, the effect of family physician contracting on healthcare costs was more pronounced among patients with chronic diseases aged less than 65 years. At the same time, it is inferred that expediting the reform of the health insurance payment system, coupled with the promotion of family physician contracting services, would enhance the wellbeing of patients with chronic diseases. This research offers valuable insights into the ongoing and future development of family physician contracting in developing countries. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to investigate the status of self‐management behaviour and illness perceptions and to examine illness perceptions in relation to self‐management behaviour in elderly patients with chronic obstructive pulmonary disease (COPD). Methods: A cross‐sectional study was conducted, and 152 elderly COPD patients were recruited via the convenience sampling method. The COPD Self‐Management Scale and the Revised Illness Perception Questionnaire for COPD patients were used to examine self‐management behaviour and illness perceptions. Pearson correlation analysis, univariate analysis and hierarchical linear regression analysis were used to explore illness perceptions in relation to self‐management behaviour. Results: The mean overall score for self‐management behaviour was 2.90 ± 0.39. Among the subscales of self‐management behaviour, information management had the lowest score of 2.20 ± 0.76. Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be significant determinants of self‐management behaviour. After controlling for these variables, several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self‐management behaviour. Conclusions: This study confirmed that elderly COPD patients' self‐management behaviour was unsatisfactory and that illness perceptions were significant determinants of self‐management behaviour. The findings may contribute to the development of self‐management interventions for elderly COPD patients. Summary statement: What is already known about this topic? Self‐management behaviour plays an essential role in managing COPD.Illness perceptions are predictors of self‐management behaviours in COPD patients, but little is known about how illness perceptions influence self‐management behaviour in elderly patients with COPD. What this paper adds? Several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self‐management behaviour.Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be determinant of self‐management behaviour. The implications of this paper: The findings may contribute to developing tailored interventions that help patients establish beneficial illness perceptions to improve their self‐management behaviour. [ABSTRACT FROM AUTHOR]

Aims: This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. Background: Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. Design: This cross‐sectional study was designed based on the theory of unpleasant symptoms. Methods: Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) Results: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. Conclusion: The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self‐coping and symptom management for kidney transplant recipients. Summary statement: What is already known about this topic? Fatigue is a common symptom of kidney transplant recipients and can impair postoperative recovery, reemployment, quality of life, social activities and physical and mental states, causing the body to be in a state of chronic energy consumption.Owing to the imperceptible physical injury upon kidney transplant recipients, fatigue is often underappreciated or even disregarded. What this paper adds? It was found that the rate of fatigue in kidney transplant recipients was high.The risk factors for fatigue in kidney transplant recipients based on the theory of unpleasant symptoms were analysed in three ways: physiological, psychological and situational. The results showed that sleep quality, duration after transplantation, serum potassium level, anxiety, depression, education level, financial burden and social support were associated with fatigue in kidney transplant recipients. The implications of this paper: Clinical nurses should conduct timely and multidimensional fatigue evaluations of kidney transplant recipients and pay more attention to those with a high level of fatigue.The findings can provide a scientific basis for kidney transplant specialist nurses to conduct targeted interventions and facilitate fatigue management for kidney transplant recipients. They can also help to develop fatigue intervention models based on the displeasure symptom theory to improve fatigue in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to introduce the Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) into China and test its applicability in Chinese infertile population. Background: Infertility‐related stress not only influences patients' psychological well‐being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. Design: The design used in this study is a cross‐sectional survey. Methods: A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI‐FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman–Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. Results: The revised Chinese version of COMPI‐FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI‐FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman–Brown coefficient was 0.836, explaining excellent reliability. Conclusion: The revised Chinese version of COMPI‐FPSS shows good reliability and validity, and it can be used to evaluate the infertility‐related stress of infertile patients in China. Summary statement: What is already known about this topic? With the number of infertile people on the rise globally, infertility‐related stress needs attention.Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) with its brief and accessible entries is extensively applied abroad.China currently lacks such a tool. What this paper adds? This study translated the COMPI‐FPSS into Chinese and the Chinese version of COMPI‐FPSS contains 11 items and 2 dimensions, including personal stress domain and social stress domain, which has good reliability and validity. The implications of this paper: The Chinese version of COMPI‐FPSS could provide a short and reliable tool for clinical practice and research, which will reduce the burden on researchers and patients. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses. Background: Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear. Methods: A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale‐Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T‐test and one‐way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research. Results: Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth. Conclusions: Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth. Summary statement: What is already known about this topic? Psychiatric patients generally have complex and special conditions, which makes psychiatric nursing work high‐risk and stressful, which often poses significant challenges for psychiatric nurses, such as compassion fatigue.There is a correlation between compassion satisfaction, compassion fatigue and posttraumatic growth among nurses. What this paper adds? Psychiatric nurses have low levels of posttraumatic growth and moderate levels of compassionate satisfaction, burnout and secondary traumatic stress, and posttraumatic growth is influenced by sleep hours per day, marital status, children and job satisfaction.Compassion satisfaction and secondary traumatic stress have a positive impact on posttraumatic growth of psychiatric nurses, whereas burnout has a negative impact on posttraumatic growth of psychiatric nurses. The implications of this paper: This study emphasizes that policy makers should clarify the relationship between posttraumatic growth, compassion satisfaction and compassion fatigue as soon as possible to support the rapid growth of psychiatric nurses in nursing work.This study provides a basis for nursing managers to explore and implement interventions to improve compassion satisfaction among psychiatric nurses, reduce burnout and promote personal psychological growth. [ABSTRACT FROM AUTHOR]

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

Background: The condition and correlation of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. This survey aimed to evaluate the current status and influencing factors of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas. Methods: Patients undergoing pituitary adenoma resection in two tertiary hospitals from November 2019 to November 2021 were included. The general data questionnaire, Multidimensional Fatigue Inventory (MFI‐20), Pittsburgh Sleep Quality Index (PSQI) and international physical activity questionnaire were used for data analysis. Results: In total, 184 patients with pituitary adenomas were included. The postoperative patients with pituitary adenomas had a high level of fatigue. In total, 34 (18.5%) patients had low level of physical activity, 76(41.3%) patients had medium level of physical activity and 74 (40.2%) had high level of physical activity. Postoperative time, PSQI, physical activity level and gender were the influencing factors of fatigue in patients with pituitary adenomas (all P < 0.05). Conclusions: Postoperative patients with pituitary adenomas have a higher level of fatigue, and it is related to reduced sleep quality and activity. Relevant nursing measures should be taken according to the influencing factors of fatigue to reduce the fatigue of postoperative patients with pituitary adenomas. Summary statement: What is already known about this topic? The postoperative nursing care of patients is very important to the quality of life in patients with pituitary adenomas.Fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. What this paper adds? There is a high level of fatigue in patients with pituitary adenomas within 1 year after operation.The degree of fatigue is negatively correlated with the course of disease and the level of physical activity. The implications of this paper: Interventions and nursing care strategies targeted on the factors affecting postoperative fatigue of patients with pituitary adenomas are needed. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Aims: To test the psychometric properties of the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory on a sample of patients with chronic obstructive pulmonary disease in China. Background: Measuring the self‐care of patients with chronic obstructive pulmonary disease is vital to promote the performance of effective self‐care behaviours. However, few instruments have been developed to measure self‐care in chronic obstructive pulmonary disease, and the existing instruments lack theoretical support and satisfactory psychometrics properties. The Self‐Care in Chronic Obstructive Pulmonary Disease Inventory based on Middle‐Range Theory of Self‐Care of Chronic Illness has been developed and tested previously in Italian and US population. Design: A cross‐sectional instrument development study. Methods: Construct validity was tested by confirmatory factor analysis and hypothesis testing, and reliability internal consistency using factor score determinacy coefficients. Results: A convenience sample of 185 patients with chronic obstructive pulmonary disease was recruited from September 2020 to January 2022. The instrument consists of three scales: self‐care maintenance, self‐care monitoring and self‐care management. Confirmatory factor analysis performed on the three scales produced good fit indices. The internal consistency was adequate with factor score determinacy coefficients ranging from 0.891 to 0.953 in Self‐Care Maintenance Scale, 0.990 to 0.993 in Self‐Care Monitoring Scale and 0.750 to 0.976 in Self‐Care Management Scale. Conclusions: The Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has acceptable reliability and validity. Some differences from the original instrument were identified. Further validation studies should be conducted to confirm the psychometric properties of the instrument in Chinese population. Summary statement: What is already known about this topic? The Middle‐Range Theory of Self‐care of Chronic Illness has been used to direct clinical nursing practice for coronary heart disease, heart failure, hypertension, chronic obstructive pulmonary disease and other chronic illnesses and has been shown to have good guiding significance for clinical nursing practice for the self‐care of clinical chronic illness.In patients with chronic obstructive pulmonary disease, self‐care has a significant positive effect on preserving disease stability and enhancing health‐related quality of life.There is a shortage of moderate length evaluation instruments for chronic obstructive pulmonary disease self‐care with comprehensive theoretical assessment content, but the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory, based on the Middle‐Range Theory of Self‐care of Chronic Illness, has been demonstrated to have positive application effects in Italy and the United States. However, its applicability in China is unclear. What this paper adds? This paper indicates that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has good reliability and validity and can reflect the self‐care ability of patients with chronic obstructive pulmonary disease in China. The implications of this paper: The results show that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory is simple and accessible, and nurses can use it to assess patients' capacity for self‐care regularly.The Chinese version of the Self‐Care Scale has different dimensions from the original scale, indicating that different medical backgrounds and varying understanding of concept of self‐care in various nations may result in various self‐care behaviours.To ensure its wider application, the development of this scale necessitates cross‐cultural adaptation of populations in more countries. [ABSTRACT FROM AUTHOR]

Background: Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other. Aims: The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure. Methods: A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors. Results: The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression–anxiety, subjective social support–objective social support, and subjective social support–social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA–dyspnea, depression–difficulty sleeping, and social support availability–dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes. Conclusions: Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health. Summary statement: What is already known about this topic? Limited studies have explored core somatic symptoms in patients with chronic heart failure using network analysis.There is a lack of a holistic perspective when studying symptoms in patients with chronic heart failure and their association with various factors. What this paper adds? This study identifies daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping as the four core symptoms of chronic heart failure.Targeting these core symptoms in treatments and management can potentially lead to improvements in patients' overall health.The network analysis highlights the importance of psychological and environmental factors, suggesting that interventions targeting these factors may contribute to overall health improvement. The implications of this paper: It provides evidence of core symptoms of chronic heart failure.It provides evidence of the complex interconnections among symptoms and related factors in chronic heart failure.It provides implications for future interventions and strategies in managing chronic heart failure. [ABSTRACT FROM AUTHOR]

Background: New graduate nurses often have certain potential safety hazards for patients due to insufficient knowledge and lack of clinical practice ability. To address these challenges, China has implemented a standardized training strategy. The improvements in the quality of this training involve not only the intervention of teaching methods but also the consideration of personality traits. Methods: The application software based on the BFI-2 Chinese scale was utilized to administer personality tests to nursing students; nursing students were invited to scan the QR code and voluntarily fill in a questionnaire, including basic information, personality test results, and a professional self-efficacy test scale; offline paper-based theoretical examination results of nursing students were collected before and after training. The data was then analyzed using SPSS software version 26.0, which involved descriptive analysis, one-way between-groups analysis of variance (ANOVA) and Spearman correlation analysis. Results: Based on the data, there were no observable differences in the theoretical results before and after training across different personality traits. In terms of skill assessment, conscientiousness exhibited the highest score at 78.91 ± 2.98 points, while negative emotionality showed the lowest score at 74.59 ± 2.12 points. These differences between different personality traits are statistically significant (P < 0.001). In terms of professional self-efficacy, conscientiousness scored the highest at 98.48 ± 12.69, while negative emotionality scored the lowest at 85.89 ± 11.71, with significant differences between different personality traits (P < 0.001). Professional self-efficacy was negatively correlated with agreeableness (r = -0.150, P = 0.044) and positively correlated with conscientiousness (r = -0.310, P < 0.001). Skill scores were negatively correlated with negative emotionality (r = -0.257, P < 0.001) and positively correlated with conscientiousness (r = 0.182, P = 0.014). Conclusions: This study shows that personality traits affect the skills test results and professional self-efficacy of nursing students. Conscientiousness scored the highest in this study, while negative emotionality scored the lowest. Therefore, personalized training plans are recommended to improve the quality of care for such nursing students and to further enhance patient safety. [ABSTRACT FROM AUTHOR]

Drawing data from a study on LGBT parent families that combined in-depth interviews with members of 19 families and a national online survey of 595 families, this paper focuses on the role of grandparents in providing childcare within these families. Similar to their heterosexual counterparts, grandparents are heavily involved in childcare in these lesbian and gay parent families. The participation of the families of origin in childcare not only greatly alleviates the family pressure experienced by our participants due to their alternative sexuality, but also contributes to the normalization of these queer families in the face of public scrutiny. Despite the alternative construction of kinship in queer families, the conventional notion of blood ties still influences grandparents' involvement in childcare. We contend that grandparenting in LGBT parent families exemplifies the complex yet innovative improvisation of intergenerationality in contemporary China, reflecting the ongoing negotiation between family responsibility and individual autonomy. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to assess the overall social housing development, point out factors affecting it and propose some policy implications for social housing development. Design/methodology/approach: The research investigated investors, credit institutions and officials involved in social housing development. Bac Ninh province currently has 51 social housing projects that have been and are being implemented. The hypothetical regression model has seven latent variables and is tested by the criteria through the SPSS25.0 software. Findings: There are 29 factors belonging to seven groups affecting housing development. Their impact rates range from 3.47% to 30.25%. Research limitations/implications: The study has only identified the factors affecting social housing development but has not undertaken an in-depth assessment of its development status and forecast for the future. Therefore, this gap needs to be further studied. The proposed research method could also be applied when researching social housing developments in other countries around the world. Practical implications: To develop social housing to meet the needs of the real estate market, it is necessary to improve the policies that have the strongest impact first. Then, it is necessary to improve the factors with a smaller impact. Social implications: The study proposes policy implications for faster housing development for low-income people that improve their living standards. Originality/value: To the best of the authors' knowledge, the paper has studied for the first time social housing development and the factors affecting it. The paper also shows the level of their impact so that priority policies can be applied to each factor. [ABSTRACT FROM AUTHOR]

Background: Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. Aims: This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language‐delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. Methods & Procedures: The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8‐h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3‐month online home intervention monitoring. Outcomes & Results: 146 families whose children aged 12–68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between‐group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. Conclusion & Implications: The online parent training focusing on improving daily interaction with children through speech–language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. WHAT THIS PAPER ADDS: What is already known on the subject: Parent‐implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech–language therapists and may be the primary mode of service delivery or may supplement in‐person services. What this paper adds to the existing knowledge: This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin‐speaking children and it is equally effective for children with ASD and non‐ASD diagnosis. What are the potential or actual clinical implications of this work?: Developmental behavioural paediatricians and speech–language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience. [ABSTRACT FROM AUTHOR]

Aim: To analyse the risk factors and incidence of falls in geriatric outpatients in a university hospital ward in Hangzhou, China. Methods: From May 2020 to August 2022, 1712 geriatric outpatients in a university hospital ward in Hangzhou, China, were screened using a socio‐demographic questionnaire (e.g. gender, age, living arrangement, etc.) and assessment scales. The correlation between each factor and falls was preliminarily analysed by chi‐squared tests. Finally, binary logistic regression analysis was conducted to further analyse the risk factors of falls. The STROBE checklist was used in reporting this study. Results: Of the 1712 geriatric outpatients recruited, 1626 participants (60–79 and ≥ 80 years old) with complete questionnaire and assessment data were included. The occurrence of falls for those in the 60–79 age group was 8.4%, and for those in the ≥80 age group it was 13.4%. Age (p =.007), use of a walking assistance device (p <.001), the Stay Independent Brochure Questionnaire (SIB) (OR = 7.751, 95% CI = 5.089–11.806, p <.001), living arrangement (p =.004), timed up and go test (TUGT) (p =.007) and three diseases or above (OR = 2.496, 95% CI = 1.358–11.4.586, p =.003) reached statistical significance. Conclusions: Older people have a high incidence of falls. In this study, age, disease history, SIB scores (≥4 points), living arrangement, TUGT and walking assistance device increased the probability of falls in older Chinese adults. Personalised interventions should be carried out according to the specific situation of older people to effectively reduce their incidence of falls and improve their quality of life. Relevance to Clinical Practice: The basic characteristics and fall risk factors of the older can help nurses identify fall risk, and early intervention by caregivers can reduce fall‐related injuries, which has practical significance for promoting healthy aging. Patient or Public Contribution: The subjects of this study were older patients ≥60 years old, and the demographic characteristics and fall‐related information of patients were obtained by questionnaire. The team worked closely with a team of experts in the field of health care. Some researchers collect data and rewrite them, while other researchers analyse the information and write a paper. All authors read and approved the final manuscript. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression.SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services.Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. What the paper adds to existing knowledge?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression.MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression.The positive preferences for providing information and family involvement in treatment decision‐making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. What are the implications for practice?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision‐making actively.A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression.SDM‐related training should be encouraged for MHPs to promote widespread SDM. Introduction: Shared decision‐making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well‐documented. Aim: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. Method: In this cross‐sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision‐Making Questionnaire—Physician Version (SDM‐Q‐Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. Results: The mean SDM‐Q‐Doc was 80.47 (±16.31). Within the six specific decision‐making situations, most MHPs selected non‐SDM (52.7%–71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision‐making, working in an outpatient clinic and receiving SDM training (F = 23.582; p =.000; R2 =.198; adjusted R2 =.189). Discussion: Although the MHPs' self‐rated score of SDM‐Q‐Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM‐related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer‐practitioner relationship. Implications for Practice: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high‐quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families. [ABSTRACT FROM AUTHOR]

To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self‐efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. Design: A cross‐sectional study. Methods: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self‐efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. Results: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self‐efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. Conclusion: Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self‐efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. Impact: These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self‐efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. Patient or Public Contribution: Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. Summary Statement: What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self‐regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self‐efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses. [ABSTRACT FROM AUTHOR]

Objectives: This paper has two objectives. First, it assesses whether the existing informal care provided by adult children has an impact on older people's propensity to demand community care services. Second, it compares the different statuses of sons and daughters in the formal/informal support trade‐off. Methods: The paper is based on an analysis of data from the 2018 wave of the China Longitudinal Ageing Social Survey, within the framework of a revised version of Andersen's model, and applies multilevel models to analyse the effects of adult children's gender, numbers and the quality of their support, on older people's willingness to purchase community care services. Results: Older people who had sons as well as daughters demanded fewer services, while the number of sons increased service demand. Regarding sons, community care services compensated for economic support, daily life care and spiritual consolation, but did so only in respect of daily life care from daughters. Conclusions: Many families have only one son or one daughter as a result of the one‐child policy and therefore often require support from formal care services. Moreover, there is a distinct gender division and an influential filial culture governing the impact of services on the support provided by adult children. Because ageing in place depends on both informal family support and formal services, this key policy goal is at risk if the latter provides insufficient support to the former. [ABSTRACT FROM AUTHOR]

As a sustainable mode of travel, carpooling is an effective solution to environmental and energy problems, but it has not been fully utilized. The research on carpooling attitudes, especially for college students, still needs to be improved. In response to this problem, this paper aims to investigate the effect of personal attributes, travel attributes, attitude attributes and other attributes of students on carpooling attitudes in China. To collect the data, an online questionnaire survey was implemented at Shenzhen University, and 514 students participated. Based on the samples, the multinomial logit model is used to explore the contribution of all variables. The model results showed that personal attributes such as sex and age had no significant effect on the attitude of college students towards carpooling. The safety of carpooling and its high cost make college students have a neutral attitude towards it. The most concerning factor for college students in carpooling is comfort. These findings can provide valuable suggestions for measures to be taken in response to different attributes affecting students' attitudes and are particularly important for the university and government to make optimal decisions to motivate students to select carpooling. [ABSTRACT FROM AUTHOR]

This study was aimed at comparing different formats of illustrations for children's books created by modern Chinese and Ukrainian artists. At the same time, it was not focused just on determining the leading format, but on identifying the attractiveness factors of each format. To this end, the study investigated children's illustration preferences drawing from the following three age groups: 5–6 years old (preschoolers), 7–8 years old (second‐graders), and 9–10 years old (fourth‐graders). According to the survey, children were most concerned with illustration colourfulness (this is true for paper and pop‐up books) and viewing convenience. There were no statistically significant differences found between Chinese and Ukrainian books in terms of these parameters. At the same time, Chinese e‐books appeared to outperform the Ukrainian texts in terms of feature management and illustration colourfulness. Publishers and artists of children's books can use these data for effective creative activity and making constructive decisions. At the same time, these findings may be of interest to parents, informing or guiding book selection for children. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aims to propose a self‐management clusters classification method to determine the self‐management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). Background: MCI associated with DM is a common chronic disease in old adults. Self‐management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self‐management ability are heterogeneous. Design: A cross‐sectional study based on cluster analysis is designed in this paper. Method: The study included 235 participants. The diabetes self‐management scale is used to evaluate the self‐management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k‐means clustering, k‐means clustering analysis, analysis of variance and chi‐square test. Results: Three clusters of self‐management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. Conclusion(s): This study classified three groups of self‐management styles, and each group has its own self‐management characteristics. The characteristics of the three clusters may help to provide personalized self‐management strategies and delay the disease progression of MCI associated with DM patients. Relevance to clinical practice: Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self‐management to delay the progress of the disease. Patient or public contribution: In our study, we invited patients and members of the public to participate in the research survey and conducted data collection. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

The AI-enabled intelligent learning system (AEILS) is able to provide personalised and intelligent tutoring and is more capable of meeting individuals' need. Nevertheless, limited studies focused on the effect of AI-specific factors on user behaviour. To fill this research gap, we identified the AEILS-specific affordances (i.e. interactivity, personalisation, competition, convenience) and explored their effect on user engagement and foreign language speaking anxiety (FLSA). In this paper, we integrate quantitative and qualitative studies to explore user behaviour in AEILS. Survey data was collected from 457 respondents and analysed using structural equation modelling with the smart-PLS software. The results showed that AEILS-specific affordances significantly affect flow experience and self-expansion, thus facilitating user engagement and alleviating FLSA. Semi-structured interviews were conducted to corroborate the findings of the quantitative study. These findings highlighted the importance of technology affordance in AEILS. This study contributed to the literature on IS and education by incorporating context-specific factors into account. [ABSTRACT FROM AUTHOR]

Background: Smart classroom environment has drawn worldwide attention, however, there is still a lack of studies that can explore and analyse potential factors, which affect students' satisfaction with smart classrooms in higher education. Objectives: To assess students' satisfaction with smart classrooms in higher education, this study proposed the smart classroom environment satisfaction model based on TAM and ACSI models. Methods: A sample of 1979 Chinese college students who studied in a smart classroom environment completed a survey assessing student satisfaction with the smart classroom environment. And a structural equation modelling analysis was used to further analyse students' preferences for smart classroom environments. Results and conclusions: The results showed that student satisfaction with smart classroom environment is significantly correlated with subjective perception factors after use, such as students' perceived value (PV), user experience and perceived expectations (PE). It indicated that user experience indirectly affected overall satisfaction (OS) through its positive impact on PV, while PE indirectly affected OS through its positive impact on user experience. Second, user experience had the greatest impact on student satisfaction, followed by PV and PE. This study is a theoretical supplement to future research on smart classroom environment in higher education, and can also provide reference for relevant government departments, universities and enterprises to build and manage smart classroom environment. Lay Description: What is already known about this topic?: Smart classrooms can combine technology with the goal of providing students with the highest educational services.This technology‐rich smart classroom environment provides unique opportunities for students to search, acquire, analyse and apply digital learning resources and tools in autonomous learning, collaborative learning, and exploratory learning activities.Although smart classrooms have played a certain role in the above aspects, it has invested a large amount of money to build the most advanced facilities, without considering student perspectives. What the paper adds?: This study investigates the satisfaction factors and preferences of 1979 college students to evaluate the smart classroom environment supported by technology.This study proposed the smart classroom environment satisfaction model, and a structural equation modelling analysis was used to further analyse students' preferences for smart classroom environmentsStudent satisfaction with smart classroom environment is significantly correlated with subjective perception factors after use, such as students' perceived value, user experience and perceived expectations. Implications for practice and/or policy: In order to improve students' satisfaction with the smart classroom environment, more attention needs to be paid to improving their actual user experience.Whether students can receive timely learning support and whether there is interaction in the classroom is worth special consideration to improve their user experience. [ABSTRACT FROM AUTHOR]

Background: The world is moving towards digitalization and intelligence. Programming has become an essential development competency. Even though many countries are currently making great efforts to expand programming education, the programming education in these countries shows an imbalance in geographical and gender dimensions. We found that few studies paid attention to rural girls' programming learning in developing countries. Objectives: This study focuses on programming learning among rural girls in a developing country (China) from an educational equity perspective. We investigated the level and the changes in these girls' self‐efficacy and interest in programming. Methods: We conducted a three‐month (12‐week) semester of programming teaching for rural fifth‐grade girls. Two rounds of data collection were conducted at the mid‐semester (first‐measure) and the end of the semester (second‐measure), with semi‐structured interviews at the end of the semester. Results and conclusions: The results showed that rural girls' programming self‐efficacy was at a moderate‐to‐high level and remained stable, but there were no gender differences in programming self‐efficacy between boys and girls in the second‐measure. Girls' self‐efficacy was positively correlated with interest, and programming education could help girls to increase their interest in programming, but boys and girls did not show gender differences in their programming interest in second‐measure. Interestingly, we found that girls' perceived programming knowledge acquisition was significantly higher than overall programming efficacy. Takeaways: These findings provide meaningful implications for programming education in less developed areas and female early programming education. Lay Description: What is already known about this topic: There is a significant gender imbalance in the programming field and females were severely underrepresented.Potential causes for these issues might be women's lack of confidence and interest in programming.Previous studies have shown that female college students in computer science showed insufficient confidence in programming at school, which made them avoid becoming programmers and choose other careers after graduation.Female students' low confidence and interest in programming might have already existed in their earlier studies, such as high school or even elementary school. What this paper adds: Rural fifth‐grade girls' programming self‐efficacy was at a moderately high level, with no significant differences compared to boys, and maintained a stable level throughout the entire learning period.Rural girls held a high level of programming interest at the beginning, which was reinforced by programming education, and there was no gender difference in programming interest.Rural girls' perceived programming knowledge acquisition was significantly higher than overall programming efficacy.Rural girls' self‐efficacy was positively correlated with interest. Implications for practice and/or policy: In rural areas, fifth‐grade girls and boys had approximate self‐efficacy and interest in programming.Providing early programming education to girls in rural areas can increase their interest in programming. [ABSTRACT FROM AUTHOR]

Background: Computational thinking (CT) has emerged as a critical component of 21st‐century skills, and increasing effort was seen in exploring the development of CT skills in K–12 students. Despite cumulative research on exploring students' CT acquisition and its influencing factors, learners' development of the skill over time and the underlying mechanism that contributes to individual differences remain unclear. Objective: To bridge this gap, the present study aimed to explore the individual differences in CT acquisition among primary school students and how these differences were shaped over time. Specifically, variations in the development of CT across demographics, including gender and learning experience, were explored. Method: Three waves of data were collected from a sample of 322 primary school students (aged 7–12) across 18 months, with a 9‐month interval between adjacent waves. A time‐lagged model was leveraged for data analysis, and control variables were included in the model to strengthen statistical robustness. Results and Conclusion: The results indicate that male students and those who were more experienced in coding tended to have more positive attitudes toward coding. Additionally, coding interest was found to mediate the relationship between demographics and CT, demonstrating that male students and more experienced learners tended to be more interested in coding, which, in turn, contributed to the development of CT skills in later stages. Conclusion: The study provides valuable insights into the mechanisms underlying individual differences in CT development over time. The findings highlight the importance of nurturing coding interest among female students and promoting coding exposure for novice learners. Lay Description: What is already known about this topic: Individual differences in students' CT performance were broadly reported.Demographics were identified as important factors contributing to individual differences in CT acquisition.How these differences were shaped over time remains unclear. What this paper adds: The study investigated the underlying mechanisms of individual differences in long‐term CT development.Demographic differences in primary school students' CT development over time were explored.Results illustrate that females tended to have lower coding attitudes. Prior coding experience positively predicted coding attitudes.Coding interest mediated the relationship between demographics and CT, demonstrating that male students and more experienced learners tended to be more interested in coding, which, in turn, contributed to the development of CT skills in later stages. The implications of study findings for practitioners: The findings indicate the essential role interest and motivation played in supporting students' sustainable development in CT skills.The findings suggest the need for more attention to girls' motivation and learning interest in CT and coding instructions.The findings highlight the importance of introducing coding at early educational stages and promoting coding exposure for novice learners. [ABSTRACT FROM AUTHOR]

Background: Dysphagia services have only recently been formalised within Chinese health services. There has been no comprehensive evaluation of all aspects of dysphagia services practice in China. Aims: To provide a profile for the dysphagia practice in China by assessing various facets of dysphagia services. Methods and Procedures: This is a survey study carried out from December 2022 to May 2023 online in China. One hundred fifty‐nine respondents comprising doctors, nurses or therapists involved in the field of dysphagia rehabilitation completed a questionnaire via Sojump. The questionnaire included dichotomous (e.g., yes/no) and multiple‐choice questions related to participants' general information and their provision of dysphagia management services. Results were analysed descriptively and the differences among different levels of hospitals were analysed. Outcomes and Results: Approximately two‐thirds of hospitals (67.9%) started dysphagia services within the last 5 years. A significant difference in the initiation of dysphagia rehabilitation was observed across different hospital levels (χ2 = 32.70;p < 0.001). Routine dysphagia screening was a standard practice in most hospitals (71.7%), with the most frequently employed screening method being the water swallow test (95.6%). Clinical swallowing evaluation emerged as the preferred initial assessment method (80.5%) and the most utilised assessment method (91.8%). Video fluoroscopic swallow study and flexible endoscopic evaluation swallowing were used by 22.7% and 12.6% of respondents. A significant difference was observed in the choice of assessment methods across hospitals of different levels (χ2 = 43.397; p < 0.001). The majority of respondents (53.5%) primarily employed rehabilitation as the main intervention method (76%–100%). Most respondents indicated that they would reevaluate patients after treatment (74.8%) and reported routine follow‐up with patients (60.4%). Conclusions and Implications: Despite the relatively recent development of dysphagia management in China, the practice patterns uncovered in this study are broadly consistent with Chinese guidelines and consensus. However, the use of instrumental assessments remains low, resulting in a lack of objective evaluation of patient conditions and outcomes. There is a need for policy and resource support in the field of dysphagia rehabilitation in China. WHAT THIS PAPER ADDS: What is already known on this subject: Assessment and treatment methods for dysphagia are various across different patients, medical facilities and settings. There has been no comprehensive evaluation of all aspects of dysphagia rehabilitation practice in China. What this study adds to existing knowledge: The study assessed various facets of dysphagia rehabilitation in China through an online survey. We found that the relatively recent development of dysphagia management in China, but the practice patterns uncovered in this study are broadly consistent with Chinese guidelines and consensus. Variations in practice patterns between hospitals of different levels may be attributed to resource constraints and patient needs. Besides, while rehabilitation exercises are the primary intervention method for dysphagia in China, the assessment largely centres on clinical swallowing evaluation. The use of instrumental assessments remains low, resulting in a lack of objective evaluation of patient conditions and outcomes. What are the clinical implications of this work?: The study assessed various facets of dysphagia rehabilitation in China, and the results indicate that the use of instrumental assessments needs to be improved and there is a need for policy and resource support in the field of dysphagia rehabilitation in China. [ABSTRACT FROM AUTHOR]

INTRODUCTION Hangzhou Public Places Smoking Control Regulations (2019) have been gradually adopted, which explicitly stipulate that smoking is strictly prohibited in the outdoor areas of educational and healthcare institutions for minors. However, there are few studies reporting the exposure to secondhand smoke (SHS) in outdoor public places for minors in the urban area of Hangzhou City. METHODS We aimed to assess the exposure to SHS in public spaces frequented by minors using on-site observations and questionnaires. In this cross-sectional study, the area was divided into core and non-core areas based on the spatial distribution and development process of the city. The core areas included the West Lake commercial district, extending to the Qiantang River, while non-core areas were located beyond this radius. Using stratified random sampling, 30 public places in each area were selected as observation sites. On-site observations measured SHS exposure and smoking control, and questionnaires were administered to 6 individuals at each site. The results were compared between the two investigation methods. RESULTS Among the 57 valid observation points, 24.6% (14/57) did not display any no-smoking signs. Outdoor SHS exposure rate from on-site observation P1 (observing someone smoking or smelling tobacco smoke), on-site observation P2 (observing someone smoking or smelling tobacco smoke or seeing cigarette butts) and questionnaire survey P3, were 59.6% (95% CI: 45.7-72.2), 91.1% (95% CI: 79.7-96.7) and 41.0% (95% CI: 35.5-46.7), respectively. CONCLUSIONS The outdoor SHS exposure in areas frequented by minors in the urban district of Hangzhou City remains high, coupled with a lack of awareness of SHS risks among underage individuals. Therefore, controlling outdoor SHS exposure in these key areas is a critical public health issue in Hangzhou, requiring further tobacco control efforts. On-site observation is an important and supplementary research method to investigate outdoor SHS exposure, especially to describe the SHS exposure of focus areas. [ABSTRACT FROM AUTHOR]

INTRODUCTION Youth smoking is a serious public health problem. Nevertheless, a rigorous tobacco-free environment within schools, combined with exemplary tobacco control behavior among school personnel can effectively contribute to reducing adolescent smoking. This study compared the tobacco control environment in Shanghai secondary schools in 2017 and 2021, and explored how the tobacco control environment influenced the tobacco control behaviors of school personnel. METHODS Two cross-sectional studies were conducted from October to December 2017 and October to December 2021, using stratified cluster random sampling method, and 2403 and 1761 valid questionnaires were collected, respectively. The chi-squared test was used to test the differences between categorical variables. Binary logistic regression was conducted using survey data from 2021 to explore the influencing factors of staff's tobacco control behaviors. RESULTS Compared with 2017, the percentages of staff members who were current smokers, had smoked on campus in the past year and were exposed to secondhand smoke (SHS) on campus in the past 7 days in 2021 decreased by 2.95%, 2.30% and 8.91%, respectively. However, the proportion of personnel who knew the school had organized tobacco control education decreased. Furthermore, school personnel who had received tobacco control education and agreed the school should strictly prohibit students from smoking (AOR=1.64; 95% CI: 1.25--2.15) were more likely to inform about the harm of tobacco to students. Those who had participated in tobacco control education activities or tobacco control trainings (AOR=1.87; 95% CI: 1.30--2.69) and believed that the school did not strictly prohibit either students (AOR=0.30; 95% CI: 0.22--0.41) or personnel (AOR=0.46; 95% CI: 0.36--0.59) from smoking were more inclined to stop students from smoking. CONCLUSIONS Compared with 2017, the rates of smoking and secondhand smoke exposure among school personnel decreased in 2021, but some schools still lacked comprehensive education on tobacco control behaviors for the staff. Enhancing the health literacy and strengthening tobacco control education among staff were effective strategies to encouraging their active adoption of tobacco control behaviors. [ABSTRACT FROM AUTHOR]

Background: Data literacy (DL) is vital for teachers, as it enables them to build on data and improve teaching and learning. Therefore, developing DL among pre‐service teachers is critical. Objectives: The purpose of this study is threefold: to evaluate whether a feedback visualisation of peer assessment‐based teaching approach (FVPA‐based teaching approach) can (1) promote pre‐service teachers' DL; (2) enhance their learning motivation; and (3) improve their cognitive load. Methods: The research was conducted based on a pre‐test‐post‐test control group quasi‐experimental design. With 20 participants in the experimental group and 21 in the control group, a total of 41 pre‐service teachers were included in the study. The pre‐service teachers in the experimental group adopted the FVPA‐based teaching approach, and those in the control group adopted the traditional peer assessment‐based learning approach. Results and Conclusions: The experimental group participants outperformed the control group participants in DL, learning motivation, and cognitive load. FVPA was conducive to helping pre‐service teachers critically interpret data, understand their teaching and learning issues, and improve self‐reflection. The findings indicate a reciprocal relationship between learning motivation and DL; improving the learning motivation of pre‐service teachers could promote their DL. Implications: This study contributes to current knowledge by providing empirical evidence on the benefits of an FVPA‐based teaching approach in improving pre‐service teachers' DL, motivation, and cognitive load. The study findings, limitations, and prospects for future research are discussed. Lay Description: What is already known about this topic?: Teacher data literacy has emerged as a crucial competency for the forthcoming generation of educators, gaining attention from education institutions globally.Peer assessment, a well‐established practice in pre‐service teacher education, has proven effective in enhancing the learning experience for disadvantaged students by fostering motivation and improving academic performance.Despite the acknowledged benefits of feedback visualisation in facilitating self‐reflection, motivation, and academic performance, creating meaningful visualisations remains a challenge for educators and learners. What this paper adds?: This study introduces feedback visualisation in peer assessment to enhance comprehension of feedback information among pre‐service teachers.Feedback visualisation augments the benefits derived from peer assessment, refining data literacy, improving learning motivation, and alleviating cognitive load among pre‐service educators.The analysis of data directly relevant to pre‐service teachers and the provision of timely feedback can motivate critical analysis and utilisation of data, facilitating the identification of pedagogical and learning challenges.The study explores intricate interactions among learning motivation, data literacy, and cognitive load within the context of peer assessment visual feedback. The implications of study findings for practitioners: We encourage teacher educators to implement peer assessment instruction grounded in visual feedback for a comprehensive understanding of learning outcomes, identification of pedagogical challenges, determination of causes, and evidence‐informed instructional decision‐making.Teacher educator should diversify strategies to augment the motivation of pre‐service teachers, cultivating their proactive engagement in data analysis, interpretation, and application to enhance overall data literacy.We recommend that teacher educators provide rich visual feedback or present complex data in a visually accessible format for pre‐service teachers who need additional assistance to mitigate cognitive load and facilitate successful learning outcomes. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that psychological needs frustration strongly influences adolescent depression. However, this influence's underlying mechanisms remain unknown, and related protective factors have not been identified. Based on an integration of basic psychological needs theory, the cognitive vulnerability model of depression, and findings regarding the link between psychological suzhi (a Chinese cultural construct that includes a hierarchical and integrated set of positive psychological qualities) and mental health, we assessed a structural equation model examining the mediating role of self-esteem and moderating role of psychological suzhi in the relationship between psychological needs frustration and depression. Participants were 1552 Chinese adolescents (Mage = 12.30, SD = 0.54, 49.10% male) who effectively completed paper-based questionnaires. The results indicated that psychological needs frustration significantly and positively predicted adolescent depression. Furthermore, the relationship between psychological needs frustration and depression was significantly mediated by self-esteem and significantly moderated by psychological suzhi; specifically, psychological suzhi buffered the association between psychological needs frustration and adolescents' depression. Additionally, we provide further evidence for the relationship between psychological needs frustration and depression, revealing the relevant underlying mechanisms and protective factors; these findings have practical relevance in the prevention and treatment of Chinese adolescents' depression. Highlights: Psychological needs frustration significantly and positively predicted adolescent depression. Self-esteem played a mediating role between psychological needs frustration and depression. Psychological suzhi played a moderating role in the association between psychological needs frustration and depression. [ABSTRACT FROM AUTHOR]

Background: Deep discussions play an important role in students' online learning. However, researchers have largely focused on engaging students in deep discussions in online asynchronous forums. Few studies have investigated how to promote deep discussion via mobile instant messaging (MIM). Objectives: In this study, we applied learning analytical tools (i.e., KBdeX and word clouds) to enhance students' shared epistemic agency and thereby support their deep discussions in MIM. Methods: Forty Chinese college students participated in this study and reflected on their MIM engagement by participating in the learning analytics (LA)‐augmented meta‐discourse sessions. The study used multiple data analysis methods, including content analysis, statistical analysis, epistemic network analysis and lag sequential analysis. Results: We found that LA engaged students in deep discussions and shared epistemic agency‐related discourse, such as creating shared understanding, creating knowledge objects, and projective and regulative processes. In particular, word clouds engaged students in more complete shared epistemic agency discourse trajectory which started from creating awareness of unknowns, then progressed to setting projective plans and sharing information, and ultimately, creating shared understanding. Moreover, our analysis indicated that epistemic agency discourse moves of creating shared understanding led students to a high level of deep discussion. Implications: This study contributes to research by extending the 'comparison paradigm', which focuses on comparing (a)synchronous forums with MIM, to a 'design paradigm', which mobilises design features from (a)synchronous forums to MIM and using learning analytical tools to engage students in deep online discussions by promoting their epistemic agency. Lay Description: What is known in this subject matter: Supporting students' online deep discussions is important.Prior studies have shown multiple technological and pedagogical strategies to support deep discussions in (a)synchronous discussion forums, but few studies in mobile instant messaging (MIM).MIM is a quasi‐synchronous tool. It is difficult to transform the traditional external scaffolds (i.e., scripts or teachers' facilitation) which promote deep discussions from (a)synchronous forums to MIM. What this paper adds to this: We constructed a design framework which used learning analytical tools‐augmented meta‐discourse to engage students in shared epistemic agency discourse moves to promote their deep discussion in MIM.We conducted multiple types of analyses (content analysis, statistical analysis, epistemic network analysis and lag sequential analysis) on students' WeChat message (a major MIM in China).Results indicated both learning analytical tools helped engage students in shared epistemic agency discourse moves, such as creating shared understanding, creating knowledge objects, projective and regulative, thus, to promote students' deep discussions. Word cloud especially engaged students in more complete shared epistemic agency discourse trajectory. Moreover, analysis results indicated that shared epistemic agency discourse moves of creating shared understanding would lead students to a high level of deep discussions. Implications of study findings for practitioners: Our study provides a feasible way to educational practitioners who want to promote students' deep discussions in their online learning course (both fully online and flipped classroom mode).Knowledge Building Discourse Explorer (KBDeX presents the original analysis results of students' written messages in discussion forums as socio‐cognitive networks.) could be implemented in the classroom. The objective is to encourage students to understand the importance of connecting with peers' ideas in a one‐session implementation period.If time allows, teachers could use word cloud and meta‐discourse to engage students in socio‐metacognitive conversations in class to promote their shared epistemic agency discourse in online discussions. [ABSTRACT FROM AUTHOR]

Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

The popularity of social networks turns them into a legal method for promoting a healthy lifestyle, which benefits not only people but also different countries' governments. This research paper aimed to examine the Keep fitness app integrated into WeChat, Weibo and QQ as regards long-term improvements in health-related behaviors (physical activity, nutrition, health responsibility, spiritual growth, interpersonal relationships and stress management) and assess the associated risk of increased social media addiction. Students from Lishui University in China (N  = 300) participated in this study, and they were formed into control and experimental groups. The Healthy Lifestyle Behavior Scale and Social Media Disorder Scale were used as psychometric instruments. The Keep app was found to improve respondents' scores on the parameters of physical activity, nutrition and health responsibility (P  = 0.00). However, the level of dependence on social media did not change in either the control or the experimental group during the year of research (P  ≥ 0.05). It is concluded that fitness apps can be an effective tool to promote healthy lifestyles among young people in China and other countries. The feasibility of government investment in fitness apps to promote healthy lifestyles is substantiated. [ABSTRACT FROM AUTHOR]

INTRODUCTION Healthcare workers are integral to public smoking cessation; however, their own smoking behavior can create a significant obstacle to intervening in patients' cessation efforts. Conversely, their success in quitting can enhance their ability to support patients. Research on smoking behavior, particularly smoking cessation among Chinese psychiatric professionals is limited. This study addresses this gap by examining the factors associated with smoking cessation in this population, providing insights for targeted tobacco control policies. METHODS A cross-sectional survey was conducted, targeting psychiatric professionals including psychiatrists and psychiatric nurses, in 41 tertiary psychiatric hospitals in China. From January to March 2021, a WeChat-based questionnaire was distributed to collect demographic, occupational, and health-behaviors (including smoking) data. Statistical analyses, including the chi-squared test and adjusted binary logistic regression analysis, were conducted to identify the factors associated with smoking cessation. RESULTS Among the 12762 psychiatric professionals who participated in the survey, 11104 (87.0%) were non-smokers, 1196 (9.4%) were current smokers, and 462 (3.6%) were ex-smokers. Several factors were found to be associated with smoking cessation. Women had a higher prevalence of ex-smokers than men (AOR=1.88; 95% CI: 1.332-2.666, p<0.001). Compared to East China, the prevalence of exsmokers among participants in Central and Northeast China was lower. Older age (≥50 years), higher level of education (Master's degree or higher), and non-drinkers, showed a higher likelihood of being ex-smokers. Notably, compared to current smokers, ex-smokers reported a lower prevalence of burnout (AOR=0.70; 95% CI: 0.552-0.892, p=0.004). CONCLUSIONS Smoking cessation interventions or health promotion programs should also focus on gender, age, education level, region, alcohol use, and burnout to effectively address smoking cessation within this specific professional group. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. METHODS Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. RESULTS The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). CONCLUSIONS Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers. [ABSTRACT FROM AUTHOR]

INTRODUCTION In recent years, e-cigarettes as an emerging tobacco product have been favored by college students. Our study aims to explore the factors affecting the use of e-cigarettes among college students and to put forward feasible suggestions for effectively controlling the use of e-cigarettes among college students. METHODS The participating students were from three undergraduate and three specialized colleges in Guangdong Province, surveyed from January to March 2022. The Fuzzy-set Qualitative Comparative Analysis (fsQCA) method was used to analyze the influence mechanism and path of five antecedents: self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, on the use of e-cigarettes. The fsQCA used in this study is a novel research methodology that combines the strengths of qualitative and quantitative analyses, through which we can determine which conditions are essential to the outcomes that lead to e-cigarette use among college students, and which combinations of conditions are more important than others. RESULTS The interaction of self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, affected college students' use of e-cigarettes. Through the fsQCA method, it was found that self-efficacy alone constitutes a necessary condition for college students not to use e-cigarettes. There are four possible pathways for college students not to use e-cigarettes, with higher self-efficacy, correct cognition, and a healthy social environment influencing the most important combination of conditions for college students to use e-cigarettes. CONCLUSIONS The use of e-cigarettes by students in Guangdong Province is the result of the synergistic effect of multiple factors. Tobacco control action suggestions focus on improving students' self-efficacy and paying attention to the combination of different factors to achieve more effective tobacco control. [ABSTRACT FROM AUTHOR]

INTRODUCTION Food delivery drivers represent a rapidly growing occupational group in China in recent years. Their unique work patterns such as a complex work environment and high time-pressure may subject them to more severe tobacco use issues compared to other professions. This study aims to investigate the prevalence of tobacco use within this group and examine the underlying reasons behind it. METHODS A cross-sectional, multistage sampling design was conducted to select 1879 food delivery riders from Guangzhou and Shenzhen. A self-administered questionnaire was used to collect the data from August to December 2022. Chi-squared analysis and binary logistic regression analysis, adjusted for factors including gender, education level, type of employment, alcohol use, job-related uncertainty stress, and emotional exhaustion, were used to explore the key factors associated with smoking among this occupational group. RESULTS Altogether, 65.5% of individuals in this sample were smokers, with 69.5% among males and 26.2% among females. Factors found to be significantly associated with smoking behavior were male sex (AOR=5.48; 95% CI: 3.74-8.02), education level of junior high school or lower (AOR=1.60; 95% CI: 1.21-2.11), education level of senior high school (AOR=1.52; 95% CI: 1.18-1.95), full-time job (AOR=1.39; 95% CI: 1.18-1.80), alcohol use (AOR=3.91; 95% CI: 3.14-4.87), moderate level of job-related uncertainty stress (AOR=0.58; 95% CI: 0.42-0.81), high level of emotional exhaustion (AOR=1.57; 95% CI: 1.17-2.10) and moderate level of emotional exhaustion (AOR=1.52; 95% CI: 1.00-2.30). CONCLUSIONS Demographic factors like gender, education level, job type, and substance use should be considered in designing smoking cessation campaigns for this group. Improving work conditions, reducing emotional exhaustion, and managing stress may also reduce smoking and enhance the well-being of these riders. [ABSTRACT FROM AUTHOR]

Background: In a context where synchronous online teaching has become a new trend of instruction for online education due to the COVID‐19 pandemic, it is valuable and insightful to examine what factors contribute to teachers' satisfaction with synchronous online teaching. Objective: Informed by the technology acceptance model (TAM), this study investigated English‐as‐a‐foreign‐language (EFL) university teachers' synchronous online teaching satisfaction in China from social (i.e., subjective norms), institutional (i.e., facilitating conditions), and individual (i.e., self‐efficacy, attitudes toward use, perceived usefulness, and perceived ease of use) levels during the COVID‐19 pandemic. Methods: A total of 250 in‐service EFL university teachers participated in this study. An online questionnaire was adaptively developed to measure teachers' perceptions of and satisfaction with synchronous online teaching. The structural equation modelling (i.e., path analyses) was performed to find out a model that can best represent EFL university teachers' synchronous online teaching satisfaction. Results and Conclusion: The results showed that facilitating conditions, self‐efficacy, attitudes toward use, and perceived usefulness are direct contributors to EFL university teachers' satisfaction with synchronous online teaching. Whereas, perceived ease of use, self‐efficacy, and subjective norms are indirect contributors through the mediation of attitudes toward use. Moreover, different from previous TAM research, facilitating conditions have been found to be the most significant direct factor positively contributing to satisfaction. The findings of this study are expected to shed light on how to enhance teachers' synchronous online teaching satisfaction. Lay Description: What is already known about this topic: The technology acceptance model (TAM) has been frequently adopted to examine teachers' acceptance of technology in various contexts over the last two decades.The TAM model identifies three key factors that contribute to people's intention of technology use: perceived usefulness, perceived ease of, and attitudes toward technology use.Although the TAM model has been extensively examined in various technology‐supported teaching contexts, there has been a lack of focus on livestream technology‐supported synchronous online teaching. What the paper adds: EFL university teachers' synchronous online teaching satisfaction during the COVID‐19 in China.Teachers' satisfaction with synchronous online teaching is a joint interplay of individual (i.e., self‐efficacy, attitudes toward use, perceived usefulness, and perceived ease of use), institutional (i.e., facilitating conditions), and social (i.e., subjective norms) factors.Facilitating conditions, self‐efficacy, attitudes toward use, and perceived usefulness are direct contributors, while perceived ease of use, self‐efficacy, and subjective norms are indirect contributors to teachers' synchronous online teaching satisfaction through the mediation of attitudes toward use.Different from previous TAM research, facilitating conditions have been found to be the most significant direct factor positively contributing to satisfaction. Implications for practice and/or policy: This study offers a diagnostic measure for schools and universities to understand the status quo of their teachers' perceptions of and satisfaction with synchronous online teaching.Universities are advised to provide teachers with readily accessible support and training to enhance their self‐efficacy for synchronous online teaching so that their satisfaction with synchronous online teaching can be strengthened. [ABSTRACT FROM AUTHOR]

Background: Integrating programming in K‐12 curriculum has become a global consensus. Teachers are central figures in programming instruction. But the majority of current research focuses on teachers' external teaching behaviours and less on teachers' attitudes towards programming. Objectives: The purpose of this study is to validate the K‐12 in‐service Teacher Programming Attitudes Scale (TPAS), to analyse teachers' programming attitudes and their differences in personal, teaching, and environmental factors, and further explore the predictive relationship. Methods: The sample is 888 K‐12 teachers from China. First, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted to validate the availability and reliability of TPAS; Second, independent sample t‐test and one‐way Analysis of Variance (ANOVA) were adopted to explain the differences. Finally, correlation analysis and linear regression analysis were adopted to verify the correlation and prediction relationship. Results and Conclusion: TPAS possess good reliability and validity (χ2/df = 2.488, RMSEA = 0.055, CFI = 0.943, TLI = 0.935, and IFI = 0.943). Further analysis found that, first of all, male teachers possess more positive programming attitudes than female teachers; second, young teachers who are under 30 and the length of teaching under 5 years possess more positive programming attitudes; thirdly, in addition to Information and Communication Technology teachers, primary science teachers also possess high programming attitudes, followed by teachers of Humanities and Arts, reflecting the potential of teaching programming in integrated subjects and the humanities. Finally, primary school teachers possess the best programming attitudes. With the growth of grade, teachers' enthusiasm for programming has gradually decreased. Additionally, discipline, grade and gender factors were considered to predict K‐12 teachers' programming attitudes. Implications: The results of this study contribute to integrating programming teaching of teachers and promoting programming education in K‐12 classrooms. Lay Description: What is already known about this topic:.Integrating programming in K‐12 curriculum has become the consensus for most countries.Teacher is one of the core figures of K‐12 programming teaching.There is currently less attention paid to teachers' attitudes towards programming.K‐12 teachers' programming attitudes measurement tool is needed to analyze the impact of various factors on teachers' programming attitudes. What this paper adds: The K‐12 teacher programming attitude scale (TPAS) is developed and validated.Male teachers and teachers under the age of 30 and under the length of teaching of five years possess more positive programming attitudes.Information and Communication Technology teachers and primary school Science teachers possess high programming attitudes.Discipline, grade and gender factors are considered to predict K‐12 teachers' programming attitudes. Implications for practice and/or policy: The K‐12 Teacher's Programming Attitude Scale (TPAS) fills the gap in measurements of teachers' programming attitudes.The study results provide the guidance for interdisciplinary programming teaching for K‐12 teachers. [ABSTRACT FROM AUTHOR]

The current study aimed to explore the protective factors and underlying mechanisms associated with loneliness and psychological distress among older Chinese adults within the framework of a longitudinal design. This investigation specifically focused on the mediating role of attitudes toward own aging (ATOA) in the relationship between social support and the experience of loneliness and psychological distress (comprising depression, anxiety, and stress) amidst the backdrop of the COVID-19 pandemic. A cohort of 345 elderly individuals (mean age = 83.84 years, standard deviation = 8.49 years; 55.1% females) participated in this research endeavor. The participants were required to complete self-report instruments measuring their perceived levels of social support at Time 1 (T1), attitudes towards own aging, ATOA at Time 2 (T2), and their experiences of loneliness, and psychological distress (including depression, anxiety, and stress) at T1 and Time 3 (T3). The data collection timeline encompassed baseline data collection at T1 in September 2020, a subsequent six-month follow-up at T2 in March 2021, and a one-year follow up at T3 in September 2021. The findings of this investigation unveiled a negative predictive relationship between social support at T1 and psychological distress (encompassing depression, anxiety, and stress) at T3. Furthermore, it was discerned that ATOA at T2 acted as a mediating mechanism, elucidating the longitudinal association between social support at T1 and the manifestation of loneliness and psychological distress (including depression, anxiety, and stress) at T3. The discussion section of this paper delves into an exploration of the limitations and implications inherent in these conclusions, particularly concerning their relevance to potential intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Disease-related knowledge deficits are common in Chinese immigrants living in Western countries, putting them at risk of disease progression and mortality, particularly those with a coronary heart disease (CHD) diagnosis. However, no measurement instrument is available to assess CHD-related knowledge in this population. Objectives: The aim of this study was to culturally adapt and examine the psychometric properties of the short version of Coronary Artery Disease Education Questionnaire (CADE-Q SV) (simplified Chinese version) in Chinese immigrants with CHD. Methods: Mandarin-speaking people recruited from medical centers and cardiology clinics across metropolitan Sydney completed the 20-item CADE-Q SV (5 domains; potential scores: 0-20). Internal consistency was assessed using Cronbach a. A subgroup (n = 40) repeated the survey 2 weeks later for test-retest reliability by intraclass correlation coefficient. Factor structure (confirmatory factor analysis) and discriminant (known-groups) validation using education and English proficiency (univariate general linear model) were also undertaken. Results: Participants (n = 202) had a mean (SD) age of 66.08 (10.93) years, 45.1% were male, and the mean (SD) total CADE-Q SV score was 13.07 (4.57). Reliability and consistency were good (intraclass correlation coefficient > 0.70; Cronbach a coefficients > 0.70, for total and per domain, respectively). The 5-domain structure was validated by confirmatory factor analysis. The scale demonstrated discriminant validity, with loweducation (P < .001) and lowEnglish proficiency (P = .017) associated with lower knowledge scores. Conclusion: The CADE-Q SV (simplified Chinese version) can be used as a valid and reliable instrument, either paper based or digital, to evaluate the CHD-related knowledge of Chinese immigrants. This scale can be adapted to other migrant populations in the future. [ABSTRACT FROM AUTHOR]