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Abstract Background Enhancing nursing undergraduates’ sense of coherence is crucial for the growth of the nursing workforce. Yet, existing research primarily examines the aggregate level of sense of coherence among nursing undergraduates and its correlations with other variables, overlooking the individual heterogeneity in nursing undergraduates’ sense of coherence in nursing. This study aimed to identify different subgroups of nursing undergraduates’ sense of coherence and explore the influencing factors pertinent to each subgroup. Methods A cross-sectional study was conducted from May to June 2020 among 1,251 nursing undergraduates using convenience sampling. Latent profile analysis was employed to identify subgroups of nursing undergraduates’ sense of coherence, and multiple logistic regression was utilized to analyze the factors associated with each subgroup. Results Four potential subtypes of nursing undergraduates’ sense of coherence were identified: low sensitivity-low coping group (25.7%), high sensitivity-high coping group (29.7%), moderate sensitivity-moderate coping group (17.8%), and high sensitivity-low coping group (26.8%). Multiple logistic regression analysis revealed that factors influencing nursing undergraduates’ sense of coherence included family financial situation, high school subject choice, religious beliefs, belief in having good interpersonal relationships, meaning in life, and professional identity. Conclusion The heterogeneity of nursing undergraduates’ sense of coherence suggests that nursing educators should provide targeted intervention guidance according to the potential category characteristics of nursing undergraduates’ sense of coherence; at the same time, they should strengthen the cultivation of nursing undergraduates’ meaning of life and professional identity to improve their level of sense of coherence, so as to promote the growth of the nursing workforce.

Abstract Background Since the outbreak of the Coronavirus Disease 2019 (COVID-19), front-line nurses have faced not only daily work stress but also a high risk of infection and excessive workload, leading to unsatisfactory professional quality of life (ProQOL). This study aimed to explore whether self-compassion (SC) and benefit finding (BF) play a chain mediating role between work stress and ProQOL among Chinese nurses during the COVID-19 pandemic. Methods From March to April 2022, a sample of 13,936 Chinese nurses was recruited through snowball sampling. Demographic information, work stress, SC, BF, and ProQOL were assessed. The SPSS 25.0 software and Amos 24.0 software were used for statistical analysis. The bootstrap method was employed to construct and examine the chain mediating structural equation model. Results The ProQOL level of Chinese nurses during the COVID-19 pandemic was moderate. The overall fit indices for the compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) models were satisfactory (χ²/df = 2.486, 3.256, 2.553, RMSEA = 0.011, 0.014, 0.011, the GFI, AGFI, NFI, and CFI values were all above 0.90). Work stress had direct effects on CS, BO, and STS (β=–0.171, 0.334, 0.222, P

Summary: Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p

Abstract Background Promoting patient participation stands as a global priority in nursing care. Currently, there is a lack of a standardized tool to assess the culture of patient participation from the perspective of nurses in China. Aims To translate and examine the validity and reliability of the Patient Participation Culture Tool for healthcare workers (PaCT-HCW) on general hospital wards in Chinese nursing context. Methods A cross-sectional research study was conducted among 812 nurses. Brislin's recommendations were adhered to during the translation of the scale. Validity was assessed using construct validity, content validity, and face validity. Split-half reliability, test–retest reliability, and internal consistency reliability were used to evaluate dependability. The study was guided and reported following the STROBE checklist and recommendations for reporting the results of studies of instrument and scale development and testing. Results The Chinese version of PaCT-HCW (the PaCT-HCW-C) exhibits good face validity and content validity. A rigorous exploratory factor analyse verified a six-factor (competence, support, perceived lack of time, information sharing and dialogue, response to questions and acceptance of a new role) scale structure with a cumulative variance contribution of the factors with 44 items of 68.840%. With a Cronbach's α coefficient of 0.962, split-half reliability of 0.866, and intraclass correlation coefficients of 0.989, the instrument demonstrates great reliability. Confirmatory factor analysis results validated the consistency of the six factors with the structure of the PaCT-HCW-C scale. Conclusions The 44-item PaCT-HCW-C is a valid and reliable instrument with satisfactory psychometric properties. It could serve as a tool for assessing the effectiveness of international programs aimed at fostering patient participation from the perspective of nurses, while also providing insights from China's practical experiences.

Abstract Background The caregiver contribution to self-care plays an important role in improving the health outcomes of chronic patients, which needs urgent attention. However, it has been hindered by the lack of a tailored instrument that assesses the caregiver contribution to self-care of stroke. Objectives To test the psychometric characteristics of the caregiver contribution to self-care of stroke Inventory (CC-SCSI) in health care practice. Methods Participants were recruited in Henan Province from March 2021 to October 2022, utilizing a multicenter stratified sampling approach. A 23-item self-report CC-SCSI with 3 separate scales measuring caregiver contribution to self-care maintenance of stroke, caregiver contribution to self-care monitoring of stroke and caregiver contribution to self-care management of stroke was tested for validity through discriminant validity, confirmatory factor analysis, concurrent validity and convergent validity. The reliability was tested by Cronbach’s α coefficient and test-retest reliability. Qualitative data were analysed using thematic analysis. A STROBE checklist was used. Results The three scales of the CC-SCSI exhibited good discriminant validity. Confirmatory factor analysis supported the three-factor structure of the Caregiver Contribution to Stroke Self-Care Maintenance and Management scales and the one-factor structure of the Caregiver Contribution to Stroke Self-Care Monitoring scale. The moderate correlation between the CC-SCSI and the Self-Care of Stroke Inventory indicated acceptable concurrent validity. The moderate correlation between the CC-SCSI and the Caregiver Contribution to Self-Care of Chronic Illness Inventory indicated acceptable convergent validity. Cronbach’s αs for the Caregiver Contribution to Self-Care Maintenance, Self-Care Monitoring, and Self-Care Management scales ranged from 0.876 to 0.974. Test-retest reliability showed average ICC values ranging from 0.828 to 0.903 (P

Abstract Background One factor that influences nursing students' decision to engage in volunteer activities is volunteer motivation. It is important to understand the motivations of nursing students to volunteer. However, the majority of current studies have concentrated on the present level of nursing students' motivation to volunteer. Objectives To identify subgroups of nursing students' volunteer motivation and its influential factors. Methods From January to February 2022, a cross-sectional online study was conducted, and 2569 nursing students from 10 provinces in China were recruited. Participants completed the General Information Questionnaire, Volunteer Functional Inventory (VFI), Perceived Stress Scale (PSS) and Perceived Social Support Scale (PSSS). We explore the categories and characteristics of volunteer motivation using latent profile analysis. Then, we determined factors that affect undergraduate nursing students' volunteer motivation using multinomial logistic regression. Results The volunteer motivation score of the nursing students was 77.65 (15.22). The study found that volunteer motivation could be divided into three categories: low-low protective volunteer motivation group (9.3%), general-high career values volunteer motivation group (37.5%), and high volunteer motivation group (53.2%). Perceived social support scale score, perceived stress scale score, gender, and grade significantly influenced the volunteer motivation of nursing students in different categories (both P

Abstract Background Promoting self‐care is the core response strategy of the global health system to the burden of stroke. Although self‐care in stroke represents a dyadic phenomenon, the dyadic self‐care experience of stroke survivors and their caregivers is often overlooked in clinical practice. Objectives The aim of this study was to explore the dyadic self‐care experience of stroke survivors and their caregivers. Design A descriptive qualitative design was used to conduct the study. Results The Consolidated Criteria for Reporting Qualitative Research was used for study reporting. A total of 21 stroke survivor–caregiver dyads were recruited for this study between May 2022 and September 2022. Data were collected through semistructured interviews and analyzed using thematic analysis. In this study, four themes were identified: (1) poor relationship quality of the dyads, (2) dyadic incongruence in managing stroke, (3) a slow and tiring dyadic self‐care process and (4) happy cooperation in coping with dyadic self‐care. Discussion and Conclusion Healthcare professionals should give greater consideration to the contradictions and disparities that may arise between stroke survivors and caregivers during the self‐care process. It is crucial for them to provide personalized and tailored support and interventions that can assist these individuals in achieving a more optimal balance in their dyadic self‐care. Patient/Public Contribution Patients were involved in the formulation of interview questions for this study. No members of the public were involved in this study.

Abstract Background Compassion is closely linked to psychological well-being, and several assessment tools have been developed and studied to assess the level of compassion in different populations and for more precise measurement. There is currently a scarcity of comprehensive knowledge about compassion-related assessment tools, and our research provides an overview of these tools. Aims To identify scales used to measure compassion from different flows, and to assess their measurement properties and quality. Methods Focusing on compassion assessment tools, the authors conducted a thorough search of 10 Chinese and English databases from their establishment until August 14, 2022. Data extracted included the author, year, country, objectives, target population, as well as the primary evaluation content. Using the COSMIN checklist, the methodological quality and measurement properties of the included studies were appraised. This scoping review was registered with the Open Science Framework and followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. Results There were 15,965 papers searched, and 36 compassion-related measurement tools were identified in this study. None of the 36 studies provided possessed all nine psychometric properties, as outlined by the COSMIN criteria. On the basis of a systematic evaluation of quality, measurement qualities were ranked. The results for internal consistency and content validity were relatively favorable, whereas the results for structural validity were variable and the results for the remaining attributes were either uncertain or negative. A Venn diagram was used to illustrate the overlapping groups of compassion measurement tools based on the three-way flow of compassion. An overview of the reference instrument and theoretical basis for the included studies was provided, and half of them did not contain any theoretical or scale-based evidence. Conclusion In this study, 36 compassion-related measuring instruments were identified, and the methodological quality and measurement properties of the included studies were acceptable. The included measurements were consistent with flows of compassion. A further focus of further research should be on developing theories in the compassion domain and developing instruments for measuring compassion that are multidimensional, multi-populations, and culturally relevant.

Abstract Background One factor that influences nursing students' decision to pursue a nursing career is professional calling. It is important to comprehend nursing students' professional calling, which may have an impact on their career choice and career development. Objectives To investigate possible calling types and contributing variables among nursing students. Design Cross-sectional descriptive study. Participants A total of 10,583 nursing students were enrolled in this survey. Methods From November 16th, 2022, to January 17th, 2023, a cross-sectional study was carried out among nursing students using a convenient sampling. The subjects were given the Chinese Calling Scale and the General Demographic Information Questionnaire. Latent profile analysis (LPA) was used to separate nursing students' professional calling into a variety of subgroups. To find the variables connected to the prospective calling categories, we used ordinal and multinomial Logistic regression analysis. Results Respondents were divided into three calling groups, low (N = 3204), moderate (N = 4492), and high calling group (N = 2887), which accounted for 30.3%, 42.4%, and 27.3% of the total respondents, respectively, in accordance with the findings of the latent profile analysis. Across scale scores and dimensions for the three separate categories, three groups demonstrated statistically significant differences (both p

Abstract The associations of physical activity (PA) intensity and types with CVD (cardiovascular diseases) in different population are inconsistent and remains not very clear. A total of 7854 males and 10,876 females over 15 years were selected by multistage random sampling methods. In males, moderate-intensity physical activity (MPA) had no effect, while vigorous-intensity physical activity (VPA) played a significant protective role (OR = 1.319 and 0.615). However, in females, both MPA and VPA had significant protective effects (OR = 0.593 and 0.537). VPA presented as a significant protective factor in stroke patients and combined CVDs for males in all age groups; however, in females, the results suggested that, for those aged over 60–74 years, MPA was a protective factor. Furthermore, for the middle-aged or younger participants, the area under the curves (AUCs) of work, housework, and leisure activity were generally higher than that of other types, while for patients aged over 60 years, the AUCs of sedentary time and sleep activity seemed much higher. VPA had a better protective effect for preventing cardiovascular events, while the young and female population could benefit from MPA as well. Regardless of the types of PA, leisure activities were strongly recommended, and young people were much more likely to benefit from exercise than older people.

Abstract Background Meaning in life, defined by an individual’s understanding and appreciation of life, is a vital aspect of a positive psychological state, that has a significant influence on physical and mental health. Therefore, improving the sense of meaning in life among nursing students has emerged as a crucial concern in nursing education. This study aimed to clarify the profiles and influencing factors of meaning in life among nursing students. Methods A descriptive cross-sectional online survey was conducted among nursing students in China from November 16, 2022, to January 17, 2023. The demographic information questionnaire and the meaning in life questionnaire (MLQ) were used to collect data. Latent profile analysis (LPA) was used to identify groups exhibiting distinct levels of meaning in life. Additionally, univariate analysis and multinominal logistic regression analysis were used to investigate the factors influencing each group. The reporting of this study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results A total of 10,583 valid responses were received, and the analysis revealed four distinct profiles. The profiles identified were the medium meaning group (C1, 41.4%), medium fluctuation meaning-no motivation group (C2, 8.7%), lower meaning group (C3, 9.7%), and higher meaning group (C4, 40.2%). The univariate analysis revealed that age, gender, ethnicity, marital status, educational level, grade, university classification, student leadership experience, and political affiliation were factors that influenced the four latent profiles (P

Abstract Aims To investigate the relationship between stroke survivors' perceptions of recurrence risk, coping styles and depression state, and the role coping styles play in mediating that relationship. Design A cross‐sectional descriptive study. Methods From one hospital in Huaxian, China, 320 stroke survivors were randomly selected as a convenience sample. In this research, the Simplified Coping Style Questionnaire, the Patient Health Questionnaire‐9 and the Stroke Recurrence Risk Perception Scale were all used. Structural equation modelling and correlation analysis were used to analyse the data. This research followed the EQUATOR and STROBE checklists. Results There were 278 valid survey responses. There were mild to severe depressive symptoms in 84.8% of stroke survivors. In stroke survivors, there was a significant negative relationship (p

Abstract Background Multimorbidity has a significant impact on public health and primary care. Medication adherence is recognized as the most effective measure for managing and preventing multimorbidity. Studies have shown that medication literacy has a positive effect on medication adherence in patients with multimorbidity. However, limited knowledge exists regarding the underlying mechanisms of this relationship in older adults with multimorbidity. Therefore, the aim of this study was to investigate the mediating role of self-efficacy in the association between medication literacy and medication adherence in this population. Methods This study employed a cross-sectional design and convenience sampling method to survey older patients with multimorbidity in six communities in Zhengzhou, China, from July 12, 2021, to December 15, 2021. Participants were assessed using a demographic questionnaire, the Chinese Version of the Medication Literacy Scale (C-MLS), the Self-Efficacy for Appropriate Medication Use Scale (SEAMS), and the Chinese Version of the Morisky Medication Adherence Scale-8 (C-MMAS-8). Data were analyzed using descriptive statistics, t-tests, one-way analysis of variance, Pearson correlation analysis, and mediation analysis. Results A total of 350 elderly patients met the inclusion criteria, and 328 valid questionnaires were collected. The mean age of the participants was 74.90 ± 7.37 years, with a slightly higher proportion of males (55.8%) than females (44.2%). The mean score for medication adherence was 4.85 ± 1.57, indicating poor medication adherence among the participants. Medication adherence scores varied significantly among participants of different ages, education levels, employment statuses and kinds of medication (p

Introduction The promotion of self-care has begun to serve as a central response strategy to the rising burden of stroke. In fact, stroke self-care can be recognised to be a dyad phenomenon having an effect on the health of stroke survivors and their caregivers. While studies have confirmed the effectiveness of smartphone-based interventions in improving self-care among stroke survivors, there remains a lack of evidence specifically regarding dyadic self-care interventions for both patients and caregivers.Aim The present single-blinded, two-arm, randomised controlled trial aims to verify the effectiveness of a smartphone-enabled dyadic self-care programme (SDSCP) for stroke survivors and their caregivers.Methods and analysis The estimated sample size is 152 stroke survivor–caregiver dyads. The participants will be randomly classified (1:1) into either a control (N=76) or an experimental group (N=76) through block randomisation. The participants classified into the experimental group will be provided with SDSCP, and during the initial home visit, the research team members will provide instructions to all patients and caregivers on how to download and use the smartphone application. While the participants in the control group will be given the existing stroke standard care. The main outcome measures of stroke survivors will consist of the Self-Care of Stroke Inventory and a short version of the Stroke Specific Quality of Life Scale. The outcome measures of stroke caregivers will primarily cover the Caregiver Contribution to Self-Care of Stroke Inventory and Zarit burden interview. The data of this study will be collected at three time points, including baseline, 1 month and 6 months from the baseline.Ethics and dissemination This study has been approved by the Ethics Committee of Zhengzhou University (ZZUIRB 2021–115) in January 2021. The results achieved in this study will facilitate the clinical practice to improve self-care of stroke survivors and promote dyadic health outcomes for stroke patients and caregivers.Trial registration number The study was registered with the Chinese Clinical Trial Registry and the registration number is ChiCTR2100053591.

Nudge theory is an emerging behavioral intervention theory based on behavioral economics and positive psychology, which has been widely used and proven effective in chronic disease self-management abroad. Compared with traditional intervention methods for chronic disease self-management, nudge theory-based intervention program possesses stronger generalization owing to lower requirements for patients' knowledge and attitude regarding chronic disease self-management without interfering with their freedom of choice. We introduced the concept, mechanism of action and classification of nudge theory, and reviewed the advances in its application in chronic disease self-management from four aspects: symptom monitoring, diet control, physical exercise, and medication adherence. On this basis, we put forward the following recommendations to ensure the effectiveness of nudge theory-based interventions: developing nudge theory-based intervention programs targeting the barriers to chronic disease self-management, delivering different types of interventions to different patients using digital technology as a method for classifying the intervention program, having close contact with the community during the intervention, and strengthening the supervision of relevant departments.

Active implementation of patient-centered polypharmacy management for older adults with multimorbidity can help to identify and correct the medication errors that patients may have, avoid the occurrence of potential medication errors, reduce and control the development of drug-related diseases, improve the clinical treatment effect, and delay the disease progression, thereby facilitating the achievement of targets for disease control, and improvement of quality of life of patients. In the light of problems of polypharmacy in Chinese elderly patients with multimorbidity, we summarized relevant interventions including strengthening top-level design of management, building multidisciplinary teams, innovating medication management technologies, and meeting patients'needs of drug information, providing a reference for medication management of these patients. We found that problems of polypharmacy in Chinese elderly patients are serious, and actively exploring multiple approaches to polypharmacy management based on medication features of these patients may be a key breakthrough for addressing the problems.

Background The modern lifestyle trend of pet ownership is undoubtedly beneficial for both physical and mental health. Research has shown a connection between pet ownership and staff self-compassion. However, there has not been any evidence linking pet ownership to self-compassion in the nurse population. Aims To investigate the current status of pet ownership among nurses and explore the influence of pet ownership on self-compassion among nurses. Methods An online survey was conducted in July 2022 with 1,308 nurses in China. Data were collected using a general information questionnaire and a self-compassion scale. To compare categorical variables, the independent t test, one-way ANOVA, and multiple linear regression analysis were utilized. SPSS software was used for the statistical analysis. Results We found that 16.9% of nurses owned at least one pet, and dogs and cats were the primary pets. The t test for independent samples showed that pet owners and non-pet owners scored differently on self-compassion (t = 3.286, p = 0.001), self-kindness (t = 3.378, p = 0.001), common humanity (t = 2.419, p = 0.016), and mindfulness (t = 2.246, p = 0.025). One-way ANOVA revealed that the highest degree was an influencing factor of self-compassion (χ2 = 1.386, p = 0.019). Multiple linear regression showed that average monthly income, pet ownership, and highest degree were the factors that influenced self-compassion most significantly (F = 8.335, p

Abstract Background Self-efficacy is a significant predictor of return to work and affects the confidence of survivors to return to work after illness. The Return-to-work self-efficacy (RTW-SE) questionnaire is a self-report questionnaire to assess confidence in returning to work with good reliability and validity. The aim of this study was to translate and cross-culturally adapt the RTW-SE questionnaire into Chinese and examine the psychometric properties among young and middle-aged stroke survivors using Rasch model analysis. Methods The cross-cultural adaptation and translation procedures followed a dual-translation approach. The psychometric properties of the RTW-SE questionnaire were examined using Rasch model analysis by Winsteps software. The unidimensionality and local independence were analyzed by principal component analysis of the residuals (PCAR) and standardized residual correlations.Category diagnostics were performed for scale function, and the item fit, reliability, and separation were also validated. Item-person maps were used to examine the distribution and matching of item’s location and person ability. Finally, the differential item functioning (DIF) was used to measure gender-related group equivalence. Results A total of 366 participants aged 23–59 years were recruited from three communities in Zhengzhou. The RTW-SE questionnaire demonstrated unidimensionality and a 5-point Likert rating scale was more appropriate to investigate young and middle-aged stroke survivors’self-efficacy. There was a good fit for the items with both person and item reliabilities greater than 0.8 and separation indices of 3.75 and 3.94, respectively. The item location was identified from the item-person map as not covering person ability, but the scale did not have an age-related DIF. Conclusions The results confirm evidence of appropriate psychometric properties of the RTW-SE questionnaire and can be used as a reliable and validated instrument for measuring self-efficacy to return to work in young and middle-aged Chinese patients with stroke.

Abstract Background Among stroke survivors, the risk of stroke recurrence is high, and stroke survivors' perception of the risk of recurrence is crucial to promote healthy behaviours. Objectives This study aimed to explore the perceptions of stroke survivors about their risk of recurrence and healthy behavioural modifications. Design A qualitative interview study was carried out. Results We interviewed 19 stroke survivors from 3 hospitals. Thematic analysis showed that the perceptions of recurrence risk and healthy behavioural changes differed between first‐ever and recurrent stroke survivors. Three themes were generated from the data of first‐ever stroke survivors: indifference to and unawareness of the risk of stroke recurrence, the need for professional information support and different awareness of the importance of different healthy behaviours. For first‐relapse stroke patients: worry but feel powerlessness towards recurrent event, accurate information is still warranted, regret of unhealthy behaviour patterns. For the survivors suffered two or more times recurrences: perceived severity of recurrences, increased psychological care need, incorrect perceptions of healthy behaviour. Discussion and Conclusion Stroke survivors with or without recurrence hold different perceptions towards the risk of recurrence and behavioural changes. The need for information related to warning signs, recurrence risk and risk factors remained consistently unmet. The benefits of healthy behaviours could be a double‐edged sword for the prevention of stroke recurrence if the survivors fail to understand these accurately. It is strongly recommended that a specific recurrence risk communication tool and related health education plan be explored on the basis of the number of times patients have experienced stroke recurrence to inform secondary prevention of stroke in the future. Patient/Public Contribution The patients were involved in the formulation of interview questions and conduct of this study. No public was involved in this study.

BackgroundThe outbreak of the new coronavirus-2019 (COVID-19) has had a significant impact on people's mental and physical health. Meanwhile, people's perceptions of risk may influence their emotional states and preventative behavior during an epidemic. Previous research have revealed the diversity and uniqueness of risk perception, and college students may have a different perspective on risk perception. The objective of this study was to describe the subtypes of risk perception for COVID-19 among college students in China, identify the subtypes' traits, and investigate their affecting variables.MethodsCollege students from 10 Chinese provinces participated in a cross-sectional study (n = 2,000) that from January 16 to 30, 2022. The latent profiles and influencing factors for risk perception were investigated using latent profile analysis, one-way analysis of variance, and multinomial logistical regression.ResultsThe sample group of this survey was 1,946 students, and the response rate was 97.3%. The best model was suggested to consist of three profiles: “neutral risk perception” (20.3%), “perception seriously without susceptible” (52.8%), and “low risk perception” (26.9%). Risk perception of COVID-19 was positively associated with attention to negation information (r = 0.372, p < 0.01), anxiety (r = 0.232, p < 0.01), and depression (r = 0.241, p < 0.01), and negatively associated with perceived social support (r = −0.151, p < 0.01). Logistic-regressions analyses mainly revealed that the risk perception of three profiles related to having chronic diseases (OR = 2.704, p < 0.01), medical major (OR = 0.595, p < 0.01; OR = 0.614, p < 0.05), without having COVID-19 confirmed cases around (OR = 0.539, p < 0.01), attention to negative information (OR = 1.073, p < 0.001; OR = 1.092, p < 0.001), and perceived social support (OR = 0.0.975, p < 0.01).ConclusionsThe level of risk perception for COVID-19 among Chinese college students was unsatisfactory, and the risk perception of COVID-19 had significant group characteristics and heterogeneity. Colleges and public health practitioners could have a theoretical and empirical basis to implement risk perception intervention efforts by identifying latent subgroups during the COVID-19 epidemic.

Introduction The global burden caused by stroke is shifting to young and middle-aged people. Researchers have emphasised the significance of benefit finding (BF) in psychological health. However, current research has paid little attention to stroke and has discussed BF from only a single perspective, that is, that of either patients or caregivers. Our study aims to understand the changing trajectory, predictors and dyadic interaction of BF in dyads of patient who had a stroke and caregiver.Methods and analysis This study is a longitudinal mixed-methods, multicentre study. A total of 142 patients who had a stroke and 142 spousal caregivers will be investigated. Participants will be recruited from four large public hospitals in northern China. Quantitative and qualitative data will be collected at five time points (near discharge and 1, 3, 6 and 12 months following discharge). Validated and reliable questionnaires will be used in quantitative studies. Information on sociodemographic data, BF, functional status, perceived stress, coping styles and mutuality will be collected from the dyads. Qualitative data will be collected via semistructured interviews and observations. The growth mixture model will be used to analyse quantitative data, and Colaizzi’s seven-step analysis method will be used to analyse qualitative data. We plan to conduct parallel but separate quantitative and qualitative data analyses and ultimately integrate the data sets to determine confirmation, expansion or discordance.Ethics and dissemination All participants will be provided with an informed consent form. This study will encode all identifiable data and store all recorded data on a secure research server. This study has been approved by the Ethics Review Committee of the College of Nursing and Health, Zhengzhou University (ZZUIRB2020-53). The results of the longitudinal study will be published in peer-reviewed journals and presented at national conferences.Trial registration number ChiCTR2000039509.

Background The velvet antler is a complex mammalian bone organ with unique biological characteristics, such as regeneration. The rapid growth stage (RGS) is a special period in the regeneration process of velvet antler. Methods To elucidate the functions of microRNAs (miRNAs) at the RGS of antler development in Gansu red deer (Cervus elaphus kansuensis), we used RNA sequencing (RNA-seq) to analyze miRNA expression profiles in cartilage tissues of deer antler tips at three different growth stages. Results The RNA-seq results revealed 1,073 known and 204 novel miRNAs, including 1,207, 1,242, and 1,204 from 30-, 60-, and 90-d antler cartilage tissues, respectively. To identify key miRNAs controlling rapid antler growth, we predicted target genes of screened 25 differentially expressed miRNAs (DEMs) and specifically expressed miRNAs (SEMs) in 60 d and annotated their functions. The KEGG results revealed that target genes of 25 DEMs and 30 SEMs were highly classified in the “Metabolic pathways”, “Pathways in cancer”, “Proteoglycans in cancer” and “PI3K-Akt signaling pathway”. In addition, a novel miRNA (CM008039.1_315920), highly enriched in “NF-kappa B signaling pathway”, may need further study. Conclusions The miRNAs identified in our study are potentially important in rapid antler growth. Our findings provide new insights to help elucidate the miRNA-mediated regulatory mechanisms involved during velvet antler development in C. elaphus kansuensis.

Abstract Background In the long-term use of multiple medications for elderly patients diagnosed with chronic diseases, medication problems are prominent, which seriously reduces their quality of life. The burden of medications of patients critically affects their medication beliefs, behaviors and disease outcomes. It may be a solution to stress the burden of medications of patients. Its medication issues develops a novel perspective. The present study aimed to exploit the Chinese version of Living with Medicines Questionnaire-3(C-LMQ-3) to quantify the medicines burden of elderly patients diagnosed with chronic diseases in China, and evaluate the relevant demographic characteristics of sub-populations with high medicines burden. Methods The survey was distributed to elderly patients aged ≥ 60 years with chronic disease by using ≥ 5 medicines, C-LMQ-3 scores and domain scores were compared by the characteristics of elderly patients by employing descriptive statistics and performing statistical tests. Results On the whole, 430 responses were analyzed, and the participants were aged between 60 and 91 years, with the average age of 73.57 years (SD: 7.87). Most of the responses were female (61.7 %) with middle school education (38.5 %). Moreover, 54.1 % of the participants lived with spouse only, 16.2 % had both spouse and children, and 10.0 % lived alone. As indicated from regression analysis, higher C-LMQ-3 scores were associated with those who were with low education level, 60–69 years-old, using ≥ 11 medicines, using medicines ≥ 3 times a day, income per month (RMB) ≤ 3000, and who having higher monthly self-paid medication (RMB) ≥ 300 (p

Abstract Background Respect for patients’ autonomy is usually considered to be an important ethical principle in Western countries; privacy is one of the implications of such respect. Healthcare professionals frequently encounter ethical dilemmas during their practice. The past few decades have seen an increased use of courts to resolve intractable ethical dilemmas across both the developed and the developing world. However, Chinese and American bioethics differ largely due to the influence of Chinese Confucianism and Western religions, respectively, and there is a dearth of comparative studies that explore cases of ethical dilemmas between China and the United States. Methods This paper discusses four typical cases with significant social impact. First, it compares two cases concerning patient privacy: the “Shihezi University Hospital Case”, in which a patient was used as a clinical teaching object without her permission, and the “New York-Presbyterian Hospital Case”, in which the hospital allowed the filming of a patient’s treatment without his consent. Second, it compares two cases regarding patient autonomy and potentially life-saving medical procedures: the “Case of Ms. L”, concerning a cohabitant’s refusal to sign a consent form for a pregnant woman’s caesarean, and the “Case of Mrs. V”, concerning a hospital’s insistence upon a blood transfusion for a dissenting patient. This paper introduces the supporting and opposing views for each case and discusses their social impact. It then compares and analyses the differences between China and the United States from cultural and legislative perspectives. Conclusions Ethical dilemmas have often occurred in China due to the late development of bioethics. However, the presence of bioethics earlier in the US than in China has not spared the US of ethical dilemmas. This paper highlights lessons and inspiration from the cases for healthcare professionals and introduces readers to the role and weight of privacy and autonomy in China and in the US from the perspectives of different cultures, religions and laws.

BackgroundsThere were conflicting results on the comparison of brain-derived neurotrophic factor (BDNF) levels between poststroke depression (PSD) patients and stroke patients without PSD among previous studies. Thus, we conducted this systemic review and meta-analysis to explore the alteration of serum BDNF levels in PSD.MethodsThis study included articles from the Web of Science and PubMed databases that were published before December 2021. STATA 12.0 software was used to compute the standardized mean difference (SMD) and 95% confidence interval (CI) regarding the comparison of serum BDNF in PSD and stroke patients without PSD.ResultsWe collected the mean value and standard deviation (SD) of serum BDNF in PSD and stroke patients without PSD from six studies (PSD: n = 268, stroke patients without PSD: n = 425). The present meta-analysis showed decreased serum BDNF level in patients with PSD, compared to stroke patients without PSD with a random-effects model (mean value of BDNF level [PSD vs. stroke patients without PSD]: 14.106 vs. 17.995 ng/ml; SMD = –1.578; 95% CI: –2.820, –0.337; I2 = 97.8%, p-value for Q test < 0.001).ConclusionBrain-derived neurotrophic factor may work as a potential biomarker to predict the risk of PSD among stroke survivors. More large-sample clinical trials exploring the alteration of serum BDNF levels in PSD among stroke patients need to be conducted to verify this result.

Objective The aim of this study was to assess the reliability and validity of the Chinese version of the Family Resilience (FaRE) Questionnaire among patients with breast cancer in China.Design It was a cross-sectional study, which involved translation, back-translation, cultural adjustment and psychometric testing of a 24-item FaRE Questionnaire.Setting Three tertiary hospitals in Zhengzhou, China: respectively are the First Affiliated Hospital of Zhengzhou University, Second Hospital Affiliated to Zhengzhou University and Henan Provincial People’s hospital.Participants A total of 559 patients with breast cancer volunteered to participate in the studyPrimary outcome measures Data analysis was performed using the IBM SPSS software V.21.0 and AMOS software V.21.0. Cronbach’s α coefficient was used to examine the internal consistency. The test–retest reliability was calculated using the intraclass correlation coefficient on 30 participants. The content validity index was calculated based on the values obtained from six expert opinions. Construct validity test was performed using factor analysis including exploratory factor analysis and confirmatory factor analysis.Results For the Chinese version of FaRE Questionnaire, the Cronbach’s α coefficient of the total questionnaire was 0.909, and Cronbach’s α coefficients of four factors were 0.902, 0.932, 0.905 and 0.963, respectively. The test–retest reliability index of the total questionnaire was 0.905. The Scale-Content Validity Index was 0.97, and Item-Content Validity Index ranged from 0.83 to 1.00. The questionnaire included 24 items, exploratory factor analysis extracted four factors with loading >0.4, which could explain 72.146% of the total variance. Confirmatory factor analysis showed the Chinese version of FaRE Questionnaire had an excellent four-factor model consistent with the original questionnaire.Conclusion The Chinese version of FaRE Questionnaire has acceptable reliability and validity among patients with breast cancer in China. It can effectively assess family resilience and provide basis for personalised family resilience interventions for patients with breast cancer.

Introduction Stroke is known as one of the leading causes of mortality and disability worldwide. Self-care plays a significant role in improving the quality of life, self-efficacy and many other outcomes of stroke survivors. However, it is a dyadic phenomenon where patient self-care and the caregiver contribution to self-care are inter-related in terms of predictors and outcomes. Currently, there is still no systematic assessment conducted to examine the overall effectiveness of self-care interventions carried out in stroke survivor–caregiver dyads and explore the effect on stroke survivor and/or caregiver outcomes.Methods We plan to conduct a systematic review and meta-analysis of the evidence regarding the self-care interventions carried out in stroke survivor–caregiver dyads. We will undertake a systematic search of multiple databases including PubMed, Web of Science, CINAHL, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials and four Chinese databases (CNKI, CBM, WANFANG and VIP) from inception to July 2021 for the purpose of collecting the relevant articles. The eligible studies are defined as those original researches, written in English or Chinese, on self-care interventions in stroke survivor–caregiver dyad samples. Two independent researchers will be deployed to identify the eligible trials according to the selection criteria and extract the relevant data. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist has been used for this protocol. We will use the Cochrane Risk for Bias tool to assess the risk of bias for randomised controlled trials.Ethics and dissemination In our review, any identifiable patient data will be excluded, which removes the need for ethical approval and participant consent. The final results of our study will be published in an open-access peer-reviewed journal, and abstract will be presented at suitable national/international conferences.PROSPERO registration number CRD42021239824.

The velvet antler is a unique model for cancer and regeneration research due to its periodic regeneration and rapid growth. Antler growth is mainly triggered by the growth center located in its tip, which consists of velvet skin, mesenchyme and cartilage. Among them, cartilage accounts for most of the growth center. We performed an integrative analysis of the antler cartilage transcriptome and proteome at different antler growth stages. RNA-seq results revealed 24,778 unigenes, 19,243 known protein-coding genes, and 5535 new predicted genes. Of these, 2722 were detected with differential expression patterns among 30 d, 60 d, and 90 d libraries, and 488 differentially expressed genes (DEGs) were screened at 30 d vs. 60 d and 60 d vs. 90 d but not at 30 d vs. 90 d. Proteomic data identified 1361 known proteins and 179 predicted novel proteins. Comparative analyses showed 382 differentially expressed proteins (DEPs), of which 16 had differential expression levels at 30 d vs. 60 d and 60 d vs. 90 d but not at 30 d vs. 90 d. An integrated analysis conducted for DEGs and DEPs showed that gene13546 and its coding protein protein13546 annotated in the Wnt signaling pathway may possess important bio-logical functions in rapid antler growth. This study provides in-depth characterization of candidate genes and proteins, providing further insights into the molecular mechanisms controlling antler development.

This study aimed to explore the relationship between intrusive and deliberate rumination, to identify distinct trajectories of intrusive and deliberate rumination, and to examine their predictors in young and middle-aged stroke survivors. This study employed a longitudinal design in which 200 young and middle-aged stroke survivors were investigated at 1-week pre-discharge (T0), 1 month (T1), 3 months (T2), and 6 months (T3) post-discharge. The Event-Related Rumination Inventory, Simplified Coping Style Questionnaire, and Perceived Social Support Scale were used for data collection. The results showed that intrusive rumination was positively correlated with deliberate rumination at T0 and T1, and negatively correlated with deliberate rumination at T3. Growth mixture modeling identified three classes of intrusive rumination: Stable-low, Declined, and Elevated group, and two classes of deliberate rumination: High-level and Low-level group. Furthermore, number of children or dysfunctions, type of stroke, family history of stroke, negative coping, and social support were found to predict intrusive rumination. These findings can help healthcare providers timely intervene on survivors in the Elevated and Stable-low intrusive rumination groups, and the Low-level deliberate rumination group. [ABSTRACT FROM AUTHOR]

Abstract Background The onset of deep vein thrombosis (DVT) in patients after total hip arthroplasty (THA) may expand or enlarge and subsequently lead to significant mortality. The objective of this study was to investigate potential risk factors for DVT in patients after THA. Methods Eligible patients with hip joint diseases who were scheduled for unilateral primary THA at our hospital were prospectively included into this study. The demographic and clinical features, preoperative plasma biomarkers were detailed, recorded, and compared. The multiple logistic regression analysis was used to evaluate potential risk factors for DVT. Results A total of 214 subjects were enrolled into our study cohort for the final analysis, and 23 of them have suffered DVT with an incidence of 9.5%. The performance of logistic regression analysis showed that preoperative expression of plasminogen activator inhibitor-1 (PAI-1) was an independent risk factor for the onset of DVT in patients after THA (OR 1.18, 95% CI 1.04–1.29; p = 0.011). Conclusions Our study indicated preoperative plasma PAI-1 expression as an independent risk factor for DVT in patients who underwent THA.

The gravel packing completion method for horizontal wells has the advantages of maintaining high oil production for a long time, maintaining wellbore stability, and preventing sand production, so it has become the preferred completion method for horizontal wells. At present, this technology still faces the problems of high sand bed height and poor gravel migration. In order to improve the efficiency of gravel packing in horizontal wells, pulsed gravel packing technology for horizontal wells is proposed for the first time. Based on the mechanism of hydraulic pulse, the Eulerian–Eulerian model, k-ε model based on the renormalization group theory (RNG k-ε model), and Fluent are used to simulate the solid-liquid two-phase flow. By optimizing the parameters such as frequency and amplitude of pulse waveform, the optimal pulse waveform of pulsed gravel packing in horizontal wells is determined. The effects of parameters such as sand-carrying fluid displacement, sand-carrying fluid viscosity, sand-carrying ratio, gravel particle size, and string eccentricity on pulsed gravel packing in horizontal wells are studied, and the distribution law of gravel migration velocity and volume fraction in horizontal wells is obtained. According to the results, it can be seen that with the increase of displacement and viscosity of carrier fluid, the volume fraction of fixed bed and moving bed decreases gradually, while that of suspension bed increases gradually. With the increase of sand-carrying ratio, gravel particle size, and string eccentricity, the volume fraction of fixed bed and moving bed increases gradually, while that of suspended bed decreases gradually. Comparing the effects of conventional gravel packing and pulsed gravel packing in horizontal wells, it can be concluded that the efficiency of pulsed gravel packing in horizontal wells is higher. The volume fraction of fixed bed and moving bed decreased by 30% and 40% respectively, while the volume fraction of suspended bed increased by 20%. The migration velocity of moving bed and suspended bed increased by 40% and 25%, respectively, and the migration ability of gravel improved obviously.