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To investigate the current status of workplace spirituality and moral resilience among clinical nurses and to explore the relationship between these two factors, thereby providing a reference for developing strategies to enhance nurses' moral resilience.
A cross-sectional survey design.
From February to April 2025, a convenience sampling method was used to select 1680 nurses from ten hospitals in the Pingliang area of China. Data were collected using the general data questionnaire, Workplace Spirituality Scale(WSS). Furthermore, the relationship between workplace spirituality and moral resilience was analyzed.
A total of 1657 valid questionnaires were ultimately recovered, yielding an effective response rate of 98.63%. The mean score for workplace spirituality was 102.36 ± 21.65, and the mean score for moral resilience was 41.76 ± 6.31, both indicating a moderate level. A significant positive correlation was found between the two variables (r = 0.231, p < 0.05). Multivariate linear stepwise regression analysis revealed that monthly income, department, monthly night shifts, and workplace spirituality scores were significant predictors of moral resilience (p < 0.05).
The moral resilience of clinical nurses is at a moderate level. Enhancing workplace spirituality can contribute to improving their moral resilience.
by Jun Zhang, Mengduan Pang, Ling Li, Chuanjia Guo
BackgroundEndometriosis is a common gynecological disorder among women of reproductive age worldwide. This study aims to examine global patterns of endometriosis disease burden among reproductive-aged women and to evaluate its correlation with socioeconomic development indices.
MethodsThis study conducted a comprehensive analysis of endometriosis disease burden using epidemiological parameters from the Global Burden of Disease (GBD) 2021 database, including incidence rates, prevalence rates, Disability-Adjusted Life Years (DALYs), and corresponding age-standardized rates. Through stratified analyses at global, regional, and national levels, we systematically evaluated the disease burden patterns among reproductive-aged women and performed correlation analysis with socioeconomic development indices.
ResultsWe found that the highest incidence of endometriosis among women of reproductive age globally occurs in the 20–24 age group, with an incidence rate of 399.49 per 100,000 in 1990 and 304.31 per 100,000 in 2021. The results show that the global disease burden of endometriosis is mainly influenced by population size, followed by epidemiological changes. Compared to countries with a medium Social Development Index (SDI), the disease burden of endometriosis in low and high SDI regions fluctuated significantly from 1990 to 2021. In most countries with SDI values between 0.2 and 0.6, the burden of endometriosis showed a gradual decline.
ConclusionEndometriosis remains a significant public health issue for women of reproductive age globally. Although the global disease burden of endometriosis among women of reproductive age showed a slight decline from 1990 to 2021, the disease burden continues to fluctuate in certain regions and countries. In light of the differences in the disease burden of endometriosis across regions and countries, regionalized disease management strategies are expected to be developed in the future.
Determine the positive psychological experience of patients with chronic heart failure through a systematic literature review and to provide a reliable basis for their psychological care.
Qualitative meta-synthesis.
A qualitative meta-synthesis was conducted to extract and analyse qualitative research from PubMed, Web of Science, Embase, Cochrane, CINAHL, PsycINFO and Chinese Database, including China National Knowledge Internet, Wanfang Database, China Biology Medicine Disc and VIP database from the inception of the database to 24 March 2024.
Two researchers screened, extracted and cross-checked data. Disputes resolved via discussion or 3rd researcher. Irrelevant titles/abstracts were excluded; full-texts were reviewed for final inclusion.
A total of 17 qualitative studies yielded 58 results, categorised into 10 groups and synthesised into three themes: positive attitudes and emotional responses, positive changes after the disease diagnosis and supportive factors for positive psychology.
Heart failure patients can experience positive psychology post-illness. Care providers should prioritise psychological assessment and support factors to meet needs, foster rehabilitation and improved quality of life.
CHF patients crucially contributed to this qualitative meta-synthesis by sharing insights into their positive psychological experiences, resilience and coping strategies.
In China, more than 30% of patients have not initiated treatment within 30 days of HIV diagnosis. Delayed initiation has a detrimental influence on disease outcomes and increases HIV transmission. The study aims to evaluate the effectiveness of a nurse-led antiretroviral therapy initiation nudging intervention for people newly diagnosed with HIV in China to find the optimal intervention implementation strategy.
A Hybrid Type II sequential multiple assignment randomized trial will be conducted at four Centers for Disease Control and Prevention in Hunan, China. This study will recruit 447 people newly diagnosed with HIV aged ≥18 years and randomly assign them into two intervention groups and one control group. On top of the regular counselling services and referrals, intervention groups will receive a 4-week, 2-phase intervention based on the dual-system theory and the nudge theory. The control group will follow the currently recommended referral procedures. The primary outcomes are whether treatment is initiated, as well as the length of time it takes. The study outcomes will be measured at the baseline, day 15, day 30, week 12, week 24 and week 48. Generalized estimating equations and survival analysis will be used to compare effectiveness and explore factors associated with antiretroviral therapy initiation. Both qualitative and quantitative information will be collected to assess implementation outcomes.
Existing strategies mostly target institutional-level factors, with little consideration given to patients' decision-making. To close this gap, we aim to develop an effective theory-driven nudging strategy to improve early ART initiation.
This nurse-led study will help to prevent delayed initiation by employing implementation science strategies for people newly diagnosed with HIV. This study contributes to the United Nations' objective of ending the AIDS pandemic by 2030.
Chinese Clinical Trial Registry ChiCTR2300070140. The trial was prospectively registered before the first participant was recruited.
The nudging intervention was finalized through the Nominal Group Technique where we invited five experts in the related field and five people living with HIV to participate.
To develop and validate a machine learning-based risk prediction model for delirium in older inpatients.
A prospective cohort study.
A prospective cohort study was conducted. Eighteen clinical features were prospectively collected from electronic medical records during hospitalisation to inform the model. Four machine learning algorithms were employed to develop and validate risk prediction models. The performance of all models in the training and test sets was evaluated using a combination of the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, Brier score, and other metrics before selecting the best model for SHAP interpretation.
A total of 973 older inpatient data were utilised for model construction and validation. The AUC of four machine learning models in the training and test sets ranged from 0.869 to 0.992; the accuracy ranged from 0.931 to 0.962; and the sensitivity ranged from 0.564 to 0.997. Compared to other models, the Random Forest model exhibited the best overall performance with an AUC of 0.908 (95% CI, 0.848, 0.968), an accuracy of 0.935, a sensitivity of 0.992, and a Brier score of 0.053.
The machine learning model we developed and validated for predicting delirium in older inpatients demonstrated excellent predictive performance. This model has the potential to assist healthcare professionals in early diagnosis and support informed clinical decision-making.
By identifying patients at risk of delirium early, healthcare professionals can implement preventive measures and timely interventions, potentially reducing the incidence and severity of delirium. The model's ability to support informed clinical decision-making can lead to more personalised and effective care strategies, ultimately benefiting both patients and healthcare providers.
This study was reported in accordance with the TRIPOD statement.
No patient or public contribution.
Chronic heart failure (CHF) is a progressive life-limiting condition that necessitates early implementation of advance care planning (ACP). However, patients and caregivers encounter emotional, informational, and cultural barriers to effective ACP engagement. This meta-synthesis consolidates qualitative evidence to deepen our understanding of ACP practices in CHF care.
This study aimed to explore experiences of CHF patients and their caregivers in ACP, which is defined as a proactive decision-making process to establish future treatment plans based on patients' values. The study also aimed to identify barriers and facilitators influencing ACP decisions and assess the impact of flexible, personalized ACP approaches on care quality.
Using qualitative meta-synthesis, we analyzed 10 qualitative studies on CHF patients' and caregivers' ACP experiences. Data were thematically synthesized to identify emotional, relational, and practical factors that influence engagement in ACP.
Three themes emerged: (1) heart failure patients and caregivers face difficulties in ACP (difficulties from patients, difficulties from the family, and difficulties from the society), (2) multidimensional drivers and impacts of ACP (advance care planning drivers, acceptance and implementation of ACP, emotions and effects of ACP), (3) flexible, personalized ACP delivers tangible benefits (timing and effectiveness of ACP discussions, patients and caregivers have personalized needs for ACP, and patients and caregivers affirm ACP benefits).
ACP plays a critical role in improving end-of-life care quality and reducing emotional and decision-making burdens on caregivers. Flexible and personalized ACP strategies supported by trained healthcare professionals more effectively meet the unique needs of patients and families. To overcome persistent barriers and promote broader ACP adoption, healthcare systems should prioritize provider communication training, ACP education, and support systems tailored to diverse cultural contexts.
FreshRSS 