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Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception.
To explore the concept of fall risk perception in older adults.
A concept analysis.
The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023.
The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of “fall risk perception” in older adults.
Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions.
A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.
To explore the current situation, influencing factors and pathways of safety behaviour of nurses in tumour specialized hospitals, in order to provide a theoretical basis for managers to manage and train nurses, improve their safety behaviour level and ensure medical safety.
An anonymous cross-sectional survey.
A total of 2147 nurses from Grade A cancer hospitals in 15 provinces of China were selected by a convenient sampling method. Questionnaires were collected through the Questionnaire Star platform. Nurses' safety behaviour was measured using the nurse Safety Behaviour Scale, Self-efficacy by the General Self-efficacy Scale, and nurses' occupational burnout was measured by the occupational Burnout Scale, and work engagement through the the Work Engagement Scale. Structural equation modelling was used to test the relationship among nurses' safety behaviour, general self-efficacy, occupational burnout and work engagement. SPSS25.0 software was used to test the relationship among the safety behaviour of nurses, general self-efficacy, occupational burnout and work engagement.
The total score of safety behaviour of nurses was 55.45 ± 6.879, the total score of general self-efficacy was 31.39 ± 5.729, the total score of occupational burnout was 44.99 ± 26.587, and the total score of work engagement was 38.48 ± 13.433; the scores of the Nurse Safety Behaviour Scale, Self-Efficacy Scale, and Work Engagement Scale were positively correlated (all p < .001); the occupational burnout scale was negatively correlated with the scores of self-efficacy scale, work engagement scale and nurse safety behaviour scale (all p < .001); Structural equation model analysis shows that self-efficacy and work engagement have a direct positive impact on nurse safety behaviour(β = .103, β = .096, all p < .001); Occupational burnout has a direct negative impact on self-efficacy, work engagement and nurse safety behaviour(β = −.371, β = −.413, β = −.328 all p < .001). Bootstrap analysis showed that occupational burnout and job involvement had a significant chain mediating effect between self-efficacy and the safety behaviour of nurses (95% CI: 0.148–0.21). The total effect of self-efficacy on the safety behaviour of nurses was 0.283 (p < .001, 95% CI: 0.225–0.301), the direct effect was 0.096 (p < .001, 95% CI: 0.042–0.15), and the indirect effect was 0.179 (p < .001, 95% CI: 0.085–0.215), The mediating effect accounted for 63.3% of the total effect size.
Occupational burnout and work engagement play a partial mediating role between self-efficacy and nurse safety behaviour. It is necessary to strengthen training on nurse safety culture awareness, improve the nurse self-efficacy and work engagement, reduce nurse occupational burnout, and thereby improve the level of nurses' safety behaviour.
To establish a cognitive appraisal path model that examines the impact of stroke knowledge on stigma with the parallel mediating effects of negative and positive coping traits, as well as the moderating effects of family functioning.
Stroke-related stigma, a ‘mixture’ of negative emotions involving internal criticism and external judgement, has been shown to impair patients' health outcomes. However, the specific factors underlying cognitive appraisals and their pathways remain unknown.
A cross-sectional design.
The cross-sectional sample was from two stroke centres in China. Questionnaires were administered to collect sociodemographic data, stroke knowledge, coping traits, family functioning and stigma. Hierarchical regression models and the moderated parallel mediation model were constructed to analyse influencing pathways. The study adhered to the strengthening the reporting of observational studies in epidemiology guideline.
All 144 samples reported stigma symptoms with a moderate-to-high standardising score. The best hierarchical regression model explains 55.5% of the variance in stigma. The parallel mediation model indicated that negative and positive coping traits co-mediating the association of stroke knowledge and stigma. After adding the family functioning as a moderator, the moderated parallel mediation model was confirmed with adequate fit indices.
Among the cognitive appraisal factors affecting stroke-related stigma, stroke knowledge reduces stigma by modifying coping traits, while poor family functioning may serve as an opposing moderator. Notably, when family support is insufficient, enhanced stroke knowledge might paradoxically exacerbate the stigma.
This study contributes knowledge on transforming health education and emphasises the pivotal roles of clinical nursing practitioners. In similar global contexts, the study highlights integrating health education, psychological counselling and family support to advance systematic nursing practices.
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