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This study aims to investigate whether higher levels of depression predict increased physical frailty over time and whether worsening physical frailty predicts higher levels of depression over time, at both the between-person and within-person levels.
A longitudinal study.
A total of 269 patients who underwent cardiac surgery were included in this study at T1 (admission). We followed up depression and physical frailty at T2 (the seventh day after surgery), T3 (the day before discharge), and T4 (the three-month follow-up). To determine the temporal order of the association between depression and physical frailty at both between-person or within-person levels, we employed the cross-lagged panel model (between-person effects), and random intercept cross-lagged panel model (within-person effects).
The cross-lagged panel model findings revealed a time-dependent shift in directionality: physical frailty initially predicted depression between T1 and T2, whereas depression subsequently emerged as a significant predictor of physical frailty from T2 to T4. These between-person effects suggest that the dominant direction of influence may vary across different perioperative stages. Notably, the random intercept cross-lagged panel model results identified a robust unidirectional within-person effect, indicating that increases in depression consistently predicted subsequent increases in physical frailty over time, while the reverse pathway was not statistically significant. This finding underscores the potential causal role of depression in driving physical frailty progression, beyond the influence of stable between-person characteristics.
This study advances understanding of the depression-physical frailty relationship in middle-aged and older cardiac surgery patients by delineating temporal precedence and disentangling within- and between-person effects. Depression emerges as a key driver of physical frailty, underscoring the need to prioritize its management in postoperative care protocols. Future research should explore mechanisms linking intraindividual depression to physical frailty progression and evaluate integrated psychosomatic interventions to optimize recovery outcomes.
We have adhered to the STROBE guideline.
This study did not include patient or public involvement in its design, conduct, or reporting.
To understand the current situation of nurses' compassion competence and analyse the characteristics and influencing factors of different categories of nurses' compassion competence based on latent profile analysis, to provide a theoretical basis for formulating targeted compassion training programmes.
A cross-sectional study.
From June to October 2023, 550 nurses from tertiary grade A hospitals in Shandong province were selected by convenience sampling and investigated by utilising a demographic characteristics questionnaire, the Compassion Competence Scale for the Nurses, the Mindful Attention Awareness Scale and the Maslach Burnout Inventory-Human Service Survey. Latent profile analysis was performed to explore the potential categories of nurses' compassion competence, and single-factor analysis and logistic regression analysis were used to explore the related influencing factors.
A total of 513 nurses were included. The compassion competence of nurses could be divided into four categories: the compassion competence deficient group (7.56%), the compassion competence low-imbalanced group (15.35%), the compassion competence high-balanced group (50.38%) and the compassion competence excellent group (26.70%). Department, years of working, humanistic care training experience, whether work is supported by colleagues and leaders, mindfulness and job burnout were the influencing factors of different potential categories (all p < 0.05).
There are four categories into which nurses' compassion competency can be categorised. Nursing managers and medical institutions can formulate precise training methods that enhance nurses' compassion competency based on the traits of various nurse categories in order to improve the quality of nursing service.
The results of this study help to understand the categories and heterogeneity of nurses' compassion competence and provide a basis for nursing managers and medical institutions to improve the compassion competence of different categories of nurses.
All participants were nurses who completed an electronic questionnaire related to this study.
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