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This study aimed to examine the level of vicarious posttraumatic growth among intensive care unit nurses in China and explore the mediating role of death coping ability in the relationship between moral resilience and vicarious posttraumatic growth.
A multicentre, cross-sectional study was conducted in accordance with the STROBE guidelines.
Between January and March 2025, a questionnaire survey was conducted among 666 intensive care unit nurses from nine tertiary Grade A hospitals across five provinces in China. Participants completed three standardised instruments: the Rushton Moral Resilience Scale, the Coping with Death Scale–Short Version, and the Vicarious Posttraumatic Growth Inventory. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, and correlation analyses, and employed AMOS 27.0 to perform structural equation modelling for testing mediation effects.
Intensive care unit nurses demonstrated a moderate level of vicarious posttraumatic growth. Moral resilience was positively associated with both death coping ability and vicarious posttraumatic growth. Death coping ability was found to play a partial mediating role in the relationship between moral resilience and vicarious posttraumatic growth.
Moral resilience and death coping ability are key factors associated with vicarious posttraumatic growth among intensive care unit nurses. Nurses with stronger moral resilience are more likely to cope constructively with death-related stress, which may support psychological growth in trauma-intensive environments.
This study highlights the need to enhance intensive care unit nurses' moral and emotional capacities through ethics education, emotional coping training, and institutional support strategies. Strengthening these competencies may foster professional development and mental wellbeing in critical care settings.
by Yilin Zhang, Zitong Zhang, Yunyun Peng, Wanting Zhang, Guiyuan Ma, Sulan Lin, Carmen W.H. Chan, Ankie Tan Cheung, Jianhui Xie, Can Gu
ObjectiveThis systematic review aimed to examine the impact of technology- and parent-based psychosocial interventions on family factors among children with cancer, focusing on family dynamics.
MethodsData were sourced from ten databases (CNKI, Wanfang, VIP, Sinomed, the Cochrane Library, Embase, PubMed, Web of Science, Scopus, and CINAHL) up to August 2024. The PRISMA statement guidelines, the Cochrane risk bias assessment tool, and the non-randomized controlled trial risk bias assessment tool were used in this study and experimental and quasi-experimental studies were included. The review protocol is registered in PROSPERO (CRD42023435402).
ResultsTwelve studies, including seven randomized controlled trials and five quasi-experimental studies, involving 1,309 parents of children with cancer, were included in the review. These studies utilized various theoretical models and delivered interventions through different modes, such as Internet-based platforms and telehealth. Overall, technology- and parent-based interventions have demonstrated positive effects on family dynamics factors, including family function, communication, coping ability, and family burden.
ConclusionsTechnology- and parent-based psychosocial interventions showed promise in enhancing family dynamics factors although intervention methods varied across studies. This review recommends larger-scale randomized controlled trials to evaluate the effectiveness of technology- and parent-based psychosocial interventions on family dynamics factors among this vulnerable population and highlights the potential of such interventions to improve care quality, treatment outcomes, and resource allocation in pediatric oncology.
To evaluate the predictive validity and reliability of the Waterlow scale in critically adult hospitalised patients.
A multi-centre cohort study.
This study was conducted in 72 intensive care units (ICUs) in 38 tertiary hospitals in Gansu Province, China. All adults admitted to the ICU for greater than or equal to 24 h without pressure injury (PI) on admission were screened by the Waterlow scale on admission, during ICU stay and ICU discharge from April 2021 to February 2023. Receiver operating characteristic (ROC) curves were used to determine a potential cut-off value for critical adult hospitalised patients. Cut-off values were then determined using Youden's index, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated based on these cut-off values. Test–retest reliability was used to evaluate inter-rater reliability.
A total of 5874 critical patients on admission were included, and 5125 of them were assessed regularly. The area under curve (AUC) was 0.623 (95% CI, 0.574–0.690), with a cut-off score of 19 showing the best balance among sensitivity of 62.7%, specificity of 57.4%, positive predictive value of 2.07% and negative predictive value of 99.08%. The test–retest reliability between the first assessment and the regular assessment was 0.447.
The Waterlow scale shows insufficient predictive validity and reliability in discriminating critical adults at risk of PI development. To further modify the items of the Waterlow scale, exploring specific risk factors for PI in the ICU and clarifying their impact degree was necessary. Risk predictive models or better tools are inevitable in the future.
Patients or family members supported nurses with PI risk assessment, skin examination and other activities during the inquiry.
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