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To estimate the longitudinal predictive relationships between anxiety, depression and post-traumatic stress disorder symptoms in nurses exposed to horizontal violence and identify the most influential symptom using cross-lagged panel network analysis.
A longitudinal cross-lagged panel network analysis study.
Data were obtained from a short longitudinal survey conducted at four tertiary hospitals in Shandong Province, China. Two follow-up surveys spaced 7 weeks apart were conducted on 298 nurses with horizontal violence exposure using the General Information Scale, the Negative Acts Questionnaire, the seven-item Generalised Anxiety Disorder scale, the nine-item Patient Health Questionnaire and the four-item SPAN. Unique longitudinal relationships between symptoms were estimated using cross-lagged panel network analysis.
The results showed that the out-expected influence of A2 (Uncontrollable worry) and P2 (Physiological arousal) was highest and they were the most predictive symptoms in the network. The bridge out-expected influence of A2 (Uncontrollable worry) was also highest and it was the key bridge symptom within the network.
A2 (Uncontrollable worry) and P2 (Physiological arousal) were the top risk factors contributing to mental health deterioration in nurses with horizontal violence exposure.
This study precisely identified the predictive mechanisms and core symptoms among psychological symptoms in nurses exposed to horizontal violence, which is expected to play a significant role in improving the mental health of this group. The results showed that “Uncontrollable worry” and “Physiological arousal” were the core symptoms with the strongest predictive effects on other symptoms. Additionally, “Uncontrollable worry” was also the bridge symptom driving the mutual transmission and development of anxiety, depression and post-traumatic stress disorder. Nursing managers should prioritise “Uncontrollable worry” and “Physiological arousal” as intervention targets, optimising mental health interventions to effectively enhance the psychological well-being of nurses exposed to horizontal violence.
No patient or public contribution.
The aim of the study was to develop a set of nursing-sensitive quality indicators for accelerating spine surgical rehabilitation.
This is a modified Delphi study. A two-round Delphi study was conducted from November to December 2023.
Based on an evidence-based perspective and semi-structured interviews, an outline of nursing-sensitive quality indicators for accelerated rehabilitation in spine surgery patients was formulated. The Donabedian structure-process-outcome theory model was used as the theoretical framework to develop the indicator system; the indicators were improved and refined after two rounds of Delphi surveys, and the weights of the indicators were determined by the analytic hierarchy process. A total of 23 experts from 10 hospitals in 7 Chinese provinces completed the two rounds of the modified Delphi process.
The experts reached a consensus on the definition of the indicators, the calculation formula and the data collection method, and included a sensitive quality indicator system for accelerated rehabilitation care in spine surgery with 3 primary indicators, 9 secondary indicators and 26 tertiary indicators.
A set of indicators about accelerated rehabilitation care in spinal surgery covers the key aspects of patient education, assessment, measures, and rehabilitation, and its content is scientific, comprehensive, and targeted, which can provide a basis for objective evaluation of the quality of accelerated rehabilitation care in spinal surgery.
Medical institutions can routinely collect monthly data based on this indicator, conduct horizontal comparisons of the quality of accelerated rehabilitation care in spinal surgery among hospitals at the same level with the assistance of a national or even global networked auditing platform, and establish an internal safeguard mechanism for evaluating the quality of perioperative care.
This study follows the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies.
No patient or public contribution was made in this study.
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