Ke Zhang

Aims: Accelerated population aging has driven substantial growth in demand for palliative care services. Such services can effectively enhance the living quality for end‐of‐life patients through multidimensional interventions. Currently, China lacks a localised experience‐oriented quality assessment scale for palliative care, resulting in gaps in service quality supervision. To develop a self‐reported measurement for palliative care services, with the foundation in the Senses Framework. Design: This study developed a scale by extracting core contributors of palliative care experiences through 14 patients and 16 families' narratives. To refine and improve the scale, a total of 19 experts were invited to participate in a two‐round Delphi expert consultation. Additionally, an empirical research was conducted, with 380 valid samples from two independent cohorts collected to complete the full psychometric testing of the scale. Results: The final Palliative Care Experience Scale (PCES) comprises two dimensions: sense of security and belonging, and sense of purpose and significance, with a total of 13 items. The total variance includes 79.26% that is explained by these two factors. Confirmatory factor analysis confirmed a stable factor structure for the PCES. The scale exhibited good reliability, with a total Cronbach' α of 0.937, McDonald' ω of 0.952, and Spearman‐Brown corrected split‐half reliability of 0.897. Cronbach's α for both dimensions exceeded 0.88. The scale's SEM was 1.50 and MDC95 was 4.16, offering a validated threshold to identify real changes in patients' palliative care experience. Conclusion: This study developed an assessment scale of palliative care quality based on the Senses Framework, uniquely centred on patient experiences. Validated through robust methodologies, this scale fills a gap in the evaluation of experiential dimensions of palliative care in China, providing a scientific and feasible measurement tool for the continuous improvement of services. Impact: This study addresses the critical gap of a culturally adapted, patient experience‐centred tool for evaluating palliative care service quality in China. Its core finding is the successful development and full psychometric validation of the 13‐item Palliative Care Experience Scale (PCES). This research provides a reliable tool for palliative care clinical practice and academic research to capture patients' care experience, offers clinicians and administrators a practical instrument to identify service gaps and guide quality improvement, and delivers foundational reference data for policymakers to advance patient‐centred palliative care development in China. Reporting Method: We adhered to the relevant EQUATOR reporting guidelines. The development and validation process followed the COSMIN framework for patient‐reported outcome measures. Patient or Public Contribution: Patients receiving palliative care and familes played an integral role in designing and conducting this study. In Phase I, qualitative data from semi‐structured interviews with 14 patients and 16 families helped define core thematic constructs and develop the initial item pool, which ensured the scale's content validity were based on their real‐life experiences. In Phase III, we recruited a new, independent cohort of participants to complete the psychometric testing of the scale, providing key data for its validation.

Objective To examine the relationship between social support and psychological birth trauma among Chinese primiparous women and the mediating effects of childbirth readiness. Design A cross-sectional study was conducted between November 2021 and March 2022. Setting 10 general tertiary hospitals and 3 specialised maternity hospitals in 7 provinces in China. Participants A total of 751 primiparous women were recruited for this study. Outcome measures The questionnaires consisted of questions on demographic characteristics, the Birth Trauma Scale, the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey and the Childbirth Readiness Scale. Hierarchical multiple regression was used to explore the associated factors and mediating role of childbirth readiness in the relationship between social support and psychological birth trauma. The mediating model was examined by the PROCESS macro for SPSS. Results After adjusting for demographic variables, social support was negatively associated with psychological birth trauma (r=−0.242, pConclusions Childbirth readiness plays a mediating role between social support and psychological birth trauma among primiparas. Strategies and interventions to enhance childbirth readiness levels may be expected to improve the impact of social support on women’s psychological birth trauma.

Aims and objectives: This study aims to gain a comprehensive understanding of the illness experience of amyotrophic lateral sclerosis (ALS) patients in China and the meaning they attach to those experiences.Background: ALS is a progressive and fatal neurodegenerative disorder that significantly impacts individuals and families. There is a large number of patients with ALS in China. However, little is known about how they live with ALS.Design: Phenomenological qualitative research was performed among twenty people with ALS from the neurology department of a tertiary hospital in China. Colaizzi's method was used to analyse the participants’ data. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used as a guideline to secure accurate and complete reporting of the study.Results: We proposed three themes and eight subthemes on the illness experience of participants: (1) life countdown: ‘my body was frozen’ (body out of control and inward suffering); (2) family self‐help: ‘we kept an eye on each other’ (family warmth and hardship, and supporting the supporter); and (3) reconstruction of life: ‘what was the meaning of my life’ (learning to accept, rebuilding self‐worth, resetting the priority list and living in the moment).Conclusions: In the family self‐help model, patients are prompted to turn from negative mentalities to search for meaning in life actively. Healthcare providers need to attach importance to the family self‐help model to alleviate the pressure on medical resources.Relevance to clinical practice: Healthcare providers should encourage patients to play a supportive role in the family and provide more care support and professional care knowledge guidance to caregivers, to promote the formation of the family self‐help model which might help to improve the experience of patients and families.

Background: The psychological birth trauma is a universal phenomenon in childbearing women. The influences could extend in a wide range, which includes the mothers’ health, mother-infant relationship, partner relationship. The medical staff could even choose to quit playing their part in the birthing process. The phenomenon has gradually garnered attention around the world. However, it has rarely been discussed under Chinese special conditions. The study was to explore Chinese women’s lived experiences of psychological birth trauma during labor and birth. Methods: A descriptive phenomenological approach was adopted in this study. Twenty-four women were recruited, who reported having experienced psychological birth trauma. In-depth interviews were conducted within 1 week after birth. Colaizzi’s method was used to analyze the data. Results: Twenty-four women participated in the study. Four themes emerged to describe the women’s experience of psychological birth trauma: “How am I supposed to relieve the endless pain?” “ Can’t I be weak?” “Am I not important?” “What uncertainties are waiting for me?” Conclusions: The findings provide deep insight into Chinese women’s unique experience of psychological birth trauma. The social and health system could prevent psychological harm during birth and promote maternal health by measures of pain management, thoughtful attention, adequate caring, and prenatal preparation.

Background: The psychological birth trauma is a universal phenomenon in childbearing women. The influences could extend in a wide range, which includes the mothers' health, mother-infant relationship, partner relationship. The medical staff could even choose to quit playing their part in the birthing process. The phenomenon has gradually garnered attention around the world. However, it has rarely been discussed under Chinese special conditions. The study was to explore Chinese women's lived experiences of psychological birth trauma during labor and birth.Methods: A descriptive phenomenological approach was adopted in this study. Twenty-four women were recruited, who reported having experienced psychological birth trauma. In-depth interviews were conducted within one week after birth. Colaizzi's method was used to analyze the data.Results: Twenty-four women participated in the study. Four themes emerged to describe the women's experience of psychological birth trauma: "How am I supposed to relieve the endless pain?" " Can't I be weak?" "Am I not important?" " What uncertainties are waiting for me?"Conclusions: The findings provide deep insight into Chinese women's unique experience of psychological birth trauma. The social and health system could prevent psychological harm during birth and promote maternal health by measures of pain management, thoughtful attention, adequate caring, and prenatal preparation.