Hui Yang

Background: Hospice nurses may encounter vicarious trauma during the empathy process with patients. However, vicarious trauma is a neglected issue in most hospice clinical nursing settings. The study aims to explore vicarious trauma experience and perspectives among hospice nurses. Methods: We conducted participatory observations in three hospitals and held semi-structured in-depth interviews with 16 hospice nurses from 9 cities between May and October 2023. Field notes and interview transcripts were analyzed as one coherent text by using reflexive thematic analysis. Results: Three main themes were identified: (1) “Falling in,” with subthemes of suffering from vicarious trauma and self-perceiving vicarious trauma; (2) “Struggling,” with subthemes of dealing with ambivalence; (3) “Climbing out,” with subthemes of “digesting” vicarious trauma and calling for organizational support. Conclusion: The findings indicated that hospice nurses are deeply affected by vicarious trauma. Nursing managers should pay more attention to the potential impacts of vicarious trauma on hospice nurses, and explore scientifically informed training courses and empowerment strategies to prevent and intervene in the vicarious trauma experiences of hospice nurses.

The aim of this study was to clarify and develop a conceptual framework for nursing professionalism. Nursing professionalism serves as a guide for nurses in all aspects of their work. Nurses with strong professionalism are key to safeguarding the health of all people. However, the concept of nursing professionalism remains ambiguous. This study used Charmaz's Constructing Grounded Theory. Thirty-eight participants, including nursing students, clinical nurses, nursing managers, doctors and patients in China, were interviewed from May 2021 to August 2022. We used purposeful sampling and theoretical sampling. By exploring stakeholders’ understanding of the concept of nursing professionalism, the researchers clarified its conceptual components. The conceptual framework of nursing professionalism encompasses four components: altruism, dedication, caring, and professional competence. Altruism includes putting patients-first and benefiting others. Dedication includes sacrifice, patience, tolerance, and expecting nothing in return. Caring reflects reverence for life, empathy, compassion, and concern. Professional competence includes sensitivity, responsibility, excellence, self-discipline, and collaboration. This study clarifies the conceptual framework of nursing professionalism, providing guidance for cultivating professional values in nursing education and clinical practice. The framework also enables the development of precise assessment tools to systematically evaluate nursing professionalism.

Aims: Prolonged intensive care unit (ICU) stays in heart failure patients are associated with poor prognosis and result in high medical expenses. To develop and validate a predictive model for prolonged ICU stays in heart failure patients. Methods and results: A retrospective cohort study was conducted involving ICU patients with a primary diagnosis of heart failure. The model development cohort comprised 5744 ICU heart failure patients from Beth Israel Deaconess Medical Center, while the external validation cohort included 4056 ICU heart failure patients from 208 hospitals across the USA. The primary outcome was prolonged ICU stay in heart failure patients. Feature selection was performed using Least Absolute Shrinkage and Selection Operator, univariate, and multivariate logistic regression. Nine machine learning algorithms were applied to develop the prediction models. Based on discrimination, calibration, and clinical utility metrics, the XGBoost emerged as the superior model. The top 10 predictive variables identified were malignant arrhythmia, acute kidney injury, Sequential Organ Failure Assessment (SOFA) score, breath sounds, valvular disease, systolic blood pressure, diuretics, blood urea nitrogen, SpO2, and cardiac catheterization. The area under the receiver operating characteristic curve for the XGBoost model was 0.861 [95% confidence interval (CI): 0.836–0.886] with a Kappa value of 0.518 in the internal validation set, and 0.815 (95% CI: 0.799–0.831) with a Kappa value of 0.437 in the external validation set. Conclusion: The XGBoost model exhibited robust discrimination, calibration, and clinical utility, making it a robust tool for risk stratification of prolonged ICU stays in heart failure patients.

Purpose Most chemotherapy reactions occur outside of the hospital; therefore, providing transitional care (TC) to patients is essential. However, patients’ preferences for TC remain poorly understood. This study aims to investigate the preferences and willingness to pay for TC among breast cancer patients. Methods Data were collected using a discrete choice experiment from a large general hospital in North China. The study used six attributes to describe the preferences of patients for TC. Conditional logit and mixed logit models were applied to assess patient preferences, estimate willingness to pay, and simulate uptake probabilities across different scenarios. Results A total of 261 respondents completed the survey. The study showed that patients strongly preferred a TC to be provided by a specialist doctor and specialist nurse (β = 0.925; p < 0.001) and were willing to pay CNY¥105.381. The service content most preferred was symptom management, psychological care, and rehabilitation guidance (β = 0.286; p < 0.001), and patients were willing to pay CNY¥32.606. The forms of services most preferred were at outpatient clinics (β = 0.239; p < 0.001), and patients were willing to pay CNY¥27.285. Low out-of-pocket expense was preferred by patients (β = − 0.009; p < 0.001). When TC was provided by a specialist doctor and specialist nurse in an outpatient clinic in conjunction with multidimensional care services and out-of-pocket payment of CNY¥20 per visit, the probability of breast cancer patients’ participation increased to 91.39%. Conclusion The results of this study suggest that breast cancer patients have strong preferences for the provider, content, and form of transitional care (TC), as well as for minimizing out-of-pocket costs.

Aims: Clarify and define the concept of professional bereavement in nursing.Design: Rodgers' evolutionary method was used to identify the attributes, antecedents, and consequences of professional bereavement in nursing.Data Sources: Literature from inception to May 20, 2024, was searched from PubMed, Embase, Web of Science, CINAHL, PsycINFO, Scopus, Medline, EBSCO host, Proquest, Ovid, and Cochrane.Reporting Methods: The preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines were adopted.Results: The 32 articles included in the study provided data on the concept of professional bereavement in nursing. We propose the concept of professional bereavement in nursing as follows: Professional bereavement in nursing is the experience of a patient or colleague's death in the workplace, influenced by contextual, internal, and external factors. Nurses perceive personal and professional losses, exhibit a multidimensional liminal state, and experience personal impacts (life and worldview) and professional impacts (health‐related productivity and professional ability).Conclusions: We developed a preliminary conceptual model of professional bereavement in nursing based on its attributes, antecedents, and consequences. This conceptual model promotes the development of theories related to professional bereavement.Impact: This is the first article to clarify and define professional bereavement in nursing. We have clarified the antecedents, attributes, and consequences of professional bereavement, which provides a conceptual framework for understanding professional bereavement. The conceptual framework guides the content of interventions and suggests future professional bereavement interventions from a dialectical perspective.Patient or Public Contribution: Not applicable.

Introduction: Adverse childhood experiences (ACEs) impact cognitive function, but the relationship remains unclear. We aim to identify cognitive function trajectories and scrutinize the correlation between ACEs and cognitive function.Methods: To identify cognitive trajectories, we employed a group-based trajectory model, and influential factors were determined using multinomial unordered logistic regression analysis.Results: Three cognitive decline subgroups emerged: low-start decline, high-start stability, and mid-start decline. There is no dose-response relationship between cumulative adverse childhood experiences and cognitive function. The high-start stability group had specific residence and education traits, while sibling death affected them. The mid-start decline group was vulnerable to parental death, physical abuse, and domestic violence. The low-start decline group should consider age structure and childhood friendships.Conclusions: No dose-response association between cumulative ACEs and cognitive decline. Still, specific ACE metrics are correlated with cognitive trajectories. We can incorporate patients’ ACEs into cognitive function assessments for early risk factor identification and tailored interventions. Moreover, recognizing the influence of early-life experiences on cognitive function, we can advocate for nurturing positive family and societal environments to optimize cognitive function.

Background: The shortage of nurses threatens the entire healthcare system, and nursing professionalism can improve nurse retention and enhance the quality of care. However, nursing professionalism is dynamic, and the factors influencing its development are not fully understood. Methods: A qualitative descriptive study was conducted. Using maximum variation and purposive sampling, 14 southern and northern China participants were recruited. Semi-structured interviews were conducted from May 2022 to August 2023 in face-to-face conversations in offices in the workplace or via voice calls. The interviews were transcribed verbatim and analyzed via thematic analysis. Results: Three main themes emerged: (1) nourishment factors: promoting early sprouting; (2) growth factors: the power of self-activation and overcoming challenges; and (3) rootedness factors: stability and upward momentum. Participants described the early acquisition of nursing professionalism as derived from personality traits, family upbringing, and school professional education, promoting the growth of nursing professionalism through self-activation and overcoming challenges, and maintaining the stable and upward development of nursing professionalism through an upward atmosphere and external motivation. Conclusion: We revealed the dynamic factors that influence the development of nursing professionalism, including “nourishment factors”, “growth factors”, and “rootedness factors”. Our findings provide a foundation for future development of nursing professionalism cultivation strategies. Nursing administrators can guide the development of nurses’ professionalism from many angles according to the stage they are in, and the development of professionalism deserves more attention. In the future, we can no longer consider the development of nursing professionalism solely as the responsibility of individual nurses; the power of families, organizations, and society is indispensable to jointly promoting nursing professionalism among nurses.