Table of Content

01 May 2025, Volume 41 Issue 9

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Treatise

Impact of psychological flexibility and work family boundary infiltration on occupational burnout among obstetric and gynecological nurses

PENG Chan, WU Zhenzhen, GAN Yanling, GUO Tingting, PENG Zizi, WANG Jing

2025, 41(9):  1153-1157. 

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Objective To understand the impact of psychological flexibility and work family boundary infiltration on occupational burnout among obstetric and gynecological nurses. Methods Convenience sampling method was used to survey 182 obstetric and gynecological nurses from 6 grade-A tertiary hospitals in Wuhan from January to February 2024 using the psychological flexibility scale,work family boundary penetration scale,and occupational burnout scale,and the data were analyzed. Results The psychological flexibility,work family boundary penetration,and occupational burnout scores of obstetric and gynecological nurses were （35.37±6.24）,（47.85±7.48）,and （61.35±9.26）points,respectively. The psychological flexibility scores of obstetrics and gynecology nurses with different ages,years of work,professional title,monthly income,and monthly night shift numbers were compared,and the differences were statistically significant（all P<0.05）. There were statistically significant differences in the work family boundary penetration and occupational burnout scores among obstetric and gynecological nurses of different ages,length of service,professional title,marital status,monthly income,and monthly night shift numbers（all P<0.05）. The psychological flexibility of obstetric and gynecological nurses was negatively correlated with occupational burnout（r=-0.645,P<0.01）,and work family boundary penetration was positively correlated with occupational burnout（r=0.614,P<0.01）. The psychological flexibility was negatively correlated with the work family boundary penetration（r=-0.592,P<0.01）. Psychological flexibility partially mediated the relationship between work family boundary penetration and occupational burnout,with a mediating effect of 0.195,accounting for 36.38% of the total effect. Conclusion The work family boundary penetration and psychological flexibility of obstetric and gynecological nurses can directly affect their level of occupational burnout,and their psychological flexibility partially mediates the impact of work family boundary penetration on occupational burnout.

Analysis of occupational hazards in a construction waste recycling and reuse project in Jiangyin City

GU Wenlong

2025, 41(9):  1158-1161. 

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Objective To analyze and evaluate the occupational hazards of a construction waste recycling and reuse project in Jiangyin City,and provide reference for employers to strengthen occupational hazard protection and protect the health of workers. Methods Qualitative and quantitative analysis of occupational hazards in a construction waste recycling and reuse project in Jiangyin City was conducted in February 2023 using on-site investigation and testing methods. Results The production process of a construction waste recycling and reuse project in Jiangyin City involved occupational hazards such as silicon dust,noise,and power frequency electromagnetic fields. The test results showed that the concentration of silicon dust（10% ≤ free SiO₂ content ≤50%,respiratory dust） at each testing point in the construction project workplace was <0.7 mg/m³,which met the requirements of occupational exposure limits. The measurement result of the power frequency electric field strength of the electrician in the distribution room was 0.6-0.8 V/m,which met the occupational exposure limit requirements. The equivalent sound level intensity of the cab operation position of the material excavator in workshop 1 exposed to noise for 8 hours was 83.2-83.9 dB（A）,which met the occupational exposure limit requirements. The equivalent sound level intensity of the other testing positions exposed to noise for 8 hours was greater than 90 dB（A）,exceeding the occupational exposure limit. Conclusion The noise detection rate of a construction waste recycling and reuse project in Jiangyin City exceeded the standard by 85.7%,which belongs to a construction project with serious occupational disease hazards. It is recommended to take effective vibration and noise reduction measures and individual protective measures to protect the occupational health of labors.

Mediating effect of positive psychological capital on the relationship between occupational burnout and quality of life among nurses in public grade-A tertiary hospitals in Xianyang City

ZHANG Chen, YU Ping, ZHAO Yan, YANG Qiong, WANG Xige

2025, 41(9):  1162-1167. 

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Objective To understand the current situation of nurses' positive psychological capital in Xianyang public grade-A tertiary hospitals,and analyze the mediating effect of positive psychological capital on the relationship between nurses' occupational burnout and quality of life. Methods A total of 376 nurses from two public grade-A tertiary hospitals in Xianyang City from January to February 2024 were selected as the research subjects by convenience sampling. The positive psychological capital questionnaire,the Maslach burnout inventory-general survey and the world health organization quality of life scale-brief form questionnaire-revised version were used to investigate,and the data were analyzed. Results The scores of positive psychological capital,occupational burnout,and quality of life for nurses in two public grade-A tertiary hospitals in Xianyang City were （119.26±19.42）,（63.07±10.96） and （99.01±15.95）points,respectively. Positive psychological capital was negatively correlated with occupational burnout（r=-0.631,P<0.01）,and positively correlated with quality of life（r=0.670,P<0.01）. The results of the structural equation model showed that positive psychological capital partially mediated the relationship between nurse occupational burnout and quality of life,with an effect value of -0.267 and a mediation effect accounting for 23.6%. Conclusion Positive psychological capital is an important mediating variable between occupational burnout and quality of life among nurses in public grade-A tertiary hospitals. Occupational burnout can affect quality of life through positive psychological capital. Therefore,it is recommended to cultivate positive psychological qualities and abilities of nurses,mitigate the impact of various negative events in work,slow down the occurrence of occupational burnout,and promote the improvement of nurse quality of life.

Occupational health risk assessment of phosphine exposure in a sewage treatment plant in Beijing

WANG Luyang, BI Mingli, WANG Xiaoshun, ZHANG Xiaojun, ZHAO Xupeng, DING Xiaowen

2025, 41(9):  1168-1172. 

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Objective To evaluate the occupational health risks of phosphine exposure in inspection workers of two sewage treatment plants in Beijing,and provide suggestions for further reducing the risk of phosphine exposure. Methods Operators involved in phosphine in two sewage treatment plants（A and B） in Beijing were selected as the study subjects. In April and June 2023,on-site sampling method was used to measure phosphine concentration in the normal production stage of the enterprises. Combined with exposure time,frequency,years and other factors,the environmental protection agency（EPA） inhalation non-cancer risk model and occupational hazard classification method were used to evaluate the occupational health risks of phosphine among workers in plants A and B. Results The non-cancer hazard quotient（HQ） of phosphine exposure for sewage treatment operator, sludge thickening dewatering operator and sludge nitrification operator in plant A were 40.65,15.84 and 3.45,respectively. B plant wastewater treatment operator phosphine non-cancer HQ was 8.9. The non-cancer risk indicators of phosphine in inspection operations of both plants A and B were greater than 1. Plants A and B were relatively harmless operations（level 0）. Conclusion The occupational health risks associated with phosphine are high in urban sewage treatment plants,and further comprehensive measures of engineering technology and occupational health management practices should be taken to reduce occupational exposure health risks of phosphine.

Effect of Usma grass on hair growth in hair removal mouse models

ZHANG Chi, ZHANG Yifan, MEI Yujie, MA Xiaofan

2025, 41(9):  1173-1179. 

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Objective To discuss the effect of Usma grass on hair growth in hair removal mouse models and whether the content of parathyroid hormone（PTH） in mice affects hair growth rate,providing experimental basis for the treatment of hair loss with Usma grass. Methods Totally 59 mice were divided into groups based on gender and the dosage of Usma grass liquid,and the experimental area was taken from the symmetrical part of their backs. The blank control group was not treated,while the hair removal group had hair removal every three days. The experimental group was divided into physiological saline group,high,medium,and low dose groups according to gender. Apply the hair removal cream evenly to the skin on the back of the mouse and wipe off after 6 minutes. The experimental group was divided into groups and administered continuously for 24 days. The hair growth status,histological changes of hair follicles,and the diameter of final and velvety hair sections in the depilation area of mice were recorded. Measure the PTH content in mice using an ELISA kit. Results There was a statistically significant difference in hair growth scores between mice on days 11,15,18,and 21（P<0.05）. There were no statistically significant differences in hair regeneration weight between different groups（all P>0.05）. There were no statistically significant differences in PTH content in the blood between mice of different genders（all P>0.05）. Comparing the hair follicle slices of the experimental area on the back of mice, the number of final hair follicles in mice treated with Usma grass reagent was higher than that in the control group. Hair removal cream reduced the number of terminal hairs in the hair follicles of the experimental area and increased the number of velvety hairs. Conclusion Usma grass has a promoting effect on hair growth in hair removal mouse models,and the effect of PTH content on hair growth rate in mice is meaningless. This can provide experimental evidence for the treatment of hair loss with Usma grass.

Exploring the protective effect of lutein on cranial nerve damage in rats exposed to manganese based on the Nrf2-HO-1 pathway

DING Chawen, QIAO Hong

2025, 41(9):  1180-1186. 

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Objective To explore the protective effect of lutein on cranial nerve injury in rats exposed to manganese based on the nf-e2-related factor 2（Nrf2）-heme oxygenase-1（HO-1） pathway. Methods Totally 50 SD rats were divided into half and half of both sexes：control group,model group,low,medium and high dose lutein groups（40.0,80.0,160.0 mg/kg）. Except for the control group, all other groups of rats were given manganese sulfate solution（30 mg/kg） by gavage every day for 3 months. During the experiment, rats with low,medium and high doses of lutein were given corresponding doses of lutein by gavage every day,the control group and model group were given equal volumes of normal saline by gavage. After the experiment,the rats' neurological function indicators,neuronal apoptosis levels,superoxide dismutase（SOD）,glutathione（GSH）,lactate dehydrogenase（LDH）,reactive oxygen species（ROS）,and malondialdehyde（MDA） in hippocampal tissue were measured. Real-time fluorescence reverse transcription（RT-PCR） and Western blot were used to measure the levels of Nrf2,quinone oxidoreductase-1（NQO-1）,and HO-1 in hippocampal tissue. Results The pathway length,slope test score,hippocampal tissue SOD and GSH levels,and hippocampal tissue Nrf2,NQO-1, and HO-1 mRNA protein levels of rats in the manganese exposure group were lower than those in the control group,Longa nervous system score,modified neurological deficit score（mNSS） score,TdT-mediated dUTP nick end labeling（TUNEL） positive cells in the hippocampus,hippocampal tissue LDH,ROS,and MDA levels were higher than those in the control group,and the differences were statistically significant（all P<0.05）. After intervention treatment with low,medium,and high doses of lutein,the pathway length,slope test scores,SOD and GSH levels in hippocampal tissue,and Nrf2,NQO-1,and HO-1 mRNA protein levels in hippocampal tissue in each lutein dose group were higher than those in the manganese exposure group（0.86±0.07 vs 1.26±0.10, 1.56±0.17,2.84±0.23;0.53±0.06 vs 1.22±0.11,1.64±0.20,3.01±0.29;0.53±0.05 vs 1.18±0.14,1.82±0.19,3.14±0.30;0.28±0.03 vs 0.58±0.06,0.81±0.08,0.99±0.08;0.19±0.03 vs 0.31±0.04,0.63±0.07,1.03±0.09;0.21±0.02 vs 0.46±0.07,0.67±0.07,1.02±0.10,all P<0.05）,Longa nervous system score,mNSS score,number of TUNEL-positive cells in hippocampus,and hippocampal tissue LDH,ROS,and MDA levels were lower than those in the manganese exposure group,and the differences were statistically significant（all P<0.05）,and with the gradual increase of lutein dosage,the pathway length,slope test scores,SOD and GSH levels in hippocampal tissue,Nrf2,NQO-1,and HO-1 mRNA protein levels in hippocampal tissue gradually increased（1.26±0.10,1.56±0.17,2.84±0.23;1.22±0.11,1.64±0.20,3.01±0.29;1.18±0.14,1.82±0.19,3.14±0.30;0.58±0.06,0.81±0.08,0.99±0.08;0.31±0.04, 0.63±0.07,1.03±0.09;0.46±0.07,0.67±0.07,1.02±0.10）,Longa nervous system score,mNSS score,number of TUNEL-positive cells in hippocampus,LDH,ROS,and MDA levels in hippocampal tissue gradually decreased,and the dose-effect relationship was significant（all P<0.05）. Conclusion Lutein has a significant therapeutic effect on cranial nerve damage caused by manganese exposure,and its mechanism is related to the activation of the Nrf2-HO-1 pathway in the hippocampus of manganese exposed rats by lutein.

Epidemiological analysis of foodborne disease events in the "Chengdu metropolitan area" from 2015 to 2023

XIONG Rui, SONG Yang, ZHANG Li

2025, 41(9):  1187-1191. 

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Objective To understand the prevalence of foodborne disease events in Chengdu,Deyang,Meishan and Ziyang（hereinafter referred to as 'Chengdu metropolitan area'） in Sichuan Province from 2015 to 2023,and to explore the prevention and control methods of foodborne diseases in the same city,so as to provide a basis for relevant departments to formulate timely and effective policies to deal with cross-regional foodborne disease events. Methods Descriptive epidemiological analysis was conducted on foodborne disease events reported to have occurred in Chengdu,Deyang,Meishan and Ziyang in the "Foodborne Disease Event Monitoring System" from 2015 to 2023,and SPSS 25.0 software was used for statistical analysis. Results From 2015 to 2023,a total of 464 foodborne disease events were reported in the "Foodborne Disease Event Monitoring System",with 3 924 cases and 5 deaths. The most frequent occurrence of incidents occurred in households（54.96%）,and the food causing the most incidents was poisonous mushrooms（33.41%）. Among the events that identified the pathogenic factors,the number of events and the number of patients caused by pathogenic microorganisms accounted for the highest proportion. There were statistically significant differences in the distribution of the number of affected individuals,locations,pathogenic factors,and pathogenic microorganisms in each foodborne disease event among the four cities of Chengdu,Deyang,Meishan,and Ziyang（χ²=23.712,27.176,56.831,24.942, all P<0.01）. Conclusion The foodborne disease events are characterized by cross-regional,uneven distribution and inconsistent factors. The prevention and control of foodborne diseases in the "Chengdu metropolitan area" can effectively reduce the occurrence of foodborne disease events and improve the disposal efficiency.

Analysis of the status quo and influencing factors of decent work perception of community medical staff in Guizhou Province

CHENG Yuanfen, HE Jin, LI Dan, YANG Juanhua, YANG Ting, CAO Yu

2025, 41(9):  1192-1196. 

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Objective To understand the status quo and influencing factors of decent work perception of community medical staff in Guizhou Province,and to provide reference for improving the level of decent work perception of community medical staff. Methods A multi-stage cluster random sampling method was used to select 2 076 community medical staff from 9 cities（prefectures） in Guizhou Province from September to October 2023. The basic situation questionnaire,decent work perception scale,professional identity scale and professional delay of gratification scale were used to investigate. Pearson correlation analysis was used to explore the correlation between decent work perception and professional identity,professional delay of gratification,and multiple linear regression model was used to analyze the influencing factors of decent work perception. Results The total score of decent work perception was （48.85±6.74）points,and the overall average score was （3.05±0.42）points. There were statistically significant differences in the decent work perception scores of medical staff with different professional titles and monthly incomes（both P<0.05）. The decent work perception was positively correlated with professional identity and negatively correlated with occupational delay of gratification（r=0.385,-0.073,both P<0.05）. Professional title,monthly income,professional identity and occupational delay of gratification were the influencing factors of decent work perception（all P<0.05）,which explained 18.2% of the total variation of decent work perception. Conclusion The level of decent work perception of community medical staff in Guizhou Province is not high. Professional title,monthly income,professional identity and professional delay of gratification are the influencing factors of decent work perception. It is suggested that managers take measures to increase the level of decent work perception of community medical staff from the perspective of influencing factors.

Analysis on current status and influencing factors of risk screening for obstructive sleep apnea among power plant employees in Taishan City

WU Ao, XIE Hongzhen, DUAN Xinyu, FAN Xiaoqi, WANG Jianjing, REN Lifang

2025, 41(9):  1197-1202. 

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Objective To understand the current status of screening of obstructive sleep apnea（OSA） risk among power plant employees in Taishan City,analyze the influencing factors of its increased risk,and explore the changes and significance of blood indicators related to OSA in non-diagnosed populations,aiming to provide a theoretical basis for promoting subsequent research on disease prevention. Methods Convenience sampling was used to select 242 employees from a power plant in Taishan City who underwent physical examination in August 2023. STOP-Bang questionnaire was used to screen them for obstructive sleep apnea,and they were divided into low-risk group（STOP-Bang score <3 points） and high-risk group（STOP-Bang score ≥3 points）. The baseline data and blood indexes of the two groups were compared,and the influencing factors of OSA risk degree were analyzed by Poisson regression. Results There were 113 high-risk patients with OSA,with a high-risk rate of 46.7%. Poisson regression results showed that male（RR=6.56,95%CI：2.546-16.901）,aged 40-<60 years（RR=1.713,95%CI：1.270-2.311）,aged ≥60 years（RR=2.230,95%CI：1.197-4.155）,diagnosed with OSA related diseases（RR=1.493,95%CI：1.137-1.960）,triglycerides（RR=1.596, 95%CI：1.224-2.081）,total cholesterol（RR=1.066,95%CI：1.020-1.115）,low-density lipoprotein（RR=5.287,95%CI：2.330-11.997）,uric acid（RR=1.002,95%CI：1.000-1.003）,blood glucose（RR=1.050,95%CI：1.023-1.079）,glycated hemoglobin（RR=1.085, 95%CI：1.034-1.138） were independent risk factors for OSA,while high-density lipoprotein（RR=0.750,95%CI：0.632-0.889） was independent protective factor. Conclusion The high risk rate of OSA among employees in the power plant is relatively high,and the high risk rate contrasts sharply with the low diagnostic rate. It is suggested that medical institutions at all levels should pay attention to the popularization of OSA. According to the analysis results,it is suggested that the employees of the power plant should pay attention to their own blood lipid,blood glucose and uric acid levels,and they should actively undergo screening and diagnosis of OSA,if there is a significant increase,especially for elderly males and those with a history of OSA related diseases.

Analysis of perceived autonomy levels and influencing factors of 460 oldest old residents in nursing homes in Ningbo

MA Linlin, WANG Jialu, FANG Yi, CHEN Huixian, LI Zhi, YIN Zhiqin

2025, 41(9):  1203-1208. 

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Objective To investigate the current status of perceived autonomy among oldest old residents in nursing homes in Ningbo,and analyze its influencing factors,in order to provide a scientific basis for developing improvement strategies,relevant policies,and enhancing the quality of elderly care services. Methods A cross-sectional survey design was adopted to conduct a questionnaire survey on 460 oldest old residents from 11 nursing homes in Ningbo from July 2023 to January 2024 using convenience sampling method. The survey instruments included a general information questionnaire,the simplified Chinese version of the perceived enactment of autonomy scale,Barthel index,patient health questionnaire-9 items,mini-mental state examination,and social support rating scale. Multiple linear regression analysis was used to analyze the influencing factors of perceived autonomy. Results The total score of perceived autonomy for the oldest old residents in nursing homes in Ningbo was （66.52±18.54）points. Multiple linear regression analysis revealed that activities of daily living,depressive symptoms,cognitive function,and social support were significant influencing factors of perceived autonomy（all P<0.01）,explaining 91.0% of the total variance in perceived autonomy scores. Conclusion The level of perceived autonomy among the oldest old residents in nursing homes in Ningbo is relatively high. It is recommended that nursing homes provide personalized support and services based on the identified factors,such as improving self-care abilities,enhancing depression screening,conducting cognitive training,and establishing social support networks,to further enhance the level of perceived autonomy among the oldest old residents.

Mediating role of rumination in the relationship between insomnia and depression among clinical nurses in a grade-A tertiary hospital in Anhui Province

WU Jingmei, TANG Wangqin, WANG Jieyu, SHEN Xing

2025, 41(9):  1209-1213. 

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Objective To explore the relationship between insomnia,rumination and depression in clinical nurses,and analyze the effect of rumination on insomnia and depression. Methods From August to October 2023,631 clinical nurses from a grade-A tertiary hospital in Anhui Province were randomly selected as the investigation objects. General information questionnaire,self-rating depression scale,insomnia severity index scale and rumination response scale were used to investigate,and the data were analyzed. Results The prevalence rate of depression among clinical nurses in agrade-A tertiary hospital in Anhui Province was 56.6%. There were statistically significant differences in depression scores among clinical nurses of different ages,professional title,length of service,and whether they were engaged in nursing research work（all P<0.05）. The difference in insomnia scores between clinical nurses who worked in nursing research and those who did not was statistically significant（P<0.05）. The higher the degree of depression,the higher the scores of insomnia（F=88.200,P<0.01） and rumination thinking（F=60.129,P<0.01）,and depression was positively correlated with insomnia and rumination thinking（r=0.567,0.527,both P<0.01）. The structural equation model showed that the direct effect of insomnia on depression was 0.753,and the indirect effect was 0.292. The higher the insomnia score,the higher the depression score,and insomnia positively predicted depression. Rumination had a significant indirect effect on depression through insomnia（B=0.416,95%CI：0.626-0.880）,and rumination had a partial mediating effect between insomnia and depression,accounting for 27.9% of the total effect. Conclusion Insomnia and ruminative thinking are the factors that cause depression in clinical nurses. Insomnia can act on depression through direct and indirect pathways,and ruminative thinking plays a part of mediating role.

Intermediary role of workplace social capital in authentic leadership and organizational silence among clinical nurses in general hospitals

ZHANG Sirui, HUANG Qimi, LUO Limin, WANG Yanan, DENG Baogui

2025, 41(9):  1214-1219. 

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Objective To explore the relationship between perceived authentic leadership,organizational silence,and workplace social capital among clinical nurses,and to provide a new perspective for improving hospital management quality. Methods From January to April 2024,595 clinical nurses from 9 general hospitals in Guangdong Province and 2 general hospitals in Chongqing were surveyed by general information questionnaire,authentic leadership questionnaire,nurse organizational silence evaluation questionnaire and workplace social capital scale by convenient sampling method,and the data were analyzed. Results The total scores of clinical nurses' authentic leadership,organizational silence and workplace social capital were （69.44±12.63）,（46.61±20.74） and （33.79±6.70）points,respectively. There were statistically significant differences in authentic leadership scores among clinical nurses of different ages and average monthly incomes（both P<0.05）. There were statistically significant differences in organizational silence among clinical nurses of different professional titles and working years in the unit（both P<0.05）. There were statistically significant differences in workplace social capital scores among clinical nurses of different ages,professional titles and average monthly incomes（all P<0.05）. Authentic leadership was negatively correlated with organizational silence,while positively correlated with workplace social capital,and workplace social capital was negatively correlated with organizational silence（all P<0.01）. Workplace social capital had a complete mediating effect between clinical nurses' authentic leadership and organizational silence,and the mediating effect was -0.333,accounting for 69.52% of the total effect. Conclusion The organizational silence of clinical nurses is at a medium level,and authentic leadership and workplace social capital have a mitigating effect on organizational silence. Nursing managers should strengthen the cultivation of authentic leadership and improve the level of workplace social capital to reduce the organizational silence of nurses.

Analysis on current status and correlation between role overload and thriving at work of pediatric caregivers in 5 public comprehensive hospitals in Nantong City

YAN Guomei, CUI Lei, GE Chunyan, TANG Wenjuan

2025, 41(9):  1220-1224. 

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Objective To understand the current situation and the relationship between role overload and thriving at work among pediatric caregivers,in order to provide reference for stabilizing the pediatric caregiver talent team and improving the quality of pediatric caregiver services. Methods From October 2023 to February 2024, a questionnaire survey was conducted on 330 pediatric caregivers from 5 public comprehensive hospitals in Nantong City using demographic data questionnaire,role overload scale,and thriving at work scale,and the data were analyzed. Results The total score of role overload among 330 pediatric caregivers was （18.62±3.64）points,with a score rate of 74.40%. The score of thriving at work was （46.63±13.43）points,with a score rate of 66.57%. The role overload score of pediatric caregivers was negatively correlated with thriving at work and its various dimensions（r=-0.420--0.485,all P<0.01）. Nursing level,sleep quality,employment type and role overload were the influencing factors of thriving at work among pediatric caregivers（all P<0.05）,which explained 35.9% of the variance of thriving at work. Conclusion The role overload and thriving at work of 330 pediatric caregivers were at a moderate level,and this group should be given attention. The prosperity of pediatric caregivers can be promoted through implementing person-post matching,strengthening skills training,and improving role overload.

Network co-morbidity pattern of generalized anxiety symptoms and obsessive-compulsive symptoms in healthcare workers in Leshan general hospital

HUANG Xianying, LI Chenglong, WANG Haohao, CHEN Wei, CAI Bayuan, SHI Min

2025, 41(9):  1225-1228. 

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Objective To understand the current situation of generalized anxiety symptoms and obsessive-compulsive symptoms among healthcare workers in Leshan general hospital,and analyze the network co-morbidity pattern of generalized anxiety symptoms and obsessive-compulsive symptoms among healthcare workers. Methods From January to April 2023,a survey was conducted on medical staff at Leshan general hospital using the generalized anxiety disorder scale and obsessive-compulsive inventory-revised. A symptom coexistence network was drawn based on the graphical lasso program and Bayesian hill climbing method. Results The total score of generalized anxiety symptoms among 574 medical staff was （2.55±4.00）points,with a detection rate of 25.2%. The total score of obsessive-compulsive symptoms was （10.01±12.02）points,with a detection rate of 16.1%. The combined detection rate of the two was 12.4%. In undirected networks,generalized anxiety symptoms and obsessive-compulsive symptoms formed two closely related network clusters,with the core symptoms being "obsessive-compulsive ideation"（expected impact value=1.22,bridge expected impact value=0.57） and "fear"（expected impact value=1.08,bridge expected impact value=0.25）,and both played a bridging role in the symptom network（r=0.15）. According to directed network analysis,the concept of "compulsive behavior" pointed to compulsive behavior and anxiety symptoms as the driving points of the entire symptom network. Conclusion Although generalized anxiety symptoms are highly correlated with obsessive-compulsive symptoms,the symptom boundaries are clear. Obsessions play a key role in the occurrence and maintenance of compulsive behavior and generalized anxiety symptoms.

Analysis of current situation and influencing factors of medical nursing staff's anxiety in Chengdu

LONG Zhiren, CAO Ying, LUO Linwen, LIU Zhenya, LIU Min

2025, 41(9):  1229-1233. 

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Objective To understand the current situation of anxiety among medical nursing staff in Chengdu,analyze the main factors affecting the anxiety of nurses,and provide countermeasures and suggestions for further improving the quality of elderly care. Methods In June 2023,a self-made questionnaire and self-rating anxiety scale（SAS） were used to survey 393 medical and nursing staff in medical and elderly care institutions in Chengdu,and the data were analyzed. Results There were 393 medical nursing staff,with an average age of （51.12±3.12）years old,334 of them were female,accounting for 84.99%,and 184 of them had primary school education,accounting for 46.82%. The average anxiety score was （44.65±6.18）points,and the anxiety rate was 12.98%（51/393）. Age（OR=2.068）,type of hospital（OR=3.557）,marital status（OR=2.510） and monthly rest time（OR=2.537） were the influencing factors of anxiety（all P<0.05）. Conclusion The incidence of anxiety among 393 medical nursing staff in Chengdu is relatively high,with older age,lack of fixed rest time,and non-marital status being the main risk factors for anxiety. It is suggested to strengthen the training of psychological professional knowledge,carry out regular mental health assessment and intervention,rationally allocate working time,reduce work intensity,and strengthen care and concern to reduce anxiety.

Study on the cognition and coping behavior of sexually transmitted diseases among undergraduate students in Shaanxi Province in 2022

WANG Xiaoli, LI Hong, ZHU Tong, CHEN Jiacheng, WANG Maoning, WANG Yongfeng

2025, 41(9):  1234-1238. 

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Objective To understand the cognitive level,coping behavior,sexual behavior,and prevention and treatment of sexually transmitted diseases（STD） among undergraduate students in Shaanxi Province,and to provide reference for the development of health education on STD among college students. Methods In October 2022,a cluster sampling method was used to select undergraduate students in Shaanxi Province as the research subjects,a survey questionnaire on cognition and coping behavior of sexually transmitted diseases among college students was developed,and the data were analyzed after being filled in anonymously by students voluntarily. Results 35.51% of the students had a high cognitive level of STD,and the cognitive level of six STD was a negative shrinkage radar map indicating that the students' cognitive level was in a bad state. 51.40% of students deliberately avoided STD patients,girls,senior students had a higher fear and had a higher willingness to screen for STD before having sex（all P<0.05）. The students with higher cognitive level had significantly higher in deliberately avoiding sexually transmitted disease patients,the possibility of infection of STD and the willingness of active screening before having sex（all P<0.05）. The incidence of sexual activity was 15.58%,among which 87.00% had taken measures to prevent STD,and 26.00% had sought relevant examination and treatment because they felt ill or suspected to have contracted STD. Conclusion The cognitive level of STD among undergraduate students in Shaanxi Province is not high,and the awareness of coping behavior is not strong. Improving their cognitive level can guide them to actively cope with behaviors,especially by strengthening health education for female students,younger students,rural students,parents with low educational levels,and students with left behind experience.

Research on the decision-making preferences of nursing undergraduate students in public emergency response at a university in Hangzhou City

YIN Na, WANG Yangyang, LI Jiaqi, ZHANG Ju

2025, 41(9):  1239-1243. 

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Objective To understand the public emergency call response decision-making preferences of nursing undergraduates,and provide reference for emergency managers and emergency educators. Methods A questionnaire was designed using the discrete choice experimental method from August to December 2023. Convenience sampling was used to survey 211 nursing undergraduate students at a university in Hangzhou City,and a mixed logistic model and a marginal effect model were constructed for preference analysis. Results A total of 211 survey subjects were included,with an average age of（19.47±2.16）years. The mixed logistic regression model showed that clear legal protection（β=1.001,95%CI：0.713-1.290,P<0.05）,high level of personal first aid skills（β=0.504,95%CI：0.204-0.803,P<0.05）,and first aid training experience ≥6 times/year（β=0.352,95%CI：0.114-0.591,P<0.05） were the three most significant attributes influencing undergraduate nursing students' preference choices. When the baseline condition changed from unclear legal protection to clear protection,the probability of selection increased by 26.6%. When personal first aid skills improved from moderate to high,the probability of selection increased by 13.5%. Conclusion The degree of legal protection is the most critical attribute influencing the public emergency response decision-making preferences of nursing undergraduate students at a university in Hangzhou,followed by their own first aid level and first aid training experience.

Effect of clinical learning environment on the safety behavior of nursing interns in higher vocational

ZHONG Junping, JIANG Yu, LI Xiao, ZHOU Yiming, CHEN Liqin

2025, 41(9):  1244-1248. 

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Objective To explore the mediating role of patient safety competence between clinical learning environment and safety behavior among nursing interns in higher vocational colleges. Methods Convenience sampling method was used to conduct a questionnaire survey was conducted on 450 nursing interns in a higher vocational college in Longyan from November to December 2023,using general information questionnaire,clinical learning environment scale,patient safety competence scale and nurse safety behavior scale,and the data were analyzed. Results The total score of safety behaviors among nursing interns was （47.93±9.65）points,the total score of clinical learning environment was （143.46±34.65）points,and the total score of patient safety competence was （107.37±21.18）points. Safe behavior was positively correlated with clinical learning environment and patient safety competence（r=0.716,0.656,both P<0.01）,and clinical learning environment was positively correlated with patient safety competence（r=0.498, P<0.01）. The patient safety competence of nursing interns played a partial mediating role between the clinical learning environment and safety behaviors,with the mediating effect accounting for 27.68% of the total effect. Conclusion Safety behavior of nursing interns need to be improved in some specific aspects. A better clinical learning environments has an indirect effect on nursing interns' safety behavior through patient safety competency.

Effect of social network upward social comparison on sleep quality of medical students and the mediating role of envy

XU Mintao, ZHU Xu, LIAO Shiyao, PENG Kexin, FANG Xinyu, DANG Caiping

2025, 41(9):  1249-1253. 

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Objective To explore the current state of sleep quality among medical students and how social network upward social comparison（SNUSC） affects sleep quality through envy. Methods From January to April 2023,324 randomly selected medical students from Guangzhou Medical University were surveyed using the Pittsburgh sleep quality index,upward social comparison scale and envy questionnaire. SPSS 22.0 was used to perform chi-square test,t-test,Pearson correlation analysis,and mediation effect model test to analyze the data. Results The incidence of sleep disorders among 324 medical students was 29.94%（97 people）,with a sleep quality score of （6.179±3.249）points,SNUSC score of （19.667±5.171）points,and envy score of （2.984±0.561）points,and three were pairwise correlated（r=0.284,0.120,0.266,all P<0.05）. Envy played a full mediating role in the pathway of SNUSC affecting sleep quality（β_indirect=0.071,P<0.05）,and mainly acted on the sleep disorders and daytime dysfunction in sleep quality factors（all P<0.05）. Conclusion The sleep quality problem of medical students at Guangzhou Medical University is prominent,and SNUSC can affect the sleep quality of medical students through envy.

Meta-analysis of factors influencing the experience and support of second victims in clinical nurses

FU Juan, QIU Yu, QIN Xiao, ZHANG Jinhua, BAO Qingzhu

2025, 41(9):  1254-1260. 

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Objective To systematically evaluate a cross-sectional study on the influencing factors of clinical nurses' second victims using the second victim experience and support scale as a tool,and provide reference for the development of relevant intervention measures for clinical nurses' second victims. Methods The databases of CNKI,Wanfang,VIP,CBM,Pubmed,WOS,Embase,and Cochrane Library were searched by computer,and the study on the influencing factors of the experience and support of the second victim of clinical nurses was collected. The retrieval time was from the establishment of the database to October 2023. Meta-analysis was conducted using Revman 5.3 software. Results A total of 19 studies were included,including 13 999 clinical nurses. Personal related factors included the degree of desire to resign（r=0.159,95%CI：0.100-0.264）,perceived internal organizational pressure（r=0.149,95%CI：0.090-0.197）,with the working years（r=0.110,95%CI：0.030-0.178）,clinical department（r=0.110, 95%CI：0.040-0.178）,professional title（r=0.139,95%CI：0.020-0.245）,the number of adverse events（r=0.110,95%CI：0.050-0.168） and monthly night shift（r=0.149,95%CI：0.050-0.245） in background/environmental factors,which were weakly positively correlated with the experience and support of the second victim of clinical nurses（all P<0.05）. Resourcefulness level（r=-0.446, 95%CI：-0.585--0.282） and resilience（r=-0.438,95%CI：-0.551--0.310） were moderately negatively correlated with the experience and support of the second victim of clinical nurses（both P<0.05）. Sense of organizational support（r=-0.565,95%CI：-0.824--0.119） among background/environmental factors was highly negatively correlated with the experience and support of the second victim of clinical nurses（P<0.05）. Conclusion The level of resourcefulness,psychological resilience,sense of organizational support,working years,professional title,clinical department,number of night shifts per month,degree of desire to resign,number of adverse events,and perceived internal organizational pressure were the main influencing factors for the experience and support of the second victim of clinical nurses. Hospital nursing administrators should establish appropriate care programs and support systems,and conduct peer and leader training related to support.

Investigation and Research

Analysis of occupational health examination results of noise-exposed workers in Tianjin

HUANG Lei, WANG Andong, CHENG Li, WANG Dayu

2025, 41(9):  1261-1264. 

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Objective To understand the differences in various indicators of occupational health examination results among noise-exposed workers in Tianjin. Methods Noise-exposed workers who underwent occupational health examinations at Tianjin Occupational Disease Precaution and Therapeutic Hospital from January to December 2023 were selected as research subjects. SPSS 27.0 software was used to analyze the basic information of the workers and the examination results of blood pressure,electrocardiogram,and pure tone audiometry. Results A total of 23 100 noise-exposed workers were included in the study. Among them,3 840 cases（16.62%） were identified with hypertension,3 284 cases（14.22%） had abnormal ECG results,and 7 043 cases（30.49%） exhibited high-frequency hearing threshold loss. There were statistically significant difference in the detection rate of various abnormal results among workers of different genders,ages,and working years（all P<0.05）. Furthermore,stratified individuals with high-frequency hearing loss,compared the prevalence of hypertension and ECG abnormalities among different levels,and the differences were statistically significant（both P<0.05）. Conclusion There are significant differences in the incidence of hypertension and electrocardiographic abnormalities among noise-exposed workers stratified by gender,age,length of service,and hearing loss. There is a correlation between occupational noise exposure and high-frequency hearing threshold loss,elevated blood pressure,and electrocardiographic abnormalities. In the high-frequency hearing loss frequency band of 4 000 Hz hearing level stratification,it is an independent influencing factor for hypertension and abnormal electrocardiogram.

Continuing Medical Education

Practices and effects of the training program for nursing assistants

TAN Wenxuan, ZHANG Rong, ZHONG Yunling, ZHANG Lili, LI Xingwen, ZHU Jin

2025, 41(9):  1265-1269. 

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Objective To develop and implement a competency training program for nursing assistants aimed at comprehensively enhancing their theoretical knowledge,practical skills,and core competencies,and to evaluate the effectiveness of the training. Methods From September to November 2023,60 nursing assistants from 37 medical institutions participating in the Guangdong Province medical nursing professional skills competition were selected as training objects,and the training was carried out based on the conceive-design-implement-operate（CDIO） teaching model. The theoretical scores,skill operation scores and core competence scores of the trainees were compared before and one week after the training,and the satisfaction of the trainees with the training and teaching was investigated by questionnaire survey. Results After training,the theoretical test score of nursing assistants was（84.41±3.35）points,which was higher than before training[（74.68±4.71）points,t=13.674,P<0.05]. The score of skill operation test was （50.30±10.21）points,which was higher than before training[（43.29±9.01）points,t=24.077,P<0.05]. The total score of core competence was （206.53±13.90）points,which was higher than before training[（174.23±10.03）points,t=28.370,P<0.05]. Among them,the score of theoretical knowledge was （39.73±2.83）points,practical skills was （78.10±5.97）points,comprehensive ability was （41.30±3.67）points,human trait score was （47.40±4.57）points,which were all higher after training than before training（t=6.746,14.083,2.101,8.376,all P<0.05）. The overall satisfaction of the trainees was 97.02%. Conclusion The competency training program for nursing assistants,based on the CDIO model,has enhanced the trainees' theoretical knowledge,practical skills,and core competencies. It promotes the continuous growth of nursing assistants and has significant implementation value and potential for broader application.

Health Management and Research

Current situation and ability improvement strategy of professionalization among administrative personnel in a tertiary public hospital in Tianjin

AN Guoliang, WANG Ximo

2025, 41(9):  1270-1274. 

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Objective To analyze the professionalization status of administrative management personnel in a tertiary public hospital in Tianjin,explore the implementation of scientific and effective strategies for improving professional abilities,and promote the high-quality development of the hospital. Methods From 2022 to 2023,multi-dimensional data collection was conducted on the distribution of 165 administrative staff members at a certain tertiary public hospital in Tianjin,and descriptive analysis methods were used to analyze the data. By reviewing literature,a professional competence index consultation form was compiled,and 20 experts were consulted to rank the 12 professional competence indicators according to their scores. After the training,a survey was conducted among 129 trained personnel to assess their adoption of training content in actual work. The operational status of the hospital in 2022 and 2023 was analyzed and compared,and statistical analysis was performed on the collected data. Results Of the 165 administrative staff at the hospital,54 graduated from management-related higher education institutions,accounting for 32.7%,and 32 had a master's degree or higher,accounting for 19.4%. Additionally,43 had associate senior or higher professional titles,accounting for 26.1%. Based on the results of expert consultation,six professional competencies had been identified as key content for education and training,including the ability to identify problems,the ability to conduct research and investigation,interpersonal communication skills,the ability to optimize processes,the ability to establish rules and systems,and the ability to handle emergencies and crises. A questionnaire survey revealed that training had a substantial impact on the specific administrative management behaviors of 72.87% of the participants. In 2023,the operational indicators of the hospital,including the number of outpatient and emergency visits,the number of discharged patients,the volume of fourth level surgeries,the average length of hospital stay,and the proportion of medical service income indicators,were all better than those in 2022,with statistically significant differences（all P<0.05）. Conclusion The professionalization level of administrative personnel needs to be improved. Educational training and practical application in six professional abilities are effective methods to enhance the professionalization level of administrative personnel under current conditions.

Optimization strategy research of emergency mechanism for public health emergencies in Tianjin based on Delphi Method

ZHANG Xiaowang, JIN Xin

2025, 41(9):  1275-1279. 

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Objective To construct an indicator framework for Tianjin pubtic health incidents response system design by the Delphi method,and to improve and optimize the emergency response mechanism for public health emergencies. Methods A research group was established,and a preliminary survey questionnaire was designed using methods such as literature search. In May 2024, the Delphi method was applied to conduct two rounds of questionnaire consultation with 70 experts,and the data were analyzed. Results The effective response rates of the two rounds of expert inquiry questionnaires were 94.3% and 91.4%,respectively. The expert authority coefficients were 0.874 and 0.881,respectively. The coordination coefficients of the two rounds of expert opinions were 0.452 and 0.501,respectively. The final establishment of the index framework for Tianjin's response to public health emergencies includes 3 first level dimensions and 11 second level dimensions. Conclusion The emergency public health system in Tianjin is relatively complete. At the same time,the governance structure should be improved according to actual work needs,and the decision-making mechanism should be optimized to effectively strengthen auxiliary measures,thereby consolidating the comprehensive guarantee of the overall emergency system.

Overview

Research progress on assessment and management of occupational stressors in psychiatric nurses

CHEN Qi, CAO Meijuan, LING Zheyi, WANG Yating, WU Hailu

2025, 41(9):  1280-1285. 

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：With the change of nursing concept and the rapid growth of public demand for psychiatric and psychological services,the occupational stress of psychiatric nurses has increased unprecedentedly,which is highly likely to jeopardize the physical and mental health of this occupational group. Scientific and accurate assessment,analysis and management of psychiatric nurses' stressors are not only conducive to alleviating their occupational stress,but also of great significance to improving the quality of nursing services. This article is guided by the Robbins' stressor theory model and provides a review of assessment tools,factor analysis,and management strategies for occupational stressors in psychiatric nurses,in order to provide references for constructing a stress management system for psychiatric nurses in China,improving nurses' mental health,and upgrading the quality of nursing services.

Research progress on intervention for the intrinsic ability of community elderly

DONG Shuxian, LIU Yun, WANG Fen, LI Chunyan, MAO Xuehui

2025, 41(9):  1286-1290. 

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：Intrinsic ability refers to the ability of elderly people to use all their physical and mental energy to engage in any activity,and is the core of their functional state. The strategy of maintaining the functional stability of the elderly is to enhance their intrinsic abilities,which can reduce the occurrence of adverse events and improve their ability to be self-sufficient at home. Maintaining and improving the intrinsic ability level of the elderly in the community is the key point to maintain the functional status of the elderly and realize healthy aging. This paper reviews the status quo,influencing factors and type of intervention programs of the intrinsic abilities of the elderly in the community,and puts forward suggestions,so as to provide reference for making relevant intervention programs for community elderly in China.

Research progress on the effect of exercise on sleep quality based on the theory of event-group training

ZHANG Qian, XUE Fenqin

2025, 41(9):  1291-1296. 

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：The event-group training theory is an important theoretical basis to guide sports training,and it also lays the foundation for the selection of exercise prescriptions in the field of sleep quality research. Systematic and standardized sorting based on the event-group training theory is crucial to further implement the scientific guidance of the impact of exercise intervention on sleep quality. Based on the event-group training theory,this study classifies,integrates and summarizes relevant literature. Research has shown that the effect of exercise on improving sleep quality has been widely recognized by the academic community,but the exercise patterns involved in existing studies have problems such as lack of theoretical guidance and unclear classification. This article can be applied to the related research of exercise and sleep quality,provide reference for formulating standardized exercise intervention methods,and effectively promote the transformation of research results into practical applications.