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Aims: To describe turnover intention of emergency nurses and clarify the effects of organizational commitment, job satisfaction and workplace violence on turnover intention. Background: Research has showed the predictors of turnover intention differed among nurses of different specialties. However, research on turnover intention has mostly focused on general nurses rather than emergency nurses. Design: A descriptive, cross-sectional study was conducted. Methods: A self-administered questionnaire was used to collect data from 415 emergency nurses in Beijing, China, using convenience sampling. Path analysis was used to test the relationships between organizational commitment, job satisfaction, workplace violence and turnover intention. Results: Most emergency nurses (90.2%) had a high level or very high level of turnover intention. Contrary to previous studies, organizational commitment had a significant direct positive effect on workplace violence. It also had a direct positive effect on job satisfaction and a negative effect on turnover intention. Workplace violence had a negative effect on job satisfaction and a positive effect on turnover intention. Job satisfaction had a direct negative effect on turnover intention. Conclusion: To reduce turnover intention in the emergency department, measures should be taken to reduce workplace violence and increase nurses' job satisfaction, especially those with high organizational commitment.

Aims To determine job stress among Chinese operating room nurses, test the mediating effect of burnout and verify the moderating effect of over‐commitment between job stress and mental health. Design A descriptive, cross‐sectional study. Methods A multistage sampling method was adopted. First, a random sampling method was used to select 30 tertiary hospitals in Beijing, after which 509 operating room nurses were selected by convenience sampling from March‐June 2017. Self‐administered questionnaires were used to evaluate job stress, burnout, and organizational commitment among participants. Multiple‐group path analysis was used to test the mediating effect and the moderating effect. Results Of all nurses, 70.3% were in a state of job stress, which had negative effects on organizational commitment mediated by emotional exhaustion and depersonalization. The result of multiple‐group path analysis showed that the path coefficients are different between the low and high groups of over‐commitment. When facing job stress, operating room nurses with low over‐commitment were more likely to have emotional exhaustion (β = 0.750 vs. 0.602), while those with high over‐commitment were more likely to have low organizational commitment (β = −0.641 vs. −0.594). Conclusion The job stress of operating room nurses in China was high. Burnout played a mediating role between job stress and organizational commitment. Over‐commitment played a moderating role in the relationship among job stress, burnout, and organizational commitment. Impact This study analysed the relationship among operating room nurses’ job stress, burnout, and organizational commitment. The findings provided confirmatory support on the mediated effect of burnout between job stress and organizational commitment and the moderation effect of over‐commitment. Different measures are needed to reduce job stress, as for easing burnout and improving organizational commitment among different groups of nurses.

Unique environment, coupled with overload, low job control, and high risk might put operating room (OR) nurses in a state of high job strain, which might have negative influences on burnout and organizational commitment. Based on the Job Demand-Control-Support model and previous studies, we hypothesized that the relationship between job strain (determined by job demand and control) and organizational commitment could be mediated by burnout (emotional exhaustion and depersonalization), the effect of job strain on burnout and organizational commitment could be moderated by social support. To verify the hypothesis, a quantitative cross-sectional survey was conducted, 509 OR nurses from 30 tertiary hospitals in Beijing were recruited. Multiple-group path analysis was used to test the moderated role of social support. Propensity score matching was applied to match job strain in different groups. Our research found that in the low social support group, job strain was not related to organizational commitment, while in the high social support group, depersonalization was not related to organizational commitment. Furthermore, nurses in the low social support group were more likely to have depersonalization under job strain compared to the high social support group. Social support should be provided to alleviate the negative impact of job strain.

ObjectiveTo explore the relationships between swallowing functional outcomes and nutritional status in patients with head and neck cancer undergoing radiotherapy (RT).MethodsThis longitudinal study included 122 patients. Data were collected at three time points: baseline (T1), the third week of RT (T2) and the completion of RT (T3). The Common Terminology Criteria for Adverse Events was used to assess the symptom of dysphagia and other toxicities; the MD Anderson Dysphagia Inventory (MDADI) was used to assess the patient-perceived swallowing functional outcomes; the nutritional status was evaluated by the weight ratio and the Patient-Generated Subjective Global Assessment (PG-SGA). The generalised estimating equation (GEE) was used to measure the correlation of MDADI with the weight ratio or PG-SGA and also to analyse the influential factors of swallowing functional outcomes.ResultsThe participants’ acute dysphagia rates were 5.7% at T1, 69.7% at T2 and 77.9% at T3. The swallowing functional outcomes worsen over RT (p<0.001) and were associated with weight ratio (β=0.032, p=0.008) and PG-SGA (β=−0.115, p<0.001). GEE models showed that patients with cancer of the pharynx region, advanced stage, chemoradiotherapy and high RT dose perceived worse swallowing functional outcomes. Oral mucositis, pharynx mucositis and salivary gland inflammation were positively correlated with swallowing functional outcomes, and the pharynx mucositis presented the highest absolute value of β.ConclusionThe swallowing functional outcomes were negatively correlated with nutritional status. Healthcare professionals should identify early on the population at higher risk and focus on multiple toxicities, especially the management of pharynx mucositis, to improve nutritional status.

Objective: The objective of this study was to explore the interrelationship between anticipatory grief (AG), caregiver burden, communication, preparation for death, and coping style. Methods: A convenience sample of 256 Chinese family caregivers of patients with advanced cancer were recruited from an academic cancer hospital between April 2018 and May 2019. This cross-sectional survey included the AG Scale, caregiver burden (Caregiver Reaction Assessment), communication (Caregivers' Communication with Patients about Illness and Death Scale), preparation for death, and coping style (Simplified Coping Style Questionnaire). Structural equation modeling tested the interrelation between them. Results: The final model fitted the data acceptably (χ 2 = 25.79, degrees of freedom = 17, P = 0.08, root mean square error of approximation = 0.05, goodness-of-fit index [GFI] = 0.98, adjusted GFI [AGFI] = 0.95, parsimony GFI [PGFI] = 0.46, normed fit index = 0.94, comparative fit index = 0.98). Poor communication contributed to less preparation for death and caregiver burden, which further aggravate AG. Communication was positively associated with AG. In addition, communication and positive coping style interacted to further influence caregiver burden. Conclusions: Preliminary results supported the model and showed that poor communication, less preparation for death, and caregiver burden contributed to AG while positive coping alleviated AG. Findings suggest the need for further studies to explore effective intervention for communication, preparation for death, burden, and coping style of caregivers to ultimately alleviate AG.

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BackgroundBody composition may influence the prognosis of head and neck cancer (HNC) patients. To find out the most crucial factors in this relationship, we explored the association between body composition and survival.MethodsIn this prospective longitudinal study, HNC patients who underwent radiotherapy (RT) from March 2017 to December 2018 were recruited. The association between body composition and survival was analyzed using Cox proportional hazard regression.ResultsFinal analysis included 316 patients, with a median follow‐up of 34.4 months. Multivariable analysis revealed that weight loss 6 months before RT and body composition changes during RT did not affect the survival outcome. However, patients with low appendicular skeletal muscle mass index (ASMI) before RT exhibited poor overall survival (OS). ASMI before RT was an independent prognostic factor for OS.ConclusionsBody composition loss was common during RT, and ASMI before RT independently influenced the survival outcomes of HNC patients.