Aims: To explore whether the clinical learning environment (CLE) has an indirect effect on professional identity through the mediation of career self-efficacy (CSE) in nursing students. Background:The shortage of nurses has become a universal problem worldwide.Improving nurses' professional identity is considered an effective way to reduce the turnover rate of nurses. However, little is known about the relationship between the CLE, CSE and professional identity. Design: An observational, questionnaire-based, cross-sectional study. Methods: A web-based survey was completed by 212 undergraduate nursing students from June to August 2018. Measures included Chinese translations of the CLE, the Career Self-Efficacy Scale, and the Professional Identity Scale.Results: Both the CLE (r = 0.552, p < 0.01) and CSE (r = 0.868, p < 0.01) correlated positively with professional identity. The indirect effect of the CLE on professional identity through CSE was positive (β = 0.342, p < 0.05) and the effect was 77.2%.Conclusions: A better CLE and higher scores in CSE were associated with professional identity in nursing students, and a better CLE had an indirect effect on the professional identity of students through CSE.
Objective The purpose was to explore the alertness of premonitory symptoms in stroke patients with prehospital delay, and to analyze the influencing factors. Design and Sample A cross‐sectional study using the convenience sampling method was conducted in the neurology department of a general hospital between November 2018 and July 2019. A total of 352 stroke patients were participated in the survey. Measures A hierarchical multiple regression was performed to analyze the factors related to the alertness of premonitory symptoms (0–9 scores) in stroke patients with prehospital delay. Results The alertness score was 6.53 ± 2.377. The lowest score of 0.55 ± 0.498 was for “Continuous yawning occurs continuously despite no tiredness or lack of sleep is okay, and need not be treated.” The hierarchical regression results revealed that symptom onset, symptom change before admission, knowledge, social support were the influencing factors delaying the alertness of premonitory symptoms. Knowledge and support from friends could improve the alertness, while support from family and other support had a notable negative impact. Conclusions Stroke patients need to be more alert toward premonitory symptoms. This alertness is related to stroke knowledge and social support. Nurses should formulate interventions and advise stroke patients to improve their stroke knowledge and expand their social network.
BackgroundStroke has become a leading cause of mortality and adult disability in China. The key to treating acute ischemic stroke (AIS) is to open the obstructed blood vessels as soon as possible and save the ischemic penumbra. However, the thrombolytic rate in China is only 2.5%. Research has been devoted to investigating the causes of prehospital delay, but the exact controllable risk factors for prehospital delay remain uncertain, and a consensus is lacking. We aimed to develop a risk assessment tool to identify the most critical risk factors for prehospital delay for AIS patients.MethodsFrom November 2018 to July 2019, 450 patients with AIS were recruited. Both qualitative and quantitative data were collected. The Delphi technique was used to obtain expert opinions about the importance of the risk indices in two rounds of Delphi consultation. Then, we used the risk matrix to identify high-risk factors for prehospital delay for AIS patients.ResultsThe risk matrix identified the following five critical risk factors that account for prehospital delay after AIS: living in a rural area; no bystanders when stroke occurs; patients and their families lacking an understanding of the urgency of stroke treatment; patients and their families not knowing that stroke requires thrombolysis or that there is a thrombolysis time window; and the patient self-medicating, unaware of the seriousness of the symptoms, and waiting for spontaneous remission.ConclusionsThe risk analysis tool used during this study may help prevent prehospital delays for patients with AIS.
Objectives: Although the evidence from numerous longitudinal studies has indicated a remarkable change in cognitive function (CF) and depressive symptoms (DS) over time, the parallel latent growth curve model (LGCM) has seldom been used to simultaneously investigate the relationship between their change trajectories. This study aimed to examine whether a change in DS was associated with CF over time using an LGCM.Methods: Data were collected from the Chinese Longitudinal Healthy Longevity Survey’s 2011, 2014, and 2018 waves. A parallel LGCM examined the association between CF and DS.Results: The multivariate conditioned model’s goodness of fit supported the validity of the longitudinal model (Tucker-Lewis index [TLI] = 0.90, comparative fit index [CFI] = 0.96, root mean square error of approximation [RMSEA] = 0.04). The results showed that the CF intercept was positively to the DS slope (β = 0.42, p = 0.004). The CF and DS slopes were significantly linked (β = −0.65, p = 0.002).Conclusion: The findings expand the knowledge about CF’s effect on DS in older adults.
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