Objective To investigate the current situation of career decision-making self-efficacy of higher vocational nursing students during practice,and analyze the relationship between professional commitment,emotional intelligence and career decision-making self-efficacy to provide reference for the career development,career guidance and career education.Methods Nursing students from 6 classes (less than 3 months until the end of clinical practice) in Changsha Health Vocational College were randomly selected from April to May 2016. The questionnaires were distributed and taken back on the spot. The questionnaires consisted of general information questionnaire,career decision-making self-efficacy scale,professional commitment scale and emotional intelligence scale. The Chinese version of SPSS 22.0 was used for data statistics and analysis. Results The average score of career decision-making self-efficacy was (3.16±0.43). In self-assessment, information-acquisition,planning and problem-solving aspects,the differences of students between 3-year system (starting point from high school) and 5-year system (starting point from junior school) were statistically significant (t=2.72,2.70,2.88,2.54;P<0.05). Statistically significant difference was observed between the scores of the only-child students and the non-only-child students (t=2.53,3.09,3.71,2.43;P<0.05). Professional commitment,most dimensions of emotional intelligence were positively correlated with career decision-making self-efficacy (r=0.568,0.361,0.509,0.435,0.390,0.360,0.373,0.176,0.348;P<0.05). Emotive commitment,ideal commitment,normative commitment and emotional development were positive predictors of career decision-making self-efficacy scores which explained 38.1% of the total variance (t=3.492, 2.633,2.116,1.862;P<0.10).Conclusions The level of career decision-making self-efficacy of higher vocational nursing during practice was not high. Professional commitment and emotional intelligence affect the career decision-making self-efficacy. Higher vocational college should improve levels of professional commitment and emotional intelligence of the students,strengthen the cultivation of professional role and promote successful employment of nursing students.

Objective:To investigate the risk factors of birth weight discordance in dichorionic diamniotic (DCDA) twins.Methods:This study retrospectively analyzed 1 757 cases of DCDA twin pregnancies from 11 Chinese hospitals from January 1, 2014, to December 31, 2017. Birth weight discordance was defined as ≥ 20% difference between the twins. All cases were divided into two groups: the concordant group ( n=1 520) and discordant group ( n=237). General information was compared and the high-risk factors of birth weight discordance were analyzed. Mann-Whitney U test, Chi-square test or Fisher's exact test, and logistic regression analysis were used as statistical methods. Results:Compared with the concordant group, the discordant group showed a higher incidence of hypertensive disorders of pregnancy [24.5% (58/237) vs 12.8% (194/1 520), χ2=22.882, P<0.05], fetal structural malformations [4.2% (10/237) vs 1.0% (15/1 520), χ2=15.160, P<0.05], fetal distress [6.3% (15/237) vs 1.4% (21/1 520), χ2=22.602, P<0.05], umbilical cord abnormalities [3.8% (9/237) vs 1.2% (18/1 520), χ2=7.607, P<0.05] and abnormal placental cord insertion [3.8% (9/237) vs 1.4% (21/1 520), χ2=34.904, P<0.05], but lower incidence of premature rupture of membranes [11.0% (26/237) vs 16.5% (250/1 520), χ2=4.645, P=0.034]. Logistic regression analysis showed that the independent risk factors of birth weight discordance in DCDA twins were hypertensive disorders of pregnancy ( OR=2.258, 95% CI: 1.620-3.184, P<0.001), fetal structural malformations ( OR=4.268, 95% CI: 1.892-9.631, P<0.001), umbilical cord abnormalities ( OR=2.889, 95% CI: 1.245-6.705, P=0.014) and abnormal placental cord insertion ( OR=2.318, 95% CI: 1.012-5.311, P=0.047). Conclusions:Hypertensive disorders of pregnancy, fetal structural malformations, umbilical cord abnormalities and abnormal placental cord insertion may be the risk factors of birth weight discordance in DCDA twins.