Objective:To examine the relationship between perceived stress and clinical practice maladjust-ment,as well as the mediating roles of executive function and depressive symptoms in the relationship among intern nurses.Methods:A total of 624 nursing interns were recruited and followed up during this eight-month longitudinal study.Baseline data(Tl)were collectedon the day of internship orientation(July 2022)with the Perceived Stress Scale(PSS),Geurten Executive Function Questionnaire(G-QEF)and Patient Health Questionnaire Depression Module(PHQ-9).Follow-up data(T2)were collected shortly before the end of the internship(March 2023)with the PSS,G-QEF,PHQ-9,and Nursing Students Clinical Internship Maladjustment Scale(NSCPMS).The chain me-diation effect of executive function and depressive symptoms in the relationship between perceived stress and clini-cal practice maladjustment was analyzed.Results:The PSS scores at T1 significantly predicted the NSCPMS scores at T2(β=-1.00,P＜0.001).Executive function and depressive symptosm jointly mediated the relationship be-tween perceived stress and clinical practice maladjustment,with a mediation effect value of-0.01(95％CI=-0.026--0.004).Additionally,depressive symptoms alone significantly mediated the relationship between per-ceived stress at T1 and clinical practice maladjustment at T2,with a mediation effect value of-0.06(95％CI=-0.101--0.017).Conclusion:Perceived stress at the beginning of the internships may negatively impact long-term clinical adjustment among nursing interns,potentially through impaired executive function and depressive symptoms.This finding suggests that early prevention measures and interventions to reduce stress at the start of in-ternships are needed to help interns better adapt to clinical practice.

Objective:To examine the relationship between perceived stress and clinical practice maladjust-ment,as well as the mediating roles of executive function and depressive symptoms in the relationship among intern nurses.Methods:A total of 624 nursing interns were recruited and followed up during this eight-month longitudinal study.Baseline data(Tl)were collectedon the day of internship orientation(July 2022)with the Perceived Stress Scale(PSS),Geurten Executive Function Questionnaire(G-QEF)and Patient Health Questionnaire Depression Module(PHQ-9).Follow-up data(T2)were collected shortly before the end of the internship(March 2023)with the PSS,G-QEF,PHQ-9,and Nursing Students Clinical Internship Maladjustment Scale(NSCPMS).The chain me-diation effect of executive function and depressive symptoms in the relationship between perceived stress and clini-cal practice maladjustment was analyzed.Results:The PSS scores at T1 significantly predicted the NSCPMS scores at T2(β=-1.00,P＜0.001).Executive function and depressive symptosm jointly mediated the relationship be-tween perceived stress and clinical practice maladjustment,with a mediation effect value of-0.01(95％CI=-0.026--0.004).Additionally,depressive symptoms alone significantly mediated the relationship between per-ceived stress at T1 and clinical practice maladjustment at T2,with a mediation effect value of-0.06(95％CI=-0.101--0.017).Conclusion:Perceived stress at the beginning of the internships may negatively impact long-term clinical adjustment among nursing interns,potentially through impaired executive function and depressive symptoms.This finding suggests that early prevention measures and interventions to reduce stress at the start of in-ternships are needed to help interns better adapt to clinical practice.

Objective:To investigate the clinical practice level and influencing factors of geriatric nursing specialist nurses.Methods:This study was a cross-sectional survey. Using the convenient sampling method, a total of 332 specialist nurses from 5 phases trained by Beijing Nursing Association from January to February 2021 were selected as the research objects. The general data questionnaire, Questionnaire on Clinical Practice Level of Geriatric Nursing Specialist Nurses, Questionnaire on Unit Support for Geriatric Nurses and Core Competence Self-Assessment Scale of Geriatric Nursing Specialist Nurses were used to investigate the nurses. Pearson correlation was used to analyze the relationship between unit support, self-assessment of core competence and practice level. Multiple linear regression was used to analyze the factors influencing the clinical practice level of geriatric nurses. A total of 332 questionnaires were distributed, 306 questionnaires were returned and 298 were valid questionnaires.Results:The total mean score of clinical practice of geriatric nursing specialist nurses was (3.42±0.83) . The results of multiple linear regression analysis showed that the work department, unit support and core competence were the influencing factors of the clinical practice level of geriatric nursing specialist nurses ( P<0.05) . Conclusions:Specialist nurses who work in the geriatric ward, have a high degree of unit support and have a high level of core competence have a higher clinical practice level.

Objective:To explore the current situation and related factors of asphyxia prevention and management for the elderly in elderly care institutions, so as to provide a reference for improving the safety management of elderly care institutions.Methods:This research was a cross-sectional survey. From December 2020 to January 2021, convenience sampling was used to select 43 elderly care institutions from the China Aged Care Alliance. The self-designed questionnaire was used to collect the content related to asphyxia prevention and management for the elderly in institutions, and analyze its current situation and related factors. A total of 43 questionnaires were distributed in this survey, and 43 were recovered, with a recovery rate of 100%.Results:Among the 43 elderly care institutions, and 3 (6.98%) were state-run, and 22 (51.16%) were private, and 18 (41.86%) were public and private. The average occupancy rate was (67.63±20.59) %, and the average proportion of moderate to severe disability among the elderly residents was (80.10±20.25) %. The proportions of elderly care institutions that formulated systems and regulations for monitoring and early warning of asphyxia events, reporting of asphyxia events, analysis and improvement of asphyxia incidents in the elderly were 53.49%, 51.16%, and 51.16%, respectively. The proportions of elderly care institutions that carried out asphyxia risk screening, swallowing function assessment, and swallowing function training for the elderly residents were 65.12%, 51.16%, and 46.51%, respectively.Conclusions:Most elderly care institutions have problems in the prevention and management of asphyxia for the elderly, which needs to be improved. It is recommended that building a complete asphyxia prevention and management system, carrying out risk screening, assessment and training of swallowing function for high-risk groups, strengthening the professional training of agency leaders and caregivers, and seeking continuous external professional support so as to improve the safety management system of elderly care institutions, and ensure the quality of life and personal safety of the elderly.

Objective:To explore the demand for suffocation prevention training for nursing staff in elderly care institutions and analyze its influencing factors to provide reference for improving training strategies.Methods:In this cross-sectional study, from December 2020 to January 2021, the caregivers from 43 elderly nursing institutions under China Geriatric Care Alliance were selected by convenient sampling. Self-made questionnaires were used to collect personal information of caregivers as well as related experience and training needs of suffocation prevention for the elderly. Totally 526 questionnaires were recovered, of which 412 were valid, with an effective rate of 78.33%.Results:Among the 412 caregivers, 53 (12.86%) were registered nurses and 359 (87.14%) were senior caregivers. They had a high demand for suffocation prevention, identification, and emergency treatment training. The top three most demanded are the common causes of suffocation, the risk factors of suffocation for special elderly people, and the identification of abnormal physical signs to detect suffocation in time. There were statistically significant differences in the scores of content requirements for suffocation prevention training between institutions which had and had not experienced suffocation and caregivers who knew or did not know the medication status or suffocation history of the care recipients ( P<0.05) . Conclusions:Caregivers in elderly care institutions have a high demand for suffocation prevention training. It is recommended that elderly care institutions apply pre-prevention to the management of suffocation prevention for the elderly, and guide caregivers to fully understand the medication status, suffocation history, and swallowing function of the care recipients, and provide registered nurses and elderly caregivers with systematic training related to suffocation prevention.

Objective To explore the relationship between adverse childhood experiences,negative emotions and interpersonal sensitivity.Methods Adverse Childhood Experiences Questionnaire (ACEQ),Depression Anxiety Stress Scale (DASS-21) and the Interpersonal Sensitivity Subscale of Symptom Check-List (SCL-90) were applied to investigate the 492 new enrolled medical students.Results Boys got higher ACEQ scores than girls; Compared with only-child,non-only-child scored higher in depression,interpersonal sensitivity; Compared with students from non-rural areas,those from rural areas got higher scores in depression,anxiety stress,interpersonal sensitivity.There existed significant differences of scores on ACEQ,depression,anxiety,stress,interpersonal sensitivity among children of fathers of different educational level; while differences of scores on depression,anxiety,interpersonal sensitivity among children of mothers of different education level were statistically significant.There were significantly differences of scores on depression,anxiety,stress,interpersonal sensitivity among participants with 0,1,2 and 3 or more ACEQ.The results of correlative analysis provided evidence that adverse childhood experiences,all the factors of negative emotions and interpersonal sensitivity were significantly positively correlative.The SEM suggested that adverse childhood experiences had an indirect effect on interpersonal sensitivity through negative emotions.Conclusions Adverse childhood experiences has a great influence on negative emotions and interpersonal sensitivity.Negative emotions has a completely mediating role between adverse childhood experiences and interpersonal sensitivity.