The rising use of C-arm fluoroscopy in operating rooms raises occupational safety concerns for perioperative nurses. They may face scattered ionizing radiation despite not being classified as radiation workers. This study compared posterior Crystalline Lens Density a key indicator of radiation-induced cataract among perioperative nurses working with C-arm fluoroscopy, interventional radiology staff, and a non-exposed control group to determine whether intermittent occupational exposure is associated with measurable lens changes. In this Cross-sectional comparative study, 150 participants (50 perioperative nurses with C-arm exposure, 50 non-exposed or staff, and 50 interventional radiology personnel) underwent standardized ophthalmic examination. Pentacam Nucleus Staging quantified posterior lens density; the worse eye was analyzed. Groups were compared using chi-square tests and ANCOVA with Bonferroni correction. Interventional radiology personnel exhibited significantly higher crystalline lens density (8.99 ± 1.50) compared with both perioperative nurses (8.40 ± 0.69; mean difference: 0.53, p = 0.001) and the control group (8.20 ± 0.27; mean difference: 0.70, p < 0.001). No significant difference was observed between perioperative nurses and controls (mean difference: 0.17, p = 0.539). The frequency of posterior subcapsular opacities (6.1% vs. 3.0% vs. 2.0%, p = 0.001), PNS grade ≥ 1 (17.1% vs. 8.0% vs. 3.9%, p = 0.002), and overall cataract prevalence (19.5% vs. 6.0% vs. 4.0%, p = 0.001) were all significantly higher in the interventional radiology group, with no significant differences between perioperative nurses and controls. Perioperative nurses showed no significant difference compared with unexposed controls. These findings suggest that intermittent C-arm exposure under typical distancing conditions poses minimal measurable risk. Specifically, such exposure does not appear to increase radiation-related lens changes. Clinical trial number not applicable.

Intensive Care Unit (ICU) nurses are frequently exposed to sudden patient deaths and are often the first professionals to interact with bereaved families. Providing grief counseling for family members in the context of unexpected death presents unique emotional and professional demands on ICU nurses, who are often the primary providers of bedside care and family support. Although grief support has received growing attention in pediatric and palliative nursing, the role of nurses in delivering grief counseling for family members following unexpected adult death in ICUs remains underexplored, particularly in the Chinese cultural context. In this study, the COM-B (Capability-Opportunity-Motivation-Behavior) model was used to examine factors affecting ICU nurses' grief counseling behaviors toward family members. An exploratory qualitative study was conducted using semi-structured interviews at a tertiary hospital in East China. Purposive sampling was used to recruit registered ICU nurses with at least a bachelor's degree, one year of clinical experience, and prior experience in providing grief counseling for family members. Data were analyzed using directed content analysis guided by the COM-B framework with NVivo 11 software. Seventeen ICU nurses participated in this descriptive study. Directed content analysis identified three major themes and eleven subthemes affecting behaviors of grief counseling for family members: capability factors (inadequate grief-related knowledge, deficits in communication skills, and limited emotional self-regulation), opportunity (promotion of humanistic care initiatives, strong external support, sociocultural norms, and unit's grief-support culture), and motivational factors (professional value, self-efficacy in grief counseling for family members, attitude toward and willingness to provide counseling, and empathy awareness and development). The elements interacted in complex ways, jointly shaping whether nurses were able, willing, and confident to provide grief counseling for family members after unexpected deaths. ICU nurses' grief counseling for family members after unexpected patient death is a complex behavioral process, shaped by internal competencies, external conditions, and cultural norms. Strengthening this practice likely requires targeted education to fill in knowledge and communication gaps, supportive organizational cultures that empower nurses, and strategies that enhance professional identity and motivation. Given the exploratory design and relatively small sample size, these findings must be interpreted with caution. Ultimately, these insights underscore the critical role of nurses in grief support and call for context-sensitive interventions to improve grief care in acute settings.

The COVID-19 pandemic negatively impacted healthcare workers' (HCWs) mental health, particularly nurses, due to their demanding frontline roles. Easily accessible psychological interventions are needed to support their well-being, especially during crises like lockdowns. This study aimed to support nurses during the pandemic through online-based Acceptance and Commitment Therapy (ACT) interventions. While ACT, a third-wave cognitive-behavioral approach, has shown effectiveness in reducing work-related stress, its impact on nurses across cultures remains unexplored. We used a multi-stage process (Delphi Method) to develop online-based ACT interventions. This process included a needs assessment through semi-structured interviews with nurses (Hong Kong: n = 8; Switzerland: n = 20) and focus groups conducted to evaluate the interventions before implementation. The intervention - consisting of two half-day workshops - was then tested in a pilot study with nurses from Hong Kong (n = 7) and Switzerland (n = 10). Levels of stress, emotional exhaustion, anxiety, and depression decreased, while levels of psychological flexibility increased over time. No regional interaction effects were observed, except for depression, which declined more significantly among Hong Kong nurses than Swiss nurses. This was the first study to examine an online ACT intervention for nurses across different cultural backgrounds. Findings suggest ACT effectively improves nurses' mental health, but further research is needed to confirm its effectiveness in varied settings due to the study's exploratory design and limited sample size. The study was prospectively registered at ClinicalTrials.gov on 10.03.2021 (ID: NCT04821037), prior to data collection. In addition, the study was retrospectively registered with the Open Science Framework (OSF; registration number tpgd6) on 12.06.2025 to provide additional documentation and materials.

This study aimed to examine the association between emotional intelligence and turnover intention among nurses in Saudi Arabia, as well as the indirect effect through job stress. Nursing shortages remain a critical global concern. Turnover intention among nurses is a key workforce issue associated with negative organizational and patient outcomes. A cross-sectional, non-experimental survey design was used. Data were collected from nurses across Saudi Arabia using an online questionnaire. Emotional intelligence, job stress, and turnover intention were measured using validated instruments. Data were analyzed using SPSS and the PROCESS macro. Emotional intelligence was negatively associated with job stress (B = -0.308, p < 0.001) and turnover intention (direct effect: B = -0.572, p < 0.001). Job stress was positively associated with turnover intention (B = 0.357, p = 0.012). A significant indirect effect of emotional intelligence on turnover intention through job stress was observed (B = -0.110, 95% CI [-0.215, -0.006]), indicating partial mediation. Emotional intelligence is associated with turnover intention both directly and indirectly through job stress. However, due to the cross-sectional design, causal relationships cannot be inferred.

Operating room nurses (ORNs) are at high risk for compassion fatigue (CF), which significantly impairs individuals' well-being, undermines the stability of the nursing workforce, and jeopardizes patients' safety. The study aimed to analyze the prevalence and symptom characteristics of CF among ORNs, construct and compare predictive models using machine learning, and determine the relative contribution of distinct features to the models. This is a multi-center cross-sectional study. The questionnaires used in the study included a sociodemographic questionnaire, the Professional Quality of Life Scale (ProQoL), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Pittsburgh Sleep Quality Index (PSQI). LASSO regression was used to select critical variables, and predictive models such as decision tree, logistic regression, random forest, SVM, and XGBoost were constructed and compared. SHapley Additive exPlanation (SHAP) were drawn to show the contribution of each feature to the models. SPSS version 26.0 and R software version 4.4.0 were used for statistical analyses. In this study, a total of 1024 ORNs from 20 cities across China were recruited. According to ProQoL, 326 (31.8%) reported severe CF, 311 (30.4%) moderate CF, and the remaining 387 (37.8%) no or mild CF. Among the three dimensions, the incidence of secondary traumatic stress was most common (95.4%), followed by low compassion satisfaction (61.3%) and burnout (35.0%). In five machine learning-based predictive models, the RF model stood out with the highest AUC at 0.851 (95%CI: 0.795-0.907) in testing set. Following closely, the XGBoost model showed favorable efficacy with the AUC at 0.824 (95%CI: 0.769-0.879) in testing set, outperforming the remaining algorithms. The results of the two SHAP plots (RF and XGBoost) were consistent: depression, anxiety, self-mental health training, sleep quality, and length of service emerged as the five most significant contributors to the models. This study identified severe CF among ORNs, and the most serious symptom was secondary traumatic stress. The RF model exhibited the best performance in identifying high-level CF among ORNs, and SHAP improved the interpretability of the model. The findings of this study could help medical managers and researchers better understand CF and provide timely interventions for ORNs. Not applicable.

The transition from hospital to home presents significant psychological and practical challenges for older heart failure patients living alone (OHELP), who must navigate complex self-care needs within a socially isolated context. Although discharge preparation is a critical period for adapting to solitary living, the psychological and behavioral coping mechanisms of this vulnerable population remain underexplored. This study aimed to explore the psychological experiences during the pre-discharge period regarding self-care readiness, and to describe the behavioral strategies preferred by the OHELP. This descriptive qualitative study employed purposive sampling to recruit 26 participants from a geriatric hospital in Zhengzhou, China, between January and June 2025. Interview data were systematically organized and coded using NVivo 12, and reflexive thematic analysis was conducted through the research. Four themes and twelve sub-themes emerged from the analysis: (a) anticipated psychological burden of living alone, (b) perceived deficits: needs vs. resources, (c) coping strategies for self-care and the defense of autonomy, (d) reconstructing one's self-worth and meaning. The OHELP addressed anticipatory psychological burden during discharge preparation through adaptive strategies such as reestablishing daily routines and enhancing technological literacy, thereby reconstructing self-worth and maintaining autonomy. Not applicable.