Against the backdrop of a persistent global shortage of nursing human resources and prominent job stress and retention difficulties among Chinese nurses, some nurses have exhibited occupational alienation characterized by psychological detachment and decreased engagement despite remaining in their positions, while existing measurement tools have limitations in cultural adaptability and structural stability. This study aims to develop a reliable and valid Clinical Nurse Occupational Alienation Scale (NOAS) that is applicable to the Chinese cultural context, and to conduct preliminary application research to provide a scientific basis for assessment and intervention.

A cross-sectional study design was adopted. From June to October 2025, clinical registered nurses were recruited from 6 hospitals in Chongqing through multistage stratified convenience sampling. In the scale development and validation phase, an initial NOAS item pool was constructed based on literature review, and a pilot version of the NOAS was formed after Delphi consultation, cognitive interviews, and a preliminary survey. The participants were divided into Group A (n=441) and Group B (n=318). Group A was used for item analysis and exploratory factor analysis (EFA), and Group B was employed for confirmatory factor analysis (CFA) and reliability/validity testing. Group C (a random subsample from Group B, n=78) was utilized for test-retest reliability testing. In the scale application phase, a general information questionnaire and the final version of the NOAS were used for cross-sectional status surveys to analyze the current status of occupational alienation among clinical nurses and its influencing factors.

The final version of the NOAS consisted of 53 items across 6 dimensions: work overload, powerlessness, emotional exhaustion, loss of professional meaning, relational isolation, and value conflict. EFA extracted 6 common factors with a cumulative variance explanation rate of 69.45%, and factor loadings ranging from 0.69 to 0.81. CFA indicated good fit for the 6-factor model (χ²/df=2.27), with a comparative fit index (CFI) of 0.92, a Tucker-Lewis index (TLI) of 0.92, a root mean square error of approximation (RMSEA) of 0.06, and a standardized root mean square residual (SRMR) of 0.06. The average variance extracted (AVE) for each dimension ranged from 0.49 to 0.61, and composite reliability (CR) ranged from 0.88 to 0.92. The total NOAS score was significantly positively correlated with the emotional exhaustion dimension of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) (r=0.74) and significantly negatively correlated with the total score of the Utrecht Work Engagement Scale (UWES-17) (r=-0.69). The Cronbach’s α coefficient for the total scale was 0.96, and the test-retest intraclass correlation coefficient (ICC) was 0.85. The cross-sectional survey revealed the total occupational alienation score of 16.80±4.20 among clinical nurses, and 56.65% of nurses had the total score exceeding the theoretical median. Night shift frequency had the greatest impact on occupational alienation (β=0.33), followed by department type (β=0.19), average monthly income (β=-0.16), hospital grade (β=0.14), and gender (β=0.13). The model explained 34.10% of the total variance in occupational alienation among clinical nurses.

The 6-dimensional NOAS developed in this study demonstrates good reliability, validity, and cultural adaptability, and can effectively assess the level of occupational alienation among nurses. High night shift frequency, working in acute/critical care departments, working in tertiary hospitals, being male, and low income are risk factors for increased alienation, providing evidence-based support for nursing management interventions.

The promotion of enhanced recovery after surgery has shortened hospital stay of patients after radical prostatectomy, with most being discharged during the critical recovery period. These patients are prone to inadequate discharge preparation due to issues such as urinary dysfunction and indwelling catheterization. Although readiness for hospital discharge has been regarded as an important factor influencing patient prognosis, the mechanism by which it affects quality of life remains unclear. Based on the stress and coping theories, this study aims to explore the mediating role of coping styles in the relationship between readiness for hospital discharge and quality of life among patients after radical prostatectomy, providing evidence for developing targeted transitional care interventions.

A prospective longitudinal study design was adopted. From August 2024 to September 2025, 161 patients undergoing radical prostatectomy in the urology departments of 3 tertiary grade A hospitals in Chongqing were conveniently selected as the survey subjects. Within 24 h before discharge, the general information questionnaire, Readiness for Hospital Discharge Scale (RHDS), and Medical Coping Modes Questionnaire (MCMQ) were used for the investigation. Quality of Life (QOL) score was assessed through on-site or telephone evaluation at 1 month after surgery. The Process macro program Model 4 was utilized to construct a mediating effect model to test the mediating effect of coping styles.

The mean RHDS score of the 161 patients after radical prostatectomy was 84. 72±17. 96. The 3 dimensions of coping styles scored as follows: confrontation 19. 02±4. 02, avoidance 14. 57±2. 69, and resignation 8. 19±2. 57. The QOL score was 46. 50±7. 11. Pearson correlation analysis showed that the total score of quality of life was positively correlated with the total score of discharge readiness and the scores of each dimension (r=0. 485 to 0. 618, P<0. 01), positively correlated with the confrontation dimension of medical coping modes (r=0. 361, P<0. 01), not significantly correlated with the avoidance dimension, and negatively with the resignation dimension (r=-0. 383, P<0. 01). Process mediating effect analysis indicated that the mediating effect value of coping styles between readiness for hospital discharge and quality of life was 0. 038, with a 95%CI of 0. 014 to 0. 068, and the total mediating effect was significant (P<0. 01). The mediation effect accounted for 15. 89% of the total effect, with confrontation coping and resignation coping accounting for 6. 74% and 9. 15%, respectively.

Coping styles play a partial mediating role between readiness for hospital discharge and quality of life, with the mediating effect of reducing resignation coping being stronger. This suggests that clinicians should focus on identifying and intervening in patients with resignation coping tendencies to improve quality of life.

To investigate the mediating effects of mindfulness and resilience on perceived stress, anxiety and depression among nurses working in intensive care unit (ICU).

From April to July 2021, 563 ICU nurses from 15 hospitals in Chongqing were enrolled with convenience sampling and surveyed by using general data questionnaire, Chinese Perceived Stress Scale (CPSS), Connor-Davidson Resilience Scale (CD-RISC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Mindful Attention Awareness Scale (MAAS).

The scores of SAS and SDS were 45.99±10.10 and 48.62±11.41, respectively. Univariate analysis showed that gender and income were the influencing factors of ICU nurses' anxiety (P<0.05), and gender, professional title, income and current disease were the influencing factors of depression (P<0.05); Pearson correlation analysis indicated that anxiety was positively correlated with perceived stress (r=0.578, P<0.01), and negatively with resilience and mindful attention awareness (r=-0.487, -0.525, P<0.01). Depression was positively correlated with perceived stress (r=0.591, P<0.01), and negatively with resilience and mindful attention awareness (r=-0.569, -0.552, P<0.01). The mediating effect analysis suggested that mindfulness and resilience played chain mediating roles in stress, anxiety and depression for ICU nurses (P<0.01).

ICU nurses have high anxiety and depression. Mindfulness and resilience play chain mediating roles in perceived stress with anxiety and depression among them.