Background: A high prevalence of psychological distress is observed in nurses due to multiple occupational stressors. Personality traits and personal factors are important factors that lead to psychological distress. The personality profile reflects a combination of personality traits; however, the relationship between personality profiles and personal factors that affect psychological distress among nurses has not been defined. Methods: This cross-sectional study was conducted in November 2020 in China. Convenience and snowball sampling were used to recruit participants. Latent profile analysis was used to identify personality profiles of nurses based on the big-five personality traits. Single-factor analysis and multivariate logistic regression were used to determine the factors affecting psychological distress. The structural equation model was used to verify the hypothetical model linking personality profiles, self-efficacy, psychological resilience, and coping style with psychological distress. Results: A total of 953 Chinese nurses (934 female) with a mean (S.D.) age of 32.8 (8.6) years were recruited. Personality profiles identified were negative, normative, and positive. A personality profile may predict psychological distress directly and indirectly through self-efficacy, psychological resilience, and coping style. Limitations: No complex sampling limits the representativeness of Chinese nurses. External factors affecting psychological distress were not investigated. Conclusion: Nurses with anegative personality profile had a higher prevalence of psychological distress. This study establishes the importance of personality profile assessment to identify nurses at higher risk of psychological distress. It suggests that interventions should be based on self-efficacy, psychological resilience, and coping style as potential management strategies.

Aim: To examine the association of psychological distress with all-cause, cardiovascular disease (CVD) and cancer mortality in US adults, and verified whether the associations differed between participants with and without diabetes. Methods: A total of 485,864 adults (446,288 without diabetes and 39,576 with diabetes) who participated in the National Health Interview Survey from 1997 to 2013 were linked to the National Death Index through December 31, 2015. Psychological distress was measured by the Kessler 6 distress scale (K6). Multivariable Cox proportional hazards regression models were performed to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between psychological distress and mortality. Results: We ascertained 11,746 deaths (mean follow-up, 7. 7 years) among people with diabetes and 51,636 deaths (9.9 years) among those without diabetes. Psychological distress was associated with higher all-cause, CVD, and cancer mortality. Compared to non-diabetic adults without psychological distress, HRs (95% CI) were 1.07 (1.04 to 1.09) for mild, 1.26 (1.22 to 1.30) for moderate and 1.46 (1.38 to 1.55) for severe psychological distress. Compared to the same reference group, in diabetic participants the HRs were 1.39 (1.33 to 1.44) for no psychological distress, 1.59 (1.53 to 1.66) for mild, 1.90 (1.80 to 2.00) for moderate and 1.98 (1.82 to 2.17) for severe psychological distress. Similar associations were also observed for CVD and cancer mortality but with non-statistically significant interaction. Conclusion: Psychological distress was associated with higher mortality, particularly in participants with diabetes. Strategies to ameliorate psychological distress may be important to reduce mortality in this population.

Background: Maternal pre-pregnancy diabetes is associated with a higher risk of adverse pregnancy outcomes. Few large, cohort studies have assessed associations with a wide large range of causes of infant death. Methods: This retrospective cohort study included all singleton live births to women aged 18–49 years in the US National Vital Statistics System from 2011 to 2020. Multivariable Poisson regression models were used to estimate adjusted relative risks (RRs) with 95% confidence intervals (CIs) for all-cause and cause-specific infant mortality. Results: Of 34 918 803 pregnant women with singleton live births, 302 823 had pre-pregnancy diabetes with 3585 corresponding infant deaths [estimated mortality rate per 10 000 infants with 95% CI was 78.60 (75.96–81.25)] compared with 34 615 980 without pre-pregnancy diabetes and 171 989 corresponding infant deaths [42.63 (42.41–42.86)]. The adjusted RR (95% CI) of pre-pregnancy diabetes compared with no pre-pregnancy diabetes was 1.84 (1.78–1.91) for infant death, 1.89 (1.81–1.97) for neonatal death, 1.85 (1.77–1.94) for early neonatal death, 2.04 (1.87–2.23) for late neonatal death, and 1.75 (1.65–1.86) for postneonatal deaths. The association was stronger (RR: 2.03, 95% CI: 1.88–2.20) with lower maternal age (<25 years) than with higher maternal age (≥40 years) (RR: 1.44, 95% CI: 1.28–1.63). Associations varied across maternal race, smoking, and body mass index. Significantly increased risk was observed for 48 out of 73 specific causes of death. Conclusion: Our findings confirm that maternal pre-pregnancy diabetes is an important risk factor for infant death, encompassing a wide range of causes of death, and suggest that these effects may be systemic given the large number of specific causes of death affected.