Background: Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human–machine interactions in nursing care, but few studies have examined interruptions and nurses’ mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses’ mental workload and performance in EHR tasks. Methods: A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1^st to October 31^st, 2021. An observer documented nurses’ EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses’ mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model. Results: In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload. Conclusions: Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses’ mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload.

Aims: To investigate the mental workload level of nurses aiding the most affected area during the Coronavirus disease 2019 (COVID‐19) pandemic and explore the subtypes of nurses regarding their mental workload.Design: Cross‐sectional study.Methods: A sample of 446 frontline nurses participated from March 8 to 19, 2020. A latent profile analysis was performed to identify clusters based on the six subscales of the Chinese version of the National Aeronautics and Space Administration Task Load Index. The differences among the classes and the variables including sociodemographic characteristics, psychological capital and coping style were explored.Results: The level of mental workload indicates that the nurses had high self‐evaluations of their performance while under extremely intensive task loads. The following three latent subtypes were identified: ‘low workload & low self‐evaluation’ (8.6%); ‘medium workload & medium self‐evaluation’ (35.3%) and ‘high workload & high self‐evaluation’ (56.1%) (Classes 1, 2, and 3, respectively). Nurses with shared accommodations, fewer years of practice, junior professional titles, lower incomes, nonmanagement working positions, lower psychological capital levels and negative coping styles had a higher likelihood of belonging to Class 1. In contrast, senior nurses with higher psychological capital and positive coping styles were more likely to belong to Classes 2 and 3.Conclusion: The characteristics of the ‘low workload & low self‐evaluation’ subtype suggest that attention should be paid to the work pressure and psychological well‐being of junior nurses. Further research on regular training program of public health emergency especially for novices is needed. Personnel management during public health events should be focused on the allocation between novice and senior frontline nurses.Impact: This study addresses the level of mental workload of frontline nurses who aid in the most severe area of the COVID‐19 pandemic in China and delineates the characteristics of the subtypes of these nurses.

Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China. The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling. A quantitative survey with three closed-ended questionnaires was conducted. In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure. This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement. A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis (p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients. The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed. Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient’s willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient’s care team, especially nurses, could be integrated in the process of truth-telling.

Background: Nurses can experience psychological trauma after adverse nursing events, making it likely for them to become second victims (SVs). This negatively impacts patient safety and nurses’ development. This study aims to understand the status of psychological trauma and recovery of nurses as SVs in domestic China and examine the influencing mechanism of cognitive rumination during their recovery from psychological damage.Methods: This was a cross-sectional survey. An online questionnaire was completed by 233 nurses from across China. Data were collected using Chinese versions of the Second Victim Experience and Support Evaluation Scale, the Incident-related Rumination Meditation Questionnaire, and the post-traumatic growth (PTG) Rating Scale. Descriptive statistics, correlation, and regression, as well as mediation analysis, were used for different analyses in this study.Results: Participants experienced apparent psychological traumas (4.65 ± 0.5583) with a certain degree of PTG (76.18 ± 16.0040); they reported a strong need for psychological support (95.7%). Psychological trauma was positively and negatively correlated with rumination and PTG (r = 0.465, p < 0.001; r = −0.155, p < 0.05) respectively. Both psychologically impaired experience and rumination had significant predictive effects on participants’ PTG (both, p < 0.001). Nurses’ active rumination significantly mediated their psychological recovery from trauma to PTG (p < 0.05), but the effect of invasive rumination was not significant (p > 0.05).Limitation: The specific manifestations of the mechanism of invasive rumination are not clarified in this study.Conclusion: The present study investigated the psychological trauma of SV nurses as well as their support needs, and explored the role of cognitive rumination in the psychological repair and PTG of SV nurses. Results showed that SV nurses’ active rumination on adverse nursing events could promote their recovery from psychological trauma, but invasive rumination could not. This study provides a trauma-informed approach to care at the clinical level for nurses who experience psychological trauma caused by adverse events.

The ability of socially assistive robots (SARs) to treat dementia and Alzheimer’s disease has been verified. Currently, to increase the range of their application, there is an increasing amount of interest in using SARs to relieve pain and negative emotions among children in routine medical settings. However, there is little consensus regarding the use of these robots. This study aimed to evaluate the effect of SARs on pain and negative affectivity among children undergoing invasive needle-based procedures. This study was a systematic review and meta-analysis of randomized controlled trials that was conducted in accordance with the Cochrane Handbook guidelines. The PubMed, CINAHL, Web of Science, Cochrane Library, Embase, CNKI, and WanFang databases were searched from inception to January 2024 to identify relevant randomized controlled trials (RCTs). We used the Cochrane Risk of Bias tool 2.0 (RoB2.0) to assess the risk of bias among the included studies, and we used RevMan 5.4 software to conduct the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used to assess the quality of the evidence. Ten RCTs involving 815 pediatric subjects were selected for this review and reported outcomes related to pain and emotions during IV placement, port needle insertion, flu vaccination, blood sampling, and dental treatment. Children undergoing needle-related procedures with SARs reported less anxiety (SMD= -0.36; 95% CI= -0.64, -0.09) and fewer distressed avoidance behaviors (SMD= -0.67; 95% CI= -1.04, -0.30) than did those receiving typical care. There were nonsignificant differences between these groups in terms of in pain (SMD = -0.02; 95% CI = − 0.81, 0.78) and fear (SMD = 0.38; 95% CI= -0.06, 0.82). The results of exploratory subgroup analyses revealed no statistically significant differences based on the intervention type of robots or anesthetic use. The use of SARs is a promising intervention method for alleviating anxiety and distress among children undergoing needle-related procedures. However, additional high-quality randomized controlled trials are needed to further validate these conclusions. The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023413279).

Robotic technology is transforming healthcare by delivering more precision, convenience, and efficiency, as seen in applications like blood collection robots. However, the full potential of such innovations hinges critically on patient acceptance. To systematically understand the drivers of intention to use, the concept of technological readiness-an individual's stable propensity to embrace new technologies-provides a valuable lens. Nevertheless, the demographic profile of technological readiness and its specific relationship with the intention to use nursing robots remain underexplored. This study aimed to identify profiles of technology readiness among patients, analyze the factors influencing these profiles, and investigate the relationship between different profiles and the intention to use blood collection robots. In this study, data on technology readiness and intention to use were collected from 331 patients between December 2024 and February 2025 through a cross-sectional survey. Latent profile analysis (LPA) was employed to assess population heterogeneity in patients' technology readiness, whereas logistic regression analysis was applied to identify factors associated with the intention to use blood collection robots. Potential profiling revealed three distinct technology readiness populations: conservative avoiders (47.7%), ambivalent adopters (18.5%), and active adopters (33.8%). The results of the three-profile classification are related to the intention to use blood collection robots. The results clearly show that the intention to use the blood collection robot by patients belonging to conservative avoiders (profile 1) was weaker and statistically significant than both active adopters (profile 3) and ambivalent adopters (profile 2). While profile 2 has a high intention to use, it also has a high level of insecurity and discomfort. Interestingly, the group of patients with low education levels is more likely to be attributed to active adopters. The results of the multiple regression analysis on patients' intention to use revealed significant differences in education level, experience with robots, and potential profiles. This study reveals the complex psychological characteristics of patient groups when encountering new technologies and their potential relationship with intention to use nursing robots. This suggests that clinical practice should account for patient heterogeneity from standardized procedures to a patient-centered approach. Targeted measures should be proposed to enhance the efficiency of technology implementation and improve patient experience.