Aim: This study aims to explore fourth-year nursing students’ knowledge of schizophrenia and their attitudes, empathy, and intentional behaviours towards people with schizophrenia. Design: This will be a descriptive qualitative study using focus-group interviews. Methods: Fourth-year nursing students on clinical placement in a hospital in Hunan province will be invited for focus-group interviews. Snowball and purposive sampling will be used to recruit nursing students for this study. Five focus-group interviews, each including six participants, will be conducted to explore participants’ knowledge, attitudes, intentional behaviours, and empathy towards schizophrenia. The interview will be conducted through the online Tencent video conference platform and the interview data will be collected through the same platform. All interviews will be recorded and transcribed verbatim and analysed with the approach of the content analysis supported by NVivo 12. Simultaneous data collection and analysis will be performed, and the interviews will be continued until data saturation is met. The findings of this study will be helpful in developing effective interventions to decrease the stigma toward schizophrenia among nursing students and those who study healthcare disciplines.

Introduction: Opioid-induced constipation (OIC) affects up to 90% of patients with cancer receiving long-term opioid-related analgesic therapy, resulting in various potential complications, compromised pain management and decreased quality of life. Laxatives stimulate or facilitate bowel evacuation. Traditional laxatives, such as polyethylene glycol and lactulose, are widely used because of their low cost, easy accessibility and tolerability. OIC prophylaxis with laxatives is recommended for patients receiving opioid therapy. However, systematic reviews that support this practice are lacking. They have primarily focused on patients with existing constipation and the effectiveness of other pharmacological therapies. Thus, we are conducting a systematic review to evaluate the efficacy and safety of traditional laxatives in preventing OIC in adult patients with cancer.Methods and analysis: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols 2015 statement was used to guide the reporting of this protocol. Database searches will be performed in PubMed, Embase, Web of Science, Cochrane Library and EBSCO from inception to a date within 6 months of the submission of the full systematic review (estimated 31 December 2024). Reference lists will also be accessed for additional studies, including Google Scholar, for the inclusion of grey literature. A combination of Medical Subject Headings/Emtree and free-text terms will be used when searching the core concepts of ‘OIC’, ‘laxative’ and ‘cancer.’ The eligibility criteria will be defined by the type of population (patients with cancer receiving opioid therapy), type of intervention (traditional laxatives) and type of study (randomised controlled trials and quasi-experimental trials). Two reviewers will independently select eligible studies, extract data and assess the methodological risk of bias. A third reviewer will be invited to reach a consensus if necessary. Subgroup and sensitivity analyses will be conducted to explore sources of heterogeneity.Ethics and dissemination: Ethical approval is not required, as patients will not be included in systematic reviews and meta-analyses. We will publish this study in a peer-reviewed journal and communicate the results at open conferences.PROSPERO registration numberCRD42024507127.

Introduction Stroke presents a considerable burden not only to patients but also to their families and society at large. In many instances, stroke patients opt for home rehabilitation, relying on family caregivers for daily assistance. This dynamic significantly influences the physiological, psychological and social well-being of these caregivers. Despite its importance, the phenomenon of self-regulatory fatigue (SRF) among family caregivers has received insufficient attention in the literature. Therefore, the objective of this study is to investigate the levels of SRF, the characteristics of associated symptoms and the trajectories of symptom change experienced by family caregivers of stroke patients. Methods and analysis This research employs a mixed-methods approach, combining a cross-sectional study with a prospective longitudinal quantitative and qualitative design. The Chinese version of the SRF Scale and the Chinese version of Patient-Reported Outcomes Measurement Information System profile-29 are used to assess SRF, psychological and physiological symptoms, and related functional outcomes among family caregivers of stroke patients. Latent class growth analysis will be employed to model the heterogeneous developmental trajectories of SRF-related symptoms among family caregivers of stroke patients. Reflexive thematic analysis will be employed to analyse, organise and summarise qualitative data, to identify the experiences and management needs related to SRF among family caregivers during home care. Through this comprehensive mixed-methods approach, the study aims to: investigate the levels of SRF experienced by family caregivers of stroke patients, identify patterns and trajectories of related symptoms. The integration of cross-sectional and longitudinal data allows for a thorough examination of both immediate and long-term aspects of caregiver experiences, providing valuable insights into the complex dynamics of SRF in this population. Ethics and dissemination The study protocol was approved by the Medical Ethics Committee of the University of South China (approval number 2023-NHHL-051). Data collection was authorised by the ethics committees of the First Affiliated Hospital, Second Affiliated Hospital and Nanhua Affiliated Hospital of the University of South China. The results of this study will be disseminated through publication in pertinent peer-reviewed journals, presentation at local and international conferences, and communication with all relevant stakeholders. Trial registration number ChiCTR2400082717.

Background: Midwives frequently encounter complex ethical dilemmas in clinical practice, underscoring the need for strong moral judgment competence. However, limited research has investigated this competence among midwifery students in China.Objectives: This study aimed to assess the level of moral judgment competence among Chinese midwifery students, examine its relationship with empathy, and identify influencing factors.Methods: A cross-sectional study was conducted with 213 midwifery students from three vocational colleges in Hunan Province, China. Data were collected using the Chinese versions of the Moral Judgment Test (MJT) and the Jefferson Scale of Empathy for Nursing Students (JSE-NS), along with demographic information. Statistical analyses included Pearson’s correlation and multiple linear regression.Results: The mean MJT score was 11.81 ± 7.48, indicating a moderate level of moral judgment competence. Empathy also reached a moderate level (87.17 ± 12.90), and a significant positive correlation was found between empathy and moral judgment competence (r = 0.502, p < 0.01). Multiple linear regression identified five significant predictors: year of study, only-child status, religious affiliation, prior experience in studying nursing ethics, and empathy level, collectively explaining 37.5% of the variance in moral judgment competence (F = 22.219, p < 0.05, adjusted R² = 0.375).Conclusion: This study provides the first empirical evidence on moral judgment competence among Chinese midwifery students. The findings highlight the importance of integrating empathy cultivation and ethics education into midwifery training. Targeted, individualized teaching strategies may be effective in enhancing students’ ethical reasoning and preparing them for future clinical challenges.

Background The global population's aging has led to an increasing demand for long-term care (LTC), yet a significant gap exists between the high demand for LTC and the low availability of services, especially in developing countries like China. Comprehensive assessment of LTC service demands by including the time and cost analysis is crucial to inform the planning and financing of LTC resources, yet such research is lacking in China. Methods A cross-sectional study was conducted in Changsha City, Hunan Province, China, from June 2021 to December 2022. A stratified multistage cluster sampling method was used to recruit 1,270 older adults from five nursing homes and three communities/streets in three regions of Changsha City. The LTC service needs were assessed by calculating the service time required from caregivers, nurses, and doctors and the total service time (min/d). Participants' disability, activities of daily living (ADLs), mental status and social involvement (MSSI), and sensory and communication (SC) were assessed using standard scales. Generalized linear regression models were used to analyze factors associated with LTC service needs. Results The participants had an average age of 76.41 ± 8.38 years, with 43.7% being female. The median service time required from caregivers, nurses, and doctors was 53.34 min/d, 3.66 min/d, and 0.33 min/d, respectively, and the total service time was 83.31 min/d. The generalized linear regression model identified the following factors that were associated with higher total service time: Aged 75–84 years, Living in nursing homes, Income over 5000 per month, ADLs, MSSI (9 ~ 40), SC and having 3 ~ 4 kind comorbidity of geriatric (P < 0.05). Conclusions Older adults have a high need for LTC services, especially those provided by caregivers, indicating an urgent need to expand and improve LTC systems. The LTC service time needed is associated with multilevel factors encompassing sociodemographic, functional, and psychological aspects. This study assess the service time required of older adults and their influencing factors based on Time-Driven Activity-Based Costing (TDABC) and offer deeper insights into the needs, demands, and costs of LTC services for older adults and provide essential guidance for future planning and financing of LTC resources.

Aim: To explore nursing students' experiences of participating in a schizophrenia stigma-reduction intervention and identify implications for intervention refinement and implementation. Background: Nursing students play a critical role in the care and rehabilitation of individuals with schizophrenia. However, their experiences with stigma-reduction interventions remain underexplored, limiting evidence to optimize intervention design and delivery. Design: A qualitative descriptive study. Methods: Purposive sampling was used to recruit nursing students who had participated in a pilot randomized controlled trial (RCT) conducted in Changsha, Hunan Province, China (22–27 March 2023). Data were collected through online focus group interviews via the Tencent Video Conference platform. Data collection and analysis were conducted concurrently, using expanded field notes, coding tables, and iterative categorization to identify themes. Results: Thirty nursing students participated in five focus group interviews (4–8 participants per group; 46–113 min; mean ≈ 68 min). Participants were aged 20–23 years; 77% were female. Four themes emerged: feasibility of the intervention, accessibility of the intervention, perceived efficacy of the intervention, and suggestions for future implementation. Conclusions: The intervention was perceived as feasible, accessible, and effective by nursing students. Participants also provided practical recommendations to improve intervention design and delivery. These findings offer valuable insights to inform the optimisation and future implementation of schizophrenia stigma-reduction interventions among health professional students.