New nurses' clinical competency is a central concern across the world. The China Health and Planning Commission proposed an "Outline of transition programs for newly graduated nurses (try out)" to promote the new nurses' clinical competency within the first two years. Compared with the transition program in other countries, the one in China is longer. New nurses' experiences in their transition to practice were not fully explored in China. Their lived experience may inform the better transition program in China and other countries. To explore the experience of new nurses during the two-year transition period to clinical practice. A descriptive phenomenological study. Face-to-face, semi-structured in-depth interviews were conducted in two teaching hospitals in China to interview 14 nurses within three months after the completion of transition. Data were analyzed using Colaizzi's seven-step data analysis method，which includes familiarization, identifying significant statements, formulating meanings, clustering themes, developing an exhaustive description, producing the fundamental structure, and seeking verification (1978). Tape-recording and observational notes were taken and typed word by word. Two researchers verified the verbatim transcripts. Five categories and 15 theme clusters were identified: 1. early-stage stress and anxiety; perceived change of mentality and self-reflection; 2. self-encouragement; self-compulsion, tolerance, adaptation; peer support and affirmation; 3. Growth: overall clinical competency improvement; perceived harvesting; nursing skills improvement; knowledge enhancement; 4. self-inadequacy; rotation benefits; the merits of different departments; lack sense of belonging; and 5. Expectation: desire to be treated equally; hope to have more opportunities. The findings of our study suggested that support was most needed while the new nurses were facing challenges in the early stage to promote their sense of belonging. In addition, more systematic learning opportunities are needed to maximize learning for NGNs with different nursing degrees.

Purpose: This study aimed to investigate the status of cardiac rehabilitation knowledge and attitude of the medical staff. Patients and Methods: A questionnaire survey of doctors and nurses was performed in the departments of cardiology of 7 teaching hospitals with attitudes, knowledge toward CR in Zhejiang Province, China, from April to September 2018, to assess Chinese medical staff for the degree of mastery and attitude toward cardiac rehabilitation. Results: A total of 160 questionnaires were distributed and 152 valid were collected. The responding individuals included 106 nurses (69.74%) and 46 doctors (30.26%). The scores of cardiac rehabilitation knowledge were 56.68± 5.06, and those of cardiac rehabilitation attitude were 15.19± 3.86. Subgroup analysis showed the lower the job title (P< 0.001), the lower the educational level (P = 0.011), and the shorter the years of specialty experience (P=0.005), the more negative the attitude toward cardiac rehabilitation. Conclusion: The medical staff has a good mastery of cardiac rehabilitation knowledge. But we also find that staffs with lower education level and job title, shorter specialty work experience were associated with a more negative attitude toward implement rehabilitation.

Purpose: This study aimed to investigate the relationship between self-management task performance and key heart failure biomarkers (NT-proBNP and uric acid) in elderly patients with chronic heart failure (CHF), and to explore the mediating role of disease severity in this relationship. Design Patients and Methods: A total of 103 elderly CHF patients were recruited. And cross-sectional study conducted at two tertiary hospitals. Self-management task performance was assessed using a validated six-task evaluation scale. Clinical data, including NT-proBNP, uric acid, and other laboratory markers, were collected. Participants were stratified into low and high task performance groups based on the median score. Data were analyzed using partial correlation analysis, logistic regression, and restricted cubic spline analysis. Results: Patients with higher task performance were significantly younger (p < 0.001). Task performance was negatively correlated with NT-proBNP (r = − 0.337, p < 0.001) and uric acid (r = − 0.279, p = 0.005), indicating that lower performance was associated with higher biomarker levels, reflecting more severe disease progression. A non-linear decreasing trend in both NT-proBNP and uric acid levels was observed as task performance increased. Among the self-management tasks, medication-related tasks had the lowest success rates, while tasks related to oedema and dietary management showed higher performance rates. Conclusion: Lower self-management task performance is significantly associated with elevated NT-proBNP and uric acid levels in elderly CHF patients, suggesting that poorer performance may indicate more advanced disease progression. These findings highlight the importance of targeted interventions to enhance self-management skills, particularly in medication adherence and disease monitoring, to improve patient outcomes. Future research should investigate the long-term clinical impact of improving task performance in CHF patients.

Objective To explore the lived experiences of novice nurses during their transition from participation in the ‘Attending Rounds’ clinical case mentoring training model to independent clinical practice, and to understand its influence on their development of clinical competence, role identity and team collaboration. Design A descriptive phenomenological study using semistructured, face-to-face interviews, guided by Colaizzi’s seven-step method of data analysis. Setting Two large teaching hospitals in eastern China, representing secondary and tertiary levels of care. Participants 12 novice nurses (nine female, three male; aged 22–29 years; bachelor’s or master’s degree holders) who had completed the ‘Attending Rounds’ training at least four times and subsequently entered clinical practice. Participants were recruited purposively to ensure variation in demographic and educational backgrounds. Interventions Not applicable Primary outcome measures The primary outcomes were novice nurses’ lived experiences and perceptions of the ‘Attending Rounds’ model, captured through semistructured interviews and analysed using Colaizzi’s phenomenological method. Secondary outcome measures Experiential domains included: (1) skill improvement—enhanced clinical judgement, patient management and ward management; (2) learner anxiety and growth—initial discomfort and stress evolving into confidence and resilience; (3) role modelling—professional inspiration and learning through observation of senior nurses and (4) team cohesion—improved communication, collaboration and patient-centred care. Results Four overarching themes with 12 subthemes were identified: (1) skill improvement (clinical judgement, patient and ward management); (2) stress and growth (initial anxiety and adaptation leading to confidence); (3) role modelling (learning from senior nurses, leadership inspiration) and (4) team cohesion (enhanced collaboration, strengthened patient-centred care). Nurses described initial discomfort and anxiety, but over time developed greater competence, confidence and awareness of professional responsibilities. Conclusions The ‘Attending Rounds’ model facilitated novice nurses’ transition into clinical practice by integrating structured case-based learning, role modelling and team collaboration. While stress and anxiety were common at the outset, these experiences were ultimately perceived as catalysts for growth. Findings suggest the model may be further refined to support novice nurses’ professional identity formation and clinical competence. Trial registration This study was registered with the Chinese Clinical Research Registry (registration number: MR-33-24-058353).

Objectives To gain an in-depth understanding of the real support priorities and perceptions of caregivers of individuals receiving care with end-stage heart failure regarding hospice care. Design A qualitative descriptive approach was employed. Participants and setting Using a purposive sampling approach, 16 primary caregivers of individuals receiving care with end-stage heart failure from a tertiary hospital in Hangzhou, Zhejiang province, were selected as interview participants. A semi-structured interview outline based on literature review was used to conduct face-to-face interview. Tape-recorded data with notes were transcribed, and the content analysis method was applied to analyse the data and distil themes. Results After integration and analysis of 16 interview transcripts (n=16), the thematic analysis resulted in four themes supporting the overall findings, including seeking collaborative decision-making in palliative care, demand for appropriate healthcare resources, search for emotional respite and support in hospice settings and desire for knowledge and information about hospice care and heart failure. Each theme encompasses two subthemes. Conclusions Caregivers of individuals receiving care with end-stage heart failure have multiple care responsibilities and diverse support priorities. Medical personnel should be aware of the burden that family caregivers bear and provide more targeted and individualised assistance to the caregiver. At the organisational level, administrators support priorities to establish comprehensive, lifelong and compassionate hospice services to ensure that the quality of life for caregivers and the quality of care for individuals receiving care can be further enhanced.

Observational studies have indicated an association between metabolites and hypertension. However, establishing a causal relationship remains challenging. This study aims to investigate this causal relationship using Mendelian randomization methodology. Genome-wide association study summary statistics for plasma metabolites were obtained from 3 studies, encompassing over 2000 varieties. Genome-wide association study summary statistics for hypertension were derived from 2 studies, with a sample size of 122,996 and 129,909, respectively. The main method used was the inverse variance weighting (IVW) method, and the results were adjusted using Bonferroni multiple correction. The IVW method estimated effects between the levels of taurochenodeoxycholate, 1-dihomo-linolenoyl-GPC (20:3n3 or 6), N-acetylphenylalanine, and dihomo-linolenate (20:3n3 or n6) and hypertension are 1.041 (95% confidence interval [CI] 1.022–1.059, P = 1.49e−05), 1.023 (95% CI 1.015–1.031, P = 5.32e−08), 1.029 (95% CI 1.021–1.037, P = 6.10e−12), and 1.019 (95% CI 1.010–1.028, P = 1.54e−05), respectively. The IVW method estimated effects between the levels of 2-hydroxyoctanoate, 1-docosapentaenoyl-GPC (22:5n3), X-11538, gamma-glutamyl-alpha-lysine, and 2-butenoylglycine and hypertension are 0.954 (95% CI 0.936–0.972, P = 8.87e−07), 0.981 (95% CI 0.973–0.989, P = 4.14e−06), 0.981 (95% CI 0.975–0.987, P = 7.53e−10), 0.942 (95% CI 0.922–0.963, P = 8.71e−08), and 0.930 (95% CI 0.902–0.958, P = 2.22e−06), respectively. In summary, there are indications that some metabolites have a causal relationship with hypertension. It is necessary to conduct further investigations to comprehend the underlying biological mechanisms that support these associations.