Jie Zhang’s research while affiliated with Changsha Medical University and other places

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Publications (42)


Hypothetical model of influencing factors for vicarious posttraumatic growth in nurses
Mean and standard deviations of variables
Correlations of factors and VPTG
The method of independent variable assignment
Multiple linear regression analysis examining covariates of VPTG (n = 1025)
Critical factors shaping vicarious posttraumatic growth in nurses: a cross-sectional study
  • Article
  • Full-text available

March 2025

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28 Reads

BMC Nursing

Yitong Cai

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Jie Zhang

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Yifei Li

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[...]

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Chaoran Qu

Background Nurses face high levels of occupational stress due to direct and indirect trauma exposure, resulting in psychological challenges such as anxiety, depression, and secondary traumatic stress. However, vicarious posttraumatic growth (VPTG), a positive outcome of trauma exposure, can improve resilience and professional satisfaction. Understanding the factors affecting VPTG is key to developing strategies that enhance nurse well-being. This study sought to explore the various factors that affect VPTG among clinical nurses, using a cross-sectional design. Methods A cross-sectional survey was performed during the period from September to November 2023, involving 1,025 nurses from 13 tertiary and secondary hospitals across China. The study utilized various validated scales, including the Chinese adaptation of the Vicarious Posttraumatic Growth Inventory, the Coping Style Questionnaire, the Perceived Social Support Scale, the Event Related Rumination Inventory, the Interpersonal Reactivity Index, and the Core Beliefs Inventory. Statistical analysis, including Pearson correlation and stepwise multiple regression, was performed using SPSS 27.0 to identify key factors influencing VPTG. Results The average VPTG score was 105.02 (SD = 15.75), with 70.1% of nurses exhibiting low to moderate levels of VPTG. Positive coping (β = 0.358), social support (β = 0.266), core beliefs (β = 0.186), age (β = 0.083), and empathy (β = 0.066) were significant positive predictors of VPTG, while intrusive rumination (β =-0.078) negatively impacted VPTG. Receiving psychological trauma training also contributed positively (β = 0.046). These factors explained 49.8% of the variance in VPTG. Conclusions Positive coping strategies, social support, core beliefs, and empathy play pivotal roles in enhancing VPTG among nurses. Tailored interventions focusing on these areas could significantly promote VPTG, thereby improving nurse resilience and patient care quality.

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Fig. 1. The development process of the dyadic Mindfulness Self-Compassion intervention.
Development of a dyadic mindfulness self-compassion intervention for patients with lung cancer and their family caregivers: A multi-method study

November 2024

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18 Reads

Asia-Pacific Journal of Oncology Nursing

Objective Lung cancer and its prolonged treatment are profoundly unsettling for patients and their family caregivers, and developing dyadic measures to alleviate their negative affectivity is pivotal. This study aimed to develop a complex intervention to alleviate dyadic psychological stress among patients with lung cancer and their family caregivers. Methods A stepwise multi-method study was conducted following the Medical Research Council framework. Three phases were adopted, namely: (1) a preparation phase, a systematic review was conducted to identify the evidence base, (2) a development phase, empirical data from a quantitative study and a qualitative study were integrated to identify effective components, and (3) a modification phase, an online Delphi survey was carried out to refine the intervention. Results The dyadic Mindfulness Self-Compassion intervention developed in this study consists of six weekly sessions. The key components of the intervention include: (1) getting along with cancer (introductory session targets illness perception), (2) practising mindful awareness (core session for mindfulness), (3) defining dyadic relationships and introducing self-compassion (core session for self-compassion), (4) promoting dyadic communication (maintenance session targets communication skills), (5) promoting dyadic coping (maintenance session targets coping skills), and (6) a summary session reviewing the rewards and challenges of dyadic adaptation named embracing the future. Conclusions An evidence-based, theory-driven, and culturally appropriate dyadic Mindfulness Self-Compassion intervention was developed for patients with lung cancer and their family caregivers. Future studies are warranted to pilot and evaluate the usability, feasibility, acceptability, satisfaction, and effectiveness of this complex intervention. Trial registration ClinicalTrial.gov NCT04795700.


Cross-cultural adaptation and reliability of the inventory of vicarious posttraumatic growth and research of its influencing factors: a cross-sectional study

October 2024

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30 Reads

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2 Citations

BMC Nursing

Objective The purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables. Methods The Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG. Results The Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett’s test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach’s α = 0.951), with dimensions’ Cronbach’s α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG. Conclusion The Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.



Job satisfaction and psychological factors influence the caring behavior in nurses in Sierra Leone: a cross-sectional study

September 2024

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29 Reads

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1 Citation

Objective Identifying the status of caring behavior and its influencing factors in nurses is crucial for improving the quality of care for patients. However, there is a lack of studies on this in Sierra Leone. This study explored the status of caring behavior and associated factors in nurses working in Sierra Leone. Study design A cross-sectional descriptive survey was conducted from October 3 to December 15, 2022, with clinical nurses recruited through convenience sampling. Methods The participants included 360 nurses from various nursing departments from 12 hospitals in Sierra Leone. Measurements included a general information questionnaire, the Caring Behavior Inventory, Connor-Davidson Resilience Scale, McCloskey/Mueller Satisfaction Scale and Zung’s Self-Rating Anxiety Scale. Descriptive statistics, one-way analysis of variance and independent-sample t-tests, Pearson’s correlation analyses, and multiple regression analyses were performed. Results Caring behavior score was 128.97 (SD 11.967); it significantly and positively correlated with job satisfaction and resilience and negatively correlated with anxiety. Linear regression analysis showed that resilience, job satisfaction, anxiety, daily working time, and position were the main predictors of caring behavior. Conclusion The level of caring behavior in nurses in Sierra Leone was moderate. Resilience and job satisfaction significantly and positively predicted nurses’ caring behavior. Anxiety, daily working time, and position are important factors of caring behaviors. Implications for practice It is suggested to create a conducive working environment, reduce the excessive workload of nurses, enhance their positive psychological state, and their job satisfaction by providing recognition and rewards to improve the level of nurses’ caring behavior.


The influence of parents on children’s consciousness of gender equality: a multi-group structural equation modeling approach

August 2024

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54 Reads

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2 Citations

Objective This study aimed to understand the consciousness of gender equality among school-aged children in China and its influencing factors using structural equation modeling to explore the pathways, intensity and group differences among these factors. Methods A cross-sectional survey was conducted using stratified random whole-group sampling of primary school students in grades 1–6 and their parents who met the inclusion and exclusion criteria. In this study, 1,312 valid questionnaires were collected from a total of 1,500 school-aged children in Hunan Province, China (effective response rate of 87.5%). Statistical analysis was conducted using SPSS 26.0 and AMOS 24.0 software. Statistical inference consisted of t-tests, analysis of variance, the LSD test, Pearson correlation analysis, multiple stepwise linear regression analysis and structural equation modeling. Results School-aged children had the lowest consciousness of gender equality in the area of occupation and relatively higher consciousness in the areas of family and school. Children’s age, gender, gender role, parent–child relationship, teacher-student relationship and parents’ gender equality consciousness had predictive effects on children’s consciousness of gender equality. The structural equation model constructed in this study is applicable to school-aged children of different genders. There was a significant difference in the structural equation modeling for children in different study period groups. Conclusion In the education process, parents and teachers should attempt to improve their own consciousness of gender equality, integrate the concept of androgynous education, enhance close relationships with children, and adopt appropriate education methods according to the characteristics of different groups of children.


Latent profiles of relational job characteristics among nurses
Subgroups of relational job characteristics and their differences in turnover intention and subjective well-being among nurses: a latent profile analysis

July 2024

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26 Reads

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1 Citation

BMC Nursing

Objective Relational job characteristics include perceived social worth and perceived social influence. Good relational job characteristics mean that nurses have high prosocial behavior. The purpose of this study was to explore the potential profile of nurses’ relational job characteristics, influencing factors and their differences in turnover intention and subjective well-being, thus finding the most suitable clinical relationship job characteristics. Methods A cross-sectional survey was conducted among 1013 clinical nurses using the general demographic data questionnaire, Relational Job Characteristics scale, Turnover Intention Questionnaire and Campbell index of well-being. A latent profile analysis was performed to explore relational job characteristics latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the turnover intention and subjective well-being in each latent profile. Results Five latent profiles were identified and labeled ‘High prosocial job characteristics’ profile (20.7%), ‘Moderate prosocial job characteristics’ profile (41.7%), ‘High social worth-low social impact perceived’ profile (6.3%), ‘Low social worth‐high social impact perceived’ profile (18.8%) and ‘Low prosocial job characteristics’ profile (12.5%). Factors affecting the different types of nurse relationship job characteristics include age, marital status, hospital department, nursing years, professional title and hospital position. Among them, chief nurse, nurses with more than 20 years of nursing experience and obstetrics and gynecology nurses were more likely to be ‘high prosocial job characteristics’ profile. The turnover intention of nurses in ‘high prosocial job characteristics’ profile was significantly lower than that of other profiles, and their subjective well-being was significantly higher than that of other profiles. Conclusion Improving nurses’ perception of social worth and social impact on clinical work can improve nurses’ prosocial behavior and subjective well-being, and reduce their turnover intention. Nursing managers or policy makers can formulate targeted intervention measures according to the influencing factors of potential profiles.


A lower gender equality consciousness in rural and left-behind children: a latent class analysis

July 2024

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75 Reads

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1 Citation

Objective School age is a critical period for the development of individual gender equality consciousness. The purpose of this study was to explore the potential classes of school-age children’s gender equality consciousness, influencing factors and their differences in gender role, thus providing targeted guidance for the formulation and implementation of gender equality education strategies. Methods A cross-sectional survey was conducted among 1846 school-age children using the demographic information questionnaire, gender equality consciousness questionnaire and Bem Sex Role Inventory. A latent class analysis was performed to explore gender equality consciousness latent classes. Multinomial logistic regression analysis was conducted to examine the predictors of class membership, and chi-square test was used to compare the gender role of each latent class. Results The average age of the included 1846 participants was 10.10 ± 1.82 years old. The proportion of boy, grade 6 and living in urban area, respectively, were 50.8, 25.3, and 60.2%. The only children was 16.3% and left-behind children was 22.5%. 60.5% of all children thought their parents had a good relationship. The core family structure in all participants was 54.1%. Mothers were the caregivers of most children (63.6%). The same-sex friends more than 3 was 73.5%, while opposite-sex friends ranged from 0 to 1 was 41.7%. Three latent classes were identified and labeled “high gender equality consciousness” class (20.6%), “moderate gender equality consciousness” class (42.3%) and “low high gender equality consciousness” class (37.1%). Factors affecting the different types of school-age children’s gender equality consciousness include gender, grade, caregiver, place of residence, whether they are left-behind children and parental relationship. Rural and left-behind children are more likely to enter the “low gender equality consciousness” group. Children in the “low gender equality consciousness” group had a lower proportion of androgynous gender role. Conclusion Rural children and left-behind children are the priority groups for gender equality education. Gender role is the important predictors and intervention targets of children’s gender equality consciousness. Educators or policy makers can formulate targeted intervention measures according to the influencing factors of potential classes.


Cross-Cultural Adaptation and Reliability of the Inventory of Vicarious Posttraumatic Growth and research of its influencing factors: A Cross-Sectional Study

June 2024

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29 Reads

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1 Citation

Objective The purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables. Methods The Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG. Results The Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett's test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach's α = 0.951), with dimensions' Cronbach's α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG. Conclusion The Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.



Citations (32)


... The QQS consisted of 9 items, and the sample size was determined based on classical measurement theory [19]. For Exploratory Factor Analysis (EFA), the recommended minimum sample size was 5 to 10 times the number of items, requiring at least 56 valid responses, assuming a 20% invalid response rate [19,20]. For Confirmatory Factor Analysis (CFA) using Structural Equation Modeling (SEM), a minimum sample size of 200 was recommended [20]. ...

Reference:

Psychometric properties of the Chinese version of the Quiet Quitting Scale
Cross-cultural adaptation and reliability of the inventory of vicarious posttraumatic growth and research of its influencing factors: a cross-sectional study

BMC Nursing

... Researchers revealed that work environments impacted the nurses' job performance [25]. One study reported that resilience, job satisfaction, and anxiety predicted 16% of the nurses' caring behaviors [26]. However, the other predictors of caring behaviors are unknown. ...

Job satisfaction and psychological factors influence the caring behavior in nurses in Sierra Leone: a cross-sectional study

... Nartey et al., 2018). In fact, Li et al. (2024) found that parents' explicit beliefs about gender equality significantly influenced their children's consciousness of gender equality, but this effect varied across cultural contexts. In families with strong patriarchal values, children's awareness of gender equality was more likely to be shaped by indirect socialization processes, such as observed parental interactions, rather than direct instruction. ...

The influence of parents on children’s consciousness of gender equality: a multi-group structural equation modeling approach

... The Vicarious Posttraumatic Growth Inventory (VPTGI), Initially created by Deaton (2020) [33], With proper authorization, our team translated this work into Chinese [34]. The Chinese version comprises 22 items across four dimensions, with responses on a 5-point scale. ...

Cross-Cultural Adaptation and Reliability of the Inventory of Vicarious Posttraumatic Growth and research of its influencing factors: A Cross-Sectional Study

... Previous research shows that nurses who provide patient-centered care often display lower turnover intentions as these nurses feel more connected to their workplace and are motivated to pursue organizational goals [21]. Te alignment between their personal values and professional roles fosters a sense of commitment and dedication, which is generally associated with lower turnover intention [22]. However, the efectiveness of prosocial orientation in reducing turnover intention is not absolute and depends on how well nurses can manage the emotional demands of their work. ...

Subgroups of relational job characteristics and their differences in turnover intention and subjective well-being among nurses: a latent profile analysis

BMC Nursing

... Previous studies examining the association between PR and symptom burden have predominantly employed latent variable models, which assume that latent variables are the common causes of observed variables and that the correlations between observed variables are entirely explained by the latent variables. However, for exploring the specific and global interactions between different components of PR and symptom burden, this approach is limited [20,21]. Network analysis can serve as a powerful complement to latent variable models, facilitating the construction and fitting of interaction systems among various observed variables. ...

A latent profile analysis of resilience and their relation to differences in sleep quality in patients with lung cancer

Supportive Care in Cancer

... As frontline caregivers, nurses spend a significant amount of time in direct contact with patients; they are responsible for the care of not only their patients but also their families while maintaining their own health and families. Therefore, the nursing profession faces numerous challenges, including burnout, compassion fatigue, and the pressures of an overwhelming workload, exacerbated by staff shortages (Peters 2018(Peters , 2023Tamata and Mohammadnezhad 2023;Ulrich et al. 2020;Zhang et al. 2023). These challenges hinder nursing efficiency, which also takes a toll on the nurses' overall quality of life (Nolte et al. 2017). ...

Clinical nurses’ compassion fatigue psychological experience process: a constructivist grounded theory study

BMC Nursing

... Furthermore, low social support increases the likelihood of burnout dimensions such as EE, DP, and reduced PA [25,31,[33][34][35][36][37][38]. Low social support also increases the likelihood of compassion fatigue, or secondary trauma forms [25,33,34,37,39,40], whereas higher social support increases the likelihood of compassion satisfaction [37]. However, most of the studies in our literature review measured burnout in a slightly different from the way burnout is defined in the PQoL framework. ...

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling

BMC Nursing

... However, the enhancement of nursing knowledge and skills, the achievement of career goals, and stress management are all intricately intertwined with learning. Studies have shown a negative association between self-directed learning ability and stress as well as a positive association between self-directed learning ability and professional identit [10,11]. Moreover, self-directed learning ability is pervasive throughout the entire work process and serves as a fundamental pillar of lifelong learning [12]. ...

Subgroups of self-directed learning ability and their differences in professional identity among nursing undergraduates during the COVID-19 pandemic: a latent profile analysis

BMC Nursing