BACKGROUND: Transgender women have a high prevalence of suicidal ideation, with stress and low interpersonal needs as its main risk factors. This study aimed to investigate the mediating role of interpersonal needs on the relationship between perceived stress and suicidal ideation among transgender women in China.
METHODS: A cross-sectional study was conducted in Shenyang and Kunming from April to September 2018. 247 transgender women were recruited. Sociodemographic statistics, perceived stress, interpersonal needs and suicidal ideation were obtained. Correlation analysis and mediation analysis were performed to test the relationship among perceived stress, suicidal ideation and interpersonal needs.
RESULTS: 14.6 % of the participants reported suicidal ideation within a year. Perceived stress was positively correlated with suicidal ideation (r = 0.228, p < 0.001), interpersonal needs and its three dimensions (r = 0.300-0.583, ps < 0.001)-thwarted belongingness, perceived burdensomeness and social exclusion. Interpersonal needs and its three dimensions were also positively correlated with suicidal ideation (r = 0.148-0.299, ps < 0.05). Interpersonal needs, perceived burdensomeness and social exclusion partly mediated the relationship between perceived stress and suicidal ideation, while thwarted belongingness didn\'t play a mediating role.
CONCLUSIONS: Cross-sectional study limited confirmation of causality between variables. The investigation didn\'t aim at the specific stressors of sexual minorities. And that participants came from only two regions might affect the generalization of the results.
CONCLUSIONS: We found a partial mediating role of interpersonal needs between stress and suicidal ideation. Stress reduction and increased social inclusion are needed to reduce suicidal ideation in transgender women.

BACKGROUND: Compassion among intensive care unit (ICU) nurses is an essential component of humanistic care in the ICU However, the enormous pressures of the job and the lack of social support have led to persistently severe compassion fatigue. Sensory processing sensitivity, as a personality trait for individuals to perceive external factors, has underlying significance for compassion fatigue.
OBJECTIVE: This study aims to investigate the internal and external environmental factors and the underlying mechanisms that influence the impact of sensory processing sensitivity among ICU nurses on the development of compassion fatigue.
METHODS: A cross-sectional descriptive study was conducted with 290 nurses from various hospitals in five cities in China.
METHODS: A self-designed demographic questionnaire, the Chinese version of the Professional Quality of Life Scale, the Chinese version of the Highly Sensitive Person Scale, the Chinese version of the Perceived Social Support Scale, and the Chinese version of the Perceived Stress Scale were used to survey 290 ICU nurses. The mediating roles of perceived social support and perceived stress between sensory processing sensitivity and compassion fatigue were tested.
RESULTS: The research results indicate that the total effect of sensory processing sensitivity on compassion fatigue is significant (0.245 [0.093, 1.160]), whereas the direct effect of sensory processing sensitivity on compassion fatigue is not significant (-0.43 [-0.402, 0.247]). Perceived social support and perceived stress exhibit serial mediating effects between sensory processing sensitivity and compassion fatigue (-0.065 [-0.142, -0.013]).
CONCLUSIONS: Our results revealed, for the first time, the underlying mechanism between sensory processing sensitivity and compassion fatigue among ICU nurses. Providing necessary stress-relief condition and abundant social support are important measures for nursing managers to reduce compassion fatigue and improve the quality of critical care humanistic nursing services.

Life satisfaction refers to an individual\' s cognitive evaluation of the overall quality of their life considering the various aspects therein. Although the existing research has demonstrated the between-person relationship between negative life events and life satisfaction based on retrospective measures, less is known about this relationship at the within-person level. A daily diary method could examine this within-person relationship and decrease systematic recall biases. Therefore, this study investigated the link between daily negative life events and daily life satisfaction, as well as the mediating role of perceived stress and the moderating role of trait rumination in 146 young adults (Mage = 20.75, SD = 1.35) using a 14-day daily diary design. Multilevel regression analysis showed that daily negative life events had negative predictive effects on daily life satisfaction. In addition, the multilevel 1-1-1 mediation analysis indicated that daily perceived stress mediated the association between daily negative life events and daily life satisfaction. More importantly, the mediating effect of perceived stress was moderated by trait rumination, with the within-person mediating effect being stronger for individuals with higher than those with lower trait rumination tendencies. These findings contribute to the understanding of the underlying pathways in the relationship between daily negative life events and daily life satisfaction and provide a new perspective for improving individuals\' life satisfaction.

OBJECTIVE: The incidence of breast cancer patients with negative body image has increased. However, research on interventions that explicitly reduce negative body image among breast cancer patients remains inadequate. The development of more pragmatic interventions is imperative. Therefore, we conducted this study to assess the effectiveness of a 6-week online Mindful Self-Compassion (MSC) intervention to reduce the negative body image in breast cancer patients.
METHODS: We randomly assigned 64 female breast cancer patients to either the MSC group or the control group. The MSC group received a 6-week online Mindful Self-Compassion intervention, while the control group received no psychological training. Participants were surveyed by the Self-Compassion Scale-Short Form (SCS-SF), the Self-Acceptance Questionnaire (SAQ), the Chinese Perceived Stress Scale (CPSS), and the Body Image Scale (BIS) at baseline (T1), post-intervention (T2), and 1-month follow-up (T3).
RESULTS: All outcome variables demonstrated significant time main effects and nonsignificant group main effects. The MSC and control groups had significant time × group interaction effects on self-compassion, self-acceptance, perceived stress, and negative body image. Simple main effects analysis revealed significant improvements in outcome variables at three-time points for the MSC group.
CONCLUSIONS: A 6-week online Mindful Self-Compassion intervention can improve self-compassion and self-acceptance and reduce perceived stress and negative body image among the breast cancer patients in MSC group. Mindful Self-Compassion intervention shows promise as a viable way to maintain the mental well-being of breast cancer patients.

OBJECTIVE: The traumatic experience of cancer, in addition to its negative impact on breast cancer patients, can also bring about positive change, i.e., post-traumatic growth (PTG). PTG can help boost patients\' confidence in their fight against the disease and improve their adherence to treatment, thereby facilitating their recovery. The study aimed to investigate the effect of perceived stress on the PTG of patients undergoing postoperative chemotherapy for breast cancer and to examine the roles of rumination and self-efficacy between two.
METHODS: The data was collected using a cross-sectional design. From December 2021 to October 2022, a total of 306 breast cancer patients who had undergone chemotherapy following surgery and met the inclusion and exclusion criteria were selected from three tertiary-level A hospitals in Henan Province, China. We conducted descriptive analysis, Pearson correlation analysis, and a regression analysis using PROCESS Macro Model 80 to explore the relationships among perceived stress, rumination, self-efficacy, and PTG.
RESULTS: Perceived stress of patients undergoing postoperative chemotherapy for breast cancer had a negative predictive effect on PTG (r = -0.340, P < 0.01); Rumination and self-efficacy played a partial mediating effect between perceived stress and PTG, accounting for 45.25% of the total effect.
CONCLUSIONS: Clinical nursing staff could promote PTG by strengthening psychological assessment and timely psychological intervention for patients with high perceived stress levels, encourage patients to adopt a positive way of thinking about illness and improve their self-efficacy level, so as to improve their PTG level.

BACKGROUND: Health care workers (HCWs) frequently face multiple stressors at work, particularly those working night shifts. HCWs who have experienced distress may find it difficult to adopt stress management approaches, even if they are aware of the effects of stress and coping processes. Therefore, an individualized intervention may be required to assist distressed HCWs in bridging the \"knowledge-practice\" gap in stress management and effectively alleviating stress symptoms.
OBJECTIVE: The main objective of this research was to compare the effects of a complex interactive multimodal intervention (CIMI) to self-guided stress management interventions on stress symptoms of distressed HCWs, as measured by physiological (heart rate variability), psychological (perceived stress, mental distress, and subjective happiness), and sleep disorder (fatigue and sleepiness) indicators.
METHODS: We conducted a nonrandomized, controlled study in 2 Chinese general hospitals. The participants in this study were 245 HCWs who fulfilled at least 1 of the 3 dimensions on the Depression, Anxiety, and Stress Scale. All eligible individuals were required to complete a questionnaire and wear a 24-hour Holter device to determine the physiological signs of stress as indexed by heart rate variability at both baseline and after the intervention. The CIMI group received a 12-week online intervention with 4 components-mobile stress management instruction, a web-based WeChat social network, personalized feedback, and a nurse coach, whereas the control group simply received a self-guided intervention.
RESULTS: After a 12-week intervention, the Perceived Stress Scale (PSS) scores reduced significantly in the CIMI group (mean difference [MD] -5.31, 95% CI -6.26 to -4.37; P<.001) compared to the baseline levels. The changes in PSS scores before and after the intervention exhibited a significant difference between the CIMI and control groups (d=-0.64; MD -4.03, 95% CI -5.91 to -2.14; P<.001), and the effect was medium. In terms of physiological measures, both the control group (MD -9.56, 95% CI -16.9 to -2.2; P=.01) and the CIMI group (MD -8.45, 95% CI -12.68 to -4.22; P<.001) demonstrated a significant decrease in the standard deviation of normal-to-normal intervals (SDNN) within the normal clinical range; however, there were no significant differences between the 2 groups (d=0.03; MD 1.11, 95% CI -7.38 to 9.59; P=.80).
CONCLUSIONS: The CIMI was an effective intervention for improving sleep disorders, as well as parts of the psychological stress measures in distressed HCWs. The findings provide objective evidence for developing a mobile stress management intervention that is adaptable and accessible to distressed HCWs, but its long-term effects should be investigated in future research.
BACKGROUND: ClinicalTrials.gov NCT05239065; https://clinicaltrials.gov/ct2/show/NCT05239065.

OBJECTIVE: Diet plays a fundamental role in promoting resilience against stress-related disorders. We aimed to examine the overall and sex-specific association between food groups and perceived stress in adults.
METHODS: We analyzed the prospective data of 7,434 adults who completed both the 2011 and 2015 surveys of the China Health and Nutrition Survey (CHNS). The Diet Quality Questionnaire (DQQ) was used to code all the food items of 2011 dietary intake into 29 food groups, and perceived stress in 2015 was measured using a 14-item perceived stress scale (PSS-14). Univariate analysis and logistic regression models were used to examine the relationship between food groups and perceived stress.
RESULTS: People who perceived a higher level of stress (PSS-14 total score > 25) made up 41.5% and 45.1% of the male and female groups, respectively (χ2 = 9.605, p = 0.002). Individuals with increased intake of food groups such as legumes, other vegetables, other fruits, yogurt, poultry, fish & seafood, fluid milk, and fruit juice were less likely to experience a higher level of psychological stress (OR range: 0.544-0.892, p < 0.05). Additionally, we found sex-specific associations between food groups and perceived stress. The difference in the proportion of food groups, such as fluid milk and fish & seafood, between the two stress groups in men was statistically significant (p < 0.025). In the female group, the distribution of eight food groups, like legumes and nuts & seeds, between the two stress groups was statistically significant (p < 0.025).
CONCLUSIONS: This study indicated that food groups were differentially associated with perceived stress.

Shift work is a recognized work pattern for nurses worldwide. The disruption of shift workers\' biological clocks usually leads to sleep disorders and affects their awareness at work. Eveningness and occupational stress might be effective in causing burnout syndrome. Therefore, this study aimed to evaluate the chronotype, job burnout and perceived stress among Chinese tertiary hospital nurses, and understand the predictors of circadian rhythm in this group. Between July and September 2020, 23 hospitals were randomly selected from 113 tertiary hospitals in Hunan Province. Twenty-five percent of the nurses working in each hospital were targeted for selection. 28.1% and 17.6% of nurses reported eveningness type and morningness type, respectively. The scores for emotional exhaustion, depersonalization, and perceived stress of eveningness nurses were higher than those of morningness counterparts. Eveningness nurses also reported a lower sense of personal accomplishment. Risk factors of eveningness included being under 30 years old, never exercising, having the stressors of late-night shifts and career development, higher levels of emotional exhaustion, sleep latency, sleep duration, and hypnotic use. Shifts may be unavoidable for nurses, nevertheless, understanding the predictors and related factors of chronotype for nurses is necessary for nursing educators and managers to develop a reasonable shift system and appropriate measures to assist nurses in adjusting their work.

BACKGROUND: Given the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health.
METHODS: We used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis.
RESULTS: The higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = -1.83, P < 0.001; depression: a1 = -2.44, P < 0.001; and perceived stress: a1 = -1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls\' mental health (anxiety: a1 = -1.97, P < 0.001; depression: a1 = -2.71, P < 0.001; perceived stress: a1 = -1.23, P < 0.001).
CONCLUSIONS: The cross-sectional study design limited the inference of causal relationships between variables.
CONCLUSIONS: These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

Drawing on the stressor-perception-coping-response model of stress, this study examined the associations between negative life events, present-moment awareness, problem-solving, and perceived stress among rural adolescents, focusing specifically on gender differences. Using a cross-sectional design, 3519 Chinese rural adolescents completed measures assessing negative life events, present-moment awareness, problem-solving, and perceived stress. Structural equation modeling was employed to examine the hypothesized serial mediation model. The results revealed a positive association between negative life events and perceived stress in rural adolescents, which was serially mediated by present-moment awareness and problem-solving. Furthermore, significant gender differences were observed. Specifically, girls exhibited larger effects than boys in the overall effect of negative life events on perceived stress, the indirect effect of present-moment awareness, and the serial mediating effect. These findings suggest that present-moment awareness and problem-solving may serve as crucial mechanisms for understanding rural adolescents\' perceived stress in response to negative life events, particularly among female rural adolescents.