Aim:This study aims to identify the role that spiritual climate has in reducing burnout and intentions to leave amongst clinical nurses.Background: Both shortages and the high turnover of nurses are challenging problems worldwide. Enhancing the spiritual climate amongst nurses can enhance teamwork, organisational commitment and job satisfaction and can play a role in reducing burnout and turnover intention. Methods:A total of 207 clinical nurses working at a tertiary university hospital were included in this cross-sectional, single-site study. Independent-samples t test and ANOVA, Pearson correlation analysis and hierarchical regression analysis were used to explore the relationships amongst related factors. Results:Most clinical departments showed a moderate spiritual climate (60.24 ± 0.82) with high job burnout (33.62 ± 0.28) and turnover intention (2.37 ± 0.57). A good spiritual climate was correlated with high job satisfaction (r = 0.412, p < 0.01), low burnout and turnover intention (r = −0.423, p < 0.01 and r = −0.292, p < 0.01, respectively). Spiritual climate could also indirectly influence nurses' job burnout and turnover intention (R 2 = 10.31%). Conclusions: Different departments have different spiritual climates. The findings from this study indicate that spiritual climate may impact nursing burnout and turnover. Implications for nursing management: Using a spiritual climate scale provides health care decision-makers with clear information about staff spirituality wellbeing. Interventions to improve spiritual climate can benefit teamwork in clinical departments. K E Y W O R D S burnout, job satisfaction, nurses, spiritual climate, spirituality, turnover intention

Aim:To explore the relationship between spiritual climate and transformational leadership, and examine their impact on nurses perceived emotional exhaustion and intentions to quit.

Aims and objectives To summarise and thematise fear of hypoglycaemia (FOH) in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) to provide a theoretical basis for the development of effective interventions. Background FOH is common in this population and can reduce quality of life (QOL) and adversely impact upon diabetes self‐care management. Design A systematic review. Methods Articles published between 2000–2019 were searched in PubMed, MEDLINE, EMBASE, Web of Science and three Chinese databases (CNKI, Wan‐fang data and VIP). Eligible articles were selected using the Preferred Reporting Item for Systematic Review and Meta‐analysis (PRISMA) guidelines. The quality of all articles finally included was evaluated by the Joanna Briggs Institute (JBI) Critical Appraisal tools. Results Eighteen studies from 8654 papers were included. The sample size of each study ranged from 48–3812 subjects. FOH negatively impacted QOL, particularly psychosocial functioning, daily life and sleep quality. Conclusions FOH is a common and serious problem for patients, leading to poor QOL. It has been suggested that psychological concerns, QOL and effective countermeasures in individuals with T1D and T2D should be taken seriously. Advanced technology should be evaluated for its benefits before being used by patients. Relevance to Clinical Practice The review highlights that FOH negatively impacts QOL, including psychosocial factors, daily life and sleep quality. Healthcare providers should develop targeted and professional assessment tools for FOH and QOL for patients with T2D, especially for patients who are about 60 years old. Advanced technology should be evaluated for its benefits before being used by patients.

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Aim The study aimed to explore the association between diabetes‐related distress as a dependent variable and fear of hypoglycaemia as a independent variable in Chinese individuals with type 2 diabetes, which can provide a basis for the development of effective nursing interventions. Design A cross‐sectional descriptive study. Methods Pre‐piloted scales were used to determine whether they experienced fear of hypoglycaemia and whether this impacted upon their management of the disease. From June–October 2019, participants were asked to complete the “hypoglycaemia fear survey” and “diabetes distress scales” to assess levels of fear and distress. Stepwise multivariate regression analysis was applied to reveal relationship between distress as a dependent variable and fear as a independent variable. Covariates included demographic, clinical or lifestyle factors. Results A total of 258 participants were recruited for the survey, and they were characterized by little or no distress (39.53%), moderate distress (45.35%) and high distress (15.12%). The prevalence of moderate to severe distress in patients was 60.47%. Increased diabetes‐related distress was strongly correlated with increased fear of hypoglycaemia and closely associated with the scores of the worry and behaviour subscales. These results indicated that 62.3% of diabetes‐related distress may be explained by fear of hypoglycaemia. Conclusion Increased diabetes‐related distress is associated with increased fear of hypoglycaemia in individuals with type 2 diabetes.