Background Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH. Methods We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi’s phenomenological approach. Results Twenty-two respondents completed the interviews (aged 29–75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends’ helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison). Conclusion The study reveals that multiple stressors drive MHD patients’ LH. These salient phenomena demonstrate the importance of recognizing MHD patients’ LH. We suggest that support services should be developed alongside a framework that addresses MHD patients’ LH from the beginning of treatment.

Background: Learned helplessness is an early psychological concept, but in the field of nursing, the concept of learned helplessness in renal dialysis patients and its unique challenges are not well understood. Objective: This article provides a conceptual analysis of learned helplessness in renal dialysis patients to increase knowledge of this psychological phenomenon in the setting of renal nursing. Design: Rodgers' evolutionary concept analysis. Methods: The literature published in five databases (PubMed, CINAHL, Embase, PsycINFO, CNKI) was searched using specific terms. In the first stage, search terms and strategies were used to narrow the relevant articles. In the second stage, the data were extracted from the included articles. In the third stage, the data were analyzed using thematic analysis, and the results were presented in the form of attributes, antecedents, consequences, surrogate terms, and related terms. We found additional instruments and interventions and presented a model case to emphasize the practicality of the concept. In the fourth phase, experts contributed to the discussion and interpretation of the findings. Results: A total of 22 articles were included. Four attributes of learned helplessness in renal dialysis patients were identified: low selfconcept, perceived loss, negative cognitive set, and abandonment of action. The antecedents were sociodemographic characteristics, disease and treatment, and psychological factors. Consequences were separated into four themes: psychological problems, physiological problems, quality of life, and health-related behavior. Surrogate terms are hopelessness and powerlessness, and the related term is depression. Conclusion:The process of conceptual analysis in this study provides a means of identifying awareness gaps and practice challenges of learned helplessness in renal dialysis patients and other concepts. The findings can be used to guide the design of tools and interventions to expand the use of learned helplessness theory in nursing.

ObjectivesThis study is conducted to examine whether overall workplace violence (WPV) and its five types are associated with high burn-out among healthcare workers in China.DesignA WeChat-based cross-sectional survey. Snowball sampling was used in this study.ParticipantsFront-line healthcare workers (N=3706) from 149 cities across 23 provinces in China responded to the survey, and 22 questionnaires were excluded because of incomplete data.Primary and secondary outcome measures(1) The Chinese Maslach Burnout Inventory-General Survey was used to measure high burn-out. (2) WPV was assessed using the Chinese version of the Workplace Violence Scale. (3) An anonymous self-designed web-based questionnaire consisting of demographic, behavioural and occupational information was used to identify covariates.ResultsA total of 3684 front-line healthcare workers (934 physicians and 2750 nurses) were included. Of all participants, 13.3% (491/3193) experienced high burn-out. Adjusted logistic regression revealed that experience of WPV in the past year was associated with high burn-out (OR 2.10, 95% CI 1.69 to 2.62). Healthcare workers who had suffered emotional abuse, threat or verbal sexual harassment were more vulnerable to high burn-out.ConclusionThis study finds that healthcare workers with WPV, especially emotional abuse, threat and verbal sexual harassment, are more likely to experience burn-out. These types of WPV should be considered in interventions to reduce and prevent burn-out for healthcare workers.

Aim To assess the pain and function of acupuncture in patients with nonspecific low back pain (NSLBP). Design This is a study protocol for an upcoming, updated systematic review and meta-analysis. We have registered on the PROSPERO platform, and the registration number is CRD42020149647. Methods We will identify studies in seven English databases, including Web of Science, Cochrane Library, CINAHL, Physiotherapy Evidence Database, Medline, Embase, and Scopus, and in four Chinese databases, including China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), Wanfang Database, and VIP database. We will also manually search key journals about acupuncture, the references of identified relevant trials, and the Clinical Trials Registry Platform. Different search strategies of Medical Subject Headings (MeSH) and non-MeSH terms will be applied alone or integrated. We will evaluate methodological quality by adopting Cochrane’s risk of bias criteria and perform a meta-analysis using RevMan V.5.4 software. Results This study’s results will be reported according to the PRISMA checklist and presented at an authoritative scientific conference or an authoritative scientific journal.

Background Learned helplessness (LH) is an essential psychological factor influencing maintenance haemodialysis (MHD) patients’ health behaviour and is closely related to prognosis of the disease. This study aimed to identify potential trajectories of LH in MHD patients and assess their predictive role in self-management. Methods This study was conducted in strict compliance with national laws, the Declaration of Istanbul, and the Declaration of Helsinki. A total of 347 MHD patients at a blood purification centre in Hunan Province, China, were selected as the study population. Four longitudinal surveys (baseline and second/fourth/sixth month after baseline) were conducted using the General Information Questionnaire for MHD patients, the Chinese version of the Learned Helplessness Scale for MHD patients, and the Self-Management Scale for Haemodialysis. Latent growth mixture model (LGMM) analysis was used to identify LH trajectories, and their predictors were analysed using multinomial logistic regression. The predictive role of LH trajectory on self-management was analysed using linear regression. Results This study identified three LH trajectories in MHD patients, named the “high-decreasing group” (57.9%), “low-increasing group” (21.3%), and “low-stability group” (20.7%). The results of the univariate analysis showed that sex (χ 2 =33.777, P < 0.001), age (χ 2 =10.605, P <0.05), and subjective social status (SSS) (χ 2 =12.43, P <0.01) were associated with LH trajectory classes. Multinomial logistic regression further demonstrated that gender, age, and SSS were predictors of different LH trajectories. The intercept and slope of the overall LH trajectory were negatively correlated with self-management (β=−0.273, P <0.001; β=−0.234, P <0.01). Conclusion MHD patients show three different LH trajectories. The initial level and developmental rate of LH can negatively predict future self-management. It is necessary to screen MHD patients’ LH and develop targeted interventions for them with different LH trajectories at specific stages.