Background Professional identity is related to individuals' professional commitment. It has been a hot topic in the nursing science because of the common problem of nursing workforce shortage around the world. Professional identity is culturally shaped, but few scholars have systematically examined its developmental characteristics in a specific culture. The aim of the scoping review is to get comprehensive knowledge on the influencing factors and development process of the professional identity among nursing students and nurses in mainland China Methods A scoping review was conducted. The most common Chinese databases, China National Knowledge Infrastructure and Wanfang Data, were searched for publications in Chinese. The EBSCOhost and ProQuest dissertation and thesis global were searched for publications in English. After screening the title and abstract of the articles in the first round and the full-text in the second round, 53 articles were included for analysis. Results The influencing factors to professional identity development in nursing could be grouped into three dimensions: personal factors at micro dimension, familier factors and institutional factors at medium dimension, and social factors at macro dimension. The social factors tended to negatively affect professional identity while the factors at the other two dimensions exerted influence in different directions. A framework was established based on professional identity levels in different career stages of nurses to depict the continuum and dynamic nature of development process. Conclusions Development of professional identity in nursing is a dynamic process shaped by multidimensional factors. The biggest obstacles to the development lie in the social factors. Changes in policy should be made to reverse the nursing profession stereotype of being a passive role to medicine. As some obstacles and challenges faced by nursing are shared by nurses around the world, international cooperation is needed to address the common obstacles and challenges.

BackgroundPathway studies highlight the help-seeking behaviors of patients with physical and mental illnesses. A number of studies in this field have been completed in various parts of the world. The purpose of this study is to explore the characteristics of the help-seeking pathways of patients with mental illness from urban north China at Mental Health Professional (MHP).MethodsThe pathway diagrams, which accounted for more than five percent of patients, were documented for 441 subjects using the translated version of the World Health Organization (WHO) pathway encounter form. The patterns and durations of care-seeking were analyzed in different diagnostic groups. The χ2-test and the Mann-Whitney U test were employed, as needed.ResultsRespondents visited the MHP through a variety of pathways. Approximately three-quarters of the patients took an indirect pathway (74.8% vs 25.2%, χ2 = 108.8, p < 0.0001), and on average, each patient consulted 3.4 caregivers. The vast majority of patients first visited local tertiary general hospitals (56.4% vs 4.1%, χ2 = 138.3, p < 0.0001) or local secondary general hospitals (24.8% vs 4.1%, χ2 = 40.96, p < 0.0001). However, only 9.6% of patients were diagnosed with mental disorders for the patients who first visited non-psychiatric hospitals. Of the patients who first contacted with psychiatry hospital, 55.6% received a professional diagnosis and finally reached the MHP because of the poor treatment or high-cost medical care.ConclusionsThe majority of patients seek other pathways than to go to MHP directly and this may be due to stigma, and/or lack of knowledge. The study gives emphasis on the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders in the community health centers, the general hospitals system and by private practitioners. The pathway described by this study may be helpful while preparing mental health programs in the future.

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