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Quaedflieg CWEM, Bossi C, Bruijel J. The moderating role of conscientiousness in the temporal association of stress on sleep. J Sleep Res 2024; 33:e14224. [PMID: 38685740 PMCID: PMC11596995 DOI: 10.1111/jsr.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/25/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
Personality traits have been associated with sleep problems and stress experience. However, their impact on objective sleep and the temporal relationship of stress on sleep has remained elusive. This study examined whether daytime stress predicts sleep the following night, and the moderating role of neuroticism and conscientiousness in this relationship. To introduce stress variability in natural daily stressors, we measured college students (N = 92) during exams (e.g. high academic stress) and at the start of new course period (e.g. low academic stress). Both objective (actigraphy) and subjective sleep, and daily self-reported stress, were measured for 14 days and personality traits once. Reported daily stress was significantly higher in the exam period compared with baseline, suggesting that our natural manipulation did indeed result in variation in stress levels. Intra-individual daily variations in stress were not associated with the following night's sleep timing, duration or fragmentation, implying that more stress during the day did not affect sleep the following night. Higher levels of neuroticism were associated with poorer daily subjective sleep quality and higher stress levels over the complete period. Neuroticism did not moderate the temporal association of stress on sleep. Conscientiousness moderated the association between intra-individual stress and sleep fragmentation, and intra-individual stress and wake-up time. This implied that highly conscientious participants experienced less sleep fragmentation and woke-up earlier after more stressful days. These results suggest an interconnected relationship among stress, sleep and personality. Focusing on one aspect, like handling stress or enhancing sleep quality, might yield positive effects on the rest.
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Affiliation(s)
- Conny W. E. M. Quaedflieg
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Camilla Bossi
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Jessica Bruijel
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Limburg Brain Injury CentreMaastrichtThe Netherlands
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2
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Gwyther K, Pilkington V, Bailey AP, Mountjoy M, Bergeron MF, Rice SM, Purcell R. Mental health and well-being of elite youth athletes: a scoping review. Br J Sports Med 2024; 58:1011-1019. [PMID: 39122370 DOI: 10.1136/bjsports-2024-108244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND There is increasing recognition of the prevalence and risk factors for mental health symptoms and disorders among adult elite athletes, with less research involving elite youth athletes. This scoping review aimed to characterise the mental health and well-being of elite youth athletes who travel internationally and compete for their sport. METHOD Four databases were searched in March 2023. Inclusion criteria were studies with elite youth athlete populations (mean age 12-17 years) reporting mental health and well-being outcomes. Data from included studies were charted by outcome, and risk/protective factors identified. RESULTS Searches retrieved 3088 records, of which 33 studies met inclusion criteria, encapsulating data from 5826 athletes (2538 males, 3288 females). The most frequently studied issue was disordered eating (k=16), followed by anxiety (k=7), depression (k=5) and mixed anxiety/depression (k=2). Caseness estimates (a symptom level where mental health treatment is typically indicated) for disordered eating were wide ranging (0%-14% for males; 11%-41% for females), whereas only two studies estimated caseness for depression (7% in a mixed-sex sample; 14% for males, 40% for females) and one for anxiety (8% for males, 28% for females). Common risk factors for mental ill-health included sex, athlete status (compared with non-athletes) and social/relationship factors (with coaches/parents/peers). Contradictory evidence was observed for elite/competition level, which was associated with higher and lower rates of disordered eating. CONCLUSION Further representative research into the mental health and well-being of elite youth athletes is needed to enhance understanding and guide prevention and intervention measures.
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Affiliation(s)
- Kate Gwyther
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
| | - Vita Pilkington
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
| | - Alan P Bailey
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
| | - Simon M Rice
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
| | - Rosemary Purcell
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Victoria, Australia
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3
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Bergeron MF, Côté J, Cumming SP, Purcell R, Armstrong N, Basilico L, Burrows K, Charrin JB, Felix A, Groesswang H, Iwasaki Y, Kocher MS, Martowicz M, McConnell K, Moran J, Holm Moseid C, Mountjoy M, Soligard T, Tetelbaum E, Thiel A, Vertommen T, Viseras G, Budgett R, Engebretsen L, Erdener U. IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm. Br J Sports Med 2024; 58:946-965. [PMID: 39197945 DOI: 10.1136/bjsports-2024-108186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/01/2024]
Abstract
With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.
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Affiliation(s)
- Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
- Health Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Jean Côté
- School of Kinesiology and Health Studies, Queen's University, Kingston, Jamaica, Canada
| | | | - Rosemary Purcell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Neil Armstrong
- Childrens Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Luca Basilico
- World Skate, Maison du Sport International, Lausanne, Switzerland
| | - Kirsty Burrows
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Jean-Benoit Charrin
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Allyson Felix
- Athletes' Commission, International Olympic Committee, Lausanne, Switzerland
| | - Heike Groesswang
- International Bobsleigh & Skeleton Federation (IBSF), Salzburg, Austria
| | - Yasunobu Iwasaki
- Anti-Doping, Medical and Scientific Commission, Fédération Internationale de Gymnastique, Lausanne, Switzerland
- Anshinkai Anshin Hospital, Kobe, Hyogo, Japan
| | - Mininder S Kocher
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Magali Martowicz
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Kit McConnell
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Jane Moran
- Medical Commission, International Skating Union, Lausanne, Switzerland
- Faculty of Medicine, The University of British Columbia - Vancouver Campus, Vancouver, British Columbia, Canada
| | - Christine Holm Moseid
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Evgenia Tetelbaum
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Ansgar Thiel
- President, German Sport University, Cologne, Germany
| | - Tine Vertommen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Expertise Center People and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Gloria Viseras
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
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4
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Trabelsi K, Almarzooqi MA, Aljaloud KS, Ghazzawi HA, Alenezi AF, Salem A, Kerkeni M, Kerkeni M, Chtourou H, Ammar A, Boukhris O, Pandi-Perumal SR, Driller MW, Jahrami H. Adapting the athlete sleep behavior questionnaire (ASBQ) for Arabic-speaking populations: Translation, reliability testing, and validation using classical theory and item response theory. Sleep Med 2024; 119:267-275. [PMID: 38710132 DOI: 10.1016/j.sleep.2024.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 04/16/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
Sleep is essential for athletes' physical performance as well as their general health, well-being, and quality of life. To assess athletes' sleep behaviors, the Athlete Sleep Behavior Questionnaire (ASBQ) was developed in the English language. However, a validated Arabic-version of the ASBQ is lacking. This study aimed to translate the ASBQ into Arabic (ASBQ-AR) and evaluate its reliability and validity among Arabic-speaking athletes. A total of 458 participants (254 athletes, 202 non-athletes) from four Arabic countries completed the ASBQ-AR and the Insomnia Severity Index (ISI) questionnaires. The psychometric properties of the ASBQ-AR were examined using unidimensional reliability analysis, confirmatory factor analysis (CFA), Item Response Theory (IRT), and convergent validity. The ASBQ-AR had acceptable internal consistency (Cronbach's α = 0.723, McDonald's ω = 0.725) and a factorial structure, confirming its construct validity. CFA demonstrated improved model fit indices after the removal of two potentially misfitting items (items 4 and 13); however, the model's fit to the data remains suboptimal. IRT results indicated that the majority of items demonstrated a good model fit, suggesting effective measurement of the intended construct without significant interference, except for ASBQ-AR 4. Additionally, ASBQ-AR 4 appears to present the highest level of difficulty for respondents. In terms of convergent validity, the mean ASBQ-AR global score was correlated with the mean ISI global score (r = 0.5, p < 0.0001). The ASBQ-AR is a reliable and valid tool for assessing maladaptive sleep practices among Arabic-speaking athletes. Additional refinements to the ASBQ-AR are warranted to optimize its psychometric properties.
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Affiliation(s)
- Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia.
| | | | - Khalid S Aljaloud
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, P.O. Box 2454, Riyadh 11451, Saudi Arabia.
| | - Hadeel Ali Ghazzawi
- Nutrition and Food Technology Department, Agriculture School, The University of Jordan, P.O. Box 11942 Amman, Jordan.
| | - Ahmad F Alenezi
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Ministry of Health, Kuwait City, Kuwait.
| | - Atef Salem
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia.
| | - Mohamed Kerkeni
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia.
| | - Manel Kerkeni
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia.
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Activité Physique, Sport et Santé, UR18JS01, Observatoire National du Sport, Tunis, Tunisia.
| | - Achraf Ammar
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax 3000, Tunisia; Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, 92000 Nanterre, France.
| | - Omar Boukhris
- SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia.
| | - Seithikurippu R Pandi-Perumal
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India; Division of Research and Development, Lovely Professional University, Phagwara, Punjab, 144411, India.
| | - Matthew W Driller
- SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia.
| | - Haitham Jahrami
- Government Hospitals, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
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5
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Nédélec M, Chauvineau M, Martinent G. Development and evaluation of the psychometric properties of a new measure of athlete insomnia: Insomnia in Response to Sports-related Stress Test questionnaire. Eur J Sport Sci 2024; 24:653-658. [PMID: 38874985 PMCID: PMC11235861 DOI: 10.1002/ejsc.12095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 02/01/2024] [Accepted: 02/19/2024] [Indexed: 06/15/2024]
Abstract
To develop and validate the Insomnia in Response to Sports-related Stress Test (IRSST) questionnaire, a new specific instrument with the goal of sensitively measuring vulnerability to sport-specific stressful situations among elite athletes. Five hundred and thirty-one competitive elite athletes (mean age = 17.6 ± 4.4 years) completed the Ford Insomnia Response to Stress Test (FIRST) questionnaire and the IRSST, a six-item questionnaire developed to assess the level of sleep disturbance in response to the commonly experienced sport-specific stressful situations. A development and validation process including substantive, structural, and external stages was used in the present study. One eigenvalue of the exploratory factor analyses was greater than 1.0 (i.e., 2.91, 48.52% of explained variance) whereas the scree test provided evidence for a one-factor solution, with all the six items achieving a loading of 0.40 or higher on the factor. Cronbach alpha was 0.77 and provided evidence for the reliability of the IRSST score. The correlation between IRSST and FIRST scores was 0.47 (p < 0.001, moderate effect size). These results provide strong evidence for construct validity, indicating that the IRSST is a promising scale for assessing the likelihood of sleep disruption due to sports-related stressful situations. The results of reliability and correlational analyses provided further evidence of the promising psychometric properties of the IRSST. We believe that the IRSST could provide to the sport and sleep science communities a sleep screening tool for use in this unique population.
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Affiliation(s)
- Mathieu Nédélec
- French Institute of Sport (INSEP)Laboratory Sport, Expertise and Performance (EA 7370)ParisFrance
| | - Maxime Chauvineau
- French Institute of Sport (INSEP)Laboratory Sport, Expertise and Performance (EA 7370)ParisFrance
| | - Guillaume Martinent
- University of Claude Bernard Lyon 1 – Univ LyonLaboratory of Vulnerabilities and Innovation in Sport (EA 7428)Faculty of Sport SciencesLyonFrance
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Maringgele VE, Scherr M, Aichhorn W, Kaiser AK. Depressive symptoms are more influenced by personality traits and styles than working in nursing-a study during the COVID-19 pandemic. Front Psychol 2023; 14:1138185. [PMID: 37671102 PMCID: PMC10476868 DOI: 10.3389/fpsyg.2023.1138185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023] Open
Abstract
Background According to literature, the COVID-19 pandemic caused stressful working conditions for nurses, which may have a negative impact on their Well-Being and mental health. Aim To investigate whether nurses and non-helping professionals differ in their Well-Being. Furthermore, we analyzed, for the first time, which personality traits and styles are a risk factor for nurses' wellbeing during COVID-19 pandemic. Methods In an online survey, the following psychological tests were used on nursing staff (n = 518) and non-helping professionals (n = 335): WHO-Five (WHO-5), the Personality, Style and Disorder Inventory (PSSI), and the Freiburg Personality Inventory-Revised (FPI-R). Results Nurses and non-helping professionals did not differ significantly in terms of Well-Being. The Well-Being of nurses was correlated with the following personality traits and styles, namely Spontaneous-Borderline Personality Style, Silent-Depressive Personality Style, Strain, Emotionality, and Life Satisfaction. According to our results, 33% of participants suffered from clinically significant depressive symptoms. Discussion According to our results, nurses are not more at risk for depression. However, it was shown that Well-Being during the pandemic is highly dependent on personality. Conclusion Specific personality traits and styles are a greater predictor of depressive symptoms than profession. The stressful occupational environment during COVID-19 pandemic is not the only cause for depressive symptoms in nurses. Psychotherapeutic interventions are especially important for particular individuals and are necessary to prevent depressive symptoms during COVID-19 pandemic.
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Vitale JA, Mathieu N, Sabrina S, Michele L. Editorial: The Reciprocal Relationship Between Sleep and Stress in Elite Athletes. Front Psychol 2021; 12:797847. [PMID: 34880821 PMCID: PMC8645555 DOI: 10.3389/fpsyg.2021.797847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | - Skorski Sabrina
- Institute of Sport and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Lastella Michele
- Appleton Institute for Behavioral Science, Central Queensland University, Rockhampton, QLD, Australia
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Huang W, Cai S, Zhou Y, Huang J, Sun X, Su Y, Dai M, Lan Y. Personality Profiles and Personal Factors Associated with Psychological Distress in Chinese Nurses. Psychol Res Behav Manag 2021; 14:1567-1579. [PMID: 34629913 PMCID: PMC8495230 DOI: 10.2147/prbm.s329036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/19/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND A high prevalence of psychological distress is observed in nurses due to multiple occupational stressors. Personality traits and personal factors are important factors that lead to psychological distress. The personality profile reflects a combination of personality traits; however, the relationship between personality profiles and personal factors that affect psychological distress among nurses has not been defined. METHODS This cross-sectional study was conducted in November 2020 in China. Convenience and snowball sampling were used to recruit participants. Latent profile analysis was used to identify personality profiles of nurses based on the big-five personality traits. Single-factor analysis and multivariate logistic regression were used to determine the factors affecting psychological distress. The structural equation model was used to verify the hypothetical model linking personality profiles, self-efficacy, psychological resilience, and coping style with psychological distress. RESULTS A total of 953 Chinese nurses (934 female) with a mean (S.D.) age of 32.8 (8.6) years were recruited. Personality profiles identified were negative, normative, and positive. A personality profile may predict psychological distress directly and indirectly through self-efficacy, psychological resilience, and coping style. LIMITATIONS No complex sampling limits the representativeness of Chinese nurses. External factors affecting psychological distress were not investigated. CONCLUSION Nurses with anegative personality profile had a higher prevalence of psychological distress. This study establishes the importance of personality profile assessment to identify nurses at higher risk of psychological distress. It suggests that interventions should be based on self-efficacy, psychological resilience, and coping style as potential management strategies.
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Affiliation(s)
- Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Shu Cai
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Ye Zhou
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Jingxin Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Xibin Sun
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Yunhui Su
- Department of Emergency, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Meifen Dai
- Department of Nursing, The Sixth Affiliated Hospital, South China University of Technology (Nanhai District People’s Hospital of Foshan), Foshan, People’s Republic of China
- Meifen Dai Department of Nursing, The Sixth Affiliated Hospital, South China University of Technology (Nanhai District People’s Hospital of Foshan), Foshan, 528200, People’s Republic of China Email
| | - Yutao Lan
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
- Correspondence: Yutao Lan School of Nursing, Guangdong Pharmaceutical University, Guangzhou, 510310, People’s Republic of China Email
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