BackgroundIntensive care nurses repeatedly witness suffering, dying, grief, and conflict. In contemporary intensive care, protocols and monitoring routines can compress nursing work into execution and vigilance, limiting opportunities to exercise moral agency and creating ethically fraught "witnessing" positions.Research objectivesTo explore how intensive care nurses experience vicarious trauma, and how moral agency, ethical tensions, and organizational conditions shape its accumulation and repair.Research designA qualitative study using face-to-face semi-structured interviews and reflexive thematic analysis.Participants and research contextFifteen registered nurses from a general intensive care unit in eastern China, purposively sampled for maximum variation in gender, professional title, experience, and recent high-impact exposures.Ethical considerationsEthical approval was obtained from the Ethics Committee of The First Affiliated Hospital of Zhejiang Chinese Medical University (approval number: 2025-KLS-184-02). Written informed consent was obtained; confidentiality and a distress protocol were applied.FindingsFour themes were generated: (1) occupational boundary permeation and resonance, including identity mirroring, emotional absorption, and moral tension; (2) a spectrum of adaptation, where defensive distancing functioned as a strategy of moral survival under repeated exposure; (3) fractures in professional meaning and points of rupture, including constrained voice and experiences of powerless witnessing; and (4) meaning reconstruction in the cracks, reflecting moral repair through process-oriented care, renewed boundaries, and re-grounding in dignity-preserving practice.ConclusionsVicarious trauma in intensive care nursing is not only an individual psychological burden but an ethical and organizational phenomenon shaped by constrained moral agency and ethically contested trajectories of care. Interventions should move beyond individualized resilience and strengthen ethical infrastructures that legitimize nursing voice, support reflective processing, and enable ethically defensible practice in high-acuity settings.

Grit is recognized as a key psychological resource for military personnel, yet limited longitudinal research has examined whether and how grit develops during military training. This study investigated the developmental trajectory of grit among 318 military cadets over one academic year using a four-wave longitudinal design. Latent growth modeling and multi-group analysis were employed to identify psychological predictors of grit development and to examine whether these predictors operated consistently across different grade levels. Results showed that grit exhibited a significant positive growth trajectory after controlling for psychological antecedents. A dual-process mechanism emerged from the analysis. Hope, growth mindset, and deliberate practice functioned as foundational factors that predicted initial levels of grit. Emotion regulation served as a catalytic factor and was the only significant predictor of the rate of grit growth over time. These psychological mechanisms were invariant across grade levels, suggesting that grit development is driven more by psychological factors than by maturation. Furthermore, both initial grit levels and grit growth positively predicted prosocial behavior and negatively predicted counterproductive behavior at the end of the academic year. These findings indicate that grit can be cultivated through targeted psychological training, offering practical guidance for military education and counseling programs.

The relationship between increased psychopathology and hypnotic susceptibility has been a topic debated since the time of Charcot. The primary aim of this study was to investigate this relationship using the Stanford Hypnotic Susceptibility Scale type A and the major dimensions of psychopathology on the Symptom Check List 90 Revised (SCL-90-R); the secondary objective was to highlight any relationship between responses to induced individual ideomotor phenomena and the severity of psychopathological features. This study highlights the absence of a relationship between increased psychopathology, hypnotic susceptibility and response to formally induced ideomotor suggestions. However, it found that subjects who responded to the suggestion of lowering the left hand (item 3) had lower scores for SCL-90-R Obsession-Compulsion and Depression. Adopting a cautious approach, this study proposes a neurobiological hypothesis for the underlying mechanisms of action, suggesting that while a generalized trance state may facilitate the process, the efficacy of hypnotic suggestions depends fundamentally on the individual recipient and their functional specificity.

Sleep paralysis (SP) is understood as a form of temporary muscle paralysis that occurs during the transition between rapid eye movement (REM) sleep and wakefulness. SP is normally associated with vivid, fear-provoking hallucinations such as being threatened or attacked by home invaders and paranormal encounters like alien abductions. SP affects about 20% of the population, and it is a common symptom of narcolepsy, a disorder that disrupts regular sleep cycles and causes sleep deprivation. This article is intended to illuminate the use of relational hypnotherapy in conjunction with lucid dreaming suggestions with a 62-year-old white male suffering from SP in the form of recurring, waking nightmares that affected his overall mental health. Although clinical hypnosis has been used to treat SP, little to no research has explored the connection between hypnosis and lucid dreaming as a means of altering SP. Lucid dreaming, an individual's ability to realize they are dreaming, has been shown to reduce nightmares and distress, and improve sleep quality. This article will demonstrate how lucid dreaming interventions can be included with hypnotherapy and discuss how a lucid dreaming experience can transform waking nightmares into preferred dream experiences.

Hypogammaglobulinemia is common in patients with chronic lymphocytic leukemia (CLL). Prior studies demonstrated that intravenous immunoglobulin (IVIG) reduced infections without survival benefit. We conducted a single-institution retrospective cohort study of infectious outcomes in CLL patients who received IVIG between 2005 and 2022 to assess the impact of IVIG across evolving CLL treatment paradigms, including the introduction of targeted agents. 52 patients met inclusion criteria of IVIG use for hypogammaglobulinemia and recurrent infections, with also any infection up to 1 year prior to the initiation of IVIG. Baseline mean IgG prior to IVIG was 389 mg/dL (range 93 - 891 mg/dL). By design, all 52 patients (100%) experienced at least one CTCAE grade ≥ 2 infection in the 12 months prior to IVIG initiation. In the 12 months following IVIG initiation, only 17 patients (33%) experienced a grade ≥ 2 infection. IVIG therapy was associated with a 67% reduction in risk of grade 2 infections (RR 0.33, 95% CI 0.22 - 0.48; p < 0.0001), corresponding to an absolute risk reduction of 67% and a number needed to treat of 1.5. The mean number of infections per patient also reduced from 2.1 to 0.4. Baseline IgA and IgG levels, as well as recent CLL treatment, were not predictors of residual post-IVIG infections. These findings suggest IVIG may yield meaningful improvements in patient quality of life by reducing infections.