Abstract:Objective:To explore the latent profiles and influencing factors of self-management behaviors in convalescent stroke patients,and to analyze the predictive roles of post-stroke fatigue and post-traumatic growth on self-management behaviors.Methods:A total of 302 convalescent stroke patients from a tertiary grade A hospital and communities in Yanji city were selected as the study subjects by convenience sampling from October 2023 to November 2024.Four follow-ups were conducted to evaluate patients'post-stroke fatigue,post-traumatic growth,caregiver contribution,and self-management behaviors.Latent growth mixture modeling was used to fit the latent categories of self-management behaviors.Logistic regression analysis was employed to explore the influencing factors of these latent categories in convalescent stroke patients.Results:The self-management behaviors of convalescent stroke patients were categorized into three categories,namely the low-level initial increase followed by decrease group(45.0%),the high-level decline group(12.6%),and the medium-level increase group(42.4%).Logistic regression analysis showed that scores for post-stroke fatigue,post-traumatic growth,caregiver contribution,living alone,gender,presence of other chronic diseases,and residential area were influencing factors for the trajectory categories of self-management behaviors in convalescent stroke patients(P<0.05).Mediation model analysis indicated that the mediating effect of post-traumatic growth and the moderating effect of caregiver contribution between post-stroke fatigue and self-management behaviors were not significant.Conclusions:Self-management behaviors in convalescent stroke patients shows group heterogeneity.Interventions should be strengthened in areas such as fatigue management,psychological adjustment,and family support to enhance the level of self-management behaviors in these patients.

Abstract:Objective:To construct a home-based agile exercise fall prevention program for patients with subacute ischemic stroke,to provide a basis for fall prevention management in stroke patients.Methods:Based on the health action process approach(HAPA)theory,a preliminary draft of the home-based agile exercise fall prevention program for patients with subacute ischemic stroke was developed through literature review and group discussions.The Delphi method was applied to finalize the program.Results:Two rounds of expert consultation were conducted.The questionnaire response rates of 83.33%and 100.00%,respectively.The expert authority coefficient was 0.840.Kendall's coordination coefficients were 0.333 and 0.300,respectively(both P<0.001).In the second round,the coefficient of variation ranged from 0.05 to 0.23.The item importance scores ranged from 3.93 to 4.93.The full-score rates ranged from 33.3%to 93.3%.The finalized program included 3 first-level indicators,8 second-level indicators,and 27 third-level indicators.Conclusions:The home-based agile exercise fall prevention program for patients with subacute ischemic stroke is reliable,scientific,feasible,and safe.It could provide a basis for developing fall prevention management interventions for patients with subacute ischemic stroke.

Abstract:Objective:To analyze the causal relationships between mental disorders,insomnia,and irritable bowel syndrome(IBS)using a bidirectional two-sample Mendelian randomization(MR)approach.Methods:The primary analysis was conducted using the random-effects inverse variance weighted(IVW)method on genome-wide association study summary data.Heterogeneity was assessed using Cochran's Q statistic.The horizontal pleiotropy was tested using the intercept from MR-Egger regression.Results:Forward MR analysis revealed that major depressive disorder,schizophrenia,and insomnia were positively associated with the increased risk of IBS(all P<0.05).Reverse MR analysis indicated that IBS was positively associated with the increased risk of major depressive disorder and insomnia(all P<0.05).Cochran's Q test in the forward MR analysis showed heterogeneity in the causal estimates for the genetic instruments of schizophrenia,insomnia,and bipolar disorder,while no heterogeneity was observed for other outcomes.MR-Egger regression indicated no significant horizontal pleiotropy for any of the results(P>0.05).Conclusion:Major depressive disorder,schizophrenia,and insomnia have causal associations with IBS.

Abstract:Objective:To explore the dynamic change characteristics of the incidence of hospital infections before and after the intervention of antimicrobial stewardship measures,and to quantitatively evaluate the short-term and long-term impacts of antimicrobial stewardship measures.Methods:Data on the infection rate of Klebsiella pneumoniae(KPN)among inpatients from July 2017 to December 2018 were collected as pre-intervention data.Data on the KPN infection rate among inpatients from January 2019 to June 2020 were collected as post-intervention data.The Bayesian interrupted time series method was used to evaluate the changing trend of KPN infection rate before and after the implementation of antimicrobial stewardship measures.Results:The average monthly KPN infection rate from July 2017 to June 2020 was 0.941%.The average monthly KPN infection rate before the implementation of antimicrobial stewardship measures was 0.947%.The average monthly KPN infection rate after the implementation of antimicrobial stewardship measures was 0.934%.The parameter estimation results of the model with a lag period of 2 months showed that(β)2 was statistically significant(P<0.05),with a risk ratio of 0.818.(β)3 was statistically significant(P<0.05),(β)1+(β)3=0.021,with a risk ratio of 1.021.(β)4 was statistically significant(P<0.05),with a risk ratio of 1.661.The results of the relative changes between the predictive values and counterfactual values showed that the changes from March to May 2019 all decreased(all P<0.05),while the changes from April to June 2020 all increased(all P<0.05).Conclusions:The Bayesian interrupted time series model could effectively evaluate the short-term and long-term effects of intervention measures.It could also evaluate whether the intervention had a lag effect or not.The implementation of hospital antimicrobial stewardship measures could reduce the infection risk in the short term,with a 2-month lag period in the intervention effect,while the long-term effect was not ideal.

Abstract:Objective:To develop and apply home-based dietary management protocol for diabetic foot patients.Methods:Literature analysis and quality assessment were conducted to formulate initial draft of the home-based dietary management protocol for diabetic foot patients.Expert consultation was organized to revise and refine the draft.The final version of the home-based dietary management protocol for diabetic foot patients was formed.A total of 90 home-based diabetic foot patients from a tertiary grade A hospital and communities in Shanxi province were selected as research subjects from July to October 2024.Participants were randomly divided into control group and observation group using random number table.There were 43 cases in each group after excluding dropout cases.The control group received routine diabetes dietary care instructions,while the observation group received guidance based on the home-based dietary management protocol for diabetic foot patients.The nutritional status,dietary management level,glycated hemoglobin(HbA1c)levels,and wound outcomes were assessed in both groups.Results:The final home-based dietary management protocol for diabetic foot patients was established,structured according to the pathological stages of diabetic foot wounds(inflammatory phase,proliferative phase,remodeling phase).The effective recovery rate of questionnaire was 100%.The expert authority coefficient was 0.85.The Kendall's W coefficient was 0.318(P<0.001).The observation group showed superior outcomes compared to the control group in terms of Mini Nutritional Assessment(MNA)scores,Dietary Management Scale for Type 2 scores,HbA1c levels,and overall wound treatment effectiveness(all P<0.05).Conclusions:The home-based dietary management protocol for diabetic foot patients is scientific and feasible.Its application is beneficial for improving the nutritional status,dietary management capabilities,glucose metabolism indicators,and wound outcomes of diabetic foot patients.

Abstract:Objective:To analyze the correlation between peripherally inserted central catheter(PICC)standardized catheterization length and body parameters in low birth weight infants(LBWI),and to construct a predictive formula for PICC standardized catheter placement length.Methods:A total of 175 LBWIs who received PICC in the right upper limb or right lower limb in the neonatal intensive care unit of Shanxi Bethune Hospital were selected as research subjects from January 2023 to December 2024.General demographic data(gender,postnatal age at catheterization)and catheterization data[catheterization vein,arm circumference(for upper limb),calf circumference(for lower limb),body weight at catheterization,standardized catheter placement length]were collected.Pearson correlation analysis was used to explore the correlation between variables and standardized catheter placement length for each vein.Based on simple linear regression analysis results,predictive formulas for PICC standardized catheter placement length in different veins for LBWIs were constructed.Bland-Altman plots were used to analyze the agreement between predicted and actual insertion lengths for each vein.Results:Standardized catheter placement lengths for the right basilic vein,right median cubital vein,right cephalic vein,and right great saphenous vein were all positively correlated with arm circumference,calf circumference and body weight at catheterization(all P<0.05).Standardized catheter placement lengths for the right basilic vein and right great saphenous vein were also positively correlated with postnatal age at catheterization(both P<0.05).Among all parameters,body weight at catheterization showed the highest correlation with standardized catheter placement length for all four veins.Based on simple linear regression analysis,four prediction equations were constructed to predict the standardized catheterization length.Standardized catheter placement length for right basilic vein=6.941+2.562×body weight at catheterization(kg).Standardized catheter placement length for right median cubital vein=8.110+2.153×body weight at catheterization(kg).Standardized catheter placement length for right cephalic vein=7.583+2.539×body weight at catheterization(kg).Standardized catheter placement length for right great saphenous vein=16.574+3.953×body weight at catheterization(kg).Bland-Altman plots showed that the mean differences between predicted and actual insertion lengths were small for all four veins,with almost all data points falling within the 95%confidence interval.Conclusions:PICC standardized catheter placement length in LBWIs is positively correlated with body weight at catheterization.The prediction formulas based on body weight at catheterization demonstrate high accuracy.

Abstract:Objective:To analyze the definition and connotation of feeding intolerance in critically ill children,to provide a theoretical basis for research and clinical practice.Methods:Literature on feeding intolerance in critically ill children was retrieved from CNKI,Wanfang Data,VIP Database,CBM,PubMed,ProQuest,CINAHL,EMbase,and Scopus.The Walker and Avant concept analysis method was applied to analyze feeding intolerance in critically ill children.Results:Ultimately,43 articles were included.The defining attributes of feeding intolerance in critically ill children were identified as three aspects,namely high gastric residual volume,gastrointestinal symptoms,and insufficient enteral nutrition intake.Antecedents included physiological factors,treatment factors,and feeding-related factors.Consequences encompassed impacts on the child and effects on clinical practice.Conclusions:The concept analysis clarified the conceptual attributes of feeding intolerance in critically ill children,which was beneficial for providing reference for the clinical management of this condition and promoting the implementation of enteral nutrition.

Abstract:Objective:To explore the latent categories of nutritional literacy and the differences in dietary health beliefs across different categories in maintenance hemodialysis(MHD)patients.Methods:A total of 238 MHD patients from the hemodialysis center of Taihe Hospital in Shiyan city were selected as the study subjects from October to December 2024 by convenience sampling.Data were collected using a general demographic information questionnaire,the Nutritional Literacy Assessment Questionnaire for MHD Patients,and the Dietary Health Belief Questionnaire for Hemodialysis Patients.Latent profile analysis(LPA)was used to classify patients'nutritional literacy into different categories,and differences in dietary health beliefs across categories were compared.Results:The nutritional literacy of MHD patients could be classified into three latent categories,namely passive acceptance type(34.5%),guidance-dependent type(52.1%),and self-management type(13.4%).There were statistically significant differences in the total scores of dietary health beliefs among MHD patients with different nutritional literacy categories(P<0.05).Logistic regression analysis showed that age,gender,and place of residence were influencing factors of the latent categories of nutritional literacy in MHD patients(P<0.05).Conclusions:There is heterogeneity in the nutritional literacy of MHD patients.The levels of dietary health beliefs vary across different nutritional literacy categories.Healthcare professionals should develop personalized intervention strategies based on patients'nutritional literacy categories to improve their nutritional literacy and dietary health beliefs.

Abstract:Objective:To evaluate the effect of aerobic exercise combined with auricular point sticking therapy on ectopic fat deposition in pancreatic,liver,and muscle tissues in patients with impaired glucose tolerance.Methods:A total of 140 patients with impaired glucose tolerance in Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine and Pukou Hospital of Traditional Chinese Medicine Affiliated to China Pharmaceutical University were selected as the study subjects from December 2021 to October 2023.They were randomly divided into four groups using a random number table,namely the aerobic exercise group,the auricular point sticking group,the combined intervention group,and the control group,with 35 patients in each group.The control group received routine management.The aerobic exercise group received structured exercise intervention in addition to routine management.The auricular point sticking group received auricular point sticking therapy in addition to routine management.The combined intervention group received both structured exercise intervention and auricular point sticking therapy in addition to routine management.Before the intervention and after 6 months of intervention,the patients'glycosylated hemoglobin(HbA1c),liver proton density fat fraction(PDFF),pancreatic fat fraction(PFF),psoas muscle fat fraction,and visceral adipose tissue(VAT)volume were measured.Results:A total of 106 patients were finally included,with 24 in the aerobic exercise group,28 in the auricular point sticking group,22 in the combined intervention group,and 32 in the control group.The intraclass correlation coefficient(ICC)for the abdominal fat measurement indicators ranged from 0.812 to 0.897(all P<0.001).After 6 months of intervention,there were statistically significant differences in terms of HbA1c,VAT,PDFF,PFF,and psoas muscle fat fraction among the four groups(all P<0.05).Factorial analysis results showed that aerobic exercise and auricular point sticking had synergistic effects on improving HbA1c,PDFF,and PFF(all P<0.05).Conclusions:Aerobic exercise combined with auricular point sticking can synergistically reduce PDFF and PFF levels in patients with impaired glucose tolerance,and improve HbA1c.It has great significance in delaying the progression of impaired glucose tolerance and preventing diabetes.

Abstract:Objective:To explore the latent categories and influencing factors of complication risk perception in young and middle-aged patients with type 2 diabetes.Methods:A total of 364 young and middle-aged patients with type 2 diabetes who visited two tertiary grade A hospitals in Henan Province were selected as the study subjects by convenience sampling method from February to August 2024.Surveys were conducted using a general information questionnaire,the Chinese version of Risk Perception Survey-Diabetes Mellitus(RPS-DM),Health Literacy Scale(HLS),Family APGAR Index(APGAR),and Perceived Social Support Scale(PSSS).Latent profile analysis was performed to assess complication risk perception.Logistic regression analysis was used to explore the influencing factors of the latent categories.Results:The complication risk perception of the young and middle-aged patients with type 2 diabetes could be classified into three latent categories,namely low risk perception-high optimistic bias(40%),moderate risk perception-low personal control(44%),and high risk perception-comprehensive type(16%).Logistic regression analysis showed that place of residence,per-capita monthly family income,family history of diabetes,duration of diabetes,BMI,diabetes health literacy,family caring,and perceived social support were influencing factors of the latent categories(P<0.05).Conclusions:There is heterogeneity in the characteristics of complication risk perception in young and middle-aged patients with type 2 diabetes.Healthcare providers could implement targeted interventions based on the features of different patient categories to improve their level of complication risk perception.

Abstract:Objective:To explore the dynamic sleep quality trajectories and analyze the influencing factors in postoperative patients with cervical spondylotic myelopathy.Methods:A total of 244 postoperative patients with cervical spondylotic myelopathy in our hospital were selected as the study subjects by convenience sampling from August 2023 to August 2024.The Chinese version of the Pittsburgh Sleep Quality Index(PSQI)was used to assess sleep quality of patients at baseline,1 week,1 month,and 3 months after operation.Latent class growth modeling was employed to analyze the classification of sleep quality trajectories.Univariate analysis and Logistic regression analysis were used to explore the influencing factors of the trajectories.Results:The sleep quality trajectories of the 244 postoperative patients with cervical spondylotic myelopathy could be categorized into 3 categories,namely high quality-improving type(65 cases,26.6%),low quality-improving type(109 cases,44.7%),and low quality-declining type(70 cases,28.7%).Logistic regression analysis showed that age,monthly per-capita household income,preoperative disease duration,number of involved spinal segments,preoperative Chinese version of Japanese Orthopaedic Association(JOA)score,preoperative Visual Analogue Scale(VAS)score,preoperative Self-Rating Depression Scale(SDS)score,and preoperative Self-Rating Anxiety Scale(SAS)score were all influencing factors for the sleep quality trajectories in postoperative patients wtih cervical spondylotic myelopathy(P<0.05).Conclusions:There is certain heterogeneity in the sleep quality trajectories in postoperative patients with cervical spondylotic myelopathy,which are influenced by multiple factors.It suggests that healthcare professionals can predict postoperative sleep quality trajectories of patients based on these influencing factors and develop personalized nursing plans to improve patient's sleep quality.

Abstract:Objective:To investigate the current status,influencing factors,and correlations of loneliness with social constraints,negative social expectations,and coping styles among patients with gynecological malignancies.Methods:A total of 331 patients with gynecological malignancies hospitalized in a tertiary Grade A hospital in Shanxi Province from January to August 2024 were selected as the study subjects.The General Information Questionnaire,Cancer Loneliness Scale,Negative Social Expectations for Cancer Scale,Social Constraints Scale,and Medical Coping Modes Questionnaire were used for the survey.Results:The loneliness score of patients with gynecological malignancies was(16.22±4.18).The scores for social constraints,negative social expectations,and coping styles were(23.91±5.33),(14.40±3.94),and(42.53±5.99),respectively.Social constraints were positively correlated with negative social expectations,avoidance,resignation,and loneliness(P<0.001).Negative social expectations were positively correlated with loneliness,avoidance,and resignation dimensions(P<0.001).Loneliness was positively correlated with avoidance and resignation dimensions(P<0.001).Regression analysis showed that educational level,marital status,cancer type,social constraints,negative social expectations and avoidance coping were influencing factors of loneliness in patients with gynecological malignancies(P<0.05).Conclusions:The level of loneliness in patients with gynecological malignancies is moderate.Nursing staff can help patients return to normal life earlier by reducing the occurrence of social constraint events,improving patients' negative cognitive tendencies,and promoting positive coping.

Abstract:Objective:To analyze the types and characteristics of decision preferences regarding polypharmacy among elderly patients with cardiometabolic multimorbidity(CMM),and provide a basis for personalized medication management and intervention strategies.Methods:Based on the capability opportunity motivation-behavior model(COM-B),a descriptive qualitative research approach was employed.Purposive sampling was used to recruit 18 elderly patients with cardiometabolic multimorbidity for semi-structured interviews.Interview data were analyzed through content analysis to extract and summarize a labeling system,and a visual user persona was constructed accordingly.Results:The user persona labels of medication decision preferences covered four dimensions:basic characteristics,capability,opportunity,and motivation.The personas were classified into four types:participation decision-making type,independent exploration type,dependent support type,and passive/resistant type.Conclusions:Decision preferences for polypharmacy among elderly CMM patients demonstrate heterogeneity and diversity.Medical staff should formulate personalized medication plans and management strategies based on different preference types to improve patients' medication behavior.

Abstract:Objective:To analyze the latent profiles and influencing factors of symptom characteristics in postoperative breast cancer patients undergoing chemotherapy,and to explore the relationship between different symptom profiles and supportive care needs.Methods:A total of 302 postoperative breast cancer patients receiving chemotherapy from November 2023 to August 2024 were selected from three tertiary Grade A hospitals in the Xinjiang Uygur Autonomous Region.A general information questionnaire,the Memorial Symptom Assessment Scale,and the 34-item Short-Form Supportive Care Needs Survey were used for investigation.Latent profile analysis was employed to identify potential profiles of symptom characteristics.Univariate analysis and multinomial logistic regression were used to analyze the influencing factors of different profiles and their relationship with supportive care needs.Results:The symptom characteristics of postoperative breast cancer patients undergoing chemotherapy could be categorized into three latent profiles:a low-symptom burden group(54.3%),a moderate-symptom burden-gastrointestinal symptoms group(28.5%),and a high-symptom burden group(17.2%).Body Mass Index(BMI),number of comorbidities,number of chemotherapy cycles,and whether targeted therapy was used,psychological needs,care and support needs were identified as influencing factors for the symptom characteristics across different profiles(P<0.05).Scores on physiological and daily living needs,psychological needs,and care and support needs significantly differed among the different profile groups(P<0.05).Conclusions:Symptoms among postoperative breast cancer patients undergoing chemotherapy demonstrate significant population heterogeneity and are associated with varying levels of unmet supportive care needs.Nursing staff should implement patient-centered symptom management strategies based on patients' specific symptom profile characteristics to meet their supportive care needs effectively.

Abstract:This review summarized the epidemiological characteristics and risk factors of skin tears(ST)among the elderly in care institutions,collated prevention and management strategies for skin tears from various countries,highlighted the research gaps in this area within Chinese elderly care institutions.And it aims to provide theoretical and practical guidance for developing a localized risk assessment and prevention management system.

Abstract:This article summarized the language characteristics of individuals with mild cognitive impairment and speech analysis technologies.It introduced intelligent speech screening tools used both domestically and internationally,and discussed existing challenges along with proposed suggestions.The aim was to provide a foundation for the development of intelligent speech technology-based screening tools for mild cognitive impairment in China.

Abstract:Objective:To investigate the current status of core competencies among nursing staff in hosting hospitals of national regional medical center and explore its influencing factors.Methods:A total of 962 nursing staff from four hosting hospitals of regional medical center in Shanxi province were surveyed using the Chinese Registered Nurse Core Competency Scale,and the influencing factors were analyzed.Results:The core competency score of nursing staff in the four hosting hospitals of regional medical center in Shanxi province was(138.78±42.05),indicating an above-average level.Among the competencies,ethical and legal practice abilities and professional development scored relatively high,while critical thinking and research abilities,as well as clinical nursing abilities,scored relatively low.Multivariate regression analysis showed that job position and professional rank were influencing factors of the core competencies of nursing staff(P<0.05).Conclusions:The overall core competencies of nursing staff in hosting hospitals of national regional medical center are at an above-average level.Among these,ethical and legal practice abilities and professional development abilities are relatively strong,while critical thinking and research abilities,as well as clinical nursing abilities,still require improvement.Job position and professional rank are important factors influencing the core competencies of nursing staff.

Abstract:Objective:To develop a social integration scale for cancer patients and test its reliability and validity,so as to provide a measurement tool for facilitating their successful return to society and implementing precise interventions.Methods:The preliminary version of the scale was formulated through literature review,qualitative interviews,expert consultation,and cognitive interviews.A convenience sample of cancer patients from seven Grade A tertiary hospitals in Shanghai was surveyed between October 2024 and January 2025.The first round of surveying 250 cancer patients was used for exploratory factor analysis(EFA).The second round of surveying 235 cancer patients was used for confirmatory factor analysis(CFA).Item analysis and exploratory factor analysis were applied for item selection,and the scale's reliability and validity were tested.Results:The developed social integration scale for cancer patients comprises three dimensions:identity adaptation(6 items),interpersonal interaction(7 items),and activity participation(7 items),totaling 20 items.The cumulative variance contribution rate was 62.90%.The total scale's Cronbach's α coefficient was 0.944.The split-half reliability was 0.959.The test-retest reliability was 0.983.The average content validity index(S-CVI/Ave)was 0.960.Results from the confirmatory factor analysis indicated that the main evaluation indices were within acceptable ranges.Conclusions:The development process of the social integration scale for cancer patients was scientific and rigorous.Evaluation and validation demonstrate good reliability and validity,indicating it could used as an effective tool for assessing the level of social integration among cancer patients.

Abstract:Objective:To summarize the best available evidence regarding fertility preservation decision-making for breast cancer patients of reproductive age,so as to provide a reference for supporting these patients making decisions.Methods:The databases and websites including UpToDate,BMJ Best Practice,Cochrane Library,JBI Evidence-Based Healthcare Center database,the UK National Institute for Health and Care Excellence(NICE),PubMed,Web of Science,and EMbase for evidence related to fertility preservation decision-making for breast cancer patients of reproductive age were systematically searched.The types of evidence sought included clinical decision support tools,guidelines,systematic reviews,evidence summaries,and expert consensus documents.The search period was from the inception of each database to Februry 18,2025.Two researchers with a background in evidence-based nursing independently conducted the literature quality assessment.Evidence meeting quality standards was then extracted and summarized,incorporating input from relevant professionals.Results:A total of 15 articles were included,comprising 2 clinical decision support documents,4 guidelines,3 expert consensuses,2 evidence summaries,and 4 systematic reviews.The summarized best evidence covers four key aspects:the fertility preservation decision-making team,pre-decision assessment,decision-making methods,and decision content,resulting in a total of 30 best evidence statements.Conclusions:The summarized best evidence provides an evidence-based foundation for clinical healthcare professionals to support fertility preservation decision-making in breast cancer patients of reproductive age.In clinical application,healthcare providers need to respect patients' reproductive intentions,continuously advance the decision-making process,and protect the fertility potential of breast cancer patients as much as possible.

Abstract:This paper systematically reviewed the international development experiences in nursing informatics and,in light of China's current context,analyzed the challenges and deficiencies in areas such as policy-level top-level design,technology application and optimization,data standardization,and talent cultivation.It emphasized that clarifying strategic positioning and adopting a dual-track approach that combines top-down and bottom-up strategies were essential.The paper recommends strengthening systematic planning and standard development at the national level while actively promoting technology empowerment and innovative cycles in frontline nursing practice,thereby fostering the professionalization,scalability,and sustainable development of nursing informatics in China.