Abstract:Objective To constructe a pediatric nursing quality indicator system for family of children based on Grounded Theory,Enhancing the understanding of factors influencing quality and providing empirical and theoretical guidance for improvement.Methods To use purposive sampling to select the family members of hospitalized children from four pediatric tertiary hospitals in Guangdong Province as the research subjects,conducting semi-structured interviews based on the Expectation-Perception model and Family Systems Theory.Combined with the Delphi expert consultation method,the study aimed to construct key indicators of pediatric nursing quality based on the Grounded Theory of family members'perceptions.Results The final establishment of the pediatric nursing quality indicator system based on family of children perception included 5 primary indicators,15 secondary indicators,and 20 tertiary indicators.Conclusion The grounded theory-based pediatric nursing quality indicator system constructed elaborates on the connotations of pediatric nursing service quality from five aspects,emphasizing the necessity of considering comprehensive factors,and provides a reference for future research and practice.

Abstract:Objective To understand the current situation,hotspots and development trends in the field of psychological safety among nurses.Methods The CiteSpace software was used to conduct a visual analysis of the research literature on the psychological safety of nursing staff included in the Web of Science database from its inception to November 1,2024.Results A total of 257 articles were included.The overall number of related publications showed an upward trend with a sharp increase in 2021.The United States,Australia,China,Canada and England were the five countries with the largest number of publications.Close connections and a high degree of collaborations among certain institutions and authors had formed key research groups in the field.Research hotspots mainly focused on patient safety,influencing factors and outcomes of psychological safety,the mental health field and psychological safety in simulated learning environments.Conclusion At present,research on the psychological safety among nurses has formed a research hotspot that focuses on patient safety,with nursing staff behavior at its core.New research directions for the future should focus on psychological safety among nurses in the mental health field and simulated learning environments,which warrant further exploration.

Abstract:Objective To construct a rehabilitation functional exercise nursing guidance program for elderly patients with total hip arthroplasty(THA)based on Cognitive Load Theory,providing reference for rehabilitation exercise nursing.Methods The initial draft of the rehabilitation functional exercise program was constructed through theoretical analysis,literature review,brainstorming method and expert panel discussions based on the Cognitive Load Theory.Delphi expert consultations were conducted with 22 experts nationwide to refine and finalize the program items.The Analytic Hierarchy Process was used to determine the weights of each item.Results Two rounds of Delphi consultations were conducted among 22 experts,and the effective recovery rate of the questionnaire was 100%.The expert authority coefficient was 0.891,and the Kendall's coefficients of concordance of the 2 round consultations were 0.254 and 0.278 respectively(P<0.001).The mean importance scores of all indicators ranged from 4.06 to 5.00.The final nursing guidance program contained 3 first-level items,10 second-level items,and 35 third-level items.The results of hierarchical analysis showed that the CR values of all matrices were less than 0.1,meeting consistency requirements.Compared with the control group,the cognitive load level of the experimental group was significantly lower and the Harri score was significantly higher(P<0.001).Conclusion The rehabilitation nursing guidance program based on Cognitive Load Theory for THA patients constructed in the study is scientific and targeted,which can effectively reduce the cognitive load level of elderly patients with total hip replacement and improve their hip joint function.It is targeted and applicable to the rehabilitation of elderly patients with total hip replacement.

Abstract:Objective To analyze the current situation and influencing factors of clinical nurses'job crafting,and to explore the influence of workplace social capital and personal-organizational fit on job crafting,with a view to providing references for optimizing the quality of nursing services and realizing nurses'role fit and reshaping.Methods The convenience sampling method was used to select a total of 356 nurses from four tertiary grade A hospitals in Tianjin and Shandong from April to June 2023.The General Information Questionnaire,Job Crafting Scale,Workplace Social Capital Scale and Person-Organization Fit scale were used for investigation.Results The score of nurses'job crafting was(71.82±11.30),and job crafting was positively correlated with workplace social capital and person-organization fit(r1=0.433,r2=0.465,both P<0.05).Multivariate linear regression analysis showed that the nature of employment,one-way commuting time,workplace social capital and person-organization fit entered the regression equation(all P<0.05),which could explain 30.8%of the total variation.Conclusion The job crafting of clinical nurses is at a medium level.The nature of employment,one-way commuting time,social capital in the workplace and person-organization fit are the main influencing factors of nurses'job crafting.Nursing managers can strengthen team communication and cooperation by creating a harmonious working environment with values and supply and demand,so as to improve the level of nurses'job crafting and improve the quality of nursing service.

Abstract:Objective To understand the current status of clinical nursing practices in the prevention and management of device-relat-ed pressure injuries on the head and face of ICU patients,formulate clinical nursing review indicators,analyze the barriers and facilitating fac-tors,and provide a theoretical basis for clinical nursing.Methods The relevant domestic and international databases and websites were searched in sequence in accordance with the"6S" evidence model.The included literatures were evaluated for quality,and the evidence con-tent of the same category was extracted and integrated.Guided by the Integrated-Promoting Action on Research Implementation in Health Services Framework,an in-depth analysis of obstacles/promoting factors were conducted from three dimensions:change,change recipients,and organizational environment,and action strategies were formulated accordingly.Results Finally,19 pieces of best evidence were included,and 14 review indicators were formulated.Among them,the implementation rate of 12 review indicators was less than 60%,and 4 of them had an implementation rate of 0.The main obstacles were the lack of prevention plans and procedures for device-related pressure injuries on the head and face of ICU patients,as well as the low level of knowledge,belief and practice of nursing staff and their weak awareness of preven-tion.Conclusion There is a significant gap between the best evidence and clinical practice in the prevention and management of device-re-lated pressure injuries on the head and face of ICU patients.Improvements should be made targeting the relevant barrier factors,and compre-hensive strategies should be adopted to promote the effective translation of evidence into clinical practice.

Abstract:Objective To explore the latent classes of chronic pain self-efficacy and their relationship with self-management stages in patients with rheumatoid arthritis(RA).Methods A total of 255 RA patients from the rheumatology departments of 3 hospitals were investi-gated by using the general information questionnaire,Chronic Pain Self-Efficacy Scale,Pain Stages of Change Questionnaire,Disease Activity Scores with 28-Joint Counts and Pain Catastrophizing Scale.The latent profile analysis was employed to identify distinct latent classes of self-efficacy.The multivariate Logistic regression was used to analyze influencing factors,and a generalized linear mixed model was applied to compare differences in self-management stage distributions across the latent classes.Results The total score of chronic pain self-efficacy in RA patients was(73.62±26.42).Three latent classes were identified:the low efficacy-low pain management group(28.24%),the moderate efficacy-low symptom coping group(26.27%)and the high efficacy-high pain management group(45.49%).Gender,pain intensity,disease activity and pain catastrophizing were significant factors that influencing the self-efficacy classification(all P＜0.05).The distribution of self-management stages significantly differed among the latent classes(P＜0.05),with the low efficacy-low pain management group predomi-nantly in the precontemplation stage.Conclusion Chronic pain self-efficacy in RA patients is at a moderate level with significant population heterogeneity,and distinct latent classes are closely associated with self-management stages.It recommends to developing individualized inter-vention strategies based on different category characteristics that enhance self-efficacy and promote the progression of self-management stages.

Abstract:Objective To investigate the current status of professional identity in "Internet+Nursing Service" among hemodialysis nurses,and to analyze its influencing factors.Methods From May to August 2024,a convenience sample of 214 hemodialysis nurses from 6 tertiary grade A hospitals in Xi'an were selected as the research subjects.Data were collected using the General Information Questionnaire,"Internet+Nursing Service" Professional Identity Scale,Cognitive Scale for Online Nursing Service Order Acceptance,Nurse Social Respon-sibility Questionnaire,and Risk Factors and Outcomes Assessment Scale for"Internet+Nursing Service" Nurses.Results The scores of pro-fessional identity in"Internet+Nursing Service" among hemodialysis nurses were(73.90±12.51).Multiple linear regression analysis showed that working years,prior"Internet+Nursing Service" training/work experience,implementation of the"Internet+Nursing Service" appraisal system,order acceptance cognition,social responsibility,and nurse risk factors and outcomes were influencing factors.These factors explained 47.9%of the total variation(P＜0.01).Conclusion The professional identity of hemodialysis nurses in"Internet+Nursing Service" is at a moderate level and affected by multiple factors.Managers should focus on nurses with short working experience,limited "Internet+Nursing Service" training/work experience,incomplete implementation of performance appraisal system,poor order acceptance cognition,low social re-sponsibility,and weak risk assessment ability.It is recommended to strengthen specialized knowledge and skills training for hemodialysis nur-ses,enhance "Internet+Nursing Service" training,and improve their social responsibility and risk assessment capabilities to boost their pro-fessional identity in "Internet+Nursing Service".

Abstract:Objective To explore the potential categories of activation and the correlation between patient activation and health behav-iors in elderly stroke patients.Methods A convenience sampling method was used to select a total of 327 elderly stroke patients from 4 terti-ary grade A hospitals in 2 cities in Anhui Province from December 2023 to March 2024 as subjects.A general information questionnaire,the Consumer Health Activation Index and the Health Behavior Scale for Stroke Patients were used as investigative tools.Mplus 8.3 was employed to conduct a categorical analysis of patient activation in elderly stroke patients and explore the relationship between the level of activation and health behaviors.Results The characteristics of activation in elderly stroke patients could be classified into three categories,including low activation-helpless coping group,medium activation group,and high activation perception-action group,accounting for 25.08%,29.05%and 45.87%respectively.There was a positive correlation between the activation of elderly stroke patients and health behaviors(P＜0.01).The differences in total health behavior scores,as well as the scores in the dimensions of exercise,medication adherence,following instructions,re-sponsibility,and nutrition,among different latent categories of patient activation were statistically significant.Higher levels of patient activation were associated with better health behaviors(P＜0.001).Conclusion There is group heterogeneity in the positivity of elderly stroke patients.The potential category of positivity has a significant impact on the health behavior of elderly stroke patients.Clinical medical staff need to de-velop precise and systematic intervention strategies based on the activation characteristics of different categories of patients,in order to pro-mote patients'transition from passive health to active health,improve their health behaviors,and promote active aging.

Abstract:Objective To investigate the pain status and influencing factors in patients with acute hypoxic respiratory failure in awake prone position,so as to provide a basis for formulating intervention strategies and improving treatment tolerance.Methods A survey was conducted using a general information questionnaire,the Numerical Rating Scale and the Barthel Index Scale on a total of 105 awake prone positioning patients with acute hypoxic respiratory failure admitted to the ICU of a tertiary hospital.Results There were 87 cases(82.86%)of patients experien-cing pain during the awake prone positioning.The main influencing factors for moderate to severe pain in conscious prone position in patients were age,hypertension comorbidity,Barthel index scores and the number of turns per day(P＜0.05).Conclusion Patients with acute hypoxic respiratory failure have a higher incidence of pain during awake prone position.Medical staff should pay attention to evaluating the pain symp-toms and needs of patients,focusing on potential or existing influencing factors based on individual characteristics,and developing personal-ized nursing intervention strategies to alleviate patients'pain,improve their tolerance and compliance.

Abstract:Objective To explore the status quo of discharge readiness of elderly stroke patients and analyze its influencing factors,so as to provide basis for formulating discharge plans and continuous care programs.Methods A total of 497 elderly stroke inpatients were sur-veyed using the general information questionnaire,discharge readiness assessment scale for stroke patients,modified Barthel Index Inder,Instrumen-tal Activities of Daily Living Scale and Stroke Self-Efficacy Questionnaire.Results The total score of discharge readiness was(115.89±19.16),the score of modified Barthel index was 62.00(28.50,97.00),and the score of instrumental daily living ability was 5.00(0.00,15.00),the score of stroke self-efficacy was 79.92(58.25,110.00).Multiple linear regression analysis showed that education level,family per capita monthly income,living style and stroke self-efficacy were the influencing factors of discharge readiness of elderly stroke patients(P＜0.05).Conclusion The discharge readiness of elderly stroke patients is at a medium level,and there is still room for improvement.Medical staff should strengthen the health education of patients and their caregivers,implement personalized discharge plan and continuous nursing plan,and reduce the incidence of complications and readmission rate after discharge.

Abstract:Objective To investigate the effect of chronic cancer pain history on postoperative moderate-to-severe pain after hepatic artery infusion chemotherapy(HAIC)in patients with liver cancer.Methods A total of 1 303 liver cancer patients who underwent HAIC in three hospitals in Shanghai were selected,grouping based on the presence or absence of a history of chronic cancer pain and propensity-matched scores were used to adjust the covariates between the two groups.Results The incidence of moderate-to-severe pain after HAIC was 23.02%for all patients,and the incidence of moderate-to-severe pain after HAIC was 53.85%in patients with a history of chronic canc-er pain.Chronic cancer pain history raised the risk of post-HAIC moderate-severe pain(OR=5.333,95%CI:2.716～10.661,P＜0.001),as well as increased the number of times that patients experienced moderate-to-severe pain in the 24-hour period after HAIC and the highest postoperative pain score(P＜0.001).Conclusion Patients with liver cancer who experience chronic pain before surgery show increased risk and severity of postoperative pain following HAIC.Clinical staffs need to formulate preventive analgesic strategies and provide them with accu-rate and efficient pain management to reduce the risk and severity of postoperative pain after HAIC.

Abstract:Objective To develop a full-process monitoring system for pain management which based on an intelligent information platform,and to appraise its clinical effectiveness.Methods By integrated Internet of Things(IoT)architectures with big-data analytics technologies,a full-process monitoring information system for pain that unifies standardized assessment protocols,multi-source data fusion,multidisciplinary collaborative workflows and whole-process quality control.A total of 234 patients before the systematic application served as the control group,while 2,100 patients after the systematic application formed the experimental group.The accuracy rates of pain assessment,timeliness of analgesic treatment,qualification rates of pain records for surgical patients,and satisfaction with pain care were compared between the two groups.Results The experimental cohort exhibited statistically significant improvements compared with the control group in pain-assessment accuracy,timeliness of analgesic interven-tion,qualified documentation rate of perioperative pain records,and satisfaction with pain nursing care(all P＜0.001).Conclusion The full-process monitoring information system for pain management developed in the study significantly enhances the precision and efficiency of pain care,streamlines clinical workflows,and improves patient satisfaction,thereby offering an evidence-based reference for advancing the standardization and homogenization of pain-management practices.

Abstract:Objective To identify risk factors for fear of progression in chemotherapy-treated breast cancer patients,construct and ver-ify a nomogram model of risk prediction.Methods A convenience sampling approach was employed to select a total of 551 chemotherapy-treated breast cancer patients.They were randomly assigned to a modeling group(n=386)and a verification group(n=165)at a ratio of 7∶3.A general information questionnaire,Fear of Progression Questionnaire-Short Form(Fo P-Q-SF),the Social Support Rating Scale(SSRS),Chinese Version Perceived Stress Scale(CPSS)and the Distress Disclosure Index(DDI)were used for investigation.Logistic regres-sion analysis was used to identify influencing factors,and then a nomogram prediction model was constructed.Results The incidence of fear progression was 66.32%in the modeling group.Logistic regression results showed that age,education level,monthly family income,TNM stag-ing,chemotherapy cycle,social support,perceived stress and distress disclosure were the risk factors of fear progression.The results of Hosmer-Lemeshow confirmed good model fit(χ2=4.907,P=0.768),and area under the ROC curve was 0.941,a specificity of 0.877,and a sensitiv-ity of 0.875.The result of external verification showed that the specificity of the model was 0.912 and the sensitivity was 0.876.Conclusion The incidence of fear of progression on breast cancer patients is high,and the construction of risk prediction model has a good prediction effect,which can provide a reference basis for clinical effective assessment of the risk of fear of progression on breast cancer patients.

Abstract:Objective To explore the benefit finding level among elderly hypertensive patients and its impact pathways,providing refer-ences for the development of targeted intervention strategies.Methods From February to September 2023,there were 203 elderly inpatients with hypertension from a tertiary grade A hospital in Dalian selected as the research subjects by convenience sampling.They were investigated by used the General Information Questionnaire,Revised Life Orientation Test,Social Support Rating Scale,Illness Perception Questionnaire,Medical Coping Modes Questionnaire and Benefit Finding Scale.Results The scores of the optimistic tendency,social support,illness percep-tion,benefit finding in elderly hypertensive patients were 22.00(17.00,27.00)、35.00(31.00,39.00),31.00(29.00,53.00)and 53.00(38.00,60.00),respectively,the highest dimension score of coping style was facing 25.00(14.00,28.00).Benefit finding was positively correlated with optimistic tendency,social support,and the confront(P＜0.01),and also negatively correlated with illness perception(P＜0.01).The mediating effect analysis showed that:in elderly patients with hypertension,illness perception and the confront played a chain mediating role between optimism and discovery of benefits.The direct effect between optimistic tendency and benefit finding was significant,with a value of 0.316,the indirect effect were 0.070,0.079,and 0.010,respectively.And the total effect was 0.475.Illness perception and the confront also exerted a chain mediating effect between social support and benefit finding.The direct effect between social support and benefit finding was significant,with a value of 0.245,the indirect effect were 0.102,0.036,and 0.015,respectively.And the total effect was 0.398.Conclusion The optimistic tendency and level of social support in elderly hypertensive patients can directly influence their benefit finding levels,as well as indirectly affect these levels through the mediating effects of disease perception and coping styles,and the chain mediating effects of these two factors.It suggests that while improving the level of benefit finding in elderly hypertensive patients,medical staff should fo-cus on reducing their negative disease perception,increasing family and social care and support,maintaining optimistic emotions to actively cope with the troubles caused by the disease,and enhancing the sense of benefit to improve the quality of life.

Abstract:Objective To explore the effect of prevention measures on the orthostatic hypotension(OH)in patients with gynecological benign diseases during the perioperative period.Methods A total of 102 hospitalized patients from January 2022 to December 2023 were ran-domly divided into the control group(n=51)and the observation group(n=51).The control group received routine care,while the observa-tion group were worn medical elastic stockings 30 minutes before getting out of bed based on the control group.Blood pressure,heart rate,and dizziness scores were compared between the two groups within 3 minutes of post-bed exit,sitting,and standing.Results The seated diastolic blood pressure(73.80±9.28)mm Hg,standing systolic blood pressure(117.78±11.93)mm Hg and diastolic blood pressure(71.71±8.67)mm Hg in the observation group were significantly higher than those of the control group(P＜0.05).The incidence of OH in the observation group(3.92%)was significantly lower than that of the control group(27.45%)(P＜0.05).The postoperative seated heart rate(80.29±10.12)beats per minute and standing heart rate(81.02±10.54)beats per minute in the observation group were significantly lower than those of the control group(P＜0.05).The moderate dizziness rate at the seated position after surgery in the observation group was 0,and moderate dizziness rate at the standing position after surgery in the observation group was 1.96%,which were significantly lower than those of the control group(P＜0.05).Conclusion Preventive measures for patients after laparoscopic surgery can reduce the incidence of OH,maintain stable blood pressure and heart rate,improve the dizziness condition,accelerate venous return,ensure cerebral blood flow perfusion,and reduce the risk of cardiovascular accidents and falls.The clinical application effect is quite good.

Abstract:Objective To construct a virtual reality(VR)-based emergency nursing thinking training system,apply in the teaching of standardized training nurses in emergency departments,and explore its effects.Methods A total of 105 nurses were conveniently selected from March 2024 and September 2024 served as the observation group,and receiving training via VR emergency clinical thinking training sys-tem.The control group comprised 110 nurses from September 2022,March 2023,and September 2023,who received traditional training.Differ-ences in the clinical first aid ability,clinical thinking ability,theoretical scores and operational performance between the two groups were com-pared after the training.Results The observation group had higher levels of knowledge reserve,emergency response ability,personal quality,critical thinking ability,systematic thinking ability,theoretical score and operational performance than those of the control group,and the differences were statistically significant(all P＜0.05).Conclusion The VR-based emergency nursing thinking training system demonstrates scientific and practical value.It effectively improves the first-aid ability,clinical thinking ability and assessment outcomes,and provide refer-ence for optimizing standardized nurse training programs.

Abstract:Objective To explore the effect of the Transtheoretical Model in patients with upper gastrointestinal bleeding.Methods A total of 93 patients with upper gastrointestinal hemorrhage admitted to a hospital in Beijing were retrospectively selected as the study objects,and randomly divided into control group(42 cases)and experimental group(51 cases)according to different intervention methods.The control group received routine nursing care for upper gastrointestinal bleeding,and the intervention group received nursing intervention based on the Transtheoretical Model.Nutritional indexes,self-management ability,psychological resilience and quality of life were compared between the two groups.Results After intervention,the nutritional index,self-management ability,psychological resilience and quality of life of the ex-perimental group were improved compared with those of the control group(P＜0.05).Conclusion The nursing practice based on the Trans-theoretical Model can significantly improve patients'self-management ability,improve psychological resilience,enhance the level of nutrition indicators,and further enhance their quality of life.

Abstract:Objective To systematically review the applicalion of intervention programs based on Gratitude-Topology Construct Theory for breast cancer patients,systematically organizing the format,duration,content and outcome measures of the intervention programme to future research.Methods A systematic search was conducted in Cochrane Library,PubMed,Embase,Web of Science,China Biology Medicine Disc,China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP Chinese Science and Technology Journal data-base.The search time limit was from the establishment of databases to June 18,2025.Results Totally,13 articles were included.After revie-wing the literatures,it was found that the content and forms of intervention programs based on the Gratitude-Topology Construct Theory were diverse.Among breast cancer patients,they are mainly used to improve fear of cancer recurrence,cancer-related fatigue,sleep quality,psycho-social adaptation,and quality of life in breast cancer patients.Conclusion Gratitude intervention based on Gratitude-Topology Construct The-ory show a positive impact on patients with breast cancer.It can provide a foundation for the positive psychology into oncology nursing.

Abstract:Objective To explore the mediating effect of organizational support on the relationship between abusive supervision and work engagement among nurses in tertiary hospitals.Methods A questionnaire survey was conducted using convenience sampling among a to-tal of 2,277 nurses from 11 tertiary hospitals in Anhui Province from June to October 2024.The survey instruments included a general infor-mation questionnaire,the Abusive Supervision Scale,the Perecived Organizational Support Scale,and the Utrecht Work Engagement Scale.Results The scores for abusive supervision,organizational support,and work engagement were(9.57±4.25),(47.04±9.50),and(47.13±15.17),respectively.Nurses'perception of abusive supervision was negatively correlated with both organizational support(r1=-0.387,P＜0.01)and work engagement(r2=-0.333,P＜0.01).Organizational support was positively correlated with work engagement(r=0.602,P＜0.01).Organi-zational support partially mediated the relationship between abusive supervision and work engagement,accounting for 64.20%of the total effect.Conclusion Nurses in tertiary hospitals perceive low level of abusive supervision,while organisational support and work engagement are both at moderately high level.Organisational support serves as a mediating variable between nurses'perception of abusive supervision and their level of work engagement.It suggests that managers should adopt more scientific management approaches,fully recognize the important role of organizational support among nursing staff,reduce negative management behaviors.It will help nurses to enhance their work commit-ment,thereby providing patients with higher-quality nursing services.

Abstract:Spinal cord injury(SCI)patients often use metaphorical language to express the severity of their neuropathic pain(NP),which makes it difficult for healthcare professionals and family members to accurately assess the pain,severely impacting the patients'quality of life.The article summarizes the assessment of pain metaphors,the forms of metaphorical expression in SCI patients with NP,influencing fac-tors,and intervention strategies.It proposes suggestions such as developing targeted pain metaphor assessment tools,conducting multivariate a-nalysis of influencing factors,and formulating multidisciplinary integrated strategies.By enhancing pain neuroscience education for healthcare staff,accurately identifying metaphorical pain expressions in NP patients,and providing personalized nursing services,which to offer a refer-ence for future related research.