To identify the multidimensional health profiles and related characteristics of community-dwelling (pre)frail older adults,and to provide a scientific basis for stratified and precise health management.

A total of 824 community-dwelling (pre)frail older adults from 17 communities in Shanxi province were recruited between May and September 2025 using a multistage stratified sampling method.Data were collected using a general information questionnaire,the FRAIL Scale,the Katz Activity of Daily Living Scale(ADL),the Lawton Instrumental Activity of Daily Living Scale(IADL),the Short Portable Mental Status Questionnaire(SPMSQ),the 5-item Geriatric Depression Scale(GDS-5),the University of California Los Angeles Loneliness Scale-8(ULS-8),and the Lubben Social Network Scale-6(LSNS-6).K-medoids cluster analysis was performed to identify multidimensional health profiles,and the demographic and health-related characteristics among different profile groups were compared.

Four distinct multidimensional health profiles were identified among community-dwelling (pre)frail older adults:the comprehensive health profile(n=207,25.1%),the cognitive-loneliness profile(n=222,26.9%),the general stability profile(n=328,39.8%),and the multiple impairment profile(n=67,8.1%).Significant differences were observed among the four profiles in age,gender,educational level,marital status,living arrangement,subjective economic status and number of chronic diseases(P<0.05).

The multidimensional health profiles identified through cluster analysis demonstrated substantial heterogeneity among community-dwelling (pre)frail older adults.Profile-based management tailored to the characteristics of each subgroup may facilitate the transformation of health management from a homogeneous approach to a more refined and individualized model,thereby improving management efficiency and promoting healthy aging.

To explore the nonlinear exposure-lagged characteristics of various influencing factors for frailty in Chinese older adults using the distributed lag non-linear model(DLNM),and to identify the lag windows corresponding to the peak effects of each risk factor, thereby providing evidence for phased and precise frailty prevention.

Data from the 2011,2013,and 2015 waves of the China Health and Retirement Longitudinal Study(CHARLS) were used to obtain information on frailty,cognitive function, depression, activities of daily living,and demographic characteristics.A DLNM was constructed for analysis.

A total of 745 older adults were included.Different factors showed marked lag heterogeneity:the effects of physical activity,impaired activities of daily living,depression,poor self-rated health,and pain peaked within relatively short lag periods.In contrast,the peak effect of hearing impairment appeared with a longer delay.Although visual impairment showed a trend toward delayed effects,the association was not statistically significant.

The time to peak lagged effects of factors associated with frailty onset varies among Chinese older adults,indicating different pathways and temporal windows through which these factors act.Physical activity,impaired activities of daily living,depression,poor self-rated health,and pain primarily affect individual functional status through short-term effects,whereas sensory impairments such as hearing and visual dysfunction tend to exhibit delayed cumulative effects.Phased interventions should be implemented based on these distinct lag characteristics to achieve early prevention and long-term management of frailty.

To examine the association between adverse childhood experiences(ACEs) and the 10‑year frailty development trajectories in Chinese middle‑aged and older adults,so as to provide evidence for life‑course‑oriented healthy ageing promotion strategies.

Using data from the China Health and Retirement Longitudinal Study(CHARLS) spanning 2011-2020,we identified frailty development trajectories through group‑based trajectory modelling,and applied multinomial Logistic regression to analyse the relationship between ACEs and these trajectories.

A total of 10 032 middle‑aged and older adults were included.The baseline frailty index was 0.14±0.09,and 78.86% of the respondents reported at least one ACE.Three frailty trajectories were identified in the Chinese sample:stable non‑frailty(65.9%),critical turning point(23.9%),and progressive frailty(10.1%).Multinomial Logistic regression showed that ACEs were significantly associated with frailty trajectories(P<0.05),and a higher number of ACEs was associated with a higher relative risk of belonging to more severe frailty trajectory groups(P<0.05).

ACEs are associated with the 10‑year frailty development trajectories in Chinese middle‑aged and older adults,suggesting that childhood adversity may be an important distal risk factor for the long‑term evolution of frailty in later life.This highlights the need for early prevention from a life‑course perspective and precise intervention in old age.

To investigate the preferences of community residents in Suzhou for "Internet+nursing" services using a discrete choice experiment,and to provide a reference for enhancing service uptake and establishing a scientific service delivery model.

A discrete choice experiment was conducted via a questionnaire survey among 522 residents from three administrative districts in Suzhou. A mixed Logit model was employed using Stata 15.0 to quantify preference coefficients for service attributes,and to calculate willingness-to-pay and relative importance.

Residents in Suzhou preferred service plans characterized by lower out-of-pocket costs,one-day advance appointment scheduling,nurses with over 10 years of work experience,shorter service duration,and service provision by community health centers,public secondary hospitals,or public tertiary hospitals(P<0.05).The impact of changes in different attributes on choice probability varied.

Nursing cost,the type of healthcare institution providing the service,nurses' years of experience,and appointment waiting time are key attributes influencing residents' choices.Service attributes of "Internet+nursing" should be optimized based on the preference characteristics of Suzhou residents,with a focus on enhancing the supply of services from public healthcare institutions and senior nurses to align with resident needs and improve service utilization.

To explore the trajectory of psychological stress changes and its influencing factors in nurses as second victims following adverse nursing events,aiming to provide references for healthcare institutions and managers to accurately identify key intervention populations and to develop more targeted support strategies.

A purposive sampling method was used to select 178 nurses who had experienced adverse nursing events from three tertiary first-class hospitals in Shandong province.Surveys were conducted using a general information questionnaire,the Perceived Stress Scale,the Second Victim Experience and Support Scale,and the Connor-Davidson Resilience Scale at four time points:upon reporting the adverse event(T1),and at 1 month(T2),2 months (T3),and 3 months (T4) post-event.Latent class growth modeling was employed to identify latent categories of psychological stress change trajectories.The Logistic regression analysis was used to examine influencing factors.

The psychological stress change trajectories of nurse second victims were classified into three categories:moderate-level slow-decline group(51.7%),high-level rapid-decline group(16.3%),and low-level slow-decline group(32.0%).Logistic regression analysis revealed that department type,whether the adverse event involved a verification error,nurse resilience,and second victim experience and support were significant influencing factors for the trajectory of psychological stress change(all P<0.05).

The psychological stress changes in nurse second victims exhibit three distinct trajectories,indicating population heterogeneity.Targeted interventions can be developed based on the group characteristics and influencing factors of these stress change trajectories,enabling nurses to receive effective psychological and emotional support following adverse events.

To investigate the effects of different body positions on hyphema,comfort,sleep quality,visual acuity,intraocular pressure,and the incidence of postoperative ocular adverse reactions in patients following primary open-angle glaucoma surgery.

A total of 159 postoperative patients with primary open-angle glaucoma hospitalized in the department of ophthalmology,the People's Hospital of Guangxi Zhuang Autonomous Region from September 2023 to December 2024 were enrolled.They were randomly divided into three groups using a random number table:experimental group 1(30° semi-recumbent position),experimental group 2(45° semi-recumbent position),and control group(60° semi-recumbent position),with 53 cases in each group.Hyphema,comfort,sleep quality,visual acuity,intraocular pressure,and incidence of postoperative ocular adverse reactions were compared among the three groups before intervention,24 hours post-intervention,and 48 hours post-intervention.

A total of 154 patients completed the intervention,including 52 in experimental group 1,51 in experimental group 2,and 51 in the control group.After 24 hours intervention,the Kolcaba Comfort Scale scores in experimental groups 1 and 2 were higher than that in the control group(P<0.05).The sleep quality score in experimental group 1 was lower than those in experimental group 2 and the control group(P<0.05).The incidence of postoperative adverse reactions in experimental group 1 was lower than that in experimental group 2 and the control group(P<0.05).No statistically significant differences were observed in terms of hyphema scores,visual acuity,or intraocular pressure among the three groups(P>0.05).

All three body positions facilitate hyphema absorption.However,the 30° and 45° semi-recumbent positions are superior to the 60° semi-recumbent position in improving patient comfort.Furthermore,the 30° semi-recumbent position not only effectively promotes hyphema absorption but also improves sleep quality and reduces the incidence of postoperative adverse reactions,providing evidence-based support for clinical nursing staff in decision-making of body position.

To identify the latent classes of physical activity barriers in pre-pregnancy overweight/obese women during gestation and to examine the relationship between these classes and sleep self-efficacy.

A total of 356 pre-pregnancy overweight/obese women attending obstetric clinics at a tertiary hospital in Shanxi Province from October 2024 to June 2025 were enrolled.Data were collected using a general information questionnaire,the Physical Activity Barriers Scale for Pregnant Women,and the Sleep Self-Efficacy Scale.Latent profile analysis was performed to classify physical activity barriers.Multinomial logistic regression was used to identify influencing factors for each class,and linear regression was applied to examine the effect of different classes on sleep self-efficacy.

Three latent classes of physical activity barriers were identified:low barriers(25.3%),moderate barriers(41.3%),and high barriers(33.4%).Multinomial Logistic regression showed that education level,gestational week,history of falls during pregnancy,and exercise habits significantly influenced class membership(P<0.05).Linear regression indicated that,after adjusting for confounders,the latent class of physical activity barriers was a significant predictor of sleep self-efficacy(P<0.05).

Physical activity barriers in pre-pregnancy overweight/obese women exhibit population heterogeneity.And they are closely associated with sleep self-efficacy.Comprehensive assessment of these barriers is warranted to develop targeted nursing interventions aimed at improving sleep self-efficacy in this population.

To investigate the dynamic histopathological evolution of catheter-related thrombosis(CRT) in rabbit marginal ear veins within 12-96 hours,and identify the critical time point for the initiation of thrombus organization.

Fifty New Zealand rabbits were divided into five indwelling groups with catheter retention durations of 12 h,24 h,48 h,72 h and 96 h(8 rabbits per group,with an additional 2 puncture-only control rabbits for each group).Semi-quantitative scoring was performed to evaluate thrombus characteristics,inflammatory response and vascular injury after hematoxylin-eosin(HE) staining.

The incidence of CRT rose from 25.0% at 12 h to 100.0% at 96 h(P<0.001).Scores for thrombus area,composition and adhesion stability increased significantly over time(all P<0.05).The dominant inflammatory cell shifted from neutrophils to macrophages,and vascular injury progressed from endothelial denudation to elastic lamina rupture.The total thrombus score was positively correlated with the total inflammatory score(r=0.89,P<0.001).

The pathological progression of CRT in rabbit marginal ear veins is time-dependent.The 48-hour time point may serve as a critical turning point for early thrombus organization and aggravated vascular injury,providing experimental histopathological evidence for determining the safe indwelling duration of peripheral intravenous catheters in clinical practice.

To assess the collaboration willingness and practices of clinical and nursing students during their internships and to analyze key influencing factors.

A total of 135 clinical medicine students and 143 nursing students interning at three tertiary first-class hospitals in Shanxi Province were recruited.Surveys were conducted using a demographic questionnaire,the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration,and a Physician-Nurse Collaboration Behavior Scale.

The total score of collaboration attitude among clinical medicine students was(50.97±5.47),while that of nursing students was(50.08±6.98),with no statistically significant difference between the two groups(P>0.05).The total score of physician-nurse collaboration behavior among clinical medicine students was (104.58±18.31),while that of nursing students was (95.53±22.00),There was a statistically significant difference between the two groups(P<0.05).Regression analysis revealed that professional identity and prior completion of interprofessional collaboration courses positively influenced collaboration attitude.Key factors affecting collaboration practices included joint case discussions with supervisors,internship stress,and professional identity.

Interns in medicine and nursing generally exhibit positive and convergent collaboration willingness,yet significant disparities in power perception and divergence in collaborative behaviors are evident.A dual-drive strategy combining "educational empowerment" and "structural empowerment" is recommended to enhance physician‑nurse collaboration competencies.

To evaluate the bidirectional causal relationship between emotional swing and colorectal cancer using Mendelian randomization,and to test the causal regulatory effect of emotional swing on lipid metabolism.

Using summary data from genome-wide association studies,we selected genetic variants associated with emotional swing, colorectal cancer,total cholesterol,and triglycerides as instrumental variables.A bidirectional Mendelian randomization design was applied to assess causal associations in both directions between emotional swing and colorectal cancer.The inverse variance weighted method served as the primary analysis,supplemented by weighted median and MR-Egger regression for sensitivity analysis.We also tested the individual effects of total cholesterol and triglycerides as potential mediators.

Forward causal analysis detected only a marginal negative association between emotional swing and colorectal cancer using inverse variance weighting(OR=0.981),suggesting insufficient robustness.Reverse causal analysis found no significant causal effect of colorectal cancer on emotional swing(OR=0.839).Further analysis revealed that emotional swing exerted opposite causal effects on the two lipid indicators:a negative causal relationship with total cholesterol(OR=0.688) and a positive causal relationship with triglycerides(OR=1.797),with stable results.

There is no robust bidirectional causal relationship between emotional swing and colorectal cancer,but emotional swing participates in disease progression through differential regulation of total cholesterol and triglycerides.Given the potential value of medicinal and edible resources of Shanxi in intervening in the emotion-metabolism-cancer axis,we recommend incorporating lipid metabolism indicators into comprehensive colorectal cancer risk management and exploring pathways for industrializing non‑nutrient components in community prevention and treatment.

To explore the latent profiles of undergraduate nursing students' perceptions of engaging in elderly care work and the influencing factors,and to provide references for improving elderly nursing education models.

From January to April 2025,599 undergraduate nursing students from six universities in Henan province were selected as the survey subjects.A general information questionnaire,the Nursing Students' Perceptions of Engaging in Elderly Care Work Scale, and the Attitudes Toward the Elderly Scale were used for the survey.Latent profile analysis was employed to identify the latent profiles of undergraduate nursing students' perceptions of engaging in elderly care work.Logistic regression analysis was used to explore the influencing factors.

Undergraduate nursing students' perceptions of engaging in elderly care work fell into three latent profiles:low cognition-expectation type (62%),moderate cognition-expectation type(24%),and high cognition-expectation type(14%).Logistic regression analysis showed that whether nursing was the first choice in the college entrance examination,whether living with elderly individuals,experience in caring for the elderly,optimism about the development prospects of the elderly care industry,and attitudes toward the elderly were influencing factors of the latent profiles of undergraduate nursing students' perceptions of engaging in elderly care work(P<0.05).

The low cognition-expectation type is the main profile among nursing students' perceptions of elderly care work.It suggests educators need to focus on comprehensive reform in geriatric nursing education.Reforms should address the nature of work,social recognition,interest, and career prospects.The goal is to enhance students' professional understanding and willingness to work in this field.

To explore the latent profiles of post-traumatic stress disorder(PTSD) in women undergoing involuntary termination of pregnancy,to analyze the characteristics of women in different profiles,and to investigate the related influencing factors.

From January to April 2025,205 women who underwent involuntary pregnancy loss and hospitalized in the tertiary grade A hospital in Changsha were selected as survey subjects.The General Information Questionnaire,the PTSD Symptom Scale-Self Report,and the Perceived Partner Responsiveness Scale were used for data collection.Latent profile analysis was conducted on PTSD symptoms.The univariate analysis and logistic regression analysis were employed to identify the influencing factors of these latent profiles.

PTSD in women undergoing involuntary pregnancy loss was classified into three profiles:low symptom-adaptive type(57.6%),moderate symptom type(31.2%),and high symptom-cognitive-emotional dysregulation type(11.2%).Logistic regression analysis showed that education level,average monthly family income,occupation,history of involuntary pregnancy loss,conception method,regularity of prenatal check-ups,and perceived partner responsiveness were influencing factors for the latent profiles of PTSD in these women(all P<0.05).

Heterogeneity exists in the PTSD symptoms among women undergoing involuntary pregnancy loss.Healthcare professionals should implement targeted nursing interventions based on the characteristics of patients in different profiles to improve their mental health.

To explore the potential categories and influencing factors of limb swelling after total knee arthroplasty(TKA).

A total of 239 patients undergoing TKA in the department of orthopedic surgery of a tertiary grade A hospital in Jiangsu province from June 2023 to May 2025 were selected as survey participants. Baseline surveys were conducted within one week postoperatively using the General Information Questionnaire,Limb Swelling Circumference Assessment Form, Pictorial Knee Self-Assessment Questionnaire,Orthopedic Patient Functional Exercise Adherence Scale,and Social Support Rating Scale.Limb swelling severity was assessed using the Limb Swelling Circumference Assessment Form on postoperative days 1,3,and 7,as well as at 1,3,and 6 months after discharge.Growth mixture modeling was used to identify potential categories of limb swelling after TKA,and logistic regression analysis was performed to examine influencing factors.

A total of 206 patients(86.19%) completed the follow-up. Three potential categories of limb swelling were identified:high-level swelling with a high plateau(30.58%),moderate-level swelling with fluctuation (35.44%),and low-level swelling with a decreasing trend(33.98%).Logistic regression results showed that inflammation level,pain severity,knee joint function,comorbidities,functional exercise adherence,and social support were significant influencing factors of the potential categories of limb swelling after TKA(P<0.05).

Limb swelling after TKA exhibits population heterogeneity.Based on these findings,healthcare providers can implement stratified assessment and personalized interventions for postoperative swelling to improve patient outcomes in swelling rehabilitation.

To explore the risk factors for hematochezia in infants with cow's milk protein allergy(CMPA) and to construct and to validate a prediction model.

A retrospective study was conducted.A total of 408 infants with CMPA who visited the pediatric or child health care outpatient departments of tertiary hospitals from January to December 2024 were included as the modeling group.Another 175 infants with CMPA were included as the validation group.Participants were divided into a hematochezia group and a non-hematochezia group based on whether hematochezia occurred.Characteristic variables were selected using a combination of LASSO regression and the Boruta algorithm. Five machine learning algorithms-random forest,support vector machine,extreme gradient boosting(XGBoost),decision tree,and Logistic regression,were applied to construct prediction models.The area under the receiver operating characteristic curve(AUC) from internal validation was used as the primary criterion for selecting the optimal model.The optimal model was then subjected to external validation and interpretability analysis.

Feeding intolerance,age in months,eczema,early-life antibiotic exposure,formula feeding,maternal consumption of allergenic foods during lactation,maternal history of allergy,and first feeding(formula) were identified as independent risk factors for hematochezia in infants with CMPA.The XGBoost model demonstrated the best predictive performance,with AUC values of 0.841 in the modeling group and 0.821 in the validation group.SHAP values of the XGBoost model revealed that feeding intolerance,age in months,and eczema were the top three important predictive factors.

The XGBoost model shows good performance in predicting the risk of hematochezia in infants with CMPA. It could serve as a reference for healthcare professionals to identify high-risk infants early.

To construct a dynamic adjustment theoretical framework of childbirth fear among nulliparous women by using grounded theory.

A total of 35 nulliparous women were recruited by using purposive and theoretical sampling and participated in semi-structured in-depth interviews,with data analyzed by using grounded theory.

A total of 10 first-order categories were identified,including psychological factors,physiological factors,social factors,antecedent stimuli,risk perception,need fulfillment,cognitive restructuring,belief enhancement,coping behaviors,and control.These were further integrated into four second-order categories:causes of childbirth fear,adjustment motivation,adjustment strategies,and adjustment outcomes.The core category,termed the dynamic adjustment process of childbirth fear,was identified,based on which a theoretical framework describing nulliparous women's dynamic adjustment to childbirth fear was developed.

The theoretical framework of dynamic adjustment of childbirth fear among nulliparous women could assist obstetric healthcare professionals in the early identification of childbirth fear and provide theoretical basis for developing targeted nursing interventions and optimizing maternity care processes.

Taking the hospital needlestick injury report as the application scenario,to construct a comprehensive assessment framework of "theme quality-interpretability-action transformation-technical characteristics" to compare the potential Dirichlet scores,the differences between the two topic modeling methods,LDA and the Deep Learning Topic Framework Based on Pre-trained Language Models(BERTopic),in risk identification and management decision support,and input the theme-driven intervention suggestions.

A total of 160 needlestick injury reports were collected from a tertiary hospital between January 2018 and September 2025.After preprocessing including Chinese word segmentation,stop-word removal,and synonym merging,LDA and BERTopic models were trained separately.Model comparison was conducted using topic coherence,expert blind evaluation,and technical indicators such as training time,parameter sensitivity,and degree of automation.The resulting topics were then mapped onto a tiered intervention framework to formulate actionable countermeasures.

Both models identified key risk scenarios including blood specimen collection, needle withdrawal/needle handling,and complex procedures in special departments.LDA generated five macro-level topics,suitable for rapid overview and routine monitoring.BERTopic generated four semantically coherent topics and one noise cluster, which more clearly delineated actionable scenarios such as blood collection chain risks among intern nurses,systemic failure in post-needle processing,and exposure in high-infection-risk cases.The topic coherence scores for BERTopic and LDA were 0.587 and 0.452, respectively.The overall expert rating scores were 4.555 and 3.944,respectively.Training times were 182 seconds and 45 seconds,respectively.

BERTopic demonstrates superior advantages in semantic depth and action translatability, making it suitable for root cause analysis and targeted improvement initiatives.LDA is better suited for rapid daily screening and trend monitoring.This study recommends a tiered application strategy of "routine LDA monitoring plus periodic BERTopic deep dives" in hospitals.The topic results can be transformed into structured interventions and evaluation indicators targeting populations,workflows,and devices,thereby forming a closed-loop management cycle of risk identification-intervention-review.

To translate the Pregnancy Eating Attitudes Questionnaire(PEA-Q) into Chinese and test its reliability and validity.

Following Brislin's translation model,the English version of PEA-Q was forward-translated,back-translated,cross-culturally adapted,and pilot-tested to develop the Chinese version of PEA-Q.From June to October 2025,1 032 pregnant women were recruited from one tertiary hospital and three community health centers in Changzhou.Classical test theory and item analysis were used to evaluate reliability,validity,measurement invariance,and item performance.

The Chinese version of PEA-Q consisted of 11 items across three dimensions:permissive eating attitude,self-regulated eating attitude,and mildly restrained eating attitude.The scale-level content validity index was 1.000,and the item-level content validity index was 1.000.Exploratory factor analysis extracted three common factors,with a cumulative variance contribution rate of 78.075%.Confirmatory factor analysis indicated a good fit for the three-factor model.The overall Cronbach's α coefficient was 0.895.The questionnaire demonstrated measurement invariance across different gestational weeks and age groups.Item discrimination ranged from 1.59 to 2.80,and item difficulty ranged from -2.02 to 2.17.

The Chinese version of PEA-Q shows good reliability,validity,and cross-group measurement invariance.Its items exhibit strong measurement performance. It is a reliable tool for assessing eating attitudes during pregnancy.

To compare the psychometric properties,feasibility,and clinical utility of the Pain Intensity Measure for Persons with Dementia(PIMD) and the Mobilization-Observation-Behaviour-Intensity-Dementia Pain Scale(MOBID-2) for pain assessment in hospitalized older adults with cognitive impairment.

A total of 134 hospitalized older adults with cognitive impairment from a tertiary grade A hospital in Guangdong province were enrolled.Using the Chinese version of the Pain Assessment in Advanced Dementia Scale(PAINAD) as the criterion,patient's self-reported Numeric Rating Scale pain scores were obtained,followed by pain assessments at rest and during activity using the three scales(PAINAD,PIMD,and MOBID-2) in random order.The internal consistency,inter-rater reliability,criterion validity,construct validity,and pain screening ability were compared between PIMD and MOBID-2.Additionally,22 clinical nurses from six hospitals in Guangdong Province evaluated the feasibility and clinical utility of the two scales.

At rest and during activity,the Cronbach's alpha coefficients of PIMD were 0.821 and 0.889,and the inter-rater reliability coefficients were 0.847 and 0.839,respectively.Exploratory factor analysis extracted two common factors for the PIMD in both states,with cumulative variance contribution rates of 71.047% and 77.402%,respectively.Regarding criterion validity,the correlation coefficients between the PIMD and the PAINAD were 0.996 at rest and 0.954 during activity.During activity,the Cronbach's alpha coefficient of the MOBID-2 was 0.781,and the inter-rater reliability coefficient was 0.775;exploratory factor analysis extracted four common factors with a cumulative variance contribution rate of 67.229%;the correlation coefficient between the MOBID-2 and the PAINAD was 0.883.The area under the receiver operating characteristic curve(AUC) for the PIMD and the MOBID-2 were 0.984 and 0.930,with sensitivities of 91.9% and 71.2%,and specificities of 95.7% and 100.0%,respectively.The Kappa values for agreement among the three scales were all>0.4,and the pain detection rates ranged from 59.0% to 82.8%.The mean feasibility and utility scores for the PIMD and the MOBID-2 were 4.2 and 4.2,3.7 and 4.2,respectively.

The PIMD demonstrates good reliability and validity,while MOBID-2 shows good reliability but moderate validity.Both scales can be used for pain assessment in hospitalized older adults with cognitive impairment.However,considering the psychometric properties,feasibility,and clinical utility of each scale,PIMD is recommended as the priority choice.

To develop a journey map of home health management for patients with tracheoesophageal fistula after "three-tube" interventional procedure,systematically analyze their core experiences and needs at different stages,and propose targeted nursing strategies accordingly.

From March to August 2025,patients who underwent "three-tube" procedure for tracheoesophageal fistula and their caregivers were selected from the interventional radiology department of a tertiary general hospital in Zhengzhou city for readmission follow-up as study subjects.Semi-structured in-depth interviews were conducted,and the interview data were analyzed using Colaizzi's seven-step analysis method to develop a patient journey map.

A total of 26 sub-themes were summarized from tasks,emotions,pain points dimensions,forming a journey map covering the early discharge period,transitional adaptation period,long-term tube-living period,and rehabilitation sprint period.

The home health management needs of patients with tracheoesophageal fistula after "three-tube" interventional procedure present stage-specific and multidimensional characteristics,with prominent needs for caregiving skill support,psychosocial adaptation,and swallowing safety reconstruction.In the future,phased and systematic transitional nursing strategies can be developed and implemented based on the constructed health management journey map.

To explore multifactor combination patterns of unplanned extubation using association rule mining and to construct a Bayesian network predictive model.

A retrospective case-control study was conducted.Clinical data were collected from 133 patients with unplanned extubation and 350 control patients at a tertiary grade A hospital in Guizhou province between January 2013 and December 2023.The Apriori algorithm was used to mine association rules and screen strong association rules. Meanwhile,the max-min hill-climbing(MMHC) algorithm was employed to construct a Bayesian network predictive model,which was used to analyze causal relationships and risk probabilities among various factors.

A total of 20 strong association rules were identified. Factors such as night shift,years of nursing experience,caregiver responsibility lacking,omission of catheter assessment,pain,agitation,restraint status,catheter retention time,and age were closely associated with unplanned extubation.The Bayesian network model consisted of 10 nodes and 14 directed edges,and the incidence of unplanned extubation under high-risk combinations could reach 90%.

Unplanned extubation results from the interaction of multiple factors,with omission of assessment during handover representing a core risk link.The predictive model constructed in this study demonstrates strong risk identification and predictive capabilities,providing a quantitative tool for early warning and intervention in clinical settings.

To identify latent classes of fall risk perception in patients with posterior circulation ischemia(PCI),and to analyze their influencing factors,and to explore the impact of different classes on exercise self-efficacy.

A total of 200 PCI patients admitted to our hospital from August 2023 to July 2025 were enrolled.Surveys included a general information questionnaire,the Fall Risk Perception Scale,Pittsburgh Sleep Quality Index(PSQI),Berg Balance Scale(BBS),Exercise Self-Efficacy Scale(MSES),and Activities of Daily Living(ADL) scale.Latent profile analysis(LPA) was used to identify latent classes of fall risk perception and their influencing factors.The impact of these classes on exercise self-efficacy was further examined.

Fall risk perception in PCI patients fell into three latent classes:insufficient perception(78 cases,39.0%),moderate perception(92 cases,46.0%),and excessive perception(30 cases,15.0%).Multivariate logistic regression showed that PSQI score was a factor for the insufficient perception class(OR=1.553,P<0.001).BBS score,ADL score,MSES score,and fall history were factors for the excessive perception class(OR=0.840,0.882,0.933,and 2.945 respectively,P<0.05).Multiple linear regression showed that after controlling for confounders,the excessive perception class was a predictor of exercise self-efficacy score(P<0.05).

Fall risk perception in PCI patients showed population heterogeneity and it was influenced by sleep quality,balance function,and daily activity ability.The excessive perception class negatively predicted patients' exercise self-efficacy. Clinicians may consider identifying different patient classes and develope targeted intervention strategies.

To explore the mechanism underlying the transition of nursing undergraduate interns from "peripheral participation" to "full participation" and to construct a theoretical model.

Using procedural grounded theory, semi-structured interviews were conducted with 15 student nurses. Nvivo 15.0 software was used for three-level coding of data from the first 13 participants,followed by a theoretical saturation test performed by two researchers.

Open coding yielded 101 initial concepts and 21 categories.Axial coding synthesized 7 main categories,covering initial peripheral participation status,multidimensional characteristics of full participation,transitional value,spatiotemporal context,driving factors,inhibiting factors,and individual coping strategies.Selective coding identified the core category as "self-construction of professional identity".

The proposed transition mechanism model indicates that student nurses' participation transition occurs within a community of practice and represents a dynamic,non-linear,and multi-factor interactive socialization process.Clinical educators should build supportive environments,create success experiences through structural empowerment and graded task design,and systematically guide structured reflection,so as to facilitate interns' subjective construction and professional socialization.

To integrate the Chronic Illness Trajectory Model and Self-Determination Theory to explore the dynamic evolutionary mechanisms of health-related behaviors in breast cancer patients and to propose a phased theoretical intervention framework.

A purposive sampling method was used to conduct longitudinal semi-structured interviews with 65 breast cancer patients.Data were organized and analyzed using grounded theory and narrative analysis combined with Nvivo 12 Plus software.

Patients' health-related behaviors exhibited a three-stage dynamic model:"external drive phase-motivation internalization phase-autonomous integration phase",which was dynamically influenced by the interaction of four dimensions:"cultural beliefs, family dynamics, medical interactions,and individual traits".Based on these findings,a three-tier intervention framework of "mindfulness-narrative-community" was proposed.

Health-related behaviors in breast cancer patients follow a nonlinear three-stage evolution of "external drive phase-motivation internalization phase-autonomous integration phase",dynamically influenced by four dimensions including cultural beliefs and family dynamics.The "mindfulness-narrative-community" three-tier intervention framework provides a scientific basis for developing individualized nursing strategies in clinical practice.

To systematically retrieve,analyze,and summarize domestic and international tools for assessing nurses' evidence-based practice competence,and to integrate their psychometric properties,so as to provide references for developing more scientific and practical assessment tools in the future.

A systematic search was conducted in CNKI, Wanfang Data,VIP,CBM,PubMed,Cochrane Library,EMbase,and Web of Science for literature on nurses' evidence-based practice competence assessment tools from the inception of each database to April 1,2026.The included literature was integrated and analyzed.

A total of 27 articles were included.The assessment content covered nurses' attitudes,knowledge,perceptions,self-efficacy,and critical thinking regarding evidence-based practice;continuous quality improvement,nurse managers' leadership,and compatibility of evidence-based practice with professional work;barriers to and facilitators of searching for and reviewing evidence,barriers to and facilitators of changing practice based on evidence,practices for improvement,and abilities to generate,synthesize,disseminate,and evaluate evidence;and abilities to apply evidence and evaluate outcomes.Psychometric results showed that the included tools had good reliability and validity.

Existing tools for assessing nurses' evidence-based practice competence have comprehensive dimensions and generally good reliability and validity.However,issues remain,including an overemphasis on theoretical content,a lack of unified standards for result interpretation,and insufficient cross-cultural applicability. Further optimization is needed to enhance the scientific rigor,practicality,and comparability of these tools.