To evaluate the efficacy and application potential of different large language models in health education consultation for stroke patients.

Using 21 common clinical questions of stroke and 2 sets of typical clinical scenario simulation cases,three rounds of tests were conducted on DeepSeek R1,ERNIE Bot X1,ChatGPT-4o,and Claude 3.7 Sonnet large language models.Three neurology department chief physicians were selected to evaluate the models from five dimensions:accuracy,comprehensiveness,understandability,humanistic care,and case analysis ability.

The overall performance of all models was good.DeepSeek R1 had the highest total score, followed by ChatGPT-4o,Claude 3.7 Sonnet, and ERNIE Bot X1.DeepSeek R1 and ChatGPT-4o performed outstandingly in complex clinical reasoning,evidence-based medical knowledge transmission,humanistic care,and case analysis.ERNIE Bot X1 had an advantage in the adaptability to the Chinese context.

Large language models showed positive auxiliary application value in the field of stroke health education.However,the clinical review mechanism needs to be combined to enhance the reliability of the information.The clinical application of these models could be promoted by optimizing the transparency of the algorithms and the adaptability to the local context.

To analyze the multidirectional prognosis and predictive factors of the motoric cognitive risk syndrome in the elderly in China.

The data were sourced from the China health and retirement longitudinal study(CHARLS) from 2011 to 2015.A total of 430 elderly people with the motoric cognitive risk syndrome were selected.Demographic,lifestyle,physical condition,and social psychological variables were collected.Unordered multinomial Logistic regression analysis was used to identify the predictive factors for the outcomes of the motoric cognitive risk syndrome.

During the 4-year follow-up period of the 430 elderly people with the motoric cognitive risk syndrome,the incidence rates of stable type,transient reverse type,progressive type-physical disability,and progressive type-dementia were 19.07%,70.00%,8.37%,and 2.56%,respectively.The probability of the elderly with motoric cognitive risk syndrome experiencing reversal towards non-motoric cognitive risk syndrome decreased when their grip strength reduced.Alcohol consumption behavior was significantly associated with the risk of progression from motoric cognitive risk syndrome to dementia in the elderly.

The outcomes of the motoric cognitive risk syndrome in the elderly in China showed multidirectionality and heterogeneity.It is recommended to strengthen the assessment of grip strength and alcohol intervention for the elderly with the motoric cognitive risk syndrome,so as to reduce the risk of adverse outcomes.

To explore the dynamic trajectory of estimated pulse wave velocity in middle-aged and elderly people and its relationship with cardiovascular diseases.

Based on the population cohort data from the China health and retirement longitudinal study(CHARLS),general information and laboratory indicators of the population were collected. The group-based trajectory model (GBTM) was used to construct the heterogeneous trajectories of the estimated pulse wave velocity dynamics in the community among the elderly. Logistic regression analysis was applied to explore the relationship between the estimated pulse wave velocity dynamic trajectory and cardiovascular diseases.

A total of 5 933 participants were included in the analysis, among whom 1 112 cases (18.7%) developed cardiovascular diseases.The GBTM analysis revealed four estimated trajectories of pulse wave velocity changes:the low-level stable group(30.0%),the medium-level ascending group(39.6%),the ascending and stable group(23.0%),and the high-level ascending group(7.4%).Logistic regression analysis showed that, after adjusting for confounding factors, compared with the low-level stable group,the risk of cardiovascular diseases significantly increased in the medium-level ascending group, the ascending and stable group,and the high-level ascending group.

The estimated pulse wave velocity trajectories of the elderly in the community showed population heterogeneity.The higher estimated pulse wave velocity trajectories was correlated with the occurrence of cardiovascular diseases.It is suggested that medical staff should pay attention to the changes in the estimated pulse wave velocity of the elderly and formulate corresponding intervention strategies based on different trajectories.

To develop the pulmonary rehabilitation training program for adolescent patients with severe pectus excavatum during the perioperative period,and to provide a reference for promoting the recovery of children undergoing pectus excavatum surgery.

Based on the concept of pulmonary rehabilitation,through literature analysis and semi-structured interviews,a questionnaire for the pulmonary rehabilitation training program for adolescent patients with severe pectus excavatum during the perioperative period was constructed.The final program was determined using the Delphi expert questionnaire method.

Two rounds of expert questionnaires were conducted.The effective recovery rate of the questionnaire was 94.44% and 100.00% respectively.The expert questionnaire authority coefficient was 0.859.The importance of each item was 3.76-4.88 and 4.06-4.88 respectively.The coefficients of variation were 0.068-0.238 and 0.070-0.183 respectively.The Kendall coefficients were 0.484 and 0.328(P<0.001).The final perioperative pulmonary rehabilitation training program for adolescents with severe pectus excavatum included 8 primary items,25 secondary items,and 29 tertiary items.

The constructed pulmonary rehabilitation training program for adolescent patients with severe pectus excavatum during the perioperative period was scientifically and operationally sound.It could provide reference for guiding the recovery of children during the perioperative period and promote their rapid recovery after surgery.

To construct the evaluation index system for service quality of designated long-term care institutions.

The evaluation index system for the service quality of designated long-term care institutions was constructed by literature summary and semi-structured interview period expert consultation.Its weights were determined.

Two rounds of expert inquiries were conducted.The positive coefficients of the experts were 91.3% and 100.0% respectively.The authority coefficient was 0.90.The Kendall's coefficient of concordia in the second round was 0.291(P<0.001).The importance scores of each evaluation index in the first round of expert inquiries ranged from 4.20 to 4.95 points,and the coefficient of variation ranged from 0.04 to 0.19.The importance scores of each evaluation index in the second round of expert inquiries ranged from 4.38 to 4.95,and the coefficient of variation ranged from 0.05 to 0.13.The final constructed evaluation index system for service quality of designated long-term care institutions included 4 first-level indicators,12 second-level indicators and 35 third-level indicators.

The constructed evaluation index system for service quality of designated long-term care institutions has good scientificity and practicality.It could provide references for the quality supervision of long-term care services,the renewal of institution agreements,the disbursement of expenses and the management of fund payments.

To investigate the changing trajectory of oral frailty in elderly stroke patients and its associated influencing factors, and to provide reference for targeted clinical interventions.

A convenience sample of 300 elderly stroke patients admitted to the neurology department of a tertiary grade A hospital in Shandong province were enrolled in this study.Data were collected using a general information questionnaire and standardized assessment tools,including the Oral Frailty Index-8(OFI-8),the Oral Health Assessment Tool(OHAT),the Geriatric Self-Efficacy in Oral Health Scale(GSEOH),and the Perceived Social Support Scale(PSSS).Oral frailty levels were evaluated based on these instruments.

The changing trajectory of oral frailty in elderly stroke patients was categorized into two distinct patterns:a high-level slow increase group(49.7%) and a low-level slow increase group(50.3%).Logistic regression analysis revealed that age,smoking history,prior cerebral infarction,number of remaining teeth,subjective chewing difficulty,oral health status,and perceived social support were significant predictors of oral frailty(all P<0.05).The decision tree model identified four key clinical variables:wearing dentures,oral health status,subjective masticatory difficulty,and prior cerebral infarction.The areas under the receiver operating characteristic curves for the decision tree and Logistic regression models were 0.939 and 0.943,respectively,indicating strong predictive performance.

Oral frailty in elderly stroke patients generally progresses gradually over time,with notable heterogeneity among subgroups.Both the decision tree and logistic regression models demonstrate considerable predictive accuracy.Healthcare professionals can develop intervention plans based on these two models to achieve early identification of oral frailty and precise care.

To develop the integrated traditional Chinese and western medicine health education program for Parkinson's disease based on the chronic illness trajectory framework,and to provide evidence-based guidance for clinical nurses.

Guided by the framework of chronic illness trajectory,the draft plan was formed based on evidence-based research.The final plan was determined through the Delphi method.A total of 192 nurses from tertiary grade A hospitals specializing in neurology were selected for the feasibility assessment of the plan.

Two rounds of expert inquiries were conducted.The expert authority coefficients were 0.815 and 0.855 respectively.The coefficient of variation was less than 0.25 for two rounds of expert inquiries.The Kendall's coefficients of agreement were 0.420 and 0.481 respectively(P<0.01).Finally, the integrated traditional Chinese and western medicine health education program for Parkinson's disease based on the chronic illness trajectory framework was formed.It covered 7 stages of disease trajectory:pre-disease,onset,diagnosis,treatment,stability,deterioration,and death.The feasibility assessment of the plan showed that the average scores in four dimensions(structure rationality,content scientificity,implementation feasibility,and overall evaluation) were all above 4.5 points.

The constructed the integrated traditional Chinese and western medicine health education program for Parkinson's disease based on the chronic illness trajectory framework was scientifically sound,reliable,and feasible.It could provide standardized tools for the whole-process health management of Parkinson's disease.It provides evidence-based guidance for clinical nurses in conducting health education for Parkinson's disease.

To analyze the concept of digital dementia,and to provide reference for related research and clinical practice.

A systematic search and analysis of literature related to digital dementia in Chinese and English databases was conducted by using conceptual analysis.

A total of 12 articles were included in the final literature review.The defining attributes of digital dementia were dependence,compensatory,non-pathological and reversible.Antecedents included boredom proneness,fear of missing out,and technological factors.Consequences included a decline in activity functioning,negative mood,sleep problems,and social isolation.There were no research assessment tools for digital dementia at home or abroad.Future research should focus on the development of localised assessment tools.

Clarifying the concept of digital dementia will help researchers to better understand and assess digital dementia and to construct effective intervention strategies for antecedent factors and other factors to prevent digital dementia.

To analyze and clarify the conceptual connotation of emotional labor for nurses.

Systematically search for studies related to emotional labor for nurses in the databases of China National Knowledge Infrastructure(CNKI),WanFang Database,VIP Database,China Biomedical Literature Service System,Web of Science,PubMed,EMbase,CINAHL,and Cochrane Library.The search period was from the establishment of the database to November 30,2024.The included literature was analyzed by applying the Rodgers evolutionary concept analysis method.

A total of 44 papers were included.Emotional labor included five defining attributes:emotional regulation,the appropriateness of emotional expression,the psychological burden of emotional labor,the coordination between emotional labor and professional roles,and the social and cultural background of emotional labor.The antecedents included the individual level(demographic factors,individual characteristic factors),the situational level (patients' inappropriate words and aggressive behaviors,workload,work atmosphere),and the organizational and institutional level(high-engagement work practices,supervisor support,managers' leadership styles).The consequences included the individual level(mental health, empathy ability,humanistic care quality,job burnout),the organizational level(tendency to quit,attendance,performance,professional values),and the patient level(patient safety,doctor-patient relationship,medical outcomes).

The Rodgers evolutionary concept analysis method was adopted to conduct a conceptual analysis of emotional labor for nurses,providing theoretical support for the subsequent related research and clinical practice of emotional labor for nurses.

To develop an assessment scale for the perceived organizational resilience of elderly care institutions by the elderly,and to test its reliability and validity.

The initial item pool was constructed based on literature research,semi-structured interviews,and group discussions.The initial scale was formed through Delphi expert consultation.By using the convenience sampling method,a questionnaire survey was conducted among 467 elderly people in 9 elderly care institutions in Chongqing from May to September 2024.The reliability and validity of the scale were tested.

The assessment scale for the perceived organizational resilience of elderly care institutions by the elderly included 4 dimensions and 24 items.Exploratory factor analysis extracted four common factors,and the cumulative variance contribution rate was 62.025%.The results of confirmatory factor analysis showed that all the fitting indices of the modified model were within the acceptable range.The item-level content validity index(I-CVI) ranged from 0.867 to 1.000.The scale-level content validity index(S-CVI) was 0.992.The Cronbach's α coefficient of the total scale was 0.938.The test-retest reliability was 0.983.The split-half reliability was 0.846.

The assessment scale for the perceived organizational resilience of elderly care institutions by the elderly has good reliability and validity.It could be used as an effective tool for evaluating the organizational resilience level of elderly care institutions.

To translate the Breastfeeding Relationship Scale(BFRS) into Chinese,and to test its reliability and validity,so as to provide a reliable tool for evaluating breastfeeding relationships in China.

After strictly following the Brislin translation model for translation,backtranslation,expert consultation,and cultural adaptation,the Chinese version of BFRS was formed.By using the convenience sampling method,670 pairs of mothers and infants were selected for a questionnaire survey to test the reliability and validity of the scale.

The Chinese version of BFRS included 3 dimensions and 16 items.The scale-level content validity index(S-CVI) was 0.983.The item-level content validity index(I-CVI) ranged from 0.909 to 1.000.Exploratory factor analysis extracted three common factors.The cumulative contribution rate of variance was 78.442%.Confirmatory factor analysis showed that the model fitted well.The Cronbach's α coefficient of the scale was 0.945.The split reliability was 0.865.The test-retest reliability was 0.951.

The Chinese version of BFRS has good reliability and validity.It could be used as an assessment tool for perceived insufficient milk production in mothers and infants within 6 months of age.

To develop the diabetic retinopathy risk perception questionnaire for patients with diabetes mellitus,and to test its reliability and validity,in order to provide an effective tool for assessing the perception of retinopathy risk.

Based on the protection motivation theory as the theoretical framework,a questionnaire was developed through literature analysis,expert consultation,and pre-survey.Using cluster random sampling method,a total of 402 diabetic patients from 3 community health centers were selected for the investigation to test the reliability and validity of the questionnaire.

The response rates of the two rounds of expert questionnaire inquiries were 90.48% and 100.00%.The expert authority coefficient was 0.93.The total Cronbach's α coefficient of the questionnaire was 0.865.The Cronbach's α coefficients of all dimensions were 0.844,0.892,0.828,0.831,0.845,0.901,and 0.823. The scale-level content validity index(S-CVI) was 0.968.The item-level content validity index(I-CVI) ranged from 0.86 to 1.00.Exploratory factor analysis extracted 7 common factors.The cumulative variance contribution rate was 68.589%.Confirmatory factor analysis showed that the model fit was good overall.The diabetic retinopathy risk perception questionnaire for patients with diabetes mellitus was compiled,including 7 dimensions of severity,susceptibility,internal reward,external reward,self-efficacy,response efficacy and response cost,with a total of 30 items.

The diabetic retinopathy risk perception questionnaire for patients with diabetes mellitus has good reliability and validity.It could be used to evaluate the level of risk perception of diabetic retinopathy in patients.

To reveal the core symptoms and subgroup heterogeneity of depression in disabled middle-aged and elderly people using network analysis methods,and to provide basis for formulating precise intervention plans.

Data from the 2018 China health and retirement longitudinal study(CHARLS) were selected.A total of 10 336 middle-aged and elderly people were included as the research subjects.The structural differences in depression symptoms between the disabled and healthy groups were compared using a symptom network model.The symptom intensity characteristics among subgroups of disabled middle-aged and elderly people were deeply analyzed.

There was no significant difference in the overall strength of the depression network among disabled and healthy middle-aged and elderly people.The core symptoms were all "depressed mood","feeling troubled",and "unable to continue living".Among the symptom networks of the disabled middle-aged group,the intensity value of "unable to continue living" was the highest,while for the disabled elderly group,the most prominent symptom was "depression of mood".Compared with disabled men,the intensity value of "depression of mood" for disabled women was greater.For disabled middle-aged and elderly people with educational attainment below primary school,the intensity value of "depression of mood" was the highest,while for those with educational attainment at or above primary school,the most prominent symptoms were "feeling troubled" and "unable to continue living".For married and cohabiting disabled middle-aged and elderly people,the main symptoms were "depression of mood","feeling troubled" and "unable to continue living",while for other disabled elderly people,the main symptoms were "depression of mood", "feeling troubled" and "lack of happiness".

The core symptoms of depression in disabled elderly individuals exhibit heterogeneity characteristics related to age,gender,educational level,and marital status.It is suggested that in clinical practice,individual differences of disabled middle-aged and elderly individuals should be fully considered.Categorized interventions should be adopted to improve their mental health levels.

To explore the status quo and influencing factors of comorbidity of postpartum post-traumatic stress disorder,postpartum depression and postpartum anxiety in postpartum women.

Using the convenience sampling method,a total of 463 postpartum women who underwent postpartum follow-up in two tertiary grade A hospitals in Zhuhai city,Guangdong province from October 2023 to January 2024 were selected as the survey subjects.The general information questionnaire for postpartum women,the City Birth Trauma Scale(CityBiTS),and the Depression Anxiety Stress Scale-21(DASS-21) were used for the investigation.

Among the 463 postpartum women,the prevalence rate of comorbidity of postpartum post-traumatic stress disorder,postpartum depression and postpartum anxiety was 6.91%.The results of Logistic regression analysis showed that the mode of delivery,pain during delivery,and stress factors were the influencing factors for the comorbidity of postpartum post-traumatic stress disorder,postpartum depression,and postpartum anxiety in postpartum women(P<0.05).

The prevalence rate of comorbidity of postpartum post-traumatic stress disorder,postpartum depression and postpartum anxiety in postpartum women was relatively high.Medical staff should pay attention to the mode of delivery,pain during delivery,and stress conditions of parturients,and take effective measures to reduce the incidence of postpartum post-traumatic stress disorder,postpartum depression,and postpartum anxiety.

To explore the application effect of video education program based on the timing theory in young and middle-aged patients with coronary heart disease undergoing PCI.

A total of 93 young and middle-aged patients with coronary heart disease undergoing PCI who were hospitalized in the department of cardiovascular medicine of the First Affiliated Hospital of Henan University of Chinese Medicine from January to August 2024 were selected as the research subjects.They were divided into an observation group of 47 cases and a control group of 46 cases according to the order of admission.The control group received conventional health education,while the observation group implemented a video health education program based on the timing theory.The scores of the Coronary Artery Disease Self-management Scale(CSMS),the China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases(CQQC),satisfaction with health education and the incidence of cardiovascular negative related events were compared between two groups of patients before the intervention and 3 months after the intervention.

A total of 92 patients completed the intervention,with 46 cases in the observation group and 46 cases in the control group.After 3 months of intervention,the scores of CSMS and CQQC in the observation group were higher than those in the control group,the satisfaction with health education was higher than that in the control group,and the incidence of cardiovascular negatively related events was lower than that in the control group.The differences were all statistically significant(P<0.05).

The video education program based on the timing theory was helpful for young and middle-aged patients with coronary heart disease undergoing PCI to establish and maintain healthy behaviors,improve self-management ability,reduce the incidence of cardiovascular negatively related events,and thereby improve the quality of life.

To investigate the characteristics of family communication patterns among depressed adolescents,and to analyze their influencing factors,so as to provide reference for formulating personalized auxiliary plans for the prevention and control of depression among adolescents.

By using the convenience sampling method,a total of 563 depressed adolescents were selected as the research subjects who visited the outpatient department of psychological medicine in a tertiary grade A hospital in Zhengzhou city,Henan province from October 2023 to August 2024.The investigation was conducted by using the general information questionnaire,the Center for Epidemiologic Studies Depression Scale(CES-D), the Revised Family Communication Patterns Instrument(RFCP),the Emotion Regulation Questionnaire(ERQ) and the Adolescents Self-harm Scale.

The characteristics of family communication pattern among depressed adolescents were mainly protective type in 183 cases(32.5%).The total score of the RFCP was 5.64±0.92.The score of conversation orientation was 2.91±0.87.The score of obedience orientation was 2.71±0.94.The results of linear regression analysis showed that the gender of depressed adolescents,whether they were the only child,whether they had history of being left behind,the educational level of the mother,the place of residence,the average monthly income per capita of the family,the score of Adolescents Self-harm Scale,and the score of ERQ were the influencing factors of family communication patterns(P<0.05).

Medical staff should formulate targeted intervention measures based on the influencing factors of family communication patterns,to help depressed adolescents and their parents actively cope with the disease,improve their family communication patterns,and thereby alleviate their negative emotions and psychological disorders.

To construct the prediction model for intraoperative hypotension in cesarean section parturient,and to verify the predictive effect of the model.

A total of 245 pregnant women who underwent elective cesarean section in a tertiary grade A hospital in Shanxi province from December 2022 to December 2023 were selected as the research subjects.The parturient were divided into the normal blood pressure group and the hypotension group based on whether they experienced intraoperative hypotension.Logistic regression analysis was used to analyze the risk factors for intraoperative hypotension during cesarean section and to establish a risk prediction model.The sensitivity and specificity of the model were evaluated by using the area under the receiver operating characteristic(ROC) curve and the Hosmer-Lemeshow goodness-of-fit test.

Among the 245 cesarean section patients,a total of 128 experienced intraoperative hypotension,with a prevalence of 52.24%.The results of Logistic regression analysis showed that the maternal's post-pregnancy body mass index,uterine height,sensory block plane,and abdominal circumference were the risk factors for intraoperative hypotension in cesarean section parturients.The risk prediction model was drawn.The area under the ROC curve(AUC) of this model was 0.918,with a sensitivity of 0.904 and a specificity of 0.872.The Hosmer-Lemeshow test showed a good fit.

The established prediction model for intraoperative hypotension in cesarean section parturient has a good predictive effect.It could provide reference for clinical identification of risks and timely implementation of preventive intervention measures.

To know the status quo and influencing factors of delayed medical decision-making in patients with diminished ovarian reserve during reproductive age,and to provide references for formulating and implementing targeted intervention measures.

A general information questionnaire,Chinese-Perceived Barriers to Health-care Seeking Decision(PBHSD-C),Mishel Uncertainty in Illness Scale for Adults(MUIS-A),Perceived Social Support Scale(PSSS),and Medical Coping Modes Questionnaire(MCMQ) were used to conduct a survey on 283 patients with diminished ovarian reserve.

The score of PBHSD-C was 34.50±11.67.The educational level,place of residence,uncertainty in illness,perceived social support,and medical coping modes of patients were the influencing factors of their delayed medical decision-making(P<0.05).

The delayed medical decision-making of patients with diminished ovarian reserve during reproductive age was at a moderate level.Relevant health care departments should pay more attention to female reproductive health,early identify the groups prone to delayed medical treatment, and carry out appropriate interventions.

To understand the status quo of organizational silence among nurses in general hospitals,and to analyze the sociodemographic characteristics that affect organizational silence,so as to provide ideas for improving the phenomenon of organizational silence among hospital nurses.

A stratified random sampling method was adopted to select 1 828 nurses from secondary and tertiary general hospitals in Sichuan province as the research subjects.The investigation was conducted using the general information questionnaire and the Nurses' Organizational Silence Questionnaire.

The total score of nurses' organizational silence was 47.59±15.13.The item average score of negative silence was 2.57±0.83.The item average score of prosocial silence was 2.54±0.98.The item average score of defensive silence was 2.39±0.95.The item average score of indifferent silence was 1.91±0.77.There was statistically significant difference in the total score of organizational silence among nurses in different working years groups(P<0.05).

Organizational silence among nurses in general hospitals in Sichuan province was at a medium level of silence.The working years of nurses have a direct impact on the organizational silence of nurses.It is suggested that managers should pay attention to the ideological status and comprehensive development of junior nurses in the organization,which has positive effect on improving their silent and negative phenomena in the organization.