Latest ArticlesTo investigate the perioperative specific symptom trajectories and influencing factors in patients with primary liver cancer.
A total of 200 patients diagnosed with primary liver cancer and undergoing liver resection at West China Hospital,Sichuan University were selected as study subjects from October 2024 to January 2025.Symptom scores were assessed using the Symptom Module Specific to Primary Liver Cancer(TSM-PLC) on the 7th to 10th day before surgery,the 1st day before surgery,the 7th day after surgery,and the 30th day after surgery.Group-based trajectory model was applied to classify and fit the perioperative specific symptom trajectories in patients with primary liver cancer.Logistic regression analysis was conducted to explore the influencing factors of different trajectory types.
Patients with primary liver cancer were divided into three groups based on symptom trajectories,namely persistent low burden(16.0%),low burden with an initial increase followed by a decrease(52.5%),and high burden with an initial increase followed by a decrease(31.5%).Logistic regression analysis showed that compared to the persistent low burden group,patients with sleep disturbances on the 30th day after surgery and with fatigue on the 30th day after surgery were more likely to belong to the high burden with an initial increase followed by a decrease group(all P<0.05).Additionally,compared to the low burden with an initial increase followed by a decrease group,patients with persistent perioperative pain and with fatigue on the 30th day after surgery were more likely to belong to the high burden with an initial increase followed by a decrease group(all P<0.05).
Sleep disturbances after surgery,fatigue after surgery,and persistent perioperative pain may influence the perioperative specific symptom trajectories in patients with primary liver cancer.
To analyze the influencing factors of medical expenses of middle-aged and elderly patients with coronary heart disease complicated with comorbidities based on machine learning model.
A total of 3 002 patients with coronary heart disease complicated with complications hospitalized in the 27 public hospitals in a provincial capital city in central China was selected as subjects from January 2022 to January 2023.The patient data were collected.The influencing factors of medical expenses of middle-aged and elderly patients with coronary heart disease complicated with comorbidities were analyzed based on four machine learning models,namely ridge regression,Lasso regression,random forest,and decision tree.
Compared with other models,the random forest model had better fitting effect.The material cost(27.72%) and western medicine cost(19.43%) accounted for relatively high proportion of the patient's medical expenses,while the nursing cost(4.02%) and consultation cost(1.15%) accounted for relatively low proportion.The hospitalization days,the level of medical institution(tertiary hospital),gender(female),age(>50~70 years old), discharge department(cardiology),admission department(cardiology),and common complication(hypertension) were the main influencing factors of medical expenses of middle-aged and elderly patients with coronary heart disease complicated with comorbidities.
Managers should formulate effective measures according to the influencing factors of medical expenses in middle-aged and elderly patients with coronary heart disease with complication to eliminate the waste of medical resources and reduce the burden of middle-aged and elderly patients with coronary heart disease complicated with comorbidities.
To explore the chain mediating role of self-esteem and neurotic personality in anxiety and insomnia among patients with type 2 diabetes(T2DM).
A total of 635 T2DM patients from six tertiary grade A hospitals in Xi'an City,Shaanxi Province were conveniently selected as the study subjects from June to December 2024.Surveys were conducted using the General Information Questionnaire,Self-Rating Anxiety Scale(SAS),Rosenberg Self-Esteem Scale(RSES),Eysenck Personality Questionnaire-Revised Short Scale for China(EPQ-RSC),and Athens Insomnia Scale(AIS).The SPSS Process macro was used to construct the chain mediation model.
Anxiety was positively correlated with insomnia(r=0.321,P<0.05),self-esteem was negatively correlated with insomnia(r=-0.237,P<0.05),and neurotic personality was positively correlated with insomnia(r=0.371,P<0.05).The mediation analysis results showed that the total indirect effect of anxiety on insomnia was 0.046.Among this,the independent mediating effect of self-esteem accounted for 7.69% of the total effect.The independent mediating effect of neurotic personality accounted for 20.28% of the total effect.The chain mediating effect of self-esteem→neurotic personality accounted for 4.90% of the total effect.
Anxiety in T2DM patients can directly affect insomnia.It can also indirectly affect insomnia through the chain mediation path of self-esteem→neurotic personality.The study provide an important basis for developing targeted nursing interventions for insomnia in T2DM patients from psychological and personality perspectives.
To explore the change trajectory of health concern among the elderly in China and to analyze its influencing factors.
Data from the China Health and Retirement Longitudinal Study(CHARLS) conducted in 2013,2015,2018,and 2020 were used.The latent growth mixture model(LGMM) was applied to classify the change trajectory of health concern among the elderly.A multi class Logistic regression model was used to analyze the influencing factors of the change trajectory.
The change trajectory of health concern among the elderly in China could be divided into three groups,namely a rising-fluctuating group(567 persons,accounting for 32.5%),a stable-moderate group(741 persons,accounting for 42.5%),and a declining-fluctuating group(436 persons,accounting for 25.0%).Regression analysis showed that age,gender,number of chronic diseases,social medical insurance,retirement status,and frequency of social activities were influencing factors for the classification of the change trajectory of health concern among the elderly(all P<0.05).
Health concern among the elderly in China showed group heterogeneity.In the future,attention should be paid to the change trends of different trajectories.Long-term intervention measures should be formulated based on the influencing factors to provide a basis for effectively promoting the active health among the elderly.
To systematically review the behavioral and psychological factors influencing adherence to adjuvant endocrine therapy(AET) in patients with breast cancer,based on the theoretical domains framework.
Chinese and English literature on the behavioral and psychological factors influencing adherence to AET in patients with breast cancer was retrieved from nine databases,namely PubMed,Web of Science,EMbase,CINAHL,Cochrane Library,CBM,CNKI,WanFang Data,and VIP.Literature was independently screened by two researchers.Data was extracted.Data analysis was performed using Nvivo 14 software.Texts related to behavioral and psychological factors influencing adherence to AET were coded using the 14 domains of the theoretical domains framework as primary nodes.Secondary nodes were refined using thematic analysis.
A total of 50 articles were included,yielding 297 coding references.These were synthesized into 30 secondary nodes and distributed across 12 domains of the theoretical domains framework.Environmental context and resources,emotion,and social influences were the three domains with the highest number of coding references.Physical condition was the most frequently cited factor influencing patient adherence.
The behavioral and psychological factors influencing adherence to AET in patients with breast cancer span multiple domains of the theoretical domains framework.These factors may interact.Future research should explore the pathways through which various factors influence adherence to enable more precise and effective behavioral interventions.
To explore the research dynamics of music intervention in the psychological adjustment of families of critically ill patients,to reveal the research hotspots,knowledge structure,and evolutionary trends in this field,and to provide theoretical basis and practical reference for clinical psychological care.
Relevant literature was retrieved from CNKI,Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform,PubMed, and Web of Science(WOS).The retrieval time spanned from January 10,2005,to June 9,2025.Bibliometric methods were used to analyze annual publication volume,productive authors,and institutions. Research topic evolution was analyzed through keyword co-occurrence analysis,cluster analysis,and burst analysis.
A total of 162 Chinese articles were included,showing a fluctuating growth trend in annual publication volume.A total of 1 193 English articles were included,showing a significant growth trend.Regarding authors,Chinese publications formed two major clusters,while core English authors did not form a collaborative network.In terms of publishing institutions,the department with the highest number of Chinese publications was the department of neurology at the Second Hospital of Hebei Medical University,while English publications were concentrated among eight major international institutions.Chinese literature research hotspots focused on 10 cluster modules,namely music therapy,family members,intervention measures,nursing care,impact,psychological nursing,music intervention,end-of-life,childbirth outcomes,and comprehensive nursing intervention.Burst keyword analysis indicated a thematic shift from "nursing care" to "music therapy".
Music therapy is gaining increasing attention in the field of psychological adjustment for families of critically ill patients.Research scale in both Chinese and English literature continues to expand,but development is uneven. Interdisciplinary integration and the development of localized evidence-based protocols may become future research directions.
To summarize the evidence on the assessment and management of X-linked hypophosphataemia(XLH) in children and to provide an evidence-based foundation for clinical practice.
Clinical questions on the assessment and management of XLH in children were formulated.Relevant professional association websites and databases were searched for relevant literature following the '6S' evidence model.The quality of literature was evaluated.The evidence was extracted,graded,and summarized.
A total of 13 literature were included,comprising 4 guidelines,1 systematic review,2 clinical decision resources,and 6 expert consensus documents.The evidence on the assessment and management of XLH in children encompassed two main themes(assessment and intervention),which were further divided into 10 categories,namely clinical manifestations,laboratory investigations,imaging studies,conventional therapy,Burosumab therapy,surgical intervention,dental management,complications,genetic counseling and prenatal diagnosis,and follow-up.These categories comprised a total of 30 individual evidence points.
This study summarizes the evidence on the assessment and management of XLH in children.Clinical healthcare professionals can selectively translate the evidence into practice based on the individual child's characteristics and disease progression.
To Chinesize and to test its reliability and validity of the Social Integration in Later Life Scale(SILLS),and to establish a norm.
According to Brislin's classic back-translation model,the Social Integration in Later Life Scale was translated,back-translated,and culturally adjusted to form a Chinese version of the Social Integration in Later Life Scale.From July to September 2024,a conveniencesampling method was used toselect 373 elderly community-dwelling residents in Shanghai city for asurvey to evaluate the reliability and validity of thescale.From October to December 2024,a conveniencesampling method was used to investigate 1 158 elderly residents in 6 community hospitals in China and to establish a norm for thescale.
The Chinese version of the the Social Integration in Later Life Scale includes four dimensions:satisfaction withsocial relationships,satisfaction withsocial activities,involvement insocial relationships,and participation insocial activities,with a total of 18 items.The answering time for thescale was(7.37±1.93) minutes.The correlation coefficient between thescores of each item on thescale and the totalscore was 0.45-0.74(P<0.01).The content validity index at thescale level was 0.98.The content validity index at thescale item level was 0.83-1.00.Four common factors with eigenvalues>1 were extracted,with a cumulative variance contribution rate of 70.00%.The Cronbach's alpha coefficient of the totalscale was 0.89.The Cronbach's alpha coefficients of the four dimensions were 0.85-0.89.The mean norm of the totalscore among community-dwelling older adults in Jiangsu,Zhejiang,and Shanghai was(56.58±11.78).The normative data werestratified by gender and age groups.Percentile norms were established at 5% intervals for the four dimensions and the totalscale.Utilising x-s,x-0.5s,x+0.5s,and x+s as cut-off points,social integration levels were categorised into five distinct level,namely low,relatively low,moderate,relatively high,and high.
The Chinese version of Social Integration in Later Life Scale was ascientific and feasible measurement tool.The Social Integration in Later Life Scale norms provided a reliable basis for evaluating thesocial integration level of the older adults in China.
To preliminarily construct a patient-reported outcome(PRO) scale for pneumoconiosis under the disease-syndrome combination model using the Delphi method.To provide a basis for the development of a formal scale.
The framework of the PRO scale for pneumoconiosis was established under the disease-syndrome combination model.The scale item pool was drafted by the research team through literature analysis,interview,and derivation methods following group discussions.Two rounds of expert consultations were conducted using the Delphi method.The reliability and validity of the initial draft scale were tested.
The effective questionnaire recovery rates for the two rounds of consultations were 85% and 94%,respectively. The expert authority coefficients were 0.900 and 0.785,respectively.The average importance scores of items ranged from 2.29 to 4.76 and ranged from 3.35 to 4.82,respectively.The full score rates ranged from 0 to 82% and ranged from 18% to 82%, respectively. The Kendall's coordination coefficients were 0.415 and 0.243,respectively(both P<0.001).The coefficient of variation were ranged from 0.11 to 0.49 and ranged from 0.08 to 0.35,respectively.The item-level content validity indices ranged from 0.41 to 1.00 and ranged from 0.76 to 1.00,respectively.The average scale-level content validity indices were 0.87 and 0.97,respectively.The Cronbach's α coefficients for the total scale were 0.992 and 0.966,respectively.The Cronbach's α coefficients for the various domains ranged from 0.893 to 0.989 and ranged from 0.751 to 0.941,respectively.Ultimately,the initial draft of the pneumoconiosis PRO scale was established,which comprises 49 items across the physiological,psychological,social,and satisfaction domains.
The initial draft of the pneumoconiosis PRO scale was consistent with the disease characteristics of pneumoconiosis and could be used to evaluate the quality of life of pneumoconiosis patients.It could provide a scientific basis for the development of a formal scale and offer an appropriate evaluation tool for clinical research.
To investigate the categories of missed nursing care of intensive care unit(ICU) nurse and to analyze influencing factors based on the theoretical model of missed nursing care.
A total of 517 ICU nurses from 13 cities in Jiangsu Province were selected as survey subjects in January 2025 by convenience sampling.Data were collected using a general information questionnaire,the ICU Missed Nursing Care Content Assessment Subscale,the Chinese version of Decision Fatigue Scale,the Chinese version of National Aeronautics and Space Administration-Task Load Index(NASA-TLX),the Chinese version of the Nurses' Occupational Coping Self-Efficacy Scale,and the Perceived Organizational Support Scale.Latent profile analysis was used to explore the categories of missed nursing care of ICU nurses.Univariate analysis and Logistic regression analysis were used to examine the influencing factors of different categories.
Missed nursing care of ICU nurses could be categorized into 3 categories,namely low missed care group(52.2%),moderate missed care group(36.0%),and high missed care group(11.8%).Results from the Logistic regression analysis showed that the average number of patients responsible for per shift,average monthly income,whether the nurse was an ICU specialist nurse or not,decision fatigue,and perceived organizational support were influencing factors for the different categories of missed nursing care of ICU nurses(P<0.05).
The level of missed nursing care of ICU nurses was relatively low but had group heterogeneity.Nursing managers need to continuously optimize the work environment,enhance nurses' perceived organizational support,and help to reduce their decision fatigue,thereby lowering the level of missed care and ensuring patient safety.