作者机构：
[Zhang, JP; Li, Juan; Zhang, Jing-Ping] Cent South Univ, Xiangya Sch Nursing, Changsha, Peoples R China.;[Li, Chan] Guangzhou Univ Chinese Med, Clin Med Coll 5, Guangzhou, Peoples R China.;[Li, Chan] Yeahcome Hlth Ind Grp Co Ltd, Changsha, Peoples R China.;[Zou, Jie] Chongqing Univ Canc Hosp, Hepatobiliary Pancreat Oncol Ctr, Chongqing Key Lab Translat Res Canc Metastasis & I, Chongqing, Peoples R China.;[Cheng, Fang-Qun] Xiangtan Cent Hosp, Dept Nursing, Xiangtan, Peoples R China.
通讯机构：
[Zhang, JP ] C;[Chen, OY ] H;Cent South Univ, Xiangya Sch Nursing, Changsha, Peoples R China.;Hunan Univ Tradit Chinese Med, Sch Nursing, Changsha, Peoples R China.
关键词：
Lung cancer patients;Caregivers;Psychological stress;Prevalence;Influencing factors;Anxiety;Depression
摘要：
A lung cancer diagnosis has a huge impact on the psychological well-being of both patients and family caregivers. However, the current psychological stress status among dyads remains unclear. We aimed to determine the prevalence of anxiety and depression and identify the factors that influence patients with lung cancer and their caregivers. We conducted a cross-sectional study of 254 dyads of lung cancer patients and family caregivers from four tertiary hospitals in Hunan Province, China from January 2021 to June 2021. Besides, we used several instruments to collect data on depression, anxiety, illness perception, mindfulness, self-compassion, and dyadic coping. The independent samples t-test, analysis of one-way variance, Spearman’s correlation analysis, and multiple linear regression analysis were employed. Results showed that 21.3% of patients and 29.5% of caregivers experienced depression, while 22.0% of patients and 33.5% of caregivers reported anxiety. For lung cancer patients, patients’ illness perception positively predicted their depression scores and patients’ level of mindfulness and level of self-compassion negatively predicted their depression scores; patients’ illness perception positively predicted their anxiety scores, and only living with children, patients’ mindfulness and self-compassion levels were negatively predicted their anxiety scores. For caregivers, caregivers’ level of illness perception and the number of other caregivers positively predicted their depression and anxiety scores, and caregiver’s dyadic coping level, residence (county or town, and city), and caregiver’s self-compassion level, were negatively predicted their depression and anxiety scores. The prevalence of psychological stress response of lung cancer patients and caregivers was high and influenced by family living situation, number of persons assisting in care, place of residence, patient-caregiver relationship, levels of illness perception, mindfulness, self-compassion, and dyadic coping. ClinicalTrial.gov NCT06746948.
作者：
Xu, Binbin;So, Winnie K. W.;Choi, Kai Chow;Huang, Yu;Liu, Mei;...
期刊：
Asia-Pacific Journal of Oncology Nursing,2025年12:100636 ISSN：2347-5625
通讯作者：
So, WKW
作者机构：
[Xu, Binbin] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.;[So, Winnie K. W.; Choi, Kai Chow; Xu, Binbin; So, WKW] Chinese Univ Hong Kong, Nethersole Sch Nursing, Hong Kong, Peoples R China.;[Huang, Yu] Guizhou Med Univ, Affiliated Canc Hosp, Nursing Dept, Guiyang, Peoples R China.;[Liu, Mei] Xuzhou Canc Hosp, Infect Control Dept, Xuzhou, Peoples R China.;[Qiu, Lanxiang] Xuzhou Med Univ, Affiliated Hosp 3, Nursing Dept, Xuzhou, Peoples R China.
通讯机构：
[So, WKW ] C;Chinese Univ Hong Kong, Nethersole Sch Nursing, Hong Kong, Peoples R China.
摘要：
Objective China’s diverse economic landscape across its regions may contribute to disparities in cancer-related financial toxicity (FT), but empirical evidence is lacking. This study examined regional disparities in cancer-related FT across economically diverse provinces in China.
China’s diverse economic landscape across its regions may contribute to disparities in cancer-related financial toxicity (FT), but empirical evidence is lacking. This study examined regional disparities in cancer-related FT across economically diverse provinces in China.
Methods A cross-sectional study was conducted among adult patients with cancer from six tertiary and six secondary hospitals across three Chinese provinces with varying economic statuses (high-, middle-, and low-income). FT was assessed using the COmprehensive Score for financial Toxicity (COST). Hierarchical regression analysis was employed to compare FT among participants from different economic regions, controlling for 13 patient-level sociodemographic and clinical risk factors.
A cross-sectional study was conducted among adult patients with cancer from six tertiary and six secondary hospitals across three Chinese provinces with varying economic statuses (high-, middle-, and low-income). FT was assessed using the COmprehensive Score for financial Toxicity (COST). Hierarchical regression analysis was employed to compare FT among participants from different economic regions, controlling for 13 patient-level sociodemographic and clinical risk factors.
Results From February to October 2022, 1208 participants completed the survey (response rate = 97.3%). Mean COST scores were 21.99 ± 6.37 (high-income), 20.38 ± 8.01 (middle-income), and 19.20 ± 5.14 (low-income), showing significant differences ( P < 0.001), with lower scores indicating more severe FT. After adjusting for covariates, regional economic level was significantly associated with FT, with more severe FT in middle- (B: −1.515; 95% CI: −2.250, −0.780) and low-income regions (B: −2.159; 95% CI: −2.899, −1.418) than in high-income regions.
From February to October 2022, 1208 participants completed the survey (response rate = 97.3%). Mean COST scores were 21.99 ± 6.37 (high-income), 20.38 ± 8.01 (middle-income), and 19.20 ± 5.14 (low-income), showing significant differences ( P < 0.001), with lower scores indicating more severe FT. After adjusting for covariates, regional economic level was significantly associated with FT, with more severe FT in middle- (B: −1.515; 95% CI: −2.250, −0.780) and low-income regions (B: −2.159; 95% CI: −2.899, −1.418) than in high-income regions.
Conclusions This study reveals significant disparities in cancer-related FT across economically diverse provinces in China. The findings underscore the need for targeted policies and interventions to improve health equity in cancer care, with a focus on not neglecting middle-income regions. Oncology nurses are expected to enhance awareness of FT management, voice the needs of patients, and advocate for policy reforms to address these disparities.
This study reveals significant disparities in cancer-related FT across economically diverse provinces in China. The findings underscore the need for targeted policies and interventions to improve health equity in cancer care, with a focus on not neglecting middle-income regions. Oncology nurses are expected to enhance awareness of FT management, voice the needs of patients, and advocate for policy reforms to address these disparities.
期刊：
AGING CLINICAL AND EXPERIMENTAL RESEARCH,2025年37(1):1-16 ISSN：1594-0667
通讯作者：
Wen, Zhi;Chen, Q
作者机构：
[Guo, Cheng; Wen, Zhi; Chen, Qing; He, Fangyi; Kuang, Gaoyan; Lan, Xiangzhou; Li, Lingjia; Jia, Qing; Chen, Miao] Hunan Univ Tradit Chinese Med, Affiliated Hosp 1, Changsha 410007, Hunan, Peoples R China.;[He, Fangyi; Li, Lingjia; Jia, Qing] Hunan Univ Chinese Med, Sch Nursing, Changsha 410208, Hunan, Peoples R China.;[Zeng, Weike] Changsha Modern Nurse Magazine Co LTD, Changsha 410011, Hunan, Peoples R China.
通讯机构：
[Wen, Z; Chen, Q ] H;Hunan Univ Tradit Chinese Med, Affiliated Hosp 1, Changsha 410007, Hunan, Peoples R China.
关键词：
Knee osteoarthritis;Physical modalities therapy;Network meta-analysis;Pain relief;Joint function
摘要：
OBJECTIVE: This network meta-analysis (NMA) aimed to compare the efficacy of various physical modalities in alleviating pain, stiffness, and functional impairment in patients with knee osteoarthritis (KOA). METHODS: In accordance with PRISMA-P guidelines, we systematically searched nine databases(CNKI, VIP Database, Wanfang Database, SinoMed, PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library) from inception to October 2024 to identify randomized controlled trials (RCTs) evaluating physical therapies for KOA. The interventions assessed included electrical stimulation therapy (EST), low-level light therapy (LLLT), thermotherapy (TT), cryotherapy (CT), and extracorporeal shock wave therapy (ESWT), with resistance and range of motion exercises (RRE) serving as comparators. Outcome measures comprised the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 6-minute walk test (6 MWT). Bayesian network meta-analyses and pairwise meta-analyses were performed using Stata 17.0 and R 4.4.1 software. RESULTS: 32 RCTs involving 2,078 participants were included. LLLT demonstrated the highest efficacy for pain reduction (VAS: MD=-3.32, 95% CI:-3.82 to-0.75; WOMAC pain: MD=-3.74, 95% CI:-6.68 to-0.72) and joint function improvement (SUCRA = 79.8). ESWT ranked second for pain relief (VAS: MD=-1.31, 95% CI:-2.42 to-0.16) and mobility enhancement (6 MWT: SUCRA = 71.5), while TT showed superior efficacy in reducing stiffness (WOMAC stiffness: MD=-2.09, 95%CI:-3.06 to-0.94; SUCRA = 98.1). In contrast, ultrasonic therapy (UT) did not provide significant benefits. CONCLUSIONS: The findings suggest that LLLT and ESWT may be optimal for pain relief and functional improvement in patients with KOA, whereas TT appears to be the most effective in reducing stiffness. Optimal dosing parameters of these physical modalities are crucial for maximizing clinical benefits. Clinicians should individualize treatment strategies based on patient-specific factors. Future large-scale RCTs are warranted to validate these protocols and address the heterogeneity of existing evidence. CLINICAL TRIAL NUMBER: Not applicable.
作者机构：
[Su, Linfei; Da, Hui; Zhang, Yan] Huazhong Univ Sci & Technol, Sch Educ, Wuhan, Peoples R China.;[Ji, Binbin] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.;[Xiao, Qiang] Hosp Huazhong Univ Sci & Technol, Wuhan, Peoples R China.;[Shi, Hui; Shi, H] Capital Med Univ, Beijing Chao Yang Hosp, Dept Cardiopsychiat Liaison Consultat, Beijing, Peoples R China.
通讯机构：
[Shi, H ] C;Capital Med Univ, Beijing Chao Yang Hosp, Dept Cardiopsychiat Liaison Consultat, Beijing, Peoples R China.
关键词：
Depression;Insomnia;Functional near - infrared spectroscopy (fNIRS);Hemodynamics
摘要：
Insomnia inflicts physical and spiritual harm, potentially leading to depressive disorders. Insomnia has a symbiotic relationship with depression, and even could be predictive of depression, which as an early marker of it. Early detection and intervention among high risk of depression due to insomnia may promote positive individual development. Total of 865 subjects were recruited: 439 in the depression-insomnia group, 262 in the insomnia group, and 164 in the healthy group. Functional near-infrared spectroscopy(fNIRS) combined with a verbal fluency task recorded brain activation, along with depression/ anxiety/ insomnia scores. In the left dorsolateral prefrontal cortex (DLPFC), oxyhemoglobin(HbO) levels were higher in the healthy group compared to both the insomnia and depression-insomnia groups (p < 0.01). In the right Broca’s and left orbitofrontal cortex (OFC), HbO were higher in insomnia group than in the depression-insomnia group (p < 0.05). There was a positive correlation between depression scores, insomnia scores, and HbO in the left DLPFC (p < 0.05). Insomnia scores showed positive correlation with HbO in the left OFC (p < 0.05). The left OFC mediated the process from insomnia to depression, while the left DLPFC directly moderated the impact of insomnia on depression and moderated the influence of the left OFC on depression. Hemodynamic patterns in the right Broca’s and left OFC could serve as early indicators to differentiate whether insomnia population are also experiencing depression, suggesting that fNIRS could be used as a diagnostic tool. Interventions the left OFC and DLPFC in insomnia population have the potential to alleviate depressive symptoms.
期刊：
Asia-Pacific Journal of Oncology Nursing,2025年12:100669 ISSN：2347-5625
通讯作者：
Lu, Q;Lukkahatai, N
作者机构：
[Shen, Aomei; Qiang, Wanmin] Tianjin Med Univ, Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc,Minist Educ,Dept Nursin, Tianjin, Peoples R China.;[Lu, Qian; Shen, Aomei] Peking Univ, Sch Nursing, Beijing, Peoples R China.;[Li, Mingfang] Sun Yat Sen Univ, Sch Nursing, Guangzhou, Peoples R China.;[Ning, Hongting] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.;[Han, Gyumin] Pusan Natl Univ, Coll Nursing, Res Inst Nursing Sci, Yangsan, South Korea.
通讯机构：
[Lu, Q ] P;[Lukkahatai, N ] J;Peking Univ, Sch Nursing, Beijing, Peoples R China.;Johns Hopkins Univ, Sch Nursing, Baltimore, MD 21218 USA.
关键词：
Acupressure;Cancer;Lymphedema;Scoping review
摘要：
Objective Acupressure is widely used to effectively manage cancer-related symptoms; however, limited evidence has been seen on the application of acupressure in managing cancer-related lymphedema (CRL). This study aims to identify, describe, and map the current evidence that used acupressure for CRL prevention and management.
Acupressure is widely used to effectively manage cancer-related symptoms; however, limited evidence has been seen on the application of acupressure in managing cancer-related lymphedema (CRL). This study aims to identify, describe, and map the current evidence that used acupressure for CRL prevention and management.
Methods This review was conducted following Arksey and O’Malley’s methodology and Joanna Briggs Institute guidance for scoping reviews. A systematic search was performed in eight English databases and four Chinese databases from inception to Oct 20, 2023, and updated on July 20, 2024. Reference lists were hand-searched. Two independent reviewers performed study selection and data extraction. Disagreements were solved through discussion or consultation with a third reviewer. A narrative synthesis was performed to summarize and synthesize the findings.
This review was conducted following Arksey and O’Malley’s methodology and Joanna Briggs Institute guidance for scoping reviews. A systematic search was performed in eight English databases and four Chinese databases from inception to Oct 20, 2023, and updated on July 20, 2024. Reference lists were hand-searched. Two independent reviewers performed study selection and data extraction. Disagreements were solved through discussion or consultation with a third reviewer. A narrative synthesis was performed to summarize and synthesize the findings.
Results A total of 16 articles published from 2010 to 2023 were included. The majority of the studies ( n = 11) were from China. There were six randomized controlled trials (RCTs), four quasi-experimental studies, one retrospective cohort study, one qualitative study, three reviews, and one report. Nine studies examined acupressure, one employed tuina, and one utilized Transcutaneous Electrical Acupoint Stimulation. Neiguan (PC 6), Hegu (LI 4), Jianjing (GB 21), Quchi (LI 11), Chize (LU 5) were most commonly used acupoints. The dosage varied among studies. Acupressure was performed by trained nurses or patients. Acupressure showed improvements in lymphedema management, limb function, quality of life, and inflammatory factors.
A total of 16 articles published from 2010 to 2023 were included. The majority of the studies ( n = 11) were from China. There were six randomized controlled trials (RCTs), four quasi-experimental studies, one retrospective cohort study, one qualitative study, three reviews, and one report. Nine studies examined acupressure, one employed tuina, and one utilized Transcutaneous Electrical Acupoint Stimulation. Neiguan (PC 6), Hegu (LI 4), Jianjing (GB 21), Quchi (LI 11), Chize (LU 5) were most commonly used acupoints. The dosage varied among studies. Acupressure was performed by trained nurses or patients. Acupressure showed improvements in lymphedema management, limb function, quality of life, and inflammatory factors.
Conclusions The review concluded the effectiveness of acupressure in CRL prevention and treatment. Further rigorous research is recommended, particularly well-designed RCTs involving diverse populations.
The review concluded the effectiveness of acupressure in CRL prevention and treatment. Further rigorous research is recommended, particularly well-designed RCTs involving diverse populations.
作者机构：
[Zheng, Chaoting; Tang, Wei; Li, Hong; Hu, Li] Guizhou Med Univ, Affiliated Hosp, Guiyang, Peoples R China.;[Xu, Binbin] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.
通讯机构：
[Li, H ] G;Guizhou Med Univ, Affiliated Hosp, Guiyang, Peoples R China.
关键词：
Nurse;Breast cancer;Oncofertility barriers
摘要：
Despite the importance of oncofertility care in supporting women coping with fertility challenges after breast cancer, the practice of oncofertility care among nurses remains suboptimal. There is an urgent need to investigate oncofertility barriers faced by nurses caring for women with breast cancer. A cross-sectional online study was conducted among registered nurses caring for women with breast cancer. A self-developed questionnaire and the Oncofertility Barriers Scale (OBS) were used to assess participants' characteristics and self-perceived barriers. A score ≥ 3 indicates a high level of oncofertility barriers requiring further attention. 372 nurses completed the survey, with 45.54% reporting a score of ≥ 3 on the OBS. Notably, 85% of participants reported high levels of barriers in at least one domain and 27.42% reported barriers in all six domains of the scale. The most commonly reported barrier was "Stereotype of cancer patients" (71%). Nurses without fertility training, those who did not read fertility-related guidelines, and those in departments lacking such guidelines reported significantly higher barriers (all p < 0.05). The prevalence of oncofertility barriers among nurses is high. Educational programs should be developed to address these barriers, improving the quality of oncofertility care for women with breast cancer.
摘要：
Catheter-related thrombosis (CRT) poses serious risks for cancer patients. Identifying risk factors and implementing targeted interventions can prevent CRT. To explore thromboelastogram parameters and clinical risk factors for CRT in elderly lung cancer patients. A total of 663 elderly lung cancer patients were selected from three hospitals in Hunan, Hainan, and Qinghai provinces in China from January 1, 2022, to June 30, 2024. The patients were divided into two groups: a CRT group (221 patients) and a non-CRT group (442 patients), with a ratio of 1:2. A between-group comparison and binary logistic regression were used to analyze risk factors for CRT in elderly lung cancer patients. Binary logistic regression analysis showed that decreased R (odds ratio [OR]: 0.849, 95% confidence interval [CI]: 0.763-0.945, p = 0.003), decreased K (0.571, 95% CI: 0.404-0.807, p = 0.001), advanced age (OR: 1.073, 95% CI: 1.033-1.113, p < 0.001), elevated platelet count (OR: 1.006, 95% CI: 1.004-1.009, p < 0.001), increased hemoglobin level (OR: 1.020, 95% CI: 1.009-1.031, p < 0.001), shortened PT (OR: 0.904, 95% CI: 0.830-0.985, p = 0.022), surgery ≤ 1 month (OR: 2.258, 95% CI: 1.420-3.590, p = 0.001), male sex (OR: 4.534, 95% CI: 2.815-7.304, p < 0.001), diabetes (OR: 2.478, 95% CI: 1.373-4.472, p = 0.003), hypertension (OR: 2.386, 95% CI: 1.505-3.784, p < 0.001), physical activity disorders (OR: 9.038, 95% CI: 4.462-18.309, p < 0.001) were independent risk factors for CRT in elderly lung cancer patients. Independent risk factors for CRT in elderly lung cancer patients include decreased K-values and decreased R-values, shortened PT, advanced age, elevated platelet count, increased hemoglobin level, surgery ≤ 1 month, male sex, diabetes, hypertension, and physical activity disorders.
摘要：
Staff-to-resident abuse in institutional settings demands political attention and evidence-based interventions. Certified nursing assistants (CNAs) views and suggestions on preventing elder abuse can offer practical and policy-relevant insights. This study explores CNAs’ perceptions and strategies to address elder abuse in institutional care. Sixteen CNAs from residential aged care facilities (RACFs) in Hunan Province, China, were purposively sampled. Semi-structured qualitative interviews were conducted, and transcripts were analysed using content analysis. CNAs demonstrated a surface-level understanding of elder abuse, including its types, causes, and interventions. However, they provided detailed suggestions through an ecological-systems lens. At the microsystem level, strengthening staff professionalism and empathy was noted as critical, while the mesosystem involved enhancing institutional management. At the macrosystem level, suggested strategies included boosting social support, such as developing the senior care sector, increasing senior benefits, and strengthening legal safeguards. This study highlights CNAs’ limited understanding of elder abuse and presents actionable recommendations for policy and practice. The gap between their perceptions and the ability to ensure abuse-free care underlines the need for evidence-based training and standardised reporting systems. Strengthening staffing quality, institutional leadership, and community support within an ecological-systems framework is essential to reduce elder abuse and promote safe, respectful care environments for older adults.
通讯机构：
[Zhu, HL ] H;Hunan Acad Tradit Chinese Med, Hunan Prov Hosp Integrated Tradit Chinese & Wester, Nursing Dept, Affiliated Hosp, 58 Lushan Rd, Changsha 410006, Hunan, Peoples R China.
关键词：
Diabetes;Experiences;Interpretative phenomenological analysis;Skin pruritus;Women of childbearing age
摘要：
Aim This study aims to explore the experiences and feelings of women of childbearing age with diabetes skin pruritus after being diagnosed.
This study aims to explore the experiences and feelings of women of childbearing age with diabetes skin pruritus after being diagnosed.
Methods Using the Interpretative Phenomenological Analysis method, semi-structured interviews were conducted with women of childbearing age who suffer from diabetes skin pruritus, followed by data analysis.
Using the Interpretative Phenomenological Analysis method, semi-structured interviews were conducted with women of childbearing age who suffer from diabetes skin pruritus, followed by data analysis.
Results Three superordinate themes and eight subthemes were identified, including psychological distress (self-identity, lack of understanding from others, emotional damage and self-disgust), physical impairment (loss of bodily control, treatment challenges, impact on female sexual characteristics), and coping post-trauma (social withdrawal, active coping).
Three superordinate themes and eight subthemes were identified, including psychological distress (self-identity, lack of understanding from others, emotional damage and self-disgust), physical impairment (loss of bodily control, treatment challenges, impact on female sexual characteristics), and coping post-trauma (social withdrawal, active coping).
Conclusion The physical and mental health of women of childbearing age with diabetes skin pruritus has been severely compromised, particularly their sense of self-worth as women of childbearing age. Despite this, they demonstrate a solid willingness to seek treatment. Therefore, it is recommended to strengthen research in this field, improve health education, establish online support platforms for sharing experiences, and enhance government oversight of social security measures. These initiatives will promote active treatment and recovery among patients, ultimately improving their quality of life.
The physical and mental health of women of childbearing age with diabetes skin pruritus has been severely compromised, particularly their sense of self-worth as women of childbearing age. Despite this, they demonstrate a solid willingness to seek treatment. Therefore, it is recommended to strengthen research in this field, improve health education, establish online support platforms for sharing experiences, and enhance government oversight of social security measures. These initiatives will promote active treatment and recovery among patients, ultimately improving their quality of life.
期刊：
Thinking Skills and Creativity,2025年:101867 ISSN：1871-1871
通讯作者：
Hui Shi
作者机构：
[Yan Zhang] School of Education, Huazhong University of Science and Technology, Wuhan, 430074, China;Department of Psychology, Shihezi University, Shihezi, 832000, China;[Binbin Ji] School of Nursing, Hunan University of Chinese Medicine, Changsha, 410208, China;[Hui Shi] The Department of Cardio-Psychiatry Liaison Consultation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China;[Wen Guo] School of Education, Huazhong University of Science and Technology, Wuhan, 430074, China<&wdkj&>Department of Psychology, Shihezi University, Shihezi, 832000, China
通讯机构：
[Hui Shi] T;The Department of Cardio-Psychiatry Liaison Consultation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
摘要：
In higher education, critical thinking is crucial, particularly in light of digital technology and globalization. Over the past few years, the interactive approach has been increasingly integrated into critical thinking instruction in Chinese higher education. However, it remains unclear how this approach affects Chinese college students’ critical thinking skills and the underlying neural mechanisms. The purpose of this research is to explore the effects of interactive independent courses on critical thinking skills and their neural correlates using functional near-infrared spectroscopy (fNIRS). A course of eight modules spanning eight weeks in total was designed to integrate interactive teaching into independent critical thinking courses for Chinese college students. Multimodal data sources of critical thinking skill tests and brain connectivity were employed to investigate the development of cognitive components of 147 college students’ critical thinking. Results showed that emphasizing classroom interaction was significantly associated with improvements in critical thinking abilities of Chinese college students in an independent critical thinking course. Furthermore, the functional connectivity during the stereotyped critique experimental task was strengthened after the courses. This study provides empirical evidence and practical recommendations for critical thinking education among college students in China.
In higher education, critical thinking is crucial, particularly in light of digital technology and globalization. Over the past few years, the interactive approach has been increasingly integrated into critical thinking instruction in Chinese higher education. However, it remains unclear how this approach affects Chinese college students’ critical thinking skills and the underlying neural mechanisms. The purpose of this research is to explore the effects of interactive independent courses on critical thinking skills and their neural correlates using functional near-infrared spectroscopy (fNIRS). A course of eight modules spanning eight weeks in total was designed to integrate interactive teaching into independent critical thinking courses for Chinese college students. Multimodal data sources of critical thinking skill tests and brain connectivity were employed to investigate the development of cognitive components of 147 college students’ critical thinking. Results showed that emphasizing classroom interaction was significantly associated with improvements in critical thinking abilities of Chinese college students in an independent critical thinking course. Furthermore, the functional connectivity during the stereotyped critique experimental task was strengthened after the courses. This study provides empirical evidence and practical recommendations for critical thinking education among college students in China.
关键词：
Neoplasms;Digestive system;Surgical site infection;Prediction model;Systematic review
摘要：
BACKGROUND: Currently, various risk prediction models for surgical site infection (SSI) in patients with gastrointestinal tumors have been developed, but comprehensive comparisons regarding the model construction process, performance, and data sample bias are lacking. This study conducts a systematic review of relevant research to evaluate the risk bias and clinical applicability of these models. MATERIALS AND METHODS: The Web of Science, PubMed, Cochrane Library, Embase, CINAHL, CBM, CNKI, Wanfang, and VIP databases were searched for studies related to SSI prediction models in gastrointestinal cancer patients published up to August 19, 2024. Two researchers independently screened the literature, extracted the data, and evaluated the quality. A meta-analysis was conducted on the common predictive factors included in the model, using odds ratio (OR) values and 95% confidence interval (CI) as effect statistics. The Q test and heterogeneity index I(2) were used to assess heterogeneity. All the statistical analyses were performed via Stata 16.0 software. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was submitted as a supplement. RESULTS: A total of 28 articles were included, and 39 models were constructed. The area under the receiver operating characteristic curve (AUC) for the models ranged from 0.660 to 0.950, indicating good predictive performance. Eight studies conducted internal validation, eight studies conducted external validation, and two studies used a combination of internal and external validation for model evaluation. The overall risk of bias in the literature was high, but the applicability was good. The results of the meta-analysis revealed that factors such as underlying diseases, surgical factors, demographic factors, and laboratory-related indicators are the main predictors of surgical site infections in patients with gastrointestinal tumors. CONCLUSIONS: Currently, risk prediction models for surgical site infections in patients with gastrointestinal cancer remain in the developmental phase, and there is a high risk of bias in the areas of study subjects, outcomes, and analysis. Researchers need to enhance research methodologies, conduct large-scale prospective studies, and refer to the reporting standards of the bias risk assessment tool for predictive models to construct predictive models with low bias risk and high applicability.
摘要：
AIM: This study aims to determine the mediating effect of emotional exhaustion on the relationship between lateral violence in nursing and turnover intentions. DESIGN: A cross-sectional survey. METHODS: This research project involved the enrollment of 314 nursing professionals from two tertiary medical facilities associated with academic institutions in Changsha, Hunan Province, China. To measure the variables, a series of self-administered questionnaires was used. The data were analysed using SPSS 25. RESULTS: Lateral violence and emotional exhaustion were positively correlated with turnover intention. Emotional exhaustion partially mediated the relationship between lateral violence and turnover intention. CONCLUSION: Emotional exhaustion serves as a partial mediator in the relationship between lateral violence and turnover intention. Reducing lateral violence and avoiding emotional exhaustion can help to reduce the turnover intention of nurses. IMPLICATIONS FOR THE PROFESSION: When developing targeted programs or policies aimed at decreasing nurses' turnover intention, it is important to consider the issue of lateral violence among nurses, as well as their negative emotions. IMPACT: The study provides us with a more fine-grained understanding of the relationship between lateral violence among nurses and turnover intention. Insights to enhance nurse retention are also provided, which can support the development of future relevant policies and guidelines. REPORTING METHOD: The study adhered to the STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
作者机构：
[Zhao, Fen; Lv, Jianhong; Zhang, Wenxia; Xu, Wenting] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.;[Mao, Hongyan] Hunan Acad Tradit Chinese Med, Affiliated Hosp, Changsha, Peoples R China.;[Huang, Jing; Huang, J] Hunan Acad Tradit Chinese Med, 142 Yuehua Rd, Changsha 410013, Hunan, Peoples R China.
通讯机构：
[Huang, J ] H;Hunan Acad Tradit Chinese Med, 142 Yuehua Rd, Changsha 410013, Hunan, Peoples R China.
摘要：
AIMS: This study aims to analyse the current state of life enjoyment among Alzheimer's disease patients; and explore the correlations between life enjoyment of patients with Alzheimer's disease and caregiver's knowledge of Alzheimer's disease, caregiving attitudes and caregiving empowerment. DESIGN: This research adopted a cross-sectional study approach. METHODS: A cross-sectional survey was conducted from May to August 2024. A convenience sampling method was employed to recruit 417 inpatients with Alzheimer'sdisease and their caregivers from tertiary-level hospitals, elderly healthcare facilities, and community welfare centres in Changsha, Hunan Province, China. The data collection tools included a general information questionnaire, the Pleasant Events Scale for Patients with Dementia (PES-AD), the Alzheimer's Disease Knowledge Scale (ADKS), the Scale of Attitude Toward with Dementia (ATD) and the Empowerment Scale for Family Caregivers with Dementia (EFCD). The SPSS27.0 software was utilized to analyse the current state and influencing factors of the life enjoyment of patients with Alzheimer's disease, and to investigate the correlations among caregivers' caregiving attitudes, caregiving empowerment, knowledge level about the disease and patients' life enjoyment. RESULTS: Patients with Alzheimer's disease obtained scores of (17.33 ± 2.71) on the Pleasant Events Scale, (15.16 ± 2.99) on the Alzheimer's Disease Knowledge Scale, (24.70 ± 1.21) on the Scale of Attitude Toward with Dementia, and (26.88 ± 1.65) on the Empowerment Scale for Family Caregivers with Dementia. The results of the Pearson's correlation analysis indicated that there was a positive correlation between the Alzheimer's disease pleasant events of patients and the knowledge, attitude, and empowerment of caregivers regarding Alzheimer's disease (P < 0.05). The results of multiple linearregression analyses showed that patients' gender, age, self-care situations, severity of diseases, caregiver's cumulative duration of caregiving, the availability of shared caregivers, and whether caring for patients feels stress, whether or not educated about AD, knowledge of Alzheimer's disease, caregiving attitudes, and caregiving empowerment were the main influences on patients' sense of life enjoyment (P < 0.05). CONCLUSION: The life pleasure of Alzheimer's disease patients was at a medium level; caregivers' knowledge of Alzheimer's disease was at a medium level, while their caregiving attitude and caregiving empowerment were at a medium-high level. Future research can identify the most effective interventions based on caregivers' knowledge of Alzheimer's disease. This will facilitate the enhancement of disease-related health knowledge education and training, elevate caregivers' awareness of the disease, and thereby improve the life pleasure of Alzheimer's Disease (AD) patients. IMPACT: At present, the caregiving issues for Alzheimer's Disease Patients represents a global public health challenge, with caregiving capacity also significantly impacting patients' quality of life. Thus, in order to decelerate AD progression and improve patients' quality of life, a comprehensive analysis of caregivers' Alzheimer's Disease knowledge, caregiving attitudes, caregiving empowerment, and their correlation with patient outcomes is crucial for promoting the physical and mental health of AD patients in the future.
作者：
Ji, Binbin;Peng, Xinyi;Hong, Lu;Shimpuku, Yoko;Teramoto, Chie;...
期刊：
Journal of Autism and Developmental Disorders,2025年:1-10 ISSN：0162-3257
通讯作者：
Chen, SM
作者机构：
[Hong, Lu; Ji, Binbin; Peng, Xinyi] Hunan Univ Chinese Med, Sch Nursing, Changsha 410208, Hunan, Peoples R China.;[Teramoto, Chie; Chen, Sanmei; Shimpuku, Yoko; Chen, SM] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Div Nursing, 1-2-3 Kasumi,Minami Ward, Hiroshima 7348553, Japan.
通讯机构：
[Chen, SM ] H;Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Div Nursing, 1-2-3 Kasumi,Minami Ward, Hiroshima 7348553, Japan.
关键词：
Autism;Children;Parents;Social inclusion;Mainstream school
摘要：
This study investigated whether attending mainstream school is associated with improved social inclusion among children on the autism spectrum and their parents. The cross-sectional study took place from July to August 2023 at 30 rehabilitation centers for children on the autism spectrum in Hunan Province, China. Participants included 860 children aged 3-14 years, with autism history receiving outpatient rehabilitation services, and their primary caregiver parents aged 23-54 years. Social inclusion among children on the autism spectrum was evaluated using the Chinese version of the social inclusion subscale of the KidsLife-ASD Scale. Parental social inclusion was assessed using the Chinese version of the Social Inclusion Scale. Linear mixed models were used to explore the association between attending mainstream school and social inclusion. Among children on the autism spectrum, 36.2% attended mainstream school. These children showed significantly higher levels of social inclusion compared to non-attenders. Subgroup analysis based on the severity of autism symptoms revealed that the significant association remained in both the mild and moderate/severe subgroups, being more pronouced in the mild subgroup (P(for interaction)<0.001). Parents of children attending mainstream school reported greater social inclusion levels than those whose children did not; however, after adjusting for severity of autism symptoms and other factors, this association became non-significant. Our study demonstrates a positive association between attending mainstream school and social inclusion for children on the autism spectrum, highlighting the critical role of mainstream school education in fostering social opportunities and providing diverse learning resources. It also underscores the need for targeted support strategies for parents.
摘要：
Objective To systematically review published machine learning models aimed at predicting the risk of falls among hospitalized patients.
To systematically review published machine learning models aimed at predicting the risk of falls among hospitalized patients.
Design A systematic review and meta-analysis.
A systematic review and meta-analysis.
Methods According to the inclusion and exclusion criteria, we comprehensively searched the database PubMed, EMBASE, Web of Science and The Cochrane library from inception through November 14, 2023. Data extraction followed the CHARMS checklist, and bias risk and applicability were assessed using the PROBAST tool. A meta-analysis was performed utilizing Meta-disc software, with the area under the curve, sensitivity, and specificity serving as the effect measures. Heterogeneity was assessed through the Chi-square test and I 2 test.
According to the inclusion and exclusion criteria, we comprehensively searched the database PubMed, EMBASE, Web of Science and The Cochrane library from inception through November 14, 2023. Data extraction followed the CHARMS checklist, and bias risk and applicability were assessed using the PROBAST tool. A meta-analysis was performed utilizing Meta-disc software, with the area under the curve, sensitivity, and specificity serving as the effect measures. Heterogeneity was assessed through the Chi-square test and I 2 test.
Results A systematic search yielded a total of 2007 studies, 14 of which were selected following screening, and 13 of these studies were subjected to quantitative analyses. The incidence rate of inpatient falls ranged from 0.14 % to 50.69 %, with corresponding area under the curve (AUC) values varying between 0.57 and 0.99. Age, multiple drugs, emerged as the most frequently employed predictive factors. While the overall quality of the studies was considered satisfactory, a high risk of bias was identified, primarily attributed to insufficient reporting in the participant and analysis domains. The combined AUC of the 13 predictive models was 0.82, with a sensitivity of 0.69 (95 % CI [0.68-0.7]) and a specificity of 0.70 (95 % CI [0.70-0.71]), indicating robust discriminative performance.
A systematic search yielded a total of 2007 studies, 14 of which were selected following screening, and 13 of these studies were subjected to quantitative analyses. The incidence rate of inpatient falls ranged from 0.14 % to 50.69 %, with corresponding area under the curve (AUC) values varying between 0.57 and 0.99. Age, multiple drugs, emerged as the most frequently employed predictive factors. While the overall quality of the studies was considered satisfactory, a high risk of bias was identified, primarily attributed to insufficient reporting in the participant and analysis domains. The combined AUC of the 13 predictive models was 0.82, with a sensitivity of 0.69 (95 % CI [0.68-0.7]) and a specificity of 0.70 (95 % CI [0.70-0.71]), indicating robust discriminative performance.
Conclusion Although machine learning models provide an emerging and promising method for predicting hospital falls, they require broader validation to ensure practical applicability. This review highlights the potential drawbacks of current methods, including high risk of bias and low reproducibility, and provides various recommendations on how to address these challenges.
Although machine learning models provide an emerging and promising method for predicting hospital falls, they require broader validation to ensure practical applicability. This review highlights the potential drawbacks of current methods, including high risk of bias and low reproducibility, and provides various recommendations on how to address these challenges.
Clinical relevance Falls are a frequent and significant issue for patients in hospitals, often resulting in severe physical harm and longer hospital stays. This research offers a fresh approach and tool for medical professionals by thoroughly examining how machine learning models can predict falls, aiming to enhance personalized and precise fall risk management.
Falls are a frequent and significant issue for patients in hospitals, often resulting in severe physical harm and longer hospital stays. This research offers a fresh approach and tool for medical professionals by thoroughly examining how machine learning models can predict falls, aiming to enhance personalized and precise fall risk management.
作者机构：
[He, Jiaqing] Hunan Univ Chinese Med, Sch Nursing, Changsha, Peoples R China.;[Elihuruma, Eliufoo; Tian, Yusheng; Yang, Jiaxin] Cent South Univ, Xiangya Hosp 2, Clin Nursing Teaching & Res Sect, 139 Renmin Middle Rd, Changsha 410011, Hunan, Peoples R China.;[Tian, Yusheng; Yang, Jiaxin] Cent South Univ, Natl Clin Res Ctr Mental Disorders, Xiangya Hosp 2, Changsha, Hunan, Peoples R China.;[Tian, Yusheng; Yang, Jiaxin] Cent South Univ, Dept Psychiat, Xiangya Hosp 2, Changsha, Hunan, Peoples R China.;[Yang, Min] Hunan Cent South Univ, Xiangya Stomatol Hosp, Changsha, Hunan, Peoples R China.
通讯机构：
[Li, YM ] H;Hunan Prov Peoples Hosp, Dept Nursing, 61 Jiefang West Rd, Changsha 410005, Hunan, Peoples R China.
关键词：
Head nurse leadership;Job demands;Job resources;Burnout;Nurse
摘要：
Many elements in the workplace contribute to nurses’ burnout experiences, affecting patient safety and the healthcare organizations’ efficiency. Leaders’ presence and conduct are the most potent “master” factors in every work setting. Although previous studies have shown that head nurse leadership, job demands, job resources, and job burnout are significantly related, the interaction mechanism remains unclear. This study investigates the parallel mediating roles of job demands and job resources between head nurse leadership and job burnout in nursing staff. A cross-sectional, anonymous, and confidential online survey was conducted from March to June 2024 to collect data from 579 registered nurses in four hospitals in Hunan provinces. The independent variable was head nurse leadership, the mediating variables were job demands and resources, and the dependent variable was job burnout. Parallel mediation analysis was performed using the PROCESS macro in SPSS. This study found that head nurse leadership negatively relates to nurses’ burnout. The parallel mediation analysis suggests that job resources and job demands play parallel roles in the relationship between head nurse leadership and job burnout. As predicted, head nurse leadership weakened job burnout through job resources and contributed to job burnout through job demands. This study finding highlights the importance of head nurse leadership in decreasing nurses’ job burnout and reveals two potential mechanisms through which head nurse leadership is related to nurses’ burnout. By understanding the role of head nurse leadership, job demands, and job resources, interventions can be targeted to improve nurses’ mental health.
期刊：
Science of The Total Environment,2025年970:179052 ISSN：0048-9697
通讯作者：
Zhenggang Zhu
作者机构：
[Zhu, Zhenggang] School of Nursing, Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang, China. Electronic address: 897846734@qq.com;[Ji, Binbin] School of Nursing, Hunan University of Chinese Medicine, Yuelu District, Changsha, Hunan, China;[Tian, Jun] Geriatric Department, Xiangya Hospital of Central South University, Kaifu District, Changsha, Hunan, China;[Yin, Ping] Hunan Maternal and Child Health Hospital, Kaifu District, Changsha, Hunan, China
通讯机构：
[Zhenggang Zhu] S;School of Nursing, Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang, China
摘要：
Introduction Heat exposure and heatwaves are becoming more frequent and prolonged due to global warming. Heat exposure poses a significant potential risk for respiratory diseases. However, a comprehensive synthesis of existing evidence on the health impacts of heat exposure on respiratory diseases is lacking. This review aims to address this knowledge gap.
Heat exposure and heatwaves are becoming more frequent and prolonged due to global warming. Heat exposure poses a significant potential risk for respiratory diseases. However, a comprehensive synthesis of existing evidence on the health impacts of heat exposure on respiratory diseases is lacking. This review aims to address this knowledge gap.
Methods The PubMed, Scopus, Embase, and Web of Science databases were searched for reviews examining the impact of heat exposure on respiratory-related mortality and morbidity, as well as on respiratory diseases such as asthma, pneumonia, COPD, acute bronchiolitis, and acute respiratory infections. The final search was conducted in July 2024. The quality of evidence for each health outcome category was assessed using a modified GRADE framework.
The PubMed, Scopus, Embase, and Web of Science databases were searched for reviews examining the impact of heat exposure on respiratory-related mortality and morbidity, as well as on respiratory diseases such as asthma, pneumonia, COPD, acute bronchiolitis, and acute respiratory infections. The final search was conducted in July 2024. The quality of evidence for each health outcome category was assessed using a modified GRADE framework.
Results A total of 28 reviews were included. There is strong evidence linking heat exposure to increased mortality in respiratory diseases. However, the associations between heat exposure and respiratory morbidity are less robust. Asthma is the most studied condition and has the most consistent evidence supporting its association with heat exposure. For other respiratory diseases, the evidence remains inconclusive.
A total of 28 reviews were included. There is strong evidence linking heat exposure to increased mortality in respiratory diseases. However, the associations between heat exposure and respiratory morbidity are less robust. Asthma is the most studied condition and has the most consistent evidence supporting its association with heat exposure. For other respiratory diseases, the evidence remains inconclusive.
Conclusion This review strengthens the evidence that heat exposure increases the risk of respiratory diseases globally. Future research should focus on low-income countries, specific respiratory diseases, and the integration of multi-dimensional data to develop evidence-based prevention and adaptation strategies.
This review strengthens the evidence that heat exposure increases the risk of respiratory diseases globally. Future research should focus on low-income countries, specific respiratory diseases, and the integration of multi-dimensional data to develop evidence-based prevention and adaptation strategies.
期刊：
Complementary Therapies in Medicine,2025年89:103152 ISSN：0965-2299
通讯作者：
Ong, ML
作者机构：
[Ong, Marilyn Li Yin; Zhu, Zhenggang; Ooi, Foong Kiew; Muhamad, Ayu Suzailiana] Univ Sains Malaysia, Sch Hlth Sci, Kubang Kerian, Kelantan, Malaysia.;[Zhu, Zhenggang] Wenzhou Med Univ, Sch Nursing, Wenzhou, Zhejiang, Peoples R China.;[Omar, Norsuhana] Univ Sains Malaysia, Sch Med Sci, Kubang Kerian, Kelantan, Malaysia.;[Pan, Xiaoyan] Hunan Univ Chinese Med, Sch Nursing, Changsha, Hunan, Peoples R China.;[Ong, ML] Univ Sains Malaysia, Sch Hlth Sci, Exercise & Sports Sci Programme, Kota Baharu 16150, Kelantan, Malaysia.
通讯机构：
[Ong, ML ] U;Univ Sains Malaysia, Sch Hlth Sci, Exercise & Sports Sci Programme, Kota Baharu 16150, Kelantan, Malaysia.
关键词：
Chronic obstructive pulmonary disease;Mawangdui exercise;Pulmonary function;Muscle strength;Flexibility;Quality of life
摘要：
Background Physical exercise intervention in pulmonary rehabilitation is recommended to increase strength, endurance, and flexibility in chronic obstructive pulmonary disease (COPD). However, certain physical intervention may be restrictive to COPD patients, as it induces fatigue and shortness of breath. Mawangdui exercise, a low-to-medium-intensity aerobic exercise, has been gaining popularity in China as an adjuvant physical therapy, particularly for patients with contraindications to exercise, to improve their health.
Physical exercise intervention in pulmonary rehabilitation is recommended to increase strength, endurance, and flexibility in chronic obstructive pulmonary disease (COPD). However, certain physical intervention may be restrictive to COPD patients, as it induces fatigue and shortness of breath. Mawangdui exercise, a low-to-medium-intensity aerobic exercise, has been gaining popularity in China as an adjuvant physical therapy, particularly for patients with contraindications to exercise, to improve their health.
Objective To investigate the effectiveness of the traditional Chinese Mawangdui exercise for patients with COPD in a mild to moderate stable stage.
To investigate the effectiveness of the traditional Chinese Mawangdui exercise for patients with COPD in a mild to moderate stable stage.
Methods A total of 54 COPD patients in stable stage (Mawangdui group, n = 27; control group, n = 27) were enroled for a period of 12-weeks. The Mawangdui group practised the Mawangdui exercise, while the control group maintained daily activities without additional exercise. The outcomes measurements were pulmonary function, exercise capacity, back-leg-chest muscle strength, sit-and-reach flexibility, dyspnoea symptoms, and quality of life. The outcomes were assessed at baseline, 24 h, 6 weeks, and 12 weeks post-intervention.
A total of 54 COPD patients in stable stage (Mawangdui group, n = 27; control group, n = 27) were enroled for a period of 12-weeks. The Mawangdui group practised the Mawangdui exercise, while the control group maintained daily activities without additional exercise. The outcomes measurements were pulmonary function, exercise capacity, back-leg-chest muscle strength, sit-and-reach flexibility, dyspnoea symptoms, and quality of life. The outcomes were assessed at baseline, 24 h, 6 weeks, and 12 weeks post-intervention.
Results Improvements were observed for Borg CR-10 score, SpO 2 , BMI, body fat%, fat mass, flexibility mMRC, and SGRQ scores ( p < 0.05) at 12 weeks. At week 12, Mawangdui group showed improved exercise capacity (6MWT mean difference 63.39 m, CI 48.36－78.40), back-leg-chest muscle strength (mean difference 5.92 kg, CI −2.57－-14.41), and dyspnoea (CAT score mean difference −5.50, CI −6.42－-4.59) in per-protocol population. However, FEV 1 , FVC, FEV 1 % pred, and fat-free mass did not show improvements with Mawangdui exercise.
Improvements were observed for Borg CR-10 score, SpO 2 , BMI, body fat%, fat mass, flexibility mMRC, and SGRQ scores ( p < 0.05) at 12 weeks. At week 12, Mawangdui group showed improved exercise capacity (6MWT mean difference 63.39 m, CI 48.36－78.40), back-leg-chest muscle strength (mean difference 5.92 kg, CI −2.57－-14.41), and dyspnoea (CAT score mean difference −5.50, CI −6.42－-4.59) in per-protocol population. However, FEV 1 , FVC, FEV 1 % pred, and fat-free mass did not show improvements with Mawangdui exercise.
Conclusion COPD patients in stable stage who performed Mawangdui exercise for 12 weeks improved exercise capacity, dyspnoea, muscle strength, flexibility, BMI, body fat%, fat mass and quality of life. Therefore, Mawangdui exercise is recommended for COPD patients in the stable stage to improve physical fitness and quality of life.
COPD patients in stable stage who performed Mawangdui exercise for 12 weeks improved exercise capacity, dyspnoea, muscle strength, flexibility, BMI, body fat%, fat mass and quality of life. Therefore, Mawangdui exercise is recommended for COPD patients in the stable stage to improve physical fitness and quality of life.
摘要：
Objective Lung cancer and its prolonged treatment are profoundly unsettling for patients and their family caregivers, and developing dyadic measures to alleviate their negative affectivity is pivotal. This study aimed to develop a complex intervention to alleviate dyadic psychological stress among patients with lung cancer and their family caregivers.
Lung cancer and its prolonged treatment are profoundly unsettling for patients and their family caregivers, and developing dyadic measures to alleviate their negative affectivity is pivotal. This study aimed to develop a complex intervention to alleviate dyadic psychological stress among patients with lung cancer and their family caregivers.
Methods A stepwise multi-method study was conducted following the Medical Research Council framework. Three phases were adopted, namely: (1) a preparation phase, a systematic review was conducted to identify the evidence base, (2) a development phase, empirical data from a quantitative study and a qualitative study were integrated to identify effective components, and (3) a modification phase, an online Delphi survey was carried out to refine the intervention.
A stepwise multi-method study was conducted following the Medical Research Council framework. Three phases were adopted, namely: (1) a preparation phase, a systematic review was conducted to identify the evidence base, (2) a development phase, empirical data from a quantitative study and a qualitative study were integrated to identify effective components, and (3) a modification phase, an online Delphi survey was carried out to refine the intervention.
Results The dyadic Mindfulness Self-Compassion intervention developed in this study consists of six weekly sessions. The key components of the intervention include: (1) getting along with cancer (introductory session targets illness perception), (2) practising mindful awareness (core session for mindfulness), (3) defining dyadic relationships and introducing self-compassion (core session for self-compassion), (4) promoting dyadic communication (maintenance session targets communication skills), (5) promoting dyadic coping (maintenance session targets coping skills), and (6) a summary session reviewing the rewards and challenges of dyadic adaptation named embracing the future.
The dyadic Mindfulness Self-Compassion intervention developed in this study consists of six weekly sessions. The key components of the intervention include: (1) getting along with cancer (introductory session targets illness perception), (2) practising mindful awareness (core session for mindfulness), (3) defining dyadic relationships and introducing self-compassion (core session for self-compassion), (4) promoting dyadic communication (maintenance session targets communication skills), (5) promoting dyadic coping (maintenance session targets coping skills), and (6) a summary session reviewing the rewards and challenges of dyadic adaptation named embracing the future.
Conclusions An evidence-based, theory-driven, and culturally appropriate dyadic Mindfulness Self-Compassion intervention was developed for patients with lung cancer and their family caregivers. Future studies are warranted to pilot and evaluate the usability, feasibility, acceptability, satisfaction, and effectiveness of this complex intervention.
An evidence-based, theory-driven, and culturally appropriate dyadic Mindfulness Self-Compassion intervention was developed for patients with lung cancer and their family caregivers. Future studies are warranted to pilot and evaluate the usability, feasibility, acceptability, satisfaction, and effectiveness of this complex intervention.
Trial registration ClinicalTrial.gov NCT04795700.
ClinicalTrial.gov NCT04795700.
期刊：
European Journal of Oncology Nursing,2025年74:102782 ISSN：1462-3889
通讯作者：
So, WKW
作者机构：
[Xu, Binbin] Hunan Univ Chinese Med, Sch Nursing, Changsha, Hunan, Peoples R China.;[So, Winnie K. W.; Choi, Kai Chow; Xu, Binbin; So, WKW] Chinese Univ Hong Kong, Nethersole Sch Nursing, 7-F Esther Lee Bldg, Hong Kong, Peoples R China.
通讯机构：
[So, WKW ] C;Chinese Univ Hong Kong, Nethersole Sch Nursing, 7-F Esther Lee Bldg, Hong Kong, Peoples R China.
摘要：
Purpose To explore how regional economic levels moderate the relationships between cancer-related financial toxicity (FT) and its associated risk factors.
To explore how regional economic levels moderate the relationships between cancer-related financial toxicity (FT) and its associated risk factors.
Methods A secondary analysis was conducted using data from a cross-sectional survey of 1208 adult patients with cancer, conducted in six tertiary and six secondary hospitals across three Chinese provinces from February to October 2022. The interactions between the regional economic level-categorised as high- or low-/middle-income based on the gross domestic product per capita- and 13 previously identified risk factors for FT were examined via moderation analysis using the PROCESS macro for SPSS software.
A secondary analysis was conducted using data from a cross-sectional survey of 1208 adult patients with cancer, conducted in six tertiary and six secondary hospitals across three Chinese provinces from February to October 2022. The interactions between the regional economic level-categorised as high- or low-/middle-income based on the gross domestic product per capita- and 13 previously identified risk factors for FT were examined via moderation analysis using the PROCESS macro for SPSS software.
Results Regional economic level moderated the impacts of both patients' and family carers’ negative work changes due to cancer and the hospital level on FT (all p-values for interaction effect <0.05). Job changes had more severe effects on FT in high-income regions (patients: B = −2.07, standard error [SE] = 0.67, p = 0.002; carers: B = −1.58, SE = 0.66, p = 0.017), while treatment in tertiary hospitals had a stronger negative impact on FT in low-/middle-income regions (B = 1.81, SE = 0.87, p = 0.037).
Regional economic level moderated the impacts of both patients' and family carers’ negative work changes due to cancer and the hospital level on FT (all p-values for interaction effect <0.05). Job changes had more severe effects on FT in high-income regions (patients: B = −2.07, standard error [SE] = 0.67, p = 0.002; carers: B = −1.58, SE = 0.66, p = 0.017), while treatment in tertiary hospitals had a stronger negative impact on FT in low-/middle-income regions (B = 1.81, SE = 0.87, p = 0.037).
Conclusions These findings highlight the need for region-specific FT mitigation strategies. In high-income regions, more attention could be paid to managing the adverse work-related effects of cancer on patients and their families. In low-/middle-income regions, increased awareness and management of cancer-related FT in tertiary hospitals is needed. Future research should explore other risk factors associated with FT that may be moderated by regional economic levels.
These findings highlight the need for region-specific FT mitigation strategies. In high-income regions, more attention could be paid to managing the adverse work-related effects of cancer on patients and their families. In low-/middle-income regions, increased awareness and management of cancer-related FT in tertiary hospitals is needed. Future research should explore other risk factors associated with FT that may be moderated by regional economic levels.
