Objective: To develop and validate a tool for hierarchical nursing grading in hemodialysis patients, thereby providing a standardized instrument for clinical nursing practice. Methods: A preliminary tool was constructed through literature review, qualitative interviews, and a Delphi expert consultation. Later 335 patients admitted to a tertiary grade A hospital hemodialysis center from May to June 2025 were conveniently selected as samples for the validation study. In order to finalize the tool, we conducted item analysis, inter-rater reliability testing, and compared the grading results obtained using the tool with the results analyzed subjectively by nurses. Results: The final tool comprised primary assessment (15 items) and instant assessment (11 items). Substantial agreement was observed between the results obtained by the tool and clinical nurses subjectively with a weighted Kappa of 0.617. Cross-tabulation analysis showed that compared with the subjective grading, patients with a higher score according to the tool often tend to have objective clinical risk indicators. Inter-rater reliability testing showed a Kendall's W of 0.817 (P<0.001). Conclusion: The assessment tool demonstrates good reliability and validity, providing scientific basis for the precise stratification and graded nursing of hemodialysis patients.

This review highlights the major applications of Artificial Intelligence during the hemodialysis process, including intradialytic hemodynamic monitoring and risk prediction, prescription optimization, and multi-source data-driven volume management in hemodialysis, dry weight adjustment and intelligent assessment of dialysis adequacy. It further outlines the potential of Artificial Intelligence technologies to enhance monitoring accuracy, support clinical decision-making, and facilitate individualized patient management. Besides, key challenges, such as data standardization, model interpretability, and integration into clinical workflows, are also discussed.

Objective: To develop a nursing operational checklist (hereinafter referred to as the checklist) for blood purification therapy via central venous catheter, and analyze its preliminary application effects, providing a reference tool for quality control of this procedure in clinical practice. Methods: We systematically reviewed government and association websites, guideline databases, and other relevant sources to extract high-quality evidence. A preliminary version of the checklist was drafted, and later 16 experts were invited to participate in a two-round Delphi consultation. The checklist was refined based on expert feedback to form the final version, which was then pilot-tested in eight nursing units of a tertiary grade A hospital where the procedure was performed. Results: Two rounds of consultation were completed, with expert participation rates of 100.00% and 93.75%, and authority coefficients of 0.837 and 0.835, respectively. The Kendall's W values were 0.089 and 0.109 for the first round, and 0.165 and 0.197 for the second round, all demonstrating statistically significant differences (P<0.05). The final checklist comprised 4 dimensions including 37 items. Compared with before quality control, preliminary application of the checklist as a quality control and scoring tool showed significant improvement in nursing procedure scores during and after quality control (P<0.05). Conclusion: The checklist comprehensively covers critical and essential elements, demonstrating scientific rigor, reliability, and practicality. It serves as a valuable reference for standardizing and homogenizing clinical nursing practices and implementing standardized quality management.

Objective: To investigate the health status of Maintenance Hemodialysis (MHD) patients and analyze its influencing factors, so as to provide evidence for developing targeted and comprehensive intervention programs. Methods: A convenience sampling method was used to include 469 MHD patients from the blood purification centers of five tertiary hospitals in Beijing from May 2024 to December 2024. The EuroQol Five-Dimension Three-Level (EQ-5D-3L) Scale was used to collect patients' sociodemographic, clinical, and laboratory data to assess their health status. Then univariate analysis, multiple linear regression, and Logistic regression were used to analyze the influencing factors. Results: The mean EQ-5D-3L utility value for MHD patients was 0.93±0.14. Multivariate analysis showed that advanced age, high Charlson Comorbidity Index score, and severe muscle weakness symptoms were independent risk factors for patients' health status (P<0.05). Conversely, moderate-to-high physical activity level, good nutrition, combination therapy modes like hemodialysis/hemodialysis+hemoperfusion or hemodialysis/hemodialysis+hemoperfusion/hemodiafiltration, and serum potassium levels within the high-normal range were identified as protective factors (P<0.05). Conclusion: The health status of MHD patients is influenced by multiple factors including age, nutrition, physical activity, and symptom burden.

Objective: To analyze the influencing factors for Autologous arteriovenous Fistula (AVF) dysfunction in Maintenance Hemodialysis (MHD) patients, and to provide evidence for formulating individualized AVF protection strategies. Methods: A prospective cohort study was adopted, MHD patients with AVF as the vascular access were recruited from 4 hospitals in Beijing from May 2023 and January 2024. We collected data, including patients' demographic characteristics, comorbidities, dialysis-related parameters, laboratory indices, and AVF assessment results from the beginning to October 2025 when the follow-up ended. Univariate analysis and multivariate Cox proportional hazards model were used to identify influencing factors for AVF function. Results: A total of 231 patients were enrolled, with a mean follow-up of 21.05±7.72 months. By October 2025, apart from the 31 patients being lost to follow-up, 40 patients developed AVF dysfunction. Multivariate Cox proportional hazards regression analysis showed that longer dialysis vintage (HR=0.850, P=0.005), use of high-flux dialyzers (HR=0.329, P=0.049), higher total cholesterol level (HR=0.663, P=0.047), and higher palpation score (HR=0.567, P=0.006) were protective factors against AVF dysfunction. As to risk factors, there were not newly created AVF (HR=4.970, P=0.003) and a history of AVF intervention (HR=2.545, P=0.012). Kaplan-Meier survival curves demonstrated a significant negative correlation between the palpation score and AVF patency rate (Log Rank χ2=105.534, P<0.001), with a cut-off value of 3 to effectively distinguish high-risk patients from low-risk patients. Conclusion: Dialysis vintage, type of dialyzers, number of AVF creations, history of AVF intervention, total cholesterol level, and palpation score were factors influencing AVF function in MHD patients. Moreover, the palpation scoring system may serve as a convenient bedside predictive tool, providing evidence for early clinical intervention and individualized management.

Objective: To explore the coping experiences of parents of preterm infants undergoing home oxygen therapy, aiming to provide a reference for the development of related intervention strategies. Methods: A descriptive qualitative research method was employed, with semi-structured interviews conducted from February to April 2025 with 15 parents of premature infants requiring home oxygen therapy from a tertiary grade A hospital's neonatal intensive care unit in Jinan. Directed content analysis was used for summarizing and extracting themes. Results: Three themes were identified: understanding home oxygen therapy; challenges and adjustments in managing home oxygen therapy; interpretation of the meaning of home oxygen therapy. Conclusion: Effective coping resources aid parents of premature infants in facing multiple challenges associated with home oxygen therapy. Healthcare professionals should enhance education on oxygen therapy-related knowledge to help parents establish accurate cognition, explore positive coping resources, so as to improve the quality and safety of home oxygen therapy.

Objective: To construct and apply an exergame intervention program, providing a reference for clinical psychological nursing and rehabilitation of adolescents with depression. Methods: Based on the behavioral activation theory, the exergame intervention program was developed through a literature review, semi-structured interviews, and the Delphi expert consultation. From October 2024 to February 2025, a convenience sample of 72 adolescents with depression was recruited from a tertiary grade A psychiatric hospital in Guangzhou and randomly assigned to either an intervention group or a control group, with 36 cases in each group. The control group received conventional treatment and nursing, while the intervention group received exergame intervention program on the basis of the control group. The effectiveness of the intervention was assessed using the Behavioral Activation for Depression Scale Short Form (BADS-SF), Self-Efficacy for Exercise Scale (SEE) and Hamilton Depression Scale-17 Items (HAMD-17) before and after the intervention. Results: The final intervention program consisted of 9 themes and 42 measures. After 3 weeks of intervention, the BADS-SF scores, behavioral activation dimension scores and SEE scores in the intervention group [32.83±6.54, 23.72±5.64, 37.00(31.25, 50.75)] were significantly higher than those in the control group [25.81±5.72, 18.06±6.13, 24.50(15.75, 41.75)] (P<0.05). Conclusion: The intervention program of exergame based on behavioral activation theory has a positive effect on promoting the behavioral activation level and enhancing the exercise self-efficacy of adolescents with depression, which can provide a reference for clinical psychological care of this population.

Objective: To identify self-management patterns of pain in patients with Knee Osteoarthritis (KOA) , and to provide evidence for targeted self-management strategies. Methods: A stratified multi-stage random cluster sampling method was adopted to conduct a cross-sectional survey among 1738 middle-aged and elderly people in 2 cities of Hunan province from February 15, 2020 to May 31, 2020. The Knee Discomfort Self-management Behavior Self-Rating Scale were used to conduct a cross-sectional survey and potential profile analysis was conducted on the results. Results: The self-management behaviors for pain were classified into four latent categories, including "Conventional Self-Management Pattern" (22.8%), "High Self-Management-High Symptom Anxiety Pattern" (10.9%), "Low Self-Management-Low Symptom Anxiety Pattern" (31.4%), and "Professional Self-Management Pattern" (35.0%). Significant differences existed across categories in BMI, ethnicity, educational attainment, monthly per capita income, number of chronic conditions, frequency and severity of pain and discomfort symptoms (all P<0.05). Conclusion: KOA patients' self-management behaviors for pain can be categorized into four latent groups. Tailored self-management strategies should be developed based on patients' socioeconomic status, disease characteristics and whether they are overweight, incorporating both direct and indirect experiential learning.

Objective: To develop a psychiatric nursing grading assessment scale, thereby providing a scientific and effective tool for rapidly screening psychiatric patients at risk and implementing differentiated levels of nursing care. Methods: Based on the three-dimensional nursing model, a preliminary version of the scale was developed through literature review, qualitative interviews, and expert consultation. Using convenience sampling, 314 inpatients from four tertiary grade A psychiatric hospitals in Beijing, Guangzhou, Nanjing, and Xiamen were selected from January to March 2025. Item analysis was conducted, grading criteria were established, and the scale's reliability and validity were tested. Results: The psychiatric nursing grading assessment scale consists of 6 items (aggressive behavior, suicidal and self-injurious behavior, consciousness status, psychiatric symptoms, emotional state, and activities of daily living) and 30 specific scoring items. Exploratory factor analysis extracted three common factors with eigenvalues >1, accounting for a cumulative variance contribution rate of 73.379%. The scale's Cronbach's α coefficient was 0.765, and Kendall's W coefficient was 0.866 (P<0.05). Conclusion: The psychiatric nursing grading assessment scale demonstrates good reliability and validity and can be used for nursing care classification in psychiatric inpatients.

Objective: To develop an intelligent Q&A system for day surgery patients based on the WeChat official account and evaluate its effectiveness, aiming to address the issues of low efficiency and lack of personalization in traditional health education models. Methods: The perioperative health education pathway for day surgery was outlined and analyzed to develop the intelligent Q&A system based on the LangChain framework integrated with the WeChat official account platform. A historical-control study was adopted to compare the response time, patients' readiness for discharge, and postoperative recovery quality before and after the application of the system. The answer accuracy of the system and users' satisfaction were also evaluated. Results: After the application of the system, the average response time decreased from (600.25±100.13) seconds to (7.58±0.37) seconds (P<0.001), with an answer accuracy rate of 97.5%. Patients' readiness for discharge scores improved from 90.77±13.05 to 101.77±11.07 (P<0.05), and postoperative recovery quality scores increased from 102.13±6.21 to 127.39±5.17 (P<0.05). The user satisfaction survey showed the satisfaction rate reached 92.3%. Conclusion: The WeChat official account-based intelligent Q&A system can provide efficient and accurate health guidance for day surgery patients, helping to improve their health outcomes, while offering a good user experience and demonstrating certain promotional value.

Objective: To identify the developmental trajectories of frailty in elderly postoperative colorectal cancer patients and analyze the influencing factors, aiming to provide a basis for the development of interventions. Methods: Convenience sampling was employed to select 268 elderly colorectal cancer patients undergoing radical resection surgery at a tertiary grade A hospital's gastrointestinal surgery department in Sichuan province from February to July, 2024. Patients' frailty level were assessed at 1 day before discharge, 1 month post-surgery, 3 months post-surgery, and 6 months post-surgery, respectively. The Latent Class Growth Model was constructed to identify the trajectory categories, with unordered multinomial Logistic regression analysis used to examine the influencing factors. Results: A total of 231 elderly patients with colorectal cancer completed four surveys. Three distinct progression trajectories were identified: "high-level slow ascent group" (22.1%), "moderate-level fluctuation group" (61.0%), and "low-level sustained ascent group" (16.9%). Regression analysis results revealed that age, gender, marital status, hospitalization costs, primary tumor stage, stoma, self-reported aging scores, and nutritional risk screening scores were significant predictors of frailty trajectories (P<0.05). Conclusion: Three distinct frailty trajectories exist in elderly postoperative colorectal cancer patients. Medical professionals are supposed to utilize these influencing factors to guide precision intervention strategies for frailty management.

Objective: To analyze the current status of apathy and its influencing factors among community-dwelling older adults, and to explore feasible pathways for improving apathy. Methods: From September to December 2024, 408 community-dwelling older adults in Nanjing and Yancheng, were selected via convenience sampling. Data were collected using a general information questionnaire and the GDS-3A. Based on the health ecological model, independent variable were categorized into five levels: individual characteristics, behavioral characteristics, interpersonal networks, living and working conditions, and policy environment. A binary Logistic regression model was employed to identify factors influencing apathy among older adults. Results: Apathy was observed in 39.7% (n=162) of the older adults. Low memory level, low self-rated health, having more children, depression, absence of a spouse, and an urban residence were identified as risk factors for apathy. Conclusion: Given the high prevalence of apathy, targeted interventions across multiple levels are urgently needed to mitigate risks. Comprehensive strategies addressing individual, behavioral, social, environmental, and policy-related factors should be implemented to improve outcomes for community-dwelling older adults.

Objective: To explore the potential categories and influencing factors of kinesiophobia trajectory in elderly patients with Chronic Heart Failure to provide basis for targeted intervention. Methods: A convenience sampling method was used to investigate 248 elderly hospitalized patients with Chronic Heart Failure admitted to a tertiary grade A hospital in Jinan city, China, from May 2023 to May 2024, and assess the level of patients' kinesiophobia at discharge, 1 month, 3 months and 6 months after discharge. Then the latent category growth model was used to identify the potential categories of kinesiophobia trajectory, and Logistic regression was used to analyze the influencing factors of different trajectories. Results: Kinesiophobia trajectories was divided into three categories, namely, low kinesiophobia-rapid remission group (27.5%), medium kinesiophobia-slow remission group (47.1%), high kinesiophobia-unstable fluctuation group (25.4%). Educational level, place of residence, course of disease, left ventricular ejection fraction, Charlson Comorbidity Index, heart failure symptoms, type D personality and exercise self-efficacy were factors influencing the trajectory of kinesiophobia in elderly patients with Chronic Heart Failure (P<0.05). Conclusion: There is heterogeneity in the kinesiophobia trajectories of elderly patients with Chronic Heart Failure, therefore, healthcare professionals can develop targeted interventions according to the influencing factors of the trajectory categories in order to reduce the level of patients' kinesiophobia.

With the continuous intensification of population aging in China, elderly care demands have become increasingly personalized and dynamic, presenting enduring challenges to the elderly care service sector and the professional workforce. Based on the health status and self-care ability of the elderly, this study establishes a three-tiered elderly care demand framework, which specifically covers daily support, health care, and specialized nursing. Subsequently, this paper proposes a data-driven modern elderly care service system that spans from "proactive prevention" to "functional maintenance" and finally to "disease management", with the goal of promoting the specialization, precision, and intelligent development of the elderly care service system. To address the structural mismatch between tiered care demands and the capabilities of the existing workforce, the paper advocates a dual-track workforce supply mechanism that integrates talent cultivation and role transformation, aiming to comprehensively enhance the professional competency of the elderly care workforce.

Objective: To explore the development trajectory and influencing factors of postoperative kinesiophobia in elderly patients with Osteoporotic Hip Fracture (OHF), aiming to provide references for psychological care in such patients. Methods: A total of 241 elderly patients with OHF were recruited in a tertiary grade A hospital in Nanchang from January 2022 to November 2024 through convenience sampling. The Tampa Scale of Kinesiophobia was used to assess the kinesiophobia levels of patients at 1 day, 1 month, 3 months, and 6 months after treatment. The optimal number of trajectories was analyzed and named through the latent growth mixture model. Unordered multinomial Logistic regression analysis was employed to explore the influencing factors of development trajectories. Results: The kinesiophobia scores of patients at 1 day, 1 month, 3 months, and 6 months after treatment were 40.16±5.91, 38.91±6.30, 36.65±6.46, and 34.75±7.05, respectively. The development of kinesophobia could be categorized into four trajectories: no kinesiophobia-maintained (28.6%), high kinesiophobia-improved (24.1%), moderate kinesiophobia-maintained (20.7%), and moderate kinesiophobia-overcomed (26.6%). Educational level, working status, postoperative complications, other concurrent chronic diseases, anxiety, depression, pain intensity, self-efficacy, and social support level were all the independent influencing factors for the differences in the development trajectory of postoperative kinesiophobia (P<0.05). Conclusion: The development of postoperative kinesiophobia in elderly patients with OHF shows group heterogeneity. Medical staff should formulate targeted nursing measures to address the influencing factors of each kinesiophobia development trajectory.

Objective: To explore the potential categories and characteristics of nurses' perceived high performance work system, and explore the influencing factors of different categories, providing a basis for formulating precise management strategies. Methods: A total of 4037 nurses from 11 hospitals in Anhui province were selected by a convenience sampling method from June to July 2024. The General Informance Questionnaire, the High Performance Work System Scale, the Organizational Support Scale were used to investigate. Latent profile analysis was used to analyze the perception of nurses' about high performance work system, and multiple Logistic regression was used to analyze the influencing factors of different categories. Results: The perceived high performance system score was 69.96±10.10. Nurses' perceived high performance work system could be divided into three potential profiles: germination type (17.04%), growth type (49.79%), and mature type (33.17%). Logistic regression analysis showed that educational background, professional title, position, organizational support score were the influencing factors of nurses' perception of high performance work system (all P<0.05). Conclusion: The nurses' perceived high performance work system is in the upper-middle level, and there is heterogeneity. Nursing managers should support and supervise nurses according to the characteristics and influencing factors of different categories to improve their work performance.

Objective: To examine the mediating effect of change fatigue between perceived organizational support and work engagement among nurses, in order to provide strategies for alleviating change fatigue and enhancing work engagement in clinical practice. Methods: A cross-sectional study was conducted in April 2025. The convenience sampling method was used to recruit 292 nurses from a tertiary grade A general hospital in Shandong province. Data were collected using the general information questionnaire, the Perceived Organizational Support Scale, the Change Fatigue Scale, and the Utrecht Work Engagement Scale. The structural equation model was constructed using AMOS 24.0 software. Results: The scores for perceived organizational support, change fatigue, and work engagement among nurses were 44.00 (35.00, 52.00), 22.73±8.25, and 31.30±11.75, respectively. Perceived organizational support was negatively correlated with change fatigue (r=-0.452, P<0.05) and positively correlated with work engagement (r=0.597, P<0.05). Change fatigue was negatively correlated with work engagement (r=-0.691, P<0.05). The analysis demonstrated that change fatigue partially mediated the relationship between perceived organizational support and work engagement, with an indirect effect of 0.229 (95%CI: 0.192-0.390) (P<0.05), accounting for 37.79% of the total effects. Conclusion: Change fatigue serves as a mediator between perceived organizational support and work engagement among nurses. Therefore, strengthening perceived organizational support and alleviating change fatigue are effective strategies for enhancing nurses' work engagement.

Objective: To explore the heterogeneity in work engagement among outpatient nurses in tertiary grade A general hospitals and analyze its influencing factors, thereby providing a reference for developing targeted interventions. Methods: Using convenience sampling method, 542 outpatient nurses from seven tertiary grade A general hospitals in Beijing were surveyed in November 2024. Data were collected using the Utrecht Work Engagement Scale, and the Practice Environment Scale of the Nursing Work Index. Latent profile analysis was employed to identify distinct subgroups of work engagement. Multivariate Logistic regression was used to analyze the factors influencing the different latent profiles. Results: The average work engagement score among outpatient nurses was 37.56±11.14. Three distinct latent classes was revealed: the "low engagement-burnout" profile (9.23%), the "moderate engagement-vigorous" profile (43.17%), and the "high engagement-dedicated" profile (47.60%). Multivariate Logistic regression analysis indicated that average monthly income, type of employment, and the practice environment were influencing factors for work engagement profiles (P<0.05). Conclusion: Work engagement among outpatient nurses in tertiary grade A general hospitals is at a medium-high level overall but exhibits significant heterogeneity. Nursing administrators should develop targeted, group-specific interventions based on the distinct profiles of work engagement and their key influencing factors to enhance nurse engagement and improve the quality of service.

Objective: To analyze the application effect of Healthcare Failure Mode and Effect Analysis (HFMEA) in the management of high-value medical consumables in the interventional operating room, to provide a reference for medical institutions in the implementation of intelligent management of high-value medical consumables. Methods: An HFMEA working group was established on May 2023 to select the topic, map the consumables management process, identify failure modes in consumables management, analyze and confirm root causes, use a decision tree to determine improvement items, and formulate and implement action measures. Results: After the implementation of HFMEA, the pre-operative supply preparation time for emergency interventional surgeries was shorter (P<0.05). The completeness of pre-operative supply preparation improved, rising from 99.73% to 99.96% (P<0.05). The rate of abnormalities in high-value supply management decreased from 1.41% to 0.33% (P<0.05). The communication among medical staff regarding supplies and the unpacking process became more standardized, increased from 46.67% to 90.32% (P<0.05). The overall satisfaction of nurses increased, rising from 88.7% to 97.8% (P<0.05). Conclusion: The application of HFMEA to manage the high-value medical consumables in interventional operating rooms can effectively improve the quality of consumables management, and enhance the nursing quality.

Objective: To develop and evaluate a PRECEDE-PROCEED model-based self-management program for liver transplant recipients to improve their self-management and quality of life. Methods: The program was developed using the PRECEDE-PROCEED model, literature review, and qualitative interviews, then finalized through two rounds of Delphi consultation. A total of 73 patients from a tertiary grade A hospital in Qingdao were enrolled. Those transplanted from June to November 2023 received standard care (control group). Those transplanted from December 2023 to May 2024 received the intervention. Outcomes (self-management, quality of life, medication adherence, and unplanned readmissions) were assessed at discharge, 3 months, and 6 months. Results: Response rates of two rounds consultation were 84.21% and 100.00%. Kendall's W were 0.358 (P<0.001) and 0.368 (P<0.001), showing strong consensus. The final program included three domains, 9 themes, and 27 measures. Significant group-by-time interactions were found for self-management, adherence, and quality of life (all P<0.05). Unplanned readmissions were lower in the intervention group (P<0.05). Conclusion: The PRECEDE-PROCEED model-based program improves self-management, quality of life, and reduces readmissions in liver transplant recipients.

Objective: To develop a whole-process blood glucose management protocol for patients undergoing Continuous Subcutaneous Insulin Infusion (CSII) therapy in non-endocrinology departments based on in-hospital grid management and to explore its effects, so as to provide a reference for improving patients' blood glucose management. Methods: A quasi-experimental study design was adopted. The convenience sampling was used to recruit 200 patients receiving CSII therapy in non-endocrinology departments from a tertiary grade B hospital in Dongying. A total of 100 patients treated with CSII from January to June 2024 were assigned to the control group, receiving routine blood glucose management; another 100 patients treated with CSII from July to December 2024 were assigned to the intervention group, receiving whole-process blood glucose management based on in-hospital grid management. The average time to blood glucose control during CSII therapy, incidence of hypoglycemia, the Glycated Hemoglobin A1c (HbA1c) control rate 3 months after discharge, the outpatient revisit rate, and the patient satisfaction were compared between the two groups. Results: The average time to blood glucose control during CSII treatment for patients in the intervention group was 3.62±0.96 days, while that of the control group was 4.74±1.26 days, the incidence of in-hospital and out-of-hospital hypoglycemia for patients in the intervention group were both lower than those of the control group, the HbA1c control rate 3 months after discharge, the outpatient revisit rate, and the patient satisfaction for patients in the intervention group were all higher than those of the control group, all differences were statistically significant (P<0.05). Conclusion: Whole-process blood glucose management based on in-hospital grid management can improve blood glucose control indicators, reduce the risk of hypoglycemia, and increase the outpatient revisit rate and patient satisfaction among patients undergoing CSII therapy in non-endocrinology departments.

Objective: To develop scientific management strategies for pulmonary rehabilitation management in burn patients with inhalation injuries, aiming to provide a reference for standardizing their pulmonary rehabilitation management practices. Methods: The integrated Promoting Action on Research Implementation in Health Services framework was used as a guide and 17 pieces of evidence on pulmonary rehabilitation management for inhalation injury obtained from a previous study were included. Then, review indicators were developed, review methods were clarified, and analyses of factors affecting change were carried out on indicators with an implementation rate lower than 60.0% in terms of factors related to change, factors related to the recipients of change, and factors related to the organizational environment on the basis of expert interviews. Change strategies were formulated based on these analyses. Results: A total of 35 review indicators were formulated, with 19 indicators having an implementation rate of less than 60.0%. The obstacles included three aspects: failure to develop a pulmonary rehabilitation assessment process in accordance with the evidence in the change-related factors; the lack of knowledge and skills in pulmonary rehabilitation management among healthcare workers in the change-receiver-related factors; and the lack of pulmonary rehabilitation equipment in the organizational environment-related factors. Facilitating factors covered management support, high multidisciplinary teamwork motivation, and good hospital information system development capabilities. In addition, specific change strategies such as the formation of multidisciplinary teams and the construction of workflows were clarified. Conclusion: There is still a large gap between clinical practice and evidence in the management of pulmonary rehabilitation in burn patients with inhalation injuries. Healthcare professionals should make full use of facilitators and work to overcome barriers for effective application of the evidence.

Objective: To conduct clinical transformation of the evidence on the prevention and management of Post-Traumatic Stress Disorder (PTSD) in children discharged from Pediatric Intensive Care Unit (PICU), and evaluate its application effects, so as to provide a reference for improving the psychological outcomes of children. Methods: Guided by the Stetler Model of Research Utilization, a systematic literature review on pediatric post-ICU PTSD management was conducted. Evidence was synthesized and integrated with expert opinions and stakeholder feedback to develop tailored clinical implementation strategies. The PICU in a tertiary hospital in Jilin province was selected as the research site from April 1st to October 31st, 2024. Nurse compliance with PTSD prevention measures before and after evidence-based practice and the incidence of PTSD at 1, 3, 6, and 12 months after discharge of children were compared. Results: Nurse compliance with preventive measures was improved after the practice program (P<0.05). The incidence of PTSD in children was decreased from 22.0% to 9.6% after discharge (P<0.05).Conclusion: The evidence-based implementation strategy for preventing and management of PTSD in children discharged from PICU based on the Stetler model can effectively increase adherence to preventive measures, reduce the incidence of PTSD, and improve the psychological outcomes of children.

Objective: To develop and evaluate a disease management program for elderly hypertensive patients in rural areas, providing a reference for grassroots hypertension management practices. Methods: Based on the health ecology theory, a disease management program for elderly hypertensive patients in rural areas was constructed through literature analysis, semi-structured interviews, and expert consultation. In November 2023, four administrative villages in a county of Zhuzhou were selected by cluster sampling and divided into an intervention group and a control group (2 villages in each group), with a total of 235 elderly hypertensive patients enrolled as the research subjects. The control group received routine chronic disease management, while the intervention group received the newly developed program. Blood pressure, medication adherence, self-management ability, and quality of life were compared between the two groups before the intervention and at 3 and 6 months post-intervention. Results: The trends in blood pressure values over time differed between the two groups of patients (P<0.05). At 6 months after the intervention, the systolic blood pressure of the intervention group was 142.56±9.23 mmHg and the diastolic blood pressure was 81.96±9.19 mmHg, both lower than the control group's 147.63±14.72 mmHg and 85.82±12.14 mmHg, respectively (P<0.05). The trends of medication compliance, quality of life, and self-management ability over time also differed between the two groups of patients (all P<0.05). Conclusion: The disease management program for rural elderly hypertensive patients, constructed based on the health ecology theory, effectively improves blood pressure control, medication adherence, quality of life and self-management ability of elderly hypertensive patients in rural areas.

Objective: To investigate the effects of comprehensive cardiac rehabilitation on cardiopulmonary function and quality of life in patients with Heart Failure with preserved Ejection Fraction (HFpEF). Methods: A total of 142 patients with HFpEF admitted to the Department of Cardiology of a tertiary hospital in Jilin province were conveniently selected from October 2023 to October 2024. The participants were randomly divided into a comprehensive rehabilitation group of 68 cases and a control group of 74 cases. Those in the control group received only the conventional cardiac rehabilitation program, while those in the intervention group received a gradual and progressive cardiac rehabilitation program based on inspiratory muscle training, with both groups undergoing a 12-week intervention. Changes in inspiratory muscle strength, cardiopulmonary function were compared between the two groups before and after the intervention. Results: Sixty-five patients in each group completed the study. After the intervention, the maximum inspiratory pressure and peak inspiratory flow of the intervention group were (57.11±3.31) cmH2O and (3.87±1.14) L/s, respectively, which were significantly higher than those of the control group [(55.08±2.88) cmH2O and (2.91±1.27) L/s, P<0.05]. Additionally, the intervention group exhibited higher peak oxygen consumption and maximum ventilatory volume, as well as a lower Borg score, compared with the control group, with all differences being statistically significant (P<0.05). However, there was no statistically significant difference in the 6-minute walking distance between the two groups after the intervention (P>0.05). Conclusion: The integrated cardiac rehabilitation strategy based on inspiratory muscle training has significantly improved inspiratory muscle strength and endurance of patients with HFpEF, promoting the improvement of cardiopulmonary function and quality of life.

Objective: To comprehensively integrate and analyze the basic information, advantages, and disadvantages of family communication assessment tools for cancer patients, providing reference for clinical medical staff to screen communication problems in different cancer patients' families and develop and localize related tools. Methods: The domestic and foreign database were searched up to December 31, 2024 for the relevant literature on the development and sinicization of family communication assessment tools for cancer patients, and the effective information was extracted to form a standardized report. Results: A total of 22 articles were included, including 15 about the development of tools and 7 on cross-cultural adaptation, mainly involving family communication and spousal communication among cancer patients. Conclusion: The family communication assessment tools for cancer patients are trending toward more detailed evaluation content and multidimensional development, yet its overall theoretical support remains weak, with methodological quality and psychometric properties requiring further refinement. It is recommended that future development and Chinese adaptation of such tools integrate theoretical frameworks, diversify tool types, and advance tool optimization.

Decentralized Clinical Trials (DCTs) represent an innovative research model that is based on digital technologies for optimizing the design, execution, and management of clinical trials. This review introduces the concept, design, and implementation of DCTs. It also summarizes the specific applications of DCTs in nursing, including psychological interventions, chronic disease management, and symptom management. Furthermore, this review analyzes the current challenges and future implications of DCTs. By promoting the application of DCTs in nursing, it is expected to enhance nursing research efficiency, improve healthcare accessibility, and foster continuity in patient care interventions.

Psychological distress is a complex stress experience that not only causes emotional dysregulation in patients but also may trigger social dysfunction and even increase suicide risk. As an emerging technology, digital phenotyping can accurately capture patients' digital characteristics through multimodal data collection, and adopts machine learning and data mining technologies to quantitatively identify digital indicators of psychological distress, thereby providing new opportunities and challenges for the precise assessment and standardized management of patients' psychological distress. This article reviews the application mechanisms, current status, challenges, and implication of digital phenotyping in psychological distress, aiming to promote its application and development in the field of psychological distress nursing in China.

At present, the issue of employment suitability for undergraduate students majoring in nursing in private colleges and universities is becoming increasingly prominent. Against the backdrop of the rapid development of China's health industry and the transformation of the nursing sector, this article systematically analyzes the prominent problems in the cultivation of undergraduate nursing students in private colleges under the new emerging business forms, as well as the core opportunities and prominent challenges in their employment. It proposes targeted strategies from the aspects of broadening employment channels and expanding job demands, and deepening the teaching reform of nursing education, to provide references for the reform of undergraduate nursing education in private colleges and the career planning of students, and to help achieve a positive connection between the supply and demand of nursing talents.