New-generation information technologies, such as Artificial Intelligence, are profoundly transforming the healthcare field. In response to challenges including population aging, increasing disease burden, and evolving patient needs, Artificial Intelligence technology offers innovative approaches for advancing nursing models. Based on the core patient needs in both inpatient clinical care and post-discharge continuing care scenarios, this paper reviews new Artificial Intelligence technologies, products, and solutions in nursing, analyzes the main challenges currently faced by Artificial Intelligence in nursing application scenarios and discusses future development trends, aiming to provide insights for the informatization and intellectualization of nursing.

Day surgery has developed rapidly with the characteristics of "short hospital stay, fast turnover, and high coordination", which has put forward higher requirements for the standardization and coordination of nursing management throughout the entire process. As Artificial Intelligence technology continues to expand and find applications in the healthcare sector, it offers new avenues for optimizing medical service processes and enhancing management efficiency. This article systematically reviews the current application status of Artificial Intelligence in the pre-hospital, in-hospital and post-hospital full-process management of day surgery patients, and looks forward to the future development, with the aim of further promoting the deep integration of Artificial Intelligence and clinical nursing, and improving the intelligent management level of day surgery.

Objective: To examine the feasibility and effectiveness of an orthopedic Artificial Intelligence nursing follow-up system in the post-discharge management of surgical patients, to provide a reference for improving the efficiency of follow-up. Methods: Guided by the Interaction Model of Client Health Behavior, follow-up content was designed across four dimensions: health information, emotional support, decision control, and professional guidance. A dual-track mechanism integrating AI-driven automated follow-up and manual intervention was adopted to achieve closed-loop post-discharge management. Results: From December 1, 2024, to September 30, 2025, a total of 11,126 discharged patients in a tertiary grade A hospital in Beijing were included. The system successfully completed follow-up for 9214 cases (82.8%). Using cervical spine surgery as an example, among 3857 discharged patients, 3727 cases (96.6%) were successfully followed up. The system automatically generated 4982 alerts for abnormal findings, primarily related to pain and functional exercise. Conclusion: The Artificial Intelligence nursing follow-up system demonstrates high feasibility and practical value in the post-discharge management of orthopedic surgical patients. It effectively improves follow-up coverage and facilitates the early identification of post-discharge risks.

Objective: To construct a multi-modal Artificial Intelligence Standardized Patient (AISP) system for nursing education and to inform the intelligent transformation of nursing pedagogy. Methods: A multi-modal AISP system was developed based on the Nursing Process Theory and Constructivist Learning Theory, integrating natural language processing, speech recognition, and visual generation technologies. A total of 118 nursing undergraduate interns at a tertiary grade A hospital in Guangxi were selected as the research subjects to evaluate the system's effectiveness in enhancing clinical interviewing skills, medical record writing proficiency, and learning satisfaction. Results: Following AISP-based training, students' total clinical interviewing score significantly increased from 163.31±11.57 to 190.21±6.61 (P<0.001). Their medical record writing score also showed marked improvement, rising from 79.25±4.33 to 90.74±2.67 (P<0.001). Furthermore, student satisfaction significantly increased across all evaluated domains (P<0.05). Conclusion: The developed multi-modal AISP system effectively improves nursing students' core clinical competencies and learning satisfaction. It presents a feasible and promising paradigm for driving intelligent innovation in nursing education.

Objective: To explore the latent profiles of pain self-efficacy in patients with gout and to analyze its relationship with personal mastery, so as to provide a reference for the development of a pain self-efficacy intervention program for patients. Methods: From September to December 2023, 234 gout patients in Shandong province were conveniently selected as the research subjects. A survey was administered using the General Information Questionnaire, the Pain Self-Efficacy Scale, and the Personal Mastery Scale. Then we analyzed and categorized pain self-efficacy, and determined the relationship between latent profiles of pain self-efficacy and personal mastery. Results: The pain self-efficacy of patients with gout could be categorized into three categories: low self-efficacy-low daily functioning type (29.91%), medium self-efficacy-balanced type (43.16%), and high self-efficacy type (26.92%). There were statistically significant differences between patients with different pain self-efficacy latent profiles in terms of age, education level, per capita monthly household income, place of residence, number of gout attacks in the past year, tophi, comorbidities and personal mastery (all P<0.05), and the personal mastery was an independent influencing factor of the latent profiles (P<0.05). Conclusion: Pain self-efficacy of patients with gout is heterogeneous. Therefore, targeted interventions should be taken to improve their personal mastery to improve their pain self-efficacy.

Objective: To construct a functional exercise intervention program for total hip arthroplasty patients based on Noddings' caring theory and conduct a preliminary validation, in order to provide a reference for clinical care practice. Methods: A functional exercise intervention program based on the Noddings' caring theory was developed through literature review and expert consultation. The total hip arthroplasty patients in a tertiary grade A hospital in Guangxi from November 2022 to March 2023 were included in the control group (n=50) and received routine care, while the intervention group (n=50) who were included from April to August 2023 received nursing intervention based on the Noddings' caring theory in addition to the routine care. The compliance of functional exercises and hip joint function at different time points, the time of the first postoperative ambulation, and the length of hospital stay were compared between the two groups. Results: On the day of discharge, 1 month, and 3 months post-operation, the functional exercise compliance scores of the intervention group (58.02±4.13, 50.86±4.72, and 40.68±3.15, respectively) were significantly higher than those of the control group (52.02±2.10, 44.06±2.65, and 36.70±1.64, respectively) (all P<0.05). The hip function scores of the intervention group (63.68±8.34, 79.28±7.36, and 92.34±3.56, respectively) were significantly higher than those of the control group (58.52±7.93, 69.90±8.82, and 84.48±8.81, respectively) at each corresponding time point (all P<0.05). The time to first ambulation was significantly earlier in the intervention group than in the control group, and the length of hospital stay was significantly shorter (P<0.05). Conclusion: The intervention program of functional exercises for patients undergoing total hip replacement based on Noddings' caring theory has been preliminarily applied and it has been confirmed to improve the compliance of patients with functional exercises and promote the recovery of hip joint function.

Objective: To explore the influencing factors and generating mechanisms of intravitreal injection adherence in patients with macular degeneration, so as to provide a theoretical basis for intervention studies to improve patients' adherence, visual outcomes and quality of life. Methods: Based on grounded theory, we interviewed 33 participants to collect data. Then a theoretical framework for the influencing mechanism of intravitreal administration adherence in patients with macular degeneration was established by means of open coding, spindle coding and selective coding. And data mining using the Apriori algorithm in SPSS Modeler was performed to further determine the relationships between the data. Results: Patients with macular degeneration receiving intravitreal injection were found to observe the logical behavioural process of "cause-phenomenon-situational conditions-intervention conditions-action/interaction-results". According to the results, patient-related factors directly influenced their injection compliance, with disease-and treatment-related factors as internal situational factors, and healthcare system and socio-economic factors as external situational factors that could regulate patient adherence. Besides, three pairs of strong rule-based correlates were derived through data mining. Conclusion: Improving patients' adherence to intravitreal injection requires more doctor-patient communication, enhanced health education by medical staff and adequate family support. By establishing a good family and social support environment, we can help patients overcome treatment barriers and improve their knowledge of and confidence in adherence to intravitreal injection therapy.

Objective: To develop the Negative Emotional and Behavior Response Scale for Unaccompanied Hospitalized Preschool Children (NEBRSUHPC) and test its validity and reliability, aiming to provide a valid tool for assessing the negative emotion of hospitalized children. Methods: Based on the ABC Theory of Emotion and child emotional psychology, a preliminary scale was designed through literature review, expert consultations and pilot surveys. From January to October 2024, a convenience sampling method was used to select 191 unaccompanied hospitalized children from Pediatric Intensive Care Unit of 2 tertiary grade A hospitals in Wuhan for investigation, and validity and reliability test were conducted. Results: NEBRSUHPC comprised a total of 22 items which could be categorized into four dimensions: fear and vigilance, sadness and withdrawal, anger and aggression, and emotional control and management. The Cronbach's α coefficient for the overall scale was 0.924. Exploratory factor analysis identified four common factors, accounting for a cumulative variance contribution rate of 76.448%. Conclusion: NEBRSUHPC has good reliability and validity and is suitable for assessing the negative emotional and behavior responses of children aged from 3 to 7 years.

Objective: To describe the family quality of life of children with Congenital Adrenal Hyperplasia (CAH) and explore the main influencing factors, so as to provide a reference for clinical targeted nursing. Methods: A total of 196 children with CAH and their parents were selected from May 2022 to December 2023 in the pediatric endocrinology department of a Grade-A hospital in Guangzhou. The survey was conducted using the Beach Center Family Quality of Life Scale, parental competence scale and perceived social support scale. Multiple linear regression analysis was used to identify the influencing factors of quality of life. Results: The total score of satisfaction with family quality of life was (95.07±14.12) points, and the scores of each dimension were (23.76±3.58) points also the highest score for family interaction, (14.66±2.78) points for emotional health, (23.31±3.73) points for parental care, (19.09±3.65) points for physical health and material welfare, and (14.26±3.20) points for support related to disability, which ranked the lowest in number. According to the results, the higher the educational attainment of parents, the higher their sense of competence in parenting, and the more social support they could receive with better family quality of life (P<0.05). Conclusion: The overall family quality of life for children with CAH needs improvement, especially the support related to disability, which obviously needs to be enhanced. Particular attention should be paid to families with parents of lower educational attainment. Enhancing their parenting self-efficacy and providing targeted support can serve as an important pathway to improve their family quality of life.

Objective: To analyze the heterogeneous trajectories of caregiving burden among primary caregivers of elderly Alzheimer Disease patients and explore influencing factors, to provide references for optimizing care management and formulating targeted intervention measures. Methods: A total of 222 caregivers from a tertiary grade A hospital in Zhejiang province selected by convenience sampling method were surveyed from January 2022 to January 2024 using standardized questionnaires on demographics, caregiver burden, anxiety, family resilience, and benefit finding. Follow-up assessments were conducted at 1, 3, 6, and 9 months after caregiving began. Latent class growth analysis was used to identify burden trajectories, Logistic regression was used to analyze influencing factors. Results: Of the participants, 198 completed all follow-ups. Three distinct burden trajectories were identified: slow growth (41.92%), rapid growth (35.35%), and stable burden (22.73%). Disease stages of patient, caregiver's age, anxiety, family resilience, and benefit finding were influencing factors of trajectories (P<0.05). Conclusion: Caregiving burden among Alzheimer Disease caregivers shows heterogeneous changes over time. Early identification and intervention can be conducted based on influencing factors.

Objective: To develop a five-dimension integrated home-based care service model for older adults, in order to provide a reference for enhancing the comprehensiveness and continuity of home care services. Methods: Using literature review and expert focus group guided by the integrated care theory, we developed a five-dimension integrated home-based care service model for older adults. The five dimensions included "patient-centered, community-based, institution-supported, information-linked, and family-partnered" components. This service model was implemented in 32 community health service institutions of Futian district, Shenzhen in June 2024. The effects of the model was evaluated by analyzing indicators including the number of established home-based healthcare units for older adults, health outcomes of older adults, and service satisfaction among older adults. Results: A total of 520 home-based healthcare units for older adults were established, completed and closed, among which hospice care-type units accounted for 1.5%. The average establishment duration of all home-based healthcare units was 58.5(13.0, 85.0) days. Among the participants, 49.6% of the older adults showed improvement or recovery, and 25.0% maintained stable conditions. Service satisfaction rate among older adults reached 100.0%. Conclusion: The home-based care service model for older adults based on the integrated care theory is feasible, enhances the establishment efficiency of home-based healthcare units, effectively improves health outcomes of older adults, and achieves high service satisfaction.

Objective: To develop a health management strategy under integrated medical and elderly care for older adults with Mild Cognitive Impairment (MCI), offering a basis for personalized management. Methods: According to Anderson's Behavioral Model, we retrieved and analysed literatures to form a draft of the strategy for MCI older adults. Two rounds of Delphi consultations were conducted with 19 experts from November 2023 to February 2024. Results: Totally 32 studies were included, with two rounds of expert questionnaires both achieving a response rate of 100%. Expert authority coefficients were 0.879 and 0.904, and Kendall coordination coefficients were 0.205 and 0.208 (P<0.001), respectively. The strategy consisted of 60 specific terms to be categorized into four modules: health assessment, education, intervention, and follow-up. Conclusion: The health management strategy has strong scientific validity and reliability, providing a foundation for personalized management of MCI older adults.

The reablement model, as an effective approach to resolving the tension between deep aging and insufficient long-term care resources, has been promoted and implemented in numerous countries. Its application reflects a context of shared philosophy but diverse implementation pathways. On the basis of reviewing the fundamental concept and development of reablement care, this paper examines and analyzes its practical applications across different countries, including target populations, intervention characteristics, goal setting, interdisciplinary team collaboration, policy support, and implementation outcomes. Finally, policy implications tailored to China's context are proposed, aiming to provide a theoretical foundation and practical guidance for constructing a long-term older people care system suited to the actual needs of the country.

Objective: To systematically review existing self-management assessment tools for patients with Coronary Heart Disease (CHD) both domestically and internationally, and to provide evidence-based support in selecting the most appropriate assessment instrument. Methods: Databases were searched to identify studies related to self-management assessment tools for CHD patients published from inception to March 31, 2025. The COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) criteria were applied to systematically evaluate the included studies. Results: A total of 18 self-management assessment tools for CHD patients were identified. The review revealed that none of the tools had been evaluated for key measurement properties such as cross-cultural validity/measurement equivalence or measurement error. The Self-Care of Coronary Heart Disease Inventory and its Turkish version were both classified as grade C instruments due to high-quality evidence indicating "inadequate" performance in certain measurement properties. The remaining 16 tools were rated as grade B, as there was no evidence supporting "adequate" content validity and internal consistency. Conclusion: Based on current evidence, the Self-Management Behavior Questionnaire for Young and Middle-Aged Myocardial Infarction Patients is recommended for use in young and middle-aged myocardial infarction patients, and the Coronary Heart Disease Self-Management Scale is recommended for general CHD patients. However, the measurement properties of these two tools still require further refinement.

Objective: To implement evidence-based strategies for preventing and rehabilitating radiation-induced trismus in Nasopharyngeal Carcinoma (NPC) patients into clinical practice and evaluate their effectiveness, to further standardizing the prevention and rehabilitation of radiation-induced trismus. Methods: Guided by the Evidence-Based Continuous Quality Improvement Model, this study was conducted from June 2023 to August 2024 following four stages: evidence retrieval, current practice assessment, evidence implementation, and post-implementation review. The study compared compliance rates with audit criteria, departmental organizational culture, nurses' Knowledge-Attitude-Practice (KAP) levels regarding trismus prevention/rehabilitation, and the incidence/severity of trismus before and after evidence implementation. Results: In 24 audit criteria, compliance rates for criteria with baseline compliance <60% significantly improved after two rounds of post-implementation audits (P<0.001). Organizational culture scores and nurses' KAP scores post-implementation were significantly higher than baseline, the incidence of trismus significantly decreased, and patients' trismus degree was significantly lower than that in baseline measurements (all P<0.05). Conclusion: The clinical implementation of evidence-based strategies effectively reduced trismus incidence and improved mouth-opening function in NPC patients after radiotherapy.

Objective: To apply the evidence for the prevention and management of Venous Thromboembolism (VTE) during the perinatal period into obstetric clinical practice and to evaluate its effects, to improve the standardized prevention rate of VTE among perinatal women. Methods: Following the evidence translation model of the Fudan University Center for Evidence-Based Nursing, strategies were formulated based on the current clinical situation. From July 2023 to July 2024, evidence-based practice was implemented among perinatal women in the obstetrics department according to the process of baseline audit, practice change, and re-audit of change effects after evidence application. Comparisons were made before and after the evidence-based practice regarding healthcare providers' theoretical knowledge scores on VTE prevention in perinatal women, the execution rate of audit indicators, the standardized prevention rate for perinatal VTE, and the Knowledge, Attitude, and Practice (KAP) scores of perinatal women regarding VTE. Results: After the evidence-based practice, healthcare providers' theoretical knowledge scores on VTE prevention improved from 62.72±12.12 to 93.18±5.60. Among the 12 audit indicators, the implementation rate of 10 has improved. The standardized prevention rate for perinatal VTE increased from 0 to 50.83%. The KAP scores of perinatal women regarding VTE all improved. All differences were statistically significant (P<0.05). Conclusion: By formulating a practical protocol based on evidence for the prevention and management of VTE in perinatal women, the clinical application can enhance perinatal women' awareness and standardized prevention rate of VTE, improve healthcare providers' compliance with the implementation of evidence.

Objective: To retrieve, evaluate, and synthesize high-quality evidence on rehabilitation exercise for adult Hematopoietic Stem Cell Transplantation (HSCT) recipients, so as to provide evidence for clinical practice. Methods: A comprehensive search was conducted across domestic and international guideline databases, professional society websites, and Chinese/English literature databases for studies related to rehabilitation exercise in adult HSCT recipients. The search period spanned from January 1, 2018 to October 30, 2025. Eligible literature was screened, quality-assessed, and data-extracted, followed by evidence synthesis and integration. Results: A total of 25 articles were included, comprising of 2 clinical guidelines, 3 expert consensus statements, 1 evidence summary, 9 systematic reviews, and 10 randomized controlled trials. Twenty-six pieces of evidence were summarized into 7 categories, including exercise assessment, management principles, modalities, intensity, settings, risk management, and health education. Conclusion: The evidence summaried in this study is relatively scientific and comprehensive, which can provide an evidence-based basis for management on rehabilitation exercise for HSCT patients.

This article focuses on the updated and revised contents in the North American Nursing Diagnosis Association International's nursing diagnoses: definitions and classification (2024-2026) (compared with the 2021-2023 edition), providing examples and interpretations from the perspectives of nursing diagnosis names, defining characteristics, clinical indicators, and related factors. It further explores the application of this revised edition in the field of nursing, integrating insights from nursing education and clinical practice in China. It provides assistance for Chinese nursing staff to keep abreast of the global development trends of nursing diagnoses and to study them in depth.

Objective: To develop and pilot an undergraduate nursing clinical teaching quality evaluation system, with the aim of enhancing the systematization and sustainability of clinical teaching quality management. Methods: Based on the enablers of the European Foundation for Quality Management (EFQM) Excellence Model and the Kirkpatrick's multi-level evaluation concept, a three-dimensional clinical teaching quality evaluation system with the structure of "Enablers-Teaching Process-Teaching Effect" was constructed by means of literature analysis, interviews, and Delphi consultation with 15 experts. From June 2023 to March 2024, the system was initially applied to 116 undergraduate nursing interns at a university-affiliated tertiary grade A hospital in Hainan province to assess its feasibility. Results: Pilot application results indicated that: in the enabler dimension, the participation rate in teaching objective setting reached 90.0%, and the coverage rate of resource coordination was 85.0%. In the teaching process dimension, the implementation rate of teaching plans decreased from 91.5% at the hospital level to 83.1% at the department level. In the teaching outcome dimension, the students' satisfaction score was 4.51±0.32; the passing rate of the Objective Structured Clinical Examination was 88.0%; the scores of nursing quality and medical record writing were 83.11±4.77 and 89.56±3.21, respectively. Conclusion: The constructed clinical teaching quality evaluation system for undergraduate nursing education has a rational structure and strong adaptability. It supports the dynamic monitoring and continuous improvement of teaching quality, and is worthy of promotion.

Objective: To investigate the current status of pain empathy among clinical anesthesia nurses and to analyze its influencing factors, in order to provide references for improving pain empathy ability in this population. Methods: From August to September 2023, a convenience sampling method was used to select anesthesia nurses from 32 hospitals across six regions of China, including North China, East China, and Central China. Data were collected using a general information questionnaire, the Empathy for Pain Scale, and the National Aeronautics and Space Administration Task Load Index (NASA-TLX). Multiple linear regression was used to analyze the influencing factors. Results: A total of 529 clinical anesthesia nurses participated in the survey. The total score for pain empathy was 2.28±0.75. Multiple linear regression analysis indicated that professional title, marital status, educational level, work position, personal history of pain, participation in pain empathy training, and task load were significant factors influencing the pain empathy ability of anesthesia nurses (all P<0.05). Conclusion: The pain empathy ability of anesthesia nurses is at a moderate level. Healthcare institutions should enhance pain empathy ability among anesthesia nurses through measures such as implementing systematic pain empathy training and optimizing human resource allocation to reduce task load, thereby improving the quality of perioperative pain management.

Objective: To analyze the status and category characteristics of evidence-informed decision-making competence among nurses in tertiary grade A hospitals, and explore its influencing factors, so as to provide a reference for improving nurses' evidence-informed decision-making competence. Methods: Using convenience sampling, a questionnaire survey was conducted on 1403 nurses from 5 tertiary grade A hospitals in Shandong province from March to April 2025. The General Information Questionnaire, the Evidence-Informed Decision-Making competence measure for nurses, the Reflective Practice Questionnaire and the Nursing Research Self-Efficacy Scale were used to investigate. Latent profile analysis was adopted to establish a latent category model, and unordered multinomial Logistic regression was used to identify the influencing factors of nurses' evidence-informed decision-making competence in different profile categories. Results: The score for nurses' evidence-informed decision-making competence was 112.77±17.12. Nurses' evidence-informed decision-making competence could be divided into 3 latent profiles: budding type (20.0%), growing type (52.2%), and integrated practice type (27.8%). Unordered multinomial Logistic regression analysis results showed that education level, years of service, number of academic lectures or conferences attended annually, reflective practice level and nursing research self-efficacy were the influencing factors of nurses' evidence-informed decision-making competence (all P<0.05). Conclusion: The evidence-informed decision-making competence of nurses is at moderately high level with heterogeneity. Nursing managers should intervene and support nurses based on the influencing factors of different latent profiles, so as to improve their evidence-informed decision-making competence.

Objective: Apply Virtual Reality technology in home-based rehabilitation training for patients with spinal cord injury and analyze its effects, to provide references for the rehabilitation of patients with spinal cord injury. Methods: Using the convenience sampling method, patients with spinal cord injury who were discharged from a tertiary grade A hospital in Beijing from May to August 2024 and received home-based rehabilitation were selected as the research subjects and randomly divided into the intervention group (n=20) and the control group (n=20). The control group was trained according to the home-based training program based on evidence; the intervention group received additional application of Virtual Reality technology on the basis of the control group. The trunk muscle function, depression status before and 6 weeks after the intervention, blood pressure, blood oxygen saturation, discomfort symptoms, and adverse events during training were compared between the two groups. Results: One patient in the intervention group dropped out during the intervention. After 6 weeks of intervention, the root mean square of electromyographic signals during maximum voluntary contraction of the erector spinae, rectus abdominis, and external oblique abdominis in the intervention group were higher than those in the control group (P<0.01); the depression scores of the intervention group were lower than those of the control group (P<0.01). During the training period, the blood pressure and blood oxygen saturation values of both groups fluctuated within 10%, and no discomfort symptoms or adverse events occurred during training. Conclusion: The home-based rehabilitation training model for spinal cord injury patients based on Virtual Reality technology can improve the rehabilitation effect of patients and has good safety.

Objective: To develop an evidence-based practice protocol for Home Oxygen Therapy (HOT) in premature infants and provide guidance for clinical nurses to support caregivers in implementing HOT for premature infants. Methods: A preliminary HOT protocol was formulated by integrating semi-structured interviews (to understand caregivers' experiences and needs) with evidence extraction via the "6S" evidence-based methodology (literature search and synthesis). The protocol was refined through two rounds of Delphi expert consultation to 10 neonatal healthcare experts, with items revised based on expert feedback. Results: The expert response rate was 100%, the expert authority coefficient was 0.93, the variation coefficients of items in the second round ranged from 0-0.16, and Kendall’s concordance coefficients were 0.173-0.209 (P<0.05). The mean scores for importance and feasibility of all items were 4.40-5.00. The final protocol comprised 4 first-level items (preparation, implementation, follow-up, and precautions for HOT), 14 second-level items, and 29 third-level items. Conclusion: The developed protocol is comprehensive, scientifically rigorous, and highly feasible, can provide systematic guidance for family care and healthcare education.

Objective: To develop and validate an Advance Care Planning (ACP) document for patients with advanced cancer, in order to provide a basis for healthcare professionals to implement ACP. Methods: From January to September 2024, an ACP document for advanced cancer patients was developed based on the Good Death framework utilizing a combination of literature review and an expert panel. From December 2024 to January 2025, Twenty-five advanced cancer patients were recruited by purposive sampling from a tertiary grade A hospital in Guangzhou to pilot and evaluate the ACP document. Results: The final ACP document included seven primary themes: introduction to ACP, informed consent, quality-of-life aspirations, medical care directives, life dignity directives and love and legacy agreements, and health assessment, as well as 33 secondary themes. The mean score of feasibility, applicability, satisfaction, and meaning were 4.91±0.32, 4.80±0.52, 4.75±0.66, and 4.93±0.63, respectively. Ninety-two percent of patients believed that the document was highly meaningful. Conclusion: This ACP document, based on the Good Death framework and Chinese cultural context, demonstrates scientific rigor and feasibility, and provides a reference for clinical healthcare professionals in implementing ACP practices.

Objective: To develop a decision-making assistant program for cardiac rehabilitation exercise in patients after Percut-aneous Coronary Intervention for Acute Myocardial Infarction (AMI) who are affected by kinesiophobia and to evaluate the effects of this program, in order to provide a reference for improving patients' compliance with cardiac rehabilitation exercise. Methods: Based on the Ottawa Decision Support Framework and the shared Decision Making Three-talk Model, a decision-making assistant program for cardiac rehabilitation exercise was developed. By convenience sampling, 70 AMI patients with Percutaneous Coronary Intervention (PCI) and kinesiophobia in the cardiology department of a tertiary grade A hospital in Guizhou province were recruited from December 2023 to September 2024. Participants were randomly assigned to the control group or the intervention group through the random number table. Patients in the control group received routine care, while patients in the intervention group received the cardiac rehabilitation exercise decision-making assistant program. Changes in kinesiophobia level, exercise compliance, and left ventricular ejection fraction of patients at admission, discharge, one month post-discharge, and three months post-discharge were compared. Results: There were significant differences in the temporal changes of kinesiophobia level and exercise compliance between the two groups. At discharge, 1 month and 3 months after discharge, the kinesiophobia level in the intervention group was lower than that in the control group, and the exercise compliance was higher than that in the control group, with statistically significant differences (all P<0.05). At 3 months after discharge, the left ventricular ejection fraction was 60.89±5.44 percent in the intervention group, which was higher than 56.23±8.67 percent in the control group, and the difference was statistically significant (P<0.05). Conclusion: The application of the decision-making assistant program for the cardiac rehabilitation exercise can reduce AMI-PCI patients' exercise phobia, improve exercise compliance, and enhance cardiac function.

Objective: To assess the application effects of an intelligent decision support system for perioperative pain management in orthopedic patients, provide a reference for improving the quality and efficiency of decision support. Methods: We developed a clinical decision support system based on a knowledge base for perioperative pain management in orthopedic patients. The system supported multidimensional pain assessment, pain early warning and identification, rule-based reasoning, and decision analysis. Totally 339 orthopedic inpatients in a tertiary grade A hospital in Nanjing from October to December 2022 were recruited as the control group, and 330 orthopedic inpatients from January to March 2024 were recruited as the experimental group. The control group received conventional pain care management, while the experimental group was managed with an intelligent decision support system for perioperative pain management in orthopedics. The first pain assessment rate, re-assessment rate of moderate to severe pain, timely pain management rate, incidence of moderate to severe pain, average time of first postoperative ambulation, satisfaction of nurses and patients, and average hospital stay were compared between the two groups. Results: The first pain assessment rate in the experimental group was 99.1%, and that in the control group was 85.3%, with no statistically significant difference between the two groups (P>0.05). The re-assessment rate of moderate to severe pain in the experimental group was 96.1%, and the timely pain management rate was 97.9%, which were higher than those in the control group. The incidence of moderate to severe pain in the experimental group was 22.1%, the average time of first postoperative ambulation was 22.79±1.26 hours, and the average hospital stay was 6.50±0.90 days, all of which were lower than those in the control group. The satisfaction scores of nurses and patients in the experimental group were higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: The intelligent decision support system for pain management effectively improves the closed-loop management quality of perioperative pain in orthopedic patients, enhances the work efficiency of nurses, reduces the incidence of moderate to severe pain in patients, enables early postoperative ambulation, and increases patient satisfaction.

Objective: To analyze the application status and implementation barriers of the 2013 Caprini Risk Assessment Model (Caprini RAM) in Venous Thromboembolism (VTE) prevention of surgical patients, in order to help the 2013 Caprini RAM be disseminated, implemented and maintained. Methods: A retrospective investigation was conducted on patients who underwent elective surgery and were discharged between June 2023 and March 2024 from five tertiary grade A hospitals in Guizhou province using the 2013 Caprini RAM, to evaluate its application status in surgical patients. From July to November 2024, primary nurses in charge of the wards of the retrospective study subjects were selected as qualitative research subjects. Semi-structured interviews were conducted to understand the barriers to the implementation of the 2013 Caprini RAM in surgical patients. Results: Among the 86,420 surgical patients, the 2013 Caprini RAM accounted for 36.21% of the total evaluated at the seven evaluation times, and the incidence of VTE was 38.98%. The incidence of VTE varied with the lack of evaluation at different time points. The insufficient cognition, training, applicability, and evaluation process were the obstacles to the implementation of the 2013 Caprini RAM in surgical patients. Conclusion: The application of the 2013 Caprini RAM in surgical patients is not yet mature. Its clinical promotion is constrained by multidimensional factors including cognitive level, training, model applicability, and the evaluation process.

Exercise snacks is a new exercise strategy characterized by intermittency, short duration, and medium and high intensity. It has shown significant application value in promoting physical activity, interrupting sedentary behavior, and enhancing physical function in patients with chronic diseases. This article introduced the related concepts, main types and unique advantages of exercise snacks, summarized the application forms and effects of exercise snacks in diabetes, obesity and other chronic disease groups, and put forward future research prospects for the challenges faced in the application process. It is hoped to provide a reference for the further application and development of the exercise snacks in patients with chronic diseases in China.

With the rapid development of genetics in the medical field, clinical nurses' genetics literacy plays a crucial role in improving the quality of nursing care and promoting precision medicine. This paper reviews the concept, instruments, current situation, influencing factors and interventions of clinical nurses' genetic literacy to provide theoretical references for improving the level of genetic literacy of clinical nurses in China and enhancing the content of nursing management training.