Background:Coping styles and psychological capital are both associated with the mental health of pregnant women. However, the relationships among psychological capital, coping styles, and prenatal depression in pregnant women have not yet received sufficient attention. This study examines how coping styles mediate the link between psychological capital and prenatal depression in pregnant women. Methods:A cross-sectional study was conducted from March 2024 to December 2024. Pregnant women (n = 769) were recruited from two hospitals in Guangdong Province, China. All participants completed the Positive PsyCap Questionnaire, the Simple Coping Style Questionnaire, and the Edinburgh Postnatal Depression Scale. Spearman correlation analysis was applied to explore the relationships among psychological capital, coping style, and prenatal depression and to evaluate the mediating role of coping style. Results:Prenatal depression was detected in 34.70% of participants. Both psychological capital and positive coping strategies were significantly negatively correlated with prenatal depression (r = -0.46, p < 0.001 and r = -0.26, p < 0.001, respectively). In contrast, a significant positive correlation was observed between negative coping strategies and prenatal depression (r = 0.18, p < 0.001). Psychological capital can directly affect prenatal depression, and coping style is the intermediary variable between psychological capital and depression, with a mediating effect of -0.51 and accounting for approximately 11.87% of the total effect of psychological capital on prenatal depression. Conclusion:Psychological capital can not only directly affect prenatal depression, but it can also alleviate it by increasing positive coping or suppressing negative coping. Healthcare professionals should pay attention to the mental health status of pregnant women, improve the level of psychological capital, and guide positive responses to improve prenatal depression.

BackgroundThe COVID-19 pandemic exposed structural vulnerabilities in the global health emergency workforce. Sustained monitoring of response competence dynamics is critical for maintaining health system resilience during protracted outbreaks. ObjectiveThis study aimed to investigate trends and structural transitions in nurses’ infectious disease emergency response competence during different phases of the COVID-19 pandemic. MethodsUsing the Healthcare Workers’ Infectious Disease Emergency Response Competence Questionnaire, 3 repeated cross-sectional surveys were conducted in February 2020, August 2021, and February 2023. The participants were matched in a 1:1:1 ratio by their demographic characteristics via propensity scores. Temporal trends were analyzed using ANOVA, and competence structure transitions were examined via network analysis. ResultsThree-wave analyses (n=2525 per wave) demonstrated a sustained decline in competence, from 4.05 (SD 0.63) in February 2020 to 3.81 (SD 0.66) in August 2021 and further to 3.70 (SD 0.66) in February 2023. All pairwise comparisons were statistically significant (all P<.001). Network analysis identified critical structural shifts in competence architecture: in February 2020, the core network node was T24 (emergency management of body fluid exposure; strength=1.764), whereas in August 2021 and February 2023, the core network node was T19 (acquisition of key information on emerging infectious diseases; strength=1.759 and 1.852, respectively). Network structure comparisons revealed significant differences between February 2020 and August 2021 (P=.01) and between February 2020 and February 2023 (P=.01), whereas the difference between August 2021 and February 2023 was not significant (P=.07). ConclusionsDespite accumulated pandemic experience, nurses’ infectious disease response competence declined substantially, indicating systemic fragility during prolonged crises. However, this experience reshaped competence architecture, evolving from technical infection prevention toward higher-order competence in information integration and clinical decision-making under uncertainty. To rebuild resilience, phase-specific training programs are essential: early-phase training emphasizes infection prevention, whereas prolonged outbreaks focus on information identification and decision support. Additionally, standardized information platforms and psychological support are essential to manage ongoing pandemic pressures.

OBJECTIVE:This qualitative study aimed to explore the experiences of nursing undergraduate students using Generative Artificial Intelligence (GenAI) for their case study theses. BACKGROUND:The growing use of GenAI in academic settings has facilitated its gradual integration into nursing education. Although the application of GenAI for educational purposes in nursing is gaining traction, in the integration of GenAI into thesis writing practices, especially the type of case study, remains limited. DESIGN:This study employed a qualitative descriptive design. PARTICIPANTS:Participants were selected using purposive sampling. A total of 19 graduates holding a Bachelor of Science in Nursing degree were included in the study. METHOD:Data were collected through semi-structured interviews to obtained perspectives from nursing graduates. The collected data were encoded and analyzed using thematic analysis method. RESULTS:We extracted 163 codes from the interview data and categorized them into three main categories with eight subcategories: a) AI-Driven Factors: insufficient academic writing skills, lack of supervisor's guidance and a climate of widespread recommendations; b) Dual-edged performance: boost writing efficiency and accuracy concerns; c) Hidden costs of AI: outsourcing of cognition, ethical compliance challenges and self-deception. CONCLUSION:This study revealed the diverse experiences among nursing undergraduates using GenAI in their case study work. It provides valuable insights for nursing institutions to establish GenAI usage guidelines and enhance support systems, offering insights to inform educational interventions.

Objective: To explore the configurational effect of the factors influencing the work alienation among emergency nurses. Background: In recent years, work alienation of emergency nurses has become increasingly prominent. This issue not only affects nurses’ professional burnout and mental health, but also may compromise the quality of nursing care and even increased the risk of medical errors. Existing studies on work alienation among emergency nurses primarily focus on examining the independent effects of individual factors. However, the formation mechanism of work alienation typically involves complex interactions among multiple factors, and the underlying configurational effects and developmental pathways have not yet received sufficient attention. Method: A cross-sectional study design was employed. From December 2025 to March 2026, 274 emergency nurses were recruited from 8 tertiary Grade-A hospitals through online surveys in Guangzhou, China. Univariate analysis, correlation analysis and linear regression analysis were used to explore the influencing factors of work alienation among emergency nurses. In addition, the configurational effect of the factors affecting work alienation was explored through fuzzy-set qualitative comparative analysis (fsQCA). Results: The score of work alienation among emergency nurses was 25.00 (17.00, 34.25). Linear regression analysis showed that sex, experience of workplace violence, work stress, overall perceived humanistic care and psychological resilience were significant factors influencing work alienation of emergency nurses. The fsQCA results identified seven configurational pathways leading to work alienation, which could be categorized into three types: (C1) high work stress, experience of workplace violence, lack of perceived humanistic care; (C2) experience of workplace violence, lack of perceived humanistic care, low psychological resilience; and (C3) high work stress, lack of perceived humanistic care, poor health status. Conclusion: The development of work alienation among emergency nurses arises from the interactive and synergistic effects of multiple factors, with humanistic care plays a central and universal role. Nursing managers should formulate multidimensional and multi-path intervention strategies to reduce work alienation among emergency nurses based on varying contextual combinations, thereby promoting team stability and development.

Background: Disaster rescue nurses (DRNs) play an essential role in disaster medical rescue. To ensure an effective response, it is imperative to assess the core competencies of DRNs. In 2019, the International Council of Nurses (ICNs) published the Core Competencies in Disaster Nursing Version 2.0 (CCDN V2.0), which outlines 33 competencies for DRNs. However, these competencies currently lack psychometric evaluation in China, which limits the direct assessment of DRNs' core competencies in disaster nursing and the effectiveness of disaster nursing education. Objectives: The objective of this study was to develop and validate the Core Competencies in Disaster Nursing Scale for Disaster Rescue Nurses (CCDNS-DRNs). Design: A methodological and cross-sectional design was used to develop and validate this scale. Methods: The researchers developed an initial scale using cross-cultural translation. Expert consultation was utilized to validate the content validity. A total of 401 nurses were surveyed by purposive sampling. They completed a general information questionnaire along with the CCDNS-DRN. Data analysis was performed using SPSS 26.0, Mplus 8.3, and R 4.5.0 and included general statistical analysis, classical test theory (CTT), and item response theory (IRT) analyses. Results: A 33-item eight-factor CCDNS-DRN was developed with satisfactory validity and reliability, with a content validity index of 0.980 for the total scale and a content validity index of 0.780-1.00 for each item. The confirmatory factor analysis showed that x 2 /df: 2.940, CFI: 0.933, TLI: 0.923, RMSEA: 0.069, and SRMR: 0.036. The Cronbach's alpha, split-half validity, and internal correlation coefficient (ICC) of the scale were 0.978, 0.918, and 0.898, respectively. The results of the IRT revealed that the discrimination indices of all items ranged from 2.037 to 4.970, the difficulty parameters of all items ranged from -2.837 to 1.396, and the average information values for the items ranged from 0.961 to 3.424. Conclusions: The CCDNS-DRN exhibits good psychometric properties, providing a scientifically sound and effective instrument to evaluate the core competencies in disaster nursing among DRNs in China.

The study aimed to explore perspectives on death among rural older adults in mainland China. A semi-structured interview was conducted with 18 rural older adults from Guangzhou, China. Data were sorted and coded using NVivo 12.0 software, and analyzed through thematic analysis. Three themes were extracted, including attitudes toward death (lack of contemplating death, coexistence of death acceptance and death anxiety, avoidance of discussing death), end-of-life preferences (defining a good death, preference of place of death, not desiring to be over-rescued) and needs of death education (participation attitudes, content and form). Results suggested that rural older adults in mainland China lacked contemplating death, avoided discussing death, and experienced a certain degree of death anxiety. In the future, it's important to provide appropriate death-related interventions for them, guide them in actively contemplating death and expressing their perceptions and preferences, and ultimately improve their death competence and enhance quality of death.

BACKGROUND: Thrombolytic therapy is an effective intervention for acute ischemic stroke. However, the timely administration of this treatment can be hindered by delayed decision-making on the part of family members. Little is known about the reasons for their delay in making decisions. METHODS: This qualitative interview study used face-to-face, individual, semistructured interviews with 16 participants from 2 tertiary hospital neurology wards in Guangdong, China. The interviews were analyzed using inductive content analysis, and descriptive statistics were used to summarize participants' characteristics. RESULTS: Three main themes emerged: a large family communication network, struggling with bleeding risk, and seeking distance treatment advice. CONCLUSION: In China, family members make decisions on behalf of patients and are affected by various factors in the decision-making process, resulting in delayed decision-making. They may experience psychological conflicts when deciding whether to permit thrombolysis, and they tend to seek information from external sources without understanding thrombolysis. Healthcare professionals caring for stroke patients eligible for thrombolytic therapy should provide decision-making support programs tailored to the specific needs of these family members to reduce delayed decision-making.

BACKGROUND:Family caregivers of breast cancer patients often experience significant psychological challenges, including depression, anxiety, and fear of cancer recurrence (FCR), yet these issues receive insufficient attention. This study aims to explore the heterogeneity of FCR among family caregivers and identify distinct subgroups based on their FCR levels. METHODS:A cross-sectional survey was conducted with 866 family caregivers of breast cancer patients at two tertiary hospitals in Guangzhou, Guangdong Province. All participants completed the Fear of Cancer Recurrence Scale (FCR-7), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Scale (GAD-7) to assess their levels of FCR, depression, and anxiety. Latent class analysis (LCA) was used to identify subgroups of FCR, and multiple logistic regression analyses were performed to explore factors influencing FCR. RESULTS:Three distinct subgroups of FCR were identified: low FCR group (16.17%), moderate FCR group (13.16%), and high FCR group (70.67%). Predictors of higher FCR included lower income, higher anxiety, and higher depression levels. CONCLUSIONS:Family caregivers of breast cancer patients exhibit varying levels of FCR, with significant predictors being income, anxiety, and depression. Targeted interventions (e.g., psychoeducation, stress management, mindfulness exercises, and cognitive-behavioral therapy) that address these factors may help improve the mental health and well-being of family caregivers.

This study used latent class analysis to explore the potential characteristics of stroke preparedness and the factors that influence it in middle-aged and older adults. A total of 845 middle-aged and older adults were recruited from 16 communities in Guangdong Province between July and August 2022. We identified four potential categories of stroke preparedness among middle-aged and older adults: recognition of stroke-emergency medical services (EMS) activation, low symptoms alertness-hospital avoidance, recognition of stroke-go to the hospital, and overlook arm weakness-go to the hospital. The categories could be determined by education level, medical background, knowledge of stroke and knowledge of Stroke 1-2-0 (Chinese version of FAST), conscientiousness traits, and level of family support. The findings of the four categories and their influencing factors suggest that community caregivers should adopt targeted interventions according to the characteristics of different groups of middle-aged and older adults to improve their ability to recognize and cope with stroke.

ObjectiveTo explore the core competencies in disaster nursing possessed by clinical nurses in Guangzhou, China, and then to uncover the influencing factors that shape these competencies. Methods A cross-sectional design of 1,151 nurses from Guangzhou was conducted from December 2022 to February 2023.A localized scale was compiled to construct a measurement tool that conforms to international standards and China's actual situation, providing guidance for analyzing capability shortcomings and constructing training programs and improving the disaster response level of Chinese nurses. Latent Profile Analysis (LPA), univariate analysis, and multivariate logistic regression analysis was conducted to explore the predictors of latent profile membership and their influencing factors. Results A total of 1151 questionnaires were valid.The core competencies of nurses were categorized into three distinct groups: deficient competence group(62.6%),moderate competence group(26.6%), and acceptable competence group(16.9%).Factors such as participation in disaster relief, drills, and belonging to emergency/disaster medical response teams were found to be significant influences. ConclusionHeterogeneity exists in the core competencies of disaster nursing among nurses in Guangzhou, with the moderate competence group scoring the highest in the legal and ethical dimensions. This study recommends the implementation of targeted training programs and multidisciplinary drills to enhance the capabilities of nurses.

Background: Pre-hospital delay is the major cause of stroke treatment delay, and behavioral intention is considered to be the most direct predictor of behavior. Therefore, to effectively reduce stroke pre-hospital delay, it is essential to further understand the relationship between stroke pre-hospital delay intention (SPDBI) and its social-psychological influencing factors, namely personality traits, social support and coping style. Aim: This study aims at examining the relationships among personality traits, coping style, social support, and SPDBI. Methods: A cross-sectional, self-administered questionnaire was distributed to 845 residents. The content of the questionnaire included demographic information, the knowledge of "Stroke 120", Ten-Item Personality Inventory-Chinese version, Simplified Coping Style Questionnaire, Perceived Social Support Scale and SPDBI Scale. Path analysis was used to investigate the relationship among SPDBI and its psychosocial influencing factors. Results: The final path model showed a good fit to the data (chi 2 /df = 2.981, RMSEA = 0.048, GFI = 0.936, CFI = 0.941). Extroversion ( fl = 0.106), positive coping ( fl =-0.110), negative coping ( fl = 0.150) and the knowledge of "Stroke 120" ( fl =-0.152) had only direct effects on SPDBI. While agreeableness ( fl = 0.113), openness ( fl =- 0.121) and social support ( fl =-0.118) had direct effects on SPDBI, they also had indirect effects ( fl =-0.009;- 0.022;-0.049) on SPDBI though positive coping. Conclusions: Adequate social support and positive coping of health threat may reduce residents' SPDBI. Meanwhile, the interventions to reduce SPDBI should take personality differences into consideration.

AimThis study aimed to assess the level of core competencies in disaster nursing of New Graduate Nurses (NGNs) and explore its influencing factors.BackgroundIn recent years, the overall frequency of disasters around the world has been on the rise. As the emerging workforce in clinical settings, NGNs play an integral role in future disaster relief efforts. NGNs’ level and influencing impact of core competencies in disaster nursing need to be understood.DesignA cross-sectional design.MethodsFrom June to September 2023, the Core Competencies in Disaster Nursing Scale - General Professional Nurse (CCDNS-GPN), designed according to the CCDN V2.0, was used to collect data from NGNs of six nursing schools and 15 hospitals in Guangdong, China. Descriptive analysis was conducted to examine the scores of core competencies in disaster nursing. Furthermore, one-way analysis of variance and multivariate linear regression analysis were used to explore the influencing factors.ResultsA total of 607 NGNs participated in this study. The scores of CCDNS-GPN of NGNs were 90.23 (SD 15.09) (score ratio: 51.56%), indicating a low level of core competencies in disaster nursing. The highest competency was the recovery (score ratio: 55.00%), while the lowest competency was the communication (score ratio: 45.44%). The predictor for core competencies in disaster nursing of NGNs were male (β = 0.091, p < 0.05), below bachelor’s degree (β = -0.109, p < 0.05), had received disaster nursing education at school (β = 0.087, p < 0.05), had participated in a disaster rescue drill at school (β = 0.140, p < 0.05), had been to the ICU during internship (β = 0.135, p < 0.05) and had the intention to be a disaster specialized nurse (β = 0.114, p < 0.05).ConclusionsThe NGNs exhibited insufficient core competencies in disaster nursing in Guangdong, China. Nursing schools and clinical institutions should collaborate and play their respective roles to enhance nurses' core competencies in disaster nursing, ensuring they can timely, safely and efficiently participate in disaster medical relief efforts.

目的:探讨驱动蛋白家族成员20A(KIF20A)对结直肠癌(CRC)恶性行为和化疗耐受的影响及其机制.方法:12例CRC及配对正常肠黏膜组织样本获自南方医科大学南方医院病理科.免疫组化、Western blot和RT-qPCR分析CRC组织和癌旁组织中KIF20A表达水平.KIF20A短发夹RNA(sh-KIF20A)转染或KIF20A过表达慢病毒(LV-KIF20A)感染CRC细胞.将RKO或LOVO细胞分为MOCK组(未转染的RKO或LOVO细胞)、LV-NC组(对照慢病毒感染RKO或LOVO细胞)和LV-KIF20A组(LV-KIF20A感染RKO或LOVO细胞);将HCT-116细胞分为MOCK组(未转染的HCT-116细胞)、sh-NC组(对照shRNA转染HCT-116细胞)和sh-KIF20A组(sh-KIF20A转染HCT-116细胞).CCK-8和集落形成实验检测细胞活力和集落形成能力;流式细胞术检测细胞凋亡;Western blot检测凋亡相关蛋白cleaved caspase-3、Bax和Bcl-2及JAK2/STAT3信号通路相关蛋白的表达.免疫组化检测化疗敏感的CRC组织和化疗不敏感CRC组织中KIF20A和p-STAT3蛋白水平.将LV-NC或LV-KIF20A感染的RKO细胞接种于BALB/c裸鼠右侧皮下(每组5只),检测KIF20A对肿瘤体内生长的影响.结果:KIF20A在CRC组织及细胞中显著上调(P<0.05).敲减KIF20A抑制CRC细胞的活力和集落形成能力,而过表达KIF20A则促进CRC细胞活力和集落形成能力.在5-氟尿嘧啶处理下,敲减KIF20A促进cleaved caspase-3和Bax表达,抑制Bcl-2表达,促进细胞凋亡;而过表达KIF20A会抑制cleaved caspase-3和Bax表达,促进Bcl-2表达,抑制细胞凋亡.机制研究表明,过表达KIF20A可上调p-JAK2和p-STAT3水平并激活JAK2/STAT3通路,KIF20A沉默可下调p-JAK2和p-STAT3水平.沉默STAT3可逆转由KIF20A过表达引起的细胞增殖能力提高和凋亡减少.与化疗敏感的CRC组织相比,KIF20A和p-STAT3在化疗不敏感的CRC组织中表达水平更高.体内实验表明,KIF20A过表达促进CRC肿瘤生长(P<0.05).结论:KIF20A通过激活JAK2/STAT3信号通路调节CRC的恶性增殖及化疗耐受.

目的 分析我国中老年人慢性病共病与健康相关行为的关联模式.方法 基于2018年中国健康与养老追踪调查数据,选取19 145名中老年人为调查对象,通过关联分析探讨不同人口学特征的中老年人慢性病共病与健康相关行为的关联.结果 中老年人慢性病共病率为55.76％;中老年群体中,低体力活动、睡眠不足或过长的人患慢性病共病的置信度为72.51％;男性中低体力活动、无社交和吸烟的人患慢性病共病的置信度为64.55％;女性中低体力活动、睡眠不足或过长的人患慢性病共病的置信度为76.23％;随着年龄的增高,慢性病共病与健康相关行为的关联规则增多,45～59岁人群中,睡眠不足或过长、无社交的人患慢性病共病的置信度为53.10％;60～74岁、75岁及以上人群中,低体力活动、睡眠不足或过长的人患慢性病共病的置信度分别为78.11％和76.40％.结论 中老年人慢性病共病率较高,不同性别和年龄组的人群慢性病共病与健康相关行为的关联模式不同,医疗机构可根据不同群体特征开展精细化健康教育,改善中老年人慢性病共病情况.

目的 了解灾害专科护士的角色体验和对临床实践感知,为灾害专科护士的职业发展和管理提供参考.方法 采用描述性质性研究方法,对广东省三甲医院急诊科的15名灾害专科护士进行半结构访谈,运用内容分析法分析资料.结果 提炼出灾害专科护士工作体验的3个主题(感知个人专科角色、参与专科临床实践、融入医院应急救援队伍建设)及9个次主题.结论 灾害专科护士在灾害护理继续教育、多学科合作和医疗紧急救援队伍建设等方面可发挥重要作用,医院需结合灾害护理多学科交叉的特点,明确灾害专科护士角色定位和岗位范围,进一步发挥专科护士价值.

Background Stroke high-risk population screening project is a national health project being vigorously promoted in China, but it is found that the participation rate of residents in it is low, which seriously affects the screening efficiency. Screening intention is an important predictor of screening behavior, however, there are few studies on the current status and influencing factors of the intention to screen for high-risk stroke among community residents. Objective To understand the current status of the intention to screen for high-risk stroke among community residents and explore the influencing factors. Methods A total of 648 residents of Guangdong Province were selected as survey respondents by using convenient sampling method from March to May 2022. Self-designed questionnaires (including General Data Questionnaire, Stroke High-Risk Screening Intention Scale, Stroke Health Knowledge Scale, Community Medical Service Trust Scale, Perceived Social Support Scale) were used to investigate the respondents. The scores of Stroke High-Risk Screening Intention Scale among residents with different characteristics were compared, and the factors affecting intention to screen for high-risk stroke among community residents were analyzed by multiple linear regression. Results A total of 600 valid questionnaires were collected with the recovery rate of 92.6%. The average total score of the Stroke High-Risk Screening Intention Scale among residents was (101.30±14.98), of which 352 (58.7%) residents had a high level of intention for screening, 248 (41.3%) residents had a middle or low level of intention for screening. There were significant differences in the scores of Stroke High-Risk Screening Intention Scale among residents by gender, residential status, hypertension, hyperlipidemia, smoking status, awareness of high-risk stroke screening, implementation of previous high-risk stroke screening in the community, acceptance of previous high-risk stroke screening, self-perceived lifetime risk of stroke and self-perceived risk of stroke within 1 year (P<0.05). There was a positive correlation of the score of Stroke High-Risk Screening Intention Scale with the scores of Stroke Health Knowledge Scale, Community Medical Service Trust Scale and Perceived Social Support Scale (P<0.05). Multiple linear regression analysis showed that gender, hypertension, hyperlipidemia, community has implemented stroke high-risk screening, self-perceived lifetime risk of stroke, scores of Perceived Social Support Scale, Community Medical Service Trust Scale and Stroke Health Knowledge Scale were influencing factors of intention to screen for high-risk stroke among community residents (P<0.05) . Conclusion The overall intention of community residents in Guangdong Province for high-risk stroke screening is high, but the screening intention of some residents still needs to be improved. It is suggested that the community should focus on male residents with low intention of screening, strengthen education of the health knowledge of stroke, especially risk factors, to help residents understand their own risk of stroke and the importance of high-risk screening. The investment in screening equipment and medical facilities in community health service institutions should be increased, the construction of community medical and nursing personnel needs more attention at the national level, so as to enhance the trust of residents in community medical services. Meanwhile, the positive impact of social support on the level of intention to screen for high-risk stroke should also be emphasized, to effectively increase the level of intention of residents to participate in high-risk stroke screening through expanding the publicity at the social level and creating an atmosphere of universal participation in screening.

Stroke patients suffer from public stigma because strokes cause visible disability and heavy social burden. However, existing tools measuring stroke-related stigma do not consider public stigma. The aim of this study was to develop and evaluate a public stigma of stroke scale (PSSS). This cross-sectional study recruited 730 participants, aged above 18 years, with no diagnosis of stroke before. Scale items were generated after reviewing relevant literature and conducting interviews. An expert panel evaluated the validity and reliability of a preliminary scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), bifactor CFA (B-CFA), Exploratory structural equation modelling (ESEM), bifactor-ESEM (B-ESEM) were performed to extract factors and evaluate fit on the factor structures. The Omega coefficient was 0.93, and the test–retest reliability coefficient was 0.721. The EFA extracted four factors: inherent ideology, aesthetic feelings, avoidance behaviour, and policy attitudes. These explained 61.57% of the total variance in the data. The four-factor model was confirmed by B-CFA, and met the fitness criteria. The PSSS yields satisfactory psychometric properties and can be used to assess stroke-related public stigma.

Background Message framing (gain-framed message vs loss-framed message) plays a major role in health education, but its significance in public stroke education is still unclear. Objective To compare the impact of gain- and loss-framed messages about "Stroke 1-2-0" (a kind of stroke educational video) on residents' intention to delay seeking care in the situation of identifying pre-stroke symptoms. Methods From January to September 2021, the gain-framed message video and loss-frame message video based on "Stroke 1-2-0" were developed through three steps: script writing, video production, and video evaluation. Then during October to November 2021, 81 residents aged 35-80 selected by convenience sampling from Guangzhou, Guangdong Province were randomized into a gain-framed message video intervention group (n=40) and a loss-framed message video intervention group (n=41) , to watch the gain-framed message video and loss-framed message video, respectively. The impact of the intervention was appraised by comparing pre- and post-intervention status of correct recognition and management of pre-stroke symptoms assessed using a self-developed Pre-stroke Symptom Recognition and Management Questionnaire, and pre- and post-intervention total score and domains scores of the Stroke Pre-hospital Delay Behavior Intention (SPDBI) scale. Results A total of 75 cases (37 in the gain-framed message video intervention group and 38 in the loss-framed message video intervention group) who completed the study were finally included. Two groups had no significant differences in pre-intervention rates of correct recognition and management of pre-stroke symptoms (P>0.05) . There were no significant intergroup differences in mean pre-intervention total score and each domain score of the SPDBI scale (P>0.05) . After intervention, significantly increased rates of correct recognition and management of various pre-stroke symptoms, and significantly lowered mean total score and domain scores (except the non-treatment justification) of the SPDBI scale were found in the gain-framed message video intervention group (P<0.05) . In the loss-framed message video intervention group, the correct recognition rate of various pre-stroke symptoms significantly improved (P<0.05) , and the rate of correct management of pre-stroke symptoms (except the deviated mouth) was also notably improved (P<0.05) . Moreover, the total score and each domain score of the SPDBI scale were lowered notably (P<0.05) . Post-intervention intergroup comparison demonstrated that the loss-framed message video intervention group had lower mean total score of the SPDBI scale and lower mean scores of three domains (non-treatment justification, symptom attributions, habitual response style) of the scale (P<0.05) . Conclusion The loss-framed message had stronger persuasive impact on reducing residents' intention to delay accessing of care when pre-stroke symptoms occurred. Thus, the loss-framed message can be used as an expression form of health education on pre-hospital delay in stroke, focusing on the relationship between pre-stroke symptoms and the time of triggering an emergency call on the phone, and highlighting the importance and urgency of seeking medical treatment quickly.

目的 探讨脑卒中高危人群不良生活方式特征的潜在类别及影响因素.方法 于2022 年8-9 月通过便利取样法对广东省某社区40岁及以上的500名脑卒中高危人群进行问卷调查,内容包括一般人口学资料、不良生活方式行为和脑卒中防治知识.用潜在类别分析和无序多分类logistic 回归分析探讨高危人群不良生活方式特征的潜在类别分布特征及其影响因素.结果 高危人群可分为生活方式基本健康组(C1,67.20％)、久坐-缺乏运动组(C2,21.60％)和不良生活方式-吸烟突出组(C3,11.20％)3 个潜在类别.与生活方式基本健康组相比,年龄40～59 岁更容易归入久坐-缺乏运动组(OR=2.160,95％CI:1.249～3.734;P＜0.05);与不良生活方式-吸烟突出组相比,防治知识得分高人群更容易归人久坐-缺乏运动组(OR=0.935,95％CI:0.887～0.985;P＜0.05);与生活方式基本健康组相比,男性(OR=29.682,95％CI:9.758～90.283;P＜0.05)、独居(OR=2.727,95％CI:1.117～6.656;P＜0.05)和无高血压(OR=2.518,95％CI:1.312～4.831;P＜0.05)人群更容易归入不良生活方式-吸烟突出组.结论 应关注脑卒中高危人群生活方式特征的异质性,对不同类别的高危人群给予针对性干预措施.

目的 分析中老年慢性病共病人群抑郁症状发展轨迹及影响因素.方法 基于2011-2018 年中国健康与养老追踪调查,选取3 238 名中老年慢性病共病人群的调查数据,构建潜变量增长混合模型分析慢性病共病人群抑郁症状发展轨迹类别并探讨其影响因素.结果 中老年慢性病共病人群抑郁症状发展轨迹可分为:抑郁症状高危组(C1)、抑郁症状低危组(C2)、抑郁症状缓解组(C3)和抑郁症状恶化组(C4)4种类别.多元逐步logistic 回归显示,C1 与C2相比,农业户口(OR=1.81,95％CI:1.23～2.65)、残疾(OR=1.99,95％CI:1.52～2.61)、睡眠不足(OR=3.20,95％CI:1.54～6.67)、居住在平房者(OR=1.84,95％CI:1.39～2.42)更容易被归入C1 组,男性(OR=0.42,95％CI:0.32～0.54)、低慢性病共病水平(OR=0.43,95％CI:0.33～0.55)、有午睡习惯(OR=0.62,95％CI:0.49～0.78)、有社交活动者(OR=0.73,95％CI:0.58～0.93)更容易归入C2 组;C3 与C2 相比,农业户口(OR=1.82,95％CI:1.22～2.72)、残疾(OR=1.84,95％CI:1.39～2.44)、睡眠不足者(OR=3.05,95％CI:1.52～6.13)更容易归入C3 组,男性(OR=0.55,95％CI:0.42～0.72)、低慢性病共病水平(OR=0.57,95％CI:0.43～0.75)、有午睡习惯(OR=0.76,95％CI:0.59～0.97)和社交活动者(OR=0.70,95％CI:0.54～0.89)更容易归人C2 组;C4 与C2 相比,男性(OR=0.48,95％CI:0.37～0.63)和有午睡习惯者(OR=0.77,95％CI:0.60～0.98)更容易归人C2组.结论 中老年慢性病共病人群抑郁症状发展轨迹存在显著异质性,医务人员可根据人群不同特征开展针对性的健康管理,预防慢性病共病群体抑郁症状的发生和恶化.