Maladaptive daydreaming (MD) refers to excessive and immersive fantasy activity that detaches individuals from reality and interferes with daily functioning. Although ordinary daydreaming may be adaptive, maladaptive daydreaming is often associated with marked impairments in social, academic, and occupational functioning. However, validated brief screening instruments for MD remain limited in Chinese populations. This national cross-sectional study translated and psychometrically validated the Polish Maladaptive Daydreaming Scale–Short Form (PMDS-5) in Chinese (PMDS-5-CN). A total of 10,691 participants from a nationwide Chinese sample completed the survey. The translation followed Beaton’s cross-cultural adaptation framework to ensure linguistic accuracy and conceptual equivalence. The factor structure was examined using exploratory and confirmatory factor analyses. Internal consistency was evaluated using Cronbach’s alpha, and convergent validity was examined using both external correlations and internal construct indices. The PMDS-5-CN demonstrated a unidimensional structure with acceptable to excellent model fit (RMSEA = 0.068, GFI = 0.990, NFI = 0.996, TLI = 0.993, CFI = 0.996) and high internal consistency (α = 0.962). In addition, PMDS-5-CN scores were moderately positively correlated with depression (r = 0.555, P < 0.001), positively correlated with adverse childhood experiences (r = 0.132, P < 0.001), and mildly negatively correlated with anxiety (r = -0.135, P < 0.001), The average variance extracted (AVE) was 0.847 and the composite reliability (CR) was 0.965, further supporting the convergent validity of the PMDS-5-CN. In the present sample, 4.5

BACKGROUND:Person-centered dementia care (PCDC) is considered the gold standard in nursing homes, but evidence on influencing factors remains limited by qualitative designs and lack of validated tools. AIM:To describe the current level of PCDC in nursing homes in northeastern China and to analyse multi-level factors influencing its implementation. DESIGN:A cross-sectional survey. SETTINGS:Sixteen nursing homes across six cities in Liaoning Province, China. PARTICIPANTS:One Hundred Eighty-Nine Participants, Including 170 Nursing and Care Staff and 19 Managers. METHODS:The Person-Centered Care Assessment Tool (P-CAT) and a newly developed questionnaire, Influencing Factors on PCDC (IF-PCDC), were administered. Kruskal-Wallis tests, Spearman's rank correlations, and multiple linear regression were used for analysis. RESULTS:The overall P-CAT score was 76% (individualized care and environmental accessibility 80%; organizational support 73%). Regression analysis showed that PCDC was associated with factors from all four IF-PCDC dimensions, including work-related stress (β = -0.242, p < 0.001), knowledge of people with dementia (β = 0.238, p < 0.001), and dementia care knowledge (β = 0.194, p < 0.001); nursing home type (β = 0.317, p < 0.001), teamwork (β = 0.187, p = 0.002), and star rating (β = 0.140, p = 0.004); family trust in staff (β = 0.123, p = 0.023); and workload and working hours (β = 0.121, p = 0.046). CONCLUSIONS:PCDC levels in northeastern Chinese nursing homes are reasonably good. This study is the first to systematically identify multi-level influencing factors using a newly developed, preliminarily validated questionnaire. Findings highlight the importance of reducing staff stress, enhancing dementia care knowledge, strengthening teamwork, building family trust, and optimizing workloads to improve PCDC. IMPACT:This study provides quantitative evidence on PCDC and its influencing factors in Chinese nursing homes. The findings may facilitate nursing home managers, policymakers, and nursing professionals to develop targeted strategies to strengthen PCDC and improve dementia care quality in long-term care settings. CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY:This study contributes quantitative evidence on PCDC from a non-Western nursing home context, addressing a gap in the international literature. By examining multilevel factors influencing care implementation, the findings enhance global understanding of PCDC across diverse health system and cultural contexts. REPORTING METHOD:This study was reported in accordance with the STROBE guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution. TRIAL REGISTRATION:We registered the study with the Chinese Clinical Trial Registrat-ion Center (ID: ChiCTR2400086418. Available from: https://www.chictr.org.cn/showproj.html?proj=234364).

AIM:This study seeks to explore the challenges and experiences of nurse educators in adopting simulation in undergraduate clinical skills training in China. BACKGROUND:Despite global recognition in nursing education, simulation's role in Chinese nursing schools' clinical skills training is largely uncharted. DESIGN:A cross-sectional study. METHODS:An online questionnaire was developed and disseminated among nurse educators. It garnered responses from 123 participants representing 50 undergraduate colleges across China. RESULTS:Of the respondents, 59 (47.9 %) reported using simulation as a teaching method in clinical skills training. However, a mere five (8.5 %) were acquainted with and applied the Healthcare Simulation Standards of Best Practice in their simulation processes. The earliest adoption of simulation occurred in 1998, with the latest instance in 2019. Role-playing (91.5 %) and task trainers (86.4 %) were the predominant simulation modalities. Most participants exhibited a deficiency in skills necessary for managing simulation activities, including structured pre-briefing, facilitation and handling technological debriefing issues. A mere seven (11.9 %) of the teachers utilized valid and reliable instruments to assess simulation experiences. CONCLUSIONS:The use of simulation in undergraduate clinical nursing skills training in China is not only infrequent but also lacks adherence to a best practice framework. Four significant challenges were identified for nurse faculty using simulation: (1) the design of standardized scenarios; (2) encouraging active student participation in simulation and debriefing; (3) the prolongation of simulation due to technical issues; and (4) the constraint of limited class time allowing only a few students to engage in simulation.

BackgroundThere is a gap between the principles of person-centred dementia care and their actual implementation. However, scoping reviews of the barriers and facilitators to implementing person-centred dementia care in long-term care facilities for Western countries and Asian countries are lacking.ObjectiveTo identify and compare the barriers and facilitators to implementing person-centred dementia care in long-term care facilities between Western and Asian countries.MethodsIn line with Arksey and O’Malley’s methodology, a scoping review was conducted and is reported following PRISMA-ScR guidelines. Nine English language databases and three Chinese databases were searched to identify qualitative and quantitative research studies published in English and Chinese. Thematic analysis was used to summarise and characterize the barriers and facilitators to implementing person-centred dementia care in long-term care facilities for Western and Asian countries.ResultsThirty-three studies were included. Over half were conducted in Western countries (n =20). Barriers and facilitators were grouped under four high level themes: Nursing and care staff factors, people living with dementia and family factors, organizational factors, and resource factors. Inadequate knowledge of person-centred care, staffing shortages, time constraints, and low wages were the principal barriers to implementing person-centred dementia care in both Western and Asian countries.ConclusionsThe findings indicate that staff encounter numerous obstacles and needs in implementing person-centred care for people living with dementia in long-term care settings. Educational levels of nursing staff in Western countries were generally higher compared to Asian countries. Additionally, work-related injuries and stigma associated with dementia care presented unique challenges for nursing staff in Asia and were not cited in Western studies. Conversely, family-related factors were more frequently and elaborately cited as influencing person-centred dementia care in Western long-term care facilities. Moreover, Asian studies identified a significant lack of educational training support for person-centred dementia care, as well as shortages in staffing and poor availability of personalized, home-like environments

BACKGROUND:Person-centred care is considered the gold standard for long-term care of people living with dementia, yet there remains a significant gap between this standard and its actual implementation. Integrating this Western-developed approach into the distinct cultural context of Chinese nursing homes presents unique challenges. Currently, there is a lack of qualitative research exploring the barriers and facilitators faced by Chinese nursing home staff in implementing person-centred care for people living with dementia. OBJECTIVE:To investigate the barriers and facilitators encountered by nursing home staff in implementing person-centred care for people living with dementia. DESIGN:A qualitative descriptive approach was adopted. METHODS:Purposive sampling was employed to recruit a total of 17 staff members or managers (including dean, supervisors, nurses, caregivers, social workers, or interns) from two nursing homes in China. In-depth, face-to-face, one-to-one interviews were conducted with all participants using a semi-structured interview guide, with field notes taken after each interview. Data collection continued until data saturation. Qualitative content analysis was employed. RESULTS:Data analysis resulted in four themes, each encompassing both barriers and facilitators: nursing and care staff factors, family factors, organizational factors, resource factors. Notably, limited remuneration and benefits, low social status, high staff turnover rates, challenges in addressing the non-cognitive symptoms of dementia, and inadequate training were found to be the primary barriers to the implementation of person-centred dementia care. CONCLUSIONS:The findings indicate that nursing home staff encounter numerous barriers and needs in implementing person-centred care for people living with dementia. To effectively address these challenges, there is a need to enhance staff education and training, improve benefits and working conditions for nursing home staff, and increase societal support for nursing homes. Collaborative efforts are required to promote dementia care practices, truly embodying the person-centered care philosophy and enhancing the quality of care for people living with dementia. TRIAL REGISTRATION:This study is part of a mixed-methods study, which has been registered with the Chinese Clinical Trial Registration Center. Available from:. REGISTRATION NUMBER:ChiCTR2400086418.

OBJECTIVE:To systematically evaluate the current status of apathy in dementia patients and its associated factors. METHODS:We searched Chinese and English databases to collect studies on the associated factors of apathy in patients with dementia from inception to March 14, 2023. Two researchers independently screened the literature, evaluated the quality, and extracted the data RESULTS: A total of 20 studies were included, and the incidence of apathy in patients with dementia ranged from 21 % to 90 %. According to the model of apathy proposed by Massimo in 2018, the associated factors were divided into individual factors for dementia patients, caregiver factors, and environmental factors. The individual factors of apathy in patients with dementia mainly include demographic characteristics, the severity of cognitive impairment, a combination of other behavioral and psychological symptoms of dementia, acute medical problems or adverse drug reactions, unmet needs, and malnutrition. Caregiver factors mainly include emotional expressions of hostility or criticism towards dementia patients and caregivers' expectations for a better life in the future. Environmental factors mainly include too high or too low stimulation and a lack of daytime activities CONCLUSIONS: Existing studies have shown that the incidence of apathy in dementia patients is high and is affected by multi-dimensional factors. There are more studies on individual factors in dementia patients and fewer studies on caregivers and environmental factors. In the future, a large number of high-quality studies are needed to demonstrate the mechanism of apathy in dementia patients and to find more related factors.

IntroductionChronic inflammation is a recognized independent risk factor for cardiovascular disease (CVD), highlighting the need for reliable inflammatory indicator to predict CVDs. As an inflammatory indicator which has been proved to have predictive value for prognosis of CVDs, neutrophil percentage-to-albumin ratio (NPAR) has obtained increasing attention, but further research is needed to confirm the relationship with mortality in the general population.MethodThis prospective cohort study included 21,317 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010, where baseline characteristics and NPAR level were extracted. Data for CVD and all-cause mortality were acquired by linking the cohort database with the National Death Index through December 31, 2019. We employed restricted cubic spline analyses to examine the nonlinear association. Weighted Kaplan–Meier curves with log-rank tests were conducted to access cumulative survival differences across different NPAR results. Multivariable Cox proportional hazards regression models were used to compute hazard ratios and 95% CIs. Receiver Operating Characteristic (ROC) curves were used to compare predictive value of NPAR with systemic immune inflammation index (SII) and neutrophils percent.ResultsIn this cohort study, during 270,014 person-years of follow-up, 4,074 all-cause deaths and 1,116 CVD-cause deaths were documented. NPAR levels exhibited significant nonlinear associations with both CVD-cause (P = 0.018 for nonlinearity) and all-cause mortality (P < 0.001 for nonlinearity). Participants in the highest NPAR tertile had a significantly increased risk of all-cause mortality (HR: 1.46, 95% CI: 1.33–1.61) and CVD-cause mortality (HR: 1.54, 95% CI: 1.32–1.80) compared to those in the lowest tertile in the fully adjusted model, while no association was detected for individuals in the middle tertile. Further ROC analysis confirmed that NPAR had higher predictive value than neutrophil percent segment and SII.ConclusionsElevated NPAR level was significantly associated with an increased risk of all-cause and CVD-cause mortality in general population. The high predictive value of NPAR, combined with the easy-to-calculate property, suggests that its potential as a novel inflammatory indicator is worthy of further investigation.

OBJECTIVE:To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals. RESEARCH METHODOLOGY/DESIGN:This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation. SETTING:Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China. RESULTS:In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (β = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (β = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support. CONCLUSION:ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators. IMPLICATIONS FOR CLINICAL PRACTICE:Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.

Objectives: This study examines the recommendation behaviors and influencing factors for the 13-valent Pneumococcal Conjugate Vaccine (PCV13) among 3579 Chinese healthcare workers (HCWs), including 1775 pediatric care providers (Peds-PCPs) and 1804 primary care providers (PCPs). Data were collected from May to July 2023 through a national cross-sectional survey using a structured questionnaire, distributed across hospitals providing pediatric services in five provincial-level administrative divisions. Methods: The sociodemographic data, vaccine knowledge, and recommendation practices were analyzed using Pearson's chi-square test, Wilcoxson rank-sum test, and multivariate logistic regression. Results show that while PCPs are more likely to recommend PCV13, vaccine hesitancy persists among Peds-PCPs. Logistic regression revealed that higher influenza vaccination intention, salary, vaccine consultation frequency, familiarity with immunization, work ethic, and flexible schedules positively impacted HCWs' recommendation behavior. Results: Factors influencing Peds-PCPs' recommendations include vaccine training (OR: 1.470, CI: 1.049-2.509), safety recognition (OR: 1.986, CI: 1.163-3.391), concern over rejection (OR = 1.274, CI: 1.076-1.508) and vaccine cost (OR = 1.203, CI: 1.023-1.414). For PCPs, influencing factors were the perceived susceptibility of children to pneumonia (OR = 2.185, CI: 1.074-4.445), acceptance of herd immunity (OR: 1.717, CI: 1.101-2.677), and belief that parents with better family conditions are more likely to accept vaccine recommendations (OR = 1.229, CI: 1.024-1.477). Conclusion: This survey underscores the need for tailored interventions to address differing perceptions and enhance confidence in the safety and efficacy of vaccines among HCWs, particularly Peds-PCPs.

There are many types of assessment tools for dementia patients both domestically and internationally. However, assessments using single-dimensional measurement tools often have limitations, and there is still a lack of reports on comprehensive assessment tools specifically for dementia patients in current. Based on this, the comprehensive assessment tools for the elderly with dementia are reviewed both domestically and internationally, 8 assessment tools from the perspectives of demand and function for the elderly with dementia are summarized, and the content, reliability and validity, application of each tool are discussed in this paper, in order to provide reference for the use and development of assessment tools for the elderly with dementia in China.

This study aims to gain a deeper understanding of what dignity is for older people cared for in a hospital. Old age is one stage in life where dignity might be threatened during hospitalization. This study is rooted in the theoretical perspective of caring and caring science. The overall methodology is the hermeneutical philosophy of understanding as outlined by Hans-Georg Gadamer. The interpretation revealed the patients’ struggle between death and life, and the struggle between being dignified and being violated. Being old and hospitalized entail a struggle in standing on one’s dignity.

目的 分析PubMed数据库与万方数据库中关于老年人压力性损伤(PI)研究热点和研究趋势.方法 检索2个数据库相关文献,检索时限为2018年1月1日-2022年6月26日.应用BICOMB软件对文献进行文献计量学分析,应用gCLUTO软件对高频词进行聚类可视化分析.结果 最终纳入文献2 041篇,其中中文文献1 449篇(71.0％),英文文献592篇(29.0％).国内外近5年来该领域每年发文量基本稳定.国内发文量高于国外,研究场所多聚焦于医院环境,而国外更多关注养老机构.中文文献聚类共6类:延续性护理对高危人群PI发生率的影响、长期卧床老人的综合护理、集束化护理研究现状、PI护理小组的预防效果、老年患者的常见并发症(PI)、老年人PI的风险评估.英文文献聚类共3类:养老机构PI的预防与护理质量、老年PI患者的伤口护理、老年人PI的风险评估.结论 集束化护理是我国未来研究的热点趋势,国内外该领域的共同热点是老年人PI的预防与风险评估,未来国内研究还可以多关注于养老机构内的老年人PI的预防与护理.

Abstract As the ageing population in China continues to grow, more people will be living with long-term health conditions and require support from family care-givers. This scoping review therefore aims to explore sources of stress and coping mechanisms adopted by care-givers of older relatives living with long-term conditions in mainland China. Literature searches were conducted in English (CINAHL, EMBASE, MEDLINE, PsycINFO and SCOPUS) and Chinese (CNKI, WANFANG DATA, CQVIP and CBM) databases between October and November 2019. The searches focused on the stressors and coping mechanisms utilised by family care-givers residing in the community. Narrative synthesis was used to identify themes within the data. Forty-six papers were included: 20 papers from English and 26 from Chinese databases. Six themes captured stressors: care-giving time (N = 22), financial resources (N = 17), role and personal strains (N = 42), preparedness (N = 4), social roles (N = 10) and lack of adequate formal support (N = 22); and one theme captured coping (N = 14). Unmet needs of care-givers of older relatives in mainland China were found to be extensive. Only a few studies had attempted to explore the causal link between stressors, coping and the influence of culture. Findings underscore the significance of adequately capturing intricacies around care-givers’ unmet needs, rather than generalising on the basis of culture. Qualitative studies are critical to providing a better understanding of the relationship between stressors, coping and resources afforded to care-givers by their cultural environment. Having such understanding is crucial to inform the development of competent care, which promotes self-efficacy and self-actualisation in care-givers in mainland China.

Background: As aging is a significant risk factor for dementia, the number of persons with dementia is growing annually as a result of the aging population, which implies the need for better geriatric care services in terms of both quantity and quality. Methods: The knowledge and attitudes of Nepalese nursing students (n = 177) concerning dementia were examined using a descriptive correlational research approach. Alzheimer's Disease Knowledge Scale (ADKS) and Dementia Attitude Scale (DAS) were used to measure students' knowledge and attitude of dementia. Results and discussion: The overall mean score of the ADKS was found to be 19.64 (SD = 3.363) out of 30, while the total mean score on dementia attitude of the DAS was 93.82 (SD = 10.09) out of 140. A positive relationship was established between the knowledge and the attitude scores (r = 0.148, P = 0.050), demonstrating limited knowledge and positive attitude towards people with dementia in nursing students.

Objective: To systematically synthesize research evidence on barriers and facilitators to pressure injury prevention in hospital settings. Methods: A systematic literature review of quantitative, qualitative, and mixed methods research was undertaken using PubMed, MEDLINE, Embase, CINAHL, and Cochrane Library. Studies that reported barriers or/and facilitators to pressure injury prevention in the acute care settings and published in English from 2008 to 2022 were included. Studies were excluded if they were conducted in residential care facilities and nursing homes, or other long-term community care settings. Two authors independently screened articles against the inclusion and exclusion criteria. Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. Reported results were mapped to the Theoretical Domains Framework to identify the barriers and facilitators to pressure injury prevention. Results: A total of 78 studies were included. There were 65 quantitative studies, 11 qualitative studies, and two mix-methods studies. The most salient Theoretical Domains Framework domains identified in this review were "Knowledge", "Skills", "Environmental Context and Resources", "Optimism", "Social/Professional Role and Identity", and "Social influences". Conclusion: The barriers and facilitators to pressure injury prevention in hospital settings identified in this systematic review were diverse, and included issues at both individual and organizational level. Healthcare organizations can address the barriers and facilitators from the influential Theoretical Domains Framework domains. Future research is required to investigate the effectiveness of behaviour change interventions that specifically target these barriers and facilitators to pressure injury prevention.

随着全球老龄化的加剧,失智症患者数量逐年增加,目前我国失智症患者超过 1000 万,约占全世界失智症患者总数的四分之一[1].而 90％的失智症患者会在疾病的进程中显示出至少一种精神行为症状(behavioral and psychological symptoms of de-mentia,BPSD)[2].养老机构失智症患者 BPSD 的发生率则更高,可达92％[3].目前国内外的研究[4-5]均表明,养老护理员缺少针对 BPSD 的护理相关能力的培训,进而导致失智症患者的照护质量受到影响[6],因此亟需为养老护理员提供应对BPSD方面的相关培训.本文对养老机构中针对护理员应对BPSD的相关培训内容、方式、评价等进行相关综述,为构建符合我国养老机构护理人员的培训方式提供参考.

ObjectiveTo summarize evidence⁃based guidelines for pressure injury prevention and treatment.MethodsEvidence⁃based guidelines for pressure injury prevention and treatment were retrieved from databases，guideline websites and related professional websites.The retrieval time was from the establishment of databases to 7 August，2020.The quality of included guidelines were evaluated by Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ）.And accepted and mutually exclusive recommendations in guidelines after 2015 were compared and summarized.ResultsFinally，a total of 11 evidence⁃based guidelines were included，all from abroad，and their normalized percent mean in the areas of scope and purpose，participants，rigor，clarity，applicability，and independence in AGREE Ⅱ were 76.67%，62.88%，66.14%，73.11%，37.50% and 63.45%，respectively.The overall quality evaluation results of guidelines showed that 9 guidelines were grade B and 2 guidelines were grade A.A total of 6 evidence⁃based guidelines for pressure injuries were published/updated after 2015，summarizing 32 generally accepted recommendations and 2 mutually exclusive recommendations.ConclusionsThe overall quality of included evidence-based guidelines for pressure injury prevention and treatment is good，but the applicability needs to be improved.Clinical practice of the recognized recommendations in evidence-based guidelines for pressure injuries were published/updated after 2015 needs to be strengthened，and the mutually exclusive opinions need to be further explored.

帕金森病(PD)是一种年龄相关的进行性神经退行性疾病.相较于仅依靠视觉分析及低维度信息的传统影像诊断模式,影像组学可以通过高通量计算快速挖掘医学图像中更深层次的信息,已成为PD研究中的新兴手段,在PD的诊断、分型、进展评估及结局预测等方面得到广泛应用.就影像组学的概况及在PD中的研究进展进行综述.

介绍痴呆病人照顾者自我效能评估工具,阐述不同工具的评估内容、计分方式、信效度等方面,以期为相关研究提供参考和借鉴.

老年人由于骨质疏松及生理功能的退化,已成为股骨粗隆间骨折的高发人群.有研究显示[1],约40％～55％的骨折患者合并有营养不良状况,导致该部分人群术后发生深静脉血栓、压力性损伤、切口不愈合的风险增加.因此,保证患者良好的营养状况对促进患者术后康复具有重要意义.本文分析追踪护理模式对老年股骨粗隆间骨折患者术后营养状况的影响,现报告如下.