Background:Health behaviors are critical determinants of stroke recurrence risk and long-term clinical outcomes in patients with chronic diseases. For rural patients with ischemic stroke (IS) in China, understanding the heterogeneity of these behaviors is essential for developing targeted interventions to improve both behavioral adherence and subsequent quality of life. Methods:This cross-sectional study used convenience sampling to recruit 378 rural patients with ischemic stroke from five hospitals in Liaoning Province, China. Data were collected using the Socio-demographic Questionnaire, Stroke Health Knowledge Scale, Self-Efficacy for Managing Chronic Disease 6-Item Scale, and Health Behaviors Scale for Stroke Patients. Latent profile analysis (LPA) was conducted to identify behavioral subgroups, and multinomial logistic regression was used to examine correlates of profile membership. Results:Three distinct health behavior profiles were identified: "Low Health Behaviors Group" (34.13%), "Medium Health Behaviors Group" (50.00%), and "High Health Behaviors Group" (15.87%). Male gender was associated with higher odds of belonging to the Low and Medium Health Behaviors Groups (both P < 0.001); higher self-efficacy (OR = 0.29-0.34) and higher health knowledge (OR = 0.51-0.52) were associated with lower odds of belonging to unfavorable profiles (all P < 0.001). Conclusion:Health behaviors among rural Chinese IS survivors are heterogeneous. A majority (84%) exhibit suboptimal behavioral patterns, which are known correlates of higher stroke recurrence rates. The strong association of modifiable factors like self-efficacy and health knowledge with favorable profiles provides clear targets for secondary prevention interventions. Tailored strategies that address these factors are essential to mitigate stroke-related health disparities in this underserved population.

BACKGROUND:Chronic kidney disease heavily burdens patients and health systems. Digital health interventions offer significant potential but face implementation challenges driven by stakeholders' emotional and practical experiences. This review synthesizes these affective dimensions to inform clinical practice. METHODS:A qualitative systematic review was conducted across six databases for studies published through April 2025. Methodological quality was rigorously appraised. We integrated Python-based computational sentiment analysis to quantify stakeholder emotional polarity (positive, negative, neutral) with thematic analysis. Identified barriers were mapped to established implementation frameworks to select expert-validated implementation strategies. RESULTS:Twenty-three qualitative studies were included, revealing five domains: accessibility, communication, workflow, empowerment, and clinical effectiveness. Patients praised digital empowerment but highlighted socioeconomic access barriers. Nurses valued workflow efficiencies but reported role ambiguity. Clinicians expressed deep skepticism toward remote clinical effectiveness due to diagnostic limitations. To resolve these tensions, prioritized implementation strategies include identifying clinical champions, promoting intervention adaptability, and systematically assessing organizational readiness before deployment. CONCLUSION:Stakeholder emotions critically dictate digital health adoption. For clinical practice, these findings emphasize moving beyond generic deployments. Healthcare systems must address clinician diagnostic concerns via hybrid care models, resolve nurse workflow ambiguities through targeted training, and provide low-cost devices to bridge patient equity gaps. Tailoring solutions to these psychosocial needs is essential for successful integration into routine kidney care.

AIM:To explore the factors influencing unmet care needs among young and middle-aged kidney transplant recipients and to provide a scientific basis for developing targeted nursing interventions. DESIGN:A cross-sectional study. METHOD:196 young and middle-aged kidney transplant patients in a tertiary hospital were selected using convenience sampling. Demographic and disease information questionnaires designed by the researcher, the Multidimensional Scale of Perceived Social Support questionnaire, the Mishel uncertainty in illness scale, and the unmet care needs scale for organ transplant recipients were measured. SPSS 26.0 was used for statistical analysis. RESULT:Young and middle-aged kidney transplant recipients had a moderate level of unmet care needs during their stay at home. Education level (β = -0.258), return to work/study after discharge (β = 0.168), complications within 1 month after surgery (β = -0.173), social support (β = -0.129), and illness uncertainty (β = 0.358) were included in the final multivariate linear regression equation, which explained a total of 42.9% of the variance in unmet care needs (F = 21.903, p < 0.001; R2 = 0.429). Clinical nurses should provide medical support and actively explore the underlying causes of disease-related uncertainty, thereby helping patients develop a positive perception of their condition and promoting long-term graft function and overall health. PATIENT CONTRIBUTION:The researchers assured the participants that their identities would be kept confidential and that a truthful answer would not impact their work. The authors express their gratitude to all kidney transplantation recipients who participated in the study.

This study constructs a user persona coding framework for self-management among patients with permanent enterostomy, identifying behavioral characteristics, and nursing needs to develop targeted interventions. A total of 18 patients (n = 18) were recruited via purposive sampling. Semi-structured in-depth interviews were performed, and Colaizzi’s method was applied to analyze the resulting data; this involved extracting factual labels, integrating common characteristics, and summarizing labeling dimensions, with the ultimate goal of developing patient personas. A five-dimensional coding framework was established, covering disease-related medical information, daily life, medical resource accessibility, social support, psychological state. Four self-management types were identified, including proactive (younger, high education, active learning, strong self-efficacy), dependent-regressive (elderly, low education, passive dependence), Fragmented Knowledge-Guided Practice(middle-aged, fragmented knowledge, improper operations), and Avoidant Coping (elderly, low acceptance, avoidant behaviors). This study identifies the multi-dimensional characteristics and typological differences of self-management behaviors in patients with permanent enterostomy, providing a reference for personalized nursing interventions to enhance self-management efficacy and improve patients’ quality of life. Not applicable.

Intrinsic capacity (IC) is a central pillar of healthy ageing. Diminished IC is closely associated with poorer health outcomes and a greater degree of care dependence among disabled older adults. This study used the social-ecological framework to examine lived experiences and intervention needs related to a decline in intrinsic capacity among disabled older adults in Chinese nursing homes, so as to inform personalized interventions and policy improvement. A descriptive qualitative study (single-site design, n = 16) adhering to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines was conducted. Using purposive sampling with attention to variation in age, sex, education, disability level, and length of stay, sixteen older adults with mild-to-moderate disability were recruited from one public nursing home between November and December 2025, with the sample size determined by data saturation. We conducted semi-structured in-depth interviews. A directed content analysis (hybrid deductive-inductive approach) was performed using NVivo 12.0: the micro/meso/macro levels of the social-ecological systems theory served as the a priori analytical framework, within which coding, categorization, and thematic development were conducted based on the interview data. The three overarching themes were theory-driven, whereas the sub-themes and specific intervention needs were inductively derived from participants’ narratives. Three core themes and nine sub-themes were identified: (1) Micro-level: limited awareness of intrinsic capacity and insufficient health empowerment; (2) Meso-level: multifaceted environmental barriers to health-promoting behaviors; (3) Macro-level: system-level support gaps and multidimensional intervention needs. The experiences of decline in intrinsic capacity and associated intervention needs among disabled older adults in nursing homes appear to exhibit distinct hierarchical characteristics consistent with the social-ecological systems theory within this single-center context. Key challenges include inadequate cognitive awareness of intrinsic capacity, low health empowerment, constrained health-promoting behaviors, and a lack of systematic support systems. These findings provide context-specific insights that may inform practice and policy development for nursing homes with predominantly oldest-old populations in rapidly aging regions and offer a theory-informed empirical basis for developing multilevel interventions. Further multi-site research is needed to confirm transferability.

Head and neck cancer (HNC) is a globally prevalent malignancy. However, HNC therapies often induce distressing symptoms that impair patients quality of life and treatment adherence. While non-pharmacological interventions are guideline-recommended for symptom management, a comprehensive overview of their current landscape is lacking. Guided by the UK Medical Research Council (MRC) complex intervention framework, this scoping review aims to: (1) catalogue non-pharmacological interventions for HNC patients during the peri-chemoradiotherapy; (2) detail the outcome measures assessing their effectiveness; (3) examine intervention development methodologies and frameworks; (4) assess pilot testing and efficacy evaluations; (5) categorize and analyze facilitators and barriers of implementation. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, PubMed, Scopus, Embase, and other databases were searched from inception to May 2025. A total of 68 eligible studies were included in the present study. Nurses were the primary deliverers of these interventions, which were most frequently conducted in home settings. Interventions were categorized into 9 distinct categories, and main outcome measures could be classified into 6 categories. The results revealed the multifaceted complexities of implementing interventions across patient, healthcare provider, program design, and systemic levels. Given this scoping review only maps published literature without quality assessment or effect synthesis, the research demands summarized from included studies point to an urgent need for standardized, theory-driven, patient-centered non-pharmacological interventions integrated into HNC care pathways. Future trials are recommended to boost intervention adaptability, strengthen methodological standards, and improve the scalability and sustainability of non-pharmacological symptom management.

Improving self-management is essential for the health of patients with head and neck cancer undergoing radiotherapy and chemotherapy. This study aimed to develop and validate a self-management scale at a preliminary level owing to the lack of standardized assessment tools. A cross-sectional study was conducted to develop the scale through three stages: item generation, item evaluation, and psychometric testing. Content validity was assessed using the content validity index (CVI). Construct validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent and discriminant validity were examined using average variance extracted (AVE) and composite reliability (CR). Criterion validity was assessed by correlation with the Chinese version of the Strategies Used by People to Promote Health (C-SUPPH) scale. Reliability was evaluated using Cronbach's α, split-half reliability, and test-retest reliability. After item analysis and factor analysis, the final scale consisted of 6 dimensions and 19 items. Exploratory factor analysis extracted six factors with eigenvalues greater than 1, explaining 71.78% of the total variance. Confirmatory factor analysis supported the six-factor structure with acceptable model fit indices (χ2/df = 2.939, CFI = 0.909, TLI = 0.887, RMSEA = 0.099), and the total variance increased to 79.13%. The scale demonstrated good criterion validity (r = 0.706, P < 0.001). The Cronbach's α coefficient was 0.906, the split-half reliability was 0.711, and the test-retest reliability was 0.806. The self-management scale for patients with head and neck cancer undergoing radiotherapy and chemotherapy is reliable and valid, serving as a tool for promoting self-management and offering personalized interventions to enhance patient health.

Background:Chronic kidney disease (CKD) is a global health challenge, and hemodialysis is a common treatment for end-stage renal disease. Patients undergoing hemodialysis often face significant symptom burden, affecting their quality of life. Timely help-seeking behavior (HSB) is crucial for initiating patient-centered communication and effective symptom management. Yet, the specific behavioral patterns and barriers to help-seeking in this group remain poorly understood. However, tools to assess HSB in this population are lacking. Methods:This multiphase cross-sectional study was conducted across three hospitals in China from August to October 2024, involving 425 participants. The study developed the HSB for hemodialysis symptoms (HSB-HD) scale based on literature reviews, expert consultations, and patient interviews. Psychometric evaluation was performed using classical test theory (CTT) and item response theory (IRT), focusing on reliability, validity (content, construct, criterion-related, discriminant, and convergent), and measurement invariance. Results:The exploratory factor analysis (EFA) revealed a four-factor structure (symptom detection, symptom interpretation, decision-making for help-seeking, and timely disclosure and action), explaining 72.9% of variance. Confirmatory factor analysis (CFA) showed a good model fit (CFI = 0.964, RMSEA = 0.045). Cronbach's α was 0.953, indicating excellent internal consistency. Validity tests showed significant correlations with the EQ-5D-5L pain, anxiety, and VAS scores. Measurement invariance was confirmed across gender and age groups. Conclusions:The HSB-HD scale is a reliable and valid tool for assessing HSB in hemodialysis patients. It offers a patient-centered approach to symptom management, providing health care providers with a means to identify those who may benefit from targeted interventions, thereby improving care and quality of life.

This systematic review investigates the barriers, enablers and mechanisms affecting ePROMs implementation in CKD (chronic kidney disease) management, with a focus on the perspectives of patients and healthcare providers. A qualitative systematic review was conducted using the UK Medical Research Council’s Process Evaluation Framework to analyze studies on ePROM implementation in CKD care. We systematically searched databases for peer-reviewed qualitative studies published from inception to October 2025. Thematic analysis, guided by the Process Evaluation Framework, was used to synthesize the findings. Studies from PubMed, Embase, Scopus, CINAHL, and APA PsycINFO were included. Results Eleven studies met the inclusion criteria. The synthesis identified distinct barriers and mechanisms of impact. Key barriers included structural and technical obstacles: digital literacy gaps, cognitive overload in vulnerable populations, misalignment with clinical IT systems, interface usability issues, and inconsistent implementation protocols. Regarding Enablers and Mechanisms, the review revealed a paradox. While ePROMs acted as enablers for personalized treatment and improved symptom awareness, their effectiveness was mediated by complex relational mechanisms. Both patients and clinicians expressed skepticism regarding utility in routine care. Furthermore, relational tensions arose when patient input was perceived as overlooked, highlighting that patient empowerment is conditional on the quality of the therapeutic alliance. ePROMs have the potential to enhance CKD care by providing valuable insights into patient experiences. However, their adoption is hindered by digital literacy, technological issues, and inconsistent protocols. To optimize adoption, policymakers must prioritize IT integration and standardized protocols, while clinicians should actively incorporate results into consultations to validate patient input. Future research should focus on mixed-methods studies in diverse populations to ensure equitable and effective implementation.

BackgroundSymptoms play an important role in the evolution of the patient’s disease and their quality of life among people with HIV (PWH). This study aimed to explore the Journey of symptoms experienced and perceived symptom manageability (PSM) among PWH under the Chinese Cultural Context.MethodsA qualitative, phenomenological study was conducted at an HIV-designated medical institution in mainland China. From April 2021 to June 2021, in-depth interviews with 11 PWH and focus group interviews with 6 nurses working in HIV wards were conducted, and their related experiences, attitudes, and coping were studied and deeply described. Data collection and analysis were carried out simultaneously by two researchers, respectively.ResultsBased on the research scope, two primary themes and five sub-themes were extracted and refined from the perspectives of the HIV/AIDS population and clinical nursing staff. Each theme encompasses several sub-themes: Theme 1: Perception of Symptom Manifestation includes the following sub-themes: Sub-theme 1-1: Physical and Perceptual Dimensions of Symptom Experience (Sub-theme 1-1-1: Distress Rooted in Recurrent and Persistent Symptoms; Sub-theme 1-1-2: Confusion Regarding the Different Origins of the Same Symptoms); Sub-theme 1-2: Anticipatory Anxiety About Symptom Trajectories (Sub-theme 1-2-1: Anxiety Regarding Symptom Progression and Dynamic Evolution; Sub-theme 1-2-2: Collapse Following the Concurrent Interaction of Multiple Symptoms); Sub-theme 1-3: Adaptive Tension in Symptom Management (Sub-theme 1-3-1: Comparison Between Self-Perception and Clinical Objective Indicators; Sub-theme 1-3-2: The Struggle Between Exhaustion and the Will to Survive). Theme 2: Perception of Symptom Manageability—Harmonious Unity of Heaven, Earth, and Humanity consists of the following sub-themes: Sub-theme 2-1: Perception of Self-Worth; Sub-theme 2-2: Perception of the Value of Social Support Systems (Sub-theme 2-2-1: Self-Awareness and Self-Regulation; Sub-theme 2-2-2: Self-Coping with Symptoms; Sub-theme 2-2-3: Growth Under the Care of the State and Society; Sub-theme 2-2-4: Hope Evoked by Medical Care and Nursing; Sub-theme 2-2-5: The Contradictory Nature of Resource Supply and Demand); Sub-theme 2-3: Perception of the Value of Interpersonal Interaction Systems (Sub-theme 2-3-1: The Motivation of Love and Being Loved; Sub-theme 2-3-2: Satisfaction After Reflection on Conflicting Events; Sub-theme 2-3-3: Exemplification of Successful Role Models; Sub-theme 2-3-4: The Burden Within the Culture of Illness).ConclusionThe manifestation of symptoms, coping strategies, and depictions of the concept of PSM among PWH are intricately intertwined with individual characteristics, life experiences, cultural backgrounds, and other factors. This study provides a systematic exposition and conceptual delineation of PSM. By elucidating culture-specific coping strategies and their implications for HIV care, this research significantly advances the understanding of PSM within the Chinese context. This lays the groundwork for an exploratory study into the intrinsic motivational mechanisms underlying the perception of symptom manageability in the future.

Home-based cardiac rehabilitation offers a cost-effective alternative model. However, long-term exercise adherence among patients remains suboptimal due to insufficient motivation. Self-Determination Theory and Nudge Theory provide the theoretical foundation for understanding behavioral drivers and designing low-burden intervention strategies. Therefore, this study aimed to develop a nurse-led, theory-driven, digitally platform-delivered nudge intervention program to improve long-term rehabilitation behavior in patients with chronic heart failure. A multi-stage mixed-methods design was employed. In Stage I, based on prior evidence, a questionnaire survey was used to explore patient preferences regarding nudge strategies and delivery media; findings were finalized through expert panel discussion. In Stage II, an expert participatory theory co-design process was adopted. Experts from diverse professional fields were invited to develop the programme theory and elucidate hypothesized mechanisms. Expert response rate, authority coefficient, and Kendall concordance coefficient were used to systematically assess expert engagement quality, professional authority, and consensus level on the theoretical framework. In Stage III, the Nominal Group Technique was utilized to draft the digital nudge strategies. Subsequently, stakeholder meetings were conducted to refine and finalize the digital nudge strategy package. In Stage I, 486 patients with chronic heart failure participated in the survey. Patients most preferred the nudge strategies of pre-commitment (34.6

Patients undergoing hemodialysis experience a broad spectrum of symptoms that impact their physical, psychological, and social well-being. Traditional qualitative studies often focus on isolated aspects of patient experiences and offer limited insights into the interconnected nature of symptom management. This systematic review and meta-ethnography aims to synthesise qualitative studies and develop a comprehensive model that elucidates interrelations between patient experiences and symptom management practices in hemodialysis. Our analysis integrated findings from 30 qualitative studies using a meta-ethnographic approach. The results revealed critical psychological and social dynamics influencing symptom management. The model highlights how supportive factors, such as family involvement and effective healthcare interactions, enhance coping mechanisms, improving emotional resilience and treatment adherence. Conversely, it identifies significant barriers, including chronic self-regulatory burnout and systemic inefficiencies, that hinder symptom management and exacerbate psychological distress. By integrating diverse qualitative findings, this study proposes a shift towards patient-centred, culturally sensitive care strategies that prioritise psychological support. This shift aims to transform hemodialysis care by addressing the complex interplay of medical, psychological, and social factors. The developed framework not only facilitates deeper understanding of the psychological impacts of symptom management and offers a structured approach for future research and interventions in this domain[Q1].

Cervical cancer is a serious threat to women’s health and is currently showing a trend of increasing incidence in young women. The screening rate for cervical cancer is lower than the WHO’s target, and a scientific, comprehensive, and quantifiable evaluation is crucial to determine the factors that may affect the acceptance of cervical cancer screening. In this context, we developed a cervical cancer screening uptake questionnaire (CCSTQ), which was validated among urban and rural Chinese women. We conducted a questionnaire development and cross-sectional validation study from April to June 2025. The CCSTQ was developed based on the Determinants of Screening UpTake model and a literature review. Content validity of the CCSTQ was established by a two-round Delphi expert consultation (n = 15). A pilot study (n = 10) was conducted to test the feasibility of the questionnaire. An online survey was administered to 560 Chinese women to assess the psychometric properties of the CCSTQ. Construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Kaiser–Meyer–Olkin value and factor loadings were > 0.8 and > 0.4, respectively. Internal consistency was assessed using Cronbach’s α value, and the test-retest reliability was determined using the intraclass correlation coefficient (ICC). Among the 520 participants (mean age: 49.15 ± 18.25 years), the final 43-item CCSTQ showed high internal consistency (Cronbach’s α = 0.985) and good test-retest reliability (ICC = 0.879; 95

Hemodialysis (HD) nurses are facing significant physiological and psychological pressures. These pressures increase their risk of resignation. This study explored the impact of work-family support, work engagement, and career success on the turnover intention of HD nurses. The study based on the Job Demands-Resources (JD-R) model. As a job resource, work-family support can mitigate the negative impact of high job demands. Work-family support also promotes positive outcomes, such as enhancing work engagement and career success. Work engagement further contributes to career success, which in turn reduces turnover intention.This was a cross-sectional study. In July 2024, a total of 397 nurses were recruited from 50 dialysis centers in Liaoning Province, using convenience sampling. They were investigated by Work-Family Support Scale, Work Engagement Scale, Career Success Scale and Intention of Quitting Scale. A total of 308 valid questionnaires were analyzed. The valid response rate was 77.78

BACKGROUND:End-stage kidney disease (ESKD) patients on hemodialysis (HD) endure a high symptom burden. Despite the clinical importance of symptom management, traditional methods fail to predict intervention effects or identify optimal targets due to limited consideration of symptom interactions. Computational simulations with symptom network analysis to identify core intervention targets for personalized care is needed. DESIGN:Computational simulated modeling study using cross-sectional observational data. SETTING:Across five regions of China-northern, southern, western, eastern, and central. PARTICIPANTS:A total of 1866 hemodialysis patients participated in the study. METHODS:A combination of variable-centered and person-centered approaches was used to simplify the symptoms measured by real patient-reported data, followed by latent profile analysis to classify patients into symptom burden profiles. In silico interventions were performed using the NodeIdentifyR algorithm to simulate the effects of alleviating and aggravating interventions on the symptom network. RESULTS:Four symptom clusters were identified: uremic toxin, water-electrolyte, psychological, and gastrointestinal. Latent profile analysis revealed two distinct patient profiles: severe and mild symptom groups. Network analysis highlighted key symptoms such as pruritus, fatigue, anxiety, and easy awakening as central nodes. The in silico interventions in overall groups showed that alleviating interventions targeting easy awakening, fatigue and pruritus as core targets. Treating these may reduce the symptom burden by 10.25 %, 10.00 % and 9.82 %. Aggravating interventions identified pruritus, dry skin and easy awakening as pivotal targets. Preventing the presence of these may separately reduce the symptom burden by 24.69 %, 23.05 % and 22.21 %. CONCLUSION:This study provides critical insights into the symptom burden of hemodialysis patients, offering potential targets for personalized care plans for nurses. The results of computational simulations, if go through further longitudinal study for verification, the study has potential to advance the development of more tailored and effective symptom management care approaches, which could enhance patient care and quality of life.

Faced with a shortage of nurses in China, the factors affecting the stability of the nursing workforce require urgent attention. The workplace deviance behavior of nurses is considered an important behavior in clinical practice, which will bring negative effects and affect the development of nurse team. However, no research has been done to examine the associations among workplace deviance behavior of nurses, practice environment and job burnout. Thus, this study aimed to determine the influence of practice environment on nurses’ workplace deviance behavior and confirm the mediating role of job burnout. This study was designed as a multicentre cross-sectional study, and recruited 598 nurses in China to complete a survey of the general information questionnaire, Scale of Workplace Deviance Behavior of Nurses, Practice Environment Scale, and Maslach Burnout Inventory General Survey. The model was examined using descriptive analysis, Pearson’s correlation analysis, and the PROCESS Macro in SPSS 26.0. The results of the correlation analysis demonstrated a significant relationship between the practice environment and work deviance behavior of nurses, as well as a negative relationship between job burnout and these two factors. Moreover, the relationship between practice environment and work deviance behavior among nurses was partially mediated by job burnout. A healthy practice environment and a decrease in job burnout could directly lower the work deviant behavior of nurses. Hospital managers must actively endeavor to improve the practice environment for nurses by fostering a just, fair, and supportive practice environment and by keeping lines of communication open and strong with the nursing staff. Furthermore, managers can also reduce nurses’ work deviance behavior by lower their job burnout.

Objectives: Self-reported health-related quality of life (HRQoL) is a critical metric for evaluating clinical outcomes. Although the HRQoL of patients with nasopharyngeal carcinoma (NPC) has been widely studied, the performance of these assessments in clinical practice remains uncertain, and there is a significant gap in the quality evaluation of the scales used. This review aimed to systematically evaluate self-reported HRQoL scales for patients with NPC, thereby providing guidelines for the informed selection of assessment tools. Design: A systematic review based on the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology and following the PRISMA guidelines. Methods: PubMed, Web of Science, Embase, CINAHL, PsycINFO, CNKI, SinoMed, and WanFang databases were systematically searched from their inception until August 2024. The included studies must report the assessment of measurement properties of HRQoL scales designed for NPC. Two authors independently screened the eligible literature, extracted data, and evaluated their methodological and psychometric quality. The measurement properties of HRQoL scales for NPC were evaluated according to COSMIN systematic review guidelines. Additionally, the GRADE approach was used to grade the quality of evidence. Results: Among 17 instruments across 19 studies, all demonstrated adequate content validity, construct validity, and internal consistency. However, information on cross-cultural validity, criterion validity, reliability, hypothesis testing, and responsiveness was limited. High-quality evidence on psychometric properties was provided for HRQoL instruments for Cancer Patients-Nasopharyngeal Cancer (QLICP-NA), the Functional Assessment of Cancer Therapy-Nasopharyngeal (FACT-NP), and the Quality of Life Scale for Nasopharyngeal Carcinoma Patients Version 2 (QoL-NPC V2). Conclusion: The measurement characteristics of QLICP-NA, FACT-NP, and QoL-NPC V2 scales were comprehensively assessed, exhibiting good methodological quality, strong measurement attributes, and robust supporting evidence. Therefore, these scales are recommended for evaluating the quality of life of patients with NPC. However, further validation of the remaining assessment tools is required. Relevance to Clinical Practice: Our findings will help healthcare professionals select suitable instruments for patients with NPC.

To investigate the current status of the ability to communicate bad news through latent profile analysis (LPA), identify potential subgroups and their population characteristics, and analyze the influencing factors of different categories. The ability of nurses to communicate bad news is a crucial skill in clinical practice. However, heterogeneity in nurses’ ability to communicate bad news and the factors influencing it have not been fully explored. Assessing the relationship with psychological resilience and work engagement is essential for understanding how these factors impact nurses’ communication abilities. This cross-sectional and multicenter study surveyed 274 Chinese nurses using a convenience sampling method. A demographic characteristics questionnaire, Communicating Bad News Scale (CBN), Connor-Davidson Resilience Scale (CD-RISC) and Utrecht work engagement scale (UWES) were used in this study, with Cronbach’s alpha coefficients of 0.92, 0.91, and 0.92, respectively. Statistical analyses were performed using Mplus 8.3 and SPSS 26.0. Latent profile analysis was employed to identify nurses’ ability to communicate bad news profiles using the CBN Scale. After identifying profiles via LPA, we examined their associations with psychological resilience and work engagement. Differences in sociodemographic characteristics across profiles were assessed via ANOVA, chi-square tests, and multinomial logistic regression was used to identify predictors of profile membership. A three-profile model provided the best fit. The 3-profile were titled “Low Communicating Bad News Group” (Class 1, n = 52, 18.98

BACKGROUND:Patients with chronic kidney disease on hemodialysis experience complex symptom clusters that impact their quality of life. Simplifying symptom management is essential to improve patient care and outcomes. However, there is no comprehensive evaluation of these simplification methods in current literature. AIM:To evaluate and synthesize strategies for simplifying the symptomatology associated with hemodialysis to improve patient outcomes and management practices. METHODS:We conducted a systematic review. We performed a comprehensive literature search across Pubmed, CINAHL, Embase, Web of Science, Scopus, CNKI, VIP database, and Wanfang in April 2024. Data synthesis was narrative due to the heterogeneity of the methodologies. Studies were selected based on predefined criteria focused on symptom simplification strategies among adult hemodialysis patients. Articles were retrieved and assessed for relevance and quality through April 2024. RESULTS:We identified 18 eligible studies from an initial pool of 18,324 records, focusing on variable-centered, person-centered approaches and approaches to identifying the main symptoms to symptom simplification. The studies varied significantly in their methodological quality and findings but commonly reported symptom clusters that correlated with poor patient outcomes. LINKING EVIDENCE TO ACTION:This review underlines critical areas for advancement in hemodialysis patient care through strategic symptom management integration. Our findings emphasize the necessity of implementing simplified symptom assessment protocols in routine clinical practice, thereby enhancing patient engagement and outcomes. Additionally, the results advocate for ongoing research into personalized care approaches, underscoring the potential for these strategies to decrease symptom burden significantly. These insights should inform both policy and educational programs, encouraging the adoption of standardized practices across healthcare systems. Moreover, the study highlights the need for management strategies that align with patient-reported outcomes, fostering a more patient-centered approach in healthcare settings. Ultimately, this evidence should guide educational efforts to better equip healthcare providers with the tools necessary for effective symptom management in hemodialysis care. TRIAL REGISTRATION:PROSPERO: CRD42023473789.