AIM(S):To identify distinct dyadic coping patterns among prostate cancer patients undergoing androgen deprivation therapy and their spouses using a person-centred approach, and to explore factors associated with these patterns to inform the development of personalised interventions. DESIGN:A cross-sectional, observational study design. METHODS:A total of 223 patient-spouse dyads were recruited from two tertiary urology departments in Guangdong Province, China, between October 2024 and August 2025. All participants completed a general information questionnaire and the Dyadic Coping Inventory. Latent profile analysis was used to identify distinct coping profiles. Univariate analysis and multivariate logistic regression were performed to examine factors associated with profile membership. RESULTS:Among 223 patient-spouse dyads, four distinct dyadic coping profiles were identified: Efficient Coping (12.0%), Ambivalent Coping (30.0%), Stable Coping (53.8%), and Coping Distress (4.0%). The small Coping Distress subgroup (n = 9) was excluded from further analysis. Higher dyadic coping levels were associated with patient education of high school or above, absence of tumour recurrence, sufficient patient-perceived family support, low-to-moderate spouse-perceived medical burden, frequent dyadic communication, and sufficient spouse-perceived friend/colleague support. Spouse-perceived insufficient family support was unexpectedly associated with better dyadic coping. CONCLUSION:Dyadic coping patterns among prostate cancer patients undergoing androgen deprivation therapy and their spouses are heterogeneous. Healthcare professionals should identify distinct dyadic coping characteristics and provide personalised nursing interventions based on the key influencing factors identified in this study. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:This study provides a person-centred classification framework for dyadic coping in couples undergoing androgen deprivation therapy, enabling nurses and other healthcare professionals to deliver targeted, stratified psychosocial care. Early identification of vulnerable couples, particularly those in the ambivalent coping subgroup, helps prevent maladaptive coping and alleviate psychological distress. By addressing modifiable factors including communication, family support, and caregiver burden, clinical practice can more effectively improve the psychosocial well-being and quality of life of both patients and their spouses throughout androgen deprivation therapy. REPORTING METHOD:This study adheres to the relevant EQUATOR guidelines (STROBE) for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION:Patients and their spouses were involved in the design of the study by providing feedback on the clarity and relevance of the questionnaire items during a pilot phase. They also participated in data collection by completing the self-report measures, and their input informed the interpretation of the findings related to dyadic coping experiences.

AIMS AND OBJECTIVES:To compare and rank the effectiveness of various non-pharmacological interventions on depression for community-dwelling individuals with spinal cord injury (SCI). BACKGROUND:Depression is a significant and persistent mental health problem among community-dwelling individuals with SCI. There is increasing evidence that non-pharmacological interventions are safe and effective for alleviating depression. However, the efficacy and comparative effectiveness of various non-pharmacological interventions for community-dwelling individuals with SCI remain unclear. DESIGN:Systematic review and network meta-analysis (NMA) according to PRISMA-NMA guidance. METHODS:We included randomized controlled trials (RCTs) of community-dwelling individuals with SCI comparing non-pharmacological interventions versus usual care/waiting list and reporting depressive symptoms using validated scales. China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Literature Database, China Science and Technology Journal Database, the Cochrane Library, PubMed, Web of Science, Embase, ProQuest and Scopus were systematically retrieved. Pairwise meta-analyses were performed using Review Manager 5.4.1, and the network meta-analysis was conducted using Stata 15.1. RESULTS:Thirty-two RCTs involving 2200 participants were identified from database inception to May 2026. Compared with the control group, combination therapy (SMD = -0.86, 95% CI: -1.46 to -0.27), exercise therapy (SMD = -0.66, 95% CI: -1.16 to -0.15), psychological interventions (SMD = -0.41, 95% CI: -0.70 to -0.13) and self-management education (SMD = -0.33, 95% CI: -0.61 to -0.05) showed statistically significant effects, whereas vocational rehabilitation was not (SMD = -0.03, 95% CI: -1.00 to 0.95). Combination therapy had the highest SUCRA (89.1%, mean rank = 1.5), followed by exercise therapy (76.9%, mean rank = 2.2), psychological interventions (55.5%, mean rank = 3.2), self-management education (44.0%, mean rank = 3.8) and vocational rehabilitation (24.7%, mean rank = 4.8). CONCLUSION:Combination therapy had the highest ranking probability. However, all comparisons were rated as very low certainty according to CINeMA. The findings should be interpreted with caution. RELEVANCE TO CLINICAL PRACTICE:Community nurses may consider integrating exercise, self-management education and brief psychological support into individualized depression management for individuals with SCI. Support should be tailored according to depressive symptom severity, functional status, secondary complications, patient preferences, safety considerations and available community resources. Nurse-led or nurse-coordinated care may include depressive symptom screening, exercise planning, self-management coaching, motivational interviewing, scheduled follow-up and referral to mental health professionals when indicated. TRIAL REGISTRATION:PROSPERO: CRD42022342155.

PURPOSE:To explore the effects of physical activity (PA) on depression in community-dwelling individuals with spinal cord injury (SCI). METHODS:It is a cross-sectional study. Participants completed measures of physical activity scale for individuals with physical disabilities, Beck depression inventory version 2, numeric rating scale, and chronic pain grade scale. Relationships among variables were explored by structural equation modeling (SEM). Fuzzy-set qualitative comparative analysis (fsQCA) was used to explore multiple causal pathways to depression. RESULTS:The direct effect of PA on depression was -0.213 (95% CI: -0.328, -0.099, p < 0.001). The mediating effect of pain intensity and pain interference was -0.034 (95% CI: -0.070, -0.007, p = 0.035). fsQCA found three configurations triggered high depression. In H1a and H1b, high depression was triggered by low PA, low pain intensity, high pain interference, complications, or unemployment. In H2, high depression was triggered by high PA, high pain intensity, high pain interference, complications, and unemployment. CONCLUSIONS:Making PA the foundation and incorporating pain management as a key supportive strategy may effectively improve depressive symptoms in the population with SCI. However, it is crucial to assess individuals' circumstances and provide personalized interventions rather than adopting a uniform way.

BACKGROUND:The cultivation of history-taking ability is a progressive process. Students typically begin by learning the foundational knowledge of history-taking and common clinical symptoms, and then proceed to study the knowledge of common diseases. Virtual patient (VP) can provide safe and repeatable opportunities for history-taking practice, helping to develop students' history-taking abilities. Based on this progressive process, this study designed a VP-based stepwise training approach, gradually transitioning from single symptom to comprehensive case history-taking, to meet the learning needs of students. PURPOSE:To evaluate the intervention effects of VP-based stepwise training on the history-taking abilities of nursing undergraduates at different phases. METHODS:This study adopted a non-concurrent control design and was conducted at the nursing schools of three universities in Guangdong Province, China, from March 2020 to June 2022. The intervention group of 200 students underwent Virtual Patient-based Stepwise History-Taking Training, beginning with symptom history-taking in the Health Assessment phase and followed by case history-taking in the Internal Medicine Nursing phase. The control group of 175 students received conventional history-taking instruction in both phases. Evaluation indicators included history-taking abilities and self-efficacy levels, which were separately evaluated using VPs via computer or mobile terminal for abilities and the Academic Self-Efficacy Scale (ASES) online for self-efficacy levels. Data were collected at the beginning of the Health Assessment course (T0), at its end (T1), and at the end of the Internal Medicine Nursing course (T2). Statistical analyses were conducted using Generalized Estimating Equations and the Mann-Whitney U test. RESULTS:The intervention group demonstrated significantly higher scores in both symptom (T1) and case history-taking (T2) test compared to the control group (Z = 9.604, P < 0.001; Z = 11.784, P < 0.001). At T1 and T2, referring to the baseline T0 stage, the intervention group showed a statistically significant improvement in ASES scores compared to the control group (Group × T1: β = 2.79, P < 0.05; Group × T2: β = 5.48, P < 0.001). CONCLUSIONS:The VP-based stepwise history-taking training can sustainably and significantly enhance nursing undergraduates' history-taking abilities and self-efficacy levels. This training method offers students a gradual practice pathway and supports the systematic development of their history-taking abilities, meeting the practical needs of students at different stages of their education.

Background:The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). However, the adherence rate of ABC pathway in rural Chinese patients with AF is extremely low. Aim:To explore the factors and mechanisms of adherence to the ABC pathway based on the integrated theory of health behavior change (ITHBC) among rural patients with AF. Methods:In this cross-sectional study, we recruited 940 patients with AF from rural areas in China from July 2022 to September 2023. Patients completed a questionnaire covering AF-related demographic and clinical characteristics, AF knowledge, AF health beliefs, AF self-management ability, and social support. Adherence to ABC pathway was assessed based on AF-demographic and clinical characteristics. Path analysis was used to explore the relationship between variables. Results:Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability (β = 0.449; P<0.001) and social support (β = 0.429; P<0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge (β = 0.211; P<0.001), AF health beliefs (β = 0.350; P<0.001) and social support (β = 0.085; P<0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge (β = 0.121; P<0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability. Conclusion:AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.

Massive open online courses (MOOCs) have transformed global education, yet their long-term effectiveness and evolving learner engagement remain underexplored. This study aims to comprehensively evaluate a nursing MOOC over six years, examining learner engagement, identifying distinct learner profiles, and assessing changes across different developmental stages to inform future MOOC design. A retrospective study was conducted on 4171 completers of the Medical Nursing MOOC on a Chinese MOOC platform, covering eleven semesters from 2018 to 2023. Latent profile analysis (LPA) categorized learners based on unit test scores, and profile distributions were compared across the MOOC’s developmental stages. The Medical Nursing MOOC attracted 69,642 registrants with a 5.99

OBJECTIVE: To investigate the incidence of community-acquired pressure injuries (PIs) and factors influencing their frequent occurrence (ie, 2 or more PIs after discharge) among community-dwelling individuals with spinal cord injury in China. METHODS: This retrospective study included a convenience sample of 302 community-dwelling individuals with either traumatic or nontraumatic spinal cord injury. Univariate analysis and logistic regression analysis were performed to identify factors influencing the frequent occurrence of community-acquired PI (CAPI). RESULTS: Of the sample, 34.11% had a CAPI. Independent risk factors for CAPI included complete spinal cord injury, >2 years duration since injury, low serum albumin or total protein levels before discharge, high fasting blood glucose before discharge, and the occurrence of PI during hospitalization. Independent protective factors for CAPI included having at least a senior middle school education, reporting often or always alleviating local skin pressure when sitting, and average duration of each skin pressure relief exceeding 15 seconds when sitting. CONCLUSIONS: The incidence of CAPI among individuals with spinal cord injury in China was high. It is vital that health care professionals evaluate CAPI risk for CAPI community-dwelling individuals, determine patients’ skin self-management level, and provide long-term follow-up and care after discharge.

BackgroundMassive open online courses (MOOCs) are increasingly used in nursing education, attracting learners with diverse participation modes. Social learners (self-directed) enroll voluntarily based on personal interests, while academic learners (institution-directed) are mandated by nursing schools, with performance linked to grades. Existing literature shows that academic learners outperform social learners in MOOCs, but evidence is scarce on whether this performance gap stems from distinct participation patterns shaped by institutional requirements. ObjectiveWe sought to compare participation typologies between social and academic learners using latent class analysis (LCA) and assess their association with learning outcomes. MethodsA retrospective analysis was conducted of 8222 students enrolled in a rehabilitation nursing MOOC from 2021 to 2022. Learners were classified by topic test participation frequency via LCA, and their distributions and scores were statistically compared. ResultsThe cohort comprised 7683 (93.4%) academic and 539 (6.6%) social learners. LCA identified 3 participation types: participation-declining (93/8222, 1.1%), high-participation (6959/8222, 84.6%), and lowest-participation (1170/8222, 14.2%). The distributions of participation types differed significantly between groups (χ2=2745.1; df=2; P<.001). Most social learners belonged to the lowest-participation group (482/539, 89.4%), whereas most academic learners belonged to the high-participation group (6923/7683, 90.1%). Among high-participation learners, academic learners significantly outperformed social learners (all P<.05; r=0.06-0.10). No significant between-group differences were observed for the other participation types (all P>.05). ConclusionsDistinct participation patterns were associated with the performance advantage of academic learners. Our findings highlight the importance of sustained participation, suggesting that MOOC instructors should provide enhanced support for voluntary learners.

STUDY DESIGN:Systematic review and meta-analysis. OBJECTIVES:To systematically evaluate the prevalence of diabetes mellitus (DM) among individuals with spinal cord injury (SCI), assess the association between SCI and DM compared with non-SCI populations, and synthesize evidence on associated factors within SCI populations. METHODS:Observational studies from PubMed, Embase, Cochrane Library, CINAHL, and ProQuest Dissertations & Theses Global, published up to August 2025 were identified. Two reviewers independently screened articles, extracted data, and assessed study quality using the Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) criteria. Heterogeneity was assessed using the I2 statistic, and sensitivity, subgroup, and publication bias analyses were conducted. RESULTS:Ten studies with 76,062 individuals with SCI were included, comprising six cohort and four cross-sectional studies. The pooled prevalence of DM among individuals with SCI was 12% (95% CI, 5-20%). SCI was associated with an approximately two-fold higher odds of DM compared with non-SCI populations (OR = 2.03, 95% CI, 1.30-3.16). Subgroup analyses suggested that study region and sample size contributed to heterogeneity in prevalence estimates. Within SCI populations, meta-analysis identified male sex (OR = 1.22, 95% CI, 1.05-1.40) and Black race (OR = 1.62, 95% CI, 1.24-2.10) as significant associated factors with DM. CONCLUSIONS:These findings highlight the importance of systematic DM screening, risk-stratified management, and integration of metabolic monitoring into long-term SCI care, while underscoring the need for large, prospective, and geographically diverse studies.

STUDY DESIGN:Systematic review and meta-analysis. OBJECTIVES:Despite a growing prevalence of cognitive impairment and depression after spinal cord injury (SCI), evidence of associations between specific cognitive domains and processes with depressive symptoms remains uncertain. This systematic review with meta-analysis aimed to evaluate the relationship between cognitive functions and depressive symptoms in adults with SCI. METHODS:This review was pre-registered with PROSPERO (CRD42024523479). Seven databases were searched from inception to March 2025. Eligible studies assessed depression and cognitive function in adults with SCI and were published in English. Cognitive functions included self-reported subjective cognitive failures and objective cognitive functions assessed by neuropsychological tests. Study quality was assessed via the Newcastle-Ottawa Scale. RESULTS:Ten studies (three cohort, seven cross-sectional; N = 1683 participants) were included, with seven studies eligible for meta-analysis. The pooled results revealed that elevated depressive symptoms are significantly associated with global cognitive impairment, whereas there were no associations with subjective cognitive decline or deficits in specific domains (i.e., executive function, attention, and learning and memory). CONCLUSIONS:Adults with SCI who have impaired global cognitive function exhibit higher levels of depressive symptoms. Interventions targeting either depression or cognitive function may yield concomitant benefits on both outcomes, thereby enhancing health-related quality of life of the SCI population. More prospective studies are needed to investigate the relationship between depression severity and specific cognitive domains and to elucidate their potential causal mechanisms.

ObjectiveTo explore the barriers and facilitators to leisure-time physical activity among community-dwelling adults with spinal cord injury in China, using the Capability, Opportunity, Motivation-Behaviour model as a theoretical framework.DesignA qualitative study employing semi-structured interviews.SettingTwo rehabilitation centres in Guangzhou, China.ParticipantsTwenty community-dwelling adults with spinal cord injury, purposively sampled for diversity in gender, age, injury level and severity.ResultsThe analysis identified multifaceted factors across the Capability, Opportunity and Motivation-Behaviour domains. Within the Capability domain, barriers included limited physical function and a pessimistic mindset, whereas facilitators encompassed strong psychological resilience, high self-efficacy and positive beliefs in rehabilitation. Opportunity was constrained by limited social resources, inadequate rehabilitation facilities and financial constraints, but was enhanced by diverse social support. Within the Motivation domain, engagement in leisure-time physical activity was hindered by low self-discipline, fear of physical activity and motivational conflict, while motivation was strengthened by reflection on the benefits of physical activity, a desire for social reintegration and return to work.ConclusionsPromoting leisure-time physical activity among this population requires a theory-informed, multi-level intervention strategy. Interventions should simultaneously strengthen individual capability, expand opportunity and foster motivation. Crucially, such interventions must be contextually adapted to address China-specific socioeconomic constraints and cultural norms.

ObjectiveTo translate the Physical Activity Scale for Individuals with Physical Disabilities into Mandarin according to Brislin guidelines and to examine its reliability and validity.DesignCross-sectional study.SettingsTwo rehabilitation centers in China.ParticipantsA convenience sample of 208 adults with spinal cord injury.Main MeasuresA total of 208 participants completed the Chinese version of the Physical Activity Scale for Individuals with Physical Disabilities at the first measurement. One week later, 122 of them completed both the scale and the International Physical Activity Questionnaire Short Form. Construct validity, criterion-related validity, internal consistency, test-retest reliability, goodness of fit of items, and differential item functioning were evaluated in this study.ResultsFactor analysis found a four-factor structure, including household activities, moderate to vigorous intensity activities, mild activities, and work-related activities. The Cronbach's α coefficient of the Chinese version of the Physical Activity Scale for Individuals with Physical Disabilities was 0.795. A significant correlation was found between Physical Activity Scale for Individuals with Physical Disabilities and International Physical Activity Questionnaire Short Form (r = 0.842, p＜0.05). The test-retest intraclass correlation coefficient was 0.814 (P < 0.001). Three rounds of Rasch analyses were conducted in this study. The results indicated that the Rasch model for the questionnaire had a good fit.ConclusionThe Chinese version of the Physical Activity Scale for Individuals with Physical Disabilities is a reliable and valid scale for assessing physical activity among individuals with spinal cord injury in China.

Background:Studies have shown that poor medication adherence is common in patients with rheumatoid arthritis (RA). However, the related factors and underlying mechanisms remain unclear. Through theory-based research, the mechanism of medication adherence in RA patients can be better explored and clarified, providing reference for clinical intervention. Aim:To explore the mediating role of medication self-efficacy between perceived barriers, pharmacologic treatment expectations, social support and medication adherence in patients with RA based on the social cognitive theory. Methods:A total of 232 participants diagnosed with RA were recruited from three general hospitals in Guangzhou, China. Participants' sociodemographic, disease-, and medication-related information as well as data on their perceived barriers, pharmacologic treatment expectations, social support, medication self-efficacy, and adherence were collected. SPSS 25.0 software was used for univariate analysis of medication adherence and to explore the correlation between variables. Mplus 8.0 was used to build a parallel mediation model and perform path analysis. Results:In addition to pharmacologic treatment expectations, perceived barriers, family support, and medication self-efficacy were associated with medication adherence. A mediating model with three independent variables showed that medication self-efficacy fully mediated the negative impact of perceived barriers on medication adherence. Family support had a positive effect on both medication adherence and self-efficacy, but it did not affect medication adherence through medication self-efficacy. Conclusion:Medication self-efficacy, as a mediating factor, plays a key role in improving medication adherence of RA patients. In nursing practice, timely assessment of the actual or potential barriers on medication adherence of patients and implementation of targeted intervention measures such as health education, as well as giving full play to the positive role of the family support system to improve patients' medication self-efficacy, will effectively enhance the medication adherence of patients with RA.

Cardiovascular disease has a high prevalence and mortality rate, which are mainly due to the aging population and the high prevalence and clustering of modifiable cardiovascular risk factors (CRFs); however, studies on the aging Chinese population are limited. The study aimed to investigate the prevalence and clustering of CRFs among the elderly population to provide evidence for the overall planning of medical resources and disease management. In this cross-sectional study, 41,517 participants aged ≥ 65 years were recruited from January 2020 to April 2021 in the Yuexiu district, Guangzhou city, China. Sociodemographic and health examination data were collected. Among the 41,517 participants, 42.2

AIMS:To describe the level of family decision-making self-efficacy and its associated factors among Chinese family members of ICU patients. DESIGN:Cross-sectional descriptive quantitative study. METHODS:Using convenience sampling, 154 ICU patients and their family members from two tertiary hospitals completed a paper-based questionnaire assessing sociodemographic characteristics of patients and their family members, patients' disclosure of preferences to their family members, and family members' decision-making self-efficacy, anxiety and depression, uncertainty of illness, coping and social support. The data were analysed using independent-samples t-tests, one-way analysis of variance, Pearson correlation and multiple linear regression. RESULTS:The average scores of self-efficacy in treatment, comfort promotion and facing death decision-making were 4.3 (SD = 0.6; range = 1-5), 4.2 (SD = 0.6; range = 1-5) and 3.5 (SD = 0.6; range = 1-5), respectively. Active coping was a predictor of self-efficacy in treatment, comfort-promoting and facing death decision-making. Patients' disclosure of preferences regarding mechanical ventilation, family members' anxiety and illness uncertainty were predictors of self-efficacy in treatment decision-making. Patients' disclosure of preferences regarding expensive medications was a predictor of self-efficacy in comfort-promoting decision-making, and patients' age was a predictor of self-efficacy in facing death decision-making. CONCLUSIONS:Chinese family members of ICU patients reported relatively high self-efficacy in treatment and comfort promotion decision-making but lower self-efficacy in facing death decision-making. Active coping plays a critical role in enhancing decision-making self-efficacy across these three types of decisions. The predictors of decision-making self-efficacy varied according to the specific type of decision. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:For Chinese family members of ICU patients, targeted strategies to strengthen their active coping skills are key to enhancing their confidence in making decisions with or for patients. Patients' disclosure of preferences to their family members is helpful for improving family members' confidence in making treatment and comfort promotion decisions. Extra support is especially needed for end-of-life decision-making, particularly when the patient is younger. IMPACT:This research informs future interventions by highlighting active coping and patients' disclosure of preferences to family members as key factors to strengthen decision-making self-efficacy among Chinese family members of ICU patients. However, family members' decision-making self-efficacy appears to be culturally specific, underscoring the need to design family-centered critical care approaches that are tailored to cultural contexts in other settings. Besides, while our research found a positive association between anxiety and self-efficacy in treatment decision-making, the relationship between them requires further investigation. REPORTING METHOD:STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION:No Patient or Public Contribution.

Background There is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older adults. Objective The aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older adults. Methods A two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified Delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the Delphi results and the expert panel discussion. Results Thirty-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final decision. Conclusions Using the modified Delphi method, the assessment standards of the ICF Geriatric Core Set have been developed.Future work should focus on the reliability and validity of the the assessment standards and their application to the health management of older adults.

Objective: To evaluate the feasibility, acceptability, and efficacy of a mindfulness and motivational interviewing-oriented physical-psychological integrated intervention in community-dwelling spinal cord injury (SCI) survivors. Design: A mixed-methods randomized controlled trial. Setting: Local organizations for handicapped in Hong Kong. Participants: Community-dwelling adults with SCI (N=72). Interventions: Participants in the intervention group (n=36) received video-guided exercise for daily practice and online group psychological (mindfulness and motivational interviewing-oriented) weekly sessions for 8 weeks. Participants in the control group (n=36) received an 8-week online group didactic education on lifestyle discussions and general health suggestions. Main Outcomes Measures: Primary outcomes included quality of life, physical activity, depression, and chronic pain. Secondary outcomes included exercise self-efficacy and mindfulness. Outcomes were measured at baseline, postintervention, and 3-month follow-up. Focus-group interviews were conducted postintervention. Results: The recruitment, retention, and adherence rates were 84.7%, 100%, and 98.6%, respectively. The intervention showed significant positive effects on preventing declines in quality of life at 3-month follow-up (Cohen d =0.70, 95% CI =0.22-1.18). Positive trends manifested in physical activity, depression, chronic pain, and exercise self-efficacy. Three qualitative categories were identified: subjective improvements in exercise, physical, and social well-being; perceived changes in mindfulness and mental well-being; and intervention facilitators and barriers. Conclusions: The mindfulness and motivational interviewing-oriented physical-psychological integrated intervention is feasible and acceptable. The significant prolonged effect in maintaining quality of life and positive effects on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors. Archives of Physical Medicine and Rehabilitation 2024;105:1632-41

Background: The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). Current data on adherence to the ABC pathway among rural patients with AF in China are limited. Objectives: To investigated adherence to the ABC pathway and its associated factors among rural patients with AF in China. Methods: In the cross-sectional study, we recruited 870 rural patients with AF from July 2022 to July 2023 in China. AF-related sociodemographic and clinical data was collected. Results: Among the 870 rural patients with AF, 437 (50.23 %) were male, 714 (82.07 %) were >= 65 years old. The level of adherence to ABC pathway was extremely low (5.75 %), and its associated factors included patients >= 75 years (compared with those <65 years, OR=0.165, 95 %CI: 0.065-0.417, P < 0.001), junior middle school and senior middle school education or above (compared with primary school education or below, OR=3.441, 95 %CI: 1.144-10.351, P = 0.028; OR=11.438, 95 %CI: 3.758-34.814, P < 0.001), average monthly household income per capita 1000-3000 RMB and >3000 RMB (compared with <1000 RMB, OR=3.993, 95 %CI: 1.343-11.877, P = 0.013; OR=4.474, 95 %CI: 1.478-13.541, P = 0.008), persistent AF (compared with paroxysmal AF, OR=0.062, 95 %CI: 0.008-0.466, P = 0.007) and multimorbidity (OR=0.356, 95 %CI: 0.163-0.781, P = 0.010). Conclusions: There is an urgent need to develop targeted interventions and national policies to improve the adherence to the ABC pathway of rural AF patients in China.

Spinal Cord Independence Measure (SCIM) was an important functional outcome measure specifically designed for spinal cord injury (SCI) patients, with the self-reported version of SCIM (SCIM-SR) published in 2013. This study aims to translate the SCIM-SR into Chinese, and to investigate the validity of Chinese SCIM-SR among SCI patients. This Chinese version of SCIM-SR was translated into Chinese in a standardized approach, and then filled out by a sample of patients with SCI (n=205) within 3 days after admission. Validity of Chinese SCIM-SR was then analyzed using Rasch analysis and principal component analysis. The subscale Selfcare and subscale Mobility showed good fit to the Rasch model, with no significance found in Chi-square test results for item-trait interaction, using Bonferroni adjustment for the significant level (χ2=18.125, P=0.111; χ2=33.629, P=0.006). Mean fit residual for items and persons of each subscale were within ±2.5. The model fit of the subscale of Respiration and Sphincter Management was not satisfactory even after deleting one item and merging two items with local dependence. However, Kaiser-Meyer-Olkin test was >0.50 in total score and all the subscales of Chinese SCIM-SR, and P<0.05 in the Bartlett’s test. There was no differential item functioning for gender, time post injury, age, and etiology in any of the three subscales. An online version of Chinese SCIM-SR was also developed. It is concluded that the SCIM-SR in Chinese is valid for application in individuals with SCI. SCIM-SR is considered as an important tool for self-reporting functional status from SCI individuals’ perspective.

康复护理学是康复医学的重要组成部分.随着目前"e-learnig"、大型在线开放课程教学(massive open online courses,MOOCs)、专属在线课程(small private online course,SPOC)等多种网络及移动教学方式的发展,传统面授课的教学模式已被打破,在线网络资源学习与面授课相结合的混合式教学方式是本科教育的必然发展趋势[1-4],中山大学的康复护理学教学在此方面积极进行教学改革.我们在教学实践中发现学生的"学习风格"是影响应用混合式教学实施效果的重要因素之一.学习风格是指学习者在学习过程中处理信息的方式,它是一个人对材料呈现方式的偏好或者是对学习过程中所涉及的认知过程类型的偏好[5].学生在长期学习过程中除具有自我特征的学习风格外,亦形成了适应传统教学模式的学习风格[5].Felder-Silverman学习风格模型是目前使用度最高的学习风格评价方法之一,由Felder-Silverman于1998年提出,该模型对学习者学习风格进行了四个维度的划分,每个维度内有三个类别的学习风格特征,学习者可以确定四个维度内的不同学习风格类型,具有较好的信度和效度[6].本研究在中山大学护理学本科生中实施精品视频资源共享课程结合面授课的"线上—线下"混合式授课的教学改革,采用Felder-Silverman模型对学生学习风格进行划分,旨在探讨护理学本科生不同学习风格学生经混合式教学方法改革的教学效果,为今后培养更高技能素养的康复护理人才和为今后推广大规模在线开放课程并建立更加完善的混合式教学模式奠定基础.