Aim: To comprehensively assess the quality of current breastfeeding measurement instruments and to recommend instruments. Background: The field of breastfeeding assessment is characterized by a diverse array of measurement tools, yet their application is complicated by heterogeneity in psychometric quality and inconsistent findings. Previous systematic reviews employing the COSMIN (CONsensus-based Standards for the selection of health Measurement INstruments) framework have been limited in scope, highlighting the need for a contemporary and comprehensive evaluation to guide instrument selection. Methods: Following COSMIN guidelines, we systematically searched 10 Chinese and English databases from inception to September 30, 2024. Two reviewers independently conducted study screening, data extraction, and methodological quality assessment. Evidence was synthesized and recommendations were formulated based on predefined criteria. Results: Analysis of 54 studies evaluating 24 instruments revealed substantial evidence gaps in key measurement properties. Reliability data were missing for 52% of instruments, while cross-cultural validity/measurement invariance, criterion validity, and responsiveness were assessed in fewer than 30% of cases. No instrument had established values for minimal important change or smallest detectable change. Seven instruments measuring self-efficacy, support needs, and breastfeeding behavior prediction received Grade A recommendations. Discussion: The review offers a validated evidence base to guide instrument selection. Future research should prioritize closing the identified evidence gaps, particularly establishing reliability and clinically meaningful change parameters for all recommended tools. Conclusions: This review provides an evidence base for instrument selection while identifying critical gaps in measurement property evidence, particularly in reliability and clinically interpretable parameters, directing future validation research priorities.

BACKGROUND:Differences in evidence-based practice (EBP) knowledge, clinical experience, and time availability between nursing students and practicing nurses create the potential for complementary learning, yet interactions are often hierarchical. PURPOSE:To explore nurses' experiences in an online collaborative EBP learning model with students and examine how interaction influences engagement and learning. METHODS:A qualitative descriptive study was conducted. Semi-structured interviews were undertaken with 12 clinical nurses in China. Data were analyzed using Colaizzi's method. RESULTS:A total of 3 themes emerged: perceived benefits, interaction challenges, and optimization strategies. Nurses reported improved EBP knowledge, skills, confidence, and communication. Challenges included knowledge disparities, time constraints, and limited student engagement. Suggested improvements involved structured tasks, better coordination, and stronger facilitation. CONCLUSIONS:Online collaborative learning may support nurses' EBP learning by integrating clinical experience with theoretical knowledge. Effective design and facilitation are essential to enhance engagement and outcomes.

BACKGROUND:Nursing clinical mentors play a crucial role in developing evidence-based practice (EBP) competencies among nursing students. However, the implementation of EBP teaching remains challenging. AIM:To identify and compare core barriers to EBP teaching among nursing clinical mentors using network analysis. DESIGN:Cross-sectional study. SETTING(S):Four university-affiliated tertiary hospitals in China. PARTICIPANTS:A total of 715 nursing clinical mentors participated in the survey. METHODS:A 28-item EBP teaching barriers scale was used to assess perceived barriers. Network analysis was conducted to identify central and bridge nodes. Subgroup comparisons were performed across diffusion stages. RESULTS:Perceived barrier levels were moderate to high, with scores declining as participants advanced through diffusion stages. The three most severe barriers were lack of expert nursing discussion (A2), lack of time for new ideas at work (O2), and lack of time to read research (O1). Network analysis identified the strongest edge between lack of support from non-physician staff (O7), and administrative restrictions (O8) (edge weight = 0.790). Notably, centrality analysis revealed a clear discrepancy: barriers perceived as most severe (A2, O2, O1) were not the most central. Instead, O7, O8, and lack of practical validation (I6) emerged as the most central nodes (strength = 14.377, 14.348, and 14.260, respectively). I6 also served as a key bridge node. Although the overall network structures showed no statistically significant differences across stages (Stage 1 versus Stage 2: p = 0.406; total sample versus Stage 1: p = 1.000; total sample versus Stage 2: p = 0.535), distinct patterns of central and bridging nodes emerged. CONCLUSIONS:This network analysis reveals an interconnected barrier system where organizational and evidence-translation challenges are central, while traditional high severity barriers like time constraints are less influential. The observed mismatch between perceived severity and network centrality suggests the potential value of more targeted strategies. Network-informed interventions focusing on central barriers and tailored to diffusion stages may enhance the implementation of EBP teaching among nursing clinical mentors.

AIMS:To develop the core outcome set and identify unique outcomes for the three stages and five types of nursing interventions, respectively, in lactational mastitis. DESIGN:A mixed methods study. METHODS:A systematic literature search, four semi-structured interviews for key stakeholders, two rounds of Delphi surveys and two online consensus meetings were conducted. RESULTS:Thirty-one nursing outcomes were derived from the systematic review (literature research from January 2019 to December 2021) and semi-structured interviews in 2022. Six A-category nursing outcomes and 19 B-category nursing outcomes were determined after Dephi survey and provided in consensus meeting in 2023. The consensus meetings resulted in the agreement on seven core outcomes: Pain Level, Breast Establishment: infant, Breast Establishment: maternal, Breast Maintenance, Client satisfaction: care, Sleep, and Family Support during Treatment. Specifically, the unique outcomes for the three stages were identified as Breastfeeding Maintenance, Infection Severity and Wound Healing: Primary Intention, respectively. The unique outcomes for the five interventions included Pain level, Infection Severity, Wound Healing: Primary Intention, Comfort and Knowledge: breastfeeding, respectively. CONCLUSION:Based on an evidence-based, consensus-driven approach, the core outcome set incorporates the perspectives of key stakeholders. It is recommended that all core outcomes be reported in both lactational mastitis nursing research and clinical quality control and audit. Unique outcomes should be reported based on the stages of lactational mastitis and types of interventions. IMPACT:The core outcome set and unique outcomes developed by our study could provide nursing researchers and clinical practitioners with sensitive outcomes for lactational mastitis, while also promoting standardisation. Utilising these outcomes could enhance comparability among studies, reduce reporting bias and promote standardised evaluation of practice effectiveness. REPORTING METHOD:Findings are reported per Core Outcome Set-STAndards for Reporting: COS-STAR Statement. PATIENT OR PUBLIC CONTRIBUTION:None. TRIAL REGISTRATION:https://www.comet-initiative.org/Studies/Details/1650.

BackgroundThe COVID-19 pandemic has required teachers and students to suddenly transition from face-to-face formats to distance education (DE). The uniqueness of nursing discipline is that it requires both theoretical and skills-based learning. Therefore, it is necessary to explore the influencing factors and effectiveness of DE in nursing education. This exploration can guide teaching practice and provide a basis for the future application of DE in nursing education.AimsTo describe the current distance education readiness and depth of learning among undergraduate nursing students and explore possible influencing factors. To determine the relationship between students’ distance education readiness and the depth of learning.DesignThis is a descriptive and cross-sectional online study.SettingsSchool of Nursing in a traditional Chinese medicine university, Beijing, China.ParticipantsA total of 222 undergraduate nursing students from a traditional Chinese medicine university were recruited.MethodsA questionnaire, which is composed of information form, the Online Learning Readiness Scale, and the Scale of Students Making Deep Learning, was used for data collection. Frequency, percentage, arithmetic mean, standard deviation, t-test, one-way ANOVA, and Pearson correlations were used in the analysis of the data.ResultUndergraduate nursing students have lower averages in distance education readiness and higher averages in the depth of learning. Significant differences in distance education readiness and depth of learning between different grade groups. A positive correlation was found between distance education readiness and depth of learning (r=0.894, p<0.001).ConclusionDistance education is a feasible approach to learning today. Undergraduate nursing students have exhibited poor readiness for distance education but demonstrated deeper learning conditions. Upper grades may lead to better learning outcomes. Better distance education readiness can lead to deeper learning. These conclusions prompt teachers and students to be prepared before participating in distance education to obtain better academic performance.

Background: Traditional Chinese Medicine Nursing Clinical Preceptors (TCMN-CPs) are crucial to cultivate undergraduates' evidence-based practice (EBP) competence during clinical practicum in traditional Chinese Medicine (TCM) hospitals. However, the TCMN-CPs' EBP teaching competence is unclear. Underpinned by Rogers' innovation-decision process, our study aimed to investigate TCMN-CPs' EBP teaching competence and the related characteristic factors at five stages of knowledge, persuasion, decision, implementation and confirmation.Methods: An online survey was conducted by using a modified evidence-based practice teaching competence questionnaire (EBPT-COQ) encompassing attitude, knowledge/skill and practice of EBP teaching in four TCM teaching hospitals in Beijing, China.Results: A total of 654 TCMN-CPs were included, with a response rate of 91.47 %. Most TCMN-CPs were in knowledge stage (339, 51.83 %), followed by the persuasion stage (166, 25.38 %), decision stage (123, 18.81 %), implementation stage (23, 3.52 %) and confirmation stage (3, 0.46 %). The total and dimension scores of EBPT-COQ increased as the diffusion stage developing, the confirmation stage was the highest (5.48 +/- 0.80). Twenty-three items' mean scores were higher than 4 points (95.83 %), except for "Research skills" (3.58 +/- 1.38). The related characteristic factors were 1) age (Z = -4.177), working experience (H = 11.087), clinical teaching experience (H = 12.602), management position (Z = 2.565), research experience (Z = -2.867) and EBP training (Z = 3.146) at Knowledge stage; 2) research experience (Z(Persuasion) = -2.617; Z(Decision) = -3.510), EBP training (Z(Persuasion) = 2.528; Z(Decision) = 3.433) at Persuasion and Decision stage (all P<0.05). And the first three stages TCMN-CPs' EBPT-COQ scores were positively correlated with TCMN-CPs' attitude toward clinical teaching (r = 0.244-0.331, P<0.001).Conclusions: Most of the TCMN-CPs' EBP teaching status are in the first three diffusion stages. Though their attitude, knowledge/skills and practice to EBP teaching competence have gradually improved with the deepening of the diffusion stage, much efforts should be made to keep progressing. TCMN-CPs' qualifications of EBP teaching could include rich clinical work and teaching experience, enjoying teaching. Nursing managers, with higher EBP teaching competence, might play a crucial role in promoting the diffusion of EBP teaching. All TCMN-CPs showed an inadequacy of research skills of EBP teaching. Therefore, it is warranted to explore the minimum research skill requirements for EBP teaching and to establish academic-practice partnerships.

目的 挖掘护生对项目驱动混合式教学模式的体验和感受,为后续教学模式的设计与改革提供依据.方法 对选修循证护理学课程的护生进行半结构式访谈,使用Colaizzi 7 步分析法对访谈资料进行整理分析.结果 访谈结果可归纳出4 个主题,参与式主动学习体验感明显、学习投入较多,但上课偶有懈怠;项目驱动挑战度高,迭代学习提供修正错误的机会;线上课程较为灵活,线下课堂教师反馈及时且启发较大;小组合作加深对知识理解,提升小组沟通协作能力.结论 大部分护生对该教学模式接受且认可,该混合式教学模式值得进一步推广.但值得注意的是,项目驱动须循序渐进,由易及难.

Objective To summarize and analyze the current status of reports regarding nursing operation key points in moxibustion for the treatment of rheumatoid arthritis, and to provide reference for the standardization of moxibustion nursing operation and the formulation of relevant guidelines. Methods We searched literature pertaining to moxibustion intervention in the treatment of rheumatoid arthritis from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase and Cochrane Library databases from the inception to September 26, 2022. We extracted, summarized and analyzed the included literature based on the 12 key points of moxibustion nursing operation determined by our research team in the early stage. Results A total of 262 pieces of Chinese literature and 5pieces of English literature were included. No literature fully reported the 12 key points of nursing operation in moxibustion for rheumatoid arthritis. In one Chinese article, none of the 12 key points of nursing operation were reported; 26 articles reported two or more moxibustion methods. In English literature, 5 key points of nursing operation were reported clearly while 3 of them were not reported. Conclusion Current research pays little attention to the time-response relationship in moxibustion nursing operation. In the selection of moxibustion site and the direction, inadequate attention to the relationship between meridians and diseases is found.There is no report regarding the evaluation from the patients’ perspective before, during and after the procedure. Reports vary considerably pertaining to the key points of many kinds of moxibustion or different key points of the same moxibustion.

目的 从患者、照顾者、护士、医生多视角探讨哺乳期乳腺炎护理结局,以用于构建护理核心结局集.方法 采用目的抽样法选取北京市 4 所三级甲等医院的患者、照顾者、护士及医生(共 32 名)进行半结构化访谈.采用定向内容分析法,并以护理结局分类作为指导框架进行资料分析.结果 共获取 20 个护理结局,涵盖 6 个领域,将系统评价中未报告的 8 个护理结局进一步归纳整理,覆盖心理社会健康、健康知识和行为、感知的健康、家庭健康 4 个领域.结论 在哺乳期乳腺炎护理核心结局集构建时融入利益相关者观点,有助于丰富乳腺护理门诊内涵、体现护理服务专业性.同时为护理科研的开展提供多维、基于利益相关者观点的护理结局.

The modified multi-platform method (MMPM) is used to induce animal models of paradoxical sleep deprivation and impairs memory in rodents. However, variations in MMPM protocols have contributed to inconsistent conclusions across studies. This meta-analysis aimed to assess the variations of the MMPM and their effects on memory in rats and mice. A comprehensive search identified 60 studies, and 50 were included in our meta analysis. Overall, the meta-analysis showed that the MMPM significantly reduced the percentage of time spent in target quadrants (I2 = 54 %, 95 % confidence interval [CI] = [-1.83, -1.18]) and the number of platform-area crossings (I2 = 26 %, 95 % CI = [-1.71, -1.07]) in the Morris water maze (MWM) and shortened the latency to entering the dark compartment in the passive avoidance task (I2 = 68 %, 95 % CI = [-1.36, -0.57]), but it increased the number of errors in the radial arm water maze (RAWM) (I2 = 59 %, 95 % CI = [1.29, 2.07]). Additionally, mice performed worse on the MWM, whereas rats performed worse on the passive avoidance task. More significant memory deficits were found in cross-learning and post-learning MMPM in the MWM and RAWM, respectively. This study provided evidence that the MMPM can be used in preclinical studies of memory deficits induced by paradoxical sleep deprivation.

目的 深入探索基于多元化教学模式的循证护理学课程对本科护生循证实践能力的影响.方法 采用混合方法研究中的解释性序列设计:量性部分选取 36 名选修此课程的护生,用循证实践能力评估量表在课程教学前后进行调查,质性部分选取9 名护生进行半结构式访谈.结果 多元化教学模式下循证护理教学后,护生的循证实践知识、技能及总分均有所提升且有统计学差异(P<0.05),结合质性部分在循证态度、知识及技能下得出7 个亚主题.结论 多元化教学模式下循证护理学课程有效培养了护生的循证态度和思维,增加了知识与技能的储备.但仍需基于护生的知识储备和需求,分阶段改进循证护理学课程教学,提高教学质量.

Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Embase, Cochrane library, JBI, CINAHL, PsycINFO, Clinical Trials Registry Platform portal, Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Center Watch Registry from inception to May 15, 2022 to find randomized controlled trials, non-randomized controlled trials, case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage, with search terms of mastitis, acute mastitis, lactation mastitis, puerperal mastitis, breast problem, breast engorgement, milk stasis, blocked ducked, breast pain, breast massage, and acupoint massage. Outcomes and the measurement schemes (measurement methods, timing of assessing outcome, frequency of assessing outcome, measurers) were extracted from the included studies. We used the Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) to assess the quality of each study, then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials (OMERACT) Filter 2.1 framework.Results We identified 85 clinical trials, in which 54 different outcomes were reported. A total of 81.2% (69/85) of studies were assessed as medium quality with a mean score of 2.6, and 18.8% (16/85) as low quality with a mean score of 0.9. These outcomes were organized in three core areas. Lump size (89.4%, 76/85) was the most frequently reported outcome, followed by breast pain (69.4%, 59/85) and milk excretion (68.2%, 58/85). Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous. Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.

• CHMM may have competitive strength on children oral problems and gastrointestinal disease with H. pylori infection. • From literature review, CHMM formula mostly contains aromatic herbs, which helps to improve the patients' concerned indicators. • Three innovative CHMM administration methods adopted in modern research have been mined.

Objective: The objective of this study is to explore the current situation, clinical research hot spots, and trends of traditional Chinese medicine (TCM) nursing technology in rheumatoid arthritis (RA), to draw a panorama of clinical research, to provide the basis and clues for subsequent high-level evidence integration and further in-depth research. Materials and Methods: Seven databases including China National Knowledge Infrastructure, Chinese Scientific Journal Database (VIP), Wanfang Database, Chinese Biomedical Literature Database (Sino-Med), PubMed, Embase, and the Cochrane Library were searched. The bibliometric method and visualization software CiteSpace were used to conduct a multi-dimensional analysis of the included literature. Results: A total of 805 pieces of literature were included (of them, one was written in German and four in English), and the number of published literature showed an increasing trend year by year. There were only 30 (3.73%) pieces of literature published in nursing journals. The hot spots of the co-occurrence map were concentrated in: (1) the nursing of fumigation in RA; (2) the efficacy evaluation of TCM nursing technology on pain, joint malformation, and joint dysfunction caused by RA. The included literature themes focused on five TCM technologies: fumigation, moxibustion, acupoint patching, acupoint injection, and Chinese herbal soaking. The beginning year and strength in TCM fumigation were 2012 and 5.2, and those in moxibustion were 2011 and 3.38. Conclusion: The related studies are on the rise. It has entered the field of international readers with clear research hot spots. However, there are still shortcomings such as little literature published in Chinese nursing core journals, few non-Chinese-related documents, and a lack of international exchanges and cooperation. The current research hot spots in this field are TCM fumigation, and the cutting-edge trend of future research may be fumigation and moxibustion technology. It is suggested that further research can focus on evidence integration and original research on the self-optimization of these two techniques.

合理选择结局指标不仅是科学评价干预效果和疾病转归的关键,还有助于同类研究横向比较和高质量证据的生成、推广,对提高临床护理研究质量、指导护理实践均有重要意义[1].然而,结局指标异质性极大地造成研究浪费,并阻碍系统评价/Meta分析等高级别证据的生成[2].2010 年,国际上成立"有效性试验核心结局指标"(core outcome meas-ures in effectiveness trials,COMET)工作组,明确了构建某一疾病(含或不含干预措施)核心结局指标集(core outcome set,COS)的必要性和紧迫性,2017年发布了指导 COS 构建的《The COMET Hand-book:version1 .0》(以下简称"COMET 手册")[3].目前,国际COS 研究侧重于医学领域,国内侧重于中医药领域,护理领域 COS 相对较少但有上升趋势,对护理发展有重要意义.本文以 COMET 手册为基础,对COS定义和内涵、应用价值、构建方法进行综述,并通过一项实例思考并提出护理领域 COS构建的3 个建议:结合理论以丰富结局指标反应的维度;考虑不同护理干预的敏感性结局指标以体现其独特优势;将"以患者为中心"的理念深植于 COS构建全过程以充分了解患者需求,以期为护理研究者开展COS研究提供参考.

Rosiglitazone (Avandia) and pioglitazone (Actos) belong to the class of thiazolidinediones (TZDs) drugs that act by increasing insulin sensitivity and are widely used for treating diabetic patients with insulin resistance. TZDs exhibit anti-inflammatory and antioxidant properties, then may play an active role in inhibiting plaque formation and coronary atherosclerosis. But the results of evidence-based medicine suggest that TZDs may increase the risk of cardiovascular adverse events. To explore the dispute in depth, our meta-analysis aimed to evaluate the changes in vascular endothelial and plaque-related indicators following treatment with TZDs in diabetic patients with coronary atherosclerosis. According to our meta-analysis, TZDs showed an inhibiting effect on plaque progression and a protective effect on the vascular endothelium in patients with diabetes and coronary atherosclerosis. Interestingly, these effects may not depend on the regulation of inflammation and lipid metabolism. By this token, TZDs may develop a potential protective effect on myocardial infarction. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021231663].

Abstract Rosiglitazone (Avandia) and Pioglitazone (Actos) belong to the class of thiazolidinedione drugs that act by increasing insulin sensitivity and are widely used for treating diabetic patients with insulin resistance. Thiazolidinediones (TZDs) exhibit anti-inflammatory and antioxidant properties and inhibit endothelial cell inflammation and dysfunction, and then play a role in inhibiting plaque formation and coronary atherosclerosis. But the results of evidence-based medicine suggest that thiazolinedione may increase the risk of myocardial infarction. To explore the dispute in depth, the meta-analysis aimed to evaluate the changes in vascular endothelial and plaque-related indicators following treatment with thiazolidinediones on diabetic patients with coronary atherosclerosis.According to our meta-analysis, Thiazolinediones showed a protective effect on the vascular endothelium and an inhibiting effect on plaque progression in patients with diabetes and coronary atherosclerosis and these effects may not depend on related targets or pathways such as inflammation and lipid regulation. Due to the poor quality of the evidence, more and higher-quality studies are needed to further improve the above conclusions.

Background: Previous studies demonstrated the low evidence-based practice competence of nurses in traditional Chinese medicine hospitals. University education may enhance nursing students' evidence-based practice competence. Few studies have investigated traditional Chinese Nursing Bachelor students' evidence-based practice competence. Objectives: To investigate the evidence-based practice competence of traditional Chinese Nursing Bachelor students across all grades and their influencing factors. Design: A cross-sectional online study. Settings: A traditional Chinese medicine university offering an evidence-based nursing curriculum in Beijing, China. Participants: A total of 601 traditional Chinese Nursing Bachelor students were recruited, with a response rate of 70.05%. The junior and senior groups consisted of first- and second-year students, and third- and fourth-year students, respectively. Methods: An online survey was conducted in 2019 using a self-administered questionnaire encompassing attitude, knowledge, and skill. A t-test, non-parametric test, and correlation analysis were used for data analysis. Results: Evidence-based practice attitude mean scores were the highest in both groups (3.87 +/- 0.48(junior); 3.97 +/- 0.45(senior)), followed by skill (3.33 +/- 0.46(junior); 3.48 +/- 0.46(senior)) and knowledge (3.21 +/- 0.55(junior); 3.52 +/- 0.47(senior)). In the senior group, attitude decreased (from 4.02 to 3.86). The two groups reported the same items with the lowest scores in all three dimensions. The influencing factors were 1) scientific research experience (Z = -2.87) and a medical literature retrieval course (t = -3.40) for the junior group, 2) completion of the evidence-based nursing course (Z = -2.59) for the senior group, and 3) student admission level (Z(junior) = -2.55, Z(senior) = -3.85) and English language proficiency (chi-square(junior), = 2.80, chi-square(senior )= 16.37) for both groups. Conclusions: Deficiencies in evidence implementation and decreasing evidence-based practice attitudes among fourth-year students warrant attention. Evidence-based nursing courses could be optimised, and research and English activities enriched to improve evidence-based practice competence.

Objective:With the continuous improvement of clinical requirements for evidence-based practice ability of nursing students and the emergence of "Internet +" teaching mode, the drawbacks and deficiencies of the existing evidence-based nursing teaching scheme have gradually emerged. Based on outcome-based education concept, this paper reforms and optimizes the whole teaching scheme of Evidence-based Nursing course. The four parts of course learning objective, teaching content framework, teaching mode and evaluation system are redesigned. The revised teaching scheme reflects the "learning-oriented" teaching thought, takes the students' learning results as the goal and focuses the cultivation of evidence-based thinking and evidence-based practice ability in complex clinical nursing environment. The whole teaching is driven by clinical real case projects and it takes online and offline mixed teaching and evaluates students' curriculum learning effectiveness through multi-dimensional evaluation systems to improve teaching quality.