BackgroundPerinatal psychological disorders have a significant impact on maternal and neonatal health. While many psychotherapies and psychosocial interventions have been developed and empirically evaluated for the management of perinatal psychological symptoms, the efficacy of these interventions and the most effective intervention modality remain inconclusive.AimTo assess and compare the efficacy of various perinatal psychotherapies and psychosocial interventions for depressive symptoms, anxious symptoms and stress through a comprehensive systematic review with network meta-analysis.MethodsEleven English and Chinese electronic databases were searched from inception to 30 November 2024. The Revised Cochrane Risk of Bias tool for randomized trials was used to assess the quality of the evidence. Standard pairwise meta-analyses were conducted for direct comparisons using Review Manager 5.3, and network meta-analyses were performed using Stata 16 and ADDIS 1.16.5 for different types of interventions based on random-effects models.DesignSystematic review and network meta-analysis with qualitative and quantitative syntheses were performed to holistically investigate intervention effectiveness.ResultsA total of 85 randomized controlled trials were included in the analysis, 65 of which provided available data for quantitative synthesis. The synthesized results suggest that prenatal psychotherapies and psychosocial interventions tend to be effective in reducing depressive symptoms, anxious symptoms and stress with standardized mean differences (SMDs) of -0.70, -0.81, and -1.05, respectively. Multicomponent interventions (SMD=-1.14), interpersonal psychotherapy (SMD=-0.75), cognitive behavioral therapy (SMD=-0.69), mindfulness-based interventions (SMD=-0.68), and psychoeducation (SMD=-0.14) significantly decreased depression symptoms. Acceptance and commitment therapy (SMD=-1.66), interpersonal psychotherapy (SMD=-1.24), counseling (SMD= -1.13), multicomponent interventions (SMD=-0.86), mindfulness-based interventions (SMD=-0.84), and cognitive behavioral therapy (SMD=-0.81) were effective in alleviating anxiety symptoms. Multicomponent interventions (SMD=-5.74), mindfulness-based interventions (SMD=-1.31), cognitive behavioral therapy (SMD=-1.03), and counseling (SMD=-0.82) appeared to be effective strategies for the management of perinatal stress.ConclusionsPrenatal psychotherapies and psychosocial interventions are effective in reducing depressive symptoms, anxious symptoms and stress. Specifically, multicomponent interventions, counseling, and mindfulness-based interventions are superior for alleviating the symptoms of depressive symptoms, anxious symptoms and stress, respectively. Cognitive behavioral therapy may be a reasonable option that could produce a beneficial effect on all of these prenatal psychological problems.

Pregnant women with prenatal depression could have distinctly heterogeneous constellations of symptoms. Classifying prenatal depressive symptoms into different subtypes using a person-centered approach and investigating their associated factors are beneficial for personalized assessment and management of the disorder. However, relevant evidence is still lacking. A cross-sectional study was conducted in the obstetrics outpatient clinics of two university-affiliated, governmental, tertiary hospitals in Xi’an City, Northwestern China. A total of 1020 pregnant women were included in the study and administered with a researcher-designed sociodemographic, health-related and pregnancy-related information sheet, the 8-item Patient Health Questionnaire, the five-level EuroQol five-dimension questionnaire, the Generalized Anxiety Disorder-7 and the Pregnancy Stress Rating Scale. Latent profile analysis was used to classify prenatal depressive symptoms into different subtypes, while a multivariate binomial logistic regression model was employed to identify the associated factors of the different subtypes. Health-related quality of life, prenatal anxiety and stress were compared across subtypes of prenatal depressive symptoms. Prenatal depressive symptoms were classified into three subtypes, including ‘minimal-to-mild symptoms’ (58.6

BackgroundPerceived stress is a significant risk factor for depression among healthcare professionals. While this fundamental relationship is well-documented, the potential mediating mechanisms—specifically the role of psychological flexibility and its distinct components—in buffering the impact of perceived stress on depression within the nursing community remain poorly understood.MethodsThis cross-sectional study recruited 3,920 nurses from three tertiary Grade A public hospitals in Xi’an, China, using convenience sampling, of whom 3,611 were included in the final analysis. Data were collected online using the Chinese versions of Cohen’s Perceived Stress Scale and the Comprehensive Assessment of Acceptance and Commitment Therapy Processes, as well as the Patient Health Questionnaire-9. Pearson correlation analyzes and mediation analysis were conducted to examine the associations among perceived stress, psychological flexibility, and depression.ResultsDepression was positively correlated with perceived stress (r = 0.63, p < 0.01). Mediation analysis indicated that perceived stress was significantly associated with depression both directly (b = 0.47, 95% CI: 0.45 to 0.49) and indirectly via psychological flexibility (b = 0.12, 95% CI: 0.11 to 0.13) and its components, including acceptance and cognitive defusion (b = 0.14, 95% CI: 0.13 to 0.15), and values and committed action (b = 0.06, 95% CI: 0.04 to 0.08). The indirect association through mindfulness and self-as-context was not significant (b = 0.01, 95% CI: 0.00 to 0.02).ConclusionsPsychological flexibility and some of its components were involved in partial indirect associations between perceived stress and depression among Chinese nurses. These findings suggest that psychological flexibility may help understand how perceived stress is statistically associated with depression in this population. Given the cross-sectional design, however, the results should be interpreted as statistical associations rather than evidence of causal relationships.

With rapid industrialization and urbanization in China, ambient air pollution—particularly PM2.5—has become a major public health concern. Existing evidence suggests that chronic exposure to fine particulate matter may contribute to neurodegenerative processes and cognitive decline, yet the sex-specific effects remain underexplored, especially in vulnerable aging populations. This study aimed to assess the gender-specific impact of PM2.5 exposure intensity and duration on cognitive function in the middle-aged and elderly Chinese population, identify higher risk groups for cognitive impairment, and offer insights into strategies for prevention and early intervention. Integrated datasets from the China Health and Retirement Longitudinal Study (CHARLS) for adults aged 45 to 96 and PM2.5 exposure data from 2001 to 2018 through satellite observations. Cognitive function was evaluated using the CHARLS-HCAP Neurocognitive Test Scale. We employed linear mixed-effects quantile regression models to investigate gender-specific disparities in the association between PM2.5 exposure intensity and duration and cognitive function across diverse cognitive levels. The models were adjusted for demographic, lifestyle, socioeconomic factors, and medical history. Among 17,147 participants contributing 45,242 observations, higher PM2.5 exposure intensity and extended duration were associated with reduced cognitive function in both genders (females: q ≥ 0.66, males: q ≥ 0.96). Notably, these associations were more pronounced among females than males at the same cognition score quantiles. In participants with no or mild cognitive impairment, females exhibited lower cognitive function scores due to higher PM2.5 exposure intensity and prolonged duration (PM2.5 levels ≥ 36 µg/m3) compared to males. These findings indicated differing impacts of PM2.5 exposure on cognitive function relative to gender and cognitive status. These results supported existing evidence of gender-specific differences in the impact of PM2.5 exposure on cognitive decline, identifying females with no or with mild cognitive impairment as the most vulnerable subgroup due to PM2.5 exposure.

Background Stroke is a primary cause of disability on a global scale. The resultant functional impairments consequent to stroke give rise to a range of unmet needs among patients, especially those experiencing their first stroke. The unmet needs of patients may have a significant negative impact on their quality of life (QoL). However, the mechanisms underlying this relationship remain poorly understood. Objective Examine the mediating effects of activities of daily living (ADL), depression, and social support on the relationship between unmet needs and QoL in first-stroke patients. Methods A convenience sample of 400 patients with first-ever stroke was recruited. Data were collected using the Longer-term Unmet Needs after Stroke monitoring tool, the Barthel Index, the Patient Health Questionnaire-9, the Social Support Rating Scale, and the Stroke-Specific Quality of Life Scale. A parallel mediation analysis was conducted using Model 4 of the SPSS PROCESS macro. Results The results showed that unmet needs were negatively correlated with QoL. The mediation analysis revealed a significant direct effect of unmet needs on QoL, as well as indirect effects through ADL and depression. Social support did not show a significant mediating effect. Conclusion Unmet needs affect QoL both directly and indirectly through ADL and depression. These findings underscore the importance of routine assessment and targeted management of unmet needs during post-stroke care. Interventions aimed at enhancing physical functioning and alleviating depression may be effective strategies to improve QoL in this population.

Post-extubation dysphagia (PED) in ICU patients can delay oral intake, prolong mechanical ventilation, and extend ICU stays. Despite its impact, evidence-based standard procedures for swallowing rehabilitation are lacking. This study aimed to investigate the benefits of a swallowing training program in patients with PED in the ICU. This quasi-experimental study was conducted from January to September 2024 and ICU units were randomly assigned to either a control group or an intervention group. The former were given routine rehabilitation care, whereas the latter received a swallowing training program to investigate best-evidence clinical practice, targeted enhancements were implemented for critical components with suboptimal adherence in swallowing screening and management protocols. Applying the swallowing training program to the intervention group, which included screening for dysphagia, indirect training (basic training), direct training (ingestion training), and the management of complications, for 14 days of intervention. Compared with those of the control group, the swallowing function (MD, 95

OBJECTIVES:To explore the mediating role of health locus of control in the relationship between supportive care needs and health promoting behaviours among patients with pulmonary tuberculosis. DESIGN:A cross-sectional study. SETTING:This survey was conducted in three tuberculosis-designated hospitals in Xi'an, China, between March and May 2020. PARTICIPANTS:A total of 294 participants completed the questionnaires. OUTCOME MEASURES:The participants completed a self-designed socio-demographic questionnaire, the Multidimensional Health Locus of Control scale, the Supportive Care Needs Scale for Patients with Tuberculosis and the Health Promoting Lifestyle Profile II. SPSS V.26.0 and Mplus were used for data analysis. RESULTS:The patients' supportive care needs had a negative association with their health promoting behaviours (r=-0.58, p<0.001). The supportive care needs were negatively related to internal health locus of control (r=-0.43, p<0.001), and positively related to chance health locus of control (r=0.44, p<0.001) and powerful others health locus of control (r=0.20, p<0.001). Health-promoting behaviours had a significantly positive correlation with internal health locus of control (r=0.49, p<0.001) and a negative correlation with chance health locus of control (r=-0.36, p<0.001). Both internal health locus of control and chance health locus of control acted as mediators between supportive care needs and health promoting behaviours, while powerful others health locus of control did not. CONCLUSION:Health locus of control mediated the relationship between supportive care needs and health promoting behaviours. A high level of internal health locus of control and a low level of chance health locus of control may help to improve health-promoting behaviours. Given the cross-sectional design of this study, future experimental interventions targeting health locus of control are needed to establish causal relationships with supportive care needs and health promoting behaviours.

This study compared the efficacy of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and the Childbirth Attitudes Questionnaire (CAQ) in assessing fear of childbirth (FOC) among hospitalized pregnant women, aiming to identify a practical screening tool. A total of 184 pregnant women were recruited from the Northwest Women’s and Children’s Hospital using convenience sampling. Data were collected through the General Demographic Questionnaire, Fear of Birth Scale (FOBS), W-DEQ, and CAQ. Using the FOBS as a reference, the diagnostic performance of the W-DEQ and CAQ was evaluated via receiver operating characteristic curves and Bayesian discriminant analysis. The area under the curve (AUC) for the W-DEQ (0.888) was significantly higher than that of the CAQ (0.789; Z = −2.189, p < 0.05). Optimal cutoff values were 80.5 for the W-DEQ and 31.5 for the CAQ. Cross-validation revealed accuracy rates of 75.6% and 70.7%, respectively. The incidence of FOC, as assessed by the W-DEQ, CAQ, and FOBS, was 29.9%, 43.9%, and 37.2%. Both tools demonstrated good reliability and validity, but the W-DEQ showed superior performance. It is recommended as the preferred tool for assessing FOC among pregnant women in China due to its comprehensive evaluation capacity.

BackgroundWomen with perinatal depression and their children are at increased risk of poor health outcomes. Integrating evidence based non-stigmatizing interventions within existing health systems is crucial to reducing psychosocial distress during pregnancy and preventing perinatal depression. This study aimed to evaluate the feasibility of the World Health Organization (WHO) endorsed cognitive-behavior therapy-based Thinking Healthy Programme (THP), delivered by antenatal nurses in China.MethodsA two-arm pilot randomized controlled pilot trial was conducted to assess the feasibility and of the adapted Chinese version of the Thinking Healthy Programme (THP) among various stakeholders. We recruited pregnant women between 25- and 34-weeks' gestation from two pregnancy schools within the two public sector Hospitals in Xian. Participants in the intervention group attended five face to face sessions of THP facilitated by antenatal nurses. This intervention used cognitive behavior therapy principles to offer psychoeducation, behavioral activation, problem-solving strategies, and social support. In the control group, participants received standard care, which included routine pregnancy education classes led by antenatal nurses. We assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) at baseline, after the intervention and 4–6 weeks post-intervention, along with evaluations of anxiety, perceived social support, and health-related quality of life.ResultsAmong the 737 pregnant women screened, 267 (30.26%) scored ≥5 on the PHQ-9. Out of these, 85 were eligible and consented to participate, with 42 assigned to the intervention group and 43 to the control group. Eighty participants (94.1%) completed the final assessments. Our primary findings indicated that this nurse-delivered intervention was feasible to integrate into routine antenatal care and was well-received by both the women and the delivery agents. Although the study was not designed to detect differences between the intervention and control groups, we observed positive trends towards reductions in anxiety and depressive symptoms favoring the intervention arm. No serious adverse events were reported. This trial is registered in the Chinese Clinical Trial Registry with the registration number ChiCTR1900028114.ConclusionsWe conclude that this intervention, grounded in the well-established WHO Thinking Healthy Programme, is both feasible and acceptable to stakeholders. It merits a definitive randomized trial to assess its effectiveness and cost-effectiveness across various settings.Clinical Trial RegistrationChiCTR1900028114.

Previous research has overlooked the formative influence of cultural beliefs in shaping postpartum postpartum challenges and psychological symptoms. This study aims to examine the challenges faced by primiparous women within the sociocultural context of China. It will enhance understanding of the specific mechanisms through which sociocultural factors impact maternal mental health during the postpartum period. A descriptive phenomenological study design was used. Semi-structured interviews were conducted with 25 primiparas within one year of delivery during July and September 2022. Each conversation lasted between 32 and 56 min. Colaizzi’s seven-step phenomenological approach was utilized for data analysis. Six themes were identified, including (a) body weakness, pain, and sleep deprivation are highly prevalent during the “zuo yuezi” period; (b) struggling with considerable effort, sacrifice, and obstacles in breastfeeding; (c) helplessness in childcare due to insufficient or unreliable social support; (d) confusion and difficulty in accessing scientific maternal and child health knowledge; (e) frustrating and increasing family conflicts centered on mother and mother-in-law relations; and (f) sticking to work or not can bring significant entanglement to primiparas. Postpartum distress among first-time mothers in China is not solely an individual psychological experience, but rather a complex phenomenon shaped by the interplay between traditional cultural customs and contemporary social transformations. Specifically, within the unique sociocultural context of China, primiparas develop distinct cultural understandings and postpartum behaviors that significantly influence their physical and mental health. This highlights the sociocultural factors contributing to postpartum emotional distress and underscores the need for culturally sensitive interventions tailored to the Chinese context.

ObjectiveTo develop traditional Chinese medicine dietary therapy needs scale for patients with cancer and to test its reliability and validity.MethodsThe traditional Chinese medicine dietary therapy needs scale for patients with cancer was constructed through literature review,semi⁃structured interviews,expert consultation,and preliminary survey.A total of 325 inpatients and outpatients from Fujian Cancer Hospital were surveyed from December 2021 to January 2022 to test the reliability and validity of the scale.ResultsThe traditional Chinese medicine dietary therapy needs scale for patients with cancer included 35 items.2 rounds of expert consultation were conducted,with 100% effective response rate in both rounds.The expert authority coefficient were 0.845 for both rounds.Kendall's W was 0.216(P<0.001) in the first round and 0.324(P<0.001) in the second round.The scale⁃content validity index was 0.981,while the item⁃level content validity index ranged from 0.979 to 0.983.Exploratory factor analysis extracted 8 factors with eigenvalues>1, accounting for 72.981% of the cumulative variance.The result of confirmatory factor analysis showed that all model indicators met the goodness⁃of⁃fit criteria.The Cronbach's a coefficient of scale was 0.926,split-half reliability of scale was 0.961,and test-retest reliability of scale was 0.903.ConclusionsThe traditional Chinese medicine dietary therapy needs scale for patients with cancer exhibited good reliability and validity.It could serve as a reliable tool for assessing traditional Chinese medicine dietary therapy needs of patients with cancer.

AIMS:To explore mothers' specific discharge preparation needs for preterm infants born before 32 gestational weeks, providing a foundation for developing effective discharge education programmes. DESIGN:A qualitative descriptive design. METHODS:A semi-structured interview was conducted of 16 mothers of preterm infants less than 32 weeks gestation within 1 week post-discharge in March-June 2024. Directed content analysis was conducted using the Integrated Theory of Health Behaviour Change framework to code, categorise, and identify themes within the interview data. RESULTS:Mothers provided rich, practical, experience-driven feedback regarding discharge preparedness needs. The interview resulted in three emergent themes related to the theory's constructs: maternal needs for knowledge acquisition, multifaceted social support, and adjusting learning strategies. These encompass sub-themes such as observing infant behaviour and health status, basic care knowledge, complex medical care guidance; support from medical staff, family members, fellow parents, community healthcare providers, and Wechat platform tools; learning time arrangement, and preferred learning approaches. CONCLUSION:This study explored the discharge preparation needs of mothers with premature infants less than 32 weeks gestation. A nurse-led multidisciplinary team should tailor education programmes, emphasising care knowledge, multifaceted social support, and flexible learning. Future research should assess programme effectiveness on maternal and infant outcomes. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE:The study's results provided targeted guidance for clinical nursing education, enhancing mothers' readiness for preterm infant discharge and facilitating a smoother NICU-to-home transition. IMPACT:These findings provide important guidance for nurse-led tailored discharge education and preparation services, thereby promoting improvements in clinical nursing practice and the development of nursing education. REPORTING METHOD:The COREQ checklist was used for reporting. PATIENT OR PUBLIC CONTRIBUTION:Four mothers of premature infants (< 32 weeks gestation) provided feedback on the interview guide in the design phase, refining it for the target population, without joining the main study.

Background: Postpartum depression (PPD) is a prevalent mental health issue with significant adverse consequences for both mothers and their infants. The Thinking Healthy Program (THP) is an effective intervention for perinatal depression in non-specialized healthcare settings. This study aimed to evaluate the effectiveness of a nurse-assisted digital THP in treating PPD among postpartum women experiencing elevated depression symptoms in China based on elevated Edinburgh Postnatal Depression Scale (EPDS) scores through a randomized controlled trial.Methods: Postpartum women experiencing elevated depression symptoms were recruited and randomly assigned to either a six-week nurse-assisted digital THP intervention group or a treatment-as-usual control group using computer-generated random sequences. The primary outcome was self-reported depression symptoms measured by the EPDS. Secondary outcomes included general health status (Five-level EuroQol 5-Dimensions Questionnaire), mother-infant attachment (Maternal Postnatal Attachment Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Measurements were conducted online at baseline, post-intervention, and at a three-month follow-up.Results: A total of 120 postpartum women were allocated to either the intervention (n = 60) or the control (n = 60) group. Participants in the intervention group showed a greater reduction in depression symptoms compared to the control group at post-intervention (β=-1.70, P = 0.047) and at three-month follow-up (β=-1.90, P = 0.007). However, there were no significant effects on general health status. The intervention also led to significantly greater improvements in mother-infant attachment (β=3.05, P = 0.006) and perceived social support at post-intervention (β=6.52, P = 0.027) and at three-month follow-up (β=6.96, P = 0.015).Conclusions: Our results suggest that the nurse-assisted digital THP intervention is effective in reducing maternal depression levels, enhancing mother-infant attachment and increasing perceived social support. Delivering THP via mobile apps is feasible, and nurse assistance can facilitate postpartum women's acceptance of digital psychological interventions.

Background Prematurity remains a global health challenge, with preterm infants’ immaturity placing significant caregiving demands on mothers. Objectives This study aimed to assess mothers’ discharge readiness for preterm infants and explore influencing factors using structural equation modeling to inform discharge preparation plans. Design Cross-sectional study. Settings Three Level Ⅲ hospitals in western China. Participants From July, 2023, to February 2024, 258 mothers of preterm infants were included in the study. Methods The Readiness for Hospital Discharge Scale assessed mothers’ discharge readiness. Relevant factors were evaluated using General Information Questionnaire, Self-Rating Anxiety Scale, and Quality of Discharge Teaching Scale. Data were analyzed using SPSS; hypotheses were tested with AMOS. Results Mean discharge readiness score was 198.70±29.60. Significant direct effects included gestational age (β=0.31), household income (β=0.13), online learning (β=0.18), bedside learning (β=0.20), anxiety (β=−0.24), and perception of discharge teaching quality (β=0.36). A chain mediation effect was observed among bedside learning, discharge teaching quality, anxiety, and discharge readiness. Gestational age cutoff of 224.5 days (≈32 weeks) was identified for targeting interventions. Conclusion Mothers’ discharge readiness for preterm infants was inadequate. Discharge teaching emerges as the most significant target intervention. In clinical practice, emphasis should be placed on guiding mothers of preterm infants with gestational ages <32 weeks. This can be achieved by integrating online study with bedside learning to enhance discharge teaching quality, thereby reducing anxiety levels, promoting mothers’ discharge readiness for preterm infants, and facilitating a smooth transition to home care.

BackgroundPrimigravidas of advanced maternal age (AMA) encounter distinct challenges throughout pregnancy and are particularly susceptible to heightened levels of anxiety.ObjectiveTo identify the influencing factors of pregnancy-related anxiety in AMA primigravidas and to develop, implement, and evaluate a personalized psychological nursing intervention.MethodsPhase I involved a cross-sectional survey of 300 AMA primigravidas to identify anxiety-influencing factors. Phase II was a randomized controlled trial (RCT) with 160 AMA primigravidas assigned to either a personalized psychological nursing intervention group or a standard care control group.ResultsPhase I identified key factors influencing anxiety, including perceived pregnancy risks, social support, and self-efficacy. In Phase II, the intervention group showed significantly lower anxiety levels (p < 0.001), improved self-efficacy (p < 0.001), and higher satisfaction with prenatal care (p < 0.01) compared to the control group.ConclusionPersonalized psychological nursing interventions based on identified influencing factors effectively reduce anxiety and improve psychological well-being in AMA primigravidas. Implementation of such interventions in prenatal care could significantly enhance outcomes for this vulnerable population.

BACKGROUND:Multimorbidity prevalence in China has been rising annually and has emerged as a major health challenge. While air pollution contributes to individual Noncommunicable diseases (NCDs), its impact on distinct multimorbidity patterns remains unclear. METHODS:This prospective cohort study analyzed 36,144 participants from the China Family Panel Studies (2010-2022) without baseline multimorbidity. Among 6,839 individuals (18.9%) who developed multimorbidity during median 8-year follow-up, latent class analysis identified distinct disease patterns. Fine-Gray subdistribution hazard models assessed associations between eleven air pollutants (PM2.5, PM10, O3, NO2, SO2, CO, and five PM2.5 components) and pattern-specific multimorbidity. RESULTS:Four multimorbidity patterns emerged: Musculoskeletal-Dominant (3.4%), Cardiopulmonary (3.4%), Cardiovascular-Metabolic (9.5%), and Digestive-Dominant (2.6%). In single-pollutant models, PM10 showed consistent adverse effects (sHR 1.12-1.48), while cold-season O3 demonstrated protective associations (sHR 0.66-0.78). After multi-pollutant adjustment, PM10 remained the strongest risk factor across all patterns (sHR 1.71-2.47). Both cold- and warm-season O3 maintained protective associations (sHR 0.43-0.82). PM2.5 retained significance only for Cardiovascular-Metabolic pattern (sHR 1.13, 95% CI: 1.05-1.21). Dose-response analyses revealed non-linear relationships with threshold effects. CONCLUSIONS:Air pollutants demonstrate heterogeneous associations with multimorbidity patterns, with PM10 as a universal risk factor. These findings highlight the need for pattern-specific approaches in environmental health research and air quality policy development.

This study aimed to understand the status of undergraduate nursing students' subjective well-being and psychological flexibility in China, and to explore their correlation, providing evidence for psychological health interventions. A cross-sectional study was conducted involving 1609 full-time undergraduate nursing students from 20 Chinese universities, by convenience and snowball sampling. Data were collected using a general information questionnaire, Index of Well-being and Index of General Affect, and Comprehensive assessment of Acceptance and Commitment Therapy processes. Statistical analyses were performed using SPSS25.0. The findings revealed that Chinese undergraduate nursing students had moderate subjective well-being and psychological flexibility. Students with higher psychological flexibility demonstrated greater subjective well-being, and vice versa. Among dimensions of psychological flexibility, behavioural awareness was the most significant contributor to higher subjective well-being. These results provide theoretical evidence on current status of their subjective well-being and psychological flexibility, highlighting the importance of better psychological flexibility to higher subjective well-being.

Several investigations have delved into the heterogeneity of anxiety symptom trajectories throughout pregnancy. However, the causal relationships between prenatal anxiety, stress, and psychological flexibility remain unclear. This study endeavored to identify distinct trajectory groups and influencing factors for anxiety symptoms in pregnant women, and explore the relationship between stress, psychological flexibility, and anxiety during this period. Pregnant women were recruited from March to May 2022 at a hospital in Xi’an City, Shaanxi Province, China. Structured questionnaire surveys were conducted through a WeChat applet at five time points (12, 20, 26, 32, and 37 weeks), collecting information on basic demographics, stress, psychological flexibility, and anxiety throughout their pregnancies. The latent class growth model was employed to identify potential trajectory groups of prenatal anxiety, logistic regression was utilized to analyze the factors associated with these groups, and a linear mixed model was implemented to investigate the relationship between stress, psychological flexibility, and anxiety. Three distinct anxiety trajectory groups were identified. Unplanned pregnancy (OR = 1.76, 95

BACKGROUND:The demand for wearable technologies has surged in recent years, demonstrating remarkable potential, especially in health promotion. However, there is currently a lack of clarity about the types and roles of wearable devices in health care of older adults. OBJECTIVE:This review aims to provide a comprehensive overview and categorize the current research conducted with wearable devices for health promotion and disease prevention in older adults. METHODS:We conducted a systematic literature review using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework and synthesized the results. A total of 6 databases were searched to identify wearable devices reported in studies from inception to July 28, 2024. Titles, abstracts, and full texts were independently screened by 2 reviewers. Any discrepancies were resolved by a third reviewer when necessary. The types of results from relevant studies were systematically mapped into predefined categories. RESULTS:Based on the inclusion criteria, 109 studies were included. The most commonly reported health targets of wearable devices were mobility, mental health, fall-related, arrhythmia detection, activity recognition, disease diagnosis, and sleep monitoring. Most studies were application design and observational study, and in European countries and the United States, 51 studies of the participants were healthy. The most popular anatomical landmarks for wearable placement were the wrist, waist, and chest. Two evaluation approaches for wearable devices were used: performance metrics in controlled settings and real-world assessments with end users. The opportunities presented by wearable devices are countered by multiple challenges, including data availability and reliability, technical limitations, utility and user acceptance, cost, security and privacy, performance gaps, and challenges. CONCLUSIONS:Wearable devices hold great promise for promoting health in older adults, but several hurdles remain for full adoption. A broader and more diverse group of older adults is needed to identify the most beneficial wearables and to optimize the technology. Further studies are required to statistically synthesize real-world performance and evaluation results. We hope that this review will serve as a valuable reference for the development of wearable devices in older adults.

Post-stroke depression (PSD) is a common complication that worsens neurological recovery and increases mortality among stroke survivors, creating a significant burden on patients and families. While exercise interventions are known to alleviate depressive symptoms in mild stroke cases, the effects of traditional Chinese exercises on PSD have not been systematically reviewed. This study aimed to evaluate the clinical efficacy of traditional Chinese exercises in treating PSD. A comprehensive search of eight Chinese and English databases identified randomized controlled trials (RCTs) published up to July 2024. Data were independently screened, extracted, and analyzed using RevMan 5.3 and Stata 17, with heterogeneity assessed through sensitivity, subgroup, and meta-regression analyses. Ten RCTs involving 627 participants were included. Meta-analysis revealed that traditional Chinese exercises significantly reduced depressive symptoms and improved daily living abilities in PSD patients. Specifically, HAMD scores decreased [SMD = -1.40, 95% CI (-1.88, -0.92), p < 0.00001], treatment efficacy improved [OR = 3.74, 95% CI (1.69, 8.28), p = 0.001], FMA scores increased [MD = 6.22, 95% CI (4.12, 8.32), p < 0.00001], and BI levels rose [MD = 4.95, 95% CI (2.96, 6.93), p < 0.00001]. In conclusion, traditional Chinese exercises offer significant benefits in treating PSD, demonstrating both efficacy and safety. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024574791.