Evidence-based nursing practice (EBNP) is essential in thoracic surgery nursing because of its high specialization and postoperative risks. However, existing research has paid limited attention to heterogeneity in barriers to EBNP among Chinese thoracic surgery nurses. In particular, evidence on the latent profiles of these barriers and their relationship with proactive innovation behavior (PIB) remains scarce. To identify the distinct latent profiles of barriers to EBNP among Chinese thoracic surgery nurses, examine associations between demographic factors and latent profile membership, and further explore the relationship between these latent profiles and PIB. A cross-sectional survey was conducted among 682 nurses from September to November 2025. Latent profile analysis (LPA) was used to identify profiles of barriers to EBNP, based on responses to the Barriers to Evidence-Based Nursing Practice Scale. Multinomial logistic regression analysis was performed to identify factors associated with latent profile membership. Hierarchical regression analysis was used to examine the association between barriers to EBNP and PIB. LPA identified two severity-based profiles of barriers to EBNP among nurses: a low-barrier profile (49.6

Background Older critically ill patients with ventilator-associated pneumonia (VAP) have a high mortality risk, which may be exacerbated by malnutrition. The Geriatric Nutritional Risk Index (GNRI) is a simple nutritional screening tool, but its prognostic significance in this population remains insufficiently characterized. Aim To investigate the association between GNRI and short-term (28-day) and long-term (1-year) all-cause mortality in older ICU patients with VAP, and to quantify the incremental discriminative value of adding GNRI to a baseline clinical model. Methods We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV (MIMIC-IV, 2008–2019) database. Mechanically ventilated ICU patients aged ≥ 65 years with VAP were included. The primary outcomes were 28-day and 1-year all-cause mortality. Associations were assessed using Kaplan-Meier curves and multivariable Cox proportional hazards models. Restricted cubic splines were used to assess potential non-linearity. Incremental discrimination was evaluated by Harrell’s C-index; nested models were compared using the likelihood ratio test (LRT). The change in C-index (ΔC-index) was quantified with bootstrap 95% confidence intervals. Results A total of 2,188 patients were included. Kaplan-Meier curves showed significantly lower survival among patients with lower GNRI (log-rank P < 0.001). In multivariable Cox models, higher GNRI was independently associated with lower mortality risk. Specifically, per 10-point increase in GNRI, the adjusted hazard ratio was 0.828 (95% CI 0.754–0.910) for 28-day mortality and 0.828 (95% CI 0.765–0.897) for 1-year mortality (both P < 0.001). Adding GNRI to the baseline model (age and SOFA group) improved discrimination for both 28-day mortality (C-index 0.561 vs 0.584; Δ = 0.023, bootstrap 95% confidence intervals (CI) 0.009–0.048; P = 0.001; LRT P = 1.47×10 − 5 ) and 1-year mortality (0.557 vs 0.582; Δ = 0.025, 95% CI 0.010–0.044; P < 0.001; LRT P = 6.92×10 − 7 ). Spline analyses suggested an approximately linear inverse association between GNRI and mortality, with no evidence of substantial non-linearity. Subgroup analyses showed no evidence of effect modification for most prespecified variables; however, a nominal interaction by race was observed for 28-day mortality ( P for interaction = 0.036) and should be interpreted cautiously given multiple subgroup comparisons, while all interaction tests were non-significant for 1-year mortality (all P for interaction > 0.05). Conclusions In older ICU patients with VAP, GNRI is independently associated with both short- and long-term mortality. Incorporating GNRI into a baseline clinical model provides a modest but statistically significant improvement in discrimination, supporting its use for risk stratification in nutritionally vulnerable patients.

BackgroundLung cancer is a significant public health challenge worldwide. For young and middle-aged patients undergoing lung cancer surgery, health-promoting behaviors offer a low-cost, high-impact approach for improving postoperative recovery and long-term health outcomes.ObjectiveThis study explored the associations between perceived social support, health literacy, perceived control, and health-promoting behaviors in young and middle-aged patients undergoing lung cancer surgery.MethodsWe employed a cross-sectional design to investigate 436 young and middle-aged patients undergoing lung cancer surgery who were recruited from three public hospitals between December 2024 and August 2025. Data were collected using the Sociodemographic Questionnaire, Perceived Social Support Scale, Chinese Health Literacy Management Scale, Cancer Experience and Efficacy Scale (cancer experience and control efficacy subscales), and Chinese Health-Promoting Lifestyle Profile-II. Descriptive analyses were conducted using SPSS 27.0, and AMOS 28.0 was used for structural equation modeling and mediation analysis.ResultsPerceived social support, health literacy, and control efficacy were positively associated with health-promoting lifestyles, whereas cancer experience was negatively associated with health-promoting lifestyles. The structural equation modeling results indicated that the model fit was good (root mean square error of approximation = 0.063, P < 0.05). The mediation analyses indicated that health literacy, cancer experience, and control efficacy significantly mediated the relationship between perceived social support and health-promoting lifestyles.ConclusionPerceived social support was significantly associated with healthy lifestyles among young and middle-aged patients undergoing lung cancer surgery. Health literacy, cancer experience, and control efficacy played mediating roles in this association. Early identification and interventions targeting these factors may enhance patients' adoption of health-promoting behaviors.

Background Exercise is crucial for pulmonary rehabilitation and improving the prognosis of lung transplantation (LTx) patients. However, many LTx patients in China have low exercise tolerance and compliance, and the reasons behind these challenges have not been fully elucidated. Therefore, this qualitative research aims to identify the barriers to and facilitators of exercise rehabilitation in LTx patients. Methods From January to July 2023, 15 stable LTx patients were recruited and participated in in-depth, semi-structured, face-to-face interviews at Henan Provincial People’s Hospital. The interview transcripts were analyzed using the COM-B model and the Theoretical Domains Framework (TDF). Results Six general themes including 19 barriers and 14 facilitators for the exercise rehabilitation of LTx patients were identified based on the COM-B model and TDF. The barriers to exercise included physical limitations, insufficient exercise endurance, lack of knowledge, and lack of motivation. The facilitators of exercise included motivation, self-efficacy, perceived significance of exercise rehabilitation, and social support. Conclusion The study offers detailed insight into the development and implementation of exercise rehabilitation intervention strategies for LTx patients. By combining COM-B model and TDF, the study provides strong evidence that active behavior change strategies are required for LTx patients to promote their participation in exercise rehabilitation. Professional support, pulmonary rehabilitation training, behavior change technology, and digital health tools are essential for strengthening the evidence system for reporting exercise efficacy and effectiveness.

目的:探讨三联预康复策略对肺移植等待期患者术后结局及短期生活质量的影响.方法:选取2019年1月1日～2020年1月31日收治的98例行肺移植手术患者随机分为观察组和对照组各49例,观察组接受三联预康复策略干预,对照组接受常规护理,比较两组术后结局、生活质量[采用中文版肺移植特异性生活质量量表(LT-QOL)]、心理状态[采用移植评估等级量表(TERS)和移植候选人的心理社会评估量表(PACT)].结果:干预后,两组TERS、PACT评分均低于干预前(P<0.05),且观察组低于对照组(P<0.01);观察组症状维度、情感健康维度、功能维度评分均低于对照组(P<0.05);两组1、2年内生存率比较差异无统计学意义(P>0.05).结论:将三联预康复应用于肺移植患者中,有利于改善患者社会心理状态,提高生活质量.

Abstract Background More lung cancer cases are becoming diagnosed earlier in recent years. The diagnosis is often accompanied by fear of progression (FoP). There is a clear research gap in the existing literature on FoP and the most frequent concerns in newly diagnosed lung cancer patients. Objective To identify the status and factors related to FoP in newly diagnosed Chinese lung cancer patients undergoing thoracoscopic lung cancer resection. Methods A cross-sectional design with convenience sampling was used in this study. Participants (N = 188) with newly diagnosed lung cancer (≤ 6 months) at one hospital in Zhengzhou were recruited. A demographic questionnaire, Fear of Progression Questionnaire-Short Form, Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire, and Brief Illness Perception Questionnaire were used to assess characteristics, FoP, social support, coping style, and patient illness perceptions. Multivariable logistic regression analysis was used to identify factors associated with FoP. Results The mean score of FoP was 35.39 ± 8.03. There are 56.4% of the patients (scores ≥ 34) have a clinically dysfunctional level of FoP. FoP was higher in young (18–39 years) than middle-aged patients (40–59 years) and elderly patients (≧60 years) (P = 0.004). Patients aged 40–59 years showed significantly higher fear of family-related concerns (P < 0.001), a fear of potential harm from medications (P = 0.001); Patients aged 18–39 years and 40–59 years showed significantly higher fears of work-related concerns (P = 0.012). Multiple logistic regression analyses showed that patients’ age, the time from surgery and SSRS score were found to be independently associated with higher FoP. Conclusions High FoP is a frequently reported problem among newly diagnosed lung cancer patients, especially those less than 60 years old. Professional psychoeducation, psychological interventions, and personalized support are needed for patients with a high FoP.

介绍了体力活动的概念、指南推荐和肺移植病人进行体力活动的必要性,综述了肺移植病人体力活动水平现状、影响肺移植病人体力活动的障碍因素及促进策略,以期为我国肺移植病人体力活动干预方案的制定及临床实践指导提供参考.

总结1例前纵隔巨大海绵状血管瘤患儿的术前术后护理.基于预康复理念,术前做好呼吸功能锻炼、营养支持及心理护理;术后加强并发症的预防与识别及个体化康复指导,促进患儿康复进程.

目的:调查郑州市三级医院护士营养护理能力,分析影响因素,为后续实施针对性的干预措施奠定基础.方法:2021年12月—2022年2月采用便利抽样法选取647名临床护士为调查对象,采用一般资料调查表、临床护士营养护理能力自评量表通过问卷星对其进行调查,分析郑州市护士营养护理能力的影响因素.结果:共收回642份有效问卷,有效回收率为99.23％.护士营养护理能力总分为(236.95±41.31)分.多重线性回归分析显示:定期开展营养培训、定期督查病人营养状况、科室、是否为营养支持专科护士是护士营养护理能力的主要影响因素(P<0.05).结论:郑州市三级医院护士的营养护理能力仍有待提升,管理者应定期开展营养培训,尤其加强外科、重症医学科、妇产科、儿科等科室的营养培训,重视营养支持专科护士的培养,完善督导机制,增强护士营养护理能力.

ObjectiveTo construct nursing quality sensitive indicators of adult patients with closed drainage of thoracic cavity.MethodsBased on the three⁃dimensional structural model of "structure process result"，the draft of nursing quality sensitive indicators of adult patients with closed drainage of thoracic cavity was formed through literature search and expert group meetings.Two rounds of expert consultation were conducted by Delphi method，and the items were modified according to expert opinions and suggestions.Then nursing quality sensitive indicators of adult patients with closed drainage of thoracic cavity was constructed.ResultsFinally，nursing quality sensitive indicators of adult patients with closed drainage of thoracic cavity was constructed，which included 3 first⁃level indicators（structural indicators，process indicators，outcome indicators），9 secondary⁃level indicators，and 25 tertiary⁃level indicators.The recovery rate of the two rounds of expert inquiry questionnaires was both 100%，and the effectiveness rate was both 100%.The expert opinion submission rates were 88.2% and 5.9%，respectively.The expert authority coefficients were 0.939 and 0.915，respectively.The Kendall coordination coefficient for the indicators at all levels in the second round of expert consultation were from 0.381 to 0.494.ConclusionsThe constructed nursing quality sensitive indicators of adult patients with closed drainage of thoracic cavity is scientific，reliable，professional，and practical.It is beneficial for the continuous improvement of nursing quality of adult patients with closed drainage of thoracic cavity.

目的:探讨主动循环呼吸技术(ACBT)结合反馈式抗阻吸气肌训练对肺移植术后患者的影响.方法:将 2019 年 1 月 1日～12 月 31 日 15 例患者作为ACBT组,采用ACBT治疗;将 2020 年 1 月 1 日～12 月 31 日 15 例患者作为抗阻吸气肌组,采用反馈式抗阻吸气肌训练治疗;将 2021 年 1 月 1 日～2022 年 12 月 31 日 15 例患者作为研究组,采用ACBT联合反馈式抗阻吸气肌训练治疗.比较三组干预前后护理效果.结果:干预后三组膈肌运动幅度、肺功能指标、血气指标、六分钟步行距离(6MWT)、Borg呼吸困难评分量表评分较干预前改善(P<0.05).研究组干预后深呼吸术侧及健侧膈肌运动幅度高于抗阻呼吸肌组(P<0.05),且二者均高于ACBT组(P<0.05);干预后研究组和ACBT组肺功能指标接近,均高于抗阻呼吸肌组(P<0.05);干预后研究组血气指标、6MWT高于ACBT和抗阻呼吸肌组(P<0.05),干预后研究组Borg评分低于ACBT组和抗阻呼吸肌组(P<0.05);研究组和ACBT组在术后并发症方面接近,二者发生率均低于抗阻呼吸肌组(P<0.05).结论:ACBT结合反馈式抗阻吸气肌训练可增强肺移植患者肺功能,改善患者运动耐力,二者起到了优势互补的作用,效果优于反馈式抗阻吸气肌训练或ACBT的单一干预.

目的:了解新诊断老年非小细胞肺癌术后病人的癌症复发恐惧(FCR)现状并分析其影响因素.方法:便利抽样法选取2020年6月—2021年8月在河南省某所三级甲等医院胸外科病房住院治疗的284例新诊断老年非小细胞肺癌术后病人为调查对象,采用一般资料调查表、恐惧疾病进展简化量表(FoP-Q-SF)、社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)和简易疾病认知问卷(BIPQ)对其进行问卷调查.结果:新诊断老年非小细胞肺癌术后病人FCR总分为(30.21±9.22)分,其中FCR评分≥34分的病人占36.97％(105/284).Pearson相关分析结果显示,新诊断老年非小细胞肺癌术后病人FCR总分与主观支持、客观支持、支持利用度和积极应对维度得分呈负相关(r值分别为-0.148,-0.347,-0.228,-0.188,均P<0.05),与疾病认知总分呈正相关(r=0.512,P<0.001).多元回归分析显示,新诊断老年非小细胞肺癌术后病人的居住环境、病理分期、主观支持、支持利用度和疾病认知是影响其复发恐惧水平的主要因素(P<0.05).结论:新诊断老年非小细胞肺癌术后病人FCR处于中等水平,医护人员在实施健康宣教和干预措施时应综合考虑病人情况,及时有效地识别病人存在的心理问题,提供安全、专业、适宜的应对措施,促进其心理健康.

目的 探究基于跨理论模型(TTM)的动机性访谈联合呼吸功能训练对肺癌患者肺功能锻炼依从性及生活质量的的影响.方法 选取河南省人民医院2020年1月至2021年10月收治的101例围术期肺癌患者作为研究对象,通过随机数字表法将其分为对照组和研究组,其中对照组50例行康复训练,研究组51例在对照组基础上联合基于TTM的动机性访谈进行干预.比较两组患者干预前后肺功能锻炼依从性、生活质量、焦虑/抑郁情绪、护理满意度及住院期间不良事件发生率.结果 研究组肺功能锻炼依从性(96.08％)高于对照组(82.00％),差异有统计学意义(P<0.05).两组干预后SF-36评分较干预前均升高,研究组高于对照组,差异有统计学意义(P<0.05).两组干预后HAMA、HAMD评分较护理前均降低,研究组均低于对照组,差异有统计学意义(P<0.05).研究组护理满意度(96.08％)高于对照组(84.00％),差异有统计学意义(P<0.05).两组不良事件发生率比较差异无统计学意义(P>0.05).结论 基于TTM的动机性访谈辅助康复训练应用于肺癌患者中,更有助于提升患者肺功能训练依从性,减少负面情绪,提升生活质量.

目的:探讨手绘图联合手术观摩的教学模式在胸外科护士培训中的应用效果.方法:采用类实验研究方法,便利选取河南省两家三级甲等医院胸外科86名护士参与研究,观察组43名护士接受手绘图联合手术观摩教学模式;对照组43名胸外科护士接受传统多媒体培训模式.培训结束后进行理论知识考核、培训满意度调查.结果:观察组理论知识考核成绩、培训满意度均高于对照组(P<0.05).结论:手绘图联合手术观摩的培训方式在胸外科护士培训中取得较好的效果.

ObjectiveTo construct a postoperative pulmonary rehabilitation training program for lung cancer patients.MethodsThe postoperative pulmonary rehabilitation training program for lung cancer patients in thoracic surgery was preliminarily constructed through the literature review and research group meeting.Two rounds of expert correspondence were conducted using the Delphi method，and the entries were revised according to experts' opinions and suggestions.ResultsThe postoperative pulmonary rehabilitation training program for lung cancer patients was finally constructed with 7 first⁃level indicators，16 second⁃level indicators，and 38 third⁃level indicators，including organizational planning，exercise training，breathing training，psychological care，nutritional support，health education，and effect evaluation.ConclusionsThe constructed postoperative pulmonary rehabilitation training program for lung cancer patients was scientific and safe，which could guide the pulmonary rehabilitation training clinical nursing practice in patients after lung cancer surgery.

目的:构建肺癌病人术后肺康复训练方案.方法:通过文献回顾和研究小组会议,初步构建胸外科肺癌病人术后肺康复训练方案.采用德尔菲法进行2轮专家函询,根据专家意见和建议对条目进行修改.结果:最终构建的肺癌病人术后肺康复训练方案包括组织计划、运动训练、呼吸训练、心理护理、营养支持、健康教育和效果评价7项一级指标,16项二级指标,38项三级指标.结论:构建的肺癌病人术后肺康复训练方案科学、安全,可为肺癌术后病人肺康复训练临床护理实践提供指导.

目的 构建颈内中心静脉导管拔除护理方案,规范医护人员操作行为,降低患者相关问题发生率.方法 通过文献检索、质量评价、提取并汇总证据及专家咨询,制订中心静脉导管拔除规范化护理方案,主要包括拔除时机、拔除前评估、拔除操作要点、拔除后注意事项及并发症处理.采用非同期对照研究,便利选取2021年5月—6月70例住院患者为对照组,采用常规颈内中心静脉导管拔除操作流程;2021年7月—8月的75例住院患者为试验组,实施颈内中心静脉导管拔除规范化护理方案;比较两组患者穿刺点疼痛、穿刺点渗血、拔管困难、导管断裂发生率.结果 干预后,两组患者穿刺点疼痛、穿刺点渗血发生率比较,差异有统计学意义(χ2=4.494、4.116,P<0.05);两组患者拔管困难、导管断裂发生率比较,差异无统计学意义(P>0.05).结论 开展中心静脉导管拔除规范化护理方案,可降低中心静脉导管拔除相关问题发生率,提高中心静脉导管拔除护理质量.

目的:探讨基于三维质量评价模型的阶梯式气道管理方案在人工气道病人中的应用效果.方法:选取某三级甲等医院重症医学科2018年1月—2018年6月的人工气道病人为对照组,2019年1月—2019年6月的人工气道病人为干预组进行研究.对照组采用人工气道常规护理,干预组采取基于结构-过程-结果三维质量评价模型的阶梯式气道管理方案.根据病人情况将病人分为红灯、黄灯、绿灯3类后采取不同的护理措施.比较两组病人人工气道堵管的发生率、呼吸机相关性肺炎发生率、病人重症监护室(ICU)住院日及干预组干预前、干预后第2天及干预后第5天阶梯式组别人数的分布差异.结果:干预组干预前与干预后第2天阶梯式人数分布比较差异无统计学意义(P=0.749),干预前与干预后第5天、干预后第2天与干预后第5天阶梯式人数分布比较差异具有统计学意义(P均为0.000);干预组病人人工气道堵管率低于对照组,病人ICU住院日低于对照组,二者比较差异均具有统计学意义(P<0.05);两组病人呼吸机相关性肺炎发生率差异无统计学意义(P>0.05).结论:采取基于三维质量评价模型的阶梯式气道管理方案能够降低人工气道病人人工气道堵塞发生率及病人ICU住院日,改善人工气道病人的气道状态,提高病人的住院满意度,对病人的康复具有重要作用.

Objective To explore the relationship between psychological consistency, self-efficacy and empowerment in young and middle-aged patients with lung cancer and diabetes, and the mediating effect of self-efficacy in psychological consistency and empowerment. Methods One hundred and eighty-four young and middle-aged patients with lung cancer complicated with diabetes who were treated in the Department of Thoracic Surgery of Henan Provincial People’s Hospital from October 2021 to July 2022 were selected as the study subjects. They were investigated by using self-made general situation questionnaire, psychological consistency scale, general self-efficacy scale and diabetes authorized simplified scale. Results The total score of authorization of young and middle-aged patients with lung cancer complicated with diabetes was（3.46±0.74） points, total score of psychological consistency was（48.99±9.22） points, sense of understanding was（23.63±4.31） points, sense of control was（12.92±3.00） points, sense of meaning was（12.45±3.10） points, and total score of self-efficacy was（2.75±0.43） points. The total scores of psychological consistency, comprehensibility, controllability, sense of meaning and self-efficacy were positively correlated with the total scores of empowerment（r=0.616, 0.700, 0.441, 0.429, 0.503, P＜0.001）. Self-efficacy was a part of mediating effect in psychological consistency and empowerment, among which mediating effect accounts for 23.48% of the total effect. Conclusion The self-efficacy of young and middle-aged patients with lung cancer and diabetes plays a part mediating role between the level of psychological consistency and empowerment. Medical personnel should pay attention to tapping the intrinsic potential of patients, improve their self-efficacy and enhance their empowerment.

目的 系统总结肺移植术后患者的心理体验,为指导患者术后肺康复提供依据.方法 计算机检索PubMed、The Cochrane Library、Embase、Web of Science、PsycINFO、CINAHL、中国知网、维普资讯中文期刊服务平台、中国生物医学文献数据库和万方数据库,收集有关肺移植术后患者心理体验的质性研究,检索年限为建库至2020年2月.采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,采取Meta整合的方法对结果进行整合.结果 共纳入8篇文献,提炼30个结果,归成5个类属,合成3个整合结果,即肺移植术后早期患者的消极心理、肺移植术后患者对未来的心理感受、肺移植术后患者重构生命意义.结论 肺移植术后患者的心路历程复杂且多变,医护人员应重视患者的心理状况,搭建个体化心理支持平台,指导其调整移植手术后认知及行为方式,促进其疾病适应,重塑其健康生活.