BACKGROUND:As the older adults population grows, the incidence of hip fractures continues to rise, presenting a major challenge to healthcare systems. Traditional postoperative rehabilitation often struggles with continuity and accessibility, particularly for patients in remote areas. Telerehabilitation, which leverages digital technologies for remote care, is emerging as a potential solution to overcome these limitations and provide more efficient, accessible rehabilitation for older adult patients recovering from hip fractures. OBJECTIVE:To conduct a scoping review of studies on the application of telerehabilitation in home care for older adults postoperative hip fractures, aiming to evaluate its effectiveness, methods, and potential for standardization in clinical practice. METHODS:Based on scoping review guidelines, a systematic search was conducted on CNKI, Wanfang Database, CQVIP, CBM, PubMed, Web of Science, Cochrane Library, CINAHL, and Embase, up to August 31, 2025..The included literature was summarized and analyzed. RESULTS:A total of 18 studies were included. Among these, mobile applications, WeChat platforms, and video interaction systems were the primary methods for home-based care of elderly patients after hip fracture surgery, all utilizing telerehabilitation delivered through video, text, and image-based interventions. A meta-analysis of key outcome measures revealed significant improvements in the telerehabilitation group compared to the control group across several domains: hip function (HHS, P < 0.001), walking ability (6MWT, P < 0.0001), and quality of life (SF-36, P < 0.001). Furthermore, advantages were noted in pain relief (NPRS, P < 0.05) and a reduction in depressive symptoms (HADS-D, P = 0.003). Notably, multiple studies consistently reported significantly higher exercise adherence in the telerehabilitation group compared to the control group (P < 0.05). CONCLUSION:Telerehabilitation effectively enhances functional recovery and adherence in older adults after hip fracture surgery. Its success depends on matching interventions to patients' digital literacy. Future implementation requires standardized protocols and outcome measures to be integrated into professional follow-up care, thereby overcoming existing barriers and maximizing scalability. TRIAL REGISTRATION:OSF Registration DOI: https://doi.org/10.17605/OSF.IO/QYUJM.

目的 了解云南省某中医院校本科护生心理危机、危机脆弱性和生命意义感的现状及三者间的关系,为促进护生心理健康提供科学依据.方法 采用心理危机、危机脆弱性测验问卷和生命意义感量表,于2021年10月对云南中医药大学330名在校本科护生进行问卷调查.结果 在校本科护生心理危机脆弱性得分为(25.48±4.41)分,生命意义感得分为(48.6±8.07)分,心理危机得分为(17.22±2.54)分.对专业是否认同和不同家庭关系的本科护生心理危机脆弱性得分比较,差异均有统计学意义(均P＜0.05);是否认定为贫困、对专业是否认同和不同家庭关系的本科护生生命意义感得分比较,差异均有统计学意义(均P＜0.05);户籍类型、对专业是否认同和不同家庭关系的本科护生心理危机得分比较,差异均有统计学意义(均P＜0.01).本科护生心理危机与危机脆弱性呈正相关(r=0.246,P＜0.05),与生命意义感呈负相关(r=-0.456,P＜0.05),危机脆弱性与生命意义感呈负相关(r=-0.275,P＜0.05).中介效应检验显示,危机脆弱性不仅能够直接预测生命意义感,而且能够通过心理危机的中介作用预测生命意义感,直接效应值为0.54,中介效应值为0.20,分别占总效应的72.68％和27.32％.结论 云南省某中医院校在校本科护生心理危机与危机脆弱性及生命意义感存在一定相关性,且心理危机在危机脆弱性与生命意义感间起调节中介效应.

目的 评价虚拟现实技术对老年性痴呆患者认知功能、生活自理能力及抑郁焦虑程度的干预效果.方法 计算机检索Web of Science、PubMed、Cochrane Library、EMbase、中国生物医学文献服务系统、维普网、万方数据、中国知网,搜集虚拟现实技术对老年性痴呆患者干预的随机对照研究,时间范围限定为自建库至 2023 年 6 月 1 日.由 2 名研究者独立筛选文献、提取资料并评价文献质量后,采用Review Manager 5.4 软件进行Meta分析.结果 纳入7 篇文献,共461 例样本,其中干预组230 例,对照组231 例.Meta分析结果显示,虚拟现实技术干预显著改善老年性痴呆患者的认知功能(SMD = 0.47,95%CI 0.23～0.71,P<0.01);改善老年性痴呆患者的日常生活能力(SMD = 0.74,95%CI 为 0.50～0.97,P<0.001);使患者抑郁焦虑的心理状态改善(SMD =-0.81,95%CI-1.04～0.02,P<0.01).结论 虚拟现实技术对老年性痴呆患者的干预与常规康复治疗相比疗效更加显著.

Objective To explore the mediating effect of perceived professional benefits on the relationship between occupational commitment and work alienation,and to provide a reference for nursing management.Methods A total of 223 nurses from two grade A tertiary hospitals in Yunnan Province and one grade A tertiary hospital in Shandong Province were enrolled through convenience sampling.The occupational commitment scale,perceived professional benefit scale,and work alienation scale were used.Results The scores of occupational commitment,perceived professional benefit,and work alienation were(78.65±15.64),(134.03±20.08),and(29.98±8.05),respectively.The work alienation of nurses was negatively correlated with occupational commitment and perceived professional benefits(r =-0.523,-0.559,P<0.01).The perceived professional benefits had a partial mediating effect between occupational commitment and work alienation,with an indirect effect of-0.106.The mediating effect accounted for 40.6%of the total effect size.Conclusion Nursing administrators can reduce nurses'work alienation and improve their professional identity by enhancing their perceived professional benefits and occupational commitment.

Objective:To sinicize the Gerontological nursing competence (GeroNursingCom) scale and test its reliability and validity.Methods:This was a cross sectional investigation. The Brislin translation model was used for normal translation and back-translation, cultural adjustment and pre-investigation. The Chinese version of the GeroNursingCom scale was formed according to expert comments. From September to October 2021, a questionnaire survey was conducted by convenient sampling method on 312 nursing undergraduates from 3 undergraduate medical schools in Kunming to test its reliability and validity.Results:The Chinese version of the GeroNursingCom scale included 11 dimensions and a total of 50 items. The overall Cronbach′s α coefficient of the scale was 0.909, the Cronbach′s α coefficient of each dimension was 0.625-0.912, the split-half reliability coefficient was 0.768, and the test-retest reliability was 0.845. The scale-level content validity value was 0.930, and the item-level content validity value was 0.830-1.000. Exploratory factor analysis extracted a total of 11 common factors with eigenvalues>1, and the common interpretation of the results was 68.374%.Conclusions:The Chinese version of GeroNursingCom scale has good reliability and validity, and can be used as a tool to evaluate nursing interns' geriatric nursing ability.

Smoking cessation can effectively reduce the risk of death, alleviate respiratory symptoms, and decrease the frequency of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). Effective smoking cessation strategies are crucial for the prevention and treatment of COPD. Currently, clinical interventions based on theoretical frameworks are being increasingly used to help patients quit smoking and have shown promising results. However, theory-guided smoking cessation interventions have not been systematically evaluated or meta-analyzed for their effectiveness in COPD patients. To improve smoking cessation rates, this study sought to examine the effects of theory-based smoking cessation interventions on COPD patients. We adhered to the PRISMA guidelines for our systematic review and meta-analysis. The Cochrane Library, Web of Science, PubMed, Embase, Wanfang, CNKI, VIP Information Services Platform, and China Biomedical Literature Service System were searched from the establishment of the database to April 20, 2023. The study quality was assessed using the Cochrane Collaboration's risk assessment tool for bias. The revman5.4 software was used for meta-analysis. The I2 test was used for the heterogeneity test, the random effect model and fixed effect model were used for meta-analysis, and sensitivity analysis was performed by excluding individual studies. A total of 11 RCTs involving 3,830 patients were included in the meta-analysis. Results showed that theory-based smoking cessation interventions improved smoking cessation rates, quality of life, and lung function in COPD patients compared to conventional nursing. However, these interventions did not significantly affect the level of nicotine dependence in patients. Theory-based smoking cessation intervention as a non-pharmacologically assisted smoking cessation strategy has a positive impact on motivating COPD patients to quit smoking and improving their lung function and quality of life. PROSPERO registration Number: CRD42023434357.

目的:对冠心病发病风险预测模型进行系统评价,为临床实践提供参考依据.方法:检索PubMed、EMbase、Web of Science、Cochrane Library、中国知网、中国生物医学文献数据库、万方数据库、维普数据库中与冠心病发病风险预测模型有关的研究,检索时限为建库至2022年8月31日.2名研究者独立进行文献筛选和数据提取,并使用风险评估工具分析纳入文献的偏倚性和适用性.结果:纳入冠心病发病风险预测模型的研究共9项.受试者工作特征曲线下面积为0.70～0.86.在所有纳入模型中包含最多的预测因子是年龄、吸烟、糖尿病、血脂异常和血压异常.9项研究总体适用性好,但仍存在样本局限、缺失数据的情况.结论:纳入模型具有较好预测效能,可用于临床早期识别冠心病高风险人群,但模型的外推性未得到有效评价,未来需进一步探究.

Abstract Background The work in NICU puts forward higher requirements for nurses' professional ability and emergency response ability. Nurses often need to face a variety of complex emergencies, quickly make decisions, which easily lead to decision fatigue. At present, the domestic research mainly focuses on the decision-making fatigue of patients' families, and no relevant research has been found on the decision-making fatigue of NICU nurses. Objectives To investigate the status of decision fatigue of nursing staff in NICU and analyze its influencing factors, so as to provide reference for formulating and implementing corresponding intervention measures. Design An online cross- sectional survey. Participants Nurses working at provincial tri Service hospitals in Yunnan, China Primary and secondary outcome measures In February, 2023, 218 NICU nurses in four Class III A hospitals in Yunnan Province were investigated by using general information questionnaire, Chinese version of decision fatigue scale and self-control scale, and the influencing factors of decision fatigue of NICU nurses were analyzed by multiple stepwise regression. Results The total score of decision fatigue scale for 218 nursing staff in NICU was (18.56±2.812) and the score of self-control was (49.37±9.962). Multivariate stepwise regression analysis showed that age, length of service, professional title, monthly income, and self-control were the influencing factors of decision fatigue for nursing staff in NICU (all P <.05). Conclusion Nurses in NICU had higher degree of decision-making fatigue. Managers should pay attention to the status quo of decision-making fatigue of nursing staff in NICU and take corresponding intervention measures on influencing factors.

最佳人力资源管理实践是由一系列相互联系和促进的人力资源管理实践构成的整体,与企业特定的战略环境相匹配,能显著提高组织绩效.针对中国水利国际工程企业员工来自不同的国家,人力资源管理实践需要关注国际化管理特征的问题,选取中国水利国际工程企业中的典型案例进行质性研究,在传统最佳人力资源管理实践研究的基础上,结合中国水利国际工程企业的特定国际化管理情境,从战略人力资源管理理论的权变观视角和资源论视角出发,深入探究中国水利国际工程企业在"一带一路"背景下的最佳国际人力资源管理实践.属地化招聘、国际人才队伍选拔的"选人"实践,跨文化培训、国际人才培养的"育人"实践,全面的考核体系、完整公平的晋升路径的"用人"实践,有竞争力的海外薪酬水平、满足员工各层次需要的"留人"实践是最佳国际人力资源管理实践的主要因素,同时,基于AMO模型厘清了各项国际人力资源管理实践对中国水利国际工程企业绩效产生积极影响的作用机制.

目的:系统评价舒适化浅镇静策略(eCASH策略)对重症监护室(ICU)机械通气病人谵妄的干预效果.方法:计算机检索万方数据库、中国知网、维普数据库、中国生物医学文献服务系统、Web of Science、PubMed、EMbase、the Cochrane Library数据库中关于舒适化浅镇静策略对ICU机械通气病人谵妄干预效果的随机对照试验,检索时限为建库至2022年3月31日.由2名研究者严格按照纳入与排除标准独立进行文献筛选、质量评价、资料提取后,应用RevMan 5.4软件进行Meta分析.结果:共纳入22项随机对照试验.Meta分析结果显示,与常规护理相比,舒适化浅镇静策略能降低ICU机械通气病人谵妄发生率[OR=0.42,95％CI(0.34,0.52),P<0.00001],缓解谵妄持续状态[MD=-1.30,95％CI(-1.48,-1.12),P<0.00001],缩短机械通气时间[SMD=-1.23,95％CI(-1.57,-0.89),P<0.00001]和ICU住院时间[SMD=-1.06,95％CI(-1.27,-0.85),P<0.00001],降低住院死亡和放弃治疗率[OR=0.37,95％CI(0.22,0.60),P<0.0001].结论:现有证据表明,舒适化浅镇静策略能降低ICU机械通气病人谵妄发生率和住院死亡、放弃治疗率,缓解谵妄持续状态,减少机械通气时间和ICU住院治疗时间.

Background: Children who undergo wound manipulation usually experience pain. Virtual reality technology is a novel and effective non pharmaceutical therapy for reducing pain in children scheduled to undergo wound manipulation. However, the effectiveness of Virtual reality technology in controlling procedural pain in children’s wounds has not been evaluated in a systematic review. Methods: It employed a meta-analysis design. We included studies with randomized controlled trials, reporting children’s wound manipulation pain, and published them in English. Two reviewers independently evaluated the methodological quality of the included studies. Results: Of the 108 studies identified, 39 were eligible for the meta-analysis, with a total sample of 273 patients. The use of virtual reality technology has significantly reduced pain intensity during wound manipulation in children. There was a significant difference between the experimental group (virtual reality) and the control group (no virtual reality) in reducing the pain of the children’s wound manipulation ( P < .05). Conclusion: As a distraction method of non drug assisted analgesia intervention, virtual reality technology can reduce children’s procedural pain and discomfort symptoms.

目的 系统评价八段锦运动对衰弱老年人的干预效果.方法 运用循证护理的方法学,制定PICOS原则,使用计算机系统检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、The Cochrane Library、Embase数据库中关于八段锦对衰弱老年人干预的随机对照试验,检索时限为建库至2022年2月.采用Cochrane系统评价手册中的文献质量评价标准,对所纳入的文献进行质量评价,并由2名研究人员对文献质量进行严格评价和资料提取.结果 共纳入6篇文献,均为中文文献.因为不同研究之间的评价指标差异性较大,因此没有对其进行Meta分析,而只是对其进行描述性分析.结论 八段锦运动可有效改善老年人的衰弱状态.

目的:通过构建时间序列自回归移动平均模型预测未来6年我国政府卫生支出的变化情况,为政府制定和调整相关健康政策提供数据支持.方法:利用1990-2019年我国政府卫生支出及其4大具体流向总额的时间序列构建预测模型,研究我国政府卫生支出及其结构的变化情况.结果:模型的绝对误差最大值均在10％以内,拟合效果良好.经预测,2025年政府卫生支出增至34786.19亿元,6年内以年均12.04％比率增长,医疗卫生服务支出、医疗保障补助支出总额分别以年均7.59％和6.57％比率逐年上升,卫生和医疗保障行政管理支出、人口与计划生育事务性支出分别以年均38.1％和0.31％比率逐年下降.结论:未来6年我国政府卫生支出增长速度减缓,医疗卫生服务与医疗保障补助支出持续增长,卫生和医疗保障行政管理、人口与计划生育事务支出总额下降,政府卫生支出及其结构波动受医疗卫生政策等因素影响,仍需对政府卫生支出规模和结构进行科学测度与监测.

创业胜任力是创业的核心能力,大学生创业对缓解就业压力具有重要意义,如何提高大学生的创业胜任力,是目前亟须解决的社会问题.通过剖析创业胜任力的研究概念及维度,总结国内以及国外如美国、英国、新加坡等国的创业胜任力教育现状,从而对我国高校开展创业胜任力教育提供一些思路,并对未来在创业课程设置以及政策资金帮扶方面提出展望.

5 G时代的来临和全球新冠疫情的蔓延,使"互联网+"教育得到迅猛发展,"O2 O"混合模式的广泛应用呼唤高校思想教育的创新发展与变革,而信息技术的迅速发展使高校思想政治教育创新成为必然趋势,大学生的美好精神生活养成也需要高校思想政治教育创新发展.但与此同时,移动互联时代的高校思想教育面临着许多挑战,因此创新发展高校思想政治教育的路径十分必要.高校要走树立教育生态系统思想,创新发展新时代高校思想政治教育理念;创新高校科研育人、实践育人机制,巩固协同育人功效;完善高校网络育人机制保障,构建良好的高校思政教育环境;提升教师信息化网络意识;提升学生自我教育能力的思政教育创新发展路径,强化新时代的"三观"教育,让教师和学生双双受益,从而达到"生活化""无声化""跨界化"的育人效果.

基层河长作为河长组织体系中的"末梢神经",在全面建立河长制中起基础性和关键性作用.因此,构建基层河长胜任力模型对于规范基层河长的工作要求,提高其履责能力,全面落实河长制工作任务都具有重要的战略意义.运用行为事件访谈法对22位基层河长进行访谈,借助软件ATLAS对访谈内容进行分析;利用扎根理论方法,通过开放性编码、主轴性编码、选择性编码构建出包含五大维度共23项胜任要素的基层河长胜任力初始模型,据此编制基层河长胜任力测量量表.通过问卷调查,对基层河长胜任力初始模型进行检验与修正,最终得到了由河湖管理能力、协作力、抗压力、专业素质和人格特质等维度构成的基层河长胜任力模型.实践中,要把基层河长胜任力构成要素作为基层河长评价考核和培训的重要依据以及河长制制度完善的重要指引,使制度更好地服务于实践,推动河长制从"有名"向"有实"转变.

目的 了解昆明市三级综合医院护理人员临终关怀态度现状,并分析其影响因素.方法 采用便利抽样法,于2019年7—11月选取云南省4所医院老年病科、急诊科、外科、肿瘤科等科室的护理人员398名作为调查对象.采用一般资料调查问卷、中文版佛罗梅尔特临终关怀态度量表进行调查.结果 护理人员临终关怀态度总分为(97.26±9.745)分.多元线性回归分析显示,文化程度、科室、以往接受临终关怀教育情况为临终关怀态度的主要影响因素(P<0.05).结论 护理人员临终关怀态度较为积极,仍有待进一步提高.后续应强化护理人员临终关怀培训工作,加强高学历临终关怀护理人员的培养,以促进昆明市临终关怀事业的稳步发展.

目前我国进入高速发展的新经济时代,"大众创业,万众创新"的理念逐渐深入人心,创新创业人才培养既是国家发展战略的需要,也是大学生个体成长和全面发展的需要.自我领导力是领导力的重要组成部分,也是大学生成长成才的核心能力,故创新创业背景下对大学生自我领导力的开发是时代发展的必然要求.本研究拟对创新创业背景下的大学生自我领导力培养提出对策和建议,以促进对大学生的创新创业教育,为减轻就业压力,提升大学生职场竞争力提供依据.

随着我国人口老龄化的加剧,医养结合已成为国家近期政策重点方向之一,而医养结合背景下如何满足老年群体日益增长的医疗养老服务需求是我们亟待解决的问题.医养结合背景下我国老年护理人才供需严重失衡,因此特色化中医老年护理人才的培养,契合国家政策和老年群体的需求."一体双翼、三大支柱、四轮驱动"的特色化中医老年护理人才培养模式为医养结合背景下如何培养老年护理人才提供了具体的方法与策略.