OBJECTIVE:This study identified psychological empowerment profiles of women with breast cancer to provide a clinical care framework. METHODS:This multicenter cross-sectional qualitative study used an interpretative phenomenological approach with semi-structured in-depth interviews. Participants were selected from five tertiary hospitals in northeast (Harbin and Shenyang), east (Nanjing), and northwest (Xi'an) China. Each participant underwent a face-to-face interview lasting 30-60 min. Data were collected between September and December 2024 and thematically analyzed. Forty-six women (33-72 years old) with breast cancer were interviewed; the rehabilitation timeframe spanned three days after surgery to 19 years after initial diagnosis. RESULTS:The psychological empowerment profile comprised 25 subthemes and six themes. Themes 1 (Informed and Stress) and 2 (Ambivalence and Distress) reflect the negative profile; Theme 3 (Challenge and Confrontation) marks the turning point between negative and positive coping modes; Themes 4 (Adjustment and Buffer), 5 (Rationality and Acceptance), and 6 (Insight and Growth) reflect positive profiles. Participants receiving treatment (n = 36) showed higher counts in Themes 1, 3, and 4. Those from Harbin and Shenyang had higher counts across themes than those from Nanjing and Xi'an. Survivors (n = 10) dominated Theme 6, with Nanjing survivors exhibiting greater counts across themes than their Xi'an counterparts. CONCLUSIONS:Women with breast cancer showed a negative-positive psychological empowerment trajectory during rehabilitation. Geographic differences revealed the impact of healthcare infrastructure and culture, with northeastern cities (Harbin/Shenyang) engaging more themes (5/6) than eastern and northwestern cities (Nanjing/Xi'an), indicating the need for regional support programs.

Nursing students face significant academic and emotional stress, which may increase the risk of suicidal ideation. This study examines the relationships between self-regulatory fatigue, experiential avoidance, and suicidal ideation, with a focus on the mediating role of experiential avoidance and the moderating role of negative life events. We conducted a cross-sectional survey with 562 nursing students from a university in Heilongjiang, China. Data were collected using standardized scales: the General Information Questionnaire, Adolescent Suicidal Ideation Scale, Self-Regulatory Fatigue Scale, Acceptance and Action Questionnaire II, and Adolescent Self-Rating Life Events Checklist Scale. The study revealed a significant total effect of self-regulatory fatigue on suicidal ideation (β = 0.5610, p < 0.001), accounting for 52.26

目的 探讨棋盘游戏在超声诊断学中的应用效果.方法 2021年11-12月,采用方便抽样的方法,选取黑龙江省某三甲医院超声医学科20名学生为研究对象,以胃超声诊断课程为学习内容,在课堂授课结束后,将学生分成4人一组,按照指定游戏规则进行教育游戏.通过自身前后对照的方式,验证棋盘游戏在超声医学生知识掌握以及教学满意度方面的效果.结果 学生前测分数4.50(3.00,6.00),后测分数8.50(8.00,9.00),自身前后测分数比较差异有统计学意义(Z=-3.951,P＜0.05);每个知识点下学生前后测答题正确、错误数量比较(知识点1～10分别为胃部超声检查禁饮时间;胃部超声检查禁忌证;胃切迹名称;胃冠状斜切面图的识别;胃恶性溃疡判断;胃石症判断;正常胃壁蠕动波声像图表现;胃平滑肌肉瘤声像图表现;空腹胃声像图表现;食管下段以及贲门部充盈剂通过声像图表现比较)差异有统计学意义(均P＜0.05),学生对棋盘游戏的满意度总体达90％左右.结论 棋盘游戏提高了超声医学生的知识记忆,有效促进学生学习效果,值得未来在教育教学领域中推广应用.

Background In professional ethics-related events, there are various unpleasant and complex ethical issues that require strong moral courage. Our aim is to identify and describe the potential categories of moral courage among nurses and to clarify the coping styles of nurses under different categories. Method A cross-sectional study was conducted using three data collection tools: a self-designed general information questionnaire, a Chinese version of the Moral Courage Scale, and a Trait Coping Style Questionnaire. Three hundred fourteen nurses from a tertiary hospital in Heilongjiang Province, China, were analysed using potential profile analysis, descriptive analysis, and Mann-Whitney U test data. Result The latent profile analysis (LPA) results indicate that the two-profile model is the most suitable and supports the existence of two different moral courage profiles: the low moral courage group (60.51%) and the high moral courage group (39.49%), with a high relative entropy value (0.922). The results point to a good profile solution, and there are significant differences between the two profiles. The Mann-Whitney U-test results showed that the positive coping scores of the high moral courage group were significantly higher than those of the low moral courage group, and the negative coping scores of the high moral courage group were significantly lower than those of the low moral courage group. Conclusion Our results reveal the heterogeneity of moral courage in the nurse sample and indicate that nurses in the high moral courage group tend to choose positive coping styles, while nurses in the low moral courage group are more likely to develop negative coping emotions. This provides important significance and reference value for nursing managers, who can propose customised management plans based on the types of moral courage of the nursing community and the coping styles under different categories.

近年来教育游戏(EG)广泛用于教育领域,通过创建竞争活跃的游戏环境,促进学生对知识的整合与信息理解,目前EG在解剖教学中取得了良好效果,文章就EG相关概念、特点、设计要素、理论基础以及在解剖教学中的应用现状进行综述,并针对EG在解剖教学中的应用提出以下展望:(1)注重动机激励元素设计;(2)注重情感元素设计;(3)注重监督反馈机制;(4)注重远期效益与评估工具建立.

Background Emphasizes the state of academic stress, social support, and self-regulatory fatigue on the physical and mental development of Chinese nursing students, the purpose of this study was to investigate the relationship between these variables and the mediating role of social support in academic stress and self-regulatory fatigue among a group of undergraduate nursing students in Heilongjiang Province, China, in order to provide a theoretical basis for working to reduce nursing students’ self-regulatory fatigue. Methods In this cross-sectional study, 1703 nursing students from various academic years completed the scales of social support, academic stress, and self-regulatory fatigue. In the end, there were 797 valid questionnaires, for a recovery rate of 46.80%. For statistical analysis, the independent t-test, Kruskal Wallis test, and Pearson correlation coefficient were used. In addition, we undertake analyses using structural equation modeling. Results The bulk of nursing students, or 81.4%, are between the ages of 19 and 21. Eighty percent were females. The bulk (93.0%) was comprised of freshmen. Academic stress, social support, and self-regulatory fatigue had total scores of 111.28 ± 29.38, 37.87 ± 6.70, and 45.53 ± 5.55,respectively. Academic stress was correlated with social support and self-regulatory fatigue (all p < 0.001). Social support was an intermediate variable ( p < 0.001), with an intermediate effect value of 0.122, representing 32.35% of the total effect. Conclusion Academic pressure is associated with an increase in self-regulatory fatigue, mediated by social support. Educational administrators should pay attention to the social support and resource supplement of nursing students, the adjustment and compensatory development of nursing students’ physical and mental resources, the advancement of nursing students’ internal resource adjustment, and the reduction of their self-regulatory fatigue.

Abstract Background Sleep quality is related to physical and mental health. Though bedtime procrastination has been identified as a potentially key source of poor sleep quality, related research is scarce. The goal of our study was to determine bedtime procrastination among nursing students and identify its influencing factors. Methods This cross-sectional study comprised 1827 junior college nursing students. The data were collected from November to December 2021 using a mobile app-based survey. We evaluated demographic factors, Big Five personality traits, self-regulatory fatigue, future time perspective, and problematic mobile phone use. Multiple linear regression analysis was used to identify independent characteristics that influence bedtime procrastination among junior college nursing students. Results The mean bedtime procrastination score in junior college nursing students was 25.11 ± 6.88. Family monthly income of 3000–6000 RMB (β = 0.740; p = 0.015), as well as that of > 6000 RMB (β = 1.708; p = 0.001), and an extroverted personality (β = 0.225; p = 0.001), self-regulatory fatigue (β = 0.135; p < 0.001), and problematic mobile phone use (β = 0.078; p < 0.001) had significant positive effects on bedtime procrastination. Conscientious personality (β = − 0.284; p = 0.003), neurotic personality (β = − 0.203; p = 0.031), and future time perspective (β = − 0.141; p < 0.001) had significant negative effects on bedtime procrastination. Conclusion The nursing students who participated in this study had moderate levels of bedtime procrastination. Bedtime procrastination was predicted by higher monthly household income; personality traits of extroversion, conscientiousness, and neuroticism; self-regulatory fatigue; future time perspective; and problematic mobile phone use. Practical implications We recommend that effective measures are needed to help alleviate bedtime procrastination and improve the health and well-being of nursing students.

目的 探讨线上线下混合式教学模式在"护理学基础"课程中的实践效果.方法 发挥互联网技术优势,完善线上与线下课程资源建设,结合"3+2+2+3"的课程设计,同步明确相应的考核方式,制定协同措施,保障线上线下混合式教学模式在"护理学基础"课程中的教学效果.结果 护生"护理学基础"期末成绩最高分、最低分、平均分和及格率总体保持稳定.护生线上章节学习次数为15 286次,平均97.99次/人,任务完成百分比41.3％～100.0％;参与讨论次数为5327次,平均34.15次/人,参与度良好.护生对"护理学基础"课程的教学效果评价达99分以上."护理学基础"课程总浏览量达1 611 956次,累计选课人数3049人次;覆盖31所高校,在线人数累计达3万余人.结论 线上线下混合式教学模式可以提高"护理学基础"课程教学效果,提高护生课堂的参与度和满意度,起到了良好的周边示范作用与辐射效应.

严肃游戏逐渐应用于医疗相关教育背景下,密室逃脱游戏在护理教育中显示良好应用效果.本文综述密室逃脱的概念及发展,在护理教育中应用的设计细则、应用效果及展望,旨在为密室逃脱游戏在护理教育中进一步开展提供参考.

Objective:To explore whether health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.Methods:The highrisk people with stroke admitted to the hospital were randomly divided into a test group (49) and a control group (49) by excel random function method.The control group was given telephone health education once a week, a total of 12 times last 3 months; On this basis, the test group carried out from every week to every months,a total of 8 timeshealth and wellness coaching, measuring the health promotion lifestyle (HPLP-Ⅱ) scale scores of the two groups of subjects at baseline, at the end of the intervention, and 3 months after the end of the intervention.Results:There was no statistical difference in the general demographic data of the two groups of subjects. Repeated measures analysis of variance showed that three months after the intervention, the two groups of subjects had statistically significant differences in nutrition, health responsibilities, physical activity, self-actualization, and health promotion lifestyle scores between the groups, time, and interaction ( F values were 12.131-502.649, P<0.01). There were no statistical differences in interpersonal relationship and stress coping dimensions ( P>0.05). Simple effect analysis found that at the end of the intervention, the two groups of subjects had only statistical differences between the self-actualization dimension and the total score of health promotion lifestyle ( P<0.01). Three months after the end of the intervention, the total scores of nutrition, health responsibilities, sports, self-actualization and health-promoting lifestyles of the two groups of study subjects were significantly different ( P<0.01). Conclusions:Health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.

Objective:To explore the application effect of online teaching supervision in nursing teaching quality of undergraduate nursing students.Methods:Using the convenient sampling method, the 2017 (September 2019 to January 2020) and 2018 (March to July 2020) undergraduate nursing students from the School of Nursing of Harbin Medical University were selected as the research objects. The 2018 undergraduate nursing students were included in the online live teaching group ( n=80) , and the 2017 undergraduate nursing students were included in the offline teaching group ( n=76) . A total of 10 supervisors were selected to evaluate the teaching quality of teachers' online and offline classes through the Multiple Comprehensive Evaluation Tables. The results of the final examination of nursing students in the two groups were used to evaluate the effect of the online live teaching form. The teaching satisfaction with the online live teaching method of nursing students in the two groups was compared. Results:The online teaching scored (95.05±2.14) on the Multiple Comprehensive Evaluation Tables, which was higher than that of the offline teaching (90.05±0.96) , and the difference was statistically significant ( t=6.745, P<0.01) . There were no statistically significant differences in the final exam scores of nursing students in the two groups and their satisfaction with online live teaching methods ( P>0.05) . Conclusions:The practice form of online classroom teaching supervision can effectively ensure the teaching quality and teaching effect of teachers and ensure the teaching satisfaction of nursing students with online live teaching.

Ego-depletion is a phenomenon in which an individual's cognitive, emotional and behavioral control ability or willingness declines after long-term self-control. Patients with chronic diseases need to change their lifestyles for a long time, understand and master the knowledge of the disease, and they are prone to self-depletion after diagnosis. This paper summarized the research progress of ego-depletion in patients with chronic diseases through the concept of ego-depletion, subjective measurement tools, and the current research status of ego-depletion in patients with chronic diseases, and provided inspiration for future research directions, with a view to providing ideas for further research on ego-depletion in patients with chronic diseases.

本文涵括了叙事疗法(NT)概述、NT与精神疾病患者心理调适之间的联系、NT在精神疾病患者心理调适中的研究现状3部分内容.着重从研究对象、实施者与培训相关资质标准、治疗过程的监督与评价、干预形式与干预时间、实践效益5方面对NT在精神疾病患者心理调适中的研究现状进行了介绍,并探讨了NT在未来研究中的展望,以期为加强NT在促进精神疾病患者心理调适提供参考与借鉴.

Health coaching is a patient-centered intervention process, which had conducted many years in patients with chronic obstructive pulmonary disease (COPD) and made many positive outcomes. This article reviews the concept of health coaching, specific implementation measures, application effects, existing deficiencies and inspiration in patients with COPD, with a view to providing reference for the further development of health coach technology in patients with COPD.

目的 了解首发急性缺血性脑卒中(acute ischemic stroke,AIS)患者的就医决策延迟现状,并探讨希望水平、社会支持和应对方式与首发AIS患者就医决策延迟的关系.方法 采用一般资料调查问卷、社会支持量表、Herth希望量表、简易应对方式问卷对首发AIS患者进行问卷调查,构建中介效应模型对四者间的关系进行分析.结果 共纳入243例患者,就医决策时间为(125.09±6.78)min.社会支持及各维度和希望水平及各维度及应对方式中积极应对与就医决策延迟时间呈负相关,消极应对与就医决策延迟时间正相关.社会支持和积极应对在希望水平和就医决策延迟时间上发挥部分中介效应,中介效应占总效应的91％.结论 临床护士及社区卫生保健人员应多关注脑卒中高危人群,积极为其争取来自家庭、社会的支持,指导其主动采取就医行为,切实缩短就医决策延迟时间.

目的 探讨护士自我调节疲劳在家长式领导与组织承诺间的中介作用.方法 采用组织承诺测评问卷、自我调节疲劳量表、家长式领导量表对哈尔滨市某医院740名护士进行问卷调查.结果 护士组织承诺得分为(47.18±10.60)分,得分率为78.63％,其中努力承诺维度得分率最高(82.95％);自我调节疲劳总分(45.15±11.92)分,得分率为56.44％,其中认知疲劳得分率最高(60.50％);家长式领导的仁慈领导、德行领导和威权领导维度得分率分别为84.95％、84.32％和57.57％.组织承诺与自我调节疲劳呈负相关;组织承诺与仁慈领导及德行领导呈正相关,与威权领导呈负相关;自我调节疲劳与仁慈领导及德行领导呈负相关,与威权领导呈正相关.自我调节疲劳在家长式领导不同领导风格与组织承诺中均存在部分中介效应,分别占总效应的12.29％、12.61％和14.57％.结论 自我调节疲劳是家长式领导对组织承诺影响的中介变量,医院管理者应关注护士自我调节疲劳程度,采取积极手段降低其自我调节疲劳,提高组织承诺水平.

目的 探索以小规模限制性在线课程(SPOC)为媒介的FSC教学模式在护生临床见习中的应用效果.方法 采用便利抽样法在2017级护理本科生(76人)临床见习中实施以SPOC为媒介的FSC教学模式,通过自身前后对照,从知识、能力、兴趣、情感4个层面评价见习效果.结果 见习前后护生知识的掌握和应用、临床综合能力、学习热情与积极性、与教师的关系等方面有明显改善(P<0.05).结论 以SPOC为媒介的FSC教学模式有利于护生对知识的掌握与转化,有利于培养临床思维,提高沟通交流、团队协作等临床综合能力,同时也可激发护生学习热情,提高教学参与度,促进师生双向互动,值得推广.

目的 了解临床护士自我调节疲劳现状,分析其影响因素,为针对性干预提供参考.方法 采用一般资料调查表、自我调节疲劳量表、中国护士工作压力量表、心理韧性量表、组织支持感量表及社会支持评定量表对942名临床护士进行调查.结果 临床护士自我调节疲劳总分为47.00(43.00,51.00)分.多元线性回归分析显示,组织支持感、管理及人际方面的问题、对社会支持的利用度是护士自我调节疲劳的主要影响因素(均P＜0.01).结论 护士自我调节疲劳程度中度偏上,护理管理者应重视并针对主要影响因素制定干预措施,以提高临床护士自我调节能力,从而减轻疲劳程度.

目的:观察学生标准化病人(SSP)应用于《护理学基础》翻转课堂教学的效果.方法:采用整群抽样的方法,选择2017年9月-2019年10月期间哈尔滨医科大学护理学院2017级、2018级156名护理本科生纳入至本次研究中,对照组76名护生采用传统教学法,实验组80名护生应用SSP并结合探究式学习理念开展翻转课堂教学,对比两组理论成绩、操作成绩、自主学习能力及评判性思维量表评分情况.结果:实验组护理本科生理论成绩、操作成绩显著高于对照组,差异存在统计学意义(P＜0.05).干预后,两组自主学习能力、评判性思维量表评分均增加,且实验组显著高于对照组,差异存在统计学意义(P＜0.05).结论:学生标准化病人(SSP)应用于《护理学基础》翻转课堂教学效果显著,建议推广应用.