We define guideline implementability as the characteristics of the guideline that reflect the extent to which it is likely to be adopted in clinical practice. Improving the intrinsic quality (e.g., context, format, language etc.) of clinical practice guidelines (CPGs) may be a cost-effective and broadly applicable approach. This study was aimed to develop the clinical practice guidelines implementability assessment tool (CPG-IAT) and test its psychometric properties. The study used the 2022 CPGs recorded in the STAR guideline repository as the evaluation sample. The evaluation team consisted of 60 members with clinical, guideline development, or prior rating experience, responsible for assessing the included guidelines. Guideline evaluation data were randomly assigned to be utilized for an exploratory factor analysis (n = 131) or for a confirmatory factor analysis (n = 130). Reliability and validity analyses were then conducted with the full sample. The exploratory factor analysis resulted in a 16-item tool with four dimensions representing Methodological Rigor and Transparency, Recommendation Clarity and Interpretability, clinical relevance and actionability. Confirmatory factor analysis supported a priori factor structure. The tool demonstrated excellent internal consistency reliability, convergent validity, construct reliability, split-half reliability, test-retest reliability, inter-rater reliability and pragmatic. The CPG-IAT provides a psychometrically validated instrument for assessing the intrinsic implementability of CPGs both during and after the guideline development process. The CPG-IAT contributes a systematically developed and empirically validated measure of guideline implementability, with potential to inform future research and practice aimed at enhancing the translation of evidence-based guidelines into clinical practice. China Clinical Trails Registry (ChiCTR2400086931); registered July 15, 2024. https://www.chictr.org.cn/.

While influenza vaccines are the most effective measure for preventing influenza, uptake rates in China remain relatively low. Rapid Verbal Persuasion (RVP), with highly rapid fashion, has a strong evidence base in promoting behavior change. Despite this, it is underused or rarely evaluated in the context of vaccination. Additionally, the success of RVP implementation in vaccination clinics hinges on the motivation of vaccination staff, which remains critical even with stable contextual factors. Multifaceted incentive-based implementation strategies, which aim to enhance motivation to promote the implementation of evidence-based practices, could be advantageous. This study protocol outlines an implementation-effectiveness hybrid type 2 design to evaluate the effectiveness of both the incentive-based implementation strategies on implementation outcomes and RVP on increasing influenza vaccination rates. This study will be conducted as a two-tiered cluster of randomized controlled trials over three months. Initially, 32 vaccination clinics will be randomly allocated to one of two study arms: (a) implementation of RVP or (b) no implementation. At the end of the study period, differences in influenza vaccination status between the intervention and control groups will be compared (primary outcome). Subsequently, a cluster randomized factorial trial will be conducted, involving 16 clinics implementing RVP. This trial will aim to compare the impact of various implementation strategies (different combinations of incentives) on fidelity in RVP implementation (primary outcome). Data collection for the primary outcomes will include unannounced exit interviews. Modified Poisson regression models and generalized linear mixed-effects models will be utilized to analyze the association between primary outcomes and interventions. The study aims to enhance the influenza vaccination rate in China by developing financial and non-financial incentives that allow vaccination staff to deliver RVP with greater motivation. Furthermore, the evidence generated from this multi-center trial will assist policymakers in improving current incentive systems within immunization services. Chinese Clinical Trial Registry. Trial identifier: ChiCTR2400091302 (Registration Date: October 25, 2024); ChiCTR2400091324 (Registration Date: October 25, 2024).

Aims to explore factors that can influence proactive health behaviors in pre-frailty older adults. Design this is a qualitative content analysis study. Methods data collected through interviews with 20 pre-frailty older adults in a geriatric unit at a general hospital in Guangzhou, China. We used deductive content analysis to categorize codes and calculate their frequency based on the theory of planned behavior. Inductive content analysis was used to analyze data that could not be analyzed according to the theory of planned behavior. Results the data were analyzed and grouped into categories by beliefs similarity, counted from the frequencies. The factors of 6 behavioral beliefs, 6 normative beliefs, and 14 control beliefs were issued. Six themes emerged, including positive attitudes toward proactive health behaviors outcomes, lack of proactive health awareness the negative influence of children on proactive health behaviors, lack of knowledge of proactive health behaviors, spouses play an important role in proactive health behaviors, low resistance to unhealthy behavior. Conclusion this research will support to the construction of a psychometric scale to measure the intentions of proactive health behaviors in pre-frailty older adults. These influencing factors will also help us to develop measures to improve the ability of pre-frailty older adults to be proactive health in the future. Impact this research validates and extends the theory of planned behavior. The findings of factors influencing proactive health behaviors help us to develop strategies to enhance proactive health in pre-frailty older adults in the future. These findings also provide content for the construction of the psychometrics of proactive health intentions scales. Reporting Method this study follows the COREQ reporting norms.

This qualitative study aimed to gain an understanding of what it means to live with ischemic heart disease for individuals who perceive health as beyond their control and how these individuals navigate their choices regarding adhering or not adhering to self-management behavior. Participants were recruited through purposive sampling, and semi-structured interviews were conducted. Content analysis was employed to identify themes and subthemes in the interview data. The theme, "attribution of ischemic heart disease," revealed that the participants attributed their condition to lifestyle, critical events, and the natural aging process. The theme, "experiences of self-management," highlighted the different behaviors among participants who perceived health to be beyond their control. The theme, "barriers and facilitators," identified factors such as a strong sense of responsibility toward family members, the work environment, and access to medical resources. Our study showed that despite perceiving their health to be beyond their control, some individuals may still adhere to self-management practices. Understanding factors such as "attribution" and "barriers and facilitators" can provide nurses with insights into the patients' decisions to adhere or not adhere to self-management behaviors.

Objective To explore the care experiences of spouses as long-term and primary caregivers for disabled older adults in China. Methods A descriptive phenomenological method was used in this study, as well as purposive and convenient sampling. Semi-structured interviews were conducted with 15 spousal caregivers in Guangdong, China, from March to December 2021. Interview audio-recordings were transcribed verbatim and data were analyzed using Colaizzi's phenomenological analysis method. Results We identified four themes from the data: spousal care motivation; sacrifices in caregiving; obstacles in caregiving; spousal caregivers’ positive experiences. Conclusions Spouses took responsibility for providing care for their disabled partners regardless of their willingness. They had positive experiences while providing care, but negative experiences were dominant, especially for spouses of severely disabled older adults. Spouses are always perfect in caregiving roles, although they may also need medical assistance. To prevent a decline in spousal caregivers’ quality of life and relieve their care burdens, health care providers should support them as soon as possible or offer formal care for disabled older adults. It is necessary to intervene considering disabled older adults and their spousal caregivers as a unit to empower their confidence in coping with life together.

Introduction Ischaemic heart disease is a significant cause of morbidity and mortality worldwide. Self-management is a way to reduce the risk associated with ischaemic heart disease; however, some individuals may not have the ability or willingness to engage in self-management behaviours. One approach to identify an individual’s readiness and capacity to engage in self-management behaviours is to assess their health locus of control. Based on the Individual and Family Self-Management Theory, this review’s objectives are to describe: (1) how health locus of control affects the process of engaging in self-management behaviours, (2) impacts of health locus of control on outcomes associated with self-management behaviours and (3) potential contextual variations in the relationship between health locus of control and self-management behaviours.Methods and analysis The scoping review will be guided by the Joanna Briggs Institute methodological framework. A comprehensive search will encompass seven electronic databases (Ovid Medline, CINAHL, EMBASE, APA PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus) and grey literature sources (ProQuest Dissertations, ClinicalTrials.gov). Collaborative efforts with library experts will inform our search strategies, building on insights from previous reviews centred on self-management and ischaemic heart disease. Two review authors will independently conduct the screening and data extraction processes; discrepancies will be resolved through consensus or discussion with a third review author. The review will include English studies from database inception, focusing on the health locus of control among adults with ischaemic heart disease. Findings will be presented graphically and tabularly, together with a narrative description.Ethics and dissemination We will collect data from published and grey literature, meaning ethical approval is not necessary. Findings will be published in peer-reviewed journals and presented at academic conferences.Registration details Open Science Framework (https://doi.org/10.17605/OSF.IO/B4A6F).

The stress of disability significantly impacts an individual's quality of life and that of a spouse. Health empowerment, based on the idea that individuals may be successful despite disability, may be meaningful to disabled persons and their spouse carers. This cross-sectional survey study aimed to explore the effect of health empowerment on the health-related quality of life (HRQOL) of older individuals with disabilities and their spouse carers on both a personal (actor effect) and interpersonal level (partner effect). A total of 1092 dyads of older individuals with disabilities and their spouse carers residing in communities were recruited from seven provinces in China. Two separate Actor-Partner Interdependence Model analyses were conducted to examine the impact of health empowerment on the two domains of HRQOL: the Physical Component Score (PCS) and the Mental Component Score (MCS). The results revealed that health empowerment had actor effects on the PCS and MCS of older individuals with disabilities, as well as on the PCS and MCS of their spouse carers. However, no significant partner effects of health empowerment on the PCS and MCS of either the individuals with disabilities or their spouse caregivers were observed. Empowering individuals with disabilities and their spouse carers may help them enhance their own HRQOL, both physically and mentally. However, more research is required to determine the interpersonal effect of health empowerment on the HRQOL.

The aim of this study was to explore the chain mediation model of self-efficacy and health literacy between empowerment and quality of life among spousal caregivers of disabled elderly based on 'Marriage Binding'. From December 2020 to June 2022, the cross-sectional study was conducted in hospitals and communities, in Guangdong, Fujian, Sichuan, Hunan, Jiangxi, Guangxi and Yunnan provinces, China. Descriptive statistics were used to describe the demographic data and four main variables, including empowerment, self-efficacy, health literacy and quality of life. Spearman correlation analysis was used to analyze the correlation between the four main research variables. Multiple Linear Regression and bootstrap analysis were used to analyze the direct and indirect effects among them. Any two variables of spousal caregivers were correlated among empowerment, self-efficacy, health literacy and quality of life. Self-efficacy and health literacy can separately and sequentially mediate the relationship between empowerment and quality of life. To improve the quality of life of spousal caregivers of disabled elderly, the mediating role of self-efficacy, the mediating role of health literacy and the chain mediating role of self-efficacy and health literacy should take effect. In the future, some intervention studies should be taken to enhance the effects of those variables that may be beneficial for improving quality of life of spousal caregivers of disabled elderly.

目的 编制适用于我国老年慢性病患者的健康赋能需求评估量表,并检验其信效度.方法 在文献分析及参照国内外相关工具的基础上编制量表条目池;通过2轮德尔菲专家函询,形成测试版老年慢性病患者健康赋能需求评估量表.便利选取2021年3—12月在广州市某三级甲等综合医院住院的236例老年慢性病患者进行问卷调查,检验量表信效度.结果 最终形成的老年慢性病患者健康赋能需求评估量表包含5个维度、30个条目,经因子分析提取5个公因子,累计方差贡献率为64.24％;各条目内容效度指数为0.72～1.00,总量表内容效度指数为0.94;量表各维度Cronbach'sα系数为0.78～0.90,折半系数为0.68～0.83;总量表Cronbach'sα系数为0.92,折半系数为0.76.结论 本研究所研制的老年慢性病患者健康赋能需求评估量表可作为老年慢性病患者赋能需求评估的工具,为科学地制订和实施符合患者需求的个性化慢性病管理措施提供依据.

目的 总结老年髋部骨折术后患者家庭康复护理的相关证据,为临床工作者制订家庭康复护理方案提供参考.方法 计算机检索国内外相关指南网站、专业协会网站及UpToDate、BMJ Best Practice、乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、CINAHL、Embase、PubMed、Web of Science、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于老年髋部骨折术后患者家庭康复护理的相关临床决策、指南、系统评价、专家共识及证据总结,检索时限为建库至2021年10月.由2名研究者对文献进行质量评价和资料提取.结果 共纳入15篇文献,其中临床决策3篇,指南3篇,专家共识5篇,系统评价2篇,证据总结2篇.从适宜人群、出院计划、康复评估、康复预期、康复策略、强化锻炼、健康教育、随访8个方面汇总了27条最佳证据.结论 该研究总结的老年髋部骨折术后患者家庭康复护理的最佳证据较为科学、全面.建议医护人员在应用证据时,结合具体的临床情景与患者意愿制订个性化的康复护理方案.

INTRODUCTION AND AIMS:As a critical form of stroke damage, aphasia negatively impacts stroke patients' return to society. Speech and language intervention has been found to assist in optimizing poststroke aphasia patient outcomes; consequently, early identification and diagnosis are vital for poststroke aphasia to ensure that patients receive the rehabilitation they require. This project aimed to promote evidence-based practice (EBP) in the assessment and screening of stroke patients with aphasia and to improve the clinical outcomes of patients who suffer from poststroke aphasia in a large tertiary hospital. METHODS:The current evidence implementation project was conducted in the neurology and rehabilitation departments of a tertiary hospital in China. Six audit criteria were developed for the baseline and follow-up audits. The project used the JBI PACES software, as well as JBI's Getting Research into Practice audit and feedback tool, to foster evidence-based healthcare in practice. RESULTS:Although the performance of all evidence-based criteria during the baseline audit was poor, barriers were identified through baseline, and the project team carried out and implemented developed strategies following Getting Research into Practice resources. All the criteria improved from baseline after the follow-up cycle, with four out of six criteria achieving a compliance rate of 100%, and two evidence-based criteria recorded at 73 and 80% compliance, respectively. CONCLUSION:The current project successfully increased EBP for the assessment and screening of stroke patients with aphasia. Further studies are needed to ensure the project's long-term sustainability.

目的 评价并总结尿毒症患者皮肤瘙痒管理的相关证据,为临床提供参考依据.方法 系统检索UpToDate、英国国家卫生与临床优化研究所网站、苏格兰校际指南网络、美国国立指南库、医脉通、BMJ Best Practice、Cochrane Library、JBI循证卫生保健中心图书馆、国际指南协作网、国际肾脏病学会、PubMed、CINAHL、EMbase、Web of Science、ScienceDirect、中国知网、万方数据库、中国生物医学文献服务系统、维普数据库关于尿毒症患者皮肤瘙痒管理的相关证据,检索时间为建库至2022年2月.由2名具有循证护理知识的研究人员独立对文献进行质量评价和证据级别评定.结果 共纳入15篇文献,包括3篇临床决策、1篇指南、1篇推荐实践、1篇证据总结、8篇系统评价和1篇专家共识.总结包括对尿毒症瘙痒的评估、透析管理、用药管理、局部瘙痒管理、补充替代疗法、生活指导和心理指导7个方面的22条最佳证据.结论 该研究总结并形成了尿毒症患者皮肤瘙痒管理方案,医护人员在临床转化时需结合临床实际,考虑患者的自身状况和意见,为尿毒症瘙痒患者制定个性化的管理计划,以进一步提高患者的生活质量.

目的 对脑卒中后失能综合评估量表进行汉化及信效度检验,探索该量表在国内的临床适用性.方法 采用Brislin双人直译-回译法、专家评议、预调查对量表进行文化调适,便利抽取203名脑卒中患者进行调查,对中文版量表进行项目分析,并验证其重测信度、评定者间信度、内容效度、效标关联效度.结果 脑卒中后失能综合评估量表重测信度相关性分析结果显示相关系数为0.988;评定者间信度Kappa系数为0.846(95％置信区间为0.793～0.899),P<0.001;各条目内容效度指数均在0.833～1.000之间,量表内容效度指数为0.935;以改良Rankin量表为标准,效标关联效度系数为0.896.结论 中文版脑卒中后失能综合评估量表具有良好的信效度,可作为我国临床脑卒中失能评估工具.

目的 基于二元应对理论探讨失能老年人及其配偶健康素养、 赋能水平与生活质量的关系.方法 2020年12月—2021年6月,采用一般资料调查问卷、日常生活功能指数量表、慢性病病人健康素养量表、中文版简化老年人健康赋能量表及中文版生活质量量表对广东省广州市、珠海市、深圳市520对失能老年人及其配偶进行问卷调查,采用Spearman相关分析、结构方程模型对有效数据(498对失能老年人及其配偶)进行分析.结果 回收有效问卷498对.失能老年人的健康素养、赋能水平与生活质量得分中位数分别为86.00、30.00、391.39分,配偶的健康素养、赋能水平与生活质量得分中位数分别为93.00、32.00、617.28分;相关分析结果显示,除配偶赋能水平与失能老年人生活质量相关性不显著(r=0.075,P=0.094>0.05),其余变量(失能老年人与配偶的健康素养、赋能、生活质量)之间两两呈正相关(r=0.156～0.657,均P<0.05).结构方程模型显示,失能老年人健康素养可直接或通过赋能水平间接作用于生活质量(路径系数分别为0.30、0.23,P<0.001),模型拟合良好(拟合优度指数=0.811,调整的拟合优度指数=0.788,近似误差均方根=0.057).失能老年人与配偶的健康素养互相促进(路径系数为0.47,P<0.001),失能老年人生活质量对配偶生活质量有积极影响(路径系数为0.18,P=0.004).结论 失能老年人与配偶的健康素养、生活质量相互影响,提示在面对失能这一压力事件时,不能将失能老年人与配偶割裂为单独的个体,应基于二元应对理论将失能老年人及其配偶照护者视为一个整体,共同提高健康素养和赋能水平,以提高失能老年人及其配偶的生活质量.

AIMS:To explore the role of self-efficacy (SE) in the effect of patient empowerment on self-management behaviours among patients with chronic illness and to investigate the moderating effect of three types of health locus of control (HLC) in this moderated mediation model.DESIGN:Cross-sectional design.METHODS:Data were collected in a general tertiary hospital, and a sample of 254 patients was recruited between August and October 2020. The effect of moderation and mediation was tested by the PROCESS macro (Model 4 and Model 8) for SPSS 25.0 by Hayes using 5000 bootstrap samples.RESULTS:Self-efficacy significantly mediated the relationship between patient empowerment and self-management behaviour with a 95% confidence interval excluding zero. The chance HLC demonstrated a moderating effect, and the interaction effect on SE and self-management behaviour was significant.CONCLUSION:Patient empowerment may improve confidence and adherence to self-management among people with chronic illness, and such benefits were conditional on the HLC of patients.IMPACT:This study addresses the relationship between patient empowerment and self-management behaviour in patients with different personality characteristics. This result indicated that classifying the type of HLC may enable the identification of subgroups of patients who may subsequently benefit from patient empowerment. In a patient-centred programme, nurses and other healthcare professionals correctly identifying patients' HLC type and understanding the implications and then providing appropriate health care plans for patients with different health beliefs may be useful to tailor the decision-making process.

目的 总结卒中后失语患者言语康复的相关证据,为临床医务人员开展言语康复管理提供依据.方法 系统检索国内外数据库与专业机构网站中有关卒中后失语患者言语康复的临床指南、证据总结、系统评价以及专家共识,并进行质量评价与证据提取.结果 共纳入14篇文献,包括1篇临床决策,1篇证据总结,8篇指南以及4篇系统评价.从言语康复的筛查与评估、组织培训、康复环境、康复时机、康复方式、随访以及健康教育7个方面总结了24条证据.结论 积极开展失语筛查、组织培训康复团队成员、营造良好的康复环境、把握最佳的康复时机、选择个性化的康复方式以及制定全面的健康教育与随访计划可提高言语康复的有效性.

目的 评价与总结长期气管切开患者气管套管更换护理策略的最佳证据,为临床实践提供参考.方法 提出循证问题,并系统检索BMJ循证医学库、JBI循证卫生保健中心数据库、英国国家卫生与临床优化研究所指南网、Cochrane library、Pubmed、中国生物医学文献数据库、万方、中国知网等数据库中关于气管套管更换的临床决策、指南、证据总结、系统评价、专家共识等文献,并对纳入文献进行质量评价.结果 共纳入8篇文献,包括2篇指南、1篇临床决策、1篇专家共识、4篇系统评价,总结得出长期气管切开患者气管套管更换护理策略最佳证据20条,包括换管时机的识别与观察、常规换管频率、换管评估、换管人员及场所、换管前准备、换管过程配合及换管后维护等7个方面.结论 本研究可为长期气管切开患者气管套管的更换提供参考,应用前还需考虑特定的医院科室临床背景,结合患方意愿,审慎明智地选用证据,从而降低呼吸道并发症的发生率,提高护理质量.

目的 通过回顾国内外老年人健康需求评估工具,总结各类评估工具的内容特点及应用局限,为整合、开发适用于我国老年人的整体化健康需求评估工具提供参考.方法 回顾国内外相关研究,从老年人健康需求概况、老年人健康需求评估工具概况、各类工具的内部结构和应用情况及特点进行综述.结果 目前国际上针对老年人健康需求评估的工具包括:老年综合评估、国际居民评估工具、老年人健康照护需求自评问卷、健康需求工具、护理依赖量表等.当前,在评估方式、内容及结果判定方面尚未形成统一标准.国内老年健康服务体系尚未完善,老年健康需求评估尚处于探索阶段,相关工具有待进一步开发、应用.结论 丰富老年人健康需求评估的理论内涵和实践途径,开发、整合以老年人为中心的评估工具,有助于健康服务提供者采取有效措施充分发挥老年人在健康决策中的主观能动性,不断挖掘其自我健康管理的内在潜能,赋能老年人健康自我管理,最终改善老年人健康状况及生活质量,实现"健康老龄化".

PURPOSE The confidence in a study will be reduced due to the incorrect representation of statistical results. However, it is unknown to what extent p values are incorrectly represented in published nursing journals. The study aims to evaluate the articles in 30 nursing journals in terms of the error in reporting of p values (p = .000). DESIGN AND METHODS This was a bibliometric analysis. All papers published in 10 leading nursing journals (between 2015 and 2019), the 10 bottom nursing journals (2019), and 10 selected key nursing journals (2019) indexed in the Science Citation Index Journal Citation Reports were reviewed to detect errors in reporting of p values (p = .000). RESULTS A total of 3,788 papers were reviewed. Notably, it was found that 93.3% (28/30) of the nursing journals contained incorrect representation of p values (p = .000). The reporting rate of these journals ranges from 0% to 57.1%, with an overall rate of 12.8% (486/3,788). In addition, the rate of incorrect representation of p values (p = .000) showed no statistically significant difference between different publication years (Χ2 = 4.976, p = .290). However, the rate of reporting was different between study types, journals, and regions (p = .007, p = .020, and p < .001, respectively). CONCLUSIONS The incorrect representation of p values is common in nursing journals. CLINICAL RELEVANCE We recommend that both publishers and researchers be responsible for preventing statistical errors in manuscripts. Furthermore, various kinds of statistical training methods should be adopted to ensure that nurses and journal reviewers have enough statistical literacy.