BACKGROUND:Graduate nursing education plays an important role in the development of an innovative nation. Such education benefits the health of the community by cultivating competent and highly skilled nurses who can provide safe and quality nursing care. The number of students pursuing nursing degrees in China is insufficient, to meet the social demand for advanced practice nurses. The part-time Master of Nursing Specialist program for students offers flexible learning options for working nurses. However, the relatively low level of learning engagement exhibited by this group has raised concerns among policy-makers and nursing educators. An in-depth study of the factors affecting the learning engagement of part-time Master of Nursing Specialist postgraduates, especially with regard to their combined effect, is expected to provide a basis for improving the level of learning engagement among such students. METHODS:This study used ability-motivation-opportunity-theory and fuzzy-set qualitative comparative analysis to analyze the relationships between five conditions (i.e., supportive campus environment, supportive work environment, student-faculty interaction, research motivation and time management ability) and learning engagement by reference to data collected from a sample of 225 part-time Master of Nursing Specialist students who were enrolled in China. RESULTS:The fuzzy-set qualitative comparative analysis results indicated that individual examples of these antecedent conditions were insufficient to influence learning engagement. In contrast, three combinations of the five conditions led to high levels of learning engagement, and substitutability and complementarity were observed among the various elements in the configuration. CONCLUSIONS:Research motivation, student-faculty interaction, a supportive work environment and time management are factors that can influence part-time postgraduates' learning engagement. Supervisors can enhance their research skills and expertise, hospitals can establish supportive environments for students, and students can strengthen their research motivation and time management abilities.

Objective: To explore the symptom subgroups of postoperative chemotherapy patients with gastric cancer and analyze the relationship between each subgroup and unmet needs. Methods: Totally 249 postoperative patients with gastric cancer who received chemotherapy in the oncology department of two hospitals in Zhenjiang city from August to December 2021 were selected as the research objects by convenient sampling method. The general data questionnaire, the symptom evaluation questionnaire of postoperative chemotherapy patients with gastric cancer and the unmet needs scale of cancer patients were used for investigation. Results: The incidence and severity of fatigue in postoperative chemotherapy patients with gastric cancer were the highest, and the score of unmet needs was 49.10 ± 14.12. The symptoms of patients were divided into four groups: mild symptoms, high psychological symptoms and low physical symptoms, high physical symptoms and low psychological symptoms, and severe symptoms. Chemotherapy cycle, operation mode and malnutrition risk could predict the subgroup classification（all P＜0.05）. There was significant difference in the scores of unmet needs among different symptom subgroups（P＜0.05）. The score of severe symptoms group was the highest, followed by high psychological symptoms and low physical symptoms, the third was high physical symptoms and low psychological symptoms, and the lowest was mild symptoms group. Conclusion: The symptom characteristics of postoperative chemotherapy patients with gastric cancer have four subgroups, which are closely related to unmet needs, suggesting that targeted interventions should be formulated for different subgroups to alleviate symptom distress, so as to meet the individual needs of patients.

目的 探索本科护生老年照护择业动机分型及影响因素.方法 于 2022年 2-3月年通过便利抽样法选取江苏省 4所高校共 558 名本科护生为研究对象,采用一般资料调查表和护生老年护理择业动机问卷进行调查,采用潜在剖面分析和多分类Logistic回归分析.结果 本科护生老年照护择业动机有低度期望-价值组(4.3%)、中度期望-价值组(34.1%)、边缘性中度期望-价值组(53.9%)和高度期望-价值组(7.7%)4 组.多分类Logistic回归结果显示:不同类别的本科护生在第一志愿是否为护理,我国对老年护理发展重视与否,学校是否开展老年人相关活动,是否有照顾老人经历和生源地的分布上差异有统计学意义(P<0.05).结论 本科护生老年照护择业动机存在异质性,第一志愿是否为护理、我国对老年护理发展重视与否、学校是否开展老年人相关活动、是否有照顾老人经历和生源地是本科护生老年护理择业动机潜在类别的影响因素.需根据不同类型护生的特点制定针对性干预方案,尤其需关注低度期望-价值组和边缘性中度期望-价值组,以提高本科护生老年照护择业动机.

The present study aimed to examine the multi-faceted self-supporting ability profiles of rural empty-nesters in northwestern China on the basis of the self-care ability, economic self-support ability, health self-maintenance ability, physical health self-maintenance ability, and psychological health self-maintenance ability using latent profile analysis. It identified the association of self-supporting ability profiles with demographic variables and sense of coherence. The analysis included 1066 participants (mean age = 70.2; SD = 4.3). The results of latent profile analysis identified three distinctive patterns of self-supporting ability―low physical health self-maintenance ability (C1, 20.5%), low psychological health self-maintenance ability (C2, 31.4%), and high social self-adaption ability (C3, 48.0%). The specific demographic variable age (p < 0.05), monthly income (p < 0.05), education level (p < 0.05), how often their children visit (p < 0.05), how often their children contact them (p < 0.05), whether they drink (p < 0.05), the frequency of physical exercise (p < 0.05), relationship with children (p < 0.05), relationship with neighbours (p < 0.05), medical insurance (p < 0.05), and the number of chronic diseases (p < 0.05) were significantly different among the identified three profiles. A statistically significant positive association existed between self-supporting ability profiles and sense of coherence (SOC) (p < 0.001). The results of multinomial logistic regression showed that a greater sense of coherence (SOC), age ≥ 80, monthly income (RMB) (RMB is the abbreviation for Renminbi) < 1000, a good relationship with neighbours, and one type of chronic disease were significantly associated with C1 when compared with C3 (p < 0.05). Furthermore, a greater SOC, their children visiting and contacting them many times per week or once per week were more significantly related to C2 than to C3 (p < 0.05). This study revealed three groups of self-supporting ability and its related predictors in empty-nesters. The predictors related to particular classes of self-supporting ability can provide information for targeted interventions to improve the self-supporting ability of empty-nesters living in rural areas.

Purpose To explore the symptom clusters of gastric cancer patients receiving postoperative chemotherapy, identify the sentinel symptom of each symptom cluster, and compare the differences in sentinel symptoms of patients for gastric cancer with different characteristics. Methods This was a cross-sectional study. Patients with postoperative gastric cancer who received chemotherapy in the medical oncology department from October 2021 to July 2022 were selected for the study using a convenience sampling method.The General Information Questionnaire and the MD Anderson Symptom Inventory Gastrointestinal Cancer (MDASI-GI) were used for the survey. Results A total of 245 patients participated in the study. There were five symptom clusters in the patients. Fatigue, nausea, sadness, and taste alteration were the sentinel symptoms of the disease symptom cluster, gastrointestinal symptom cluster, emotional symptom cluster, and neurotoxic symptom cluster, respectively. No clear sentinel symptom was found in the gastric-cancer-specific symptom cluster. Statistically significant differences were observed in fatigue, nausea, sadness, and taste alteration among patients receiving postoperative chemotherapy for gastric cancer with differences in gender, duration since diagnosis, tumor site, chemotherapy regimen, chemotherapy cycle, red blood cell count, hemoglobin level, albumin level, plasma D-dimer level, indirect bilirubin level, glutamic pyruvic transaminase level, total bile acid level, and uric acid level. Conclusion People with postoperative chemotherapy for gastric cancer experience multiple concurrent symptoms. Of the multiple symptoms that occur simultaneously, patients tend to focus on 1 or 2 symptoms of particular significance and use the occurrence of 1 symptom to explain the others. The understanding of symptom clusters and sentinel symptoms could be beneficial to assess and manage both in postoperative patients with gastric cancer during chemotherapy. Clinical staff should use sentinel symptoms as the targets for symptom cluster evaluation and effective intervention.

目的 基于可视化软件分析乳腺癌患者共享决策的研究现状、热点及前沿.方法 检索Web of Science核心集数据库自建库至2023年1月乳腺癌患者共享决策领域的文章,采用CiteSpace 5.7.R1软件进行计量学分析.结果 共检索到1 283篇文献,最终纳入759篇文献进行可视化分析.发文量呈波动上升趋势;美国奠定了该研究领域的基础;欧美等发达国家及其机构间合作紧密;研究热点集中在乳腺癌共享决策不同女性群体、患者需求、不同决策阶段及干预技术开发等方面.结论 近年来乳腺癌患者共享决策问题持续受到关注,发达国家研究较多.建议中国临床科研人员拓宽合作领域,聚焦相关研究热点,促进中国乳腺癌患者共享决策研究的发展.

目的 描述近10年照顾者贡献相关研究的状况和变化规律,揭示研究热点及发展趋势.方法 检索2011年1月1日至2021年6月30日以"照顾者"和"贡献"为主题的Web of Science核心合集的期刊文献,利用CiteSpace软件文献计量学方法绘制知识图谱进行可视化分析.结果 共纳入239篇文献,研究分布在57个国家的477个机构,主要分布在美国、澳大利亚、英国及加拿大.获得8个聚类:姑息治疗、中风、心力衰竭、需求评估、照护、心理健康、医疗保险支出、压力;4个研究热点:照顾者贡献现状研究、照顾者心理健康研究、照顾者需求评估研究、照顾者经济学贡献研究.结论 照顾者贡献相关研究发文量整体呈增长趋势,照顾者贡献正逐渐受到研究者们的重视和关注.国内相关研究在起步阶段,建议可借鉴国外研究成果,开展照顾者贡献研究,重点关注照顾者心理健康问题及其需求,构建社会支持网络,利用经济学方法量化照护贡献,从而促进照顾者贡献能力研究的发展.

目的 探索农村空巢老人无望感的潜在类别,分析各类别农村空巢老人特征差异.方法 2021年1月至5月随机整群抽取安徽省某市下辖乡镇35个行政村400名空巢老人为研究对象,采用一般资料调查表、Beck无望感量表进行调查.结果 农村空巢老人无望感得分(8.60±3.86)分,51.7％老人有中高程度无望感.无望感有高无望感-高动机丧失组(12％)、中度无望感-高消极预期组(61％)和低无望感组(27％)3个类别.不同婚姻状况、月收入、子女探望频率、外出体育锻炼频率、医疗保险、睡眠质量的农村空巢老人无望感类别比较,差异有统计学意义(P<0.05).已婚丧偶(OR=3.796)、月收入≤1000元(OR=4.276)、从不外出体育锻炼(OR=3.390)是农村空巢老人无望感高发的危险因素(P<0.05);睡眠质量较好及有新型农村合作医疗是其无望感高发的保护因素(OR=0.038、0.116,P<0.05).结论 农村空巢老人无望感有明显分类特征,提示需从积极老龄化视角出发,找到精准干预靶点,以缓解无望感.

目的 探索我国西北地区农村空巢老人应对方式的潜在类别,分析各类别与无望感的关系.方法 2020年12月—2021年3月便利抽取甘肃、青海、陕西3省省会城市下辖乡镇32个行政村412名空巢老人为研究对象,采用一般资料调查表、简易应对方式量表、Beck无望感量表进行调查,并对数据进行分析.结果 西北地区农村空巢老人积极应对得分为(1.46±0.61)分,消极应对得分为(1.21±0.49)分,均低于全国常模(均P＜0.01);无望感得分为(8.64±3.96)分,359名空巢老人有不同程度的无望感.西北地区农村空巢老人积极应对方式与无望感呈负相关(r=-0.48,P＜0.01).西北地区农村空巢老人应对方式分为"无效应对组""积极应对组"和"混合应对组"3类.不同应对方式空巢老人在婚姻状况、文化程度、月收入、空巢情况、与子女关系和邻里关系、外出体育锻炼频率及睡眠质量的分布上差异均有统计学意义(均P＜0.05),不同应对方式的西北地区农村空巢老人在无望感3个维度的得分差异均有统计学意义(均P＜0.05),无效应对组无望感得分最高,混合应对组次之,积极应对组最低.结论 西北地区农村空巢老人应对方式存在3种不同类别,且与无望感关系密切,提示需从积极应对视角出发,提高其应对能力,降低无望感.

目的 检索、评价并整合成人糖尿病患者低血糖感知受损(IAH)管理方案的最佳证据,为临床医护人员开展规范化实践提供依据.方法 利用循证护理的方法,计算机检索Up ToDate、BMJ Best Practice、美国国家医疗保健优化研究所(NICE)、Cochrane Library、PubMed、CINAHL、美国指南网(NGC)、苏格兰校际间指南网(SIGN)、加拿大安大略注册护士协会(RNAO)、中国知网、万方数据等数据库中关于成人1型和2型糖尿病患者IAH的所有证据,包括推荐实践、指南、系统评价及原始研究;检索时限为建库至2021年4月.由两名研究者对纳入研究进行质量评价、证据提取及级别评定.结果 共纳入13篇文献,其中推荐实践1篇,指南1篇,系统评价1篇,随机对照试验6篇,类实验性研究4篇,最终总结得出19条证据,涉及IAH的评估、预防、药物处理、健康教育、技术干预及心理护理等6个方面.结论 本研究总结目前关于成人糖尿病患者IAH管理的最佳证据,为规范临床医护人员实施IAH管理方案、提升护理质量奠定基础.

目的 探讨老年共病择期手术患者护理依赖发展轨迹的类别及影响因素.方法 选取江苏省5所综合性三级医院的598例老年共病择期手术患者作为研究对象,采用一般资料调查表、疾病累积评分量表、护理依赖量表分别于术后3 d(T1)、出院时(T2)及出院后1周(T3)进行追踪调查,利用潜变量增长混合模型及无序多分类logistic回归分析数据.结果 老年共病手术患者疾病累积评分为14(8,17)分;T1、T2、T3护理依赖得分分别为(45.06±16.03)分、(54.40±16.32)分、(63.37±10.91)分;患者护理依赖发展轨迹分为独立性稳步上升组(36.3％)、先降后升组(20.9％)、迅速上升组(28.4％)、先升后降组(14.4％);多元回归分析显示,患者年龄、文化程度、人均月收入、居住方式、是否初次发病及共病程度影响护理依赖发展轨迹(均P＜0.05).结论 老年共病手术患者护理依赖存在异质性轨迹,医护人员应根据不同轨迹类别制定针对性护理措施,减少护理依赖发生.

从胃癌病人术后化疗期症状群纵向研究的理论基础、研究意义、评估方法与评估时间点设置及测评工具、发生现状等方面进行综述,总结现有研究中存在的问题,以期为临床实践提供参考.

目的 分析低血糖察觉意识受损(IAH)相关研究的现状、热点及前沿.方法 采用CiteSpace5.7.R5软件对Web of Science(WOS)核心集、PubMed和Scopus数据库1991年1月1日—2021年3月15日收录的关于IAH文献进行可视化分析.结果 共检索IAH相关文献593篇,最终共纳入209篇文献进行可视化分析.发文量表现为缓慢、平稳和快速增长共3个阶段;英美国家、学者奠定了该领域研究的基础;各研究机构之间合作密切;国际间合作频率呈现不平衡现象.研究内容主要集中在IAH不良影响、IAH技术干预及结构化教育的研究与探讨.结论 国外IAH相关研究开展较早且相对成熟,国内在该领域尚处于起步阶段,建议中国临床科研人员加强IAH相关研究,实施有效干预措施,改善低血糖患者不良结局.

目的 探讨老年人一般疏离感、关爱需求的现状及影响因素,并分析二者的相关性.方法 采用便利抽样法,选取228例老年人对其一般疏离感、关爱需求进行问卷调查.结果 老年人一般疏离感总分(37.425±5.208)分,平均每条目得分2.495分,关爱需求总分(110.065±12.435)分,平均每条目得分4.076分.一般疏离感总分及维度得分与关爱需求总分呈正相关(P<0.05).结论 老年人一般疏离感水平中等,关爱需求较高,二者呈正相关,老年人一般疏离感能影响他们的关爱需求.