Middle-aged and elderly survivors with gastrointestinal cancer experience negative emotions such as depression and fear of cancer recurrence. The patient's spouse is the primary caregiver, playing a pivotal role in coping with depression and fear of cancer recurrence among middle-aged and elderly survivors of gastrointestinal cancer. However, the relationships and pathways among fear of cancer recurrence, dyadic coping, and depression in gastrointestinal cancer survivors remain unclear. We conducted a cross-sectional study to investigate the mediating role of dyadic coping in the relationship between negative emotions. From February 2022 to June 2024, 235 middle-aged and elderly gastrointestinal cancer survivors were recruited from a hospital in China. Participants were investigated with a demographic and clinical questionnaire, the Dyadic Coping Inventory, the Fear of Progression Questionnaire-Short Form, and the Depression Subscale of the Hospital Anxiety and Depression Scale. The results showed that fear of cancer recurrence affected depression through dyadic coping. The direct effect was 0.083 (SE = 0.017, 95% confidence interval: 0.050-0.115). The indirect and total effects were 0.028 (SE = 0.008, 95% confidence interval: 0.015-0.045) and 0.111 (SE = 0.015, 95% confidence interval: 0.081-0.141), respectively. The mediating effect of dyadic coping accounted for 25.23% of the relationship in negative emotions. The fear of cancer recurrence affects depression through dyadic coping. Thus, when formulating interventions to alleviate depression in middle-aged and elderly gastrointestinal cancer survivors, the role of dyadic coping should be taken into consideration.

Objective:To explore the association between social support and demoralization and how resourcefulness and resilience mediate this relationship. Methods:A convenience sampling method was used. A cross-sectional study was conducted among 343 gynecological cancer patients in three hospitals in Hunan Province, China, from October 2024 to March 2025. The Social Support Scale, Demoralization Scale, Resourcefulness Scale, and Resilience Scale were used to collect data. Data analysis was conducted via descriptive statistical analysis, Spearman correlation analysis, and regression analysis to estimate direct and indirect effects via bootstrap analysis. Results:Social support was positively correlated with resourcefulness (r ​= ​0.395, P ​< ​0.001) and resilience (r ​= ​-0.372, P ​< ​0.001). Additionally, social support was significantly negatively correlated with demoralization (r ​= ​-0.325, P ​< ​0.001). Social support indirectly affected demoralization through three mediating pathways: resourcefulness (effect ​= ​-0.020; standard error ​= ​0.022; 95% confidence interval [CI] [-0.064, -0.024]), resilience (effect ​= ​-0.037; standard error ​= ​0.015; 95% CI [-0.072, -0.013]), and the resourcefulness-resilience pathway (effect ​= ​-0.038; standard error ​= ​0.013; 95% CI [-0.070, -0.018]). The indirect effect accounted for 18.35% of the total effect. Conclusions:We proved that resourcefulness and resilience mediated some of the effects of social support on demoralization. The findings of this study have implications for interventions to promote the social support of gynecological cancer patients and, in particular, to enhance resourcefulness and resilience.

Background Preoperative anxiety is a specific type of anxiety that focuses on concerns and worries related to anesthesia and surgical procedures. However, there has been limited research conducted on the various aspects of this phenomenon, especially in waiting areas. Objective Using latent profile analysis (LPA), this study aimed to identify various preoperative anxiety profiles among surgical patients in the preoperative waiting area. Additionally, this study aimed to explore the demographic and resilience factors associated with different preoperative anxiety profiles. Methods and Materials A cross-sectional study was conducted at comprehensive hospitals in Jiaxing, Zhejiang Province, China. Three hundred seventy-three (373) surgical patients were included in the analyses. Surgical patients completed the demographic characteristics questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), and the Connor-Davidson Resilience Scale (CD-RISC) while waiting for surgery in the waiting area. Results The LPA results indicated that the data were most consistent for four types of solutions: high preoperative anxiety-medium information need, high preoperative anxiety-low information need, low preoperative anxiety-medium information need, and low preoperative anxiety-low information need. One-way ANOVA revealed significant differences between the four groups with respect to resilience. Sex, education background, tumor diagnosis, sleep quality and surgical experience significantly predicted profile membership. Conclusion There is heterogeneity in preoperative anxiety among surgical patients in the waiting area. When supporting surgical patients in waiting areas, nurses should consider the level of psychological resilience of patients in addition to assessing demographic factors to identify high-risk subgroups to warrant intervention.

IntroductionWithout parental support, left-behind adolescents are more likely than their peers to experience negative emotions and demonstrate aggressive behavior in the same frustrating situation. However, research on this subject has been sparse. To fill this gap and identify potential targets for intervention, this study sought to examine the relationships among factors influencing left-behind adolescents’ aggressive behavior.MethodsA total of 751 left-behind adolescents were enrolled in a cross-sectional survey, with data collected using the Adolescent Self-Rating Life Events Checklist, Resilience Scale for Chinese Adolescents, Rosenberg Self-Esteem Scale, Coping Style Questionnaire, and Buss–Warren Aggression Questionnaire. The structural equation model was used for data analysis.ResultsThe results showed that left-behind adolescents reported higher levels of aggression. Further, the factors found to have a direct or indirect effect on aggressive behavior included life events, resilience, self-esteem, positive coping, negative coping, and household income. The results of confirmatory factor analysis indicated goodness of fit. In the face of negative life events, left-behind adolescents with high resilience, self-esteem, and positive coping were less likely to exhibit aggressive behavior (P < 0.05).DiscussionLeft-behind adolescents can reduce their aggressive behavior by assuaging the adverse effects of life events via increased resilience and self-esteem as well as the adoption of positive coping strategies.

Background Surgery, as one of the main diagnostic and treatment methods, is a routine work in medical settings. Patients undergoing surgery often experience acute procedure anxiety due to uncertainty. There is ample evidence showing that uncertainty is a risk factor for the acute procedure anxiety in surgical patients. However, little is known about the psychological processes mediating this relationship. Therefore, this study aims to evaluate resilience as a mediator of the association between uncertainty and anxiety. Methods A population-based cross-sectional survey with a convenience sampling method was conducted, involving 243 surgical patients in Jiaxing, Zhejiang province of China was carried out. Relevant data were collected by self-reporting questionnaires, including demographic characteristics questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), Mishel’s Illness Uncertainty Scale (MUIS), Connor-Davidson Resilience Scale (CD-RISC). Pearson correlation analysis was employed to examine correlations between various variables. A path model was used to assess the mediation effect of resilience with respect to uncertainty and acute procedure anxiety. Results In the path model, uncertainty have an indirect effect on acute procedure anxiety through resilience. The results suggest that resilience has a mediating role in uncertainty and acute procedure anxiety among surgical patients. Conclusions These findings call for the development of interventions targeting the role of resilience in effectively predicting and preventing acute procedure anxiety and uncertainty among surgical patients.

目的 探讨"互联网+"经外周静脉穿刺的中心静脉导管(PICC)上门服务网络"1+3"模式的实践效果.方法 选取该院2021年6月至2022年7月新留置PICC且小于3个月的患者744例,将2021年6-7月新置管患者402例设为对照组,2022年6-7 月新置管患者342例设为观察组.对照组在云嘉平台上单点"互联网+"PICC上门服务,观察组应用结构-过程-结果三维质量管理框架搭建区域"互联网+"PICC上门服务网络提供服务,从RE-AIM模型5方面分析两组运营差异.结果 观察组总接单率、实际服务率及维持率分别为19.0%(65/342)、98.5%(64/65)、12.5%(8/64),明显高于对照组的6.5%(26/402)、80.8%(21/26)、9.5%(2/21),其中两组总接单率与实际服务率差异有统计学意义;执行度方面,观察组在总质量、过程质量及结果质量方面的合格率均高于对照组;有效度方面,对照组导管相关并发症及不良事件发生6例(28.6%),观察组发生3例(4.7%),差异均有统计学意义(P＜0.05).结论 "互联网+"PICC上门服务网络有一定优势,其在覆盖度、有效度、采纳度和执行度上表现良好,但在服务维持度上有待加强.

Background Workplace violence has always been a critical issue worldwide before and after the COVID-19 pandemic, which can lead to burnout and turnover. In addition, the burnout and mental stress of nurses during the COVID-19 period have been widely described. To our knowledge, no studies have examined the mediating effect of the sense of coherence on the relationship between workplace violence and burnout among Chinese nurses over time. Therefore, this study aimed to explore the relationship between workplace violence and burnout among Chinese nurses and how the sense of coherence mediates the association. Methods Using a convenience sampling method, 1190 nurses from 4 tertiary grade-A comprehensive hospitals were investigated between September 2021 and December 2021 in 3 provinces of China. The Workplace Violence Scale, Burnout Inventory, and Sense of Coherence scale were used to collect data. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results The mean total scores for workplace violence and burnout were 1.67 ± 1.08 and 47.36 ± 18.39, respectively. Workplace violence was significantly negatively correlated with the sense of coherence ( r = -0.25) and positively correlated with burnout ( r = 0.27). Additionally, a higher level of workplace violence was associated with higher burnout ( β = 1.13, 95% CI: 0.68 ~ 1.56). A higher sense of coherence was also associated with lower burnout ( β = -0.98, 95% CI: -1.03 ~ -0.92). Workplace violence showed an effect on burnout through a sense of coherence. The direct, indirect and total effects were 1.13, 1.88 and 3.01, respectively. The mediating effect of the sense of coherence accounted for 62.45% of the relationship between workplace violence and burnout. Conclusion We found that the sense of coherence mediated most workplace violence on burnout. It is imperative for hospital managers to improve nurses’ sense of coherence to reduce the occurrence of burnout during COVID-19. Future intervention studies should be designed to strengthen nurses’ sense of coherence.

Abstract Background Left-behind adolescents (LBAs) are adolescents aged 11–18 years who are separated from their parents and left behind in local cities by one or both parents for a period of more than 6 months. LBAs in rural areas are likely to engage in aggressive behavior, which can affect interpersonal relationships, reduce academic performance, and even lead to anxiety and depression. To our knowledge, no studies have examined the mediating effect of resilience and self-esteem on the relationship between negative life events and aggression among Chinese rural LBAs. Therefore, this study aimed to explore the relationship between negative life events and aggression among Chinese rural LBAs and how self-esteem and resilience mediate the association. Methods Using a stratified random sampling method, 1344 LBAs in Hunan Province of China were investigated. Information was collected by a self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale and Aggression Scales to assess the psychology of LBAs. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results Negative life events were significantly related to self-esteem (r = − 0.338), resilience (r = − 0.359), and aggression (r = 0.441). Aggression was directly affected by self-esteem (β = − 0.44) and resilience (β = − 0.34). Negative life events were not only directly related to aggression (β = 0.34, 95% CI: 0.275 ~ 0.398) but also showed an indirect effect on aggression through self-esteem and resilience. The direct effect, total effect and indirect effect of negative life events on aggression through self-esteem and resilience were 0.3364, 0.4344 and 0.0980, respectively. The mediating effect of self-esteem and resilience accounted for 22.56% of the relationship between negative life events and aggression. Conclusions We found that self-esteem and resilience mediated most negative life events on aggression. It is imperative for educators and families to improve LBAs’ self-esteem and resilience to reduce the occurrence of aggression. Future intervention studies should be designed to strengthen self-esteem and resilience.

BACKGROUND:Resilience is important for patients with cancer. However, the relationships among factors affecting the resilience of patients with lung cancer have not been studied sufficiently. OBJECTIVE:The aim of this study was to clarify the relationships among social support, resilience, self-efficacy, and symptom distress among patients with lung cancer. METHODS:Through simple random sampling, 303 patients with lung cancer from 4 tertiary hospitals in Changsha, China, were recruited for a cross-sectional descriptive correlational survey. Data were collected using demographic and disease-related information, the Connor-Davidson Resilience Scale, Strategies Used by People to Promote Health, the Perceived Social Support Scale, and the Symptom Distress Scale. RESULTS:Patients' mean total resilience score was 50.01 ± 15.25. The fit indices for the model indicated a good fit. Social support had multiple effects on resilience; specifically, it had direct and indirect effects through the mediating role of self-efficacy. Symptom distress had only an indirect effect on resilience through self-efficacy. CONCLUSIONS:Social support, symptom distress, and self-efficacy are key factors associated with resilience in patients with lung cancer. These factors had direct and indirect effects on each other and on resilience. IMPLICATIONS FOR PRACTICE:To enhance resilience among patients with lung cancer, interventions that strengthen self-efficacy, provide social support, and reduce symptom distress should be developed.

Decision-making aid for cancer patients is of great significance in the diagnosis and treatment for diseases. Breast cancer is one of the most common malignant tumors in women all over the world, and breast cancer patients have become the main target population for decision-aided research. Application of decision-making assistance for patients in Western countries has developed to a certain extent, while relevant research in China is still at the early stage. There are kinds of intervention forms for patients' decision aids, including traditional brochures and videos, decision aids systems, decision coaching, multidisciplinary breast cancer teams, etc. The tools for decision-making quality evaluation include the patients' awareness for decision-making, participation, decision-making conflict, decision-making satisfaction, decision-making regret, which can provide important guidance for the application of decision-making aid treatment in breast cancer patients in the future.

目的 调查国内临床护士的知信行现状,分析其延续性护理实践行为的影响因素,为相关实践培训提供参考.方法 采用便利抽样法,对国内964名临床护士进行延续性护理知识、态度、行为问卷调查.结果 国内护士的延续性护理知信行总分为(72.02±13.09)分,处于中等水平,其中知识(72.06±15.93)分、态度(81.95±13.07)分、行为(62.54±21.40)分.多重线性回归分析得出,影响护士延续性护理实践行为的因素有:知识、态度得分、学历和是否接受延续性护理相关培训.结论 国内临床护士延续性护理知识掌握相对不足,态度较为积极,实践行为亟待加强,提示管理者需要加强延续性护理培训,完善医院-社区沟通渠道,以提高临床护士延续性护理能力,促进延续性护理的实施.

Objective: This study aims to explore the association between life events and coping styles, and how resilience and self-esteem mediate the association. Methods: A cross-sectional study was conducted among 981 left-behind adolescents (LBAs) in five junior high schools in Hunan Province, China, from April 13 to April 20, 2020. We utilized self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale, and Simplified Coping Style Questionnaire to assess the mental health of LBAs. Statistic description, Pearson correlation analysis, and structural equation model were adopted to analyze the data. Results: Results revealed that life events could negatively predict resilience (β = −0.29, P < 0.001) and self-esteem (β = −0.39, P < 0.001) and positively predict LBAs' positive coping style (β = 0.28, P < 0.001) and negative coping style (β = 0.21, P < 0.001). Self-esteem could also positively predict the resilience of LBAs (β = 0.62, P < 0.001); resilience could negatively predict the negative coping style (β = −0.21, P < 0.001) and positively predict the positive coping style (β = 0.79, P < 0.001). Life events not only have direct effects on negative coping style (β = 0.21) and positive coping style (β = 0.28) but also have indirect effects on coping styles by affecting resilience (β = −0.29) and self-esteem (β = −0.39). The total effect of life events on coping styles was 0.32, where 34.37% was mediated by resilience and self-esteem. Conclusion: We proved that resilience and self-esteem mediated most of the effects of life events on coping styles. The findings had important implications for interventions to promote mental health of LBAs, particularly the enhancement of resilience and self-esteem.

Background There is literature scarcity relating to burnout and other work stresses in relation to Chinese nursing-workforce performance. Objectives To assess the relationship between self-esteem versus burnout; and effort-reward ratio versus favorability to the work environment, among Chinese nurses. Methods We employed four validated questionnaires in the assessment burnout, self-esteem, effort-reward ratio, and favorability of nursing workplace; Maslach-Burnout Inventory (MBI), Rosenberg’s self-esteem (RS), Effort-Reward imbalance (ERI) and Work-Environment Scale questionnaires (WES). Linear and ordinal regression models were utilized to assess the relationships between the variables. Analyses were conducted by using SPSS at a 95% level of significance. Results We assessed 487 (Mean age: 38.8±7.1 years) nurses from three hospitals. Higher self-esteem was associated with a lower level of emotional exhaustion (Unstandardized coefficient: -0.579, p-Value<0.001); and a lower level of depersonalization (Unstandardized coefficient: -0.212, p-Value = 0.001). The relationship between self-esteem and personal achievement did not reach statistical significance. A higher effort-reward ratio was associated with less likelihood that nurses would consider their work environment favorable (Logit estimate of -0.832, p-Value = 0.014). Conclusion Lower self-esteem is associated with increased burnout. A higher effort-reward ratio is associated with an enhanced perception work environment as unfavorable. We recommend psychosocial intervention programs and amendments in nursing policies to improve effort-reward imbalance among Chinese nurses.

Background Resilience is important for patients with cancer. However, the relationships among factors affecting the resilience of patients with lung cancer have not been studied sufficiently. Objective The aim of this study was to clarify the relationships among social support, resilience, self-efficacy, and symptom distress among patients with lung cancer. Methods Through simple random sampling, 303 patients with lung cancer from 4 tertiary hospitals in Changsha, China, were recruited for a cross-sectional descriptive correlational survey. Data were collected using demographic and disease-related information, the Connor-Davidson Resilience Scale, Strategies Used by People to Promote Health, the Perceived Social Support Scale, and the Symptom Distress Scale. Results Patients’ mean total resilience score was 50.01 ± 15.25. The fit indices for the model indicated a good fit. Social support had multiple effects on resilience; specifically, it had direct and indirect effects through the mediating role of self-efficacy. Symptom distress had only an indirect effect on resilience through self-efficacy. Conclusions Social support, symptom distress, and self-efficacy are key factors associated with resilience in patients with lung cancer. These factors had direct and indirect effects on each other and on resilience. Implications for Practice To enhance resilience among patients with lung cancer, interventions that strengthen self-efficacy, provide social support, and reduce symptom distress should be developed.

Abstract Background High aggressive behavior will harm the physical and mental health of children, and the probability of aggressive behaviors among left-behind junior high school students is significantly higher than that of non-left-behind ones, but the systematic research and intervention measures concerning the aggressive behavior of the left-behind junior high school students quite deficient at present. This study adopts the structural equation model to analyze the interrelationship and action modes of various factors affecting the aggressive behavior of the left-behind junior high school students to provide scientific basis for the mitigation and prevention of their aggressive behavior. Methods A structural equation model was constructed based on data from a cross-sectional survey of 751 left-behind junior high school students using Adolescent Self-rating Life Events Checklist, Rosenberg Self-Esteem Scale, Resilience Scale for Chinese Adolescents, Coping Style Questionnaire, and Buss-Warren Aggression Questionnaire. Results Self-esteem, resilience, positive coping, negative coping and household income have different direct or indirect effects on the aggressive behavior of left-behind junior high school students. Among them, self-esteem, resilience, positive coping and negative coping are the important mediating factors between life events and aggressive behavior of left-behind junior high school students. Conclusions Parents, teachers and temporary guardians in the care of left-behind children should try to avoid possible adverse effects that the life events have on the children, meanwhile should also through effective psychological intervention and social support, improving the self-esteem, psychological resilience and positive coping tendencies of left-behind children, in order to reduce or prevent their aggressive behaviors.

Background Depression is a major risk factor for the morbidity and mortality of cardiovascular disease. A transtheoretical model-based intervention and motivational interviewing have been used to change health risk behaviors and have demonstrated positive effects. To our knowledge, no studies of patients with coronary heart disease (CHD) have used a transtheoretical model-based intervention and motivational interviewing as an intervention to provide dynamic education. Therefore, this study aimed to determine the effects of the transtheoretical model-based intervention and motivational interviewing on the management of depression in hospitalized patients with CHD. Method A randomized controlled trial was designed. A total of 110 participants were randomly divided into an intervention group ( n = 55) and a control group ( n = 55). The Hamilton Rating Scale for Depression and the Depression Prevention & Management Survey items (stages of change, perceived benefits, perceived barriers, process of change and self-efficacy) were used to collect data at all time points. Analysis of covariance, chi-square test and repeated measures analysis of variance were used to analyze the data. Results After the intervention, there were more positive changes in stages of change, higher scores for the cognitive and behavioral levels, the perceived benefits, and self-efficacy, and lower perceived barriers and depression in the intervention group than in the control group. Finally, there were statistically significant differences in the depression scores at different time points in the intervention group ( F = 17.814, p = 0.000 < 0.01). Conclusions The study showed that a transtheoretical model-based intervention and motivational interviewing exert positive effects on the management of depression in hospitalized patients with CHD. Trial registration Clinicaltrials.gov, NCT03953924 (Date assigned: 16/5/2019). Retrospectively registered.

随着循证实践的发展,综述及相关方法在临床实践中占据着重要的地位.但由于文献数量多、术语上的差异和重叠等原因,可能会导致研究者对一些综述类型及相关方法混淆不清和误用,甚至在文献检索时难以检索到重要的文献.因此该文对医学研究中常见的各综述类型及相关方法进行描述性的概括和举例,并使用与循证医学原则相一致的分析方法即检索、评估、综合、分析识别和区分医学研究中常见的综述类型及相关方法,总结出其优缺点和适用情况,以期帮助研究者识别各种综述类型及相关方法,促进循证和护理学科的发展.

选择、优化和补偿（SOC）自我调节策略最初多应用于青少年以及健康老年人。在人口老龄化加剧和慢性病发病率急速攀升的背景下，许多学者逐渐开始探索其在老年慢性病患者群体中的适用性以及有效性。目前已有研究证实相当数量的老年慢性病患者都使用了SOC策略，并对其健康结局指标产生了积极的影响。但现有随机对照的研究证据相对薄弱，未来需要更多的干预性研究，并进行长期的随访，以评估SOC策略在不同老年慢性病患者群体中的应用效果。

20 世纪 90 年代以来,循证实践一直在医疗卫生领域发挥着重要作用[1].如何应用循证研究对提高临床护理质量和促进护理学科发展至关重要.因此,越来越多研究者开始关注基于循证的 Meta 分析或系统评价.然而,Meta 分析或系统评虽然对基于证据的实践很重要,但由于它们着重于随机临床试验和证据的等级,很难体现出一类研究的深度和广度[2-3].而整合性综述(integrative review)不仅可以对特定主题的定量/定性的实证性研究进行批判性回顾和对结果与变量之间的关系进行分析,还可对特定主题的相关理论进行批判性回顾与总结,超越所纳入原始研究的结果,对其进行深层次的分析和整合,最终形成新的理论[4-5].此外,对于一些正在崛起的新兴领域,由于发表文献数量少,没有足够的随机对照试验来进行证据综合(系统评价和 Meta 分析),整合性综述的方法就凸显其优势,可对文献进行证据总结,生成初步的循证实践行动方案,在循证护理实 践 中 发 挥 着 巨 大 的 作 用[5-7].Feldman[8]在1971 年完成了有关整合性综述应用于社会教育学领域最具参考价值的文章,此后该方法相继被应用于护理领域[9-10],目前,整合性综述依然是国外护理领域比较热门的研究方法,而国内鲜有关于该方法学的研究.因此,本文就整合性综述的定义、方法学及目前国外已开展的护理学相关整合性研究进行综述,以期丰富护理研究方法,为国内学者开展相关研究提供参考.