Age-related cognitive decline is increasingly recognised as arising from interacting immune and neurovascular vulnerabilities rather than from isolated insults. In this Review, we synthesise current human and mechanistic evidence within a convergence framework in which inflammaging and neurovascular unit (NVU) dysfunction are conceptualised as a feedback-coupled system. Persistent immune remodelling may promote endothelial activation, redox imbalance, pericyte-astrocyte support failure, microglial priming, and impaired neurovascular coupling, thereby reducing cerebrovascular reserve and destabilising blood-brain barrier (BBB) selectivity and transport. Conversely, emerging NVU dysfunction may amplify neuroimmune signalling and increase the susceptibility of white matter and synapses to late-life injury. We organise the literature around three mechanistic interfaces-immune-endothelium, glia-vascular, and flow-metabolic-and assess how this framework may clarify biomarker stratification, mechanism-aligned endpoint selection, and heterogeneity of intervention responses. Current evidence is strongest for integrative plausibility across inflammatory, vascular, and cognitive domains, but remains more limited for temporal ordering, effect modification, and reversibility in humans. We highlight key uncertainties, including peripheral-to-central signalling, harmonisation of BBB metrics, and heterogeneity across mixed late-life pathologies, and assess the therapeutic implications of immune- and NVU-directed strategies.

Fear of falling (FoF) is prevalent among older adults with sarcopenia, frequently causing activity-restricting fear and requiring targeted interventions. Although FoF is influenced by individual factors like impaired balance or weakness of limbs, few studies have comprehensively analyzed its multidimensional factors. This study examines the relationships between FoF latent classes and multilevel factors (individual, familial, societal) in community-dwelling older adults with sarcopenia. This cross-sectional study utilized convenience sampling to recruit 356 participants (age ≥ 60 years) diagnosed with sarcopenia between December 2023 and December 2024. Data were collected using a structured questionnaire, along with the Falls efficacy scale international (FES-I), the Hospital Anxiety and Depression Scale (HADS), the Family APGAR index, and the Social Support Rating Scale (SSRS). Latent profile analysis (LPA) identified distinct FoF classes. Multivariable logistic regression and a decision tree model were employed to identify the determinants of FoF profiles in older adults with sarcopenia. Four latent profiles were identified: Low Fear of falling (22.0

AIM:This study aimed to systematically review Clinical Practice Guidelines (CPGs) for nutritional management of dementia and use evidence mapping to highlight research trends and identify gaps to inform future research. DESIGN:A systematic review of guidelines using the PRISMA statement. METHODS:Systematically collect literature on dementia management CPGs from PubMed, Embase, Web of Science and guideline databases. Extract basic information, recommendations, methodological quality and reporting quality of the CPGs. Four researchers independently evaluated eligible CPGs using the AGREE II instrument and the RIGHT checklist. All recommendations from the CPGs were summarised and analysed, and evidence mapping bubble charts were created in Excel. RESULTS:After excluding 5541 records, 10 CPGs were eventually proved eligible, 5 of which were of high quality and 5 of high quality. With 10 CPGs that combined 18 recommendations. The nutrition screening and assessment were summarised on the basis of the dementia recommendations for 4 major items, 7 items on nutritional interventions, 5 items on caring and 2 on education. CONCLUSION:This review provides an evidence map and offers new perspectives on CPGs for nutritional management in dementia. However, there are improvements to the included CPGs, but most CPGs have a number of key recommendations that can help guide clinical practice. RELEVANCE TO CLINICAL PRACTICE:The currently available guidelines on dementia nutritional management have room for methodological improvement.

Objective:To synthesise and appraise current evidence on prehabilitation strategies for patients with primary liver cancer. Methods:Using the PIPOST framework, we formulated clinical questions and defined eligibility criteria. Guided by the "5S" evidence hierarchy, a comprehensive search was conducted across 20 sources-including clinical decision systems, guideline repositories, bibliographic databases, and professional society websites-from inception to 1 December 2024. Two independent reviewers screened and appraised eligible studies, and evidence synthesis was limited to those meeting predefined quality standards. Nine experts evaluated the evidence through a structured consensus process based on the FAME framework to determine recommendation grades. Results:Twenty studies were included: 1 clinical decision tool, 5 guidelines, 5 systematic reviews, 5 expert consensuses, 3 evidence summaries, and 1 randomised controlled trial. A total of 36 evidence statements were extracted and categorised into six domains: prehabilitation candidates, timing of prehabilitation, nutritional optimisation, physical exercise, psychological support, and health education. Although part of the evidence originated from non-liver cancer populations, extrapolation was considered reasonable due to shared pathophysiological risks across major abdominal surgeries. Of these, 34 evidence statements received strong recommendations after expert appraisal. Conclusions:This study consolidates practical, evidence-based prehabilitation strategies for patients with primary liver cancer, while underscoring the cautious use of extrapolated evidence where liver cancer-specific data are lacking. Despite methodological rigour, conclusions remain constrained by the limited availability of liver cancer-focused studies. Future research should generate direct evidence to refine prehabilitation protocols. Clinical application should integrate both the best available evidence and patient preferences. Systematic review registration:Registered with the Fudan University Evidence-based Nursing Centre (ID: ES20246474).

BACKGROUND:Brain metastases occur in 20%-40% of women with breast cancer, the most common malignancy in women worldwide. These patients frequently require palliative care to improve quality of life; however, their needs and experiences remain poorly characterised. This study explored attitudes, practices, and perceived barriers and facilitators related to palliative care among patients with brain metastasis from breast cancer in China. METHODS:Between October and December 2024, we conducted qualitative interviews with 16 women with brain metastases from breast cancer at a public hospital in Shenzhen, Guangdong Province, China. Participants were purposively sampled and interviewed face to face using a semi-structured, pilot-tested topic guide. Using directed content analysis, we analysed interview transcripts to identify concepts and key ideas within a deductive framework (attitudes, practices, barriers and facilitators). From these initial concepts, categories were inductively expanded and core themes were generated. RESULTS:Findings clustered into four domains: attitudes (goal incongruence among stakeholders; misunderstandings and stigma surrounding palliative care; evolving acceptance linked to perceived benefits); practices (managing neurological symptoms; maintaining cognitive function; optimising of pain management; coordination across family, community, and hospital settings); barriers (financial strain, limited understanding, cultural-familial norms); and facilitators (multidisciplinary care, family/community support, policy support). DISCUSSION:The findings highlight the need for improved communication and education to align expectations and enhance palliative care. Addressing the economic burden and cognitive decline, and strengthening professional team support, family and community engagement, and policy/organisational backing, may enhance palliative care delivery and outcomes. Future research should examine longitudinal shifts in awareness, evaluate transferability to other tumour types and sites via multicentre studies, and incorporate clinicians' and caregivers' perspectives to optimise symptom-control protocols and family-community-hospital coordination.

Background Several risk prediction models for sarcopenia in stroke patients have been developed. However, their methodological quality and predictive performance remain uncertain. Objective To systematically review and critically appraise the current risk prediction models for sarcopenia in stroke patients. Design A systematic review conducted in accordance with the PRISMA guidelines, with methodological quality assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Methods PubMed, the Cochrane Library, Web of Science, Embase, CINAHL, ProQuest, Medline, CNKI, Wanfang, VIP, and CBM databases were systematically searched for studies indexed until May 8, 2025. Two reviewers independently screened studies, extracted data using the CHARMS checklist, and assessed risk of bias and applicability using PROBAST. Model performance was evaluated using metrics including the area under the curve(AUC). Results A total of 8 studies involving 11 models were included. The area under the AUC for all the models was > 0.6 (AUC range: 0.681–0.970) in development cohorts. However, 6 studies (75.0 %) were rated as having a high or unclear risk of bias, primarily due to issues in the analysis domain (e.g., insufficient sample size, lack of external validation). In contrast, the overall applicability of the models was generally favorable. Common predictors included age, BMI, nutritional status (MQSGA score), bone density, and the number of stroke episodes. Conclusions Risk prediction models for sarcopenia in stroke patients generally have good applicability, although they present significant methodological flaws and a high risk of bias. Future research should focus on the transparent reporting of multivariable prediction models to develop and assess sarcopenia risk scores for stroke patients, and internal and external validation is needed in clinical practice. Study registration The review protocol was registered at PROSPERO (CRD420251036935).

OBJECTIVE:To investigate the mediating role of financial toxicity in the relationship between perceived social support and negative emotions among post-surgical lung cancer patients in China. METHODS:A total of 447 lung cancer patients from China were recruited, participants completed the Comprehensive Scores for Financial Toxicity (COST), the Negative Emotion Screening Scale (NESS), and the Perceived Social Support Scale (PSSS). The hypothesized relations were explored using structural equation modeling via the bootstrapping approach. The study methods were compliant with the STROBE checklist. RESULTS:Nearly half (42.51%, n = 190) of the participants experienced financial toxicity. Negative emotions were negatively associated with perceived social support (r = -0.13) and negatively associated with financial toxicity scores (r = -0.50) (Note: COST is a reverse scoring scale, lower COST scores illustrate severe financial toxicity). Perceived social support was positively correlated with financial toxicity scores (r = 0.26). Financial toxicity scores negatively predicted negative emotions (β = -0.504). Social support and financial toxicity could explain 25.3% of the variance in patients' negative emotions. Social support positively predicted financial toxicity (β = 0.257) and explained 6.60% of the variance in financial toxicity. Furthermore, financial toxicity completely mediated the association between perceived social support and negative emotions (b = -0.124; 95% confidence interval: -0.182, -0.086). CONCLUSION:The high prevalence of financial toxicity demonstrates its crucial role in patient outcomes. Our findings reveal that social support indirectly influences negative emotions through financial toxicity, establishing a clear pathway linking psychosocial and financial aspects of cancer care. These results suggest that integrated interventions targeting both financial burden and social support networks may be particularly effective in improving psychological outcomes among lung cancer patients in China's high-middle income regions. Future healthcare policies should prioritize comprehensive support systems that address this complex interplay of socioeconomic and psychological factors.

The COVID-19 pandemic has posed unprecedented challenges to the nursing profession, exacerbating occupational stress, attrition rates, and staffing shortages. Although prior studies have examined factors influencing nursing turnover intention, no research has compared turnover intention among Chinese hospital nurses during the full liberalization of COVID-19 and the postpandemic era. The aim of this study was to investigate the prevalence and associated factors of turnover intention during these two critical periods. A 2-wave multicentre cross-sectional online survey was conducted in 25 hospitals in Guangdong, China. Data were collected during the full liberalization of COVID-19 (T1: 27 December 2022 to 7 January 2023, N = 1,766) and the postpandemic era (T2: 11 May to 23 May 2023, N = 2,643). A structured questionnaire was used to assess sociodemographic and work-related factors, such as perceived stress (10-item Perceived Stress Scale), depression (9-item Patient Health Questionnaire), anxiety (7-item Generalized Anxiety Disorder), insomnia (Insomnia Severity Index), intolerance of uncertainty (Intolerance of Uncertainty Scale), life satisfaction (Satisfaction with Life Scale), and turnover intention (Turnover Intention Scale). Statistical analyses, including descriptive statistics, chi-square tests, Pearson correlation, binary and multiple logistic regression, and hierarchical regression, were performed using SPSS 26.0. The prevalence rates of turnover intention were 73.33

Background:The psychosocial impact of cancer, particularly social isolation, has gained increasing recognition in oncology research. This bibliometric analysis maps the global research landscape and evolving trends in social isolation among cancer patients over two decades. Methods:We retrieved original research articles and review papers on cancer research associated with social isolation from Web of Science database between 2005 and 2024. Utilizing bibliometric platforms such as CiteSpace, VOSviewer, and bibliometric websites, we analyzed the annual publication trends, leading journals, countries, institutions, and authors in this field. Additionally, by analyzing keyword visualizations and keyword bursts, we identified the emerging and popular research areas related to social isolation in cancer research. Results:We systematically analyzed 1219 publications from 2005 to 2024. Globally, the United States accounted for the highest proportion of research output (34.78%), ahead of England (16.57%) and China (7.71%). In terms of institutional contributions, the top three positions were held by the University of London (58 publications), the University of California System (54 publications) and French National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale, INSERM; 52 publications). Supportive Care in Cancer was the journal with the highest number of publications (52 papers). Keyword co-occurrence analysis revealed six major research clusters: social deprivation, palliative care, social isolation, social support, physical activity, and cognitive function. The research focus is transitioning from "risk factors" (2005-2014) to "psychosocial interventions" (2015-2024), with emerging focus on disparities, social determinants of health, and symptom management. Conclusion:This study reveals accelerating global interest in cancer-related social isolation and highlights the need for multidisciplinary approaches that integrate biological and psychosocial perspectives in cancer survivorship care, particularly through targeted interventions for vulnerable populations.

The ability of geriatric nurses to cope with death affects both their physical and mental health, as well as the quality of the hospice services they provide. The aim of this study was to investigate the death coping ability, death attitude, and professional quality of life of geriatric nurses, analyse the influencing factors of death coping ability, and explore the correlations among them. A multicentre cross-sectional study design was used and reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. From October to November 2024, a convenience sampling method was used to survey 357 geriatric nurses from 9 hospitals in 8 provinces and cities, including Guangdong and Hubei, China, as the research subjects. The general information questionnaire, Coping With Death Scale (CDS), Death Attitude Profile-Revised (DAP-R), and Nurse Professional Quality of Life Scale were used for the investigation. The death coping ability score of the geriatric nurses was 135.23 ± 33.04 points, the total death attitude score was 96.65 ± 21.04 points, and the total raw professional quality of life score was 90.00 ± 11.91 points. Pearson correlation analysis revealed that the death coping ability of geriatric nurses was positively correlated with death attitudes, negatively correlated with secondary trauma and occupational burnout, and positively correlated with compassion satisfaction. Regression analysis revealed that age, frequency of sharing experiences of caring for terminally ill patients with others, participation in death-related courses or training, attitude towards death, and professional quality of life were factors influencing geriatric nurses’ ability to cope with death (P < 0.05). The death coping ability of geriatric nurses is moderate and is related to death attitude and professional quality of life. Nursing managers are encouraged to enhance death education or training for geriatric nurses to help them develop a positive attitude towards death, pay attention to the quality of professional life of geriatric nurses and improve their ability to cope with death.

Nurses face high levels of occupational stress due to direct and indirect trauma exposure, resulting in psychological challenges such as anxiety, depression, and secondary traumatic stress. However, vicarious posttraumatic growth (VPTG), a positive outcome of trauma exposure, can improve resilience and professional satisfaction. Understanding the factors affecting VPTG is key to developing strategies that enhance nurse well-being. This study sought to explore the various factors that affect VPTG among clinical nurses, using a cross-sectional design. A cross-sectional survey was performed during the period from September to November 2023, involving 1,025 nurses from 13 tertiary and secondary hospitals across China. The study utilized various validated scales, including the Chinese adaptation of the Vicarious Posttraumatic Growth Inventory, the Coping Style Questionnaire, the Perceived Social Support Scale, the Event Related Rumination Inventory, the Interpersonal Reactivity Index, and the Core Beliefs Inventory. Statistical analysis, including Pearson correlation and stepwise multiple regression, was performed using SPSS 27.0 to identify key factors influencing VPTG. The average VPTG score was 105.02 (SD = 15.75), with 70.1 • Nurses serve as vital links in healthcare but face significant occupational stress stemming from direct and vicarious trauma, resulting in psychological issues like anxiety, depression, secondary traumatic stress (STS), and post-traumatic stress disorder (PTSD). • VPTG among nurses can lead to personal growth, improved resilience, job satisfaction, and enhanced care quality, but research shows moderate to low levels of VPTG, indicating a need for further exploration of its influencing factors. • Cohen and Collens’ VPTG framework provides a solid theoretical basis for understanding how indirect trauma exposure and empathetic engagement with patients can lead to cognitive restructuring and personal growth among nurses. • The research employed the Vicarious Posttraumatic Growth Inventory (VPTGI) to assess nurses’ VPTG levels, providing an accurate reflection of their current status. The VPTGI serves as an essential tool for researchers and practitioners, offering a reliable framework for measuring the nuances of VPTG in nursing contexts, particularly given the tendency of previous studies to conflate post-traumatic growth (PTG) with VPTG. • This study identifies significant predictors of VPTG among nurses, including positive coping strategies, social support, core beliefs, and empathy. These findings highlight the vital role these factors play in fostering growth among nurses exposed to indirect trauma from patient care, addressing gaps in previous research that lacked comprehensive theoretical frameworks. • Results indicate that demographic factors, particularly age and years of nursing experience, significantly influence VPTG scores. Notably, nurses aged 41–50 and those professionals with over 30 years of experience display higher VPTG levels. This suggests that as nurses advance in their careers, they develop greater emotional resilience and coping mechanisms, which are crucial for navigating the complexities of their roles, an aspect often overlooked in earlier studies.

Background:Nurses frequently experience both direct and indirect trauma, leading to significant psychological challenges. While much research has focused on the negative impacts of such trauma, less attention has been given to vicarious post-traumatic growth (VPTG). Given the high levels of indirect trauma that nurses face, understanding VPTG is crucial for mitigating its adverse effects and enhancing mental health and work efficiency. Objective:To map and synthesize the literature on vicarious post-traumatic growth and identify key knowledge gaps in vicarious post-traumatic growth research. Methods:This scoping review follows the approach proposed by Arksey and O'Malley. We conducted this scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework. We searched 7 databases and gray literature on May 19, 2023 to obtain relevant research. Results:Finally, we included 29 studies from 9 countries. There are currently no reliable data on the incidence of vicarious post-traumatic growth among nurses worldwide. There are multiple instruments available to investigate vicarious post-traumatic growth in nurses, and the vicarious post-traumatic growth inventory is more recommended. Factors affecting nurses' vicarious post-traumatic growth include coping styles, psychological factors, and social support. Indirect trauma exposure and vicarious post-traumatic growth coexist. There are currently three intervention strategies for vicarious post-traumatic growth, but none have been proven in clinical trials. Conclusion:This is the first scoping review on vicarious post-traumatic growth, there are a lot of research deficiencies and gaps in current research on vicarious post-traumatic growth for nurses. In view of the impact of secondary traumatic events on nurses, future research should pay more attention to nurses' vicarious post-traumatic growth and promote the development of vicarious post-traumatic growth.

Background The COVID−19 pandemic was a major public health crisis, which has exacerbated the difficulties nurses face, resulting in higher turnover rates and workforce shortages. While many early studies that have examined factors contributing to turnover intention, surprisingly, as yet, no studies have compared the turnover intention of Chinese hospital nurses during the full liberalization of COVID−19 period and post-pandemic era, and it is unclear which potential factors may be associated with turnover intention of nurses at the different periods. This 2-wave repeated survey purposed to explore the prevalence and correlates of turnover intention at different stages of the full liberalization of COVID−19 and post-pandemic era in a large sample of nurses in China. Method Using a repeated cross-sectional survey design, we conducted two online surveys at 25 hospitals in Guandong, China. The 2 surveys were conducted during the full liberalization of COVID−19 period (T1: 27 December 2022 to 7 January 2023, N = 1,766), and post-pandemic era (T2: 11 May to 23 May 2023, N = 2,643). Turnover intention was measured by the six-item Turnover Intention Scale (TIS). A range of turnover intention-related factors was assessed, including sociodemographic characteristics, preceived stress, anxiety, depression, insomnia, job burnout, intolerance of uncertainty, satisfaction with life, and work-related factors. Results The prevalence of turnover intention were 73.33% and 72.34% at T1 and T2, respectively. Dissatisfaction with nursing work (aOR: 2.160–6.536, Ps < 0.001), lack of interest in nursing (aOR: 2.513–2.802, Ps < 0.001) and job burnout (aOR: 1.360–4.096, Ps < 0.01) were associated with an increased risk of turnover intention. And satisfaction with life (aOR: 0.343–0.683, Ps < 0.05) was associated with a reduced risk of turnover intention. Conclusions Turnover intention were particularly higher both in the full liberalization of COVID−19 period and the post-pandemic era. Multiple factors, especially dissatisfaction with nursing work, lack of interest in nursing, job burnout and satisfaction with life are associated with turnover intention. Early detection of turnover intention among hospital nurses and preventive and promotive interventions should be implemented during the full liberalization of COVID−19 and the post-pandemic era to reduce turnover intention among nurses.

This cross-sectional survey, utilizing a convenience sampling method, was conducted to investigate compassion fatigue (CF) among pediatric nurses in Shenzhen, China. Early identification of factors influencing compassion fatigue is a critical issue that nursing managers must address urgently. A convenience sampling technique was employed, and 539 pediatric nurses from tertiary grade A hospitals in Shenzhen were assessed using the Professional Quality of Life Scale. Logistic regression analysis was subsequently conducted to identify factors influencing compassion fatigue. A total of 534 valid questionnaires were collected, yielding an effective response rate of 99.1

OBJECTIVES:To identify, describe and synthesise the views and experiences of adults living with asthma regarding shared decision-making (SDM) in the existing qualitative literature METHODS: We conducted a comprehensive search of 10 databases (list databases) from inception until September 2023. Screening was performed according to inclusion criteria. Tools from the Joanna Briggs lnstitute were utilised for the purposes of data extraction and synthesis in this study. The data extraction process in this study employed the Capability, Opportunity and Motivation Model of Behaviour (COM-B model) as a framework, and a pragmatic meta-aggregative approach was employed to synthesise the collected results. RESULTS:Nineteen studies were included in the metasynthesis. Three synthesised themes were identified: the capability of people living with asthma, the opportunities of people living with asthma in SDM, and the motivation of the people living with asthma in SDM. CONCLUSIONS:We have identified specific factors influencing people living with asthma engaging in SDM. The findings of this study can serve as a basis for the implementation of SDM in people living with asthma and provide insights for the development of their SDM training programs. The ConQual score for the synthesised findings was rated as low. To enhance confidence, future studies should address dependability and credibility factors. PRACTICE IMPLICATIONS:This review contemplates the implementation of SDM from the perspective of people living with asthma, with the aim of providing patient-centred services for them. The results of this review can benefit the implementation of SDM and facilitate information sharing. It offers guidance for SDM skills training among adults living with asthma, fosters a better doctor-patient relationship and facilitates consensus in treatment decisions, thereby enabling personalised and tailored medical care. PATIENT OR PUBLIC CONTRIBUTION:Three nursing graduate students participated in the data extraction and integration process, with two students having extensive clinical experience that provided valuable insights for the integration.

Abstract Objective The purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables. Methods The Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG. Results The Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett’s test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach’s α = 0.951), with dimensions’ Cronbach’s α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG. Conclusion The Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.

Objective: To understand the discharge planning needs of family caregivers for the elderly with nasal feeding. Methods: From May to August in 2021, in-depth interviews were conducted with eleven family caregivers for elderly patients with nasal feeding at a tertiary hospital in Shenzhen. The interviews were analyzed using phenomenological research methods and the Knowledge, Awareness, and Practice (KAP) theory to identify and refine key themes. Results: The discharge planning needs of family caregivers for elderly with nasal feeding can be summarized into three themes: Learning needs related to nasal feeding knowledge and discharge planning (Knowledge), Factors affecting the family caregivers of elderly with nasal feeding (Awareness), and Practical needs in caregiving (Practice). Conclusion: Discharge planning for family caregivers of elderly individuals receiving nasal feeding should focus on the accurate assessment of tube placement and patient condition, operational skills, emergency response, and complication management. Medical professionals should evaluate these needs to develop personalized discharge readiness service plans, ensuring the quality of care for elderly patients with nasal feeding at home.

Objective: To establish a predictive modeling for the risk of bloodstream infection associated with peripherally inserted central catheter (PICC). Methods: Patients receiving PICC treatment in Shenzhen People's Hospital from June 2020 to December 2020 were retrospectively enrolled and divided into the infection group and the non-infection group according to the presence and absence of PICC-related infections. Then, relevant clinical information of patients was collected and the predictors of PICC-related infection were screened by the least absolute shrinkage and selection operator regression (LASSO) model. Besides, multivariate logistic regression was used to analyze the influencing factors of PICC-related infection, A nomogram was constructed based on the results of the multivariate analysis. Ultimately, a receiver operating characteristic (ROC) curve was plotted to analyze the application value of influencing factors to predict PICC-related infections. Results: A total of 505 patients were included, including 75 patients with PICC-related infections (14.85%). The main pathogen was gram-positive cocci. The predictors screened by LASSO included age >60 years, catheter movement, catheter maintenance cycle, insertion technique, immune function, complications, and body temperature ≥37.2 °C before PICC placement. Multivariate logistic regression analysis showed that independent risk factors of infections related to PICC included age >60 years [odds ratio (OR) = 1.722; 95% confidence interval (CI) = 1.312–3.579; P = 0.006], catheter movement (OR = 1.313; 95% CI = 1.119–3.240; P = 0.014), catheter maintenance cycle >7 days (OR = 2.199; 95% CI = 1.677–4.653; P = 0.000), direct insertion (OR = 1.036; 95% CI = 1.019–2.743; P = 0.000), poor immune function (OR = 2.322; 95% CI = 2.012–4.579; P = 0.000), complications (OR = 1.611; 95% CI = 1.133–3.454; P = 0.019), and body temperature ≥37.2 °C before PICC placement (OR = 1.713; 95% CI = 1.172–3.654; P = 0.012). Besides, the area under the ROC curve was 0.889. Conclusion: PICC-related infections are associated with factors such as age >60 years, catheter movement, catheter maintenance cycle, insertion technique, immune function, complications, and body temperature ≥37.2 °C before PICC placement. Additionally, the LASSO model is moderately predictive for predicting the occurrence of PICC-related infections.