AIM:This study aims to examine the impact of caring leadership on nurse caring behaviours, while testing the mediating role of general self-efficacy and the moderating role of emotional intelligence. DESIGN:A cross-sectional study. METHODS:A total of 517 clinical nurses from China were recruited. The Caring Assessment Tool-Administration, the General Self-Efficacy Scale, the Wong and Law Emotional Intelligence Scale, and the Caring Behaviors Inventory were used for data collection. Data were analysed using SPSS 26.0, including correlation analysis and moderated mediation analysis based on Model 4 and Model 5 of the PROCESS macro. RESULTS:Nurse caring behaviours were positively correlated with caring leadership, general self-efficacy, and emotional intelligence (r = 0.435, 0.511, and 0.639, respectively; all p < 0.001). Caring leadership was also positively correlated with general self-efficacy (r = 0.295, p < 0.001). General self-efficacy partially mediated the relationship between caring leadership and nurse caring behaviours, with an indirect effect value of 0.088, accounting for 27.1% of the total effect. Additionally, emotional intelligence significantly moderated the relationship between caring leadership and nurse caring behaviours (β = 0.005, p = 0.009). CONCLUSION:Caring leadership promotes nurse caring behaviours both directly and indirectly through general self-efficacy, and this effect is stronger among nurses with higher emotional intelligence. Healthcare institutions should therefore invest in developing caring leadership and in strengthening nurses' self-efficacy and emotional intelligence to sustain high-quality caring behaviours. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution was involved in the design, conduct, analysis, or preparation of this study, as it focused solely on the professional perceptions of clinical nurses.

ObjectiveTo explore the lived experiences of social alienation among Chinese women with gynecologic malignancies and identify the meanings they attached to social withdrawal and reconnection.MethodsThis descriptive phenomenological study was conducted in a tertiary hospital in Hangzhou, China, in April 2025. Twelve women with histopathologically confirmed gynecologic malignancies were recruited through purposive sampling with maximum variation. Semi-structured face-to-face interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s seven-step phenomenological method.ResultsThree themes and eight subthemes were identified. Participants described withdrawing from others to protect a threatened identity, including concealing the illness to avoid attention and restricting daily movement and social contact. They also described living in a body that feels changed and exposed, reflected in physical exhaustion and functional limits, changes in appearance and anticipated judgment, and concerns about family reputation and financial strain. Finally, they expressed a desire for understanding and a return to normal life, including feeling misunderstood in relationships and work and seeking work, normality, and meaningful connection. Across accounts, social alienation appeared to arise from the interaction of symptom burden, visible treatment effects, anticipated social judgment, practical constraints, and limited opportunities for understanding and support.ConclusionSocial alienation among women with gynecologic malignancies is a multidimensional experience shaped by bodily change, social responses, and practical barriers to participation. Supportive care should include psychosocial assessment, family-informed communication, peer support, and individualized assistance with social and occupational reintegration.

ObjectiveThis cross-sectional study aimed to identify factors influencing patient delay in older adults with acute coronary syndrome (ACS) using Andersen’s Behavioral Model at a tertiary hospital in Zhejiang Province, China.MethodsA total of 153 older adults diagnosed with ACS who survived to hospital admission were included from January 2023 to June 2023. Logistic regression analysis was used to determine factors independently associated with a longer patient delay following symptom onset.ResultsThe median delay in seeking medical care was 100.00 min (55.00, 450.00 min). Female sex (odds ratio [OR] = 2.762, 95% CI: 1.067–7.153), advanced age (≥75 years; OR = 4.244, 95% CI: 1.519–11.859), diagnosis of unstable angina (OR = 3.430, 95% CI: 1.281–9.182), and history of diabetes (OR = 3.921, 95% CI: 1.364–11.273) were significant factors associated with prolonged patient delay. In contrast, attributing symptoms to cardiac disease (OR = 0.269, 95% CI: 0.088–0.823), engaging in consultation-seeking behavior following symptom onset (OR = 0.326, 95% CI: 0.124–0.856), and a history of heart disease (OR = 0.274, 95% CI: 0.095–0.790) were associated with reduced likelihood of delay.ConclusionTo reduce patient delay among older adults with ACS, it is important to improve their ability to recognize ACS symptoms, especially in female, older, and patients with diabetes, and those with cardiovascular risk factors but no prior cardiac diagnosis. Accessible consultations could support older patients in making quick decisions about care-seeking behavior.

PurposeThere are few reports on compliance with oral nutritional supplements (ONS) after surgery in hospitalized patients. This study aimed to investigate the compliance with ONS and its influencing factors after surgery in colorectal cancer patients.MethodsSTROBE checklist was used during the preparation of this paper. A total of 103 postoperative colorectal cancer patients were selected from November 2020 to April 2021 from the Department of Anorectal Surgery in our institution, which is a tertiary hospital in Hangzhou, China. The compliance with ONS was recorded by a self-record sheet, and sociodemographic and disease-related information of these patients was gathered through a self-designed questionnaire.ResultsThe overall ONS compliance rate of patients with colorectal cancer was 57.6%. Results of univariate analysis revealed that ONS compliance rate was related to sex, admission body mass index, abdominal distension, attitude towards ONS, and satisfaction with ONS. Multi-factor analysis showed that age, sex, and perceived benefits of nutrition therapy independently influenced the ONS compliance rate.ConclusionsThe postoperative ONS compliance rate of colorectal cancer patients needs to be further improved. Healthcare professionals should pay more attention to the postoperative ONS compliance and acknowledging the influence of age, gender, and attitudes towards ONS on ONS compliance. Notably, patients' perspectives towards ONS play a crucial and modifiable role in determining ONS compliance. Nurses ought to assist patients in cultivating a positive attitude towards ONS.Relevance to Clinical PracticeDosage form and delivery method are also influence factors that deserves further exploration in the future. Future research endeavours should endeavour to craft tailored, meticulous nutritional intervention strategies tailored to the diverse factors that influence ONS compliance, ultimately leading to enhanced ONS adherence. Our findings could serve as valuable evidence for the development of strategies aimed at enhancing ONS usage practices.

Background Cancer-related fatigue (CRF) has gained increased attention in the past decade but remains difficult to treat. It is a predictor of patients' overall health and quality of life (QoL). Therefore, controlling fatigue is important for patients with cancer. Objective The aim of this study was to test the effect of solution-focused therapy (SFT) in reducing CRF and improving QoL in patients with colorectal cancer (CRC) undergoing chemotherapy. Methods A total of 124 patients with CRC undergoing chemotherapy were recruited and randomized to the SFT group or control group. Cancer-related fatigue was measured with the Cancer Fatigue Scale-Chinese version (CFS-C) at baseline, 3 months, and 6 months. Quality of life was measured with the Quality of Life Instruments for Colorectal Cancer Patients at baseline and 6 months. Results Of 124 patients, 119 (95.9%) were evaluable. The SFT group showed significantly lower Cancer Fatigue Scale-Chinese version scores than the control group in all subscales and the total scores at 3 months (P < .001). At 6 months, the SFT group had significantly lower scores in cognitive fatigue (P < .001) and total fatigue (P = .005). The CRF of the SFT group decreased in the first 3 months (P = .012) but increased at 6 months (P < .001). The SFT group had significantly higher scores in the physical and psychological domains and overall QoL (P = .002, P <.001, and P = .02) than the control group at 6 months. Conclusion Solution-focused therapy may decrease the CRF and improve QoL during chemotherapy for patients with CRC. Implication for Practice Solution-focused therapy can be implemented to relieve fatigue and improve QoL in patients with CRC.

目的 探讨转换型领导在综合性三级甲等医院建设中的实践及效果,为护理领域转换型领导建设提供借鉴.方法 通过激发共同愿景、应对临床高效工作需求的挑战、促进多方合作、树立榜样、激励人心五个方面阐述转换型领导的实践.结果 通过国家护理质量数据平台数据显示,自转换型领导实施以来,截至2019年,医院护士执业环境得分高于全国平均值的水平;离职率与全国离职率相比处于较高状态,但医院护士因工作氛围原因导致辞职的离职仅为1人.2018年度中国医院科技量值(护理学排名):医院在国内三级甲等医院中保持了第11名的学科影响力.医院有540名护士参加护理单元共治委员会,占全院护士的25.9％,98％ 的持续质量改进项目由一线护士担任项目负责人,744名一线护士担任科室质量管理单项指标的负责人,占全院护士的35.7％.结论 转换型领导应用于护理管理中是提高护士执业环境满意度、降低因工作倦怠而导致的高离职率、提升护理学科影响力和促进一线护士参与护理管理的有效途径.

To develop a quality control checklist for the prevention and control of coronavirus disease 2019 （COVID-19） in fever clinic and isolation ward of the general hospital and to assess its application. Based on the relevant prevention and control plans and technical guidelines for COVID-19，Delphi method was used to identity items for evaluation，and a quality control checklist for the prevention and control of COVID-19 in the fever clinic and isolation ward was developed in Sir Run Run Shaw Hospital. The checklists included 8 dimensions and 32 items for fever clinic，7 dimensions and 27 items for the isolation ward. The appointed inspectors conducted daily quality control for each shift with this checklist. The expert authority coefficient was 0.88，the mean of the importance of each index in the quality control table was not less than 4.8，and the coefficient of variation was not more than 0.07. During the entire February 2020，8 problems were found and rectified on-the-spot with the application of the checklist. Quality inspection rate was 100% in both isolation wards and fever clinic. The compliance rate and accuracy rate of hand hygiene were 100%; the correct rate of wearing and removing protective equipment increased from 96% to 100%. During the same period，a total of 1915 patients were admitted to the fever clinic，including 191 suspected patients （all were isolated in the hospital，3 were confirmed）. There were no medical staff infected with COVID-19，no cross infection of patients and their families in the hospital. A quality control checklist for the prevention and control of COVID-19 has been developed and applied in the isolation wards and fever clinic，which plays an important role in preventing nosocomial infection.

目的 观察多专科护理专家联合查房在慢性病护理中的应用效果.方法 组建多专科护理专家团队库,慢性病相关护理单元针对科室慢性病同时合并多种疾病/问题的患者提出联合查房申请,邀请相关专科护理专家进行联合查房评估并讨论,为临床一线护士提供护理决策和技术支持.结果 多专科护理专家联合查房16次,解决针对护理质量和疾病护理的相关问题各31条(分别占46.27％),护理流程和制度相关问题5条(占7.46％);改善了相关护理敏感指标;联合查房后,临床护士专业自我效能感量表的护理实践情况维度高于联合查房前,比较差异有统计学意义(P<0.05).结论 多专科护理专家联合查房在慢性病护理中起到积极作用,提升了护理质量,增强了临床护士的专业自我效能感.

AIM:To investigate the characteristics of workplace violence at primary hospitals in Southeast China and identify associated risk factors. DESIGN:A cross-sectional survey design was used for this work. METHODS:We distributed a workplace violence questionnaire among medical staff at primary hospitals in Southeast Zhejiang Province, China. The data were collected between December 2016 and December 2017. We analysed the categorical data by using the chi-square test and expressed it as frequencies. The risk factors were analysed by using multiple logistic regression analysis. RESULTS:Among the 2,560 questionnaires, 1,842 (71.9%) medical staff indicated that they had experienced workplace violence. Verbal assault was the most common type, followed by physical and sexual assault. Furthermore, gender, age, marital status, education, technical position and number of hospital beds' numbers were independent risk factors.

Purpose The aim of this longitudinal study was to analyze trends in fatigue among colorectal cancer patients during chemotherapy and examine the predictors of multidimensional fatigue. Methods A mixed sample of colorectal cancer patients who were receiving chemotherapy ( N = 200) was recruited in China. The patients completed the Cancer Fatigue Scale (CFS) at baseline (before chemotherapy) and after 3 and 6 months of chemotherapy. Repeated measures ANOVAs were conducted to evaluate the effect of time on the CFS score. The data on violations of the statistical assumptions (independence, normality, and sphericity) from the repeated measures ANOVAs were examined. Stepwise regression analyses were conducted to evaluate the associations of the potential predictor variables at baseline on the total fatigue score and subscale scores at follow-up. Results As chemotherapy progressed, significant increases in the three subscale scores and total scores were observed. Physical fatigue and total fatigue scores increased continuously during chemotherapy ( P < 0.001). However, affective fatigue and cognitive fatigue scores increased significantly in the first 3 months ( P < 0.001) and basically remained stable thereafter ( P > 0.05). Multiple stepwise regression was used to analyze the predictors. The results showed that the baseline fatigue subscale score was the strongest predictor of each dimension of fatigue. In addition, age affected physical fatigue, and monthly income and education affected cognitive fatigue. Conclusion Fatigue increased during chemotherapy. Early assessment and intervention may be better for controlling fatigue, especially in patients with higher baseline fatigue level, older age, and lower economic and educational levels.

总结1例肝癌射频消融术后合并血栓性血小板减少性紫癜患者的护理经验.护理要点:严密观察患者有无出血倾向;做好神经精神症状的护理;早期启动肠内营养;采取局部枸橼酸钠抗凝下血浆置换等措施预防出血.经实施上述护理,患者入ICU第15天转入普通病房,入病房第29天顺利出院.

目的 探讨临床护士参与共治在磁性医院认证中的实践效果.方法 2015年以科室委员会的模式构建了临床护士参与共治的护理管理模式,使用护理实践环境量表对参与共治实施前、实施1年后、实施3年后进行调查分析.结果 临床护士参与共治实施1年后,护士参与医院事务、高质量照护的护理基础、护士长可及和领导力及支持护士、医护关系得分均高于参与共治实施前,差异有统计学意义(P<0.05);临床护士参与共治实施3年后,护士参与医院事务、人员配置与资源充裕、医护关系得分均高于参与共治实施1年后,差异有统计学意义(P<0.05).结论 临床护士参与共治在优化护士实践环境、提高护士满意度、构建磁性文化方面有积极作用.

总结4例颈动脉支架成形术后发生脑高灌注综合征患者的护理经验.护理要点包括:密切监测神经系统相关症状,严格控制血压,做好早期癫痫发作的护理,以及相关的基础护理和加强偏瘫肢体的康复锻炼.4例患者经治疗和护理恢复良好,顺利出院.

目的 构建三级医院护理垂直管理模式架构与实践策略集,以推进护理管理改革.方法 在文献系统评价和半结构式访谈的基础上拟订初稿,采用德尔菲法对来自全国16个省市三级医院的20名专家进行2轮咨询.结果 2轮专家咨询的权威系数分别为0.93和0.94,肯德尔和谐系数为0.043～0.233.最终确立的三级医院护理垂直管理模式架构与实践策略集包含垂直联合扁平化的管理架构、转换型领导、标准化的护理专业实践、组织授权、创新与实践和支持系统6个维度、17个要素和60个要素特征及其实践策略.结论 构建的护理垂直管理模式架构与实践策略集科学、实用、内容较全面,可为国内三级医院护理管理模式改革与实践提供依据.

口腔综合治疗台(dental chair unit ,DCU )是口腔治疗过程中必不可少的设备 ,集成了包括水、电、气在内的供给系统及口腔诊疗过程中必需的部件[1] .其中,牙科综合治疗水路系统(dental u-nit waterline syetem ,DUWLs)包括了DCU 的供水瓶及其与三用枪、高低速手机、超声波洁牙机的连接水管 ,为口腔治疗供水冲洗 ,冷却高速转动的涡轮机 ,以减少口腔组织的损伤.但DUWLs 通常存在着大量的生物膜和浮游菌 ,随着治疗用水冲出管路 ,进入被治疗者口腔或在空气中形成气溶胶 ,成为潜在的污染源[2].因此 ,DUWLs的污染控制是口腔医院医院感染管理工作的重点.笔者就DUWLs内污染现状、污染造成的原因和危害及目前所探究的污染控制措施进行综述 ,以期对未来控制DUWLs的污染提供参考依据.

总结结构化认可体系在护理管理中应用体会。结构化认可体系是全面的认可制度,以360度认可体系为核心,包括自我认可、同事认可、上级认可、患者/家属及社会认可,通过荣誉授予、相互欣赏、庆祝与分享、发展机会等不同形式开展,从而有效提升护士工作满意度和优化护理职业环境。

总结护理单元标准化管理的实践体会.制定护理单元标准化管理制度,规范对患者的系统评估,护理单元床位实施中心化管理,建立标准化急救支持系统、标准化交流模式、护理单元给药追溯系统.强化护理单元标准化管理后,提高了护理单元护理质量,提升了患者满意度.

>随着医疗技术和设备的更新,医院发展开始由外延性扩张向内涵式提升的模式转变,加强内部员工的管理,对于新形势下医院的生存和发展具有重要意义 [1] 。新员工的培训考核影响着医院和员工的成长与发展方向,提高新护士的整体素质是提高护理质量和促进护理专业发展的重要保证。我院是一家三级甲等医院,感染科是一个特殊的部门,不仅需要面对50%发热待查疑难患者,还要面对每次传染病疫情流行,新员工需要面对更多的压力。本科室2009年开科至2011年护理离职人员4人,更换护理岗位3人,

总结护理质量管理体系的建立和应用体会.建立三级护理质量管理组织架构,制定护理质量敏感指标10项、护理核心制度及安全管理指标8项、护理人员管理指标4项及意外事件报告制度、近似错误上报表.将各项指标用于护理质量管理,采取自查、巡查、面和点结合的监测方法 发现问题和寻找差距,对存在问题进行持续质量改进.经2年实践,各项护理质量指标稳步提高.建立护理质量管理体系能提高护理服务质量及护士工作满意度.