BACKGROUND:Global nursing education increasingly emphasizes cross-cultural competence development through international exchanges. While existing research highlights that cross-cultural training enhances nursing students' language proficiency, clinical skills, and cultural awareness in the short term, less is known about their long-term professional and personal growth. OBJECTIVE:This study explored the growth trajectory of Chinese nursing students in Sino-U.S. exchange program, focusing on their experiences and transitions. DESIGN:A constructivist grounded theory approach was employed. SETTING:This study examined Chinese nursing students who completed a one-year, three-semester program at a U.S. nursing school during their junior year. PARTICIPANTS:From October to December 2024, 15 Chinese nursing students were recruited using purposive and theoretical sampling methods. Eligible participants had completed a one-year Sino-U.S. nursing exchange program during their junior year (program period: 2015-2024), with the length of time since program completion ranging from 1 to 8 years (mean ± standard deviation: 5.47 ± 2.23 years). METHODS:Semi-structured interviews were conducted via Zoom, exploring participants' growth trajectories. Data analysis followed constructivist grounded theory, using constant comparison to progress from initial to theoretical coding, identifying core concepts. RESULTS:Fifteen participants were included in the study. Analysis of the interview data generated four theoretical codes: (1) Self-Awaking, (2) Self-Responsibility, (3) Self-Empowerment, and (4) Self-Expansion-along with ten focused codes. These codes collectively formed the 4S Spiral Growth Model (4S-SGM) within the context of transcultural nursing education. CONCLUSION:This study employed Constructivist Grounded Theory to examine nursing students' personal growth after studying abroad. It introduces a novel model illustrating the impact of international exchange on their development. The findings offer practical insights for improving exchange programs and provide empirical support for fostering globally competent nursing professionals.

Generating emotionally appropriate responses in conversations with large language models presents a significant challenge due to the complexities of human emotions and cognitive processes, which remain largely underexplored in their critical role in social interactions. In this study, we introduce a two-stage automatic data generation framework to create CAPE, a Chinese dataset named Cognitive Appraisal theory-based Emotional corpus. This corpus facilitates the generation of dialogues with contextually appropriate emotional responses by accounting for diverse personal and situational factors. We propose two tasks utilizing this dataset: emotion prediction and next utterance prediction. Both automated and human evaluations demonstrate that agents trained on our dataset can deliver responses that are more aligned with human emotional expressions. Our study shows the potential for advancing emotional expression in conversational agents, paving the way for more nuanced and meaningful human-computer interactions.

Purpose To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. Methods A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy—cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. Results A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. Conclusion Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. Implications for cancer survivors Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.

Objective:To explore the effect of online group positive psychological intervention on the professional quality of life and professional values of oncology nurses.Methods:From November 2020 to March 2021, 100 oncology nurses from Peking University Cancer Hospital were selected as the study subjects. The nurses were divided into intervention group (50 cases) and control group (50 cases) by random number table. The control group received routine intervention, and the intervention group received online group intervention with the theme of "happy work" on the basis of the control group. The professional quality of life and professional values of the two groups of nurses were compared before, immediately after, one month and three months after the intervention.Results:Immediately after intervention, the score of compassion satisfaction in the intervention group was higher than that in the control group and before intervention, and the score of burnout was lower than that in the control group and before intervention. One month after the intervention, the score of compassion satisfaction in the intervention group was higher than that in the control group and before intervention. Three months after the intervention, the score of professional values in the intervention group was higher than that before intervention. The above differences were statistically significant ( P<0.05) . Conclusions:Online group positive psychological intervention can improve the professional quality of life of oncology nurses in a short time, and has an effect on promoting professional values.

This paper presents ChatCounselor, a large language model (LLM) solution designed to provide mental health support. Unlike generic chatbots, ChatCounselor is distinguished by its foundation in real conversations between consulting clients and professional psychologists, enabling it to possess specialized knowledge and counseling skills in the field of psychology. The training dataset, Psych8k, was constructed from 260 in-depth interviews, each spanning an hour. To assess the quality of counseling responses, the counseling Bench was devised. Leveraging GPT-4 and meticulously crafted prompts based on seven metrics of psychological counseling assessment, the model underwent evaluation using a set of real-world counseling questions. Impressively, ChatCounselor surpasses existing open-source models in the counseling Bench and approaches the performance level of ChatGPT, showcasing the remarkable enhancement in model capability attained through high-quality domain-specific data.

BACKGROUND:The social participation of older people should be encouraged, as it is fundamental to their well-being and the practice of aged care. Therefore, the ability of older persons to participate in society should be strengthened.OBJECTIVE:To evaluate the preliminary effects of a WeChat-based educational intervention on the social participation of community-dwelling older adults in China.METHODS:This study was a quasi-experimental design. Twenty-eight community-dwelling older adults participated in a WeChat-based educational intervention. The intervention contents included concepts and preparation of social participation, analysis of participation resources and capabilities, technological adaptation, emotional management, setting of to-do lists, etc. Social participation, self-worth and subjective well-being were measured via the WeChat application on smartphones at baseline, immediately after the intervention, and a 3-month follow-up. We analysed data using paired t-tests and analysis of variance (ANOVA).RESULTS:We found statistically significant improvements in social participation (active aging) (F = 4.408; p < .05) as well as the self-worth dimensions of moral worth (F = 4.135; p < .05) and psychological worth (F = 3.234; p < .05), and the negative-affect dimension of subjective well-being being decreased (F = 2.484; p < .05).CONCLUSIONS:The WeChat-based education intervention can effectively improve social participation and self-worth, and may provide effective preventive healthcare solutions for older adults in China.IMPLICATIONS FOR PRACTICE:The enormous value of the social participation of independent older adults must be recognised. Nurses can use smartphones to deliver health and social participation information in routine programs in aged care.

目的 从患者视角深入了解已完成新辅助免疫治疗临床试验患者在其参与过程中的角色感知和体验,为新辅助免疫治疗方案临床试验设计中增加患者视角,进一步促进新辅助免疫治疗用药的发展及提升我国肿瘤患者的整体诊治水平提供参考和依据.方法 采用现象学研究方法,以目的抽样选取13例已完成新辅助免疫治疗临床试验患者,进行半结构式访谈,并运用Colaizzi7步分析法对资料进行分析.结果 患者参与新辅助免疫治疗临床试验的角色感知归纳为4个主题,分别为药物发展的"试验品"、新药实践的志愿者与促进者、新药方案的参与者与评价者、医学进步的受益者.患者在新辅助免疫治疗临床试验中的参与体验归纳为3个主题,分别为来自研究团队的关怀,新辅助免疫临床试验过程中的担心与困扰(免疫不良反应的不确定性、医疗资源的不便捷性、随访检查的频繁性),医院、社会缺少对临床试验的相关宣传(试验获取途径受限、积极与支持环境的欠缺、尊重与理解的需求).结论 患者在新辅助免疫治疗临床试验参与中尚需改善其"试验品"的负性感知,参与体验也反映了目前新辅助免疫治疗临床试验中存在的相关问题,护理人员需要重视患者在试验参与中的体验,针对患者需求完善健康教育方案,提升社会支持,进而提高我国新辅助免疫治疗临床试验的质量.

Although computerized physician order entry systems improve order transmission and patient safety, overdependence on these systems can impede users' communication. This ethnographic study explored physician-nurse communication surrounding computerized physician order entry systems using a sociotechnical framework. Fieldwork conducted in a tertiary teaching hospital comprised 89 hours of participant observation, and individual semistructured interviews were held with seven nurses and five physicians. In addition, documents and artifacts were collected. Three core themes emerged. First, computerized physician order entry quality-related issues undermined the work efficiency of physicians and nurses. Specifically, usability was error prone because of cognitive overload, and the system was unable to perform relevant traces and raise alerts, demonstrating poor interoperability. Second, social factors, including insufficient training, unclear responsibilities, and a lack of awareness concerning interdisciplinary communication, compounded communication problems. Last, environmental factors, including noncoterminous spaces and times and insufficient technical support, impeded the resolution of communication problems. Technical and social contextual factors relating to computerized physician order entry systems jointly affected physician-nurse communication. Cognitive issues and insufficient alerts impacted work efficiency the most and were compounded by contextual individual- and team-related factors and environmental factors. Therefore, improved functions of computerized physician order entry systems and interprofessional communication training are required to optimize technical and social aspects of physician-nurse communication.

目的 探讨回归家庭干预对乳腺癌术后患者康复效果的影响.方法 采用非随机分组的类实验研究设计,于2020年9月—2021年1月在北京市某三级甲等医院乳腺外科病房通过目的抽样选取70例乳腺癌患者为研究对象,愿意参与回归家庭干预的患者纳入试验组,在护理门诊进行干预.选择常规护理的患者纳入对照组,在病房进行干预.干预前、后分别用上臂和肩功能自我评定量表、上肢功能障碍评定简表、癌症康复评价简表及家庭亲密度与适应性量表对两组进行测量.结果 干预后,试验组的上臂和肩功能自我评定量表得分、家庭亲密度与适应性量表得分均高于干预前和对照组(P<0.05),上肢功能障碍评定简表得分、癌症康复评价简表得分均低于干预前和对照组(P<0.05).结论 回归家庭干预可改善乳腺癌术后患者的上肢功能,提高其生活质量,增进其家庭功能,促进患者顺利回归家庭,有助于实现全面康复.

目的 运用Rodgers演化概念分析法界定老年人的社会参与,以期为护理实践提供参考.方法 系统检索中国知网、万方数据、维普网、PubMed、Web of Science和CINAHL数据库.搜索时限为建库至2021年3月.根据纳入标准选取56篇文献,以Rodgers演化概念分析法为框架对老年人的社会参与进行分析界定.结果 老年人的社会参与涉及6个定义性特征,包括参与社会活动、参与社会互动、参与资源分享、参与社会角色、实现个人价值和提升生活质量为导向.相关因素包括个体因素、家庭因素、社区因素和社会支持;结局指标包括身体功能、认知功能、心理状态、生命价值感、生活质量以及护理成本等.结论 社会参与能力是评估老年人健康的重要指标之一,界定老年人社会参与,有助于护理人员理解老年人社会参与的本质,以期更好地提升老年人的健康水平.

目的 了解空巢家庭老年配偶应对慢性病共病的体验,并探讨其压力感知特征和变化.方法 采用质性研究方法,对16名老年配偶进行半结构化深度访谈,使用主题分析法对资料进行整理分析.结果 慢性病共病空巢老年配偶压力感知和应对体验共形成4个主题:承担多重角色、感知共病压力动态多变、共病应对中的冲突和困惑、积极应对策略和收获.结论 慢性病共病给空巢家庭老年人生活带来挑战,医护人员应深入了解老年配偶的压力特征及变化、压力应对中的冲突和困惑,以及源于老年配偶智慧总结的应对策略,为实施以家庭为一体的慢性病共病管理干预项目提供依据.

Objective To analyze the development trend and research hotspots in the field of health care for the elderly in China.Methods Based on NoteExpress software and Nvivo software, the related literatures in the field of health care for the elderly since the establishment of China Journal Full-text Database（ CNKI）, Wanfang database and VIP database were statistically and visually analyzed by bibliometrics. Results A total of 903articles in the field of health care for the elderly were published on the three platforms. The number of articles increased rapidly after 2015,accounting for 92.35% of the total number of articles. The research hotspots in this field mainly focus on health care services, health care service industry, health care service system, health care service mode and combination of medical care, intelligent health care, and traditional Chinese medicine health care.Conclusion The research on health care for the elderly is of epochal character. In recent years, the field of health care for the elderly has attracted the attention of domestic scholars.

Multiple chronic conditions (MCCs) affect patients and their spouses. We explored the experience of Chinese older couples living with MCCs to gain deeper understanding of how they cope with MCCs as dyads. A qualitative research design using semi-structured in-depth interviews was conducted. Sixteen couples (≥60 years) were included and a thematic analysis was undertaken using NVivo software. Four themes under an overarching theme "A community of shared destiny" were identified: (i) various changes and impacts in normal life; (ii) perceived dynamic stress and dyadic challenges of MCCs; (iii) acceptance and reflection on MCCs influenced by aging and fatalism; (iv) mutual support and dyadic adjustment based on a shared destiny. Coping with MCCs was a dyadic and periodic journey for older couples. They perceived themselves as a community of shared destiny. Our findings are important for healthcare professionals to develop targeted interventions for older couples living with MCCs.

Aim: To assess the effect of different non-pharmacological interventions on cancer-related fatigue (CRF) in breast cancer (BC) patients and identify the most effective method for improving CRF. Design: A systematic review and network meta-analysis. Methods: Literature will be searched in the ongoing trail in the Clinical Trials.gov , World Health Organization, the International Clinical Trials Registry Platform, Cochrane Library, PubMed, EMBASE, Web of Science and CINAHL, from the inception until December 31, 2020. Two independent researchers will rigorously screen the literature according to the inclusion and exclusion criteria and assess the risk of bias based on the Cochrane Collaboration's Tool of RCTs. Stata 13.0 and Aggregate Data Drug Information System will be used for data analysis. Results: This protocol has been registered on the PROSPERO website (registration number is CRD42020222093). This study will provide the reliable evidence of the most effective non-pharmacological intervention to improving CRF.

目的 系统评价老年人应对慢性病共病的体验.方法 检索PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据库、维普中文期刊全文数据库,检索时限为建库至2021年8月,检索老年人应对慢性病共病体验的质性研究文献,依据2016版澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准评价文献质量,采用Meta整合方法分析结果.结果 共纳入15篇文献,提炼出60个研究结果,整合成10个新的类别,综合为3个整合结果:慢性病共病协同衰老所致改变;对慢性病共病的反思和反应;调适以维持正常生活.结论 慢性病共病协同衰老给老年人生活造成多方面的挑战,医护人员应关注其对共病不同应对方式,重视源于其智慧总结的应对策略,设计、开发可行的应对共病的干预性支持项目.

对国内外癌症患者灵性需求评估工具的主要内容、特点及局限性等进行综述,以期为建立和应用本土化的灵性需求评估工具提供借鉴,为有效识别、准确评估、实施个性化灵性照护提供依据.

目的 开发失禁性皮炎识别与防控管理信息系统,探讨其在危重症患者失禁性皮炎预防和护理管理中的应用效果.方法 成立失禁性皮炎管理小组,构建失禁性皮炎识别与防控管理信息系统,采用人机交互技术,包括评估、分级、决策、护理文书4个内容模块,从而实现评估预警、分级判定、指导决策和保存记录等功能.2019年7月正式在临床应用,比较系统应用前后护士评估危重症患者失禁性皮炎风险的用时、及时率及准确率、风险评估及分级评估的动态更新率、失禁性皮炎发生率等指标.结果 应用失禁性皮炎识别与防控管理信息系统后,护士评估危重症患者失禁性皮炎风险的用时由(2.88±0.35)min缩短至(1.44±0.22)min,评估及时率由52.5％上升至82.5％,评估准确率由57.5％提高至85.0％,失禁性皮炎风险评估的动态更新率由17.5％上升至77.5％,分级评估的动态更新率由20.0％提高到77.8％,差异均有统计学意义(P＜0.05).失禁性皮炎发生率由16.0％降至11.8％(P＞0.05).结论 失禁性皮炎识别与防控管理信息系统能为护士提供准确、客观的决策依据,能缩短失禁性皮炎风险评估用时,提高评估及时率、准确率、风险评估及分级评估的动态更新率,有助于提高失禁性皮炎皮肤护理质量.

Purpose: Breast cancer (BC) survivors have a lifelong risk of developing lymphedema. This study investigated the prevalence of BC-related arm lymphedema among Chinese BC survivors diagnosed in the last 10 years and examined the demographic and clinical variables as well as lifestyle factors associated with lymphedema status. Methods: In this cross-sectional study, women with BC (N = 866) who had been diagnosed and followed up in the previous 10 years were recruited from the outpatient clinic of 4 general hospitals and one cancer association in China between August 2018 and October 2019. Lymphedema status was determined using the Norman telephone questionnaire as the patient-reported occurrence of hand/lower arm/upper arm swelling. Multiple logistic regression was used to identify risk factors for lymphedema. Results: The median time from BC diagnosis was 4.0 years (interquartile range, 2.0?5.0 years). 81.4% of the patients had undergone mastectomy. The prevalence of arm lymphedema among BC survivors was 49.0%. Age ?50 years, monthly income <3000 RMB, modified radical mastectomy, postsurgical wound infection, chemotherapy, and radiotherapy were associated with an increased risk of BC-related arm lymphedema, whereas exercise of the affected arm, engagement in active physical activity, and timely reporting of symptoms of infection to a physician decreased the risk (P < 0.05). Conclusions: Arm lymphedema is a common complication for postoperative BC survivors within 10 years. It is essential to identify patients at risk of lymphedema based on demographic, clinical, and lifestyle factors and implement interventions targeting modifiable lifestyle behaviors-eg, active physical activity during the postoperative period.

ABSTRACT OBJECTIVE To explore the experience of incontinence-associated dermatitis (IAD) as perceived by nurses, obstacles in the nursing process, and need for IAD training and management. METHODS This single-setting descriptive qualitative study was conducted from June 5, 2018, to June 22, 2018. Ten nurses working in the respiratory ICU of a local hospital participated in semistructured interviews. The content analysis method was used to analyze, summarize, and refine the interview data. RESULTS The experience of ICU nurses with IAD can be divided into four types: nursing based on experiential knowledge, seeking self-improvement, disunity of cleaning methods and wiping skills, and postponement of nursing care because of priority allocation. Obstacles in the nursing process include a lack of relevant nursing knowledge and awareness, as well as the medical supplies needed. The goals of training and management include establishing IAD preventive nursing procedures, providing IAD care products, enhancing the practicality of training content and diversifying training methods, and establishing an information system to assist nurses caring for patients with IAD. CONCLUSIONS The knowledge and behavior of ICU nurses regarding IAD need to be improved. Training and management are imperative. Facilities and nurse managers should actively seek solutions to stated obstacles, formulate training methods suitable for clinical needs, and promote the standardization of nursing for IAD.