AIM:To examine the trajectories, core characteristics, and maintenance factors of social avoidance in patients with breast cancer during the first postoperative year. DESIGN:Longitudinal, explanatory sequential mixed-method design. METHODS:This longitudinal study enrolled 176 postoperative breast cancer patients, conducting six follow-up assessments over 1 year. Latent class growth analysis was employed to identify heterogeneous trajectories of social avoidance behaviour, with multivariate logistic regression subsequently analyzing predictive factors. Building on these quantitative findings, semi-structured in-depth interviews were administered to target individuals identified through the analysis. Phenomenological methods were then utilized to elucidate core manifestations and maintenance factors of social avoidance. RESULTS:Among the 176 enrolled breast cancer patients, 138 completed all six follow-up assessments. Latent class growth analysis identified two distinct subgroups with significant differences in social avoidance trajectories: 'persistent high social avoidance' and 'persistent low social avoidance group'. Logistic regression revealed melancholic temperament as an independent risk factor for 'persistent high social avoidance group', while choleric temperament demonstrated protective effects. Phenomenological analysis of qualitative data systematically identified four core themes: (1) affective manifestations, (2) behavioural patterns, (3) psychological drivers, and (4) environmental determinants of social avoidance. CONCLUSION:This study revealed heterogeneous dynamic trajectories of social avoidance behaviour in breast cancer patients, with core manifestations encompassing both affective and behavioural dimensions, sustained by multiple factors of personality, psychology, and environment. IMPACT:This mixed-methods study systematically examined the developmental trajectories, core manifestations, and sustaining factors of social avoidance behaviour in breast cancer patients. The results provide robust evidence to inform precision screening for social avoidance risk, early prevention initiatives, and tailored intervention strategies in clinical nursing practice. REPORTING METHOD:Journal article reporting standards for mixed-methods research. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.

BACKGROUND:Suicide remains a significant global public health issue. Positive psychological interventions (PPIs) have been proposed as approaches that may contribute to suicide prevention, although their effectiveness remains unclear. METHODS:We systematically searched 11 databases from inception to January 2026. Pooled effect sizes were synthesized primarily using random-effects models. Subgroup, sensitivity, and meta-regression analyses were conducted to explore heterogeneity and test robustness. RESULTS:Sixteen studies were included in the systematic review, 12 in the meta-analysis. At post-treatment, PPIs were associated with reduced suicidal ideation (Hedges' g = -0.39, 95% CI: -0.74 to -0.04). Evidence for persistence at post-intervention assessment was limited because only three studies reported short-term post-intervention assessments (Hedges' g = -0.12, 95% CI: -0.40 to 0.17). Evidence on suicide attempts and death by suicide was sparse (n = 5), although one study reported superior outcomes with PPIs versus control (log-rank χ2 = 4.85, p = 0.028). In subgroup analyses, PPIs showed greater effects versus waitlist/blank controls (Hedges' g = -0.63, 95% CI: -0.86 to -0.40). Preliminary evidence suggests greater reductions in suicidal ideation with PPIs combined with pharmacotherapy than with pharmacotherapy alone (Hedges' g = -1.06, 95% CI: -1.70 to -0.42). Larger pooled effects were observed in low- and middle-income countries than in high-income countries (p = 0.029). Meta-regression showed control type (β = -0.414, p < 0.001) and total number of intervention sessions (β = -0.061, p = 0.043) explained 73.84% and 29.40% of between-study heterogeneity, respectively. CONCLUSION:PPIs may have supportive or adjunctive value for suicide-related psychological outcomes, but evidence for suicide attempts, death by suicide, and longer-term effects remains limited.

Objective This study examined the heterogeneity of illness perceptions in patients with lung cancer and evaluated the mediating role of self-transcendence in the relation between illness perception and demoralization. Methods A convenience sample of 477 patients with lung cancer was selected from three tertiary hospitals in Wuhan, China, between January and June 2024. Participants completed the Brief Illness Perception Questionnaire, Self-Transcendence Scale, and Demoralization Scale. Data were analyzed using Mplus 8.3 and SPSS 25.0. Results Three latent illness perception profiles were identified among patients with lung cancer: low (27.25%), moderate (40.04%), and high (32.71%). Mediation analyses revealed a partial mediation effect in the relation between illness perception and demoralization in the low versus moderate (SE = 1.56, 95% CI = 14.71, 20.86) and high versus low illness perception groups (SE = 1.71, 95% CI = 35.44, 42.71). Conclusions Patients with lung cancer exhibited heterogeneous illness perceptions, and self-transcendence partially mediated the relation between illness perception and demoralization. Promoting self-transcendence may help mitigate the negative impact of illness perceptions on demoralization. Clinical interventions aimed at reducing negative illness perceptions and enhancing self-transcendence should be prioritized in the care of patients with lung cancer.

Background:Given the suboptimal quality of end-of-life care among patients with cancer in China, promoting living wills is critical in this population. Living wills ensure that individuals can receive the medical care they desire during the terminal phase of an illness, maintain their dignity, and ultimately achieve a good death. However, current awareness and attitudes about living wills among Chinese patients with cancer remain unclear. We administered a questionnaire survey on living wills to patients with malignant tumors to assess their most important needs and increase understanding about living wills. Methods:In this cross-sectional study using convenience sampling, inpatients with malignant tumors in Wuhan completed our questionnaire between July 2020 and June 2021. We collected patients' sociodemographic characteristics and details regarding their knowledge and attitudes about living wills. Results:Among 213 patients with malignant tumors, 114 (53.52%) had heard of living wills; 125 (58.69%) expressed their willingness to sign the "Five Wishes" living will document after learning about it through the questionnaire. Patients with malignant tumors had a high level of desire for the following living will items: the lives of family and friends return to normal as soon as possible after their death, maintaining personal hygiene and dignity, and remaining pain-free. The knowledge level of patients with malignant tumors was related to their educational level (p < 0.05) and self-care ability (p < 0.05). Conclusions:Patients with malignant tumors have a high need for comfort, cleanliness, and pain relief in the terminal stages. Patients with a higher level of education and those with poorer self-care ability had greater knowledge and acceptance of living wills. Promotion can first be targeted toward more highly educated patients and can then be gradually expanded to other groups.

BACKGROUND:A growing body of literature has shown a higher risk of suicide in cancer patients compared with the general population. Early detection of factors related to suicide resilience in cancer patients could prevent loss of life.OBJECTIVE:The study aimed to investigate the serial-multiple mediation of self-care self-efficacy and meaning in life in the relationship between social support and suicide resilience among Chinese cancer patients.METHODS:A cross-sectional investigation of 287 cancer patients using a battery of self-reported questionnaires was performed. For preliminary analyses, descriptive, univariate, and Pearson correlation analyses were performed. Mediation analyses were tested using a serial-multiple mediation model (PROCESS model 6).RESULTS:Mediation analysis indicated the indirect effects of social support on suicide resilience mediated solely by either self-care self-efficacy (point estimate = 0.20; 95% confidence interval [CI], 0.12-0.30), or by meaning in life (point estimate = 0.06; 95% CI, 0.01-0.12), or by the multiple mediation of self-care self-efficacy to meaning in life (point estimate = 0.03; 95% CI, 0.01-0.06).CONCLUSIONS:The findings demonstrated the crucial direct or indirect effects of social support, self-care self-efficacy, and meaning in life on facilitating cancer patients' suicide resilience.IMPLICATIONS FOR PRACTICE:Oncology nurses, as 24-hour care providers for cancer patients, may interact with and be important sources for the psychosocial care of cancer patients at risk of suicide. Prevention and intervention efforts must be directed at assisting cancer patients, improving self-care self-efficacy, and finding meaning in life after a cancer diagnosis.

To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %-47.01 %) and 24.95 % (95 % CI 10.96 %-38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression.

Background Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer. Methods This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson’ s chi-square, Pearson’ s correlation, and hierarchical multiple linear regression analysis were performed. Results In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients’ suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169, p < 0.001), entrapment × suicide resilience (β = -0.148, p < 0.001), and entrapment × meaning in life (β = -0.107, p = 0.005). Conclusion These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients’ suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.

Objective:Several studies reported that adverse reactions to treatment, neuroticism, marital relations, and quality of life may impact the development of depression in cervical cancer patients treated with radiotherapy and/or chemotherapy, but the associations between them remained unclear. This study investigated the associations between these factors using moderated mediation models.Methods:Data were extracted from a survey involving cervical cancer patients treated with radiotherapy and/or chemotherapy at five tertiary hospitals in Hubei Province, China, from June to December 2022. The SPSS-PROCESS program was used to develop a moderated mediation model to study the roles of neuroticism, quality of life, and marital relations in the association between adverse reactions and depression in the study population.Results:A total of 802 cervical cancer patients treated with radiotherapy and/or chemotherapy (54.84 ± 9.68 years) were recruited. The prevalence of depression among these patients was 72.72%, with four symptom clusters of dizziness-ringing in the ears, digestive system-related symptoms, skin dryness and itching, and urinary frequency-urgency-leakage. Adverse reactions directly and positively affected the occurrence of depression, neuroticism mediated the association between adverse reactions and depression, while this association varied according to the quality of life and marital relations.Conclusion:Our findings suggest that depression is common among cervical cancer patients receiving radiotherapy and/or chemotherapy. Intervention targets for depression in cervical cancer patients should be precisely selected and targeted according to the quality of life and marital relations differences in patients, taking into account the cost of the intervention and the benefit to the patient.

目的 评估妇科肿瘤患者心理弹性水平,并探讨与家庭关怀度、应对方式、负性情绪之间的关系.方法 采用家庭关怀度指数量表、医学应对量表、抑郁-焦虑-压力量表、心理弹性量表对224例妇科肿瘤患者进行调查.结果 妇科肿瘤患者心理弹性总分(50.88±15.17)分.家庭关怀度、医学应对的面对、回避维度与心理弹性呈正相关,负性情绪与心理弹性呈负相关(均P＜0.05).结构方程模型显示,家庭关怀度对妇科肿瘤患者心理弹性的直接预测作用不显著;应对方式、负性情绪在患者家庭关怀度与心理弹性间起完全中介作用,并存在链式中介作用.家庭关怀度、屈服、回避、面对、负性情绪对心理弹性的总效应值分别为0.413、-0.356、0.200、0.186、-0.564.结论 家庭关怀度可以通过应对方式和负性情绪预测妇科肿瘤患者的心理弹性.医护人员可通过实施家庭干预为患者构筑家庭支持网络,指导患者采取合适的应对方式,科学管理负性情绪,以提高其心理弹性水平.

Digestive system cancers are important causes of morbidity and mortality worldwide. Cancer patients are more likely to commit suicide. The objective of this scoping review is to provide a comprehensive and updated sum-mary of the existing literature on suicide among patients with digestive system cancers to identify the incidence and risk factors relevant to suicide in these populations. The PRISMA-Scr (Preferred Reporting Items for Sys-tematic reviews and Meta-Analyses extension protocol for scoping reviews) protocol was used. The review was based on relevant articles published prior to January 2022 in databases of Web of Science and PubMed. The authors identified 21 records that met the criteria for inclusion. Among the 21 articles, 18 (n = 85.7%) reported suicide risk factors, 21 (n = 100%) evaluated the incidence of suicide and 16 (n = 76.2%) involved the variation in suicide rates. Only one study comprehensively reported that the suicide rate for this population was 32.8 per 100,000 years and the standardized mortality ratio (SMR) was 1.91. Most suicides occurred in patients with pan-creatic, esophageal, and gastric cancers. The factors associated with suicide in digestive system cancers included male gender, older age, the white race, single status, advanced stage of disease, and cancer metastasis. The most critical time for suicide was in the early post-diagnostic period. It is indispensable to identify suicide in these can-cer patients, especially those with high-risk factors. In the future, more prospective research may be needed to provide more reliable support and care to prevent suicide.

QUESTION:The incidence of self-injurious behavior in adolescents and young adults is on the rise. Seeking care in the emergency department after self-injurious behavior is one way they signal for help. The purpose of this systematic evaluation was to synthesize the best available qualitative research evidence on young people's experiences of emergency department visits following self-harm behaviors and their need for emergency medical services.STUDY SELECTION AND ANALYSIS:Eleven databases were retrieved with predefined search terms from database construction to February 4, 2022. Literature was screened according to inclusion and exclusion criteria and quality assessment.FINDINGS:Eleven studies yielded fifty-five findings that were summarized into eight categories and aggregated into three composite statements: (1) positive emergency department experience; (2) negative emergency department experience; and (3) desire for help.CONCLUSIONS:Young people with a history of self-injurious behavior have a mixed sense of experience in the emergency department. The sense of negative experience makes patients feel dissatisfied and disappointed with healthcare services, and positive experiences can help them seek further help. The emergency departments should improve the diagnosis and treatment model of self-injured adolescent patients to ensure that they receive effective and high-quality medical resources.

目的 探讨失效模式与效应分析在综合医院预防住院患者自杀管理中的应用效果.方法 成立跨专业的多学科小组,绘制预防住院患者自杀流程图,对预防患者自杀管理过程中可能出现的失效模式进行严重度、发生的可能性、探测的可能性评分,根据危害评分矩阵评估风险优先指数,针对风险优先指数＞125分的5项失效模式进行改进.比较实施前后的风险优先指数和住院患者自杀发生率.结果 实施后,住院患者自杀风险总体风险优先指数由(238.96±67.03)分下降为(73.48±6.05)分;住院患者自杀率由4.8/10万下降至2.1/10万.结论 基于失效模式与效应分析的风险管理可有效降低综合医院住院患者自杀风险优先指数,可早期识别和干预有自杀倾向的住院患者,保障患者安全.

目的 探讨肿瘤科护士自杀"守门人"培训效果,以提高护士预防患者自杀能力.方法 选择56名肿瘤科护士作为研究对象,成立培训小组,根据自杀"守门人"Living Works培训体系,参考自杀学和肿瘤心理学相关文献制订培训方案,并对其进行自杀预防基础知识概述、自杀风险评估、自杀干预训练、随访与事后成长4次培训.结果 培训后,肿瘤科护士的自我效能感、自杀警告信号意识总分及各维度评分显著高于培训前,且自杀预防知识正确率显著高于培训前(P＜0.05,P＜0.01).结论 自杀"守门人"培训有利于提升肿瘤科护士的自我效能感,增强识别自杀警告信号能力,并提高肿瘤科护士的自杀预防知识.

目的 了解我国抑郁症患者自杀意念发生率,为针对性干预提供参考.方法 检索PubMed、Embase、Web of Science、Co-chrane 图书馆、中国知网、万方数据知识服务平台、维普网,搜集建库至2021年10月发表的有关中国抑郁症患者自杀意念的文献.采用R4.0.2软件进行Meta分析.结果 纳入18篇文献,总样本量7 987例.我国抑郁症患者自杀意念发生率为48.18％(95％CI:38.96,57.39);亚组分析显示不同样本来源的抑郁症患者自杀意念发生率存在差异.结论 我国抑郁症患者自杀意念发生率较高,应予以重视,及早筛查,针对性干预,以防范抑郁症患者自杀.

The Brief Symptom Inventory-18 (BSI-18) is widely used to assess psychiatric distress but has not been verified in the Chinese population. From March to April 2019, 293 hospitalized cancer patients, aged 20–87, completed the cross-sectional survey with demographics questionnaire, BSI-18, and PHQ-9. We analyzed the single suicide-related item of PHQ-9 with the full score clinical outpoint for BSI-18 and PHQ-9 using SPSS 22.0 and R 2.15, including Pearson's χ2 test and ROC curve analyses. A Pearson's χ2 test was carried out to compare the three different methods with the gold screening criteria. The p-value was correspondingly to .006, .066, .838. When the PHQ-9 ≥ 10 criteria for the BSI-18, receiver operating characteristic analysis revealed that AUC values were 0.839, optimal cut-off points for both BSI-18 ≥ 50, the sensitivity of 85.8%, and 62.5%, respectively. The BSI-18 is suitable for a screening tool for psychological distress and could also be used in clinical settings for preliminary screening of hospitalized cancer patients.

非自杀性自伤是全球性重大公共卫生问题之一,本文对青少年非自杀性自伤流行病学现状、影响因素、评估方法及护理干预措施进行综述,旨在为青少年非自杀性自伤的相关研究及临床干预提供参考,降低青少年再自伤及自杀风险.

目的 了解中国住院癌症患者自杀意念发生率的总体情况,为住院癌症患者自杀行为预防及干预提供参考.方法 系统检索Web of Science、Cochrane Library、PubMed、EMbase、中国知网、中国生物医学文献服务系统、万方数据库、维普数据库自建库至2020年10月的相关文献,采用R4.0.2软件对数据进行Meta分析.结果 共纳入文献15篇,总样本量6328例.文献分析结果显示,我国住院癌症患者自杀意念发生率为21.6％[95％CI (15.9％,27.3％)].亚组分析结果显示,女性、使用多条目自杀测评工具、南方地区癌症患者自杀意念发生率较高.结论 我国住院癌症患者自杀意念发生率较高,综合医院应早期识别住院癌症患者的自杀意念,并及时对自杀意念及自杀行为采取预防及干预措施.

To summarize concept of psychological autopsy，research content of psychological autopsy，promotion of psychological autopsy on suicide theory，and development of research methods of psychological autopsy.It also compared psychological autopsy with other methods of suicide research.This paper summarized enlightenment of psychological autopsy research to suicide research of inpatients from following four aspects：clarifying research purpose，training researchers，mastering interview skills and integrating information efficiently.It was aimed at providing new ideas for suicide research methods of inpatients in China.

从帕金森病患者安宁疗护的现状、照护模式及影响因素等方面进行综述,提出促进帕金森病患者安宁疗护的策略,旨在为帕金森病患者安宁疗护的实施与发展提供参考.

在不同皮肤病中银屑病与自杀意念的关系最为紧密,本研究探索了银屑病与自杀风险的相关性,从影响因素、共病机制、评估及干预方案等方面进行探讨.银屑病严重影响患者的生活质量和社会功能,建议制定干预方案时关注患者的自杀风险并及时评估.