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    10 July 2026, Volume 61 Issue 13
    Special Planning—Nursing Informatization
    Development and usability evaluation of a generative artificial intelligence-based nursing evidence question-answering model
    RUAN Junyi, DAI Shangzhe, BAO Zhijie, WEI Zhongyu, XING Weijie
    2026, 61(13):  1733-1738.  DOI: 10.3761/j.issn.0254-1769.2026.13.001
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    Objective To construct a nursing evidence dataset,develop a generative artificial intelligence-based nursing evidence question-answering model,and evaluate its usability,with the aim of providing real-time decision support for clinical nurses. Methods Domestic and international nursing literature was comprehensively retrieved and classified according to the “5S” evidence pyramid. A training dataset was constructed,comprising more than 6,000 evidence summaries,over 15,000 guidelines and expert consensuses,and more than 500,000 systematic reviews. A domestically developed open-source large language model with strong performance was selected as the base model. Based on the training dataset,over 800,000 instruction fine-tuning sample pairs and more than 700,000 nursing evidence were generated. Supervised fine-tuning and retrieval-augmented generation were employed to train and develop a nursing evidence question-answering model. In September 2025,23 clinical nurses were recruited via convenience sampling to test the model. The usability of the model was evaluated using a self-developed model usability evaluation questionnaire. A lower score indicates better usability. Results All 23 nurses completed the model trial. In the model usability evaluation questionnaire,the scores were as follows:model quality dimension(1.99±0.85) points,information quality dimension(2.59±1.03) points,interface quality dimension(2.28±1.25) points,user satisfaction dimension(2.76±1.00) points,intention to use dimension(2.19±1.32) points,and net benefits dimension(2.03±0.78) points. Conclusion The overall usability of the nursing evidence question-answering model was good,and its use may help clinical nurses obtain evidence-based nursing information more efficiently. Future work could further expand the model’s functions and enrich the output information.

    Development and application of a voice-interactive intelligent alarm nursing management system for pediatric blood purification
    ZHANG Jiping, ZHAO Xiaoshuang, GUAN Ruixin, ZHANG Dan, HU Lili, WU Hanshu, JU Liting, XUE Yaokang, SUN Hairui
    2026, 61(13):  1739-1146.  DOI: 10.3761/j.issn.0254-1769.2026.13.002
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    Objective To develop a knowledge graph-based voice-interactive intelligent alarm management system for blood purification and evaluate its application in a pediatric intensive care unit(PICU),with the aim of enhancing the efficiency of healthcare professionals in recognizing and managing blood purification alarms and ensuring patient safety. Methods By integrating multi-source information and establishing a knowledge framework through structured expert meetings,a knowledge ontology was constructed. Knowledge extraction and fusion were completed via manual review,forming the entity framework of the blood purification alarm management knowledge graph. Based on this knowledge graph,a voice-interactive intelligent alarm management system for blood purification was developed,encompassing 3 functional modules:prevention,response,and optimization. Using convenience sampling,pediatric patients undergoing blood purification therapy in the PICU of a tertiary A hospital in Jilin Province from May 2024 to June 2025 were enrolled as study subjects. Patients admitted after system implementation(January-June 2025) constituted an experimental group and received system-assisted management;those admitted before system implementation(from May to November 2024) constituted a control group and received routine blood purification nursing protocols. Outcomes compared between groups included the incidence of unplanned circuit downtime,filter lifespan,alarm frequency,and alarm response time. System-level metrics included response accuracy and system usability. Additionally,the degree of clinical alarm fatigue among nurses was assessed before and after system implementation. Results Compared with the control group,the experimental group demonstrated significantly lower incidence of unplanned circuit downtime,alarm frequency,and alarm response time,along with significantly prolonged filter lifespan(all P<0.05). The system achieved a response accuracy rate of 90.15% and a System Usability Scale score of(80.30 ± 4.32)points. Nurses’ Clinical Alarm Fatigue Scale scores decreased significantly from 20.00(14.00,25.00) to 13.00(10.00,19.00) points following system implementation(P<0.001). Conclusion The knowledge graph-based voice-interactive intelligent alarm management system provides effective clinical decision support for blood purification alarm management in the PICU,facilitating rapid alarm response and standardized clinical practice. This translates to a reduced alarm burden,shortened alarm response time,and overall improvement in the quality of blood purification alarm management.

    Construction and validation of a communication system based on eye-tracking technology for orotracheally intubated patients in the ICU
    XU Nan, QIAO Jun, CHEN Fang, ZHOU Jing, JIANG Zhixia
    2026, 61(13):  1747-1753.  DOI: 10.3761/j.issn.0254-1769.2026.13.003
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    Objective Constructing a communication system for ICU orotracheally intubated patients based on eye-tracking technology and validating its clinical application effectiveness,to provide references for addressing the communication challenges in orotracheally intubated patients. Methods A convenience sampling method was used to select 68 orotracheally intubated patients admitted to the comprehensive ICU of a tertiary hospital in Guizhou Province from May to October 2024 as the study subjects. They were divided into an experimental group(34 cases) and a control group(34 cases) using a random number table method. The experimental group communicated using an eye-tracking technology-based communication system for ICU orotracheally intubated patients. This system features 6 functions:eye-tracking calibration,voice output,one-touch alarm,keyboard input,needs expression,and system settings,as well as 4 modules:communication interaction,somatic discomfort,scale assessment,and autonomous entertainment. The control group received conventional ICU communication strategies,including interpreting patients’ body language,writing with paper and pen,and using communication picture books. After the intervention,communication barriers,information transmission accuracy,and patient satisfaction were compared between the 2 groups. The experimental group also evaluated the system usability of the communication system. Results The experimental group included 32 cases finally,while the control group included 31 cases. After the intervention,the scores on the ease of communication scale were(15.28±5.43) points in the experimental group and (18.77 ± 4.75) points in the control group. The accuracy of information transmission was(95.39 ± 5.96)% in the experimental group and(74.05 ± 11.14)% in the control group. Patient satisfaction scores were(3.88 ± 0.79) points and(3.35 ± 0.80) points in the experimental and control groups,respectively. The experimental group demonstrated significantly better communication effectiveness,accuracy of information transmission,and patient satisfaction compared to the control group,with all differences being statistically significant(P<0.05). The experimental group’s score on the System Usability Scale was(79.75 ± 7.17) points. Conclusion The application of an eye-tracking based communication system in ICU orotracheally intubated patients demonstrates a certain degree of innovation and applicability. It can effectively alleviate patients’ communication barriers,thereby offering a novel approach to addressing the communication challenges and enhancing patient satisfaction.

    Construction and application of an intelligent management platform for continuous nursing care of breast cancer patients
    CHU Yanxiang, XIONG Huan, DENG Yan, LUO Shuiyu
    2026, 61(13):  1754-1761.  DOI: 10.3761/j.issn.0254-1769.2026.13.004
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    Objective To construct an intelligent management platform for continuous nursing care based on the needs of breast cancer patients and to evaluate its application effect,providing a reference for the improvement of the quality of continuous care services for breast cancer patients. Methods A platform research and development team was formed. Through interviews with the continuous care needs of 10 breast cancer patients,combined with literature review and experts group discussion results,the functional modules and service contents of the intelligent management platform were constructed. Using the convenient sampling method,a total of 156 breast cancer patients who had undergone surgery in the breast surgery department of a tertiary A hospital in Wuhan were selected as the application subjects. 78 postoperative breast cancer patients who were hospitalized from March to April 2025 were set as an experimental group,and continuous nursing services were implemented through the intelligent management platform. 78 postoperative breast cancer patients who were hospitalized from July to August 2024 were set as a control group,and the responsible nurses implemented the conventional continuous nursing service model. The intervention period lasts for 6 months. The Post-Study System Usability Questionnaire was adopted to evaluate the users’ experience of the platform. The differences in the occurrence of breast cancer symptom clusters and self-care ability were compared between the 2 groups after the intervention. Results 6 cases in the experimental group dropped out,and 9 cases in the control group were lost to follow-up,so 72 cases in the experimental group and 69 cases in the control group completed the study. The Post-Study System Usability Questionnaire scores of nurses and patients were >4 points. The incidence and severity of gastrointestinal symptom clusters,fatigue symptom clusters,and emotional symptom clusters in the experimental group were lower than those in the control group,and the difference was statistically significant(P<0.05). The scores of self-care ability in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05). Conclusion The application of the intelligent management platform can effectively enhance the self-care ability of breast cancer patients after discharge,reduce the incidence and severity of symptom clusters,and improve the quality of life of patients. The platform has good usability and good application.

    Application progress of digital health technology in home care of children with asthma
    LIU Peixin, XU Hongzhen
    2026, 61(13):  1762-1767.  DOI: 10.3761/j.issn.0254-1769.2026.13.005
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    Asthma is the most common chronic respiratory disease in children,and home care plays a key role in its long-term management. The application and development of digital health technologies have addressed the limitations of traditional home-based care. By capitalizing on strengths such as dynamic monitoring,prompt intervention,and remote guidance,these technologies significantly improve both disease awareness and management skills among affected families. This article provides an overview of digital health technologies and reviews their application forms,effectiveness,limitations,and future prospects in asthma home care,aiming to offer insights for further integration and continuous improvement of these technologies in the home care of children with asthma.

    Chatbots in supportive care for breast cancer patients:a scoping review
    ZHANG Shanshan, ZHANG Mengyao, LU Hanlin, ZHANG Zhihua, LIU Fengxia
    2026, 61(13):  1768-1775.  DOI: 10.3761/j.issn.0254-1769.2026.13.006
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    Objective To conduct a scoping review of the application of chatbots in the supportive care of patients with breast cancer,providing references for future research and clinical nursing practice. Methods A comprehensive literature search was conducted in PubMed,Embase,Web of Science,the Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and the China Biomedical Literature Database(SinoMed)from database inception to December 8,2025. Data from eligible studies were extracted and synthesized descriptively. Results A total of 11 studies were included. Among them,chatbots were mainly based on hybrid technology(n=6) and provided support to patients through text-only interaction(n=6). The intervention content primarily focused on 4 domains:informational support(n=7),psychological support and emotional regulation (n=3),symptom monitoring and management(n=3),and lifestyle guidance(n=4). Outcome measures primarily covered information level,physiological status,self-management,quality of life,as well as feasibility and user satisfaction. Conclusion Chatbots demonstrate promising potential in the supportive care of patients with breast cancer,particularly showing high feasibility in providing informational support. However,several challenges remain,including the lack of standardized intervention duration and substantial heterogeneity in outcome indicators and measurement instruments. Future studies should focus on higher-quality,more refined,and stage-specific research designs,and actively explore collaborative implementation models integrating chatbots with offline nursing services to better leverage their potential value.

    Standards
    Nursing guidelines for patients with severe ischemic stroke
    Internal Medicine Nursing Committee of Chinese Nursing Association (Writing Committee:CAO Wenya, CHANG Hong, JIN Jingfen, GONG Lichao, WANG Xuan, CAO Yongxin)
    2026, 61(13):  1776-1783.  DOI: 10.3761/j.issn.0254-1769.2026.13.007
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    Objective To develop the Nursing Guidelines for Patients with Severe Ischemic Stroke,aiming to provide a scientific basis for clinical nursing practice during the acute phase for patients with severe ischemic stroke,and to promote the standardization of nursing. Methods Strictly adhering to the development process for evidence-based nursing practice guidelines,a draft of the Nursing Guidelines for Patients with Severe Ischemic Stroke was constructed. The appraisal of guidelines for research & evaluation Ⅱ was used to conduct a comprehensive expert appraisal of the draft. The guidelines were subsequently revised based on the expert appraisal results and suggestions,culminating in the formation of the final formal guidelines. Results The recommendations of the guidelines cover 4 key areas:multidimensional monitoring care,multisystem functional support care,complication prevention and treatment care,and early rehabilitation care for severe ischemic stroke. Conclusion The Nursing Guidelines for Patients with Severe Ischemic Stroke is an evidence-based guideline formulated based on the best available evidence,clinical practical circumstances,and professional judgment. It can serve as a practical basis for scientific decision-making by clinical nursing staff involved in the acute-phase care of such patients.

    Expert consensus on self-management of radiation-induced skin injury in cancer patients
    Cancer Nursing Committee of Chinese Nursing Association, Integrated Radiotherapy Nursing Committee of Chinese Anti⁃Cancer Association (Writing Committee:CHEN Li, LUO Jue, ZHANG Xiaoju, LU Zhenqi, XIE Mingzhu, LU Yuhan)
    2026, 61(13):  1784-1791.  DOI: 10.3761/j.issn.0254-1769.2026.13.008
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    Objective This consensus aims to provide evidence-based guidance for clinical nurses in educating and supporting cancer patients to conduct scientific and effective self-management of radiation-induced skin injury (RISI). Methods The consensus was developed in strict accordance with the Standard Guideline Development Process of World Health Organization. Evidence was identified through literature retrieval,quality appraisal,and data extraction to formulate the initial draft. From July to October 2025,21 experts in clinical nursing,clinical medicine,and nursing management from oncology,radiotherapy,and wound/ostomy care participated in 2 rounds of Delphi consultation,and 15 experts attended an expert panel meeting to finalize the consensus. Results The effective response rates for the 2 rounds of expert consultation were both 100%. The experts’ authority coefficients were 0.922 and 0.924;the importance ratings were(4.54±0.34) and (4.62±0.39) points;the average coefficients of variation were 0.175 and 0.162;the Kendall’s W values were 0.174 and 0.168(all P<0.001). A total of 354 comments were collected across 2 rounds. Based on expert consultation and panel discussion,the content was revised,and the final consensus includes risk factor identification,self-assessment and active reporting,daily care,selection and application of dressings,pharmacological prevention,and commonly used management methods. Conclusion This consensus provides scientific evidence for nurses to guide cancer patients in the self-management of radiation-induced skin injury and lays a foundation for subsequent research.

    Specialist Nursing Practice and Research
    A mixed study on the influencing factors of medication safety participation in patients with chronic kidney disease
    HAN Wenjing, YANG Xinru, ZHANG Xuening, KONG Dong, ZHANG Jing
    2026, 61(13):  1792-1799.  DOI: 10.3761/j.issn.0254-1769.2026.13.009
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    Objective To investigate the current status and influencing factors of medication safety participation among patients with chronic kidney disease,and to provide a basis for healthcare professionals to develop intervention strategies. Methods A convergent mixed study was used. A questionnaire survey was conducted among 244 patients with chronic kidney disease,conveniently sampled at a nephrology of tertiary hospital in Jinan,Shandong Province,from June to December 2024. Multiple linear regression analysis was used to identify factors influencing medication safety participation. Concurrently,semi-structured interviews were conducted with 18 purposefully sampled patients based on an interview guide. Quantitative and qualitative findings were integrated using a joint display analysis. Results The quantitative results showed that the total score of medication safety participation in patients with chronic kidney disease was(71.45±21.54) points,and the main influencing factors included age,health literacy,social support,self-efficacy and depression(P<0.05). The qualitative study extracted 3 core themes,including lack of medication safety management knowledge and skills,coexistence of constraining and supporting factors,and fluctuating willingness to participate. The mixed-methods study revealed that patients’ participation in medication safety behaviors requires improvement,with influencing factors including individual characteristics,health literacy,self-efficacy,psychological status,level of social support,and accessibility of medical resources. Conclusion Targeted interventions should be developed based on individual differences and social support level to enhance patients’ medication knowledge and confidence,and to promote active participation.

    Nutritional status and influencing factors in patients with oral intake following esophagectomy
    MAO Wenwen, CHEN Chong, LIU Hanxue, LU Zhenqi
    2026, 61(13):  1800-1808.  DOI: 10.3761/j.issn.0254-1769.2026.13.010
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    Objective To assess the nutritional status of patients with oral intake following esophagectomy and to explore the influencing factors based on the health ecological model,so as to provide evidence for developing intervention strategies. Methods A convenience sampling method was used to recruit patients who had undergone radical esophagectomy and attended outpatient follow-up visits at a tertiary cancer hospital in Shanghai from December 2024 to September 2025. A total of 186 patients were enrolled. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment(PG-SGA),and factors influencing nutritional status were analyzed. Results A total of 181 valid questionnaires were collected. Among the participants,30 patients(16.57%) were classified as well nourished or suspected of malnutrition;53 patients(29.28%) had moderate malnutrition;98 patients(54.14%) had severe malnutrition. Multivariate analysis showed that age,postoperative time,type of dietary,eating frequency,caloric intake,physical activity level,and mental health status were significant factors influencing nutritional status in patients with oral intake following esophagectomy(P<0.05). Conclusion The incidence of moderate to severe malnutrition is high among patients with oral intake following esophagectomy,showing a phased distribution pattern. Age≥65 years,shorter postoperative duration,semi-liquid diet,low eating frequency,inadequate caloric intake,low physical activity,and the poorer mental health status are independent risk factors for malnutrition. Early identification of these risk factors and implementation of targeted nursing interventions are essential to reduce the risk of postoperative malnutrition.

    Body image distress in patients after modified radical mastectomy for breast cancer:a qualitative study
    ZHONG Liyi, YI Xiaolin, JIA Mingfang, ZHANG Jiaxiang, JIA Xinyan, LUO Yingxia
    2026, 61(13):  1809-1815.  DOI: 10.3761/j.issn.0254-1769.2026.13.011
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    Objective To understand the real-life experiences of body image distress in patients after modified radical mastectomy for breast cancer and provide a basis for developing multidimensional clinical intervention plans. Methods Purposive sampling was used to select 15 patients with body image distress after modified radical mastectomy for breast cancer from the Department of Breast and Thyroid Surgery at a tertiary Grade A hospital in Guangzhou between November 2025 and March 2026. Data were collected through semi-structured interviews and analyzed using directed content analysis. Results A total of 5 themes and 12 sub-themes were identified:sensory imbalance triggered by multiple bodily changes,emotional distress induced by impaired appearance and disease-related concerns,cognitive trade-offs and meaning reconstruction from a survival-priority perspective,behavioral adjustment dominated by defensive avoidance,relational burden aggravated by stigma and family responsibility. Conclusion Body image distress in patients after modified radical mastectomy for breast cancer involves complex experiences,including sensory imbalance,emotional distress,cognitive trade-offs,limited behavioral adjustment,and relational burden. Healthcare professionals should pay greater attention to patients’ body image distress and develop multidimensional intervention strategies to promote gradual acceptance of bodily changes,alleviate body image distress.

    Multidisciplinary Collaborative Nursing Research
    Latent class analysis of food addiction among patients with overweight or obesity and its relationship with weight regain rate
    WANG Liping, WEI Huiyan, SHEN Funü, WU Mizhi, XIE Linyan, WANG Mengmeng, SHEN Lihua
    2026, 61(13):  1816-1822.  DOI: 10.3761/j.issn.0254-1769.2026.13.012
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    Objective To investigate latent classes of food addiction in patients with overweight or obesity,and analyze the relationship between different latent classes and weight regain rate,so as to provide references for targeted interventions. Methods A convenience sampling method was used to enroll 380 overweight or obese patients with weight regain from the weight management department of a tertiary general hospital in Hangzhou between April and August 2025. Data were collected using the general data questionnaire and the Food Addiction Scale. The latent class analysis was performed to extract potential categories of food addiction. Generalized linear model analysis was conducted with general data and potential categories as independent variables and weight regain rate as dependent variable. Results A total of 368 overweight or obese patients with weight regain completed the survey. Their food addiction could be divided into 2 latent classes:a high symptom-low social awareness group (76.90%) and a low emotional-high distraction risk group(23.10%). Generalized linear model analysis revealed that BMI,diet control,exercise control and food addiction types were the significant influencing factors(P<0.05). Conclusion There was group heterogeneity in overweight or obese patients with weight regain. Clinicians should provide targeted intervention according to the latent classes of patients’ food addiction,so as to promote long-term maintenance of weight management.

    Low-copper diet adherence in patients with Wilson’s disease:a qualitative study and nursing implications
    ZHU Yihang, ZHAN Tingting, HAO Wenjie, TU Wenjie, SHI Jinrui, ZHANG Xingxing
    2026, 61(13):  1823-1828.  DOI: 10.3761/j.issn.0254-1769.2026.13.013
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    Objective To explore the thoughts and needs of low-copper diet adherence among patients with Wilson’s disease based on the Knowledge-Attitudes-Practice theory,so as to provide a reference for developing targeted interventions. Methods A phenomenological qualitative research approach was adopted. Semi-structured interviews were conducted with 15 Wilson’s disease patients from the Department of Neurology of a tertiary hospital in Anhui Province between June and September 2025. Data were analyzed using Colaizzi’s seven-step analysis method. Results A total of 3 themes and 9 sub-themes were identified. The knowledge dimension included awareness of disease and diet(insufficient awareness of disease and treatment necessity,limited sources and judgment of low copper diet knowledge). The attitudes dimension reflected dynamic interrelations among attitude,motivation,and emotion(diverse coexisting attitudes,multiple motivations for dietary management,poor emotional experience and psychological adjustment,low self-efficacy and confidence). The behavior dimension encompassed practices and challenges in dietary management(weak personal adherence to dietary practices,family support and lifestyle adjust-ments,structural contradictions in the practice of low-copper diet adherence). Conclusion Adherence to a low-copper diet in patients with Wilson’s disease is jointly influenced by insufficient systematic knowledge,fluctuating beliefs,and difficulties in behavioral execution. A tri-dimensional intervention model of cognitive education,belief reinforcement,and behavioral support is suggested to formulate. Systematic dietary education and enhanced family and social support should be implemented to improve patients’ long-term adherence to a low-copper diet.

    Human Resource Management and Career Development
    Study on the current status and factors influencing areas of worklife among lymphedema therapists
    GUAN Yinyin, JU Hui, LIU Gaoming
    2026, 61(13):  1829-1836.  DOI: 10.3761/j.issn.0254-1769.2026.13.014
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    Objective To investigate the current status of areas of worklife among lymphedema therapists and analyze its influencing factors,so as to provide evidence for optimizing the management of specialized nursing human resources. Methods A cross-sectional study was conducted using convenience sampling from May to August 2025. A total of 205 lymphedema therapists from 18 provinces(autonomous regions,and municipalities directly under the central government) were surveyed using a general information questionnaire,the Areas of Worklife Scale,and the Specialty Nurse Work Engagement Scale. Univariate analysis,Pearson correlation analysis and multiple linear regression analysis were performed to identify factors influencing areas of worklife among lymphedema therapists. Results A total of 182 valid questionnaires were recovered,yielding an effective response rate of 88.78%. The total score of areas of worklife among lymphedema therapists was (99.71±12.44) points,with an average item score of(3.56±0.44) points. Among the dimensions,team atmosphere scored the highest score (4.02±0.54) points,while workload scored the lowest(3.12±0.74) points. Multiple linear regression analysis showed that scores of work attitude,work recognition,and work focus and enthusiasm were influencing factors for areas of worklife among lymphedema therapists(P<0.05),explaining 48.7% of the variance. Conclusion Areas of worklife among lymphedema therapists are at a moderate level,and is influenced by multiple factors including work attitude,work recognition,and work focus and enthusiasm. Nursing managers should build a diversified support system,emphasize the cultivation of professional attitudes,optimize work processes,and establish positive feedback mechanisms to improve the areas of worklife of lymphedema therapists and promote the stable development of the specialized nursing team.

    A qualitative study on the dilemmas in nursing assistant training
    MING Aihong, LONG Xiuhong, LIANG Zhijin, LI Li, YE Hua, LUO Qing, ZHAO Jianing, YANG Xiaoyi, LIU Nixing
    2026, 61(13):  1837-1844.  DOI: 10.3761/j.issn.0254-1769.2026.13.015
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    Objective To identify the dilemmas in the nursing assistant training,so as to provide evidence for optimizing training strategies and improving training quality. Methods From April to September 2024,a purposive sampling method was adopted to select 14 nursing assistants,11 trainers,and 9 administrators involved in nursing assistant training in Nanning as research subjects. Face-to-face semi-structured interviews were conducted,and the data were analyzed using the 7-step Colaizzi method. Results A total of 5 themes and 13 sub-themes were extracted:cognitive bias(low acceptance of theoretical knowledge,insufficient understanding of humanistic care),weak self-efficacy(lack of interaction during training,anxiety for examination),multiple role conflicts(difficulty balancing time and energy,challenges in training coordination and organization),limited training resources and conditions(lack of independent learning channels,delayed teaching supervision approaches,inadequate adaptation of specialized training),and low social recognition(uncertain expected value of training,limited effect of incentive mechanisms,inefficient utilization of training resources,low recognition of training outcomes). Conclusion Nursing assistant training is confronted with multiple dilemmas. It is recommended to optimize the training by constructing context-adapted training programs,innovating teaching models,and establishing mechanisms coordinated with management and linked to incentives.

    Rare Disease and Critical Care
    Emergency nursing for suture breakage after percutaneous external fixation of a high tracheal stent:a case report
    HU Juanjuan, ZHOU Niya, LING Yinlou, XU Shanxiang
    2026, 61(13):  1845-1848.  DOI: 10.3761/j.issn.0254-1769.2026.13.016
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    To summarize the emergency nursing care of a patient with tracheoesophageal fistula who developed stent migration due to suture breakage after percutaneous external fixation of a high tracheal stent. The key nursing interventions included performing combined monitoring of multiple indicators for early identification of stent migration,promptly initiating an emergency response plan for stent migration to manage the risk of airway obstruction in a difficult airway,implementing protective preventive care after secondary external fixation to reduce the risk,and optimizing nutritional support in coordination with glycemic management to promote fistula healing. After these interventions,the patient was successfully discharged after 42 days of hospitalization,and the Y-shaped customized stent was successfully replaced after 2 weeks.

    Nursing care of a patient with pituitary stalk interruption syndrome and cirrhosis undergoing liver transplantation
    HUANG Fudong, WAN Xiaofei, ZHOU Xin, YE Shaojun, PAN Li
    2026, 61(13):  1849-1853.  DOI: 10.3761/j.issn.0254-1769.2026.13.017
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    This article summarizes the perioperative nursing experience of a patient with pituitary stalk interruption syndrome(PSIS) and decompensated cirrhosis who underwent allogeneic liver transplantation. The key nursing strategies included:establishing and implementing a cross-disciplinary dynamic hormone monitoring and stepwise sequential tapering regimen,with emphasis on preventing adrenal crisis;adopting a goal-directed fluid management strategy combined with quantitative titration of posterior pituitary hormone(vasopressin) to maintain water-electrolyte balance;establishing an integrated monitoring system for adverse drug effects to accurately differentiate between rejection and drug-related complications;and implementing a metabolic profile-based nutritional intervention to effectively correct refractory hypoalbuminemia. As a result,the patient did not develop severe complications such as adrenal crisis after liver transplantation and was discharged in stable condition on postoperative day 18. During 8 months of follow-up,the patient’s liver function and hormone levels remained stable.

    Review
    The application of behavioral economics-based exercise behavior intervention strategies in older adults:a scoping review
    REN Yuan, HU Huixiu, ZHAO Yajie, XIE Lanying, FU Xuwen, WU Jinling, HAO Yuqing, SUN Chao
    2026, 61(13):  1854-1859.  DOI: 10.3761/j.issn.0254-1769.2026.13.018
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    Objective To conduct a scoping review of studies applying behavioral economics principles to exercise behavior in older adults,thereby providing a reference for future research and clinical practice. Methods Following the methodological framework for scoping reviews,literature searches were performed in PubMed,Web of Science,Embase,ProQuest,CINAHL,CNKI,VIP,and Wanfang to collect studies on exercise behavior interventions for older adults based on behavioral economics principles. The search period spanned from database inception to September 2025. An integrative analysis was conducted on the included literature. Results A total of 11 studies published between 2013 and 2024 were included. The behavioral economics principles most frequently applied in exercise interventions for older adults were loss aversion,prospect theory,and the fresh start effect. Common intervention strategies included financial incentives,gamification,and peer encouragement. The reviewed studies reported outcome measures such as daily step count,exercise duration,and exercise adherence among older adults. Conclusion Exercise intervention strategies based on behavioral economics principles are feasible. Future work should integrate these findings with China’s specific context to develop intervention programs adapted to the local cultural environment.

    Application progress of knowledge graphs in health education for patients with chronic diseases
    MI Zishuo, SONG Yulei, YIN Tingting, YAN Jingjing, WANG Yan, XU Guihua, BAI Yamei
    2026, 61(13):  1860-1865.  DOI: 10.3761/j.issn.0254-1769.2026.13.019
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    Health education is a key component of improving health literacy and self-management efficacy in patients with chronic diseases. However,existing health education resources often suffer from fragmentation and inconsistent evidential quality,making it difficult to meet patients’ needs for continuous and individualized education. As a structured semantic network,a knowledge graph can extract,integrate,and represent multisource heterogeneous health education information,providing a new approach for the digital and intelligent development of health education for patients with chronic diseases. This review summarizes the concept of knowledge graphs and their application forms,application scenarios,and application effects in health education for patients with chronic diseases,analyzes the current challenges,and proposes corresponding strategies,with a view to providing a reference for the development of digital health education systems for chronic diseases and for clinical nursing practice.

    Concept analysis of nutritional frailty and implications for nursing
    LI Jun, YANG Zhongfang, TIAN Li
    2026, 61(13):  1866-1872.  DOI: 10.3761/j.issn.0254-1769.2026.13.020
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    Objective To analyze and clarify the concept of nutritional frailty and to provide a reference for the assessment and nursing interventions of nutritional frailty. Methods A systematic search was conducted in CNKI,Wanfang Database,VIP Database,China Biomedical Literature Database,PubMed,Embase,Web of Science,and CI-NAHL from inception to October 2025. Walker and Avant’s method was used to conduct a concept analysis. Results A total of 62 articles were included. Nutritional frailty comprised 3 defining attributes:nutritional abnormalities,impaired muscle function,and physical functional decline. Antecedents included physiological factors,disease-related factors,nutritional factors,psychological and functional factors,and social and environmental factors. Consequences included an increased risk of adverse health outcomes,cognitive and psychological decline,and a greater socioeconomic burden. Conclusion This concept analysis elucidated the defining attributes,antecedents,and consequences of nutritional frailty. Future studies should develop and validate assessment tools applicable to different care scenarios on the basis of clear concepts,and explore comprehensive intervention plans to improve individuals’ health outcomes and quality of life.