Chinese Journal of Nursing

The application evaluation of medication discrepancy management during the hospital-home transitional period in geriatric patients with multimorbidity

LIU Yingying, CHANG Lu, WANG Juanli, SU Mengmeng

2026, 61(20): 2741-2747. DOI: 10.3761/j.issn.0254-1769.2026.20.001

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Objective To investigate the application effect of medication discrepancy management during the hospital-home transitional period in geriatric patients with multimorbidity，and to provide a reference for clinical nursing practice. Methods A total of 150 cases of patients with multimorbidity who were admitted to a tertiary grade A hospital in Zhengzhou City between January 2023 and December 2024 were selected as research subjects. According to the admission time，75 patients from December 2023 and December 2024 were included in an experimental group，and 75 patients from January 2023 to November 2023 were included in a control group. The experimental group received medication discrepancy management，while the control group followed standard discharge guidance protocols. The intervention period spanned from admission to 8 weeks post-discharge. After the intervention，the incidence rate of medication discrepancy events，medication literacy，medication compliance，medication self-management capabilities，medication self-efficacy were compared between the 2 groups. Results No sample loss occurred during the study period. Following the intervention，the incidence of medication discrepancy in the experimental group（10.67%） was lower than that in the control group（32.00%），with a statistically significant difference between the 2 groups（P<0.05）. The experimental group demonstrated superior medication literacy，medication compliance，medication self-management capability，and medication efficacy compared to the control group，with statistically significant differences（P<0.05）. Conclusion The hospital-home transitional medication discrepancy intervention can effectively reduce the incidence of medication discrepancy among aged patients with multimorbidity，improve patients’ medication compliance and medication literacy，and enhance their ability to self-manage medications and the self-efficacy of rational medication.

Construction and application of a progressive resistance training program for elderly patients with hip fracture complicated with sarcopenia

WANG Jun, JIANG Min

2026, 61(20): 2748-2756. DOI: 10.3761/j.issn.0254-1769.2026.20.002

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Objective To formulate a progressive resistance training（PRT） protocol for elderly patients with hip fractures complicated by sarcopenia，and to evaluate its effectiveness and feasibility，so as to provide clinical evidence for postoperative functional rehabilitation of such patients. Methods Based on the Health Action Process Approach（HAPA） theory，a progressive resistance training program was formulated through literature review and expert panel meetings. Convenience sampling was used to recruit 80 elderly patients with hip fracture complicated by sarcopenia who underwent unilateral hip arthroplasty from July to December 2024 in the Department of Geriatrics，a tertiary Grade A hospital in Yunnan Province. All patients were randomly divided into an intervention group（odd numbers） and a control group（even numbers） using a random number table，with 40 cases in each group. The intervention group received 12-week progressive resistance training combined with routine orthopedic rehabilitation nursing，while the control group received routine orthopedic rehabilitation nursing alone. The 2 groups were compared in terms of maximum grip strength，affected lower limb muscle strength，Skeletal Muscle Mass Index（SMI），Timed Up and Go Test（TUGT） time，Harris Hip Score and rehabilitation self-efficacy score at 7 days，1 month and 3 months after surgery. Results Ultimately，38 cases in the intervention group and 39 cases in the control group completed the study. After the intervention，significant time effects and interaction effects were observed in maximum grip strength，SMI，TUGT time，Harris Hip Score，and rehabilitation self-efficacy score in both groups（P<0.001）. For affected lower limb muscle strength，significant time effects and inter-group effects were found（P<0.05）. Simple effect analysis indicated that at 3 months postoperatively，the intervention group exhibited higher levels of maximum grip strength，SMI，rehabilitation self-efficacy score，Harris Hip Score，and affected lower limb muscle strength，as well as shorter TUGT time compared with the control group，and all differences were statistically significant（P<0.001）. Conclusion The progressive resistance training protocol established in this study can effectively improve muscle mass and muscle strength，promote the functional recovery of the hip joint and lower limb functional recovery，and enhance rehabilitation self-efficacy and activities of daily lining in elderly patients with hip fracture complicated by sarcopenia.

A qualitative study on health information translation dilemmas in elderly patients with cardiometabolic multimorbidity

XIAO Hanyu, CHEN Weijing, YU Renyue, LI Jialin, MU Ruimin, FENG Chenchen, JIN Jinhua

2026, 61(20): 2757-2764. DOI: 10.3761/j.issn.0254-1769.2026.20.003

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Objective To explore the dilemmas and causes of health information translation in elderly patients with cardiometabolic comorbidity，and to provide a basis for expanding health information behavior intervention programs. Methods Using a descriptive qualitative research method，18 elderly patients with cardiometabolic multimorbidity were selected by purposive sampling from a tertiary Grade A hospital in Zhejiang Province between February and April 2026 for semi-structured interviews. Data were analyzed using directed content analysis based on the Health Action Process Approach theory. Results A total of 3 themes and 11 sub-themes were extracted.Pre-intention stage：barriers to the generation of translation motivation（blunted perception of disease risk，ambiguous positive outcome expectancy，inflated empirical self-efficacy，diminished action self-efficacy after quality-of-life trade-offs）. Intention stage：barriers to the formulation of translation action plan（impaired formulation of action plan caused by conflicting information，deviation of action plan caused by information misinterpretation，accelerated action termination caused by coping plan deficit）.Action/maintenance stage：action disruption gap after translation（lack of immediate positive feedback，management inertia from behavioral fatigue，conflict between social network and behavior maintenance，differentiation in self-efficacy recovery after disease progression）. Conclusion Elderly patients with cardiometabolic multimorbidity face phased dilemmas during the process of health information translation. Healthcare providers should implement stratified intervention strategies targeting the specific dilemmas and core barriers encountered by these patients，so as to enhance their health information behavior efficacy，improve their self-management ability，and ultimately achieve better health outcomes.

Correlation analysis between intrinsic capacity and self-management behaviors in older adults with diabetes and multimorbidity and its nursing implications

CHEN Ke, HAN Dianli, GU Haiyue, LIU Yancun, WANG Jingyu, YANG Nuo, YAO Ying

2026, 61(20): 2765-2772. DOI: 10.3761/j.issn.0254-1769.2026.20.004

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Objective To examine the status of intrinsic capacity and self-management behaviors in older adults with diabetes and multimorbidity，to explore the relationship between intrinsic capacity and self-management behaviors and their internal mechanisms，and to provide a reference for developing precise interventions targeting intrinsic capacity and self-management behaviors for older adults with diabetes and multimorbidity. Methods A convenience sampling method was used to select 425 older patients with diabetes and comorbidities from 2 tertiary hospitals and 1 community health service center in Tianjin from November 2025 to January 2026. Data was collected using a general information questionnaire，an intrinsic capacity assessment tool，and the Diabetes Self-Management Behavior Scale. Hierarchical regression analysis was performed to examine the influence of intrinsic capacity on self-management behaviors. Network analysis was conducted using R version 4.5.2 to construct a network model，identify core nodes，and evaluate the stability of the network structure. Results A total of 407 valid questionnaires were recovered，with an effective response rate of 95.76%. The mean intrinsic capacity score of older adults with diabetes and multimorbidity was（3.19±1.65） points，and the mean self-management behavior score was（34.11±12.58） points. Hierarchical linear regression analysis showed that intrinsic capacity independently explained 34.2% of the total variance in self-management behaviors in elderly patients with diabetes multimorbidity. Network analysis revealed that the strongest positive correlation was between motor function and exercise behavior（r=0.486），while the strongest negative correlation was between psychological function and medication adherence behavior（r=-0.209）. Motor function had the highest strength centrality in the network（strength centrality=1.328）. Conclusion Both intrinsic capacity and self-management behaviors in older adults with diabetes and multimorbidity are at a low-to-moderate level. Intrinsic capacity and self-management behaviors are interrelated. Motor function is a key node for interventions targeting both intrinsic capacity and self-management behaviors. It is recommended that nursing professionals prioritize intervention strategies designed to improve motor function，thereby enhancing the overall quality of life in older adults with diabetes and multimorbidity.

Challenges and coping strategies for the nursing care of patients with multimorbidity in the context of population ageing

YANG Lei, LI Chunyan

2026, 61(20): 2773-2778. DOI: 10.3761/j.issn.0254-1769.2026.20.005

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With the accelerating ageing of China’s population and the growing burden of chronic diseases，multimorbidity has become a common challenge for population health and nursing care. Traditional disease-specific and specialty-centred nursing models are increasingly inadequate for meeting the complex，continuous，and integrated care needs of patients with multimorbidity. This paper analyzes the challenges of multimorbidity nursing care from 3 dimensions—“disease-patient-system”—and proposes recommendations such as advancing integrated care，enhancing holistic management of patients with multimorbidity and reducing treatment burdens；reinforcing health goal-oriented patient care to establish a personalized nursing and self-management loop；improving continuous care，data standards，and talent development systems to strengthen the support framework for multimorbidity nursing care. These measures aim to deepen multimorbidity nursing research，promote the transformation of nursing models，and build a multimorbidity nursing theory and service system tailored to China’s national conditions.

Construction and effectiveness evaluation of a health education program for parents of preterm infants in NICU family rooms

YU Yaqi, XIONG Xiaoju, DING Lingli, YU Genzhen, XIAO Yu, GUO Yue, GUO Wenyu

2026, 61(20): 2779-2786. DOI: 10.3761/j.issn.0254-1769.2026.20.006

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Objective To construct and preliminarily validate a health education program for parents of preterm infants in family rooms of the neonatal intensive care unit based on the Rowntree model，aiming to provide a reference for clinical nursing practice. Methods A convenience sampling method was employed to select 98 preterm infants and their parents admitted to the family rooms between January and August 2025. The parental health education program based on the Rowntree model was implemented，encompassing 4 core components including goal setting，process design，outcome evaluation，and continuous improvement. The intervention covered 8 dimensions including basic care，feeding and nutrition，developmental support，symptom observation，first aid knowledge，safety precautions，special care，and post-discharge support. It was delivered through group lectures，bedside guidance，and online learning. Parenting competency and anxiety were compared before and after the intervention. Additionally，parental satisfaction，preterm growth indicators at 0，1，and 3 months corrected age，follow-up rates，and readmission rates within 1 and 3 months post-discharge were evaluated. Results A total of 98 participants completed the study. Post-intervention，the parenting competency scores significantly increased to 71.50（66.75，78.00） from a pre-intervention score of 38.00（31.00，49.25）（P<0.001）. The anxiety score significantly decreased to 1.00（0，2.00） from 5.00（8.00，12.00）（P<0.001）. The parental satisfaction rate was 100%. At 3 months corrected age，the preterm infants’ growth data all reached the P₂₅-P₅₀ levels of the standard curve，with a follow-up rate of 42.86%. The readmission rate within 3 months post-discharge was 3.06%. Conclusion The health education program for parents of preterm infants in family rooms of the neonatal intensive care unit was effective in improving parental caregiving competence, alleviating parental anxiety, and reducing the risk of rehospitalization in preterm infants. The program demonstrated scientific rigor, feasibility, and good acceptability among parents.

Evidence-based practice for enteral nutrition-related abdominal distension and diarrhea in postoperative digestive system tumor patients

ZHENG Meihua, ZHU Rui, XIE Baoyuan, CHEN Feiyan, HUANG Guiyun, WANG Luzhen, LIU Yating, XU Chunhao, YANG Ruixiang

2026, 61(20): 2787-2794. DOI: 10.3761/j.issn.0254-1769.2026.20.007

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Objective To develop an evidence-based practice protocol for enteral nutrition-related abdominal distension and diarrhea in postoperative patients with digestive system tumors，and to evaluate its application effect on clinical nursing. Methods The best evidence on the prevention and management of enteral nutrition-related abdominal distension and diarrhea in postoperative patients with digestive system neoplasms was systematically searched and critically appraised. A protocol was developed by integrating the synthesized evidence with clinical context. The study was conducted from July 2024 to February 2025 in the gastrointestinal surgery，thoracic surgery，and hepatobiliary and pancreatic surgery departments of a tertiary grade A hospital in Fujian Province. The baseline group comprised 59 patients admitted between June 1 and September 30，2024，while the evidence-based group comprised 59 patients admitted between October 1，2024 and February 28，2025. Differences in the incidence of abdominal distension and diarrhea in patients，the compliance rate of review indicators，and the pass rate of knowledge assessment among medical staff were compared before and after protocol implementation. Results A total of 15 pieces of best evidence were included，based on which 18 audit indicators were developed. After evidence-based practice，the incidence of postoperative enteral nutrition-related abdominal distension decreased from 32.20% to 11.86%（P=0.008）. The compliance of healthcare professionals with 9 audit indicators was significantly improved（P<0.05），including nutritional risk screening，diarrhea/abdominal distension assessment，stepwise rate advancement，probiotic supplementation，intermittent bolus feeding，gum chewing，and prokinetic agent use. The knowledge qualification rate increased from 67.00% to 92.70%，with a statistically significant difference（P<0.001）. Conclusion The evidence-based protocol can effectively improve medical staff compliance and knowledge，and significantly reduce the incidence of enteral nutrition-related abdominal distension in postoperative patients with digestive system tumors.

A qualitative study on the rehabilitation training experience of adolescents with idiopathic scoliosis

WU Xia, XU Zhen, DANG Na, ZHU Chunyan

2026, 61(20): 2795-2801. DOI: 10.3761/j.issn.0254-1769.2026.20.008

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Objective To gain an in-depth understanding of the rehabilitation training experience of patients with adolescent idiopathic scoliosis，and to provide a basis for optimizing rehabilitation programs and improving compliance. Methods Using purposive sampling，semi-structured interviews were conducted with 12 patients with adolescent idiopathic scoliosis who attended a tertiary hospital in Tai’an from July to September 2025. The interview data were organized and analyzed using Colaizzi’s 7-step analysis method. Results A total of 5 core themes were extracted：decision-making for initiating training driven by multiple factors；dual physical and psychological adaptation and transformation；multiple obstacles to training progression；positive changes brought by rehabilitation training；demands for multi-stakeholder collaborative support. Conclusion The rehabilitation training experience of adolescents with idiopathic scoliosis encompasses multi-dimensional characteristics including decision-making initiation，physical and psychological adaptation，practical dilemmas，positive changes and diverse needs. Multi-level collaborative interventions involving patients，families，medical institutions，schools and society are required to enhance training adherence and rehabilitation benefits

Study on the current status and characteristic analysis of social frailty among patients with inflammatory bowel disease

YANG Yue, YANG Congyan, DONG Min, SHI Feifei, LI Yanru, MA Rongrong, KE Xiquan

2026, 61(20): 2802-2808. DOI: 10.3761/j.issn.0254-1769.2026.20.009

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Objective To investigate the prevalence of social frailty among patients with inflammatory bowel disease（IBD） and identify key characteristics associated with social frailty，to provide evidence for early recognition and targeted intervention for social frailty in this population. Methods Using convenience sampling，260 patients with IBD who were hospitalized in the Department of Gastroenterology at a tertiary A hospital in Bengbu City，Anhui Province，between June 1，2025 and April 10，2026 were selected as study subjects. General Information Questionnaire，Social Frailty Index，Family APGAR Index Questionnaire，eHealth Literacy Scale，Inflammatory Bowel Disease Psychosocial Adaptation Questionnaire，Inflammatory Bowel Disease Disk，and Medical Coping Modes Questionnaire were used for investigation. A random forest model was established based on repeated stratified nested five-fold cross-validation. Within the outer training folds，univariate screening，recursive feature elimination，and hyperparameter tuning were conducted to determine the optimal decision threshold. The outer test folds were used to evaluate model performance，and a Shapley additive explanation（SHAP） analysis was also performed to identify the critical features associated with social frailty. Results A total of 257 patients were included in the study，with a prevalence of social frailty of 17.51% and pre-social frailty of 29.96%. The area under the receiver-operating characteristic curve （ROC-AUC） of the random forest model was 0.991（95%CI：0.982-0.997），and the area under the precision-recall curve（PR-AUC） was 0.960（95%CI：0.920-0.987），and the F1 score was 0.888. The SHAP factors were ranked in order of importance as follows：disease burden（0.078），level of family care（0.076），number of comorbid chronic conditions（0.074），e-health literacy（0.062）and psychological adaptation（0.053）. Conclusion Social frailty is highly prevalent in patients with IBD. Disease burden，level of family care，number of comorbid chronic conditions，e-health literacy and psychosocial adaptation are vital correlates of social frailty in this population. The findings of this study can serve as a reliable basis for recognizing high risk and early targeted screening for social frailty among patients with IBD.

Design and usability evaluation of a cooking serious game for older adults with subjective cognitive decline in residential care facilities

XU Dan, WEN Xi, TIAN Fengmei, LI Huiling

2026, 61(20): 2809-2815. DOI: 10.3761/j.issn.0254-1769.2026.20.010

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Objective To develop a cooking serious game for older adults with subjective cognitive decline （SCD） in residential care facilities and evaluate its preliminary usability and user experience，thereby providing a prototype for subsequent cognitive training intervention studies. Methods Guided by flow theory，the content of the cooking serious game including 4 training phase was developed through semi-structured interviews，literature analysis，brainstorming，and an expert working group meeting. Purposive sampling was used to recruit 30 older adults with SCD from 2 residential care facilities in Suzhou，China，between April and May 2026 for usability testing. Usability was assessed using task completion rate，task completion time，numbers of errors and prompts，the System Usability Scale（SUS），and a satisfaction questionnaire. User experience was further explored through semi-structured interviews. Results The overall task completion rate was 92.50%. The total time to complete the 4 tasks was 46.29（39.71，49.90） min. The total numbers of errors and prompts were 3（2，4） and 4（3，6），respectively. The mean SUS score was（81.67±10.79） points，and the satisfaction rate was 89.86%. The semi-structured interviews yielded 3 main themes：enhancing engagement through familiar cooking scenarios，task comprehension and operational difficulties under multisensory prompts，and the experience of progressive challenges alongside individualized needs. Conclusion The cooking serious game developed in this study demonstrated good preliminary usability among older adults with SCD in residential care facilities. Future studies should refine the game prototype and conduct larger-sample，longer-term intervention studies to further evaluate its effectiveness for cognitive training.

Development and validity test of Knowledge，Attitude and Practice Scale for home-based pulmonary rehabilitation caregivers of patients with chronic obstructive pulmonary disease

GUO Lingmin, FENG Li, CAI Ji, HUANG Hui

2026, 61(20): 2816-2823. DOI: 10.3761/j.issn.0254-1769.2026.20.011

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Objective To develop a Knowledge，Attitude，and Practice（KAP） scale for home-based pulmonary rehabilitation caregivers of patients with chronic obstructive pulmonary disease（COPD），and to evaluate its reliability and validity，so as to provide a tool for assessing the caregiving ability of such caregivers. Methods Guided by the KAP theory，the initial version of the scale was developed through literature review，semi-structured interviews，and 2 rounds of expert consultation. From May 2025 to December 2025，413 home-based pulmonary rehabilitation caregivers of COPD patients followed up in the respiratory department of a tertiary hospital in Shanghai were selected as survey subjects using convenience sampling. Item analysis，exploratory factor analysis，and confirmatory factor analysis were used to evaluate structural validity. Content validity was assessed by 5 experts. Reliability was evaluated using Cronbach’s α coefficient，split-half reliability，and test-retest reliability. Results A total of 400 valid questionnaires were collected. The final KAP scale for home-based pulmonary rehabilitation caregivers of COPD patients consists of 3 dimensions，7 factors，and 42 items. Exploratory factor analysis extracted 7 common factors，with a cumulative variance contribution rate of 86.408%. Confirmatory factor analysis indicated a good model fit. The scale-level content validity index was 0.856. The Cronbach’s α coefficient of the total scale was 0.820；the split-half reliability was 0.955；the test-retest reliability was 0.827. Conclusion The developed KAP scale for home-based pulmonary rehabilitation caregivers of COPD patients demonstrates good reliability and validity，and it can be used as a tool to assess the competence of these caregivers.

Nursing care of a pediatric patient with primary type 1 hyperoxaluria after liver transplantation

WU Jun, LU Fangyan

2026, 61(20): 2824-2828. DOI: 10.3761/j.issn.0254-1769.2026.20.012

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This paper summarizes the postoperative nursing experience of a child with primary hyperoxaluria type Ⅰ who underwent liver transplantation. The key nursing measures were as follows：precise a anticoagulation combined with multi-dimensional bleeding assessment to early warn the occurrence of occult bleeding；a refined volume management strategy was formulated to maintain circulatory stability and ensure adequate perfusion of the transplanted liver；implementing de-escalation renal replacement therapy to prevent oxalate intoxication and dialysis-related complications；adopting phased nutritional support to alleviate hyperoxalemia and treat chylous leakage；and conducting individualized follow-up management to optimize organ function and create favorable conditions for sequential kidney transplantation. With meticulous nursing interventions，the child recovered and was discharged from hospital. During a 90-day follow-up，the function of the transplanted liver remained stable；the child received regular hemodialysis；the urinary oxalate level decreased steadily；the child was enrolled in the waiting list for pediatric kidney transplantation.

Nursing care of a patient with Evans syndrome complicated by herpes zoster and multiorgan dysfunction

YU Liping, LIU Yanling, WANG Li, YAN Jianhui, DUAN Tingting, LONG Chaochun, CHEN Na

2026, 61(20): 2829-2834. DOI: 10.3761/j.issn.0254-1769.2026.20.013

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This paper summarized the nursing experience of a patient with Evans syndrome complicated by herpes zoster，hepatorenal dysfunction，electrolyte and coagulation disorders，oral blood blisters，and a high bleeding risk. Key nursing interventions included：establishing a nurse-led integrated dynamic grading nursing model；implementing integrated dynamic grading nursing for bidirectional bleeding and thrombosis risk；providing mucocutaneous wound care for oral blood blisters and herpes zoster lesions；conducting early warning nursing for hemolytic crisis and airway asphyxia risk；performing sequential multiorgan protection and internal environment regulation nursing；and delivering psychological support nursing for critical illness of a rare hematologic disease. Following active treatment and individualized nursing care，the patient was discharged from the hospital after 26 days of hospitalization.

Nursing care of an elderly patient with immune-related myocarditis-myositis-myasthenia gravis overlapping syndrome

WANG Yangyang, ZHAO Han, WANG Wei

2026, 61(20): 2835-2839. DOI: 10.3761/j.issn.0254-1769.2026.20.014

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To summarize the nursing experience for a patient with pulmonary large cell neuroendocrine carcinoma with myocarditis-myositis-myasthenia gravis overlapping syndrome after receiving immune checkpoint inhibitor therapy. Key points of nursing care are as follows：strengthening the identification of prodromal symptoms in the early stage to initiate rapid response；implementing targeted dynamic monitoring to remain vigilant against fatal complications，such as malignant arrhythmias and myasthenic crisis，given the multi-organ involvement；executing strict medication administration and refined adverse event management for high-dose glucocorticoids combined with intravenous immunoglobulin；conducting combined assessments of laboratory indicators，clinical symptoms，and neuromuscular functions at critical nodes during the corticosteroid tapering phase to ensure a safe transition；providing transitional home care and follow-up support post-discharge. Following systematic treatment and meticulous nursing care，the patient was discharged in a stable condition，with no recurrence observed during the follow-up period.

A systematic review of health-related quality of life assessment tools for children with congenital heart disease

XU Qi, ZHANG Xiaotong, LI Yuxin, LI Minmin

2026, 61(20): 2840-2846. DOI: 10.3761/j.issn.0254-1769.2026.20.015

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Objective To comprehensively evaluate the methodological quality and psychometric properties of health-related quality of life assessment tools for children with congenital heart disease，and to provide evidence-based references for clinical practitioners in selecting appropriate instruments. Methods A systematic search was conducted in PubMed，Web of Science，Cochrane Library，Embase，Chinese National Knowledge Infrastructure，Wanfang Data，SinoMed，and VIP databases for studies on health-related quality of life assessment tools for children with congenital heart disease，covering the period from the inception of each database to December 17，2025. Totally 2 researchers independently performed literature screening and data extraction. We assessed the included tools for methodological soundness and psychometric characteristics based on the COSMIN framework，from which we then derived the final recommendations. Results Our final analysis incorporated 15 articles and 9 evaluation instruments. Among them，the Congenital Quality of Life，Preschool Pediatric Cardiac Quality of Life Inventory，and Pediatric Quality of Life Inventory Version 3.0 Cardiac Module received a grade A recommendation，whereas the other 6 instruments were assigned a grade B designation. Conclusion A variety of tools exist for assessing health-related quality of life in children with congenital heart disease，yet the reporting of their psychometric properties remains incomplete. Future research should further verify the unassessed measurement properties and refine the Chinese localized versions，so as to enhance the scientific validity and clinical applicability of these instruments in clinical practice.

A systematic review of risk prediction models for venous thromboembolism patients after spinal surgery

YU Qunfei, MA Yaojing, LIANG Xiaoying, YUE Lan, WANG Manman, YE Qun, YU Chengfei, SHENG Shaoying, REN Ying

2026, 61(20): 2847-2854. DOI: 10.3761/j.issn.0254-1769.2026.20.016

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Objective To systematically evaluate risk prediction models for venous thromboembolism（VTE） after spinal surgery and provide evidence for clinical risk assessment and model optimization. Methods Chinese and English databases were systematically searched from inception to June 30，2026. The CHARMS checklist was used for literature screening and data extraction. Methodological quality was assessed using the PROBAST tool，and a meta-analysis was performed for models eligible for quantitative synthesis. Results A total of 15 studies were included，most of which were retrospective cohort studies. Logistic regression was the predominant modeling approach，while several studies incorporated the LASSO regression or machine learning algorithms. The main predictors included D-dimer，age，and surgery-related factors. The AUC ranged from 0.68 to 0.94，and most models demonstrated good calibration. External validation was performed in 6 studies，and 8 studies evaluated clinical utility using DCA. 4 studies were included in the meta-analysis，yielding a pooled AUC of 0.841（95%CI：0.783-0.899）. Conclusion Existing prediction models for postoperative VTE following spinal surgery generally demonstrate good predictive performance. However，their methodological quality remains suboptimal，and external validation is limited. The predictors remain focused on conventional VTE risk factors，with inadequate reflection of the specialized characteristics of spinal surgery. Future prospective multicenter studies are warranted to identify spinal-specific predictors and improve the generalizability and clinical applicability of these prediction models.

Application of digital coaching in self-management among patients with hypertension：a scoping review

MA Yongxin, FAN Huayu, SHI Yige, LIU Jinmiao, ZHANG Zhenzhen, YANG Chaofan, KONG Liang, CAO Xiangyang, CHEN Rui

2026, 61(20): 2855-2860. DOI: 10.3761/j.issn.0254-1769.2026.20.017

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Objective To conduct a scoping review on the application of digital coaching in the self-management of patients with hypertension，providing a reference for digital interventions. Methods A comprehensive literature search was executed across the PubMed，Web of Science，Cochrane Library，CINAHL，SPORTDiscus，ACM Digital Library，CNKI，and Wanfang databases. The search encompassed literature from the inception of each database up to June 20，2026. The retrieved publications underwent systematic summarization and analysis. Results A total of 12 articles were included. Digital coaching was primarily applied to self-management content for hypertension patients，including blood pressure monitoring，lifestyle modification，disease knowledge acquisition，medication management，and stress management. 9 core functions of digital coaching were extracted and categorized into 4 levels：state awareness，decision adaptation，coaching interaction，and capability building. In terms of functional combinations，data recording，reminders，feedback，goal and plan setting，and health knowledge dissemination constituted frequently co-occurring functional combinations，with the addition of personalized guidance，motivational reinforcement，risk management support，and conversational support as extended functions. Outcome measures in the included studies primarily involved behavior and adherence，clinical health outcomes，psychological cognition，and system usability. Conclusion Digital coaching can provide a closed-loop support model for the self-management of patients with hypertension，promoting patient behavior change. Further research is needed to strengthen context awareness，study functional synergy mechanisms，and standardize outcome indicators to enhance long-term management effectiveness and clinical application value.

A scoping review of the application of digital interventions for cognitive-motor dual-task training in stroke patients

WU Xinya, JIANG Xiaoman, CHANG Ran, REN Zhenqing

2026, 61(20): 2861-2867. DOI: 10.3761/j.issn.0254-1769.2026.20.018

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Objective To conduct a scoping review of the application of digital interventions for cognitive-motor dual-task training in stroke patients，with the aim of providing a reference for rehabilitation nursing practice. Methods Original intervention studies published in Chinese and English databases from inception to March 10，2026 were systematically searched，and the included studies were summarized and analyzed. Results A total of 23 studies involving 1 182 patients with stroke were included. The intervention platforms were classified into 5 categories：virtual reality/augmented reality，motion-sensing interaction，digital occupational training，robot-assisted virtual training，and mobile network-based platforms. Most interventions were implemented in medical institutions，with only a few extending to community and home settings. The interventions integrated dual tasks of cognitive processing and motor control，and included core gamification elements such as goal rules，real-time feedback，and progressive difficulty. Outcome measures mainly focused on cognitive function，motor function，and activities of daily living，while nursing-sensitive indicators and long-term follow-up evaluations were insufficient. Conclusion Digital interventions for cognitive-motor dual-task training have promising application value in stroke patients. However，intervention protocols，training dosage，and evaluation systems require further standardization. Future studies should refine intervention standards，establish nursing support pathways，and strengthen research on home-based and remote applications.

Research progress on nursing differentiation and triage strategies for overlapping toxicities in immuno-therapy combined with targeted therapy

LI Xiaoqing

2026, 61(20): 2868-2876. DOI: 10.3761/j.issn.0254-1769.2026.20.019

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As the combination of immune checkpoint inhibitors and targeted therapy becomes the standard regimen for patients with advanced tumors，the resulting “overlapping toxicity” has become a focal point and challenge in clinical nursing assessment due to its similar clinical manifestations but distinct pathological mechanisms. This article reviews the research progress on nursing differentiation and triage strategies for overlapping toxicities. It proposes a differentiation framework based on the “treatment-symptom timeline” and “symptom cluster” analysis. Meanwhile，it summarizes the differentiated nursing essentials for target organs such as the gastrointestinal tract，liver，skin，and kidneys，and elaborates on the application of a nurse-led structured triage process，diagnostic treatment suspension strategies，and electronic patient-reported outcomes in whole-process management. On this basis，the article analyzes the value of the multidisciplinary collaboration model and the construction path of a localized nursing system in China，aiming to provide a reference for enhancing the early risk identification capabilities of oncology specialist nurses and establishing an overlapping toxicity nursing management system suitable for national conditions.

An overview of mixed methods research and its application progress in nursing

YANG Dan, DUAN Wenjie

2026, 61(20): 2877-2881. DOI: 10.3761/j.issn.0254-1769.2026.20.020

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Mixed methods research，by integrating quantitative and qualitative data，has been increasingly applied in the nursing field in recent years due to its ability to comprehensively analyze complex issues in nursing practice. This review summarizes the main application directions of mixed methods research in nursing field，including multidimensional deconstruction and mechanism interpretation of complex phenomena，multidimensional identification of care needs and construction of support strategies，identification of influencing factors and pathway analysis of health behaviors，as well as effectiveness evaluation and implementation mechanism analysis of interventions. By comparing with the reporting standards of mixed-methods research，this study further identifies several issues in current mixed-methods research，including inconsistent labeling of design types，insufficient justification of necessity，incomplete reporting of quantitative and qualitative methodologies，ambiguous integration processes and inadequate depth of integration，and insufficient reflection on methodological limitations. Targeted recommendations are proposed based on these issues，aiming to enhance nursing researchers’ systematic understanding of mixed-methods research and provide methodological references for standardized research practices.

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