Table of Content

10 May 2026, Volume 61 Issue 9

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Special Planning-Maintenance and Management of Intravenous Access Devices

Expert consensus on nursing care of central venous access device removal

Intravenous Infusion Therapy Committee of Chinese Nursing Association, Beijing Nursing Association, （Writing Committee：LI Jia, LI Xuying, QIN Huiying, CHEN Lifen, WU Zhenming, HU Zeyin, LUO Mengna, FAN Yuying, WU Jiahui, LIN Yuping, WANG Lei, SUN Wenyan, FENG Bilong, GAO Wei, LI Yanan, HOU Luoya, LI Chunyan, ）

2026, 61(9):  1157-1162.  DOI: 10.3761/j.issn.0254-1769.2026.09.001

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Objective To develop an expert consensus on the removal of central venous access devices（hereinafter referred to as the “consensus”） to standardize related clinical practices. Methods A systematic literature search，literature quality evaluation，and synthesis were conducted. Combined with practical experience，an initial draft of the “consensus” was developed. From May to July 2025，the draft underwent revision and refinement through 2 rounds of expert Delphi surveys and 2 expert panel meetings，culminating in the final version. Results A total of 24 experts from 14 provinces/municipalities（Guangdong，Guangxi，Fujian，et al） participated in 2 rounds of Delphi survey，with response rates of 92.31% and 100%. In both Delphi rounds，expert authority coefficients were 0.903 and 0.908，respectively；mean importance scores ranged from 4.04~5.00（round 1） and 3.97~4.90（round 2）；coefficients of variation were 0~0.23（round 1） and 0.06~0.25（round 2）；Kendall’s W coefficients were 0.202 and 0.138（both P<0.001）. This “consensus” covers the scope of application，definitions of key terms，indications for catheter removal，operational precautions，and related emergency management measures. Conclusion The “consensus” is scientific and rigorous，providing practical guidance for the procedures related to the removal of central venous access devices.

A study on the application of tunneled femoral PICC in pediatric patients with difficult venous access

ZHOU Xia, MA Yanyan, SHI Zhengkun, YU Haixia, ZHOU Yan, HU Hongling, LI You, CHEN Sisi, ZHANG Jinghui

2026, 61(9):  1163-1170.  DOI: 10.3761/j.issn.0254-1769.2026.09.002

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Objective To investigate the application effect of tunneled femoral vein PICC insertion in infants and young children with difficult venous access，and to provide a reference for the selection of catheterization methods. Methods A total of 254 infants and young children with difficult venous access who were hospitalized in the Children’s Medical Center of a tertiary A general hospital in Changsha from April to October 2025 were selected by a convenience sampling method. They were divided into 2 groups by a simple random grouping method. The experimental group underwent tunneled femoral vein PICC insertion，while the control group underwent non-tunneled femoral vein PICC insertion. The incidence of catheter-related complications，success rate of one-time catheterization，catheterization duration，intraoperative blood loss，intraoperative pain score，catheter indwelling duration，and unplanned extubation rate were compared between the 2 groups. Results A total of 253 infants and young children completed the study，including 127 in the experimental group and 126 in the control group. The total incidence of catheter-related complications in the experimental group and the control group was 4.72% and 31.75%，respectively，with a statistically significant difference（P<0.001）. The incidence of catheter dislodgement，catheter-related infection，and catheter-related skin injury in the experimental group were lower than those in the control group，with statistically significant differences（P<0.05）. The unplanned extubation rate in the experimental group was 0，while that in the control group was 8.73%，with a statistically significant difference（P=0.001）. There were no statistically significant differences in other indicators between the 2 groups（P>0.05）. Conclusion Tunneled femoral vein PICC insertion can reduce the risk of catheter dislodgement，catheter-related infection，and catheter-related skin injury in infants and young children with difficult venous access，and decrease the unplanned extubation rate，without affecting the success rate of one-time catheterization，intraoperative blood loss，or pain degree.

Construction and preliminary application of a risk assessment tool for central line associated bloodstream infections with needle-free connectors

HUANG Ping, LI Li, GUO Lili, XU Ying, YE Yun, JIANG Shufang

2026, 61(9):  1171-1179.  DOI: 10.3761/j.issn.0254-1769.2026.09.003

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Objective To develop and preliminarily apply a risk assessment tool for central line associated bloodstream infections（CLABSI） associated with needle-free connectors. Methods The draft tool was developed through literature review，Delphi expert consultation，Analytic Hierarchy Process（AHP），and ABC classification. A convenience sample of 200 inpatients with central venous catheters connected to needle-free connectors was selected from a tertiary hospital in Changzhou，between October and November 2025. Risk factors pertaining to the needle-free connectors were assessed to examine the tool’s reliability and validity. A self-controlled before-after design was adopted，in which a knowledge，attitude，and practice（KAP） questionnaire survey on the disinfection of needle-free connectors after intermittent medication administration was conducted among 48 nurses who used the tool，to evaluate its application effect. Results The final tool comprises 4 dimensions（medication characteristics，connector status，patient and catheter factors，clinical practice environment） and 11 items. The overall Cronbach’s α coefficient was 0.831，and the content validity index was 0.930. Inter-dimension correlations ranged from 0.440 to 0.557（all P<0.05）. Confirmatory factor analysis indicated acceptable model fit indices. After using the tool，nurses’ scores significantly increased in knowledge 25.00（20.00，25.00），attitude 16.00（16.00，18.00），practice 24.00（22.00，24.00） dimensions and total score 63.00（60.00，65.00） compared to preintervention levels（all P<0.001）. Conclusion The risk assessment tool for needle-free connector associated CLABSI developed in this study demonstrated good reliability and validity. It can enhance nurses’ risk awareness，positive attitudes，and operational compliance in key procedures such as post-intermittent medication disinfection.

Construction and validation of a risk prediction model for secondary peripherally inserted central catheter tip malposition in the upper extremity of preterm infants

LI Jia, ZHANG Yuling, XING Le, ZHANG Lifeng, NIU Xiufeng, XU Li

2026, 61(9):  1180-1186.  DOI: 10.3761/j.issn.0254-1769.2026.09.004

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Objective To analyze the status and influencing factors of secondary tip malposition of PICC in the upper extremity of preterm infants，to establish a risk prediction model，and to conduct internal validation of the model. Methods A total of 216 preterm infants who were hospitalized in the neonatal intensive care unit in Inner Mongolia from January 2022 to April 2025 were retrospectively collected. A comprehensive data set pertaining to secondary PICC tip malposition in upper extremity in preterm infants was meticulously compiled. Univariate analysis and Logistic regression ananlysis were used to explore the influencing factors of secondary PICC tip malposition in the upper extremity of preterm infants. A visual nomogram risk prediction model was established，and the model was internally verified by receiver operating characteristic（ROC） curve and Hosmer-Lemeshow fit test. Results The incidence of secondary PICC tip malposition was 12.0%. The site of tube placement，feeding interruption or reduction in milk intake，the catheter tip position，the rate of weight gain were the main influencing factors of secondary PICC tip malposition（P<0.05）. The area under ROC curve of the prediction model was 0.836（95%CI 0.731~0.958），the sensitivity was 0.867，and the specificity was 0.684.The calibration curve was close to the ideal curve. The Hosmer-Lemeshow goodness of fit test was χ²=6.234（P=0.435）. Conclusion A predictive model for secondary PICC tip malposition in the upper extremity of preterm infants has been constructed on the basis of the site of catheter placement，the presence of feeding interruption or milk reduction，the location of the catheter tip，and the rate of weight gain. This model demonstrates good predictive ability and can provide guidance for clinical diagnosis and treatment.

Nursing care of a patient with peripherally inserted central catheterization via the upper limb after bilateral innominate vein and superior vena cava artificial vascular replacement

HE Juan, ZHAO Leilei, YE Guanjun, YU Yanfen, FU Xiaojun, ZHOU Qin

2026, 61(9):  1187-1191.  DOI: 10.3761/j.issn.0254-1769.2026.09.005

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This case report details the nursing experience of peripherally inserted central catheter（PICC） placement via the left upper limb basilic vein in a patient following bilateral innominate vein and superior vena cava artificial vascular replacement. The key nursing points included：before catheterization，the vascular access was reasonably selected based on the patient’s therapeutic needs. A multidisciplinary team was established to comprehensively assess the feasibility and safety of PICC insertion through the artificial vascular segment and to formulate an individualized catheterization plan. During the procedure，vital signs were closely monitored. A modified catheter advancement technique was adopted，and intracavitary electrocardiography（IC-ECG） was combined with chest X-ray for tip localization to reduce the risks of vascular injury and catheter malposition. During the indwelling period，systematic strategies for bleeding and thrombosis prevention were implemented. The patient was also instructed on home management to improve catheter maintenance quality. Finally，the PICC was successfully placed in a single attempt. The catheter remained in place for 113 days without any related complications.

Specialist Nursing Practice and Research

Construction and application of a risk-level assessment system for early mobilization in patients with veno-venous extracorporeal membrane oxygenation

LIANG Jiangshuyuan, ZENG Fei, HE Peng, XIE Mengshan, JIANG Yue, JIANG Zongheng, WANG Jianming

2026, 61(9):  1192-1199.  DOI: 10.3761/j.issn.0254-1769.2026.09.006

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Objective To develop and validate a risk-level assessment system for early mobilization in patients undergoing VV-ECMO to promote the safety and standardization of early mobilization. Methods Convenience sampling was employed to select VV-ECMO patients hospitalized in the ICU of a tertiary A hospital in Hangzhou from January 2024 to August 2025 as the study subjects. Patients admitted from November 2024 to August 2025 were designated as a trial group（n=27），who received early mobilization guided by a risk-level assessment system in addition to routine interventions. Patients admitted from January to October 2024 were designated as a control group（n=27），who received routine early mobilization care. After the intervention，the 2 groups were compared on the differences in the following parameters，including first active mobilization initiation time，early mobilization implementation rate，optimal activity level，incidence of ICU-acquired weakness，incidence of delirium，incidence of activity-related adverse events，duration of VV-ECMO support，duration of mechanical ventilation，and length of ICU stay. Results The trial group had 2 cases of dropout，with 25 cases ultimately enrolled；the control group had 3 cases of dropout，with 24 cases ultimately enrolled. After the intervention，the trial group demonstrated higher rates of early mobilization implementation and optimal activity levels compared to the control group（P<0.05）. The trial group also exhibited shorter first active mobilization initiation time，shorter VV-ECMO support duration，shorter mechanical ventilation duration，and lower incidence of ICU-acquired weakness（P<0.05）. No statistically significant differences were observed between the 2 groups in terms of delirium incidence or ICU length of stay（P>0.05）. No severe adverse events occurred during the activity sessions. Conclusion The risk-level assessment system can safely and effectively promote early mobilization in VV-ECMO patients. It provides clinicians with an intuitive and structured decision-support tool.

Predictive value of 3 frailty assessment tools for adverse outcomes in elderly trauma patients in an emergency department

CHEN Chen, GU Xiao, GUO Fan, WANG Min, NI Xingmei, HUANG Qin, CHENG Niankai

2026, 61(9):  1200-1207.  DOI: 10.3761/j.issn.0254-1769.2026.09.007

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Objective To compare the predictive value of the Fatigue，Resistance，Ambulation，Illness and Loss of weight（FRAIL），Clinical Frailty Scale（CFS），and Trauma-Specific Frailty Index（TSFI） for adverse outcomes in elderly trauma patients in an emergency department. Methods This prospective cohort study enrolled 259 elderly trauma patients admitted to a tertiary hospital in Suzhou，China（January to June 2025）. Frailty was assessed using FRAIL，CFS，and TSFI. The predictive value of these tools for adverse outcomes in elderly emergency trauma patients was compared using the area under the receiver operating characteristic curve（AUC）. Results Among 248 included patients，75 patients（30.2%） who experienced adverse outcomes were included in an event group，and 173 patients（69.8%） who did not experience adverse outcomes were in a non-event group. Frailty scores differed significantly between groups（P<0.001）. ROC analysis revealed that TSFI（AUC=0.83，sensitivity=0.83，specificity=0.80） showed higher predictive accuracy than FRAIL（AUC=0.74，sensitivity=0.64，specificity=0.78） and CFS（AUC=0.70，sensitivity=0.59，specificity=0.75）. Conclusion TSFI demonstrated superior predictive efficacy for adverse outcomes in elderly trauma patients，making it more suitable for early frailty assessment in Chinese emergency departments.

Analysis of relapse to alcohol drinking and its influencing factors in patients with alcoholic liver disease after liver transplantation

ZHENG Yulin, LIU Jinning, ZHANG Jing, GUO Huimin, GU Yanmei, ZHANG Lili

2026, 61(9):  1208-1214.  DOI: 10.3761/j.issn.0254-1769.2026.09.008

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Objective To investigate the prevalence and influencing factors of alcohol relapse after liver transplantation in patients with alcoholic liver disease，and to provide evidence for developing postoperative alcohol management strategies. Methods A cross-sectional study design was adopted. Using convenience sampling，alcohol-related liver disease patients who attended the liver transplantation follow-up outpatient clinic of a tertiary hospital in Beijing from July 2024 to May 2025 were recruited as participants. Data were collected using a general information questionnaire，the Hospital Anxiety and Depression Scale，the Perceived Social Support Scale，and the Alcohol Use Disorders Identification Test. Univariate analysis and logistic regression analysis were conducted to explore the influencing factors. Results A total of 121 patients were enrolled in the study，data from 118 patients were included in the final analysis，totally 3 patients withdrew，with a valid questionnaire recovery rate of 97.52%. Totally 30 patients reported alcohol consumption within the preceding month，yielding a relapse rate of 25.42%，of whom 18 patients（60.00%） exhibited harmful drinking. Logistic regression identified smoking，perceived social support，and postoperative duration as significant factors influencing alcohol relapse（P<0.05）. Conclusion Patients with alcohol-related liver disease have a high incidence of relapse drinking after liver transplantation，with more than half exhibiting harmful levels of alcohol consumption. Smoking，longer post-transplant duration，and inadequate social support are major risk factors for relapse. Nursing practice should focus on the early identification and risk management of high-risk patients，emphasizing smoking cessation interventions，long-term follow-up care，and the effective utilization of social support resources to reduce the likelihood of relapse drinking.

A qualitative study on the cognition and experience of oral frailty in maintenance hemodialysis patients

YE Junshuang, SHEN Lijia, MENG Xialiang, ZHANG Yujiao, CAI Genlian, SHAO Biyun, ZHOU Yahui, ZHANG Liuqian, YING Jinping

2026, 61(9):  1215-1220.  DOI: 10.3761/j.issn.0254-1769.2026.09.009

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Objective To explore the real psychological experience of maintenance hemodialysis patients with oral frailty，and to provide a reference for formulating scientific and effective oral care intervention plans. Methods This study adopted a descriptive phenomenological research method. Through purposive sampling and following the principle of maximum variation，patients with oral frailty who underwent maintenance hemodialysis treatment in a tertiary A hospital in Hangzhou from July to August 2025 were recruited as research subjects. In-depth semi-structured interviews were conducted，and Colaizzi seven-step analysis method was used to analyze and organize the interview data. Results 3 core themes and 12 sub-themes were extracted，namely cognition and judgment （conceptual cognitive limitations，risk cognitive desensitization，clear interactional cognition of the disease，delay in severity cognition，attribution bias），motivation and resistance（hierarchical perception of benefits，contradiction in co-morbidity management，exhaustion of energy and time，multi-dimensional external obstacles），behavior and efficacy （lagging healthy behaviors，hierarchical compromise of coping strategies，differentiation of self-efficacy）. Conclusion Maintenance hemodialysis patients have systematic biases in their cognition of oral frailty. Their healthy behaviors are constrained by many factors. A comprehensive intervention system covering systematic early screening mechanisms，multidisciplinary collaborative treatment paths，and individualized behavioral support plans should be constructed to stimulate patients’ internal driving force for health behaviors while strengthening multiple external supports，thereby improving their oral health management ability and quality of life.

Multidisciplinary Collaborative Nursing Research

Construction and application of a postoperative rehabilitation nursing program for patients with diabetic lower extremity arteriosclerosis obliterans

WANG Yunjiao, YANG Yujin, ZHENG Chunyan, PENG Feijin, WANG Shuzhen, JIANG Xilu, ZHOU Weimin, WANG Wei, ZHANG Na

2026, 61(9):  1221-1229.  DOI: 10.3761/j.issn.0254-1769.2026.09.010

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Objective To develop and apply a rehabilitation nursing protocol for diabetic lower extremity arteriosclerotic obliterans（DLASO） patients post-intervention，and to provide a practical basis for clinical practice. Methods Based on the Health Action Process Approach（HAPA） model，an intervention protocol was developed through literature review，expert consultation，and a pilot study. A total of 154 DLASO patients receiving interventional therapy between January and June 2025 in vascular surgery departments of 2 campuses of a tertiary hospital in Nanchang were selected by convenience sampling and assigned by ward unit. Groups were determined by coin toss，with 77 patients each in an experimental group（HAPA-based rehabilitation） and a control group （routine care）. The differences in lower limb blood flow，motor function，self-management ability，blood glucose control，and complication rates were compared between the 2 groups. Results The final protocol included 3 primary items，8 secondary items，and 19 tertiary items. At the 3-month follow-up，the intervention group（74 cases） demonstrated superior outcomes in lower limb perfusion，motor function，glycemic control，and self-management（P<0.05） than the control group（72 cases），with significant time，group and interaction effects（P<0.001）. The incidence of postoperative complications in the experimental group was 6.76%，which was lower than 18.06% in the control group. A comparison between the 2 groups showed that the difference was statistically significant（P=0.038）. Conclusion The HAPA-based rehabilitation care protocol for DLASO patients is both scientific and practical. It significantly improves lower limb perfusion，motor function，self-management，and glycemic control，and thereby reducs the incidence of postoperative complications.

Correlation analysis between elderly-to-elder care capacity and self-neglect among older adults with chronic comorbidities and their caregivers

YANG Mingxia, AN Ran, ZANG Jinfeng, LI Chunmei

2026, 61(9):  1230-1236.  DOI: 10.3761/j.issn.0254-1769.2026.09.011

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Objective To explore the relationship between elderly caregivers’ care capacity and self-neglect in older adults with chronic comorbidities and their caregivers using an actor-partner interdependence model，to provide references for developing clinical intervention strategies. Methods Using convenience sampling，437 pairs of elderly patients with chronic comorbidities and their caregivers admitted to a tertiary A hospital in Jinan City，Shandong Province，were selected as research subjects from March to October 2025. Data were collected via questionnaires on general information，the Self-Care Ability Scale for the Elderly，the Elder-to-Elder Care Capacity Scale，and the Self-Neglect Scale for the Elderly. An actor-partner interdependence model linking elder-to-elder care capacity and self-neglect was constructed. Results A total of 411 valid questionnaires were collected. Patients’ self-care ability scores were（54.51±11.69） points，while caregivers’ elder-to-elder caregiving ability scores were（115.67±18.85） points. Patients’ self-neglect scores were（12.44±11.56） points，while caregivers’ self-neglect scores were（10.09±10.27） points. The actor-partner interdependence model revealed that both the patient’s self-care ability and the caregiver’s elderly-to-elderly care ability negatively predicted self-neglect（β₁=-0.193，β₂=-0.242；all P<0.001），indicating a significant actor’ effect. Both parties’ caregiving capacity also negatively predicted the other’s self-neglect（β₁=-0.271，P₁<0.001；β₂=-0.145，P₂=0.003），indicating a significant partner’ effect. Conclusion A significant dual interaction exists between caregiving capacity and self-neglect among elderly patients with chronic comorbidities and their caregivers. In nursing practice，it should be emphasized on dual-system collaborative interventions for patients and caregivers，enhancing both parties’ caregiving capacity to jointly prevent and reduce self-neglect behaviors.

Care Quality and Safety

Construction of nursing quality evaluation indicators in perioperative period of carotid endarterectomy

LIANG Hejing, XU Que, SHI Yunxia, ZU Jinmei, HUANG Wenjing, YANG Chunxu, GUO Minghua, WANG Lei

2026, 61(9):  1237-1244.  DOI: 10.3761/j.issn.0254-1769.2026.09.012

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Objective To construct quality evaluation indicators for perioperative nursing in carotid endarterectomy（CEA），providing standards and quantitative basis for objectively evaluating and improving the nursing quality of CEA. Methods This study was conducted based on the framework of the three-dimensional “structure-process-outcome”quality model，using literature review，qualitative interview，Delphi method and analytic hierarchy to determine the content of the indicators，and the weight of each indicator. Results The effective recovery rates of 2 rounds of expert consultation questionnaires were 100%. The authority coefficients were 0.969 and 0.952. The Kendall harmony coefficients were 0.160-0.202 and 0.173-0.244. The final evaluation indicators for perioperative nursing quality in CEA included 3 first-level indicators，10 second-lever indicators and 31 third-level indicators. Conclusion The constructed CEA perioperative nursing quality evaluation indicators has high scientificity and reliability，and can be used for the assessment and monitoring of clinical nursing quality，promoting the standar-dization and refinement of nursing services.

Analysis of incidence and influencing factors of fall injuries among elderly inpatients across 870 hospitals

HAN Yuanyuan, SHI Yuzhu, SHANG Wenhan, YAO Li

2026, 61(9):  1245-1252.  DOI: 10.3761/j.issn.0254-1769.2026.09.013

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Objective This study was conducted to determine the incidence of fall-related injuries among elderly hospitalized patients，to identify influencing factors and high-risk populations，and to provide evidence for the development of targeted fall-prevention strategies by clinical nursing staff. Methods This nationwide，multicenter retrospective study was conducted using data on fall incidents among elderly inpatients reported to the National Nursing Quality Data Platform from 2019 to 2020. Descriptive analyzes were used to characterize fall patterns；univariate analyzes were performed to screen variables；binary logistic regression was applied to identify independent influencing factors associated with fall-related injuries among elderly inpatients. Results A total of 33，984 fall incidents among elderly inpatients from 870 tertiary A hospitals across China were included in the analysis. Among these，21，408 cases resulted in fall-related injuries（62.99%），with the severity being predominantly mild（37.63%）. Moderate-to-severe injuries accounted for 25.28% of cases，including 28 deaths（0.08%）. The Department of Rehabilitation Medicine reported the highest proportion of fall-related injuries（65.42%），among which moderate-to-severe injuries accounted for 29.05%. The period between 06：00 and 08：00 was identified as a peak time for fall-related injuries. Binary logistic regression analysis identified gender，fall location，time of occurrence，date，patient mobility，fall risk assessment grade，point-in-time nurse-to-patient ratio，and hospital-wide bed-to-nurse ratio as independent influencing factors associated with fall-related injuries（P<0.05）. Conclusion The incidence of fall-related injuries among elderly inpatients in China remains high. Particular attention should be given to risk factors elderly women，morning hours，rest days，and locations outside the ward. Enhanced assessment and targeted interventions for patients using mobility aids are essential. Preventive measures，including rational allocation of nursing staff and optimization of workflows，should be implemented to reduce the risk of fall-related injuries.

Rare Disease and Critical Care

Nursing care of an adolescent patient with Graves’ disease complicated by drug-induced hypersensitivity syndrome

XIA Yunfang, WANG Hong, CUI Dai, FU Zhenzhen, ZHU Min

2026, 61(9):  1253-1256.  DOI: 10.3761/j.issn.0254-1769.2026.09.014

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This report summarizes the nursing experience of an adolescent patient with Graves’ disease complicated by drug hypersensitivity syndrome. Key nursing interventions included：prompt discontinuation of the causative drug and careful administration of immunosuppressive therapy；early identification of thyroid crisis using the Burch-Wartofsky scoring system，with immediate resuscitation initiated upon detection of abnormalities；conducting dynamic temperature monitoring and employing multiple combined cooling strategies；protecting skin and mucosal barrier function while actively preventing and controlling infections；implementing family-centered health education to enhance patients’ self-efficacy and psychological resilience. Following active treatment and meticulous care，the patient’s condition improved and they were discharged after 36 days of hospitalization. During the subsequent 3-month follow-up period，no immune-related sequelae associated with drug hypersensitivity syndrome occurred.

Emergency nursing care of a patient with hydrofluoric acid poisoning complicated by respiratory and cardiac arrest

ZHOU Yifei, WANG Haiping, HU Yihuan, YING Li, LUO Songna

2026, 61(9):  1257-1260.  DOI: 10.3761/j.issn.0254-1769.2026.09.015

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This article summarizes the emergency treatment and nursing experience of a patient with hydrofluoric acid ingestion complicated by respiratory and cardiac arrest. The key points of nursing include：strengthening the protection and repair of the digestive tract mucosa，rapidly eliminating toxins from the body；dynamically monitoring electrolytes，balancing the risks of hemorrhage and thrombosis；predicting fatal arrhythmias，and quickly implementing extracorporeal cardiopulmonary resuscitation；developing an individualized nutritional plan，and implementing precise feeding；providing goal-oriented sedation and analgesia，and implementing early rehabilitation management. After 12 days of treatment and nursing in the ICU，the patient was transferred to a general ward for treatment and recovery before being discharged. Follow-up visits via phone and outpatient visits were conducted for a month，and the patient showed good recovery.

Evidence Synthesis Research

Meta-synthesis of post-traumatic growth experiences in people living with HIV/AIDS

LI Yantao, YANG Lianzhao, LONG Xiuhong, CHEN Ling, GAO Hui, QIN Wenting, ZHU Fanghui, LUO Xueer

2026, 61(9):  1261-1268.  DOI: 10.3761/j.issn.0254-1769.2026.09.016

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Objective To systematically summarize the authentic experiences and influencing factors of post-traumatic growth（PTG） among people living with HIV/AIDS through meta-aggregation，and to provide evidence for formulating targeted intervention strategies. Methods A computerized literature search was conducted across the databases including PubMed，Embase，Web of Science，Scopus，ProQuest，PsycINFO，CNKI，Wanfang Data，VIP Data-base，and China Biological Medicine Database. The search timeframe was set from the establishment of each database to August 2025 for qualitative studies focusing on post-traumatic growth in people living with HIV/AIDS. Qualitative studies that met the inclusion criteria were evaluated using the qualitative research quality assessment tool developed by the Joanna Briggs Institute（JBI） Evidence-based Healthcare Centre in Australia，and the findings were synthesized via an aggregative meta-synthesis approach. Results A total of 9 studies were finally included，from which 31 research results were extracted，summarized into 7 categories，and further integrated into 3 main findings：the manifestations and initial responses to HIV/AIDS-related trauma，the dynamic realization path of PTG，and the influencing factors of PTG. Conclusion The PTG of people living with HIV/AIDS can typically be achieved through 3 sequential stages：trauma coping，behavioral adjustment，and growth internalization. Their growth process is subject to the dual impacts of facilitating factors（e.g.，robust social support and adequate resource guarantee） and hindering factors（e.g.，social stigma and suboptimal doctor-patient communication）. Healthcare providers should accurately understand the relevant manifestations of PTG in HIV/AIDS，explore their positive psychological experiences，and take targeted measures to help them cope with related trauma.

Risk prediction models for thrombosis in autologous arteriovenous fistulas in hemodialysis patients：a Meta-analysis

LI Tiantian, QU Nan, CUI Liping, WEI Ling, ZHANG Lifeng, CHENG Yiwei, SUN Shuang

2026, 61(9):  1269-1276.  DOI: 10.3761/j.issn.0254-1769.2026.09.017

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Objective This systematic review aims to evaluate the predictive models for thrombosis risk in arteriovenous fistulas（AVF） of hemodialysis patients，providing a reference for the clinical screening or development of high-quality risk assessment tools. Methods Databases including PubMed，Embase，Cochrane Library，Web of Science，CINAHL，Medline，CNKI，Wanfang Database，VIP，and CBM were searched from their inception to January 20，2026. There were 2 researchers who independently completed the literature screening，data extraction，and risk of bias assessment. Meta-analysis of the area under the curve of each model was conducted using MedCalc 23.0.1 software. Results A total of 9 studies involving 15 predictive models and 5，280 cases were included. After sensitivity analysis，the meta-analysis result was of the area under the curve 0.833（95%CI：0.808~0.857），with heterogeneity test I²=0（P=0.757）. The overall applicability of the included studies was good，but the overall risk of bias was high. Common predictive factors included fibrinogen，high-sensitivity C-reactive protein，AVF stenosis，platelets，diabetes，and compression hemostasis time. Conclusion The development and validation of predictive models for AVF thrombosis risk in hemodialysis patients still need to be further improved. Future research should be based on real-world data and conduct large-sample，multi-center prospective cohort studies to provide empirical evidence for secondary prevention of AVF thrombosis in hemodialysis patients in China.

Review

Research progress on supportive care needs of patients with amyotrophic lateral sclerosis

CAI Weixin, SUN Weige, ZHANG Ran, CHEN Weiqi, WANG Yuying, WANG Yilong

2026, 61(9):  1277-1283.  DOI: 10.3761/j.issn.0254-1769.2026.09.018

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Amyotrophic lateral sclerosis（ALS） is a rare neurodegenerative disease，which currently receives widespread social attention. There is no effective cure for ALS yet，and supportive care is the core measure of its full-course management，which can significantly improve patients’ self-care ability，reduce negative emotions，lower medical burden，and improve their quality of life in the terminal stage. This study reviews the literature from 3 aspects，namely assessment tools for supportive care needs of ALS patients，needs content，and intervention strategies. It summarizes specific and non-specific tools for needs assessment，needs regarding information，physical，psychological and social support，and palliative care，as well as strategies including multidisciplinary team collaboration，digital remote interventions，and assistive devices and technology support，aiming to provide a reference for constructing a standardized and full-course ALS supportive care system in China..

Application progress of the symptom science model in symptom management of patients with type 2 diabetes mellitus

ZHANG Shiyang, LIU Qiaoyu, LIN Xiaoling, AI Xingxing, CHEN Ciduan, HUANG Jiewei

2026, 61(9):  1284-1290.  DOI: 10.3761/j.issn.0254-1769.2026.09.019

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The Symptom Science Model serves as a systematic framework for symptom management，enabling the development of precise nursing interventions based on the biological mechanisms underlying symptoms，providing personalized nursing support for symptom management of patients with type 2 diabetes. This article reviews the concept，core elements，and application of the Symptom Science Model in symptom management for patients with type 2 diabetes，and proposes nursing-related recommendations to provide a reference for the scientific management of symptoms in these patients.

Application progress of chatbots in alleviating social isolation among the elderly and nursing implications

LI Yan, XU Cuiping

2026, 61(9):  1291-1296.  DOI: 10.3761/j.issn.0254-1769.2026.09.020

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Social isolation is prevalent among the elderly population in China. Traditional intervention methods are constrained by issues such as insufficient resources and poor sustainability，making it difficult to meet the current demands. As an artificial intelligence technology，Chatbots can analyze emotional information through text or voice interactions，provide empathic responses and personalized support，and are expected to become an important tool to address social isolation among the elderly. This paper elaborates on the concept and basic principles of Chatbots based on natural language processing and affective computing，reviews the application models，existing problems，and nursing countermeasures of Chatbots in alleviating social isolation among the elderly，aiming to provide a reference for optimizing social support interventions for this population.