Table of Content

10 September 2026, Volume 61 Issue 17

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Special Planning——Health Management and Promotion for the Elderly

Application of a square stepping exercise program on the elderly with mild cognitive impairment in a nursing home

LI Feifei, LOU Weimin, WU Meiqian, HU Xincheng, HU Rongrong, JIANG Biyan, ZHENG Yao, ZHENG Lingyan, LIU Caixia

2026, 61(17):  2309-2317.  DOI: 10.3761/j.issn.0254-1769.2026.17.001

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Objective To explore the intervention effect of a square stepping exercise program on elderly people with mild cognitive impairment（MCI） living in an elderly care institution，aiming to provide references for clinical practice. Methods The square stepping exercise program was developed through literature review，expert consultation and a pilot study. In this randomized controlled trial，70 elderly people with MCI from a nursing institution in Hangzhou from July to October 2025 were selected as research subjects through convenience sampling. They were randomly divided into an experimental group and a control group（35 cases in each group）. The experimental group received the square stepping exercise program for 12 weeks in addition to routine care in the elderly care institution，while the control group received routine care only. Cognitive function，balance function，mobility，and quality of life were compared between the 2 groups before and after the intervention. Results Eventually，33 cases in the experimental group and 34 cases in the control group completed the study. After the 12-week intervention，the scores in the experimental group had significant statistical differences in Montreal Cognitive Assessment，visuospatial and executive function，attention，delayed recall，Berg Balance Scale，Timed Up and Go Test and physical and mental health of 12-item Short-Form Health Survey compared with those in the control group（P<0.05）. No exercise-related adverse events occurred in the experimental group. Conclusion The square stepping exercise program is safe and feasible，and it can effectively delay the progression of cognitive decline in elderly people with MCI in nursing institutions，and improve their balance function，mobility and quality of life.

Development and usability assessment of a management platform for disability risk assessment and stratified intervention in older adults

ZHANG Yuping, GUO Zhiting, MAO Yitong, WANG Jiayi, YANG Li, LU Yiming, CHEN Jiayi, JIN Jingfen

2026, 61(17):  2318-1324.  DOI: 10.3761/j.issn.0254-1769.2026.17.002

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Objective To develop and assess the usability of a digital management platform for risk assessment and stratified intervention of disability in older adults，and conduct usability evaluation，so as to providing a tool for early precise identification and continuous management of disability. Methods The stratified intervention program for disability in older adults was developed based on literature analysis and expert consultation. Guided by the Iron Triangle framework，the functions of a management platform for disability risk assessment and stratified intervention in older adults were designed. From November to December 2025，30 older adults from 2 community health service centers in Hangzhou were recruited to pilot the platform. Platform usability was evaluated using the System Usability Scale（SUS） and the completion rate of intervention task check-ins. Results The effective response rates of the 2 rounds of expert consultation were both 100%. The expert authority coefficient was 0.93，and the Kendall’s coefficients of concordance were 0.351 and 0.426，respectively（both P<0.05）. The disability risk stratified intervention strategy was constrained by risk levels along with auxiliary rules. Intervention content，dosage，recommended frequency，and implementation requirements were established across 4 dimensions，including physical activity，dietary nutrition，rest and sleep，cognitive psychology and social support. A total of 28 valid questionnaires were included in the usability evaluation. The score of SUS was（81.43±12.41） points，and the completion rate of intervention task check-ins was 78.9%. Conclusion The management platform for disability risk assessment and stratified intervention in older adults demonstrated good usability and provides a practical tool for continuous management in the prevention and control of disability among older adults.

Analysis of related factors and impact path of intrinsic capacity among community-dwelling older adults

YANG Shu, CHU Qing, MA Xiaoqin

2026, 61(17):  2325-2330.  DOI: 10.3761/j.issn.0254-1769.2026.17.003

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Objective To explore the related factors of intrinsic capacity among community-dwelling older adults and analyze the pathways of these factors，and to provide evidence for improving their intrinsic capacity. Methods Using convenience sampling，308 community-dwelling older adults in Hangzhou were recruited as participants in March 2026. The survey utilized a general information questionnaire，the Brief Aging Perceptions Questionnaire，the Geriatric Health Promotion Scale，and the Intrinsic Capacity Assessment Scale for the Older People. Descriptive statistics，univariate analysis，Pearson correlation analysis，and multiple linear regression analysis were performed using SPSS 26.0 software. Path analysis was conducted using SPSS PROCESS v4.2. Results A total of 300 valid questionnaires were included. The intrinsic capacity score among community-dwelling older adults was（114.95± 7.31） points. Multiple linear regression analysis showed that self-perception of aging，health promotion behaviors，age，and self-rated health status were factors associated with the intrinsic capacity among community-dwelling older adults（P<0.05）. Path analysis indicated that the total effect of self-perception of aging on intrinsic capacity was -0.388，with a direct effect of -0.223. The indirect effect of health promotion behaviors accounted for 42.5% of the total effect（B=-0.165，95%CI：-0.209~-0.122）. Conclusion The intrinsic capacity among community-dwelling older adults is influenced by multiple factors. Healthcare professionals may delay the decline in their intrinsic capacity by reducing negative perceptions of aging and enhancing adherence to health promotion behaviors.

A qualitative study on the implementation dilemmas of home-based pulmonary rehabilitation in elderly patients with chronic obstructive pulmonary disease

GUO Lingmin, FENG Li, CAI Ji, HUANG Hui

2026, 61(17):  2331-2337.  DOI: 10.3761/j.issn.0254-1769.2026.17.004

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Objective To explore the challenges related to home pulmonary rehabilitation in elderly patients with chronic obstructive pulmonary disease（COPD），providing a reference for improving long-term adherence to home-based pulmonary rehabilitation in clinical practice. Methods A descriptive phenomenological study was conducted using purposive sampling from October 2025 to January 2026，selecting patients diagnosed with COPD at A tertiary comprehensive hospital in Shanghai as research subjects. Colaizzi’s seven-step content analysis method was employed to categorize and analyze the interview data. Results A total of 4 themes and 8 sub-themes were identified. ①Difficulty in understanding and practicing pulmonary rehabilitation knowledge（abstract professional guidance content makes it hard for patients to comprehend and apply；subjective symptom experiences fail to translate into effective communication and guidance foundations）. ②Disease cognition bias and symptom burden reduce motivation for pulmonary rehabilitation（insufficient or biased understanding of the disease and the value of pulmonary rehabilitation；symptom burden，test result confusion，and negative emotions hinder adherence to pulmonary rehabilitation）. ③Dual influence of family and peer support increases resistance to pulmonary rehabilitation implementation（excessive family focus and protective behaviors limit rehabilitation autonomy；peer comparisons create psychological stress and weaken participation willingness）. ④Negative coping and behavioral regression in long-term pulmonary rehabilitation（selective execution of rehabilitation plans，using forgetting and avoidance to reduce the burden of pulmonary rehabilitation）. Conclusion For elderly patients with COPD undergoing home-based pulmonary rehabilitation，the implementation challenges involve multiple aspects，including cognition，communication，social support，and behavioral coping. Nurses should strengthen comprehensible and operable individualized rehabilitation guidance，pay attention to patients’ subjective symptom expression and psychological experience，and collaborate with family caregivers to build a supportive rehabilitation environment，so as to promote long-term adherence and implementation of home-based pulmonary rehabilitation.

Application of multimodal fusion technology in the management of geriatric psychological symptoms：a scoping review

JIA Sipei, LUO Yating, WANG Jingying, GAO Chen, WANG Yanru, ZHANG Qiuxiang, WANG Sha, LI Lijun, XIE Jianfei

2026, 61(17):  2338-2344.  DOI: 10.3761/j.issn.0254-1769.2026.17.005

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Objective To conduct a scoping review of the application of multimodal fusion technology in the management of psychological symptoms among older adults，so as to provide evidence for the application of this technology in gerontological psychological nursing. Methods Based on the methodological framework of a scoping review，systematic literature searches were performed across PubMed，Web of Science，IEEE Xplore，PsycINFO，Scopus，China National Knowledge Infrastructure，Wanfang Database，VIP Database，and SinoMed. The search period spanned from the inception of each database to May 30，2026. Data extraction and narrative synthesis were carried out for the included studies. Results A total of 23 studies published between 2017 and 2026 were included，originating from China，South Korea，the United States，and other countries. The data types covered behavioral data，physiological signals，speech and language data，environmental context data，selfreported data，demographic information，and healthrelated data. Primary collection devices included wearable devices，ambient sensors，and audio capture devices. Depressive symptoms and loneliness were the most frequently studied outcomes，while less attention was paid to psychological symptoms such as anxiety and apathy. The main application domain was psychological symptom assessment，with some studies extending to dynamic monitoring and psychological intervention. Fusion strategies were evolving from feature level concatenation toward deeper interactive approaches such as attention mechanisms. Conclusion Multimodal fusion technology shows potential for assessing psychological symptoms in older adults. However，most existing studies are small sample exploratory studies with limited coverage of psychological symptoms. Future efforts should expand assessment dimensions，strengthen privacy and ethical governance，and promote the translation of relevant technologies into nursing practice.

Standards

Expert consensus on guidance for infection prevention in patients with antineoplastic drug-induced neutropenia

Cancer Nursing Committee of Chinese Nursing Association, Cancer Nursing Committee of Shanghai Anti-Cancer Association (Writing Committee：WANG Xinru, ZHANG Xiaoju, ZHANG Xiaoju, LU Yuhan, LU Zhenqi, YANG Yang)

2026, 61(17):  2345-2350.  DOI: 10.3761/j.issn.0254-1769.2026.17.006

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Objective To develop an expert consensus on self-management guidance for infection prevention in patients with antineoplastic drug-induced neutropenia（hereinafter referred to as “consensus”），aiming to provide a reference for nurses to guide patients in self-managing infection prevention during neutropenia induced by antineoplastic therapy. Methods A “consensus” development group was established. In strict accordance with the World Health Organization standard guideline development process，a systematic literature search and quality assessment were conducted，and evidence on infection prevention self-management in patients with antineoplastic drug-induced neutropenia was extracted to form the initial draft of the “consensus”. From June to October 2025，2 rounds of expert consultation and a round of expert panel discussion were performed to revise and refine the “consensus”，resulting in the final version. Results The effective questionnaire response rate was 100% in both consultation rounds. A total of 228 revision suggestions were collected. The expert opinion submission rates were 100% and 90.00%；the expert authority coefficients were 0.914 and 0.923；and Kendall’s coefficients of concordance were 0.218 and 0.110（both P<0.001）. The mean importance scores of all items ranged from 4.00 to 4.95 and 4.15 to 5.00，with coefficients of variation ranging from 0.05 to 0.27 and 0 to 0.21，respectively. Based on expert suggestions from the consultations and panel discussion，the “consensus” was revised. The final “consensus” includes guidance on 5 aspects：pre-treatment infection risk communication，home-based infection prevention measures，symptom monitoring and infection identification，medication use，and healthcare seeking measures. Conclusion This “consensus” serves as a reference for clinical nurses to guide patients undergoing antineoplastic therapy in self-managing infection prevention during neutropenia.

Expert consensus on nursing practice of transition readiness for adolescents with epilepsy

Pediatric Neurology Group of the Pediatric Nursing Alliance，National Center for Children’s Health (Writing Committee：NING Pei, CUI Cui, LI Shuangzi, ZHANG Nan, XIA Sijie, XIANG Yaling, XIE Yuan)

2026, 61(17):  2351-2357.  DOI: 10.3761/j.issn.0254-1769.2026.17.007

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Objective To develop an expert consensus on nursing practice for transition readiness in adolescents with epilepsy（hereinafter referred to as “the consensus”），in order to promote healthcare professionals in implementing standardized transitional care for adolescents with epilepsy. Methods Relevant domestic and international literature was systematically reviewed，including guidelines，expert consensuses，systematic reviews，and other sources related to transition readiness in adolescents with epilepsy. After multiple rounds of group discussions，a draft version of the consensus was developed. From September to November 2025，a round of expert correspondence and a round of online expert meetings were conducted to revise and improve the content，resulting in the final version of the consensus. Results A total of 21 experts completed the correspondence survey. The expert positive coefficient was 100%；the authority coefficient was 0.874；the suitability scores for all recommendations were greater than 7 points；the coefficients of variation were all less than 0.250；Kendall’s coefficient of concordance was 0.351（P<0.05）. The final “consensus” includes 12 aspects and 30 recommendations：identifying the key population requiring attention during the transition period，defining transition readiness，forming a multidisciplinary team，determining the start and end timing of transition readiness，setting goals for transition readiness，assessment of transition readiness，epilepsy knowledge and self-awareness，medication management，emergency management and safety management，mental health and social adaptation，nursing support in referral services，and evaluation of nursing practice effectiveness. Conclusion The “consensus” demonstrates scientific validity and practical applicability. Its content addresses the critical components of transitional care preparation for adolescents with epilepsy and provides a reference for the continuity of medical services for these patients.

Specialist Nursing Practice and Research

Development and application of a nursing care program for core muscle training for patients with lumbar disc herniation after endoscopic spine surgery

MA Jie, ZHANG Li, LI Na, ZHU Kun, YE Yuchen, CHEN Yongxia

2026, 61(17):  2358-2366.  DOI: 10.3761/j.issn.0254-1769.2026.17.008

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Objective To develop a structured early core muscle training program for patients with lumbar disc herniation after transforaminal endoscopic spine surgery and to evaluate its effectiveness，thereby providing a reference for nursing practice. Methods Relevant evidence was systematically retrieved，appraised，and synthesized，and a structured early core muscle training program was developed through 2 rounds of Delphi expert consultation. The convenience sampling was used to recruit 120 patients with lumbar disc herniation who were admitted to the Department of Orthopedics of a tertiary grade A hospital in Anhui Province and underwent surgery between October， 2024 and December，2025 as study participants. Participants were randomly assigned to an intervention group or a control group using a random-number table，with 60 patients in each group. In addition to standardized routine postoperative rehabilitation guidance，the intervention group received the structured early core muscle training program. Formal training commenced 24 h after surgery and continued until 3 months postoperatively. The control group received standardized routine postoperative rehabilitation guidance. The visual analogue scale score for pain，modified Oswestry Disability Index score，Japanese Orthopaedic Association score，36-Item Short Form Health Survey composite score，and surface electromyographic parameters of the lumbar multifidus muscles were compared between the 2 groups within 24 h before surgery and at 3 months after surgery. Results The final structured early core muscle training program comprised 3 first-level indicators，9 second-level indicators，and 26 third-level indicators. All participants completed the 3-month follow-up. At 3 months after surgery，the intervention group had a lower visual analogue scale score and higher Japanese Orthopaedic Association score，36-Item Short Form Health Survey composite score，root mean square value normalized to maximum voluntary contraction[RMS（%MVC）]，and median frequency than the control group，with all between-group differences being statistically significant（all P<0.05）. Conclusion The structured early core muscle training program developed in this study may help reduce pain，promote lumbar functional recovery，improve health-related quality of life，and improve selected surface electromyographic parameters of the lumbar multifidus muscles in patients with lumbar disc herniation after transforaminal endoscopic spine surgery.

Application of virtual reality-based shoulder rehabilitation training in postoperative patients with adhesive capsulitis

JIA Huiying, MENG Jing

2026, 61(17):  2367-2373.  DOI: 10.3761/j.issn.0254-1769.2026.17.009

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Objective To investigate the effects of virtual reality（VR）-based shoulder rehabilitation training on postoperative rehabilitation outcomes in patients with adhesive capsulitis，and improve rehabilitation effectiveness through to provide evidence for clinical nursing practice. Methods Using convenience sampling，74 patients with primary adhesive capsulitis who underwent arthroscopic capsular release at a tertiary A hospital in Qingdao，between November 2024 and November 2025 were enrolled. Participants were randomly allocated to an experimental group（n=37） or a control group（n=37） using a coin-tossing procedure. The intervention group received shoulder rehabilitation training based on virtual reality technology in addition to routine nursing care，while the control group received routine nursing care alone. The intervention lasted for 4 weeks. Shoulder pain scores，kinesiophobia levels，and shoulder range of motion were compared between the 2 groups at 2 and 4 weeks after intervention. Results A total of 36 participants in the experimental group and 37 participants in the control group completed the study. Repeated-measures analysis of variance revealed significant group and time interaction effects for shoulder pain scores，kinesiophobia scores，and shoulder range of motion，including abduction，forward flexion，and external rotation（P<0.05）. After 2 and 4 weeks of intervention，the experimental group showed significantly lower shoulder pain and kinesiophobia scores and significantly greater shoulder range of motion than the control group（P<0.05）. Conclusion VR-based shoulder rehabilitation training effectively reduced pain and kinesiophobia and improved shoulder range of motion in postoperative patients with adhesive capsulitis.

Development and validation of a risk prediction model for catheter-related thrombosis in patients undergoing artificial liver therapy via femoral vein catheterization

LIU Junxia, XU Min, GUO Siyan, YANG Shuhui, WANG Huafen

2026, 61(17):  2374-2382.  DOI: 10.3761/j.issn.0254-1769.2026.17.010

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Objective To explore the combination patterns of high-risk characteristics for catheter-related thrombosis（CRT） formation in patients undergoing artificial liver support therapy via femoral vein catheterization，and to develop and validate a cumulative risk prediction model，so as to provide a reference for implementing precise and anticipatory nursing care. Methods Patients who underwent artificial liver support therapy via femoral vein catheterization in a tertiary hospital in Hangzhou from January to December 2024 were consecutively included as the study population，and their relevant clinical data were collected. The Apriori algorithm was applied to mine the core high-risk association rules for CRT formation. Clustering and visualization analyses of these core rules were performed using grouping matrix clustering and network topology graphs. Based on the analytical results，a cumulative risk prediction model was constructed，and logistic regression analysis was employed to validate the predictive performance of the model. Results A total of 206 patients were included，and the incidence of CRT was 53.39%. Using the Apriori algorithm，1，712 core high-risk association rules were extracted. Cluster analysis was performed on the top 15 core rules ranked by lift，and 5 clusters of core characteristic combinations were identified. Among these，the combination of “impaired consciousness and number of artificial liver support therapy sessions ≥3” showed the highest average lift. Network topology analysis revealed that “number of artificial liver support therapy sessions ≥3”，“Caprini score of 3-4”，and “pre-treatment fibrinogen concentration <1.5 g/L” were the 3 hub nodes with higher connectivity in the network. Based on the 5 clusters，a cumulative risk prediction model was constructed. Logistic regression analysis showed that the model score was positively associated with the risk of CRT（OR=1.689，P<0.001）. Conclusion The model can effectively quantify the cumulative effect of multiple risk factors for CRT formation in patients undergoing artificial liver support therapy via femoral vein catheterization，and demonstrates a relatively high accuracy in identifying high-risk patients.

Sodium intake status and associated factors in maintenance peritoneal dialysis patients

XIAO Xue, ZHANG Miaomiao, LI Jin, ZHANG Xindan, CHANG Wenxiu

2026, 61(17):  2383-2389.  DOI: 10.3761/j.issn.0254-1769.2026.17.011

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Objective This study aimed to assess sodium intake in maintenance peritoneal dialysis（MPD） patients using total sodium removal measurement，analyze its influencing factors，and provide a reference for improving the quality of peritoneal dialysis nursing care. Methods A cross-sectional survey was conducted among 448 MPD patients at the Peritoneal Dialysis Center，Department of Nephrology，Tianjin First Central Hospital from December 2025 to February 2026. Sodium intake was evaluated using total sodium removal measurement and classified into 4 groups：a low sodium intake group（<1 200 mg/d），an appropriate sodium intake group（1 200~2 000 mg/d），a high sodium intake group（>2 000~2 800 mg/d），and an excessive sodium intake group（>2 800 mg/d）. Intergroup comparisons of clinical characteristics were performed using Kruskal-Wallis H test or χ² test. Spearman correlation analysis and multivariate logistic regression were employed to identify factors associated with sodium intake. Results A total of 317 valid questionnaires were collected. The median sodium intake was 2 855.15（2 197.66~3 589.12） mg/d，equivalent to 7.30（5.60~9.10） g/d of dietary salt. The rate of achieving appropriate sodium intake（1 200~2 000 mg/d） was 12.93%，with 3.15% in the low sodium intake，32.49% in the high sodium intake group，and 51.42% in the excessive sodium intake group. Sodium intake was positively correlated with body mass index，systolic blood pressure，diastolic blood pressure，urine volume，blood urea nitrogen，and serum potassium，and negatively correlated with age（all P<0.001）. Multivariate logistic regression showed that advanced age was an independent risk factor for low sodium intake（OR=1.283，P=0.043），and body mass index was an independent risk factor for both high（OR=1.172，P=0.038） and excessive（OR=1.202，P=0.014） sodium intake，and normalized protein catabolic rate（nPCR） was an independent risk factor for excessive sodium intake（OR=5.953，P=0.037）. Conclusion The achievement rate of appropriate sodium intake is extremely low among MPD patients，with a prominent coexistence of both excessive and insufficient sodium intake. Nursing staff should strengthen weight management for patients with high body mass index，enhance nutritional monitoring for elderly patients，and establish individualized sodium intake assessment systems.

A qualitative study on the dyadic coping experiences of breast cancer patients of childbearing age with chemotherapy-induced amenorrhea and their spouses

GUO Gui, LIN Xi, TU Ying

2026, 61(17):  2390-2396.  DOI: 10.3761/j.issn.0254-1769.2026.17.012

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Objective To deeply explore the dyadic coping experiences of reproductive-aged breast cancer patients and their spouses in the face of chemotherapy-induced amenorrhea，and to provide a basis for developing dyadic coping nursing intervention programs. Methods Adoping a phenomenological research paradigm and purposive sampling，15 pairs of reproductive-aged breast cancer patients and their spouses treated at a tertiary cancer specialist hospital in Wuhan from October to December 2025 were enrolled as participants. Face-to-face semi-structured interviews were conducted based on the Developmental-Contextual Coping Model. Data were analyzed using the seven-step Colaizzi analytical approach. Results A total of 3 themes and 12 subthemes were extracted，including the physical and psychological symptom experience in dyadic coping（physical symptoms，psychological symptoms），dyadic coping patterns（independent coping，empowerment-based coping，joint coping） and influencing factors（asynchronous stress perception，dislocated stress cognition，insufficient professional support，positive empathic ability，family and social support），as well as differentiated adaptation outcomes of dyadic coping （adaptive relationship enhancement，maladaptive relationship alienation）. Conclusion The dyadic coping experiences of reproductive-aged breast cancer patients with chemotherapy-induced amenorrhea and their spouses exhibit multidimensional characteristics and needs. In clinical practice，healthcare providers should comprehensively assess and promptly identify the experiences and coping needs of both partners，and implement targeted dyadic health education and psychological support tailored to individual differences，thereby facilitating positive stress adaptation for both patients and their spouses.

Multidisciplinary Collaborative Nursing Research

A qualitative study on the perception of family resilience in patients after bone transport surgery

ZHU Yuzhe, SONG Huijuan, ZHANG Muchen, LI Shuangshuang, MA Yuxia, QIN Chenghe, YANG Jinghua

2026, 61(17):  2397-2403.  DOI: 10.3761/j.issn.0254-1769.2026.17.013

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Objective To understand the subjective perception of family resilience in patients after bone transport surgery，and to provide a reference for clinical targeted nursing interventions. Methods A phenome-nological research method was used. By purposive sampling，16 patients who underwent bone transport surgery in the Department of Orthopedic Trauma of a tertiary hospital in Guangdong Province from January to February 2026 were selected as the interview subjects. Semi-structured interviews were conducted，and the data were analyzed using Colaizzi’s seven-step analysis method. Results A total of 3 themes and 10 sub-themes were extracted，including individual-level adversity challenges and protective resources（physiological burden caused by external fixator，psychological impact of repeated surgeries，and active self-regulation），pressure load and supportive resources from family and social networks（increased family economic and caregiving burden，loss and interruption of family roles，and activation of family cohesion），and constraints and supportive resources from the social culture and policy environment（insufficient supply of professional medical rehabilitation services，inadequate medical insurance policy support，stigma caused by social prejudice，and positive motivation of cultural concepts）. Conclusion Family resilience in patients after bone transport surgery is the result of multi-level systemic interactions，involving both multiple challenges and abundant resources. Medical staff should focus on patients’ individual psychological resources，strengthen family support networks，and promote macro-policy optimization to enhance family resilience and promote patient recovery.

Computer simulation network analysis of related factors of demoralization syndrome in lung cancer patients and nursing inspiration

CHEN Linlin, LIN Yiyang, LUO Wenting, CHEN Fuhong

2026, 61(17):  2404-2410.  DOI: 10.3761/j.issn.0254-1769.2026.17.014

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Objective To construct a network model of demoralization syndrome，resilience，coping styles，and family care in lung cancer patients，and to identify core nodes，bridge nodes，potential intervention nodes，and prevention nodes，so as to provide references for clinical intervention. Methods A total of 471 lung cancer patients who visited the departments of thoracic surgery，oncology，respiratory medicine，and radiotherapy in 3 tertiary grade A general hospitals in Xiamen from December 2024 to October 2025 were selected by convenience sampling method. The Chinese Brief Demoralization Scale，Medical Coping Modes Questionnaire，Family Care Index，and Chinese Brief Resilience Scale were used for investigation. The Gaussian graphical model was used to identify core and bridge nodes in the network，and then computer simulation analysis based on the Ising model was conducted to identify potential intervention and preventions nodes. Results A total of 460 lung cancer patients were finally enrolled. The mean score of demoralization syndrome among lung cancer patients was（8.62±7.33）points，with confrontation coping at（19.04±3.68）points，avoidance coping at（15.40±3.45）points，and yielding coping at（9.60±3.30）points in medical coping modes. The family care score was （8.67±1.99）points，and the psychological resilience score was（22.67±9.33）points.“I am easily hurt” was the core symptom（strength centrality 2.187）. Resignation coping was the bridge symptom（bridge strength 0.804）. Computer simulation analysis showed that “I no longer feel in control of my emotions” was the potential intervention node，and “I would rather not be alive” was a potential prevention node. Conclusion Clinically，the priority should be given to patients’ emotional vulnerability，and a screening mechanism for suicidal ideation should be established. Emotional regulation ability should be improved through cognitive reappraisal training or mindfulness-based stress reduction（MBSR），and a closed-loop management of “screening-assessment-intervention” should be implemented to block the vicious cycle of “hopelessness-worthlessness-suicidal ideation”，so as to provide references for early identification and precise psychological nursing of demoralization syndrome in lung cancer patients.

Quality and Safety of Nursing Care

Effectiveness evaluation of a whole-process nursing management program for lung cancer patients under-going day surgery

CAO Junhua, QIAN Weiming, CHEN Ying, QIU Qingmiao, ZHENG Qiongna, ZHAO Jinfeng, HUANG Hongyan, CHEN Lingling, YE Ying, LI Qun

2026, 61(17):  2411-2419.  DOI: 10.3761/j.issn.0254-1769.2026.17.015

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Objective To construct a whole-process nursing management program for patients undergoing day surgery for lung cancer and to evaluate its application effects，so as to provide a nursing practice reference for improving pre-hospitalization management of day surgery. Methods A convenience sampling method was used to recruit 560 patients who underwent day surgery for lung cancer in a tertiary Grade A hospital in Hangzhou from January to June 2025. According to admission time，the patients were divided into an experimental group and a control group，with 280 patients in each group. The experimental group received a whole-process nursing management program for lung cancer day surgery，including establishment of a pre-admission nursing unit for assessment of complex comorbidities，special medication management，pulmonary specialist evaluation，and examination management，multimodal perioperative prehabilitation education，in-hospital pulmonary rehabilitation supervision，specialized discharge follow-up，problematic case tracking management，and humanized whole-process communication management. The control group received routine pre-hospitalization management for lung cancer day surgery. Preoperative anxiety level，same-day surgery cancellation rate，accuracy rate of scheduled surgery time，postoperative pulmonary rehabilitation compliance rate，delayed discharge rate，incidence of post-discharge adverse events，and hospitalization satisfaction were compared between the 2 groups. Results A total of 544 patients completed the study，including 273 patients in the experimental group and 271 patients in the control group. The preoperative anxiety score，and post-discharge care deficit or adverse event rate in the experimental group were lower than those in the control group（P<0.05）. The surgery time accuracy rate，pulmonary rehabilitation compliance rate and hospitalization satisfaction rate were higher in the experimental group than those in the control group，with statistically significant differences（all P<0.05）. Conclusion The whole-process nursing management program for patients undergoing lung cancer day surgery can help reduce preoperative anxiety levels，decrease post-discharge care deficit or adverse event rates，and improve surgery time accuracy，pulmonary rehabilitation implementation，and hospitalization satisfaction.

Knowledge，attitudes，and practices of emergency department nurses in Guangxi Zhuang Autonomous Region regarding snakebite patient care：a cross-sectional study

LIANG Zheng, HUANG Cuiqing, LI Caiying

2026, 61(17):  2420-2426.  DOI: 10.3761/j.issn.0254-1769.2026.17.016

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Objective To investigate the current status of knowledge，attitude，and practice（KAP） regarding the care of snakebite patients among emergency department nurses，and to analyze the influencing factors. Methods From February to May 2025，a total of 327 emergency department nurses in the Guangxi Zhuang Autonomous Region were recruited by convenience sampling. Data were collected using a general information questionnaire and a self-developed KAP questionnaire on snakebite patient care for emergency department nurses. Univariate analysis and generalized linear models were used to explore the factors influencing the total KAP score. Results A total of 317 valid questionnaires were collected，yielding an effective response rate of 96.94%. The median total KAP score was 148.00（136.00，161.00）points，with a pass rate of 94.64% and an excellence rate of 52.68%. The median scores for knowledge，attitude，and practice were 29.00（20.50，41.00）points，60.00（59.00，60.00） points，and 64.00（56.00，65.00） points，respectively. Multivariate analysis indicated that hospital level，availability of antivenom in the hospital，and whether nurses had received standardized training on snakebite patient care were independent influencing factors for the total KAP score（P<0.05）. Conclusion Emergency department nurses in Guangxi Zhuang Autonomous Region demonstrate a positive attitude toward the care of snakebite patients，but their knowledge and practice still need to be strengthened. Hospital administrators should enhance standardized training on snakebite care for emergency nurses，ensure adequate antivenom supply，and develop standardized nursing procedures and manuals，so as to improve the snakebite care competence of emergency nurses and ensure patient safety.

Rare Disease and Critical Care

Perinatal nursing care of a patient with Behcet’s syndrome complicated with aplastic anemia

ZHANG Yan, ZHANG Lili, WANG Fangfang, ZHU Tongwei, CHEN Danqi

2026, 61(17):  2427-2432.  DOI: 10.3761/j.issn.0254-1769.2026.17.017

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The perinatal care for a case of Behcet’s syndrome combined with aplastic anemia was summarized. Key nursing priorities focus on the fellowing points：implementation of an individualized blood conservation strategy based on risk assessment；provision of therapeutic conflict early warning and nursing decision support based on multi-source data；execution of coordinated surveillance of maternal-fetal status；performance of rapid sequential interventions based on a precise defense system；establishment of complication-focused continuity management. Following meticulous treatment and nursing care，the patient was discharged after 34 days of hospitalization with a positive prognosis confirmed at the one-month follow-up.

Perioperative nursing care of a neonate with congenital giant omphalocele complicated with intestinal malrotation undergoing four-stage abdominal wall repair surgery

RAO Yaqin, WANG Fang, ZHONG Qilin, XU Yanxin, LIN Zhenyuan, WU Riniletu, LIU Xian

2026, 61(17):  2433-2437.  DOI: 10.3761/j.issn.0254-1769.2026.17.018

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This article summarizes the perioperative nursing experience of a neonate with congenital giant omphalocele complicated by mesenteric malrotation undergoing four-stage abdominal wall repair surgery. Based on the “stage-specific goal-oriented” concept，the perioperative nursing was divided into 4 phases. Phase 1（preoperative and post-stage Ⅰ） focused on maintaining the integrity of the membrane sac，individualized positioning management，proactive thermoregulation，and precise regulation of the internal environment. Phase 2（perioperative for stages Ⅱ-Ⅲ） centered on infection prevention and gradual abdominal expansion. The Bates-Jensen wound assessment tool was used for closed loop management of infections related to the suspension bag. An early warning system for intra abdominal hypertension was achieved using a four sign clinical trial，and positioning management was optimized accordingly. Phase 3（post-stage Ⅲ recovery） emphasized multi organ function support and complication prevention，including liver protection oriented individualized nutritional support，multimodal analgesia，and bundled nursing strategies. Phase 4（perioperative for stage Ⅳ and discharge preparation） focused on promoting wound healing and empowering the family. This involved meticulous incision and abdominal distension care，systematic family caregiver training，and online follow up care. After staged repair over 82 days of hospitalization with careful nursing care，the newborn with congenital omphalocele achieved complete abdominal closure and was discharged. At discharge，weight was 3.8 kg，length was 52 cm，and head circumference was 35 cm. At the 10 month follow up，body weight reached 9.0 kg and length 74 cm，with normal growth and development.

Review

Localized development and future prospect of nursing theories

YAO Xiuyu, YU Shuhui, LI Zheng

2026, 61(17):  2438-2444.  DOI: 10.3761/j.issn.0254-1769.2026.17.019

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As a core pillar of the nursing discipline，nursing theories adhere to a practice-oriented logic. Based on the dual connotation of their localization—“localized adaptation of foreign theories” and “original development of local theories”，this paper sorts out the development process and diverse construction paths，analyzes core challenges such as the inadequacies in localization processes，weak empirical support for original theories，insufficient adaptability of foreign theories，mismatch with digital and intelligent development，and an incomplete supporting system as well as corresponding countermeasures，and looks forward to the development direction combined with digital and intelligent characteristics，so as to provide a reference for the high-quality development and practical transformation of nursing theory localization.

Application progress of character strengths theory in nursing staff development

FU Cangcang, DUAN Wenjie, ZHU Jihua

2026, 61(17):  2445-2449.  DOI: 10.3761/j.issn.0254-1769.2026.17.020

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Character strengths theory emphasizes the identification，use，and development of positive character traits to promote psychological adaptation，work engagement，and sustainable professional development. This article reviews its connotation，measurement tools，and current applications in nursing workforce development，and discusses future directions. The aim is to provide a reference for optimizing nursing workforce development programs.