Tieying Shi

Objectives: To analyse risk factors for postoperative delirium (POD) in patients after total hip arthroplasty and develop a visual clinical prediction model. Design: A Retrospective Cohort Study. Methods: This study included 457 patients who received total hip arthroplasty. The clinical prediction model was developed based on the results of univariate and multivariate logistic regression analyses. The performance of the model was assessed through measures of discrimination, calibration and decision curve analysis. The final model was visualised as a nomogram. This study followed the TRIPOD checklist. Results: A nomogram was developed based on age, total protein, fall risk and catheterisation. The model demonstrated strong discriminative power, with an AUC of 0.867. There was a strong agreement between predicted and observed outcomes, as shown by calibration analysis, while DCA supported the model's favourable clinical applicability. Conclusions: The predictive model developed in this study showed good discriminative performance and may support early clinical risk assessment of POD in patients undergoing total hip arthroplasty. Relevance to Clinical Practice: The importance of this research lies in shedding light on the significant impact of delirium on the health outcomes of patients after total hip arthroplasty, particularly in the short term. Guide clinical workers to identify risk factors early and improve the prognosis in patients after total hip arthroplasty. Patient or Public Contribution: No patient or public contribution. What Does This Paper Contribute to the Wider Global Clinical Community?: Age, fall risk and catheterisation were independent risk factors for POD in patients after total hip arthroplasty; total protein levels were protective against it. This study offers nursing staff a visual, non‐invasive and simple nomogram for calculating the risk probability of POD in patients underwent total hip arthroplasty. This study will help nursing staff to predict POD in patients at an early stage, and give personalised intervention measures to improve the prognosis.

Aim To establish a chain mediating model examining family caring, illness acceptance, perceived control, and self-perceived burden, based on the middle-range theory of adaptation to chronic illness, and to empirically test this model. Methods From June 2023 and March 2024, 254 elderly breast cancer patients were enrolled. Data were collected using a general information questionnaire, the family APGAR questionnaire, the self-perceived burden scale for breast cancer patients, the acceptance of illness scale, and the cancer experience and efficacy scale. IBM SPSS v26.0 and IBM AMOS v26.0 were used for data analysis. Results Family caring, illness acceptance, and perceived control demonstrated direct and statistically significant associations with self-perceived burden. Family caring indirectly affected self-perceived burden through five identified pathways. Three served as independent partial mediators in the relationship between family caring and self-perceived burden: illness acceptance (β = -0.172, [-0.110, -0.042]), perceived control (cancer experience) (β = -0.115, [-0.183, -0.056]), and perceived control (control efficacy) (β = -0.136, [-0.182, -0.098]). Two others were serial mediation pathways in the relationship: one through illness acceptance and perceived control (cancer experience) (β = 0.046, [0.016, 0.088]), and another through illness acceptance and perceived control (control efficacy) (β = 0.029, [0.013, 0.052]). Conclusions and Implications for Cancer Survivors The study confirmed that family caring primarily alleviates self-perceived burden by enhancing illness acceptance and reducing negative cancer-related experiences in elderly breast cancer patients. Thus, the assessment of family caring should be integrated into routine nursing practice, and psychoeducational programs designed to promote illness acceptance and reduce negative cancer-related experiences should be implemented.

Introduction The internet of things (IoT) is widely used in nursing care for older adults as it improves the efficiency and quality of care, especially in real-time health monitoring, disease management and remote patient supervision. However, no studies have been identified that map the evaluation methods used in existing IoT technology applications for nursing care interventions. This scoping review will map and categorise the evaluation methods used in nursing care interventions examining the IoT for older adults. Methods and analysis This scoping review will be conducted using the Joanna Briggs Institute framework, which encompasses defining inclusion criteria, developing a search strategy, identifying information sources, selecting source of evidence, extracting data, collating data, summarising findings and presenting results. English, Chinese and Japanese databases will be searched (PubMed, Embase, CINAHL, PsycInfo, Cochrane Library, WanFang Data, VIP, SinoMed, China National Knowledge Infrastructure, Ichu-shi Web and CiNii research) for sources published from 1 January 2015 to 31 December 2024. The results will be reported descriptively and thematically according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines for reporting. Descriptive statistics and narrative analysis methods will be conducted to summarise the relevant topics. Ethics and dissemination Ethics approval is not required for this scoping review, as it encompasses a secondary analysis of previously published literature and does not involve the collection of primary data pertaining to human subjects. The findings of this review will be published in a peer-reviewed journal.

Introduction: Agents used in antitumour therapy have toxic effects on the cardiovascular system of breast cancer (BC) patients, increasing the risk of cardiovascular disease, which has become the most common non-cancer cause of death in BC patients. Exercise can effectively prevent or reduce the occurrence of cardiotoxicity, however, most BC patients have low levels of physical activity. The Health Action Process Approach (HAPA) model has been successfully applied to encourage patients to adhere to physical exercise. This study aims to explore the impact of exercise interventions based on the HAPA model on the monitoring indicators related to cardiotoxicity in BC patients during chemotherapy, aiming to prevent cardiotoxicity in BC patients and improve their physical activity level, exercise self-efficacy, exercise social support and exercise compliance. Methods and analysis: In a protocol for a quasi-randomised controlled trial involving a 4-month intervention, 62 patients with BC will be recruited from a tertiary care centre in China. Participants from the first oncology department will be assigned to the HAPA model-based exercise intervention group (n=31), while participants from the second oncology department will be assigned to the control group that will receive standard exercise guidance (n=31). The primary outcome will be the incidence of cardiotoxicity assessed by Electrocardiogram (ECG). The secondary outcomes will include physical activity level, exercise self-efficacy, exercise social support and exercise compliance, which will be evaluated by the short form of the International Physical Activity Questionnaire (IPAQ-SF), Self-Efficacy for Exercise Scale (SEE), Social Support Scale for Exercise (SSSE), and percentage of achieving the recommended total time of exercise per week. The chi-square test or Mann-Whitney U tests will be applied to compare the differences in ECG results and exercise compliance between the two groups. To evaluate the effect of exercise intervention on IPAQ-SF, SSE and SSSE, repeated measures ANOVA will be employed to examine the group-by-time interactions and main effects. Ethics and dissemination: This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (PJ-KS-KY-2024-267(X)). The results of this study will be published via peer-reviewed publications and presentations at conferences. Trail registration number: ChiCTR2400090672.

Background: With increasing burnout and turnover rates among nurses, health leadership can effectively improve the health and well‐being of both leaders and staff. However, in the nursing field, the definition and mechanisms of health leadership remain unclear and require further research. Aim: The main objective of this study was to define the concept of health leadership in nursing, construct a nursing model program, and promote the formation of normative nursing health leadership theories and strategies. Evaluation: We searched the PubMed, CINAHL, Embase, Web of Science, PsycINFO, and Scopus databases. The following themes were extracted from the included articles: the concept, assessment tools for health leadership, influencing factors, intervention measures, and health effects. Key Issues: A systematic search of the relevant databases yielded 3161 initial search results. Thirty‐two studies were eligible for inclusion. Research shows that the concepts and measurement tools of health leadership are rarely applied in the field of nursing. Health leadership is influenced by personal factors (e.g., leadership qualities such as care, support, courage, patience, tolerance for uncertainty, persuasion skills, work ethic, pressure, experience, effort–reward imbalance, etc.; specific knowledge; self‐awareness; psychological capital; leadership style; motivation; consideration; and a commitment to health issues) and organizational factors (e.g., work environment, attention to subordinates, job expectations, and relationship transparency). Several studies have demonstrated that interventions, such as personal development planning, leadership training, face‐to‐face communication, self‐directed learning, and reflection, are effective in promoting healthy leadership styles and improving the well‐being of leaders and employees. Conclusions: We constructed a health leadership model as a reference for the development of relevant measurement tools and intervention strategies for the nursing field. Implications for Nursing Management: Nursing leaders should focus on their health and that of their subordinates, develop and implement health leadership, and aim for improvement in employees’ well‐being and nursing quality.

Objectives The well-being of nursing staff is closely related to nursing performance and patient safety. It has attracted much attention from nursing managers and researchers. However, the most important influencing factors and their relationships are not fully understood. The purpose of this study is to identify the factors influencing the well-being of nurses and find out the mediating role of resilience of from burnout to well-being of hospital nursing staff. Design A descriptive, multicentre cross-sectional study design. Settings 111 hospitals in Northeast China were randomly selected by the random cluster sampling method. Participants An online survey was administered to 11 827 nurses in December 2021, who engaged in clinical, nursing or management work and volunteered to participate. Outcomes measures The sociodemographic characteristics, general well-being schedule, Maslach burnout inventory and Connor–Davidson resilience scale were used to assess all participants. Results There are 15 variables entered into the regression equation, which can jointly predict 57.80% of the variance. There were a number of well-being-related factors identified. The individual factors include age, educational level, exercise, smoke, drinking, general health status, chronic disease, burnout and resilience. The organisational factors include psychological group, participating in psychological group activities, leadership training or communication training, working years, monthly income and night shifts. The results showed that the structural equation model of partial mediating effect of resilience was established. And the partial mediating effect accounted for 16.91% (−0.083/0.488) of the total effect. Conclusions There were a number of well-being-related factors identified, including individual and organisational factors, which provide directions for targeted support and interventions of nurses. It could improve the resilience of hospital nursing staff, reduce burnout and enhance well-being.

Introduction Cancer-related fatigue (CRF) is one of the most common and debilitating side effects experienced by patients with breast cancer (BC) during postoperative chemotherapy. Family-involvement combined aerobic and resistance exercise has been introduced as a promising non-pharmacological intervention for CRF symptom relief and improving patients’ muscle strength, exercise completion, family intimacy and adaptability and quality of life. However, evidence for the practice of home participation in combined aerobic and resistance exercise for the management of CRF in patients with BC is lacking. Methods and analysis We present a protocol for a quasi-randomised controlled trial involving an 8-week intervention. Seventy patients with BC will be recruited from a tertiary care centre in China. Participants from the first oncology department will be assigned to the family-involvement combined aerobic and resistance exercise group (n=28), while participants from the second oncology department will be assigned to the control group that will receive standard exercise guidance (n=28). The primary outcome will be the Piper Fatigue Scale-Revised (R-PFS) score. The secondary outcomes will include muscle strength, exercise completion, family intimacy and adaptability and quality of life, which will be evaluated by the stand-up and sit-down chair test, grip test, exercise completion rate, Family Adaptability and Cohesion Scale, Second Edition-Chinese Version (FACESⅡ-CV) and Functional Assessment of Cancer Therapy -Breast (FACT-B) scale. Analysis of covariance will be applied for comparisons between groups, and paired t-tests will be used for comparison of data before and after exercise within a group. Ethics and dissemination This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (PJ-KS-KY-2021-288). The results of this study will be published via peer-reviewed publications and presentations at conferences. Trail registration number ChiCTR2200055793.

Objective To investigate the prognostic value of the Prognostic Nutritional Index, Neutrophil to Lymphocyte Ratio, and Platelet to Lymphocyte Ratio in patients with atrial fibrillation after lung cancer surgery, which can provide objective predictors for screening patients with poor prognosis. Methods From April 2020 to August 2022, 157 patients with atrial fibrillation after lung cancer resection were enrolled. The blood levels of PNI, NLR, and PLR were collected on the last day before surgery and the day of the surgery. Patients were grouped according to the median or the ROC curve's best cut-off point. The K-M survival curve was drawn to analyze the incidence of composite adverse prognostic events in different groups, and COX regression was used to analyze the influencing factors of composite adverse prognostic events. Results The K-M survival curves of the high NLR group on the last day before the surgery (P = 0.007), the high PLR group on the day of the surgery (P = 0.022), and the high PLR group on the last day before the surgery (P = 0.001) were significantly different. The high PLR group on the last day before the surgery (HR = 4.225, 95%CI 1.715–10.410) and history of malignant tumor (HR = 3.548, 95%CI 1.178–10.690) were independent risk factors for composite adverse prognostic events in patients with AF after lung cancer surgery. Conclusions Patients with a preoperative PLR > 173.55 on the last day before the surgery and a history of malignant tumor are the effective indicators for the occurrence of combined adverse prognostic events in patients with atrial fibrillation after lung cancer surgery.

Objective: This paper aims to analyze the current situation and demand of “Internet + medical” services of the elderly in China, and to provide a reference for helping the elderly group to better use “Internet + medical” services. Methods: A cross-sectional survey was conducted among 434 elderly people using the self-made “Internet + medical” service usage questionnaire and usage demand questionnaire for the elderly. Results: The utilization rate of “Internet + medical” service was low (31.1%). Age, education level, and personal monthly income are the factors affecting the current use of “Internet + medical”services for the elderly ( P＜0.05). The elderly have a high demand for “Internet + medical” services, with the top three ranking in demand for disease and treatment-related information (M=3.29), knowledge of health and nutrition care (M=3.28), and appointment registration (M=3.24). The relatively low demand was participation in online telemedicine treatment (M=2.71), online telemedicine consultation (M=2.75), and online prescribing (M=2.76). Conclusion: The elderly in China to “Internet + medical” service utilization rate is low, but the use demand is higher. “Internet + medical” service in the elderly application is affected by a variety of factors. Therefore,we should increase publicity, development of aging operation platform, improve the elderly group to the use of “Internet + medical” service.