Yinglong Duan

Aim(s): To identify latent fatigue profiles in adolescent and young adult (AYA) cancer patients and explore associated clinical and socioeconomic factors to guide precision nursing. Design: A cross‐sectional observational study. Methods: A total of 218 AYA cancer patients were recruited from a tertiary cancer center between December 2025 and February 2026. Latent Profile Analysis was used to identify fatigue subgroups based on the Piper Fatigue Scale‐Revised. Multinomial logistic regression was applied to examine correlates. Results: Three distinct profiles emerged: ‘Low‐Fatigue Well‐Adapted’ (32.6%), ‘High‐Fatigue Somatic‐Dominant’ (38.1%), and ‘High‐Fatigue Emotional‐Cognitive Exhaustion’ (29.4%). The Somatic‐Dominant group exhibited severe sensory fatigue but mild distress, strongly associated with chemotherapy (OR = 2.42, 95% CI: 1.03–5.68, p = 0.041) and non‐working status (OR = 3.02, 95% CI: 1.38–6.58, p = 0.006). Conversely, the Emotional‐Cognitive Exhaustion group showed severe affective and cognitive exhaustion. This profile was significantly linked to active chemotherapy (OR = 4.95, 95% CI: 1.98–12.38, p < 0.001), lower income levels (higher income: OR = 0.52, 95% CI: 0.38–0.71, p < 0.001), and gastrointestinal cancer (OR = 3.15, 95% CI: 1.12–8.85, p = 0.029). Conclusion: Fatigue in AYA patients appears highly heterogeneous, manifesting either as somatic‐dominant patterns potentially associated with chemotherapy or multidimensional exhaustion linked to survival and economic pressures. Implications for the Profession and/or Patient Care: Nursing practice should transition from a uniform approach to phenotype‐based precision symptom management. Patients with somatic‐dominant fatigue require physical rehabilitation, whereas those experiencing emotional‐cognitive exhaustion urgently need integrated nutritional, psychological, and socioeconomic support to mitigate their multidimensional burden. Impact: What problem did the study address? The study addressed the limitation of treating cancer‐related fatigue as a uniform symptom in AYA patients, which masks individual variability and the hidden burden of chronic socioeconomic constraints. What were the main findings? Three distinct fatigue phenotypes were identified, revealing significant symptom heterogeneity. Severe emotional‐cognitive exhaustion was strongly linked not only to chemotherapy but also to chronic economic constraints of maintaining employment while ill. Where and on whom will the research have an impact? This research will impact oncology nurses, social workers, and clinical policymakers globally by providing an evidence‐based framework for precision symptom management and targeted socioeconomic interventions for vulnerable AYA cancer survivors. Reporting Method: This study adhered to the STROBE reporting guidelines for cross‐sectional studies. Patient or Public Contribution: No patient or public contribution.

BACKGROUND Psychological distress and sleep disturbance frequently co-occur among adolescents and young adults with gynecologic cancer, creating a substantial supportive care burden. Digital health microinterventions, particularly mobile-based approaches, may provide scalable and low-burden support. However, evidence regarding the feasibility, acceptability and potential effects of mobile health (mHealth) microinterventions in this population remains limited. OBJECTIVE This study aimed to evaluate the feasibility, acceptability and preliminary effectiveness of mHealth microinterventions targeting psychological distress and sleep disturbance among adolescents and young adults with gynecologic cancer. METHODS A two-arm, parallel-group randomized controlled trial was conducted between November 2025 and March 2026 in two tertiary hospitals. Participants were randomly assigned 1:1 to the intervention group (n = 10) or control group (n = 10). Both groups received routine care plus disease-related health education via the same WeChat platform. In addition, the intervention group received a 4-week trained research interventionist-assisted WeChat-based mHealth microintervention program. Feasibility outcomes (eligibility rate, enrollment rate, consent rate, retention rate, attrition rate, adherence indicators, and perceived feasibility) and acceptability (perceived acceptability and appropriateness, backend usage data and brief interview) and preliminary effectiveness outcomes were assessed. Assessments were conducted at baseline (T0), post-intervention (T1), 1-month follow-up (T2), and 2-month follow-up (T3). Generalized estimating equations were used to examine preliminary intervention effects. Participants and interventionists were not blinded because of the nature of the intervention. Data analysts were blinded to group allocation. No adverse events or harms were reported. RESULTS Of 77 patients screened, 35 were eligible and 20 were randomized. The eligibility, enrollment, consent and retention rate were 45.5%, 26.1%, 57.1% and 100% respectively. In the intervention group (n=10), the overall intervention completion rate was 80%, and 90% of participants completed at least 75% of the intervention content. Mean scores for perceived feasibility, acceptability, and appropriateness were high at 16.40±1.90, 16.60±1.90, and 16.80±1.69, respectively. Backend usage data indicated high adherence to the psychological distress support package and the sleep behavioral regulation module. Brief post-intervention feedback indicated that the microinterventions were practical, easy to use, and low burden. Compared with the control group (n=10), the intervention group had lower psychological distress scores than the control group at T1, T2, and T3, with adjusted between-group differences of −2.22, −2.12, and −2.12, respectively. Sleep disturbance scores were lower in the intervention group at T1 and T2, with adjusted differences of −3.49 and −1.99, respectively. Anxiety symptoms showed exploratory between-group differences at T2 and T3, with adjusted differences of −0.80 and −3.20, respectively. No significant between-group differences in depressive symptoms were observed at post-baseline time points. CONCLUSIONS The mHealth microinterventions demonstrated high feasibility and acceptability among adolescents and young adults with gynecologic cancer. Preliminary findings suggest potential short-term benefits for reducing psychological distress and improving sleep disturbance and anxiety symptoms. Further adequately powered trials with longer follow-up are needed to confirm these effects. CLINICALTRIAL NA

Background: Approximately 60% of patients with advanced cancer experience the distress of cancer-related fatigue (CRF), which significantly worsens their daily function and quality of life. Baduanjin has been regarded as a promising nonpharmacological intervention for alleviating CRF, anxiety, and depression and improving quality of life. Owing to varying degrees of CRF in patients with advanced cancer, patients may have insufficient endurance, making it difficult to implement standing Baduanjin. However, relevant evidence on sitting Baduanjin for CRF in patients with advanced cancer is lacking. Objective: This study aims to design a sitting Baduanjin intervention and explore the efficacy and safety of sitting Baduanjin in reducing CRF among patients with advanced cancer. Methods: This study will be a single-blind pilot randomized controlled trial. Patients with CRF will be enlisted from a tertiary cancer hospital in China. The participants (N=98) will be randomly assigned to either a sitting Baduanjin group or a control group at a 1:1 ratio using a block-randomized scheme. The participants in the sitting Baduanjin group will undergo a 16-week sitting Baduanjin intervention in addition to standard care, whereas the participants in the control group will receive standard care in the form of a booklet on the self-management of cancer symptoms. CRF will constitute the primary outcome, whereas anxiety, depression, and quality of life will serve as the secondary outcomes. These outcomes will be assessed at baseline (T0), 12 weeks (T1), and 16 weeks (T2). Results: The study was approved by the Medical Ethics Review Committee of Hunan Cancer Hospital in March 2024 (ethics approval number 2024.50). Before this full-scale randomized controlled trial, we conducted a pilot study, which demonstrated the feasibility and acceptability of sitting Baduanjin for patients with advanced cancer, with potential benefits for relieving fatigue. Conclusions: This randomized trial will evaluate the effectiveness of sitting Baduanjin exercises in alleviating CRF among patients with advanced cancer. If proven effective, it will provide a promising alternative intervention for patients with advanced cancer.

Previous studies specific to breast nodules are relatively scarce and mainly rely on cross-sectional research methods, overlooking the dynamic evolution of

In China, emergency department (ED) nurses frequently face high turnover rates and emotional exhaustion, phenomena that are intensified by the demanding nature of their roles. While emotional exhaustion significantly influences nurses intention to leave, the potential mitigating effects of factors such as emotional support have not been thoroughly explored. This study was designed to investigate the mediating role of emotional support between emotional exhaustion and turnover intention among ED nurses in China and to examine the factors of influence on turnover intention. A cross-sectional research design was used to collect data from 427 ED nurses from different hospitals across China using convenience sampling. The research instruments used included the Emotional Support Scale, Emotional Exhaustion Scale, Self-Rated Mental Health Status Scale, and Turnover Intention Scale. The findings showed not proactively having chosen a career in nursing (β=0.096, p<.05), greater emotional exhaustion (β=0.318, p<.001), satisfactory economic status (β=-0.196, p<.001), better physical condition (β=-0.128, p<.05), and more emotional support (β=-0.092, p=.032) to correlate negatively with turnover intention and emotional support to mediate the relationship between emotional exhaustion and intention to leave (β=-0.095, Bootstrap 95% CI [-0.152, -0.046], p<.001), accounting, collectively, for 34.8% of the total effect (β=-0.273, Bootstrap 95% CI [-0.364, -0.175], p=.002). Enhancing emotional support reduces turnover intention by mitigating the effects of emotional exhaustion on ED nurses in China. Targeted interventions that bolster emotional support systems, together with strategies that address financial satisfaction and physical well-being, will be essential to enhancing both nursing staff retention and overall patient care quality in China's demanding health care environment.

Introduction: Given the high prevalence of thyroid nodules and the potential for malignancy, it is imperative to understand the various factors that contribute to their development. This study aimed to explore the relationship between metabolic syndrome, lifestyle, and thyroid nodules in adult men in southern China. Methods: This study enrolled a total of 183,990 subjects at a medical examination center in a general hospital in southern China between January 1, 2015, and December 31, 2020. Multivariate logistic regression analysis was utilized to evaluate the relationship between metabolic syndrome, lifestyle factors, and thyroid nodules. Furthermore, structural equation modeling elucidated the intricate relationships among these variables. Results: The prevalence of thyroid nodules among Chinese adult males was 14.9%. Several factors were identified as risk factors for thyroid nodules, including advanced age, irregular meal time, smoking or quitting smoking, quitting drinking, heavy manual labor, hypertension, diabetes, dyslipidemia and centripetal obesity, and those belonging to ethnic minorities and drinking alcohol were found to be protective factors against thyroid nodules. Structural equation modeling highlighted metabolic syndrome's mediating role amidst lifestyle influences on thyroid nodules. Conclusion: The prevalence of thyroid nodules in Chinese adult males is relatively moderate to low. The factors identified in this study can help clinicians identify high-risk patients and develop targeted screening strategies for the timely detection of thyroid nodules. However, further mechanistic research and longitudinal studies are necessary to explore the underlying causes and establish causal relationships.