Xia Duan

Background: Physical activity, sedentary behavior, and sleep constitute interdependent components of the 24-hour day and are jointly associated with mental health in adults. This study aimed to examine the global research landscape, hotspots, and emerging trends in this field from 2016 to 2026. Methods: Records published between 1 January 2016,and 30 April 2026, were retrieved from the Web of Science Core Collection. The bibliometrix package (version 5.3.0), implemented in R (version 4.5.2), was used to analyze publication and citation trends and contributions from countries, institutions, authors, and journals. Country-level publication output was quantified using full counting of unique document–country pairs, such that each publication was counted only once for a given country, whereas internationally co-authored publications were credited to all participating countries. Country citation rankings were determined by aggregating citations according to the corresponding author’s country of affiliation. VOSviewer (version 1.6.20) was used to construct country-level co-authorship networks using full counting and to generate keyword co-occurrence networks. The R packages ggplot2 and circlize were used for additional visualizations, including chord diagrams of citation relationships among journals. Results: A total of 527 publications were included. The annual global production from 2016 to 2026 reflected an overall upward trend with significant fluctuations. The amount of global output peaked in 2024 with 147 publications, whereas the number of total citations reached its highest in 2022 (2702). The United States was involved in 152 of the included publications, China in 118, and Australia in 87. Australia recorded the highest total citations (1757), followed by the United States (1667) and China (1556). Keyword overlay visualization revealed a shift from traditional behavioral epidemiology focused on workplace behaviors and subjective well-being toward integrated, precision-oriented mental health research emphasizing aging, cognitive health, circadian rhythm, and objective behavioral monitoring. Emerging hotspots included machine learning, compositional data analysis, isotemporal substitution, and accelerometer-based assessment. Conclusions: Research on 24-hour movement behaviors and adult mental health has evolved into an increasingly interdisciplinary field, with growing emphasis on integrated behavioral approaches, objective assessment methods, and healthy aging.

Objectives: Sleep disturbance, cancer-related fatigue, emotional distress (anxiety and depression), and pain, collectively known as psychoneurological symptom cluster (PNSC), were common during and after anti-cancer treatment in breast cancer patients. This study aimed to explore the relationship among PNSC to identify potential intervention targets. Methods: In this cross-sectional study, 304 breast cancer patients who received treatment in the Breast Surgery Department from June 2025 to January 2026 were recruited. Self-report data were collected using the Cancer Fatigue Scale, the Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, and Visual Analog Scale for Pain. Static symptom interrelationships were examined using Gaussian network model, and putative directional associations were explored using Bayesian network analysis. The dynamic correspondence between symptoms was explored through computer-simulated interventions, and simulation-derived candidate symptom targets were identified. Results: The network analysis identified physical fatigue, sleep latency, and depression as core symptoms, with expected influence (EI) values of 1.883, 0.940, and 0.794, respectively; furthermore, the study identified physical fatigue, pain, and daytime dysfunction as bridging symptoms, with bridge expected influence (bEI) values of 1.824, 1.558, and 1.331, respectively. The estimated Bayesian network also suggested that physical fatigue occupied as a key node within the network. The results of computer-simulated interventions showed that depression produced the largest reduction, with sum scores declining from 5.98 to 4.67; this was followed by the affective fatigue and physical fatigue. Meanwhile, poor sleep efficiency was associated with an increase in the total sum score, from 5.99 to 6.04. Conclusions: Our findings suggest that physical fatigue and depression may be prioritized as intervention targets to break the vicious cycle of symptom interactions within the PNSC. The integration of computer-simulated interventions and traditional network analysis allowed for prioritizing the effects of individual symptoms at both static and dynamic levels, thereby improving the accuracy and effectiveness of targeted interventions. Further research is needed to verify whether targeting these symptoms can improve clinical outcomes.

Background: Clinical evidence guiding the fertility decisions of reproductive‐age patients with breast cancer remains limited. No study has reported the impact of fertility preservation interventions on the decision‐making process of patients with breast cancer. Fertility preservation interventions reduce fertility decision‐making conflicts and address psychological issues in patients with breast cancer. Aims: We evaluated the effectiveness of fertility preservation interventions, including educational materials, decision aids, and counseling models in facilitating informed fertility‐related decision‐making among reproductive‐age patients newly diagnosed with breast cancer. Additionally, we examined the influence of these interventions on patients' psychological state. Methods: We searched PubMed, Embase, ClinicalTrials.gov , and the Cochrane Library from inception to February 20, 2025. Randomized controlled trials and non‐randomized controlled trials that reported the effects of fertility preservation interventions on fertility decision making among patients with breast cancer were included. Two authors independently screened the studies, assessed their quality, and extracted the data. Bias risk was assessed using the Cochrane risk‐of‐bias tool for randomized trials. Results: The interventions were categorized as decision aids, educational interventions, and psychological interventions. Conclusions: Fertility preservation interventions significantly enhanced the fertility knowledge of patients with breast cancer, particularly interventions such as decision aids. However, no single intervention demonstrated distinct superiority specifically in terms of mitigating decisional conflict and alleviating patients' psychological distress. Fertility preservation interventions, when combined with specialist consultation, enhanced fertility‐related knowledge and had a positive impact on fertility decision making. High‐quality research is recommended to enrich fertility preservation interventions and encourage multidisciplinary teamwork to enhance fertility decision‐making. Trial Registration: The protocol was registered on PROSPERO (Registration number: CRD420251007625)

Patient safety is a fundamental objective for healthcare systems worldwide and a prerequisite for high-quality nursing care. Growing evidence indicates tha

Purpose: Frailty is a significant factor influencing the prognosis of patients with gynecological malignancies. Surgery and chemotherapy are key components of cancer treatment; however, limited research has addressed frailty and its associated risk factors in this patient population. This study aimed to determine the prevalence of frailty and identify its associated factors in patients with gynecological malignancies following surgery and chemotherapy. Method: This cross-sectional study was conducted at two tertiary hospitals in Shanghai between January and September 2024. Patients completed five assessment scales, including the Demographic Information Scale, Vulnerable Elders Survey-13 (VES-13), Athens Insomnia Scale (AIS), Depression Anxiety Stress Scale-21 (DASS-21), and Perceived Social Support Scale (PSSS), to screen for frailty and related factors. Multivariate logistic regression analysis was used to identify risk factors for frailty, with 95% confidence intervals (CIs) used to estimate the strength of the associations. Result: A total of 211 eligible inpatients with gynecological malignancies who had undergone surgery and chemotherapy were recruited. The prevalence of frailty in these patients was 64.9%. Multivariate logistic regression analysis identified several risk factors for frailty: older age, underweight status, stress, insomnia, married status, high white blood cell count, and low albumin levels. Conclusion: This study highlights the relatively high prevalence of frailty among patients with gynecological malignancies after surgery and chemotherapy. Understanding the factors associated with frailty is crucial for implementing timely interventions that can improve health-related quality of life and treatment outcomes in this patient population.

Workplace violence (WPV) against healthcare workers (HCWs)is a global issue. Resilience, a constructive psychological resource, can help HCWs better cope w

With the increasing incidence of stroke among young and middle-aged individuals, addressing their psychological well-being has become a critical concern. Negative emotional states such as depression, anxiety, and conditions like post-traumatic stress disorder (PTSD) can hinder recovery and increase the risk of recurrence. Therefore, this study aims to conduct a meta-synthesis of qualitative research on post-traumatic growth (PTG) in this population, examining the factors that contribute to PTG, its developmental trajectory, and the coping mechanisms involved. A systematic search of 14 databases was conducted, with reference tracking, to ensure comprehensive literature retrieval. A total of 1,753 articles were initially identified. After removing duplicates and excluding articles that did not meet the criteria, 11 studies were included, involving 156 participants in total, with 5 studies conducted in China and the remaining from other regions. The review followed the Joanna Briggs Institute (JBI) approach: systematic search with predefined criteria, critical appraisal of study quality using the JBI Checklist (assessing rigor in data collection/analysis), and meta-synthesis via iterative theme development (coding, categorizing findings) and validation (cross-checking by reviewers) to derive integrated results. A total of 42 research findings were synthesized into 9 new categories, further grouped into 3 integrated results: (1) trauma and stress period, which includes physical, psychological, and social stress; (2) adjustment and reconstruction period, involving seeking support, cognitive processing, self-mobilization, and life reorganization; and (3) growth period, characterized by new possibilities and self-actualization. The limited time frame of the studies and the predominance of research from China (5 out of 11 included studies) may restrict the generalizability of the findings. Excluding non-English and non-Chinese studies introduces a potential language bias. Furthermore, as the review only included qualitative studies with generally small sample sizes (total 156 participants), the findings should be interpreted with caution. This meta-synthesis is the first to systematically synthesize qualitative evidence on PTG in young and middle-aged stroke patients, offering a novel three-stage framework (trauma and stress, adjustment and reconstruction, growth) that integrates physical, psychological, and social dimensions of recovery. By clarifying distinct emotional, cognitive, and behavioral features at each stage, this study advances existing research—previously fragmented in exploring PTG elements—by providing a holistic developmental trajectory. In clinical practice, this framework informs targeted interventions (e.g., stage-specific emotional support, cognitive guidance, and social reintegration strategies) to facilitate PTG and enhance patients’ reintegration into society.

Background: Chemotherapy causes physiological, psychological, and social impairments in patients with cancer. Frailty reduces the effectiveness of chemotherapy and increases the toxicity associated with radiotherapy and chemotherapy, the possibility of chemotherapy failure, and adverse outcomes. However, factors affecting chemotherapy-related frailty in patients with cancer remain unclarified. Objective: This systematic review aimed to identify risk factors driving frailty progression during chemotherapy in patients with cancer. Methods: A comprehensive systematic search was conducted on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database (VIP), and SinoMed for observational studies (cohort, cross-sectional, or case-control) on factors affecting the debility-of-chemotherapy stage in patients with cancers between the inception of the database and February 2025, with an updated search executed in May 2025. Literature screening, quality evaluation using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality checklist, and data extraction were conducted independently by 2 authors. Meta-analysis, effect size combination, sensitivity analysis, and publication bias analysis were performed using RevMan (version 5.4; The Cochrane Collaboration) and R (version 4.4.3; R Foundation). Results: The analysis comprised 14 studies (8 cross-sectional, 2 repeated cross-sectional, 3 cohort, and 1 mixed-design), including 3879 patients with cancer and 23 influencing factors. Methodological quality assessment using Agency for Healthcare Research and Quality (mean 8.8, SD 1.3, 95% CI 7.9‐9.7; SE 0.4) and Newcastle-Ottawa Scale (mean 8.0, SD 1.0, 95% CI 6.7‐9.3; SE 0.6) revealed 73% (8/11) of cross-sectional studies as high-quality. The meta-analysis showed a 35% (95% CI 22%‐50%) prevalence of frailty during chemotherapy in these patients. Cancer stage (odds ratio 1.99, 95% CI 1.64‐2.42), chemotherapy frequency (odds ratio 2.60, 95% CI 1.83‐3.70), transfer (odds ratio 2.18, 95% CI 1.50‐3.17), hemoglobin (odds ratio 0.29, 95% CI 0.18‐0.47), white blood cell (odds ratio 0.37, 95% CI 0.21‐0.65), comorbidity (odds ratio 1.93, 95% CI 1.30‐2.86), and hypoproteinemia (odds ratio 1.74, 95% CI 1.31‐2.30) were risk factors for frailty in patients at the chemotherapy stage. Conclusions: Frailty during chemotherapy was strongly associated with advanced cancer stage, frequent treatment cycles, metastasis, anemia, leukopenia, comorbidities, and hypoproteinemia. Clinically actionable findings emphasized hemoglobin and albumin monitoring as preventive targets, while heterogeneity in assessment tools and population bias limited generalizability. The integration of frailty screening into chemotherapy workflows is urgent to mitigate treatment-related functional decline.

Background: Seeking professional psychological help can improve outcomes for women with perinatal depression (PND). However, the use of professional psychological help-seeking behaviors for women with PND is not promising. Spouses are important sources of support and play a decision-making role in the process of seeking professional psychological help for women with PND. Exploring the factors that influence couples’ intention to seek professional psychological help is important for developing effective interventions. This study aims to investigate the level and latent profiles of intention to seek professional psychological help in women with PND and their spouses, and identify influencing factors associated with different profiles.Methods: A cross-sectional study involving 267 women with PND and 267 spouses was conducted. The General Help-Seeking Questionnaire-the Intention to Seek Professional Psychological Help (GHSQ-ISPH), the Questionnaire of Stigma for Seeking Professional Psychological Help Questionnaire, the Attitude Toward Seeking Professional Psychological Help Scale, the Self-Efficacy for Seeking Mental Health Care Help Scale and the Edinburgh Postnatal Depression Scale were used. Latent profile analysis was used to identify groups with similar levels of GHSQ-ISPH. Multiple logistic regression was used to explore influencing factors associated with the intention to seek professional psychological help.Results: The mean GHSQ-ISPH scores of women with PND and their spouses were 12.17 ± 4.06 and 12.61 ± 3.88, respectively. LPA yielded three profiles. The profiles were named based on the GHSQ-ISPH score to reflect the level to which women with PND and their spouses intend to seek professional psychological help: “Women low-Spouses high intention for help” (Profile 1), “Women high-Spouses low intention for help” (Profile 2) and “Couple high intention for help” (Profile 3). Multiple logistic regression showed that spouses with a monthly income (858-1285/USD), with lower openness to seeking treatment for emotional problems, lower knowledge competence beliefs, and negative attitudes toward seeking professional psychological help were significantly associated with Profile 2 than with Profile 3 (P < 0.05 or P < 0.001). PND women who received a university or college and with lower public stigma were more significantly related to Profile 1 than Profile 3 (P < 0.05).Conclusion: The findings of this study indicate a moderate level of intention to seek professional psychological help among women experiencing PND and their partners. These results offer valuable insights for perinatal nurses, suggesting the necessity for the development of targeted interventions aimed at enhancing couples’ intentions to pursue professional psychological support. Identifying the factors associated with each profile outlined in this research offers the opportunity for more personalized and effective interventions. Tailored approaches like these could substantially enhance engagement with mental health resources, leading to improved outcomes for couples affected during the perinatal period.

To explore symptom clusters, symptom experiences, and self-management strategies in patients with cervical cancer undergoing concurrent chemoradiotherapy. A qualitative descriptive approach was used. Semi-structured interviews were conducted with patients with cervical cancer using an interview guide. The audio recording of the interviews was transcribed. Thematic analysis was conducted using Colaizzi's seven-step framework. Thirteen participants were interviewed. The mean age of the participants was 47 years. Three themes were identified: (a) Struggle for survival among patients reintegrating into society; (b) Overcoming self-management challenges; and (c) Resilience and adaptation in the face of adversity. Individuals diagnosed with cervical cancer who undergo concurrent chemoradiotherapy often experience various clusters of symptoms. Despite facing challenges in self-management, these patients maintain a positive attitude and persistently strive to coexist harmoniously with their health conditions.