Ying Zhou

Background: Low-dose computed tomography (LDCT) has improved early detection of lung cancer, but the identification of indeterminate pulmonary nodules (PNs) often triggers psychological distress. Evidence remains limited regarding longitudinal psychological changes following different management approaches and the identification of patients at risk for persistent distress. This study aimed to longitudinally evaluate psychological outcomes and identify predictors of symptom change in patients with LDCT-detected PNs managed by surgical resection/biopsy or radiological surveillance. Methods: A prospective observational study with baseline and 1-month follow-up assessments was conducted. A total of 936 patients with newly detected PNs were consecutively enrolled at a thoracic surgery clinic. Anxiety, depression, and insomnia were assessed using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) scales. Group differences were analyzed using Wilcoxon signed-rank tests, and multivariate logistic regression with inverse probability of treatment weighting (IPTW) was applied to identify predictors of psychological improvement. Results: At baseline, clinically significant anxiety, depression, and insomnia were reported in 40.2%, 31.7%, and 24.6% of patients, respectively. After 1 month, symptoms significantly improved across the cohort (PConclusions: Psychological distress is highly prevalent among patients with LDCT-detected PNs. Surgical resection is significantly associated with anxiety, depression, and insomnia, while surveillance alone offers limited psychological benefit. Early identification of vulnerable subgroups is crucial to guide integrated clinical and psychological care and inform patient-centered management strategies.

Background: While behavioral and psychological symptoms of dementia (BPSD) are generally associated with care time, the strength and nature of these associations may vary across individual symptoms. Aim: To examine these nuanced associations using a network perspective among older adults with dementia, thereby yielding more comprehensive insights. Design: A cross-sectional study design was employed. Methods: Between December 2022 and May 2023, 205 Chinese older adults with dementia were recruited from two nursing homes in Guangzhou. BPSD severity and caregiver distress were assessed using the Neuropsychiatric Inventory (NPI). The Per-Minute Care Intensity method was used to quantify the amount of formal care time received within a 24-h period. Network analysis was conducted to illustrate the complex nuanced relationships between specific BPSD symptoms and corresponding care time. Results: Network analysis identified “irritability” and “agitation/aggression” severity, along with the caregiver distress caused by these two symptoms, as central nodes in two separate networks. In addition, the severity of “aberrant motor behaviors” and “agitation/aggression,” as well as the related caregiver distress, emerged as key bridge nodes connecting BPSD symptoms with care time. Conclusion: These findings provide preliminary evidence of potential pathways through which specific BPSD symptoms are linked to care time in older adults with dementia. This underscores the importance of prioritizing targeted interventions for central and bridge symptoms such as agitation, irritability, and abnormal motor behavior. Future intervention studies are warranted to validate these findings and further refine strategies for optimizing care practice. Patient or public contribution: No patient or public contribution. Impact: A deeper understanding of the intricate connections between specific BPSD symptoms and corresponding care time will help administrators prioritize symptoms such as agitation and irritability when designing interventions aimed at reducing caregiver burden.

Aim: To explore the abnormal experiences of time and space among transitional‐age youth with major depressive disorder. Design: A descriptive phenomenological qualitative study. Methods and Setting: The study was conducted at a psychiatric hospital in China. Purposive sampling was used to recruit transitional‐age youth with major depressive disorder. Data were collected through semi‐structured interviews and analysed using Colaizzi's method. Findings: Seventeen participants were interviewed. The abnormal experiences of time and space among transitional‐age youth with major depressive disorder were synthesised into five overarching themes: (1) Disturbance of Time Order; (2) Slackening of the Flow of Time; (3) Vital Inhibition; (4) Desynchronisation of Social Rhythms; and (5) Disturbance of Lived Space. Conclusions: This study highlights that pervasive abnormalities in temporal and spatial experiences characterise transitional‐age youth with major depressive disorder. These disturbances shape their sense of self, personal development, relationships and engagement with the world, underscoring the need for interventions that address these temporal and spatial disturbances within the context of developmental transition. Impact: This study addresses a knowledge gap regarding the subjective experience of time and space among transitional‐age youth with major depressive disorder. This study highlights that transitional‐age youth with major depressive disorder experience desynchronisation across temporal, spatial, bodily and social domains. Moreover, the desynchronisation of social rhythms appears to be a unique and developmentally salient challenge for transitional‐age youth with major depressive disorder. These insights expand phenomenological understandings of major depressive disorder and highlight the developmental vulnerabilities of major depressive disorder as it navigates this critical life phase. Patient or Public Contribution: Five participants were involved in reviewing and providing feedback on the interview content and results. Their contributions included enhancing the authenticity and credibility of the findings. Reporting Method: The study followed the Consolidated Criteria for Reporting Qualitative Research guidelines.

Background: This study aims to elucidate the mediating roles of gratitude and forgiveness tendency between mature happiness and positive mental health, seeking to reveal the significance of enhancing these psychological traits to enhance the well-being of this population, so as to provide a theoretical foundation for strategies aimed at promoting healthy aging and enhancing the happiness of elderly patients with chronic illness. Methods: From April to October 2024, elderly patients with chronic diseases in the geriatric department of a tertiary hospital in Guangzhou China were selected as subjects through convenience sampling. The study utilized the general information questionnaire, the Chinese Version of Mature Happiness Scale-Revised, the Positive Mental Health Scale, the Gratitude Questionnaire-6, and the Tendency to Forgive Scale for data collection. Results: A total of 319 valid questionnaires were obtained. The mature happiness, positive mental health, gratitude, and forgiveness tendency of elderly patients with chronic diseases were at a medium level. Correlation analysis indicated that mature happiness was positively associated with positive mental health, gratitude, and forgiveness tendency. Mediation analysis illuminated that positive mental health robustly predicted the extent of gratitude, which served as a pivotal predictor of mature happiness. Moreover, gratitude and forgiveness tendency together played a significant chain mediating role between mature happiness and positive mental health, accounting for 26.31% of the total effect (p = 0.246). Conclusions: Positive mental health has a significant positive impact on mature happiness amongst elderly patients with chronic diseases, mediated through the chain mediating effects of gratitude and forgiveness tendency. Consequently, fostering traits of gratitude and forgiveness in this population may enhance their mental health and mature happiness.

Aim: With an aging global population, there has been a growing interest in the subjective well‐being (SWB) of older people. As a positive emotion, gratitude has been found to be significantly and positively associated with SWB. However, the mechanisms underlying the relationship between gratitude and SWB remain poorly understood. This study aimed to examine the mediating effects of social support and self‐efficacy in the relationship between gratitude and SWB among older Chinese adults in nursing homes.Design: A cross‐sectional study.Methods: A sample of 354 older adults in nursing homes aged 60 years and above was recruited across three nursing homes in Guangzhou, China. Participants completed the Gratitude Questionnaire‐Six‐Item Form, the World Health Organization's well‐being index, the General Self‐efficacy questionnaire and the Multidimensional Scale of Perceived Social Support. Structural equation modelling was used to evaluate the relationships between gratitude, self‐efficacy, social support and SWB. A bootstrap test was performed to test mediating roles of self‐efficacy and social support.Results: Gratitude was found to be significantly and positively associated with SWB (β = 0.294, p < 0.001). Self‐efficacy and social support independently mediated the relationship between gratitude and SWB (indirect effect of self‐efficacy: Standardised β = 0.105, 95% CI [0.061, 0.157]; indirect effect of social support: Standardised β = 0.116, 95% CI [0.444, 0.191], all p < 0.001). Additionally, the results indicated that the mediating effect of self‐efficacy was not significantly different from that of social support in the link between gratitude with SWB.Conclusion: These findings presented strong evidence that self‐efficacy and social support provided the underlying mechanisms through which gratitude was associated with SWB in Chinese nursing home residents. This highlighted the need to develop interventions aiming at increasing gratitude, self‐efficacy and social support to promote SWB among elderly people.Patient or Public Contribution: No patient or public contribution.

Background: There are numerous symptoms related to cancer and its treatments that can affect the psychosomatic health and quality of life of patients with cancer. The use of electronic symptom management systems (ESMSs) can help patients with cancer monitor and manage their symptoms effectively, improving their health-related outcomes. However, patients’ adhesion to ESMSs decreases over time, and little is known about their real experiences with them. Therefore, it is necessary to gain a deep understanding of patients’ experiences with ESMSs. Objective: The purpose of this systematic review was to synthesize qualitative studies on the experiences of patients with cancer using ESMSs. Methods: A total of 12 electronic databases, including PubMed, Web of Science, Cochrane Library, EBSCOhost, Embase, PsycINFO, ProQuest, Scopus, Wanfang database, CNKI, CBM, and VIP, were searched to collect relevant studies from the earliest available record until January 2, 2024. Qualitative and mixed methods studies published in English or Chinese were included. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist) and the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) statement were used to improve transparency in reporting the synthesis of the qualitative research. The Critical Appraisal Skills Program (CASP) checklist was used to appraise the methodological quality of the included studies, and a meta-synthesis was conducted to interpret and synthesize the findings. Results: A total of 21 studies were included in the meta-synthesis. The experiences of patients with cancer using ESMSs were summarized into three major categories: (1) perceptions and attitudes toward ESMSs; (2) the value of ESMSs; and (3) barriers, requirements, and suggestions for ESMSs. Subsequently, 10 subcategories emerged from the 3 major categories. The meta-synthesis revealed that patients with cancer had both positive and negative experiences with ESMSs. In general, patients recognized the value of ESMSs in symptom assessment and management and were willing to use them, but they still encountered barriers and wanted them to be improved. Conclusions: This systematic review provides implications for developing future ESMSs that improve health-related outcomes for patients with cancer. Future research should focus on strengthening electronic equipment and technical support for ESMSs, improving their functional contents and participation forms, and developing personalized applications tailored to the specific needs and characteristics of patients with cancer. Trial Registration: PROSPERO CRD42023421730; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421730

Background: Amidst the expansion of student enrollment in higher education, the well-being and retention rates of students have emerged as important concerns. Resilience, especially academic resilience, a multidimensional construct that can lead to academic success in adversity, is pivotal in enabling students to successfully cope with academic challenges. While the Academic Resilience Scale-30 (ARS-30) has been validated as an effective instrument in various languages, its applicability for Chinese students in higher education remains unexplored.Objective: This study aims to translate and validate the ARS-30 in Chinese, assessing its reliability and validity among Chinese college students in higher education.Methods: A convenience sample of 1,542 students participated in this study. The inventory included the demographic form, Chinese version of ARS-30 (C-ARS-30), 10-item Connor Davidson Resilience Scale (CD-RISC-10), and General Self-Efficacy Scale (GSES). The assessment of validity was conducted by analyzing content validity, construct validity, convergent and discriminant validity, as well as criterion-related validity. Construct validity was evaluated through Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA) and Exploratory Structural Equation Modeling (ESEM). Reliability analysis was performed using Cronbach’s alpha and test–retest reliability.Results: The C-ARS-30 demonstrated commendable content validity, with the CVI value of items ranging from 0.833 to 1.000, and a total scale CVI of 0.986. ESEM analysis revealed a solid four-factor structure, maintaining the scale’s 30 items with excellent fit indices (χ²/df = 2.647, CFI = 0.937, TLI = 0.915, RMSEA = 0.057, SRMR = 0.027). The total score of C-ARS-30 exhibited positive correlations with the CD-RISC-10 (r = 0.542) and the GSES (r = 0.488). The scale demonstrated high internal consistency (Cronbach’s α = 0.930) and test–retest reliability (0.794, p < 0.01).Conclusion: The C-ARS-30 is a reliable and valid instrument for assessing academic resilience among Chinese college students, offering a valuable tool for educational and psychological evaluations.