Xiaoju Chen

Objectives: This study aimed to identify factors associated with current sleep disturbance (SD) in patients with colorectal cancer (CRC) undergoing chemotherapy and to develop and internally evaluate a nomogram for estimating the probability of current SD. Methods: A total of 630 patients with CRC undergoing chemotherapy were recruited from five hospitals in China. Participants were assessed using the Demographic Information Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS), while clinical assessment data and laboratory test results at admission were obtained from electronic medical records. The data were randomly divided into a training set and a validation set at a 7:3 ratio. Univariable analyses and multivariable logistic regression were used to identify factors associated with SD in patients with CRC undergoing chemotherapy. The training set was used for multivariable logistic regression modeling and nomogram development, whereas the validation set was used to evaluate the discrimination and calibration of the fixed model. In addition, 500 bootstrap resamples were performed within the training set for internal validation. Results: The overall prevalence of current SD was 68.7%. Gender, disease duration, ECOG performance status, HADS-D score, serum potassium, and albumin were independently associated with current SD and were included in the final nomogram. The model showed an AUC of 0.762 (95% CI, 0.716~0.808) in the training set and 0.712 (95% CI, 0.635~0.789) in the validation set. Bootstrap internal validation in the training set yielded a mean absolute calibration error of 0.022. In the validation set, the mean absolute calibration error (Eavg) was 0.055, with a calibration intercept of 0.318, a calibration slope of 0.667, and a Brier score of 0.188. Conclusions: Patients with CRC undergoing chemotherapy had a high burden of current SD. The nomogram may assist in identifying patients with a higher probability of current SD who may warrant further sleep assessment.

Objective: To systematically review the existing literature on risk prediction models for malnutrition in cancer patients. Background: Malnutrition is highly prevalent among cancer patients, and timely identification and intervention can improve patient outcomes and quality of life. Risk prediction models can forecast the future disease risk of patients. This study aims to conduct a comprehensive scoping review of malnutrition risk prediction models for cancer patients developed domestically and internationally, analyse current gaps in the field, and provide references for clinical practice and future research. Methods: This review followed the PRISMA Extension for Scoping Reviews and the Arksey and O'Malley framework, and the study was conducted in accordance with the CHARMS checklist. Systematic searches were conducted in PubMed, Web of Science Core Collection, the Cochrane Library, EMbase, CINAHL, CNKI, Wanfang, and Sinomed, with the search period spanning from database inception to October 23, 2025. Original studies reporting the development or validation of malnutrition risk prediction models in cancer patients were eligible for inclusion. Results: A total of 36 studies were included in this scoping review. Extracted data included study characteristics, model development methods, predictors included, and performance evaluation metrics. Considerable overlap was observed in the development methods across models, with traditional statistical analysis being predominant. Retrospective data collection was applied in the majority of the included studies. These prediction models covered multiple malignancies, including rectal, liver, nasopharyngeal, gastric, and oesophageal cancers. A wide range of predictors was used, with age and BMI being the most frequently included. Conclusion: This review maps cancer patients' malnutrition prediction models. Existing models screen malnutrition but have flaws in construction and validation. Future studies will adopt longitudinal, multimodal data and AI to optimize tools for early screening and intervention.

Spiritual well-being (SWB) is an integral component of palliative and holistic care for patients with advanced cancer undergoing chemotherapy. However, its latent characteristics have not been fully explored. This study aimed to identify latent profiles of spiritual well-being (SWB) among patients with advanced cancer undergoing chemotherapy and to examine the factors influencing profile membership. Cross-sectional study. The study was conducted from February to June 2025 in the oncology departments of three Grade-A tertiary hospitals in Southwest China, involving 318 patients with advanced cancer undergoing chemotherapy. Data were collected using the Demographic Information Questionnaire, the Functional Assessment of Chronic Illness Therapy Spiritual Well-being Scale (FACIT-Sp), the Hospital Anxiety and Depression Scale (HADS), the Comprehensive Scores for Financial Toxicity Based on the Patient-reported Outcome Measures (COST-PROM), and the Family APGAR Index. Descriptive statistics, latent profile analysis, univariate analysis, and multivariate logistic regression were employed to identify latent profiles of SWB and their influencing factors. The SWB of patients with advanced cancer undergoing chemotherapy was categorized into three latent classes: “Low SWB Group” (28.9%), “Moderate SWB Group” (36.5%), and “High SWB Group” (34.6%). Marital status, residence, monthly household income per capita, payment method for medical expenses, anxiety and depression, FT, and family function were identified as significant factors influencing different levels of SWB (P < 0.05). Patients with advanced cancer undergoing chemotherapy showed marked heterogeneity in SWB, which could be classified into three latent profiles. These findings suggest that healthcare providers may use a biopsychosocial (BPS) framework to guide stratified supportive care tailored to profile-specific factors, integrating symptom management with psychosocial, family, and spiritual support as well as resource linkage, to better address patients’ diverse needs and potentially improve overall well-being. The online version contains supplementary material available at 10.1186/s12904-026-02058-4.

Objective: This study aimed to investigate the dyadic relationship between illness perception, emotion regulation strategies, and posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Methods: This study used a cross‐sectional approach to collect data from 332 pairs of lung cancer patients receiving chemotherapy and family caregivers from China. Participants completed the Brief Illness Perception Questionnaire, the Emotion Regulation Questionnaire, and the Posttraumatic Growth Inventory. The actor–partner interdependence effects were used to analyze how illness perception and emotion regulation strategies affect posttraumatic growth in the patients themselves and their family caregivers. Results: Both illness perception and emotion regulation strategies had significant actor and partner effects on posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Emotion regulation strategies were categorized as cognitive reappraisal and expressive suppression, and patients had lower scores than caregivers for posttraumatic growth, illness perception, and expressive suppression, except for cognitive reappraisal scores, which were higher than caregivers. In patient–caregiver dyads, cognitive reappraisal was positively associated with posttraumatic growth in themselves and each other, whereas both illness perception and expressive suppression were negatively associated with posttraumatic growth. Conclusion: Reducing negative illness perceptions and expressive suppression may promote posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Facilitating cognitive reappraisal may be useful in enhancing posttraumatic growth, which provides direction for future intervention research. Healthcare professionals should view lung cancer chemotherapy patients and their family caregivers as a whole and develop dyadic interventions.

Objectives: Based on social cognitive career theory, this study explores the mediating effect of willingness to accept and strive in the relationship between professional identity (PI) and personal career planning among first‐year nursing students, to provide reference for their career development. Methods: From December 2024 to January 2025, 362 first‐year nursing students from two universities were recruited via convenience sampling. Data were collected using a general information questionnaire, the Professional Identity Questionnaire for Nursing Students (PIQNS), the Willing Acceptance and Striving Questionnaire (WASQ), and the Personal Career Planning Scale. SPSS 26.0 was applied for descriptive and correlational analyses; its process macro (Model 4) with 5000 bootstrap samples was used to test the mediating effect of acceptance willingness and initiative on nursing undergraduates’ PI and personal career planning. Results: The scores for PI, willing acceptance and striving, and personal career planning of first‐year nursing undergraduates were 56.97 ± 8.51, 84.16 ± 10.96, and 89.66 ± 10.85 respectively. Personal career planning was positively correlated with PI ( r = 0.399, p < 0.01); personal career planning was positively correlated with willing acceptance and striving ( r = 0.391, p < 0.01); willing acceptance and striving was positively correlated with PI ( r = 0.626, p < 0.01); and willing acceptance and striving played a partial mediating role between PI and personal career planning in the nursing major undergraduate students, with the mediating effect being 0.117 [95% CI (0.021–0.202)], accounting for 36.45% of the total effect. Conclusions: First‐year nursing undergraduates show moderate career planning (with room to improve). Willing acceptance and striving partially mediate the relationship between PI and career planning. Educators should focus on enhancing their career planning skills, PI, psychological mechanisms, and proactive attitudes to support professional growth.

Background: Self-regulated fatigue (SRF) can seriously damage the physical and mental health of persons with colorectal cancer (CRC) undergoing chemotherapy. Understanding how to improve self-regulation ability is of crucial importance. Objectives: To investigate the status of potential profiles of SRF in persons with CRC treated with chemotherapy and the factors associated with these profiles. Methods: A convenience sampling method was used to conduct a questionnaire survey with 322 hospitalized persons with CRC who were undergoing chemotherapy at three tertiary-grade A hospitals in China. Data were collected through the General Information, Self-Regulatory Fatigue Scale, Family Health Scale, the 10-item Kessler Psychological Distress Scale, and Cancer Information Overload Scale. Latent profile analysis and multiple logistic regression were used to analyze the data. Results: SRF among persons undergoing chemotherapy for CRC could be divided into three potential profiles: low SRF-extensive social profile (53.1%), moderate SRF profile (32.3%), and high SRF-low mood profile (14.6%). Sex, per capita family monthly income, family health, psychological distress, and cancer information overload were predictive factors for different profiles of SRF. Discussion: There were three latent profiles of SRF in persons with CRC. Family health, psychological distress, and information overload were significant predictors of SRF. Health care providers should adopt individualized interventions to help patients improve disease coping, reduce SRF, and provide support through family care, information filtering, and psychological support.

Objectives To characterize the lived experiences and unmet needs of nutritional education among colorectal cancer patients undergoing chemotherapy based on the Knowledge-Attitude-Practice model, thereby informing the development of evidence-based nutritional intervention programs. Methods A descriptive qualitative study was conducted using purposive sampling. From January to March 2022, semi-structured interviews were performed with 17 colorectal cancer patients undergoing chemotherapy at five tertiary Grade A general hospitals in western China. All interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Two researchers independently coded the interviews using NVivo 12, and directed content analysis was employed to inductively summarize and refine themes. Results Five barriers to effective nutritional education were identified: (1) Lack of nutrition education knowledge, (2) Lack of evidence-based nutrition beliefs, (3) non-standardized nutritional practices, (4) Barriers to receiving nutrition education, and (5) Diversified needs for nutrition education. Conclusions Colorectal cancer patients undergoing chemotherapy reported suboptimal nutritional education experiences and multifaceted needs, highlighting persistent challenges. Healthcare providers should comprehensively assess patients’ educational experiences, deliver multimodal interventions addressing diverse needs, enhance education accessibility and acceptability, and strengthen nutritional awareness to mitigate malnutrition risks. Practice Implication Our results provide insights for cancer patient nutrition educators to better help colorectal cancer chemotherapy patients, emphasizing the need to educate them about the knowledge, behaviors, beliefs, and more they have not received. This will enable colorectal cancer chemotherapy patients to receive better nutrition education, reduce their risk of malnutrition, and improve their recovery and quality of life.