Objective To investigate the prevalence, distribution characteristics, and influencing factors of mental health problems among the elderly, and to provide a scientific basis for policy-making.  Methods A convenience sampling method was used to investigate depression, anxiety, and cognitive function among permanent residents aged 65 and older at 59 mental health care sites for the elderly in Hubei Province. Multinomial logistic regression was employed to analyze influencing factors. Results The screening rates for depression, anxiety, and cognitive function at critical/high-risk levels among the elderly in Hubei Province were 9.7%, 5.4%, and 12.2%, respectively. Urban elderly had lower risks of depression and cognitive function at critical/high-risk levels compared to rural elderly (OR for critical depression = 0.640, P < 0.001; OR for high-risk depression = 0.595, P = 0.012; OR for critical cognitive function = 0.448, P < 0.001; OR for high-risk cognitive function = 0.188, P < 0.001). Six key population groups had higher risks of depression, anxiety, and cognitive function at critical/high-risk levels than others (OR for critical depression = 1.463, P < 0.001; OR for high-risk depression = 1.912, P < 0.001; OR for critical anxiety = 1.462, P < 0.001; OR for high-risk anxiety = 2.882, P < 0.001; OR for critical cognitive function = 1.381, P < 0.001; OR for high-risk cognitive function = 2.345, P < 0.001). A higher number of chronic diseases was associated with increased risks of critical and high-risk depression (OR for critical = 1.316, P < 0.001; OR for high-risk = 3.677, P < 0.001) and cognitive impairment (OR for critical depression = 1.316, P < 0.001; OR for high-risk depression = 3.677, P < 0.001; OR for critical anxiety = 1.512, P < 0.001; OR for high-risk anxiety = 1.801, P < 0.001). Conclusion It is recommended to expand mental health care sites in rural areas, improve the layout of mutual-support elderly care facilities, and explore sustainable models for rural elderly care. Efforts should also focus on enhancing social participation among the elderly through community-based activities, and strengthening cognitive screening and emotional regulation interventions, with particular attention to the mental health needs of older, isolated, and chronically ill individuals.

OBJECTIVE To investigate the current status and existing issues of hospital-associated infection manage-ment in non-public medical institutions,so as to provide data for the formulation of hospital-associated infec-tion management policies and the construction of a quality evaluation system for hospital-associated infection man-agement in non-public medical institutions.METHODS A qualitative research method was employed.In Dec.2023,semi-structured interviews were conducted with 38 directors of hospital-associated infection management depart-ments in primary,secondary and tertiary non-public medical institutions.The interview data were coded and ana-lyzed by Nvivo 12.0 software to refine themes.RESULTS Three themes were refined:the organizational system for hospital-associated infection management in non-public medical institutions had been basically established,but the division of functions and responsibilities was not yet fully clear,hospital-associated infection management had achieved certain results,including collaborating with other departments to standardize and implement infection control measures,enhancing staff awareness of infection control,and promoting the establishment of organization-al systems.There were issues in infection control works such as insufficient funding,personnel allocation not meeting requirements,and difficulties in implementing infection control measures.The most urgent assis-tance needed was to address the training and professional title promotion for full-time and part-time infection con-trol personnel.CONCLUSION Non-public medical institutions should strengthen staffing and training,enhance the pro-fessional capabilities of infection control personnel,and establish hospital-associated infection management standards that are tailored to the characteristics of non-public medical institutions at all levels.

Objective:To investigate the application value of scenario simulation combined with standardized patient teaching in the training of doctor-patient communication skills among interns.Methods:A total of 110 clinical medicine interns were selected from Qilu Hospital of Shandong University and were divided into experimental group and control group using a random number table, with 55 interns in each group. The interns in the control group received traditional lecturing, and those in the experimental group received scenario simulation combined with standardized patient case-based teaching. The SEGUE Communication Skill Evaluation Scale and Patient Satisfaction Questionnaire were used to assess the improvement in communication skills in both groups, and Physician Self-Evaluation Scale and Course Satisfaction Questionnaire were used to assess the effectiveness of the course and the degree of satisfaction with the course. SPSS 26.0 was used for the t-test, the Mann-Whitney U test, and the rank sum test. Results:After training, both groups showed significant improvements in communication skills and patient satisfaction [experimental group in terms of communication skills: (55.38±13.11) vs. (74.82±6.75), P<0.001; experimental group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 81.00 (79.00, 83.00), P<0.01; control group in terms of communication skills: (56.53±12.34) vs. (65.45±10.18), P<0.001; control group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 73.00 (68.00, 77.00), P<0.001], and the experimental group had significantly higher scores than the control group [communication skills: (74.82±6.75) vs. (65.45±10.18), P<0.001; patient satisfaction: 81.00 (79.00, 83.00) vs. 73.00 (68.00, 77.00), P<0.001]. The Physician Self-Evaluation Scale showed that the experimental group had a significant improvement compared with the control group ( P<0.05). The results of the Course Satisfaction Questionnaire showed that the degree of overall satisfaction of the course was only 87.28% in the control group, while all the interns in the experimental group were satisfied with the course ( P<0.001); the new teaching method showed great advantages ( P<0.001). Conclusions:In the training of doctor-patient communication skills among interns, the application of scenario simulation combined with standardized patient case-based teaching can significantly improve their abilities of the application of knowledge application, humanistic concern, and communication skills, and therefore, it is an effective and promising method for the training of doctor-patient communication skills.

OBJECTIVE To investigate the current status and existing issues of hospital-associated infection manage-ment in non-public medical institutions,so as to provide data for the formulation of hospital-associated infec-tion management policies and the construction of a quality evaluation system for hospital-associated infection man-agement in non-public medical institutions.METHODS A qualitative research method was employed.In Dec.2023,semi-structured interviews were conducted with 38 directors of hospital-associated infection management depart-ments in primary,secondary and tertiary non-public medical institutions.The interview data were coded and ana-lyzed by Nvivo 12.0 software to refine themes.RESULTS Three themes were refined:the organizational system for hospital-associated infection management in non-public medical institutions had been basically established,but the division of functions and responsibilities was not yet fully clear,hospital-associated infection management had achieved certain results,including collaborating with other departments to standardize and implement infection control measures,enhancing staff awareness of infection control,and promoting the establishment of organization-al systems.There were issues in infection control works such as insufficient funding,personnel allocation not meeting requirements,and difficulties in implementing infection control measures.The most urgent assis-tance needed was to address the training and professional title promotion for full-time and part-time infection con-trol personnel.CONCLUSION Non-public medical institutions should strengthen staffing and training,enhance the pro-fessional capabilities of infection control personnel,and establish hospital-associated infection management standards that are tailored to the characteristics of non-public medical institutions at all levels.

Objective:To investigate the application value of scenario simulation combined with standardized patient teaching in the training of doctor-patient communication skills among interns.Methods:A total of 110 clinical medicine interns were selected from Qilu Hospital of Shandong University and were divided into experimental group and control group using a random number table, with 55 interns in each group. The interns in the control group received traditional lecturing, and those in the experimental group received scenario simulation combined with standardized patient case-based teaching. The SEGUE Communication Skill Evaluation Scale and Patient Satisfaction Questionnaire were used to assess the improvement in communication skills in both groups, and Physician Self-Evaluation Scale and Course Satisfaction Questionnaire were used to assess the effectiveness of the course and the degree of satisfaction with the course. SPSS 26.0 was used for the t-test, the Mann-Whitney U test, and the rank sum test. Results:After training, both groups showed significant improvements in communication skills and patient satisfaction [experimental group in terms of communication skills: (55.38±13.11) vs. (74.82±6.75), P<0.001; experimental group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 81.00 (79.00, 83.00), P<0.01; control group in terms of communication skills: (56.53±12.34) vs. (65.45±10.18), P<0.001; control group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 73.00 (68.00, 77.00), P<0.001], and the experimental group had significantly higher scores than the control group [communication skills: (74.82±6.75) vs. (65.45±10.18), P<0.001; patient satisfaction: 81.00 (79.00, 83.00) vs. 73.00 (68.00, 77.00), P<0.001]. The Physician Self-Evaluation Scale showed that the experimental group had a significant improvement compared with the control group ( P<0.05). The results of the Course Satisfaction Questionnaire showed that the degree of overall satisfaction of the course was only 87.28% in the control group, while all the interns in the experimental group were satisfied with the course ( P<0.001); the new teaching method showed great advantages ( P<0.001). Conclusions:In the training of doctor-patient communication skills among interns, the application of scenario simulation combined with standardized patient case-based teaching can significantly improve their abilities of the application of knowledge application, humanistic concern, and communication skills, and therefore, it is an effective and promising method for the training of doctor-patient communication skills.

Objective:To investigate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) in thyroid cancer patients.Methods:This cross-sectional study used convenience sampling to recruit thyroid cancer patients from the Thyroid Surgery Department of Harbin Medical University Cancer Hospital between July and September 2023. Data were collected using a general demographic questionnaire, the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C), the Perceived Stress Scale (PSS-10), and the Negative Cognitive Processing Bias Questionnaire (NCPBQ) .Results:A total of 210 questionnaires were distributed, and 204 valid responses were returned, yielding a response rate of 97.14% (204/210). Among the respondents, 44 patients (21.57%) tested positive for PTSD, with a PCL-C score of 23 (19, 32). Factors influencing PTSD included age, education level, marital status, monthly income, lateral neck lymph node metastasis, comorbid chronic diseases, perceived stress, and negative cognitive processing bias ( P<0.05) . Conclusions:PTSD symptoms were present in 21.57% of thyroid cancer patients and were influenced by various factors. Healthcare professionals should develop targeted interventions based on patient characteristics to alleviate PTSD symptoms in thyroid cancer patients.

Objective:To explore the current status of self-disgust in female breast cancer patients and analyze its influencing factors, so as to provide reference for clinical intervention.Methods:Convenience sampling was used to select 283 female breast cancer patients who were hospitalized in Guangdong Provincial Hospital of Chinese Medicine from June to July 2024 for the study. A questionnaire survey was conducted using the General Information Questionnaire, Questionnaire for the Assessment of Self-Disgust (QASD), Family Avoidance of Communication about Cancer Scale, Body Image Scale, and the Chinese version of the Female Self-Advocacy in Cancer Survivorship. Factors influencing patients' self-disgust were analyzed using one-way analysis of variance and multiple linear regression.Results:The total score of QASD in female breast cancer patients was (33.77±7.64). Education level, sexual dysfunction after breast cancer, family avoidance of communication about cancer, body image and self-advocacy were influencing factors of self-disgust in female breast cancer patients ( P<0.05) . Conclusions:Self-disgust of female patients with breast cancer is at a medium to high level. It is recommended that nurses pay attention to the psychological status of patients with low level of education and sexual dysfunction after the disease, implement targeted psychological interventions to improve the family avoidance of communication about cancer and body image, and increase the awareness of self-advocacy, thus reducing the risk of self-disgust in female breast cancer patients.

Objective:To explore the current status of self-disgust in female breast cancer patients and analyze its influencing factors, so as to provide reference for clinical intervention.Methods:Convenience sampling was used to select 283 female breast cancer patients who were hospitalized in Guangdong Provincial Hospital of Chinese Medicine from June to July 2024 for the study. A questionnaire survey was conducted using the General Information Questionnaire, Questionnaire for the Assessment of Self-Disgust (QASD), Family Avoidance of Communication about Cancer Scale, Body Image Scale, and the Chinese version of the Female Self-Advocacy in Cancer Survivorship. Factors influencing patients' self-disgust were analyzed using one-way analysis of variance and multiple linear regression.Results:The total score of QASD in female breast cancer patients was (33.77±7.64). Education level, sexual dysfunction after breast cancer, family avoidance of communication about cancer, body image and self-advocacy were influencing factors of self-disgust in female breast cancer patients ( P<0.05) . Conclusions:Self-disgust of female patients with breast cancer is at a medium to high level. It is recommended that nurses pay attention to the psychological status of patients with low level of education and sexual dysfunction after the disease, implement targeted psychological interventions to improve the family avoidance of communication about cancer and body image, and increase the awareness of self-advocacy, thus reducing the risk of self-disgust in female breast cancer patients.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

OBJECTIVE: To explore the effectiveness of free paraumbilical perforator flaps in repairing skin and soft tissue defects in children. METHODS: Between February 2018 and March 2024, 12 children with skin and soft tissue defects were treated with the free paraumbilical perforator flaps. There were 7 boys and 5 girls with an average age of 6.3 years (range, 2-12 years). The defects located on the upper limbs in 6 cases, lower limbs in 5 cases, and neck in 1 case. The causes of wounds included 7 cases of electrical burns, 1 case of thermal burn, 2 cases of scar release and excision due to scar contraction after burns, 1 case of scar ulcer at the amputation stump after severe burns, and 1 case of skin necrosis after a traffic accident injury. The size of defects after debridement ranged from 7.0 cm×4.0 cm to 18.0 cm×10.0 cm. According to the defect size, 11 cases were repaired with unilateral paraumbilical perforator flaps centered on the umbilicus, among which 3 cases with larger defects were designed as "L"-shaped flaps along the lateral and lower ends of the perforator; the donor sites were directly closed. One case with extensive defect after scar excision and release was repaired with bilateral expanded paraumbilical perforator flaps; the donor sites were repaired with autologous split-thickness skin grafts. The size of flaps ranged from 9.0 cm×4.0 cm to 20.0 cm×11.0 cm. Postoperatively, analgesia and sedation were provided, and the blood supply of the flaps was observed. RESULTS: All operations were successfully completed. The operation time was 4-7 hours, with an average of 5.0 hours. After postoperative analgesia and sedation, the visual analogue scale (VAS) score for pain in all children was less than or equal to 3, and there was no non-cooperation due to pain. All flaps and skin grafts survived completely, and the wounds healed by first intention. Ten children underwent 1-4 times of flap de-fatting, finger separation, and trimming. All children were followed up 6-48 months (mean, 26.6 months). No obvious swelling of the flaps occurred, and the texture was soft. At last follow-up, among the 6 children with upper limb defects, 2 had upper limb function grade Ⅳ and 4 had upper limb function grade Ⅴ according to the Carroll upper limb function assessment method. The 4 children with lower limb defects had no limitation of joint movement. The neck flexion and rotation in the 1 child with neck defect significantly improved when compared with that before operation. The 1 child with residual ulcer at the amputation stump could wear a prosthesis and move without limitation, and no new ulcer occurred. Linear scars were left at the donor sites, and no abdominal wall hernia was formed. CONCLUSION The free paraumbilical perforator flap has abundant blood supply and can be harvested in large size. It can be used to repair skin and soft tissue defects in children and has the advantages of short operation time, minimal injury, high safety, and minimal impact on the growth and development of children.
Humans ; Perforator Flap/transplantation* ; Child ; Male ; Female ; Soft Tissue Injuries/surgery* ; Child, Preschool ; Plastic Surgery Procedures/methods* ; Burns/surgery* ; Umbilicus/surgery* ; Skin Transplantation/methods* ; Skin/injuries* ; Cicatrix/surgery* ; Treatment Outcome