Objective To explore the mediating effect of psychological resilience between perceived spousal support and dignity loss in breast cancer patients.Methods A convenience sampling method was employed,involving 377 breast cancer patients who met the study criteria and received treatment at a tertiary oncology hospital in Yunnan Province from March to September 2023.Data were collected using a general information questionnaire,the Dignity Scale,the Perceived Spousal Support Scale,and the Psychological Resilience Scale.Data analysis was conducted using IBM SPSS 26.0 software.Results The scores for dignity loss,perceived spousal support,and psychological resilience of breast cancer patients were(41.72±6.77),(100.42±6.93),and(75.27±8.50),respectively.Pearson correlation analysis showed that dignity loss was negatively correlated with both perceived spousal support and psychological resilience(r1=-0.568,r2=-0.640,both P＜0.05).Mediation effect analysis indicated that psychological resilience had a mediating effect between perceived spousal support and dignity loss,with a value of-0.320(95％CI-0.409 to-0.246),accounting for 57.1％of the total effect.Conclusion The dignity of breast cancer patients in this study is in a state of mild loss,and psychological resilience plays a partial mediating role between perceived spousal support and dignity loss.This suggests that clinical medical staff should pay attention to the spousal support situation of breast cancer patients,provide timely guidance and health education to spouses,enhance the level of support from spouses,and strengthen the confidence and capability of couples in jointly coping with the disease,thereby alleviating dignity loss in breast cancer patients and improving their quality of life.

Objective To systematically evaluate the incidence and influencing factors of falls in adult cancer patients,and provide evidence support for early identification and prevention of falls.Methods Eight Chinese and English databases,including PubMed,Embase,CNKI,and Wanfang Database,were searched by computer.The databases were established until January 2024 and included in cross-sectional,cohort,and case-control studies based on the incidence and/or influencing factors of falls in adult cancer patients.Two researchers independently screened and reviewed literature,evaluated literature quality,and extracted data before conducting meta-analysis using RevMan 5.4 software.Results A total of 19 articles were incorporated into the research,with a total sample population size of 70508 cases.The results showed that the incidence of comorbid falls in adult tumor patients was 23.0%(95%CI 0.23,0.24).Age,female,low education level,fall history,fall fear,middle and late stage of tumor,tumor type(breast cancer,reproductive system tumor,prostate cancer),comorbidity,chemotherapy,radiotherapy,multiple drugs(n≥5),drugs(antidepressants,antipsychotics,sedatives and hypnotics),related symptoms(fever,peripheral neuropathy,fatigue,depression),malnutrition,low weight,cognitive dysfunction,balance disorders,gait abnormalities,and low ability of daily living were the influencing factors for falls of adult tumor patients.Conclusion Cancer professionals should identify the influencing factors of falls early and take targeted measures to reduce the occurrence of falls.

Objective To explore the current status of oncology nurses'medical narrative competence and to analyze its influencing factors.Methods 931 nurses from the oncological departments of 17 3A grade hospitals in Yunnan Province were selected from June to August 2023 and were surveyed using the Medical Narrative Competence Scale,the General Self-Efficacy Scale,and the Humanistic Care Scale.Results The score of medical narrative competence of oncology nurses was(151.52±14.61).The results of multiple linear regression showed that general self-efficacy,humanistic competence,years of experience,department,peer support,family support,familiarity with medical narratives,and job satisfaction were the factors influencing oncology nurses'competence in medical narratives(P<0.05),which explained 38.0%of the total variation.Conclusion The medical narrative competence of oncology nurses,moderately level,is influenced by multiple factors.

Objective: Randomized controlled trials (RCTs) of Chinese patent medicines and classic traditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023. A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments. This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence. Methods: RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evidence Database for Chinese Patent Medicine (AICED-CPM), with supplementary searches conducted in China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Cochrane Library, PubMed, Embase, and Web of Science. The study characteristics and methodological quality of these RCTs were systematically analyzed and evaluated. Results: A total of 1 443 RCTs of Chinese patent medicines were included, comprising 1 399 Chinese articles and 44 English articles. Additionally, 334 RCTs of classic traditional Chinese medicine prescriptions were found, with 331 published in Chinese and 3 in English. 196 567 participants were included, covering 585 types of Chinese patent medicines (487 oral, 61 injectable, and 37 topical) and 179 classic traditional Chinese medicine prescriptions. The involved studies encompassed 22 types of diseases, with research primarily focusing on diseases of the circulatory system, the respiratory system, and the genitourinary system. The sample sizes ranged from 18 to 3 777 participants, and most studies were conducted at a single center. Methodologically, the implementation of allocation concealment and blinding remained insufficiently emphasized. Conclusion Overall, compared with 2022, both the number of RCT publications and their methodological quality have improved in 2023, with heightened attention to research on diseases of the genitourinary system. However, quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Objective:To analyze the clinical characteristics of critically ill neonates in the neonatal intensive care unit (NICU) who acquired Serratia marcescens infection for onset or colonization, and to explore the risk factors contributing to the onset of Serratia marcescens infection. Methods:A retrospective case-control study was conducted by collecting clinical data from NICU neonates at the Women and Children's Hospital of Ningbo University between January 2017 and December 2023. Forty-four neonates with clinical signs and/or symptoms consistent with Serratia marcescens infection, and with Serratia marcescens isolated from specimens, would be enrolled as the infection onset group, while 45 neonates who tested positive for Serratia marcescens in rectal and/or pharyngeal cultures during the same period, but had no clinical signs or infection symptoms, were enrolled as the colonization control group. The distribution of bacteria in the neonates infected with Serratia marcescens was observed, and clinical data were subjected to univariate and binary multivariate Logistic regression analyses for screening the independent risk factors for onset of acquired Serratia marcescens infection in NICU. Results:During the 7-year period, 5 972 neonates were admitted to the NICU, of which 297 developed hospital-acquired infections. Among these, 44 neonates were identified with Serratia marcescens infection, accounting for 14.8% of hospital-acquired infections. During the same period, a total of 45 neonates were diagnosed with the colonization of Serratia marcescens, but did not develop any symptoms. The primary infection sites of the neonates in both the colonization control group and infection onset group were respiratory tract, accounting for 86.7% (39/45) and 43.2% (19/44), respectively. The highest rate of infection in the infection onset group was respiratory tract (43.2%), followed by bloodstream infection [29.6% (13/44)], intracranial infection [15.9%, (7/44)], intestinal infection [6.8% (3/44)], and urinary tract infection [4.5% (2/44)]; no deaths were reported. In addition to respiratory tract infection, 13.3% (6/45) of the neonates in the colonization control group had intestinal infection, and no pathogenic bacteria was detected in their blood, cerebrospinal fluid, or urine. Univariate analysis showed that compared with the colonization control group, the neonates in the infection onset group had lower gestational ages [days: 28.5 (26.9, 30.0) vs. 32.0 (30.1, 34.6), P < 0.01], lower birth weights and proportion of probiotic usage [birth weights (kg): 1.20 (0.96, 1.44) vs. 1.75 (1.45, 2.23), probiotic usage: 29.5% (13/44) vs. 57.8% (26/45), both P < 0.01], longer length of NICU stay and duration of antibiotic usage [length of NICU stay (days): 65.11±23.00 vs. 40.31±20.04, duration of antibiotic usage (days): 23.09±9.57 vs. 11.80±7.19, both P < 0.01], and higher proportions of invasive procedures such as mechanical ventilation > 3 days and central venous catheterization > 7 days [mechanical ventilation > 3 days: 61.4% (27/44) vs. 20.0% (9/45), central venous catheterization > 7 days: 81.8% (36/44) vs. 28.9% (13/45), both P < 0.01], indicating that these factors were associated with Serratia marcescens infection onset acquired in NICU. Binary multivariate Logistic regression analysis showed that a birth weight of ≤ 1.5 kg [odds ratio ( OR) = 5.745, 95% confidence interval (95% CI) was 1.345-24.549, P = 0.018], a length of NICU stay > 45 days ( OR = 3.642, 95% CI was 1.102-12.041, P = 0.034), duration of antibiotic usage ( OR = 0.871, 95% CI was 0.799-0.949, P = 0.002), non-usage of probiotics ( OR = 3.191, 95% CI was 1.058-9.627, P = 0.039), and invasive procedures such as mechanical ventilation > 3 days ( OR = 5.302, 95% CI was 1.510-18.619, P = 0.009), and central venous catheterization > 7 days ( OR = 3.818, 95% CI was 1.103-13.212, P = 0.034) were independent risk factors for the onset of NICU-acquired Serratia marcescens infection. Conclusions:The incidence of NICU-acquired Serratia marcescens infection is high. Low birth weight, prolonged length of NICU stay, long-term antibiotic usage, and invasive treatments are independent risk factors for the onset of NICU-acquired Serratia marcescens infection. Oral probiotics may be a new method for preventing onset of NICU-acquired Serratia marcescens infection.

Objective To explore the different latent class and characteristics of the cognitive ability level of undergraduate nursing students in hospice care based on the individual-centered perspective,and analyze its influencing factors to provide the reference for the formulation of targeted nursing education.Methods Nursing students in a medical university in Yunnan Province were selected from March 2023 to June 2023.The general data questionnaire and hospice care knowledge questionnaire were used to conduct a cross-sectional survey.SPSS and Mplus were used for the data analysis.Results Three latent class of hospice care cognitive ability were identified,which were named as hospice care high cognitive ability group,general cognitive ability group,and low cognitive ability group,accounting for 28.74%,57.29%,and 13.97%,respectively;Nursing students'gender,nationality,place of residence,earning and practice experience of hospice care(whether they had the contact with end-stage cancer patients,whether they had received the hospice care related training),and whether they were willing to engage in the hospice care related work were the influencing factors of different potential categories of cognitive ability of hospice care among nursing students(P<0.05).Conclusion There are three latent class of hospice care cognitive ability of nursing students.Male minority nursing students who have not been exposed to end-stage cancer patients and have not received the hospice care-related training,are unwilling to engage in the hospice care-related work.Male ethnic minority nursing students residing in rural areas have the weaker cognitive levels of hospice care.Scholars in the future can formulate targeted training strategies according to different latent class of hospice care cognitive ability to improve nursing students'hospice care cognitive ability and reserve talents for hospice care teams.

Objective To explore the current situation of nurses'emergency response ability of public health emergencies and analyze its influencing factors in Yunnan province,so as to provide empirical basis for the construction of emergency response ability training system in the future.Methods A total of 4821 clinical nurses from 43 hospitals in Yunnan province were selected by convenience sampling.A cross-sectional survey was conducted using the general information questionnaire,Nurses'Public Health Emergency response Capacity Scale and Nurses'Emergency attitude scale.The influencing factors were analyzed by stepwise multiple linear regression.Results The total score of public health emergency response ability of clinical nurses in Yunnan Province was(70.35±14.08),and the total score of public health emergency response attitude was(42.26±6.14).Gender,department,hospital level,working years,whether to participate in public health emergency training,whether to experience rescue activities in public health emergencies,and attitude towards public health emergencies were the influencing factors of nurses'public health emergency response ability(P<0.05),which explained 29.0%of the total variation.Conclusions The ability of clinical nurses to respond to public health emergencies in Yunnan Province is generally above the medium level,but there is still a significant shortage in emergency knowledge.Targeted training is needed.Nursing management should build targeted layered training programs combined with influencing factors to enhance nurses'ability to respond to public health emergencies.

Objective To investigate the prevalence and related characteristics of alcohol dependence in the Pumi people of Ninglang area in Yunnan Province.Methods By stratified multistage cluster randomization,542 residents were interviewed by psychiatrists using the structural questionnaire MINI-International Neuropsychiatric Interview.Results The prevalence of drinking in the study were 37.3％,13.6％ and 22.5％ for the male,female and the total sample.There were significant differences of alcohol dependence between males and females (x2 =304.310,P＜0.01) in which males were significantly higher than those in females.The current prevalence of alcohol dependence in Pumi people was 4.8％(95％CI=3.0％-6.6％),and standardized current prevalence was 3.3％.The current prevalence of alcohol dependence in males was 9.3％,which was significantly higher than that (2.1％) in females (x2 =14.613,P＜0.01).The prevalence of alcohol dependence in the Pumi people was 6.1％ in the 21-30 years old,and 8.6％ in the 51-60 years old.There were one case of major depression,one case of panic disorder,and five cases of insomnia.Conclusion The prevalence of alcohol dependence in Pumi people of Ninglang areas is high.Alcohol dependence has become one of the most common mental disorders and the public health problem.It is necessary to carry out prevention research in the future.