1.A study on reciprocal work-family benefits in the context of narrative medicine in China
Xiaolin YANG ; Kangfu LIU ; Ying ZHAO ; Sulin ZHENG
Chinese Medical Ethics 2026;39(9):1227-1236
The “reciprocal work-family benefits” demonstrate that experiences from either professional or family roles enhance the performance and qualities of the other. A total of 4,431 narrative literacy questionnaires were returned from medical and nursing staff across seven provinces and municipalities in China. The results showed a positive correlation between professional development and family interaction (r=0.794, P<0.001), namely, the improvement of medical and nursing staff’s professional narrative competence can facilitate family narrative interaction, and vice versa. Stemming from the viewpoint of reciprocal work-family enrichment from conservation of resources theory, this paper elaborated on why family and professional roles are taken into account during the development of the Chinese Medical Professionals’ Narrative Competence Scale. Traditional views regarded profession and family as opposing relationships in resource competition, whereas Chinese narrative medicine regarded medical professionals, who simultaneously occupy multiple roles, as a “whole.” The latter advocated for the construction of multidimensional positive narrative connections between medical professionals and themselves, families, workplaces, and society, to prevent medical professionals from suffering narrative closure and occupational burnout confined to a single professional identity. This paper analyzed the mediating effect of the improvement of medical professionals’ overall narrative competence in the formation of reciprocal work-family enrichment, and further proposed benefit-enhancing strategies at both individual and organizational levels, thereby improving medical professionals’ comprehensive capabilities and advancing high-quality development of hospitals.
2.A qualitative study on the psychological experiences of lung cancer patients during treatment from the perspective of narrative medicine
Xiaoyue YANG ; Lin CHEN ; Song ZHOU ; Fengjiao LONG ; Zhong LIN ; Xiaolin YANG ; Kangfu LIU
Chinese Medical Ethics 2024;37(11):1295-1301
Objective:To explore the psychological experiences of lung cancer patients during treatment based on the perspective of narrative medicine,and to provide references for targeted nursing interventions.Methods:Guided by the concept of narrative medicine,the phenomenological method of qualitative research was used to conduct in-depth interviews with 20 lung cancer patients.The interview data were analyzed,refined,and summarized by using the content analysis method.Results:From the perspective of the humanistic value of narrative medicine,four themes were extracted from the interview contents with 20 lung cancer patients,including the loss of patients'role identity,the experience of disease uncertainty,the fear and expectation of death,and the helplessness and perception of life.Conclusion:During the treatment process of lung cancer patients,there are negative psychological experiences,such as loss of role identity,uncertainty of disease,fear of death,and hope to leave with dignity.Meanwhile,there are positive perceptions,such as contemplation of the meaning of life and actively coping with it.
3.Application of regional citrate anticoagulation in patients at high risk of bleeding during intermittent hemodialysis: a prospective multicenter randomized controlled trial.
Xiaoyan TANG ; Dezheng CHEN ; Ling ZHANG ; Ping FU ; Yanxia CHEN ; Zhou XIAO ; Xiangcheng XIAO ; Weisheng PENG ; Li CHENG ; Yanmin ZHANG ; Hongbo LI ; Kehui LI ; Bizhen GOU ; Xin WU ; Qian YU ; Lijun JIAN ; Zaizhi ZHU ; Yu WEN ; Cheng LIU ; Hen XUE ; Hongyu ZHANG ; Xin HE ; Bin YAN ; Liping ZHONG ; Bin HUANG ; Mingying MAO
Journal of Zhejiang University. Science. B 2022;23(11):931-942
OBJECTIVES:
Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment.
METHODS:
Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline.
RESULTS:
A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41).
CONCLUSIONS
Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans
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Citric Acid/adverse effects*
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Prospective Studies
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Sodium Citrate
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Hemorrhage/chemically induced*
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Citrates/adverse effects*
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Anticoagulants/adverse effects*
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Renal Dialysis/adverse effects*

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