Psychological factors have become significant contributors to the onset and progression of insomnia. This article explored the treatment of insomnia from the perspective of “liver governs wei qi （defensive qi）”. The concept of “liver governs wei qi （defensive qi）” is summarized in three aspects， firstly， the liver assists the spleen and stomach in transformation and transportation， governing the generation of wei qi； secondly， the liver aids lung qi diffusion and dispersion， governing the distribution of wei qi； thirdly， the liver regulates circadian rhythms， governing the circulation of wei qi. It is proposed that the clinical treatment of insomnia should focus on the following methods： for regulating the liver to harmonize the five viscera， and facilitate the circulation of wei qi， medicinals entering the liver channel include Chaihu （Bupleuri radix）， Baishao （Paeoniae Radix Alba）， Zhizi （Gardeniae Fructus）， and Suanzaoren （Ziziphi Spinosae Semen） could be commonly used； for nourishing the liver， the treatment should align with the day-night rhythm， and herbs such as Baihe （Lilium）， Hehuan （Albizia julibrissin）， and Yejiaoteng （Polygoni multiflori caulis） are commonly used； for soothing the liver and address both mental and physical health to calm wei qi， treatment should advocate verbal counseling， psychological regulation， and health education. Ultimately， this treatment approach can free liver qi to flow， soothe qi movement， restore the motion of wei qi， regulate during day and night， balance yin and yang， and resolve insomnia effectively.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.

Objective:To systematically synthesize the experiences and needs of thyroid cancer patients and their stakeholders in participating in treatment decision-making, so as to provide evidence-based theoretical support for the development of localized decision aids and the implementation of shared decision-making in China.Methods:A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang Data, and China Biomedical Literature Database for qualitative studies on the experiences and needs of thyroid cancer patients and their stakeholders in treatment decision-making. The search covered the period from the establishment of the databases to May 20, 2025. The 2020 version of the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research was used to assess study quality. Aggregative synthesis was applied to integrate the findings.Results:A total of 19 studies were included, from which 94 individual findings were extracted. These findings were categorized into 15 new categories and further synthesized into four overarching themes: role dynamics in treatment decision-making; challenging trade-offs between risks and benefits of treatment choices; multifactorial influences on treatment decisions; and multidimensional support needs.Conclusions:Treatment decision-making among thyroid cancer patients involves complex role identification, conflicting emotional experiences, and risk-benefit deliberations influenced by multiple factors. It is essential to build a "clinician-family-society" decision-support ecosystem encompassing informational, psychological, and social support. Future efforts should focus on developing culturally appropriate decision aids that integrate emotional support and innovative technologies to promote shared decision-making, enhance decision quality, and improve patient satisfaction.

Objective:To summarize the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms.Methods:Following the scoping review framework of Arksey and O'Malley, literature on the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms was electronically retrieved from databases including the Cochrane Library, Embase, PubMed, Web of Science, CINAHL, IEEE Xplore, China Biology Medicine disc, Wanfang Data, and China National Knowledge Infrastructure. The search period was from database establishment to August 5, 2025.Results:A total of 21 articles were included. Types of head and neck neoplasms included oropharyngeal cancer, nasopharyngeal cancer, oral cancer, tongue cancer, laryngeal cancer, hypopharyngeal cancer, and others. The application forms of digital health technologies involved virtual reality technology, telemedicine systems, interactive mobile health APPs/digital health platforms, and wearable devices. Interactive mobile health apps/digital health platforms were currently the most widely adopted form, with some applications integrating wearable devices for physiological data monitoring. The main components of the intervention included guiding swallowing training methods, training monitoring/supervision and feedback, swallowing function screening/assessment, and health education.Conclusions:The application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms is still in its early stages, but its advantages in enhancing rehabilitation accessibility and promoting patient adherence have already begun to emerge. Nevertheless, it also faces challenges such as limited user-friendliness, insufficient personalized feedback, and a lack of humanistic care. It is necessary to further explore and develop personalized, precision-oriented intelligent swallowing rehabilitation systems tailored to the specific needs of swallowing rehabilitation for head and neck cancer patients. High-quality clinical studies should be conducted to validate long-term efficacy, thereby providing intelligent solutions for clinical nursing practices in swallowing rehabilitation for these patients.

Objective:To systematically synthesize the experiences and needs of thyroid cancer patients and their stakeholders in participating in treatment decision-making, so as to provide evidence-based theoretical support for the development of localized decision aids and the implementation of shared decision-making in China.Methods:A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang Data, and China Biomedical Literature Database for qualitative studies on the experiences and needs of thyroid cancer patients and their stakeholders in treatment decision-making. The search covered the period from the establishment of the databases to May 20, 2025. The 2020 version of the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research was used to assess study quality. Aggregative synthesis was applied to integrate the findings.Results:A total of 19 studies were included, from which 94 individual findings were extracted. These findings were categorized into 15 new categories and further synthesized into four overarching themes: role dynamics in treatment decision-making; challenging trade-offs between risks and benefits of treatment choices; multifactorial influences on treatment decisions; and multidimensional support needs.Conclusions:Treatment decision-making among thyroid cancer patients involves complex role identification, conflicting emotional experiences, and risk-benefit deliberations influenced by multiple factors. It is essential to build a "clinician-family-society" decision-support ecosystem encompassing informational, psychological, and social support. Future efforts should focus on developing culturally appropriate decision aids that integrate emotional support and innovative technologies to promote shared decision-making, enhance decision quality, and improve patient satisfaction.

Objective:To summarize the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms.Methods:Following the scoping review framework of Arksey and O'Malley, literature on the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms was electronically retrieved from databases including the Cochrane Library, Embase, PubMed, Web of Science, CINAHL, IEEE Xplore, China Biology Medicine disc, Wanfang Data, and China National Knowledge Infrastructure. The search period was from database establishment to August 5, 2025.Results:A total of 21 articles were included. Types of head and neck neoplasms included oropharyngeal cancer, nasopharyngeal cancer, oral cancer, tongue cancer, laryngeal cancer, hypopharyngeal cancer, and others. The application forms of digital health technologies involved virtual reality technology, telemedicine systems, interactive mobile health APPs/digital health platforms, and wearable devices. Interactive mobile health apps/digital health platforms were currently the most widely adopted form, with some applications integrating wearable devices for physiological data monitoring. The main components of the intervention included guiding swallowing training methods, training monitoring/supervision and feedback, swallowing function screening/assessment, and health education.Conclusions:The application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms is still in its early stages, but its advantages in enhancing rehabilitation accessibility and promoting patient adherence have already begun to emerge. Nevertheless, it also faces challenges such as limited user-friendliness, insufficient personalized feedback, and a lack of humanistic care. It is necessary to further explore and develop personalized, precision-oriented intelligent swallowing rehabilitation systems tailored to the specific needs of swallowing rehabilitation for head and neck cancer patients. High-quality clinical studies should be conducted to validate long-term efficacy, thereby providing intelligent solutions for clinical nursing practices in swallowing rehabilitation for these patients.

Objective:To construct an esophageal language rehabilitation program for patients after total laryngectomy (TL) based on the behavioral change wheel theory and exploring its application effects.Methods:The multidisciplinary team constructed the first draft of the esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory, combined with a literature review, and used an expert meeting to revise the rehabilitation program to form the final draft of the program. Adopting experimental research, 35 patients after TL who attended the nursing outpatient clinic of Beijing Tongren Hospital, Capital Medical University from February 2023 to May 2023 were selected as the control group by convenience sampling method, and 35 patients after TL who attended the nursing outpatient clinic from June 2023 to September 2023 were selected as the experimental group. The experimental group applied the TL postoperative patients′ esophageal language rehabilitation program based on the behavioral change wheel theory on the basis of conventional nursing measures, and the control group received conventional nursing care. The status of language rehabilitation training, quality of life, social behavioral status, and anxiety and depression status before intervention, 1, 3, 6 months after intervention were compared between the two groups.Results:Both groups of patients completed the study. There were 29 males and 6 females in the control group, with an age of (54.63 ± 10.44) years old. There were 34 males and 1 female in the experimental group, with an age of (55.17 ± 10.67) years old. There was no statistically significant difference in the language rehabilitation training status, quality of life, social behavior status, and anxiety and depression status between the two groups before intervention (all P>0.05). The total scores of speech rehabilitation training in the experimental group at 1, 3, and 6 months after intervention were (32.80 ± 2.49), (39.80 ± 2.75), (51.91 ± 4.20) points, respectively, which were higher than those in the control group (23.40 ± 3.42), (24.40 ± 3.42), (25.80 ± 3.42) points, and the differences were statistically significant ( t=14.53, 23.44, 32.70, all P<0.05). The total scores of quality of life in the experimental group at 1, 3, and 6 months after intervention were (98.91 ± 8.49), (134.66 ± 11.31), (157.97 ± 13.97) points, respectively, which were higher than those in the control group (67.06 ± 7.64), (72.16 ± 7.64), (99.46 ± 8.09) points, and the differences were statistically significant ( t=17.53, 30.16, 21.45, all P<0.05). The scores for social occasion diet and language comprehension in the experimental group at 1, 3, and 6 months after intervention were (40.41 ± 13.94), (40.43 ± 24.08), (40.60 ± 18.56), and (43.71 ± 12.26), (47.40 ± 17.09), (52.50 ± 13.82), respectively, which were higher than those in the control group (30.59 ± 15.98), (30.57 ± 18.28), (27.21 ± 15.27), and (27.29 ± 15.13), (23.60 ± 14.78), (19.50 ± 12.78), and the differences were statistically significant ( t values were -6.88-2.16, all P<0.05). The total scores of anxiety and depression in the experimental group at 1, 3, and 6 months after intervention were (23.74 ± 2.73), (14.89 ± 3.89), (12.11 ± 3.14) points, respectively, which were lower than those in the control group (32.63 ± 1.85), (30.63 ± 1.85), (24.80 ± 2.75) points, and the differences were statistically significant (t=-19.55, -27.10, -17.97, all P<0.05). Conclusions:The esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory in this study is scientific, feasible, and can improve the patients′ esophageal language expression, quality of life, anxiety and depression, and social behavioral status, which can provide a reference for clinical care.

Objective:To explore the specialty work engagement dilemma among wound therapists in non-specialist clinics, so as to provide a reference basis for improving wound therapists' work engagement and reducing job burnout.Methods:This study was a phenomenological study. Semi-structured interviews with 12 wound therapists in non-specialist clinics from 12 hospitals were conducted between May and July 2024 using purposive sampling. Colaizzi seven-step method was used for data analysis and topic refinement.Results:A total of five themes and 13 sub-themes were extracted, including the role change dilemma (focus dispersion due to transfer of positions in clinical departments, and identity challenges due to adjustment of the field of job posting) , career development dilemma (reduced motivation due to obstacles to in-depth development in specialized fields, and limited conditions for scientific research training and implementation impeding the recognition and return of work) , support environment dilemma (insufficient medical insurance support increased job burden, lack of hospital support reduced work efficiency, lack of team support weakened work focus, poor self-support limited the depth of work engagement, lack of support from patients and their families increased the difficulty of maintaining work motivation) , pros and cons weighing dilemma (unclear delineation of risk and responsibility, difficult to weigh risk and benefit) , dilemma of whole-course management of disease (lack of communication between hospitals weakened the continuity of work, lack of home follow-up increased the uncertainty of the work) .Conclusions:Specialty work engagement dilemmas among wound therapists in non-specialist clinics are influenced by a variety of factors. It is necessary for medical institutions, healthcare workers and patients' families to work together to create a favorable working environment for wound therapists in order to promote the high-quality development of wound therapy nursing services in China.

Objective:To identify the classification of neck and shoulder dysfunction in patients after neck lymph node dissection for head and neck tumors and analyze the characteristics of these dysfunctions.Methods:A convenience sampling method was used to select patients who underwent neck lymph node dissection and visited the Head and Neck Cancer Rehabilitation Nursing Clinic at Beijing Tongren Hospital, Capital Medical University, from March to May 2024. General data questionnaires, neck function indicators, and shoulder function symptom questionnaires were used for investigation.Results:A total of 113 patients who underwent neck lymph node dissection for head and neck tumors were included in the study. The top three neck dysfunction indicators with the highest occurrence rates were abnormal neck extension (87.6%, 99/113) , abnormal neck bending on the affected side (84.1%, 95/113) , and abnormal neck rotation on the affected side (84.1%, 95/113) . The top three shoulder dysfunction indicators with the highest occurrence rates were: abnormal shoulder flexion on the affected side (83.2%, 94/113) , abnormal shoulder abduction on the affected side (81.4%, 92/113) , and abnormal horizontal shoulder abduction on the affected side (80.5%, 91/113) . Using 18 indicators of neck and shoulder dysfunction as clustering variables, patients were classified into three groups: severe dysfunction group (53.1%, 60/113) , moderate dysfunction group (35.4%, 40/113) , and mild dysfunction group (11.5%, 13/113) . The differences in disease type and neck and shoulder function indicators between the three groups were statistically significant ( P<0.05) . Conclusions:Neck and shoulder dysfunction in patients after neck lymph node dissection for head and neck tumors is relatively severe, primarily manifesting as an abnormal range of motion. Healthcare providers should strengthen neck and shoulder function assessments in these patients and consider a range of motion exercises as a key rehabilitation program.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.