International Journal of Nursing Sciences最新文献

{"title":"ICU nurses’ experiences with virtual reality technology for work-related stress reduction: A qualitative study","authors":"Yufeng Liang ,&nbsp;Xuepei Hong ,&nbsp;Yihong Cai ,&nbsp;Xiuwan Chen ,&nbsp;Fuhong Chen","doi":"10.1016/j.ijnss.2026.02.013","DOIUrl":"10.1016/j.ijnss.2026.02.013","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore experiences of ICU nurses with a virtual reality (VR)-based stress reduction intervention and identify the factors influencing its acceptance, guided by the Technology Acceptance Model.</div></div><div><h3>Methods</h3><div>A qualitative descriptive study was conducted in the ICU of a tertiary hospital in China. Fifteen nurses who had completed a VR intervention were recruited using purposive sampling. Data were collected through in-depth, semi-structured interviews between September and October 2025. The interviews were transcribed verbatim and analyzed using Colaizzi’s phenomenological method.</div></div><div><h3>Results</h3><div>The analysis yielded five key themes. 1) Perceived usefulness: nurses recognized VR’s effectiveness in reducing stress, primarily through mechanisms of immediate relaxation and psychological detachment from the high-pressure clinical environment. 2) Perceived ease of use: the adoption process was hindered not only by technical issues but, more fundamentally, by a persistent inability to disengage from patient care responsibilities during use mentally. 3) Influence of external variables: a critical barrier identified was the absence of structured organizational support, encompassing protected time, dedicated private spaces, and clear implementation policies. 4) Behavioral intention and usage patterns: despite existing barriers, participants expressed a conditional willingness to adopt VR, integrating it flexibly into their routines for in-shift respite or post-shift recovery. 5) Recommendations for improvement: practical suggestions for optimization focused on three areas, including diversifying VR content, improving hardware ergonomics, and establishing essential institutional enablers.</div></div><div><h3>Conclusions</h3><div>VR technology has the potential to alleviate stress among ICU nurses. However, its sustainable integration into clinical practice requires a systemic approach that addresses multifaceted barriers, with organizational policy and support being the most critical enabling factor. Future initiatives must extend beyond technological optimization to include protected time, dedicated spaces, and supportive policies to ensure effectiveness and long-term adoption.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 2","pages":"Pages 149-155"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147557157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time toxicity in chronic disease comorbidity care: A concept analysis using Walker and Avant’s approach","authors":"Ping Song ,&nbsp;Su’e Yuan ,&nbsp;Yuzhu Guan ,&nbsp;Yujia Chen ,&nbsp;Haijing Ma ,&nbsp;Yunxia Li","doi":"10.1016/j.ijnss.2026.02.004","DOIUrl":"10.1016/j.ijnss.2026.02.004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to conceptually analyze time toxicity within the context of chronic disease comorbidity, identifying its defining attributes, antecedents, and consequences to guide future nursing practice and patient-centered care strategies.</div></div><div><h3>Methods</h3><div>This study adopted Walker and Avant’s eight-step concept analysis approach, integrating thematic analysis with framework analysis. A systematic search was conducted, then, peer-reviewed literature and clinical guidelines were included and the defining attributes, antecedents, consequences, and empirical referents of time toxicity were extracted. Qualitative data were analyzed using NVivo 12, employing iterative coding and categorization. The summary themes were structured into a three-tiered conceptual framework. The conceptual boundaries were rigorously refined through the examination of exemplar, borderline, and contrary cases.</div></div><div><h3>Results</h3><div>A total of 35 articles were included. This study identified seven key defining attributes of time toxicity in chronic disease comorbidities: psychological burden, burden of chronic disease management, caregiver burden, medication burden, time burden, economic burden, and healthcare inequities. The antecedents of time toxicity include changes in patient conditions, deficiencies in support systems, and inefficiencies within the healthcare system, all of which interact to exacerbate its effects. The consequences for patients include declines in quality of life, impaired self-management, and deteriorating mental health, alongside increased healthcare utilization costs. Chronic disease comorbidity time toxicity can be defined as the increasingly severe, multifaceted burdens faced by patients managing multiple chronic diseases.</div></div><div><h3>Conclusions</h3><div>Time toxicity is a multidimensional construct significantly affecting patients with chronic disease comorbidity. Recognizing and addressing it is vital for improving health outcomes. Nurses and care coordinators are uniquely positioned to implement time-conscious, personalized interventions.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 2","pages":"Pages 140-148"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147557205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of dietary energy and protein intake with frailty among patients with cirrhosis and implications for nursing practice","authors":"Guangju Li ,&nbsp;Yaqi Wang ,&nbsp;Kunli Wang ,&nbsp;Kefang Wang","doi":"10.1016/j.ijnss.2026.02.001","DOIUrl":"10.1016/j.ijnss.2026.02.001","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to examine the relationships among frailty, dietary energy intake, protein intake, and protein type in patients with cirrhosis.</div></div><div><h3>Methods</h3><div>This study enrolled 267 eligible patients with liver cirrhosis from a tertiary hospital in Shandong Province between April 2024 and July 2024. Participants were divided into three groups based on the Liver Frailty Index: non-frail group (<em>n</em> = 63), pre-frail group (<em>n</em> = 132), and frail group (<em>n</em> = 72). Patients were assessed using the following questionnaires and scales: the General Demographic Information Questionnaire, the Child-Pugh Score Scale, the Liver Frailty Index, the Food Frequency Questionnaire, the International Physical Activity Questionnaire–Short Form (IPAQ-SF), and the Patient Health Questionnaire-9 (PHQ-9) for depression. Multiple logistic regression was used to examine the associations between frailty and dietary energy intake, protein intake, and the animal-to-plant protein ratio. Receiver operating characteristic (ROC) curve analysis was employed to identify the optimal thresholds for energy, protein, and protein ratio to differentiate between non-frail and frail states.</div></div><div><h3>Results</h3><div>Based on the Liver Frailty Index, 63 patients (23.6 %) were classified as non-frail, 132 (49.4 %) as pre-frail, and 72 (27.0 %) as frail. The prevalence of frailty was significantly higher in females (37.0 %) than in males (22.6 %) (<em>P</em> &lt; 0.05). Multivariable logistic regression analysis, after adjustment for potential confounders (including age, sex, education level, etiology, Child-Pugh class, physical activity, depressive symptoms, and polypharmacy), higher dietary energy (<em>P</em> = 0.044), total protein (<em>P</em> = 0.003), animal protein (<em>P</em> = 0.004), and a higher animal-to-plant protein ratio (<em>P</em> = 0.015) were associated with a lower risk of frailty. ROC curve analysis further identified the optimal thresholds for distinguishing frailty from non-frailty as 30 kcal/(kg·d) for energy intake, 0.83 kcal/(kg·d) for total protein intake, and 0.34 for the animal-to-plant protein ratio, respectively. When patients maintained their nutritional intake above these thresholds, their risk of frailty was significantly reduced.</div></div><div><h3>Conclusions</h3><div>Increasing dietary energy and protein intake, particularly from animal sources, is associated with a reduced risk of frailty in cirrhosis patients. This suggests that in clinical nursing practice, guiding patients to appropriately increase their dietary energy and protein intake, particularly by optimizing the proportion of animal protein, may help reduce the risk of frailty.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 2","pages":"Pages 201-208"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147557193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathways to self-management among older adults with multimorbidity in rural China: A fuzzy-set qualitative comparative analysis","authors":"Jianing Yu ,&nbsp;Dandan Chen ,&nbsp;Yujia Fu ,&nbsp;Haoyang Du ,&nbsp;Lina Wang ,&nbsp;Binyu Zhao ,&nbsp;Lijin Chen ,&nbsp;Zihao Zheng ,&nbsp;Xiaoting Liu ,&nbsp;Jing Shao","doi":"10.1016/j.ijnss.2026.02.010","DOIUrl":"10.1016/j.ijnss.2026.02.010","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate how individual, problem-related, and environmental factors interact to influence self-management behaviours among rural older adults with multimorbidity in China, to inform more context-sensitive interventions.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in 9 healthcare facilities across Zhejiang Province, China, from July 2022 to May 2023, involving 487 rural older adults with multimorbidity via convenience sampling, who had been diagnosed with 2 or more chronic conditions. Data were collected through questionnaires and electronic health records to assess self-efficacy, psychological resilience, physical symptoms, the Charlson Comorbidity Index, social support, and resource accessibility. Fuzzy-set qualitative comparative analysis was employed to explore the complex, non-linear interactions between contextual factors, ultimately determining the sufficient conditions for self-management behaviours.</div></div><div><h3>Results</h3><div>Correlation analyses revealed positive associations between self-management behaviours and self-efficacy, psychological resilience, social support, and resource accessibility (<em>r</em> = 0.690-0.850, all <em>P</em> &lt; 0.001), with self-efficacy (<em>r</em> = 0.784) and social support (<em>r</em> = 0.850) demonstrating the strongest correlations. Regression analysis revealed that self-efficacy (<em>β</em> = 0.385) and social support (<em>β</em> = 0.372) were the strongest factors of self-management behaviours. Fuzzy-set qualitative comparative analysis identified six factor configurations, categorized into four contextual types: “triple-enabling context,” “symptom-resource driven context,” “resource deficiency context,” and “symptom-disease overwhelmed context.” Self-efficacy was consistently identified as a core condition across all configurations.</div></div><div><h3>Conclusions</h3><div>Self-management among rural older adults with multimorbidity is shaped by complex, context-dependent interactions. Effective interventions should prioritize enhancing self-efficacy, expanding access to resources, and tailoring strategies to distinct contextual profiles. The study also demonstrates the utility of fuzzy-set qualitative comparative analysis for advancing context-sensitive healthcare solutions.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 2","pages":"Pages 130-139"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147557207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of clinical nursing work environment, moral sensitivity, and humanistic care ability on missed nursing care: A longitudinal study","authors":"Yifan Lu ,&nbsp;Qinqin Liu ,&nbsp;Congcong Dai ,&nbsp;Shuqi Zhai ,&nbsp;Huanhuan Zhang ,&nbsp;Jie Liu ,&nbsp;Chaoran Chen","doi":"10.1016/j.ijnss.2026.02.011","DOIUrl":"10.1016/j.ijnss.2026.02.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Missed nursing care is a widespread issue in clinical practice and represents a global challenge. Reducing missed nursing care is crucial for improving care quality and implementing high-quality nursing services. This study conducted a longitudinal survey among clinical nurses to investigate the impact and underlying mechanisms of the nursing work environment, moral sensitivity, and humanistic care ability on missed nursing care, aiming to provide theoretical evidence for optimizing the work environment and enhancing nursing quality.</div></div><div><h3>Methods</h3><div>From October 2024 to April 2025, a longitudinal survey was conducted at three time points among 989 clinical nurses using the Nursing Work Environment Scale, Missed Nursing Care Scale, Moral Sensitivity Questionnaire, and the Nurse Humanistic Care Ability Scale. A total of 902 valid responses were included in the final analysis. Structural equation modeling and mediation pathway analysis were performed using AMOS 26.0, and data analysis was conducted using SPSS 25.0.</div></div><div><h3>Results</h3><div>The mean score of missed nursing care among clinical nurses was 43.10 ± 15.87. The clinical nursing work environment was negatively correlated with missed nursing care (<em>r</em> = −0.502, <em>P</em> &lt; 0.01), and positively correlated with both moral sensitivity (<em>r</em> = 0.241, <em>P</em> &lt; 0.01) and humanistic care ability (<em>r</em> = 0.312, <em>P</em> &lt; 0.01). Moral sensitivity was positively correlated with humanistic care ability (<em>r</em> = 0.228, <em>P</em> &lt; 0.01) and negatively correlated with missed nursing care (<em>r</em> = −0.430, <em>P</em> &lt; 0.01). Furthermore, humanistic care ability was negatively correlated with missed nursing care (<em>r</em> = −0.526, <em>P</em> &lt; 0.01). Moral sensitivity and humanistic care ability served as a chain mediating pathway between the nursing work environment and missed nursing care (<em>β</em> = −0.015, <em>P</em> &lt; 0.001), and the overall model demonstrated good fit indices.</div></div><div><h3>Conclusion</h3><div>The clinical nursing work environment is a key factor influencing missed nursing care. Moral sensitivity and humanistic care ability among nurses act as a mediating mechanism linking the nursing work environment to missed nursing care. Therefore, healthcare administrators may consider strengthening nurses’ moral sensitivity and humanistic care capacity as strategic entry points for developing targeted interventions to reduce missed nursing care.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 2","pages":"Pages 179-186"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147557201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping research trends and competency domains in nursing-related digital and artificial intelligence technologies: A bibliometric analysis","authors":"Kanjanee Phanphairoj ,&nbsp;Wasinee Wisesrith ,&nbsp;Sutthisan Chumwichan","doi":"10.1016/j.ijnss.2025.12.011","DOIUrl":"10.1016/j.ijnss.2025.12.011","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore the research trends, thematic structures, and core competency domains in the field of nursing-related digital and artificial intelligence (AI) technologies.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was conducted in accordance with the PRISMA 2020 statement. Peer-reviewed articles published in English from 2015 to 2025 were retrieved from Scopus, Web of Science, and PubMed. Thematic clustering was conducted using the Louvain algorithm and cosine similarity. A subset of 66 frequently cited articles was then qualitatively synthesized to capture core competencies across clusters.</div></div><div><h3>Results</h3><div>A total of 83,807 articles were included for bibliometric analysis. Of these, 66 articles were chosen for thematic analysis. Five major thematic clusters were identified: remote care in primary settings, oncology and palliative care, nurse education and training, safety and quality in nursing practice, and geriatric and dementia care. Additionally, four competency domains were identified: telehealth and remote communication, health systems and informatics, digital tools in practice, and AI-powered decision support. A clear shift in research focus was observed, with the emphasis transitioning from foundational digital skills before the COVID-19 pandemic to more advanced competencies during the post-pandemic digital transformation, encompassing ethical reasoning, immersive technology use, and AI integration.</div></div><div><h3>Conclusions</h3><div>Integrating digital and AI technologies is reshaping nursing practice across various thematic areas and competency domains, highlighting a transition from foundational digital tasks to AI-supported decision-making and ethically informed technology use. This study provides a structured overview of evolving competencies in digital nursing and synthesizes evidence to support future research, curriculum design, and policy planning.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 1","pages":"Pages 36-44"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of an e-education program based on the Health Belief Model on exercise management in women with gestational hypertension: A randomized controlled clinical trial","authors":"Wen Xu ,&nbsp;Chunfeng Xing ,&nbsp;Cong Chen ,&nbsp;Yanli Huang ,&nbsp;Piyu Li ,&nbsp;Jinguo Zhai","doi":"10.1016/j.ijnss.2025.12.015","DOIUrl":"10.1016/j.ijnss.2025.12.015","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate the effectiveness of a Health Belief Model (HBM)–based electronic education program combined with individualized supervised exercise in improving exercise adherence and pregnancy outcomes among women with gestational hypertension.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A randomized controlled trial was conducted from June 2024 to February 2025 at a tertiary hospital in Shenzhen, China. A total of 142 pregnant women diagnosed with gestational hypertension were randomly assigned to either an experimental group or a control group. The experimental group received routine antenatal care plus a 6-week HBM-based e-education intervention delivered via a mobile application and short messaging service (SMS) reminders, complemented by individualized in-person exercise guidance. The control group received routine antenatal care only. After the 6-week intervention, outcomes were assessed using the 6-min walk test, a disease knowledge and attitudes questionnaire, and the Pregnancy Exercise Self-Efficacy Scale. Primary outcomes included exercise adherence, blood pressure control, incidence of preeclampsia, and other pregnancy-related outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 129 participants completed the study (the intervention group [&lt;em&gt;n&lt;/em&gt; = 65], the control group [&lt;em&gt;n&lt;/em&gt; = 64]). At 6 weeks post-intervention, the experimental group demonstrated significantly greater improvements than the control group in exercise adherence, blood pressure control, preeclampsia incidence, disease-related knowledge and attitudes, and exercise self-efficacy (all &lt;em&gt;P&lt;/em&gt; &lt; 0.05). Specifically, participants in the experimental group engaged in more frequent and longer-duration exercise sessions (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Their blood pressure was maintained within a more stable and clinically optimal range (systolic: 135.2 ± 4.7 mmHg; diastolic: 85.4 ± 4.5 mmHg), which was significantly better than that of the control group (systolic: 138.4 ± 10.4 mmHg; diastolic: 90.9 ± 6.9 mmHg; &lt;em&gt;P&lt;/em&gt; &lt; 0.05). The incidence of preeclampsia was also significantly lower in the experimental group (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Additionally, scores for disease knowledge, attitudes, and exercise self-efficacy were higher in the experimental group (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Within-group comparisons revealed that the experimental group showed significant improvements from baseline in exercise frequency, duration, total physical activity, and knowledge/attitude scores (&lt;em&gt;P&lt;/em&gt; &lt; 0.05), whereas the control group showed no significant changes (&lt;em&gt;P&lt;/em&gt; &gt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;By embedding video-based education, real-time monitoring, and personalized support into routine prenatal care, this intervention facilitated positive behavioral changes in physical activity among pregnant women. The approach offers a scalable model for clinical nurses to delivering tailored remote exercise support for ","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 1","pages":"Pages 19-26"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a digital technology-assisted personalized exercise prescription in the telerehabilitation of postoperative coronary heart disease patients: A randomized controlled trial","authors":"Yue Wu ,&nbsp;Yan Ma ,&nbsp;Chen Zhang ,&nbsp;Chuangshi Wang ,&nbsp;Shumin Zhang ,&nbsp;Mingjing Zhao ,&nbsp;Hongmei Su ,&nbsp;Chang Liu ,&nbsp;Yan Wang ,&nbsp;Xue Feng","doi":"10.1016/j.ijnss.2025.12.010","DOIUrl":"10.1016/j.ijnss.2025.12.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate whether cardiac rehabilitation with a technology-assisted personalized exercise prescription is superior to traditional remote home-based rehabilitation in improving cardiorespiratory endurance and quality of life in postoperative patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;From October 2022 to April 2024, 62 patients who underwent percutaneous coronary intervention for coronary heart disease were recruited from a tertiary hospital in Beijing and randomly assigned to either an intervention group or a control group. After baseline assessments of cardiorespiratory endurance and exercise function, the intervention group received a digitalized personalized exercise prescription combined with remote monitoring rehabilitation. This included an exercise prescription delivered via a mobile application, weekly remote monitoring sessions with an exercise therapist to supervise prescription adherence, provide feedback based on real-time electrocardiographic data, and make personalized adjustments to the exercise prescription based on this information. The control group received an application-delivered exercise movement library and a wearable electrocardiogram device for self-monitoring of exercise intensity. Both groups underwent the 12-week intervention. Changes in maximal oxygen uptake and quality of life were evaluated at enrollment, as well as at 4 weeks, 12 weeks, and 24 weeks after the intervention commenced.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 58 participants completed the study (the intervention group [&lt;em&gt;n&lt;/em&gt;=30], the control group [&lt;em&gt;n&lt;/em&gt;=28]). Twelve weeks after the interventions, the intervention group showed statistically improvements in VO&lt;sub&gt;2AT&lt;/sub&gt; (&lt;em&gt;Z =&lt;/em&gt; 2.247, &lt;em&gt;P&lt;/em&gt; = 0.025), general health (&lt;em&gt;Z&lt;/em&gt; = 2.126, &lt;em&gt;P&lt;/em&gt; = 0.033) and social functioning (&lt;em&gt;Z&lt;/em&gt; = 3.349, &lt;em&gt;P&lt;/em&gt; = 0.001) compared to the control group. At 24 weeks of follow-up, the intervention group continued to exhibit statistically significant improvements in VO&lt;sub&gt;2AT&lt;/sub&gt; (&lt;em&gt;Z =&lt;/em&gt; 2.017, &lt;em&gt;P&lt;/em&gt; = 0.044) and social functioning (&lt;em&gt;Z&lt;/em&gt; = 3.126, &lt;em&gt;P&lt;/em&gt; = 0.002). The exercise duration of patients in the intervention group during the exercise test was significantly prolonged at both 4 weeks (&lt;em&gt;Z&lt;/em&gt; &lt;em&gt;=&lt;/em&gt; −2.420, &lt;em&gt;P&lt;/em&gt; = 0.021), 12 weeks (&lt;em&gt;Z&lt;/em&gt; &lt;em&gt;=&lt;/em&gt; −2.240, &lt;em&gt;P&lt;/em&gt; = 0.029) and 24weeks (&lt;em&gt;Z&lt;/em&gt; &lt;em&gt;=&lt;/em&gt; −2.300, &lt;em&gt;P&lt;/em&gt; = 0.025) showing statistically significant differences compared to the control group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study provides new evidence-based support for the practical effectiveness of nurses acting as supervisors of rehabilitation implementation and coordinators of multidisciplinary teams within a remote digital cardiac rehabilitation model, underscoring their significant value in the secondary prevention management system for cardiovascular diseases in the information era.&lt;/div&gt;&lt;/d","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 1","pages":"Pages 11-18"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lagged effects of risk factors on the disability of older adults: A distributed lag non-linear model approach","authors":"Yitong Mao ,&nbsp;Zhiting Guo ,&nbsp;Wen Gao ,&nbsp;Yuping Zhang ,&nbsp;Jingfen Jin","doi":"10.1016/j.ijnss.2025.12.007","DOIUrl":"10.1016/j.ijnss.2025.12.007","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models (DLNMs).</div></div><div><h3>Methods</h3><div>We utilized data from the China Health and Retirement Longitudinal Study (CHARLS). After feature selection via Elastic Net Regularization, we applied DLNMs to evaluate the lagged effects of risk factors. Disability was defined as the presence of any difficulties in basic activities of daily living (BADL). The cumulative relative risk (<em>CRR</em>) was calculated by summing the lag-specific risk estimates, representing the cumulative disability risk over the specified lag period. Effect modifications and sensitivity analyses were also performed.</div></div><div><h3>Results</h3><div>This study included a total of 2,318 participants. Early-phase lag factors, such as the difficulty in stooping (<em>CRR</em> = 3.58; 95 %<em>CI</em>: 2.31–5.55; <em>P</em> &lt; 0.001) and walking (<em>CRR</em> = 2.77; 95 %<em>CI</em>: 1.39–5.55; <em>P</em> &lt; 0.001), exerted the strongest effects immediately upon occurrence. Mid-phase lag factors, such as arthritis (<em>CRR</em> = 1.51; 95 %<em>CI</em>: 1.10–2.06; <em>P</em> = 0.001), showed a resurgence in disability risk within 2–3 years. Late-phase lag factors, including depressive symptoms (<em>CRR</em> = 2.38; 95 %<em>CI</em>: 1.30–4.35; <em>P</em> &lt; 0.001) and elevated systolic blood pressure (<em>CRR</em> = 1.64; 95 %<em>CI</em>: 1.06–2.79; <em>P</em> = 0.02), exhibited significant long-term cumulative risks. Conversely, grip strength (<em>CRR</em> = 0.80; 95 %<em>CI</em>: 0.54–0.95; <em>P</em> = 0.02) and social participation (<em>CRR</em> = 0.89; 95 %<em>CI</em>: 0.73–0.99; <em>P</em> = 0.04) were significant protective factors.</div></div><div><h3>Conclusions</h3><div>The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk. Future studies should explore the underlying biological and sociological mechanisms of these lagged effects, identify intervention strategies that target risk factors with different lagged patterns, and evaluate their effectiveness.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 1","pages":"Pages 53-60"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image recognition-based detection system for preventing accidental dislodgement of head-and-neck medical supplies in ICU patients: A feasibility randomized controlled trial","authors":"Zhongjie Shi ,&nbsp;Taotao Shi ,&nbsp;Xin Gao ,&nbsp;Jian Li ,&nbsp;Hong Xu ,&nbsp;Xiaojun Li ,&nbsp;Zhanxiang Wang ,&nbsp;Sifang Chen","doi":"10.1016/j.ijnss.2025.12.001","DOIUrl":"10.1016/j.ijnss.2025.12.001","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to design and evaluate a detection system for the accidental dislodgement of head-and-neck medical supplies through hand position recognition and tracking in Intensive Care Unit (ICU) patients.</div></div><div><h3>Methods</h3><div>We conducted a single-center, prospective, parallel-group feasibility randomized controlled trial. We recruited 80 participants using convenience sampling from the ICU of a hospital in Ningbo City, Zhejiang Province, between March 2025 and June 2025, and they were randomly assigned to either the control group (routine care) or the intervention group (routine care plus image recognition-based detection system). The system continuously tracked patients’ hand positions via bedside cameras and generated real-time alarms when hands entered predefined risk zones, notifying on-duty nurses to enable early intervention. System stability was assessed by continuous system uptime; system performance and clinical feasibility were evaluated by the frequencies of risk actions and accidental dislodgement of medical supplies (ADMS).</div></div><div><h3>Results</h3><div>All 80 participants completed the intervention, with 40 patients in each group. The baseline characteristics and median observation time of the two groups were balanced (intervention group: 48 h/patient vs. control group: 49 h/patient). Compared with the control group, the intervention group showed fewer ADMS (2/40 vs. 9/40) and detected more risk actions per 100 h (36 vs. 25); all system-detected events had corroborating images with complete concordance on manual review, and all nurse-recorded hand-contact events were accurately captured.</div></div><div><h3>Conclusions</h3><div>The study demonstrated that the image recognition-based detection system can function stably in clinical settings, providing accurate and continuous surveillance while supporting the early detection of risk actions. By reducing the observation burden and offering real-time cognitive support, the system complements routine nursing care and serves as an additional safety measure in ICU practice. With further optimization and larger multicenter validation, this approach could have the potential to make a significant contribution to the development of smart ICUs and the broader digital transformation of nursing care.</div></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"13 1","pages":"Pages 3-10"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}