Table of Content

15 September 2025, Volume 22 Issue 9 Previous Issue   

Digitization and Intelligence Development of Nursing Education

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Construction and application of a virtual teaching system with generative scenarios for clinical thinking training WU Fangqin, WU Ying, WANG Yanling, WANG Qiushi, WANG Huiying, MIAO Yiqun, DENG Ying, SHI Lisha 2025, 22 (9):  1029-1035.  doi: 10.3761/j.issn.1672-9234.2025.09.001 Abstract ( 142 )   HTML ( 0 )   PDF (3175KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics With the advancement of information technology and the increasing demand for nursing education，virtual teaching system has emerged as an innovative resource，thus offering new ways to enhance teaching methods and learning efficiency. The manuscript explored the background，content development，and teaching practice of generative scenario-based virtual teaching system in nursing education. It aims to provide an innovative solution in the field of nursing education，utilizing technology to improve nurses’ clinical reasoning and clinical decision-making skills.

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Construction and evaluation of an evidence-based nursing knowledge question-answering agent driven by knowledge base and multi-model collaboration SHI Manfei, QIAN Yuhang, YANG Shuqi, HUANG Zongan, WANG Jiaqing, XING Weijie, ZHOU Yingfeng, HU Yan, ZHU Zheng 2025, 22 (9):  1036-1042.  doi: 10.3761/j.issn.1672-9234.2025.09.002 Abstract ( 123 )   HTML ( 0 )   PDF (1136KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To develop an intelligent question-answering（Q&A） agent for evidence-based nursing and systematically compare the performance of knowledge base and multi-model collaborative-driven agent with that of general large language models（LLMs）. Methods An intelligent Q&A system was developed using the low-code Coze platform. A targeted knowledge base was constructed by integrating content from the Evidence-Based Nursing textbook. Retrieval-Augmented Generation（RAG） technology was employed for knowledge retrieval. A collaborative workflow was designed involving two base models，one expert model，and one analytical model. Final outputs were generated using decision rules based on “hard voting” and “expert model priority”. Evaluation was conducted using a standard in-class test from the Fudan University Evidence-Based Nursing Center to compare performance differences among different models（the intelligent Q&A agent for evidence-based nursing，DeepSeek，Kimi，ChatGPT-4o Mini） across overall questions，questions from various chapter categories，and questions with varying difficulty levels（1-5）. Results In terms of overall answer accuracy，the intelligent Q&A agent for evidence-based nursing performed better than the three mainstream models（P<0.05）. In terms of questions across different difficulty levels，the intelligent Q&A agent for evidence-based nursing showed superior performance than the three mainstream models on level-3 questions（P<0.05）. Conclusion The constructed intelligent Q&A agent for evidence-based nursing demonstrates professionalism and reliability in evidence-based nursing. Future efforts should focus on expanding the breadth and depth of the knowledge base，building a dynamically updated structured knowledge graph，and developing a multimodal data support system to continuously make the intelligent Q&A agent for evidence-based nursing adapt to the evolution of evidence-based nursing practice.

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Design and application evaluation of the nursing informatics intelligent question-answering system based on generative artificial intelligence GE Hui, ZHANG Xingchen, HU Huiling, LI Jiashuai, WU Xue 2025, 22 (9):  1043-1048.  doi: 10.3761/j.issn.1672-9234.2025.09.003 Abstract ( 72 )   HTML ( 0 )   PDF (1909KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To construct a nursing informatics intelligent question-answering system based on generative artificial intelligence and conduct preliminary study for applying and testing. Methods Data was collected using web crawling technology to build a nursing informatics knowledge base，enhancing the reliability of the content output by the DeepSeek-V3 model. The system functions were integrated using the fastGPT platform to develop the nursing informatics intelligent question-answering system，and experimental testing was conducted. From April to May 2025，30 nursing students were recruited to evaluate the system’s usability and satisfaction through questionnaires and semi-structured interviews. Results Experimental test results showed that compared to Deep-Seek-V3，the nursing informatics intelligent question-answering system improved answer accuracy by 15.39% and semantic similarity by 3.08%. Students expressed positive attitudes and consistent opinions regarding interface clarity，system usability，answer accuracy，and reliability，with an average satisfaction score of（4.33±0.48） point. Besides，interview results indicated that the system could improve knowledge acquisition efficiency and facilitates better understanding of nursing informatics research trends and academic exchange information. However，there was still room for improvement in terms of the content of the knowledge base and system functionality. Conclusion The nursing informatics intelligent question-answering system demonstrates good effectiveness and usability. In the future，it can be further implemented in nursing education to promote the digital and intelligent transformation of nursing education and enhance teaching quality.

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Development of an artificial intelligence training system for clinical nursing decision-making thinking in acute left heart failure and its application effect among newly recruited nurses FANG Hengying, QU Fenglei, CHENG Long, HU Wangjing, JIA Jiaxin, LI Huijuan 2025, 22 (9):  1049-1056.  doi: 10.3761/j.issn.1672-9234.2025.09.004 Abstract ( 53 )   HTML ( 0 )   PDF (1478KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the preliminary application effect of the artificial intelligence training system for clinical nursing decision-making thinking in acute left heart failure for the training of newly recruited nurses. Methods Based on the pathogenesis of acute left heart failure，cases of acute left heart failure with different etiologies were designed，and case dialogue scripts based on standardized patients were drafted. By using artificial intelligence natural language processing technology，virtual simulation scenarios for acute left heart failure nursing were created. An artificial intelligence training system for nursing decision-making thinking was finally developed，which includes four modules：personal information，case training，assessment and evaluation，and system management. In May 2025，the system was applied to 173 newly recruited nurses in the hospital. Results A total of 411 training data were generated from 173 newly recruited nurses. The score of newly recruited nurses in clinical nursing decision-making thinking for acute left heart failure was（70.99±8.63） points，with an overall decision-making accuracy rate of 73.53%. The total response time for each training session was 794.96 s[interquartile range（IQR）=777.11]，and the response time for decision point was 29.44 s（IQR=28.78）. Conclusion The artificial intelligence training system for clinical nursing decision-making thinking in acute left heart failure is usable. It is helpful in stimulating the learning enthusiasm of newly recruited nurses，and identifying their weaknesses in clinical nursing decision-making thinking for acute left heart failure.

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The application of artificial intelligence technology in nursing education：a systematic review BU Haoning, CHANG Qihang, WANG Xue, YU Jiaxin, AN Libin, LI Wentao 2025, 22 (9):  1057-1064.  doi: 10.3761/j.issn.1672-9234.2025.09.005 Abstract ( 153 )   HTML ( 0 )   PDF (1787KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To systematically evaluate the application effect of artificial intelligence （AI） technology in nursing education，and to provide evidence-based reference for the integration of AI and nursing education. Methods Literature searching was conducted in nine Chinese and English databases，including CNKI，Wanfang，VIP，SinoMed，PubMed，Web of Science，Cochrane Library，Embase，and CINAHL. Randomized controlled trials and Quasi-experimental studies on the application of AI technology in nursing education from the establishment of the database to April 2025 were retrieved. After literature screening，quality evaluation，data extraction，and Meta-analysis were performed using software of RevMan 5.4. Results A total of 15 studies were included，with a total sample size of 1 892. Meta-analysis showed that AI-assisted teaching significantly improved nursing students’ knowledge level [SMD=0.92, 95%CI(0.49, 1.35), P<0.001], practical ability[SMD=0.93, 95%CI(0.27, 1.59), P=0.006], and satisfaction [SMD=0.98, 95%CI(0.44, 1.51), P<0.001]. It also had a positive effect on improving clinical thinking[SMD=0.69, 95%CI(0.15, 1.23), P=0.010], though there was no significant difference in communication ability compared with traditional teaching[SMD=-0.13, 95%CI(-0.30, 0.03), P=0.120]. Conclusion AI technology has significant effects on improving knowledge, practical ability, and satisfaction in nursing education, while its impact on clinical thinking and communication skills needs to be verified by more high-quality studies.

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Qualitative studies on nursing students’ experiences and perceptions of artificial intelligence in nursing education：a meta-synthesis PENG Tao, LI Yu, KUANG Yunyun, LAI Linyu, LIU Xin, HE Yongqin, ZHANG Yumei 2025, 22 (9):  1065-1072.  doi: 10.3761/j.issn.1672-9234.2025.09.006 Abstract ( 68 )   HTML ( 0 )   PDF (1368KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To systematically review qualitative studies on nursing students’ experiences and perceptions of artificial intelligence（AI） in teaching，and to provide insights for the further implementation of AI technology in nursing education. Methods Databases were searched from their inception to January 2025 for qualitative studies on nursing students’ experiences and perceptions of AI in teaching，including Cochrane Library，PubMed，Embase，Web of Science，CNKI，Wanfang，VIP，and CBM. The quality of the retrieved studies was assessed using the Joanna Briggs Institute（JBI） Critical Appraisal Checklist for Qualitative Research（2016），and a meta-aggregation approach was used to synthesize the findings. Results A total of 11 studies were included，from which 42 themes were extracted. These themes were categorized into nine categories，and further consolidated into three synthesized findings including diversified experiences empowered by AI technology，the tension between technology and humanistic care，nursing students’ diverse needs remain unmet in AI-enabled teaching environments. Conclusion Nursing students demonstrate diverse experiences and perceptions regarding AI-enabled teaching applications. While AI-enhanced education can improve learning efficacy，it simultaneously leads to humanistic and ethical challenges. Future efforts should be devoted to establish dynamic AI nursing training，evaluation，and supervision systems，while continuously optimizing instructional design to achieve organic integration of technology and education.

Discipline Development and Professional Construction

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Development and practice of a smart eldercare micro-specialty program based on the “care for the old and young” collaborative community HU Aizhao, SHENG Xiusheng, PAN Huiying 2025, 22 (9):  1073-1076.  doi: 10.3761/j.issn.1672-9234.2025.09.007 Abstract ( 50 )   HTML ( 0 )   PDF (819KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics To address the shortage of interdisciplinary talents in the smart elderly care industry，this study innovatively developed a Smart Elderly Care micro-program by leveraging resources from the “Collaborative Community for Elderly and Childcare Education” of Ministry of Education. Guided by collaborative governance theory，the program employed a “Five Co-construction” of model—co-goal setting，co-platform building，resource sharing，outcome integration，and model co-design to establish a competency-based curriculum. The curriculum covered six core domains，including intelligent care and rehabilitation nursing. Through curriculum resource development，cross-institutional and interdisciplinary faculty collaboration，and the establishment of a hybrid virtual-physical training platform，the program has fostered interdisciplinary training for 330 students across multiple institutions，significantly enhancing their performance in skills competitions.

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The application of design thinking in the design and teaching practice of Nursing Informatics course SHEN Jiemiao, YANG Yang, LIANG Wei, YANG Rumei, XU Qin 2025, 22 (9):  1077-1082.  doi: 10.3761/j.issn.1672-9234.2025.09.008 Abstract ( 28 )   HTML ( 0 )   PDF (1065KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the effect of integrating design thinking into Nursing Informatics courses in the context of digital transformation. Methods Nursing Informatics course in medical university-level was taken as the carrier，and 193 undergraduate nursing students enrolled in the “3+2” integrated training program were selected as the participants. The EDIPT（Empathize，Define，Ideate，Prototype，Test） model of design thinking was integrated into both theoretical and experimental teaching. The teaching effect was evaluated through course scores and changes in nursing information literacy of undergraduate nursing students before and after the course. Results The course scores of students enrolled from 2022 to 2024 were（85.70±2.34），（91.86±2.01） and （84.59±6.52），respectively. After the implementation of the teaching，the nursing information competence of undergraduate nursing students and their performance in all dimensions were significantly improved compared with before（P<0.05）. Besides，a total of 32 innovative schemes were produced by the 193 undergraduate nursing students，and four college students’ innovation and entrepreneurship projects were incubated based on these schemes. Conclusion The course design and teaching practice of Nursing Informatics integrated with design thinking can effectively promote the cultivation of information competence among undergraduate nursing students，which provide a practical reference for the reform of nursing education in the context of digital transformation.

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The development and application of a value-added evaluation scheme for Foundational Nursing Laboratory courses on undergraduate level REN Yuwen, ZHOU Yunxian, WANG Ying 2025, 22 (9):  1083-1090.  doi: 10.3761/j.issn.1672-9234.2025.09.009 Abstract ( 30 )   HTML ( 0 )   PDF (1190KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To develop a value-added evaluation scheme for Foundational Nursing Laboratory courses for undergraduate nursing students and assess its effects. Methods The value-added evaluation scheme was developed through literature review，qualitative interviews，and expert panel discussions. From February to April 2025，two classes of Grade 2023 cohort nursing students were randomly divided into an experimental group（n=103） and a control group（n=125）. The developed scheme was applied to the experimental group’s Foundational Experimental Nursing courses. With the exception of the value-added evaluation，the teaching scheme for the Foundational Nursing courses were identical in both groups. Final skill exam scores，as well as academic self-efficacy and self-directed learning ability levels before and after the course，were assessed and compared between the two groups. Results The developed value-added evaluation scheme the Foundational Nursing Laboratory courses comprised of three stages，eight steps，and 15 items. A total of 100 students from the intervention group and all students from the control group completed the study. After the course，the experimental group demonstrated significantly higher academic self-efficacy in learning ability and self-directed learning awareness compared to the control group（P<0.05）. Conclusion The developed value-added evaluation scheme for the Foundational Nursing Laboratory courses is scientific and practical，which can enhance nursing students’ self-efficacy in learning ability and self-directed learning awareness.

Curriculum，Teaching Materials，Teaching Methods

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Practice and effect analysis of blended teaching reform in Nursing Ethics course WANG Dongyu, DONG Lixia, ZENG Lan, XU Linfang, ZHU Jiayi, ZHANG Fengying 2025, 22 (9):  1091-1096.  doi: 10.3761/j.issn.1672-9234.2025.09.010 Abstract ( 26 )   HTML ( 0 )   PDF (928KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the implementation effect of blended teaching reform based on the BOPPPS （Bridge-in，Outcome，Pre-assessment，Participatory learning，Post-assessment，Summary） model in the course of Nursing Ethics. Methods Through convenience sampling，30 undergraduates majoring in nursing from the class of 2022 of Inner Mongolia Minzu University were selected as the experimental group，and 29 undergraduates majoring in nursing from the class of 2021 were selected as the control group. Students in the control group received traditional teaching. Relying on the virtual teaching and research room of the first batch of humanistic nursing courses of the Ministry of Education，and after co-constructing the Nursing Ethics course with the Sichuan University of the national first-class undergraduate course of Nursing Ethics，the blended teaching based on the BOPPPS model was implemented in the experimental group. The course scores of the two groups were compared. In addition，the learning satisfaction of the experimental group and the evaluation results of multiple subjects on the teaching of the two groups were investigated. Results The total score of the Nursing Ethics course in the experimental group was better than that in the control group（P<0.001）. In the experimental group，93.3%（28/30） and 96.7%（29/30） of the students agreed that the teaching of the Nursing Ethics had improved the effects of education and teaching，and were satisfied with the overall evaluation of the teaching design of the Nursing Ethics course. Besides，the evaluation results of the course teaching by the control group and the experimental group were 86 points and 93 points respectively，and the evaluation result of the university-level supervisors on Nursing Ethics course increased from B to A. Conclusion The reform of blended teaching based on the BOPPPS model can improve students’ learning effect and satisfaction，which is recognized by peers.

Experimental and Practical Teaching and Learning

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The application of Gibbs’ Reflective Cycle in the clinical nursing teaching of gastroenterology LIU Qingzhi, ZHAO Yishu, WANG Mei, CHEN Shifeng, ZHAO Yixin 2025, 22 (9):  1097-1101.  doi: 10.3761/j.issn.1672-9234.2025.09.011 Abstract ( 37 )   HTML ( 0 )   PDF (972KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To verify the application effect of Gibbs Reflective Cycle combined with CBL teaching method in clinical nursing education of gastroenterology. Methods According to the admission batches（students admitted in the same batch are considered as one group），nursing interns were randomly divided into an experimental group and a control group，with 60 students in each group. The control group implemented the CBL clinical teaching method，while the experimental group applied the Gibbs Reflective Cycle combined with CBL teaching method. The examination scores and clinical reflective practice abilities of both groups were compared，and evaluations of the teaching methods by the experimental group were collected. Content analysis was conducted on the reflective diaries of the experimental group. Results After the teaching，the assessment scores and clinical reflective practice abilities of the experimental group were higher than the control group （all P<0.05）；97% nursing interns of the experimental group endorsed this teaching method. Most students not only recorded their learning gains but also recognized their own shortcomings and areas needing improvement，summarizing experiences and lessons learned. Conclusion The combination of the Gibbs Reflective Cycle with CBL teaching method is helpful in improving the assessment scores and clinical reflective practice abilities of nursing interns，making it worthy of promotion and application in clinical settings.

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Analysis of the mediating effect of psychological resilience between emotional intelligence and innovation ability in undergraduate nursing interns ZHANG Jing, LUO Ting, HE Lin, WANG Jiao, ZHANG Mingmin, WANG Hong 2025, 22 (9):  1102-1107.  doi: 10.3761/j.issn.1672-9234.2025.09.012 Abstract ( 47 )   HTML ( 0 )   PDF (892KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the mediating role of psychological resilience in the relationship between emotional intelligence and innovation ability among undergraduate nursing interns. Methods From January 2024 to March 2025，a convenience sampling method was used to recruit 260 undergraduate nursing interns from three medical universities in Shaanxi Province as the participants. The Wong and Law Emotional Intelligence Scale，Connor-Davidson Resilience Scale，and the Questionnaire of Undergraduates Creativity Ability were applied for the investigation. Results A total of 246 valid questionnaires were collected，with an effective recovery rate of 94.6%. The scores of emotional intelligence，psychological resilience，and innovation ability of the 246 undergraduate nursing interns were（85.13±10.10），（87.51±12.51），and（48.52±7.60），respectively. Emotional intelligence was positively correlated with psychological resilience and innovation ability（r=0.602，0.507；both P<0.001），and psychological resilience was positively correlated with innovation ability（r=0.380，P<0.001）. Mediation effect analysis showed that psychological resilience played a partial mediating role in the relationship between emotional intelligence and innovation ability among undergraduate nursing interns，accounting for 13.91% of the total effect. Conclusion Emotional intelligence can not only directly promote innovation ability of undergraduate nursing interns but also indirectly enhance their innovation ability by strengthening their psychological resilience.

Nurse Growth and Career Development

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The application of rapid cycle deliberate practice in the skills training of arteriovenous fistula puncture under ultrasound guidance WANG Ruimin, XUE Xiaoling, WANG Yan, JIA Yajuan, YUE Xiaohong, WANG Pei 2025, 22 (9):  1108-1113.  doi: 10.3761/j.issn.1672-9234.2025.09.013 Abstract ( 38 )   HTML ( 0 )   PDF (878KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the application effect of rapid circulation deliberate practice in the skills training of arteriovenous fistula puncture under ultrasound guidance. Methods From December 2023 to June 2024，a total of 60 trainees from the ultrasound-guided arteriovenous fistula puncture training course were selected as the research participants，which 30 trainees recruited from April 2024 to June 2024 were selected as the experimental group. Skills training was conducted using the training method of rapid cyclic deliberate practice. Another 30 trainees who were trained from December 2023 to March 2024 served as the control group and received skills training of conventional methods. The assessment results of ultrasound-guided puncture skills after training，the mastery degree of arteriovenous fistula assessment，the satisfaction of training，and the clinical practice effect at three months after training were collected and compared between the two groups. Results The assessment scores of ultrasound-guided puncture skills，and the mastery rates of each item in the assessment of arteriovenous fistula skills in the experimental group were all higher than those in the control group（P<0.05）. Meanwhile，there was no statistically significant difference in training satisfaction between the two groups（P>0.05）. Conclusion The rapid cycle deliberate practice training program can enhance the ability of hemodialysis nurses to evaluate arteriovenous fistulas and improve their ultrasound-guided puncture skills in the ultrasound-guided puncture training.

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Bibliometric analysis of nurse training transfer in nursing staffs ZHOU Hongting, SUI Weijing, ZHUANG Yiyu 2025, 22 (9):  1114-1118.  doi: 10.3761/j.issn.1672-9234.2025.09.014 Abstract ( 58 )   HTML ( 0 )   PDF (992KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To analyze the research status，hot topics，and development trends of nurse training transfer in nursing staff domestically and internationally. Methods A bibliometric analysis was conducted on relevant literature related to nurse training transfer in nursing staff. Literature published from January 1994 to December 2024 was retrieved through a search of the Web of Science Core Collection，CNKI and Wanfang and analyzed using CiteSpace 6.3.R3 software. Results A total of 1 104 Chinese and 2 308 English articles were included. The analysis showed an overall upward trend in research on training transfer among nursing staff，both domestically and internationally. Chinese literatures focused on the construction of education training systems for nursing staff，and the hot topics included the influencing factors of nurse training transfer，the training and development of specialist nurses. Meanwhile，English literatures focused on the practice translation in clinical settings，and the hot spot centered on patient safety. Conclusion Further research should be conducted on the needs of nurse training transfer in China，so as to improve the localized theoretical model of nursing training transfer，and deepen clinical practice translation research. Additionally，sustainable nursing training transfer management system suitable for the Chinese healthcare context is advised.

Health Education and Health Promotion

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Construction and preliminary application of a health literacy education program for patients undergoing total knee arthroplasty ZU Xiqian, ZHANG Jing, CHEN Fuying, TIAN Miao, WANG Jia, GUO Chunhua 2025, 22 (9):  1119-1126.  doi: 10.3761/j.issn.1672-9234.2025.09.015 Abstract ( 65 )   HTML ( 0 )   PDF (1305KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To construct a health literacy education program for total knee arthroplasty patients and examin its application effect. Methods Through literature review，semi-structured interviews and Delphi method，a health literacy education program was developed. The convenience sampling method was used to select patients who underwent total knee arthroplasty in the joint department of a tertiary hospital in Hebei Province and had insufficient health literacy. The experimental group（n=33） received protocol-based health literacy education，while the control group（n=33） received routine health education. The health literacy level，functional exercise compliance，knee function and knee active range of motion were compared between the two groups at 4-week time after discharge. Results After intervention，the health literacy score，functional exercise compliance score，knee function score and knee active range of motion in the experimental group were all higher than those in the control group（P<0.05）. Conclusion The health literacy education program is scientific and feasible，which can improve the health literacy level of patients undergoing total knee arthroplasty，enhance the compliance with functional exercises and the rehabilitation effect.

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Application of multi-component intervention in improving children’s compliance with cranial MRI examination LI Yan, LI Lu, LI Li, XIE Longlong, JIN Ke 2025, 22 (9):  1127-1132.  doi: 10.3761/j.issn.1672-9234.2025.09.016 Abstract ( 27 )   HTML ( 0 )   PDF (1077KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the effect of multi-component intervention in improving children’s compliance with cranial Magnetic Resonance Imaging（MRI） examination. Methods From March to October 2024，children aged 3-9 years old who underwent their first non-sedative cranial MRI examination in the Radiology Department of Hunan Children’s Hospital were selected as the participants. Children were divided into a control group and an experimental group according to their willingness. The control group received routine nursing care，while the experimental group received differentiated multi-component intervention（including environmental adaptation training，cognitive-behavioral remodeling，immersive interactive games，and audio-visual distraction） based on the children’s age（3-6 years/>6-9 years）. The one-time success rate of the examination，examination duration，and sedation usage rate were compared between the two groups. Results Both the experimental group and the control group included 50 children aged 3-6 years old and 50 children aged >6-9 years old，respectively. For children aged 3-6 years old，the one-time success rate of the examination，examination duration，and sedation usage rate in the experimental group were all better than those in the control group（P<0.05）. For children aged >6-9 years old，the examination duration in the experimental group was shorter than that in the control group（P<0.001）. However，there was no statistically significant difference in the one-time success rate of the examination and sedation usage rate between the two groups（P>0.05）. Conclusion Multi-component intervention can improve the compliance of children aged 3-9 years old undergoing their first non-sedative cranial MRI examination and reduce the need for sedation in children aged 3-6 years old，which holds certain promotion value.

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Evidence summary for non-pharmacological management of non-alcoholic fatty liver disease SHENG Guixiao, SANG Ming, MEI Binbin, YANG Liping 2025, 22 (9):  1133-1140.  doi: 10.3761/j.issn.1672-9234.2025.09.017 Abstract ( 35 )   HTML ( 0 )   PDF (1150KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To summarize the best evidence for non-pharmacological management of patients with non-alcoholic fatty liver disease（NAFLD）. Methods A systematic search was conducted across decision support systems，Chinese and English databases，guideline websites，and professional society websites for literature on non-pharmacological management of NAFLD from inception to May 1，2025. After independent literature screening，data extraction，and methodological quality assessment by two researchers trained in evidence-based nursing，the evidence was extracted，graded，and synthesized. Results A total of 24 literature were included，comprising 11 guidelines，eight expert consensus statements，and five systematic reviews. These yielded 34 best evidence items categorized into four domains：support and follow-up management，weight management，dietary management，and exercise management. Conclusion This study consolidates the best evidence for non-pharmacological management of NAFLD，which can offer an evidence-based foundation for delivering individualized lifestyle guidance to patients.

Review

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Research progress on sense of agency of patients with chronic diseases DUAN Bomei, MEI Yongxia, WANG Xiaoxuan, ZHANG Jie, ZHANG Zhenxiang 2025, 22 (9):  1141-1146.  doi: 10.3761/j.issn.1672-9234.2025.09.018 Abstract ( 70 )   HTML ( 0 )   PDF (864KB) ( 3 )   Save References | Related Articles | Metrics Sense of agency is defined as the subjective experience of an individual in active behavior to control their movements and thereby control the external environment. For patients with chronic disease，enhancing sense of agency in disease treatment and management can lead to psychological changes，which hold positive implications for their physiological functions，emotional states，and health management. This paper provided an overview of the concepts and measurement tools related to sense of agency，as well as a review of the influencing factors and interventions for sense of agency in patients with chronic disease. On this basis，it proposed future directions for the application of a sense of agency in patients with chronic diseases. The paper aims to provide references for nursing staffs to conduct relevant research，and to develop precise intervention programs for patients with chronic disease to enhance their positive psychological feelings.

Overseas Knowledge

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Explanation and insights of the World Skills Occupational Standards for Health and Social Care from an integrated care perspective JING Xiao, NIU Geng 2025, 22 (9):  1147-1152.  doi: 10.3761/j.issn.1672-9234.2025.09.019 Abstract ( 34 )   HTML ( 0 )   PDF (921KB) ( 3 )   Save References | Related Articles | Metrics From the perspective of integrated care，this study analyzed the structural logic and competency framework of the World Skills Occupational Standards（WSOS） for Health and Social Care，and explored its implications for the development of vocational standards and talent cultivation in China’s integrated medical and elderly care system. WSOS adheres to the people-centered concept of integrated care and follows a structured workflow of assessment，planning，implementation，and evaluation. Based on the skill-based competency frameworks of assistant nurses in Europe and North America，WSOS further emphasizes comprehensive professional abilities such as work management，communication and collaboration，innovation，and interdisciplinary cooperation，in order to meet the complexity and continuity demands of integrated care services. Drawing on the experience of WSOS，this study proposed five reform pathways to promote the improvement of China’s vocational standards and training models in integrated care：deepening the practical application of the people-centered professional philosophy；expanding the scope of duties for health and social care occupations；constructing interdisciplinary competency frameworks；establishing a lifelong learning system；and promoting the integration of WSOS standards into higher vocational education curricula. These efforts aim to enhance the quality of integrated care services and facilitate the localized implementation of integrated care concepts in China.