Table of Content

15 July 2025, Volume 22 Issue 7 Previous Issue   

Discipline Development and Professional Construction

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Research on the current status of process management in full-time undergraduate nursing theses（designs） across 53 schools MEI Hua, LI Xiu, JIANG Ying, ZHU Aiyong 2025, 22 (7):  773-778.  doi: 10.3761/j.issn.1672-9234.2025.07.001 Abstract ( 16 )   HTML ( 0 )   PDF (973KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate and analyze the current status of process management for nursing undergraduate theses across different schools and to provide references for optimizing the quality management of nursing theses. Methods From October 2023 to July 2024，a combination of convenience sampling and snowball sampling was employed to select schools that had completed at least one round of thesis supervision for nursing undergraduates. Questionnaires were administered to these institutions，while in-depth interviews were conducted with administrators involved in thesis management to explore their experiences and recommendations. Results A total of 53 schools has participated in the survey. Among them， 47 institutions（89%） had established nursing thesis management systems， 43（81%） had dedicated administrative staff， 37（70%） organized unified thesis proposal reviews，and 45（85%） conducted unified thesis defenses. Only 36% of faculty advisors reported high motivation for thesis supervision. Administrators widely acknowledged the substantial workload burden on both faculty and students during the process. Key recommendations included further optimization of research training courses，allocation of qualified research supervisors，implementation of incentive mechanisms，and refinement of thesis evaluation criteria. Conclusion Critical components of nursing thesis process management need reinforcement. Future efforts should prioritize targeted training for thesis advisors，establish incentive systems，and explore diverse thesis formats to further enhance academic rigor and adaptability.

Curriculum, Teaching Materials, Teaching methods

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The practice of precision teaching reform in Clinical Nursing of TCM course based on student portraits XIA Zheyuan,YU Shuang,SHI Hui,ZHANG Huiling,WANG Xiao,WANG Xiang,HAO Shujie,YUAN Yamei 2025, 22 (7):  779-784.  doi: 10.3761/j.issn.1672-9234.2025.07.002 Abstract ( 12 )   HTML ( 0 )   PDF (1303KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Relied on big data technology to analyze the learning data of prerequisite courses，the curriculum team developed four types of student portraits，namely the passive type，the diligent type，the moderately performing type，and the all-round excellent student type. Through identifying genuine teaching issues faced by students of different portraits in the Clinical Nursing of TCM，the team initiated precision teaching reforms tailored to these students’ profiles. Before the class，the learning groups were precisely divided，students’ academic conditions were accurately diagnosed，and customized learning objectives were set. During class，precise interactions were conducted，and three types of progressive cases were designed. After class，classified learning tasks was designed to meet the learning needs of students with different portrait types. The practice has found that，as the data hub of precision teaching，student portraits can transform students’ learning data into an effective basis for teachers to adjust their teaching strategies. This is helpful for solving the contradiction between large-scale teaching and personalized teaching，and promoting the transformation of the teaching paradigm from subjective empiricism to objective dataism.

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Practice and effect analysis of blended teaching model reform of statistical methods for undergraduate nursing students ZHOU Hanjing,JI Longfei,ZHU Wangqiao,WEI Yunshi,QIN Huaxing,NONG Ming 2025, 22 (7):  785-789.  doi: 10.3761/j.issn.1672-9234.2025.07.003 Abstract ( 14 )   HTML ( 0 )   PDF (781KB) ( 1 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the application effect of a blended teaching model aimed at enhancing practical application skills in the teaching of statistical methods for undergraduate nursing students. Methods Two classes from five undergraduate nursing classes of the Nursing College of a university in grade 2022 were classified into the experimental group or control group through the random number table method. The experimental group was carried out a blended teaching model aimed at enhancing practical application skills，while the control group was taught by online self-directed learning combined with traditional offline lectures. After the course，the theoretical examination scores on statistical methods，students’ evaluations of the teaching approach，and the completion status of investigations were compared. Results In the experimental group，the scores were higher than those in the control group，with statistically significant differences（P<0.05） including t-tests，fourfold table chi-square tests，one-way analysis of variance，non-parametric tests for two independent samples，multiple linear regression analysis，and binary logistic regression analysis，as well as the total score. However，no significant differences were found in the classification of data types and correlation analysis scores（P>0.05）. The experimental group also scored higher than the control group in the overall evaluation of the teaching approach，as well as the dimensions of learning motivation and participation，learning ability and research literacy，and recognition of the teaching approach，with statistically significant differences（P<0.05）. Conclusion A blended teaching model aiming at enhancing practical application skills can stimulate students’ enthusiasm and participation，improve their learning ability，task completion rate，recognition of teaching methods，and level of knowledge in statistical methods.

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Reform and practice of the virtual reality integration course for Basic First Aid Skills in vocational nursing ZHANG Yunping,LIU Xiaofei,ZHAO Beibei,ZHANG Jing,XU Yang,XU Lu,HUANG Jingjing,XIA Liping 2025, 22 (7):  790-796.  doi: 10.3761/j.issn.1672-9234.2025.07.004 Abstract ( 11 )   HTML ( 0 )   PDF (1828KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the reform path and practical effect of virtual-real integration course of Basic First Aid Skills. Methods The course reform of Basic First Aid Skills based on the Fink integrated curriculum design model was conducted，and the teaching practice among 94 vocational nursing students was carried out afterward. After completing the course，first-aid literacy， deep learning ability and the course scores was evaluated. Results The course scores of 94 students were（90.28±3.98） points，with an excellent rate of 72%. The acquisition rate of the primary first aider qualification certificate was 100%. Besides，the scores of first aid literacy，total scores of students’ learning engagement and scores of all dimensions were significantly higher than before（P<0.05）. Conclusion The Fink integrated course design model can effectively guide the curriculum reform of Basic First Aid Skills，improve the teaching effect，and enhance students’ first-aid literacy and learning engagement. In the future，Basic First Aid Skills integration courses should be conducted among all professional students in schools to achieve the popularization of first aid skills.

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Practice and exploration of diversified teaching in the course of Maternal and Infant Care through integration of Job-Course-Competition-Certificate CHEN Huiqun,FAN Limin,ZHENG Xiaoping,LIU Ying 2025, 22 (7):  797-801.  doi: 10.3761/j.issn.1672-9234.2025.07.005 Abstract ( 5 )   HTML ( 0 )   PDF (860KB) ( 0 )   Save References | Related Articles | Metrics The teaching process of Maternal and Infant Care centered on the concept of caring for mothers and children，safeguarding health，restructuring teaching content through methods such as leading with ethics，defining classes based on positions，promoting teaching through competitions，and integrating certificates into classes. Through emphasizing the use of task-driven teaching methods，situational simulation teaching methods，and other diversified teaching models，we has built up a diversified teaching system，which is helpful in promoting educational innovation reforms，strengthening core job skills，enhancing students’ learning enthusiasm，cultivating career value awareness，and improving the quality of training for maternal and infant care personnel.

Experimental and Practical Teaching and Learning

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Construction and preliminary application of the virtual simulation experimental teaching program of multiple organ dysfunction syndrome ZHANG Nan, WANG Jingjing, LIN Jing, GAO Yan, CONG Jiyan, WANG Lan 2025, 22 (7):  802-807.  doi: 10.3761/j.issn.1672-9234.2025.07.006 Abstract ( 10 )   HTML ( 0 )   PDF (1992KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To construct a virtual simulation experimental teaching program for multiple organ dysfunction syndrome and apply it preliminarily. Methods A research team was formed to select typical cases of postpartum liver subcapsular rupture bleeding complicated with multiple organ dysfunction syndrome to construct the virtual simulation experimental teaching program. The program was applied to the experimental teaching of the multiple organ dysfunction syndrome chapter in the Emergency and Critical Care Nursing course for 77 undergraduate nursing major students in a university in Tianjin in the class of Grade 2022. After the teaching，the duration of online training，number of visits，and experimental scores of the students were analyzed. An online theoretical assessment and self-evaluation were conducted before and after the teaching. Results The number of student visits was 2（1，4） times，the online training duration was 21~155[41（27.5，61.5）] minutes，and the experimental assessment score was（75.51±12.45） points. After teaching，students’ theoretical scores and self-evaluation scores were higher than before，and the difference was statistically significant（P<0.001）. Conclusion The virtual simulation experimental teaching program for multiple organ dysfunction syndrome is high efficient and easy to use. It can enrich the experimental teaching resources，and lay a certain knowledge and skills foundation for nursing clinical practice.

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Factors related to transition shock of nursing interns：systematic review of mixed methods research LIU Ningjing, XU Yahong, YAN Yuran 2025, 22 (7):  808-815.  doi: 10.3761/j.issn.1672-9234.2025.07.007 Abstract ( 8 )   HTML ( 0 )   PDF (1145KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the factors associated with transition shock among nursing interns （i.e.，factors potentially related to changes in the level of transition shock）. Methods Databases were searched to identify studies investigating factors related to transition shock among nursing interns including CNKI，Wanfang，VIP，Sinomed，PubMed，Web of Science，Cochrane Library，Embase，EBSCO，and Scopus. Time limit was set from the inception of databases to November 2024. Two researchers independently screened the literature，extracted data，and evaluated the quality of the included studies using the Mixed MethodsAppraisal Tool（MMAT）. A convergent integrated approach was used to synthesize and analyze the data. Results A total of 27 studies were included，from which 27 research outcomes were extracted. Two integrated results of internal factors and external factors were summarized，which encompassing eight categories，namely，personality characteristics，coping ability，academic performance，professional cognition and affective attitudes，educators，clinical practice environment，internship arrangement and social support. Conclusion Transition shock among nursing interns is influenced by complex and diverse factors. Nursing educators should focus on enhancing interns’ internal coping resources，optimizing external support conditions in clinical teaching environments，and developing strategies to reduce the transition shock for nursing interns.

Ideological and Political Education and Quality Education

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A phenomenological study on the experience of recessive truancy among undergraduate nursing students under academic warning KE Hui, WANG Yuru, LIU Fangqing, ZHANG Hongchen 2025, 22 (7):  816-821.  doi: 10.3761/j.issn.1672-9234.2025.07.008 Abstract ( 9 )   HTML ( 1 )   PDF (1018KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the experience of recessive truancy among academical warned undergraduate nursing students. Methods The purposive sampling was used to select 15 students for semi-structured interviews. The data were analyzed by Colaizzi’s 7-step method. Results The experience of recessive truancy were summarized into three themes and eight sub-themes，including “I also want to listen carefully”：active presence and passive departure（cognitive awakening，helpless out）；“I will not listen to all of them”：selective persistence and dissociation （interest first，classroom orientation，utilitarian intention）；“I can listen to it or not”：inner sense of meaninglessness and external sense of nothingness（no intention to learn，addicted to virtuality，drift along）. Conclusion From the teacher’s perspective，dull teaching and inadequate classroom management suggest that teachers should improve teaching quality and classroom management. The lack of care and support for students also reveals that teachers should satisfy students’ developmental needs. From the students’ perspective，their wrong learning values should be reshaped，while their lack of motivation and unclear goals also show that they should enhance their own growth cultivation. Only through joint efforts can a spiritually aligned learning community be built，thereby preventing the recessive truancy.

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The relationship between explicit and implicit death attitudes of undergraduate nursing students and their sense of life meaning MA Zhenling, SU Xin, LI Muyao, TU Liujiao, FU Wendong, GUO Yizhe, RAN Xiaochun 2025, 22 (7):  822-828.  doi: 10.3761/j.issn.1672-9234.2025.07.009 Abstract ( 15 )   HTML ( 0 )   PDF (1040KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the explicit and implicit death attitudes among undergraduate nursing students and explore their relationships with the sense of meaning in life. Methods A convenience sampling method was adopted to recruit 211 undergraduate nursing students from a medical college in Beijing between March and May 2022 as the survey participants. The Death Attitude Profile-Revised（DAR-P） and the Chinese version of the Meaning in Life Questionnaire（C-MLQ） were utilized for the survey. Among them，58 students were conveniently selected to undergo the Single-Category Implicit Association Test（SC-IAT） to assess their implicit death attitudes. Results Among the various dimensions of explicit death attitudes of undergraduate nursing students，the natural acceptance dimension scored the highest，with a mean score of（4.11±0.60）. The implicit effect value of implicit death attitudes was（0.24±0.43），and the difference was statistically significant when compared to 0. A positive correlation was observed between the natural acceptance dimension of explicit death attitude and the sense of meaning in life（P<0.05），while a negative correlation was found between the escape acceptance dimension of explicit death attitude and the sense of meaning in life（P<0.05）. Besides，no significant correlations were identified between implicit death attitude and explicit death attitude，nor between implicit death attitude and the sense of meaning in life（P>0.05）. Conclusion Undergraduate nursing students generally exhibit a relatively positive explicit death attitude，whereas their implicit death attitude is negative and governed by an independent psychological mechanism. In future death education initiatives，it is essential to comprehensively consider both explicit and implicit death attitudes. When aiming to enhance the sense of meaning in life among undergraduate nursing students through interventions targeting their death attitudes，the focus should be on the proactive construction of explicit attitudes，while avoiding excessive “exposure to death” so as to mitigate the risk of psychological burnout.

Nurse Growth and Career Development

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Application of a standardized perioperative nurse-patient communication virtual reality training system in operating room nurse training LIU Peiyu, LI Xueyun, AN Xiaoyan 2025, 22 (7):  829-833.  doi: 10.3761/j.issn.1672-9234.2025.07.010 Abstract ( 11 )   HTML ( 0 )   PDF (1030KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the application effects of a standardized perioperative nurse-patient communication virtual reality training system in nurse training in operating room. Methods A total of 75 nurses from the Department of Anesthesiology and Surgery at a tertiary grade A hospital in Jiangsu Province were selected as participants through a convenience sampling method. Participants received a 4-week training program using a standar-dized perioperative nurse-patient communication virtual reality training system. The outcomes were evaluated through assessment scores，system usability scores，and user experience feedback. Results The average assessment score was（84.32±9.90） and the system usability score was（80.93±11.07）. Analysis of nurse feedback identified three themes：（1） stimulation of learning interest and improvement of communication skills，（2） efficient resource utilization and optimized immersive experience，and（3） insufficient personalized design and lack of tactile feedback. Conclusion The virtual reality training system for standardized perioperative nurse-patient communication can enhance nurses’ sense of immersion，stimulate learning motivation effectively，and improve communication standardization. However，continuous improvements are needed in personalized design and tactile feedback integration.

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Construction of evaluation index system for core competencies of specialty nursing educator in clincial teaching base XU Huiping, DI Ruiqing, GUO Zixin, LIU Yanjin, WANG Yehua, WANG Ling, WANG Xin, ZHANG Xinyu 2025, 22 (7):  834-841.  doi: 10.3761/j.issn.1672-9234.2025.07.011 Abstract ( 12 )   HTML ( 0 )   PDF (1154KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To develop evaluation index system for core competencies of specialty nursing educator in clinical teaching base. Methods Through literature review，qualitative interview based on grounded theory and expert consultation，the preliminary evaluation index of core competence of specialty nursing educator in clinical teaching base was preliminary formulated. From May 2024 to July 2024，the Delphi method was used for two rounds of expert consultation，and the weights of each indicator were calculated using the analytic hierarchy process. Results The response rate of the two rounds of questionnaires was 100%. The authority coefficient of experts was 0.920，0.866，and the coordination coefficients of expert opinions was 0.200 and 0.242（P<0.001）， respectively. The evaluation index system for core competencies of specialty nursing educator in clinical teaching base was finally formed，which included eight primary indicators，22 secondary indicators and 64 tertiary indicators. The eight primary indicators included personal characteristics，specialty theoretical knowledge and application ability，clinical specialty work ability，clinical teaching ability，interpersonal communication and coordination ability，nursing scientific research and innovation ability，ethical/legal awareness，and other ability. Conclusion The core competency evaluation index system for clinical teaching teachers in specialty nursing teaching bases provides a basis for the selection, training, assessment, evaluation, and management of clinical teaching teachers. In addition，it provides reference for further optimizing the training mode of nursing educator in clinical teaching base and establishing an echelon of specialty nursing educator in the teaching base.

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The mediating effect of professional identity between the performance of second victim support resources and safety behavior among ICU nurses LUO Xueli, ZHUANG Yiyu, WEI Wenjing, DONG Lianlian, WANG Xin’an, ZHOU Xinying, GONG Xiaoyan 2025, 22 (7):  842-848.  doi: 10.3761/j.issn.1672-9234.2025.07.012 Abstract ( 16 )   HTML ( 0 )   PDF (1023KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the mediating effect of professional identity between the performance of second victim support resources，and safety behaviors among ICU nurses. Methods Using convenience sampling method，nurses in ICU from eight tertiary grade A hospitals in Zhejiang Province were surveyed from July to August 2024 with general information questionnaire，Second Victim Experience and Support Scale，Nurse Professional Identity Scale，and Nurse Safety Behavior Scale. Results The total scores of the 453 ICU nurses’ performance of second victim support resources，professional identity，and safety behaviors were（63.46±11.49），（105.36±18.37），and（49.19±6.67） respectively. The total score of the performance of second victim support resources showed negative correlations with professional identity and safety behaviors score，while professional identity score was positively correlated with safety behaviors score（all P<0.001）. The mediating effect value of professional identity between the performance of second victim support resources and safety behaviors was -0.109（95%CI：-0.139~-0.080），accounting for 58.92% of the total effect. Conclusion Professional identity plays a partial mediating role between the performance of second victim support resources and safety behaviors in ICU nurses. Nursing administrators should pay attention to ICU nurses’ physical and mental health as second victims，emphasize the construction of support systems，and enhance ICU nurses’ professional identity to promote the improvement of safety behaviors.

Health Education and Health Promotion

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Application of child-friendly video combined with teach-back method in health education on functional exercise for preschool children after humeral fracture surgery ZHANG Wenwen, ZHU Jihua, XU Liqin, QIU Wenjun 2025, 22 (7):  849-854.  doi: 10.3761/j.issn.1672-9234.2025.07.013 Abstract ( 11 )   HTML ( 0 )   PDF (1013KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the application effect of child-friendly video combined with the teach-back method in functional exercise education for preschool children after humeral fracture surgery. Methods A convenience sampling method was used to select 156 children aged 4-6 years who underwent humeral fracture surgery in Orthopedic Trauma Center of Children’s Hospital Affiliated to Zhejiang University School of Medicine between January and June 2024. Participants treated from January to March 2024（n=80） were assigned to the control group receiving routine health education on functional exercise，while those treated from April to June 2024（n=76） classified to the experimental group receiving health education on functional exercise using child-friendly videos combined with the teach-back method. The Chinese version of the Child Stress Disorders Checklist （CSDC） was assessed at admission and discharge，Mayo elbow function was evaluted at 6 months post-surgery，and compliance with functional exercise within 1 month post-surgery were compared between the two groups. Results At discharge，the experimental group demonstrated significantly lower total and subscale scores on the CSDC-Chinese version compared to the control group（all P<0.05）. Additionally，the experimental group achieved higher Mayo elbow function scores at 6 months post-surgery and greater compliance with functional exercise within 1 month post-surgery than the control group（all P<0.05）. Conclusion The integration of child-friendly videos and the teach-back method in health education for preschool children after humeral fracture surgery can effectively reduce stress response symptoms，improve elbow functional recovery，and enhance compliance with rehabilitation exercises. This approach is worthy of wider application in clinical practice.

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Health literacy in patients with cancer-related lymphedema：a qualitative user persona study ZHAO Mengqin, YAO Jiaying, MEI Xiaofeng, LI Ying, PU Limin, LIU Tingting, CHEN Xiaomin 2025, 22 (7):  855-861.  doi: 10.3761/j.issn.1672-9234.2025.07.014 Abstract ( 13 )   HTML ( 0 )   PDF (1448KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the characteristics of health literacy levels and population differences among patients with cancer-related lymphedema，construct user portraits，and provide references for formulating cancer-related intervention measures. Methods Twelve patients with cancer-related lymphedema were selected according to the purpose sampling method，and semi-structured interviews were conducted based on Nutbeam Health Literacy Theory. Data were analyzed using thematic analysis to obtain personal characteristics and self-management status of lymphedema of the patients. Based on the data analysis results，patient health literacy theme dimensions and tags were manually extracted for user clustering，and the visualization of portraits was completed based on the clustering results and WordArt software. Results Ultimately，four thematic dimensions of health literacy，namely functional health literacy，interactive health literacy，critical health literacy，and e-health literacy，as well as 15 thematic labels were extracted. Four typical portraits of the health literacy level of patients were the integration of knowledge and action，lack of practice，lack of skills and passive learning. Conclusion The group variances in health literacy levels among patients with cancer-related lymphedema can be tackled through precise and individualized intervention measures in accordance with the depicted patient profiles. In the future，a management platform can be established based on user profiles to boost efficiency and precision of care.

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Analysis of the current situation and influencing factors of exercise phobia in breast cancer patients implanted with intravenous infusion ports ZHANG Xiaomeng, WANG Yue 2025, 22 (7):  862-867.  doi: 10.3761/j.issn.1672-9234.2025.07.015 Abstract ( 10 )   HTML ( 0 )   PDF (922KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the current status and influencing factors of kinesiophobia in breast cancer patients with implantable venous access ports（IVAP）. Methods From August to December 2024，a convenience sampling method was used to recruit breast cancer patients undergoing chemotherapy with IVAP implantation in the Department of Thyroid and Breast Surgery of a Grade A Class Ⅲ hospital in Beijing. Participants were assessed by a General Information Questionnaire，the Tampa Scale of Kinesiophobia（TSK），and the Cancer Patients TIVAPs Self-Management Scale. Results The mean kinesiophobia score among 194 breast cancer patients with IVAP was （44.02±4.72），with an incidence rate of 85.6%. Multivariate linear regression analysis revealed that a number of factors significantly influenced kinesiophobia （P<0.05） including educational level （junior high school or below，and college/undergraduate，with “postgraduate” as the reference）；duration of IVAP application（3-6 months，with “<3 months” as the reference）；exercise habits；familiarity with IVAP （very familiar，with “unfamiliar” as the reference）；and self-management behavior level related to IVAP. These variables collectively explained 66.6% of the variance in kinesiophobia among the patients. Conclusion Breast cancer patients with IVAP exhibit a high incidence of kinesiophobia，influenced by multiple factors. Healthcare providers should prioritize early identification of kinesiophobia in this population and implement targeted interventions to reduce fear of movement，so as to enhance physical activity engagement and facilitate rehabilitation.

Professional Practice

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The development and evaluation of medication guidance for elderly patients HE Ziwen, SUN Kejuan, WANG Yaqian, XU Xinyi, YU Hong 2025, 22 (7):  868-873.  doi: 10.3761/j.issn.1672-9234.2025.07.016 Abstract ( 12 )   HTML ( 0 )   PDF (1490KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To design an evidence-based Patient Medication Guide（PMG） tool for elderly patients and evaluate its correctness，comprehensiveness，and readability through the example of using nitroglycerin oral tablets. Methods The content themes were preliminarily identified based on an investigation of the current application status and needs of PMG among elderly patients. Best practices were determined through evidence synthesis and external review，followed by evidence refinement. After that，guided by the three-level theory of emotional design，the evidence was translated into practical applications and ultimately forming the elderly PMG tool for nitroglycerin tablets. In evaluation，clinical healthcare professionals were invited to assess the comprehensiveness and accuracy of the PMG content. Elderly patients using nitroglycerin oral tablets and relevant stakeholders were recruited to assess the readability using the Suitability Assessment of Materials （SAM） scale for health education text materials. Results A PMG was formed，including 8 themes and 22 detailed themes such as indications，contraindications，dosage and administration，adverse reactions，drug efficacy monitoring，drug compatibility，the relationship between drugs and diet，and storage methods. The average score rate of correctness and comprehensiveness of the PMG content by 52 medical staff was over 90% and the average score rate of 105 research participants was 94.94%. Conclusion The PMG for elderly patients using nitroglycerin oral tablets designed in this study holds good readability and comprehensive and accurate content，which are recognized by medical staff and patients with apllication value.

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Intermittent oro-esophageal tube feeding for patients with post-stroke dysphagia：the best evidence practice of management ZHENG Zhimin, CHEN Ren, WU Lixin, FU Fen, XIE Xiaohuan, WEN Mengling, LI Chunxia 2025, 22 (7):  874-881.  doi: 10.3761/j.issn.1672-9234.2025.07.017 Abstract ( 9 )   HTML ( 0 )   PDF (1185KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To implement evidence-based practice（EBP） based on the best available evidence for managing intermittent oroesophageal tube feeding（IOE） in stroke patients with dysphagia and evaluate its effects. Methods Guided by the Joanna Briggs Institute（JBI） Model of Evidence-Based Healthcare，audit indicators were formulated based on evidence. A baseline audit was conducted from July to September 2024 to evaluate current practices. Subsequently，barriers were analyzed，and practice improvements were initiated based on the audit findings. A post-implementation audit was performed from October to December 2024 to compare pre- and post-intervention outcomes，including compliance with audit indicators，nurses’ theoretical knowledge level and practical skills in IOE management，first-attempt success rate of tube placement，incidence of patient nausea/aspiration during placement，and improvements in nutritional status indicators following IOE intervention. Results After the implementation，significant improvements were observed in all 19 audit indicators. Nurses’ scores in theoretical and practical assessments of IOE management，and the changes rate of weight and BMI in patients were significantly improved（P<0.05）. In addition，the incidence of aspiration during tube placement got significantly reduced（P<0.05）. Conclusion The EBP protocol for IOE management in stroke patients with dysphagia can enhance nurses’ knowledge，skills，and adherence to clinical guidelines. It is also helpful in improving first-attempt success rates，reducing adverse reactions during tube placement，and optimizing patients’ nutritional outcomes.

Academic Debate

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Climate change and health：a cross-sectional survey of nurses’ awareness and attitudes TIAN Maoting, Pui Hing CHAU, Chia-Chin LIN, Roinah NGUNYULU, Michelle COLE, GU Ying, JIANG Yiqi, JI Wanyu, MO Qingyun, SHEN Xinyu, TANG Jiawei, YU Liangtong, HU Yan 2025, 22 (7):  882-889.  doi: 10.3761/j.issn.1672-9234.2025.07.018 Abstract ( 10 )   HTML ( 0 )   PDF (1173KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the awareness and attitudes of nursing professionals in certain regions of China regarding climate change and health. Methods From December 2023 to January 2024，a convenience sample of 643 registered nurses from hospitals in six provinces across China mainland was selected as the participants. The Preparedness of Nurses for Climate Change Questionnaire，developed by the Universitas 21（U21） Health Sciences Nursing and Midwifery Discipline Group was used to conduct the survey. Results A total of 595 valid questionnaires were collected，with a valid response rate of 92.53%. It was found that 54.79%（326/595） of the nursing professionals had never heard of any nursing organizations or initiatives related to climate change. Statistically significant differences（P<0.05） were observed in the awareness levels among nursing professionals with different professional titles，educational backgrounds prior to registration，levels of public health-related training，and varying degrees of confidence in implementing nursing position statements or initiatives related to climate change. The top three vulnerable groups that nursing professionals believed should be prioritized for protection were pregnant women，individuals aged 65 and above，and those aged 18 and below. Important strategies for protecting vulnerable populations from the hazards of climate change were identified including enhancing public awareness of climate change and health，conducting health education for climate-vulnerable groups，and providing direct care to these groups. About 61.18%（364/595） of nursing professionals believed that climate change had a more-than-moderate impact on the nursing community. In terms of perceptions of responsibility for climate change response，only 45.88%（273/595） of nursing professionals believed that the nursing community should also assume a more-than-moderate level of responsibility. Conclusion Nursing professionals’ awareness of climate change and its health impacts is relatively weak，and their understanding of the professional responsibilities in addressing climate change is insufficient. It is recommended to strengthen training related to climate change and its health impacts，clarify the roles and responsibilities of nursing professionals in addressing climate change，enhance their awareness and capabilities in responding to climate change，thereby promoting the establishment of a sustainable healthcare system.

Review

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Application of pre-simulation preparation in medical simulation teaching：a scoping review HU Qian, ZHANG Zhihuan, ZHANG Lichuan, SHEN Aomei, ZHANG Zijuan, LU Qian 2025, 22 (7):  890-896.  doi: 10.3761/j.issn.1672-9234.2025.07.019 Abstract ( 10 )   HTML ( 0 )   PDF (907KB) ( 0 )   Save Figures and Tables | References | Related Articles | Metrics Objective This scoping review aims to examine the use of pre-simulation preparation in medical simulation teaching and learning，summarizing its application methods and impact on educational outcomes. Methods A systematic searching was conducted across multiple databases，including PubMed，Web of Science，Embase，EBSCO，ProQuest Digital Dissertations & Theses，Education Resources Information Center（ERIC），CNKI，Wanfang，VIP，and Sinomed. The searching covered publications up to September 9，2024. Relevant studies were identified，and data were extracted and analyzed. Results A total of 23 studies were included，and the preparation methods of each study included theory review，video learning，and professional guidance. Existing studies focused on outcome indicators such as comprehensive professional competence，clinical judgment，and self-efficacy. There was some variability in the way the same outcome indicators were measured. Besides，most studies showed that pre-simulation preparation could improve learners’ abilities such as comprehensive professional competence and clinical judgment，though some studies failed to verify this conclusion. Conclusion There is a wide variety of pre-simulation preparation methods，though overall pre-simulation preparation is beneficial for teaching scenario simulation and can enhance learners’ competencies in a variety of areas. Still，there is a lack of uniform and standardized pre-simulation preparation protocols，and more consistent and repeatable protocols need to be explored in the future.