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To explore the relationship between nurses' decision-making styles and missed care across different stages of the nursing process (assessment and evaluation, planning, implementation) in oncology care settings.
A cross-sectional study was conducted among oncology nurses from three hospitals using convenience sampling. Data were collected through a sociodemographic questionnaire, the Oncology Missed Nursing Care Self-Rating Scale (OMNCS) and the General Decision-Making Style Scale (GDMS). Mann–Whitney U tests and binary logistic regression were employed to analyse the associations between different decision-making styles and missed care.
Missed care was commonly reported across all dimensions, with the highest prevalence observed in the planning stage. The rational decision-making style was dominant, with significantly higher scores in the non-omission group. It was negatively associated with missed care during the implementation stage (OR = 0.460, 95% CI 0.251–0.844; p = 0.012). The intuitive-impulsive decision-making style showed a protective effect in all dimensions (OR = 0.254–0.337, 95% CI 0.128–0.501, 0.172–0.661; p < 0.01). In contrast, the dependent and avoidant styles both significantly increased the risk of missed care during the assessment and evaluation stage.
Nurses' decision-making styles play a crucial role in the occurrence of missed care, with different styles exerting varying influences across stages of the nursing process. Therefore, nursing managers should recognise the role of these styles in nursing quality and tailor interventions to support nurses with dependent or avoidant decision-making styles. Moreover, using simulated training or decision support systems to transition between rational and intuitive approaches offers a promising strategy to reduce stage-specific missed care, enhance oncology nursing quality and improve patient safety.
Identifying high-risk stages for missed care, incorporating assessments of nurses' decision-making styles and implementing personalised interventions provide a new management pathway to reduce missed care and enhance patient safety.
What problem did the study address?: This study provides new evidence that nurses' decision-making styles are significantly associated with missed care, with this relationship varying across different stages of the nursing process. What were the main findings?: The rational style was the most common decision-making style among oncology nurses, with the non-omission group scoring significantly higher than the omission group. The intuitive-impulsive style consistently showed a protective effect across all stages. In contrast, both dependent and avoidant styles increased the risk of missed care during the assessment and evaluation stage. Where and on whom will the research have an impact?: This study informs the development of targeted interventions for nursing management. Immediate priorities include implementing structured tools and training during high-risk care stages, while long-term strategies should focus on simulation-based training and fostering a supportive culture to enhance decision-making skills and reduce missed care.
The STROBE checklist.
This is a cross-sectional study to investigate the relationship between nurses' decision-making styles and missed care at specific stages of the nursing process. In the design phase, the research team collected data on oncology nurses' general information, missed care status and decision-making styles by reviewing relevant literature. During the research process, the nurses participated in data collection, providing key primary data for the study. This cooperation ensured the smooth execution of the research and contributed to obtaining effective results.
People living with HIV (PLWH) frequently encounter mental health symptoms. Yet, a notable gap exists regarding the divergence in core mental health symptoms among PLWH across developed and developing regions. This study aims to explore the differences in mental health symptom networks among PLWH in both developed and developing regions.
A multicenter cross-sectional study was conducted in China from April 2022 to April 2023. Six designated HIV hospitals enrolled 2436 participants, including 1430 PLWH from developed regions and 1006 PLWH from developing regions. The study assessed 40 mental health symptoms across six dimensions: somatization symptoms, negative affect, cognitive processes, cognitive function, interpersonal communication, and social adaptation among PLWH.
The diverse developed regions exhibited varying mental health symptoms among PLWH, particularly concerning their core symptoms. In the developed regions of China, PLWH predominantly experience core symptoms centered around “Sadness,” “Anger,” and “Distress.” In contrast, PLWH from developing regions tends to manifest core symptoms such as “Inability to integrate into society,” “Difficulty in managing daily work and study,” and “Hostility.”
The regional variation in mental health symptoms among PLWH underscores the disparities in their circumstances. This insight is crucial for crafting tailored intervention strategies for urban PLWH. In developed regions, psychological interventions such as catharsis and empathy are integral to clinical practice, while in less developed regions, family support interventions are paramount, given the limited social interactions available to PLWH.
This study was reported according to the STROBE checklist.
No patient or public contribution.
To examine the relationship between frailty status, family functioning, and quality of life in adolescents with congenital heart disease (CHD).
Frailty is a rarely assessed health outcome in adolescents. Despite advances in paediatric CHD treatment, potential complications may cause frailty, affecting family dynamics and quality of life. Family support and early screening are vital to managing the symptoms of frailty associated with CHD.
Cross-sectional study.
During the period from July 2022 to August 2023, 302 adolescents aged between 12 and 18 who had received a diagnosis of CHD were assessed for frailty using criteria that included slowness, weakness, exhaustion, shrinkage/body composition, and diminished physical activity. Data were collected from assessments of grip strength, the 6-min walk test, body mass index, triceps skinfold thickness, the PedsQL Multidimensional Fatigue Scale Adolescent, Physical Activity Questionnaire for Adolescents, the Family Adaptability, Partnership, Growth, Affection, and Resolve scale, and the PedsQL 3.0 Cardiac Module. All data were subjected to multiple linear regression analysis.
Frailty, as measured by exhaustion and diminished physical activity, was significantly more prevalent in adolescents with severe symptoms of CHD than in those without symptoms. Of the participants, 56.6% were prefrail, and 8.3% were frail. Adolescents who were frail and lived in dysfunctional families experienced a worse quality of life than participants with robust health and those with positive family functioning.
Frailty and family dysfunction negatively affect the quality of life in adolescents with CHD.
Developing programmes that detect frailty early and improve family functioning for adolescents with CHD is critical. Establishing guidelines for identifying frailty in this population can minimise adverse health effects and enhance familial relationships.
No patient or public involvement.
by Mi Lv, Hui Che, Jiayan Hu, Wenxi Yu, Zhaoxia Liu, Xiaolin Zhou, Binduo Zhou, Jinyi Xie, Fengyun Wang
BackgroundThe overlap between non-erosive reflux disease (NERD) and epigastric pain syndrome (EPS, a subtype of functional dyspepsia) is common, yet its associated factors remain poorly defined. We aimed to identify factors associated with symptom severity in NERD-EPS overlap, focusing on psychosocial and somatic factors.
MethodsIn this multicenter cross-sectional study, 800 patients meeting Rome IV criteria for NERD-EPS overlap were enrolled. Standardized questionnaires assessed gastrointestinal symptoms (GSRS), somatic symptoms (PHQ-15), anxiety/depression (PHQ-4), and sleep quality (SRSS). Multivariable regression models identified factors independently associated with GSRS scores, adjusted for demographics and clinical covariates. Interaction terms were tested to assess whether the association between one factor and GSRS scores varied across different levels of another factor.
ResultsOf the 800 patients, 67% were female, and the mean age was (44.50 ± 14.43) years. 67% had mild or more sleep problems, and 47% had anxiety or depression. Somatic symptoms (PHQ-15) showed the strongest association with GSRS scores (β = 0.617, P P P = 0.026). Urban residence (β = 0.071) and mixed labor type (β = −0.066) were also independently associated with symptom burden.
ConclusionSomatic symptoms, psychological distress, and sleep disturbances were the factors most strongly associated with symptom severity in NERD-EPS overlap, with additional contributions from younger age, male sex, and urban residence. Our findings advocate for integrated biopsychosocial interventions to alleviate symptom burden in this population.
by Ju Liang, Fan Wang, Jia Chen, Hai-Yan Huang, Zu-Fan Dou
In UAV aerial photography scenarios, targets exhibit characteristics such as multi-scale distribution, a high proportion of small targets, complex occlusions, and strong background interference. These characteristics impose high demands on detection algorithms in terms of fine-grained feature extraction, cross-scale fusion capability, and occlusion resistance.The YOLOv11s model has significant limitations in practical applications: its feature extraction module has a single semantic representation, the traditional feature pyramid network has limited capability to detect multi-scale targets, and it lacks an effective feature compensation mechanism when targets are occluded.To address these issues, we propose a UAV aerial small target detection algorithm named UAS-YOLO (Universal Inverted Bottleneck with Adaptive BiFPN and Separated and Enhancement Attention module YOLO), which incorporates three key optimizations. First, an Adaptive Bidirectional Feature Pyramid Network (ABiFPN) is designed as the Neck structure. Through cross-scale connections and dynamic weighted fusion, ABiFPN adjusts weight allocation based on target scale characteristics, focusing on enhancing feature integration for scales related to small targets and improving multi-scale feature representation capability. Second, a Separated and Enhancement Attention Module (SEAM) is introduced to replace the original SPPF module. This module focuses on key target regions, enhances effective feature responses in unoccluded areas, and specifically compensates for information loss in occluded regions, thereby improving the detection stability of occluded small targets. Third, a Universal Inverted Bottleneck (UIB) structure is proposed, which is fused with the C3K2 module to form the C3K2_UIB module. By leveraging dynamic channel attention and spatial feature recalibration, C3K2_UIB suppresses background noise; although this increases parameters by 34%, it achieves improved detection accuracy through efficient feature selection, striking a balance between accuracy and complexity.Experimental results show that on the VisDrone2019 dataset and the TinyPerson dataset from Kaggle, the mean Average Precision (mAP) of the algorithm is increased by 4.9 and 2.1 percentage points, respectively. Moreover, it demonstrates greater advantages compared to existing advanced algorithms, effectively addressing the challenge of small target detection in complex UAV scenarios.by Xinfeng Xu, Xinyao Jiang, Meng Zou, Jinyan Hui, Guang Huang, Qian Wu
Perfluorinated compounds (PFCs) are persistent environmental pollutants with near-universal human exposure, yet their respiratory health impacts during adolescence remain insufficiently explored. This investigation evaluated single and combined effects of serum PFCs on pulmonary function and respiratory morbidity in a nationally representative adolescent cohort (n = 976, ages 12–19 years) utilizing 2007–2012 NHANES data. Advanced analytical approaches including multivariable regression, mixture modeling (BKMR and WQS), and mediation analysis were employed to assess associations with spirometric parameters (FEV1, FVC, FEV1/FVC) and respiratory symptoms while examining inflammatory and oxidative stress pathways. Computational approaches integrating network toxicology and molecular docking identified key protein targets. Analytical results demonstrated significant associations between specific PFC congeners (PFOA, PFHS, PFOS) and pulmonary function measures, with age-stratified effects observed for wheezing symptoms. Mixture analyses revealed PFOA as the predominant contributor to observed respiratory effects, partially mediated through oxidative stress pathways (6.8–8.2% mediation). Molecular investigations identified critical signaling nodes (INS, AKT1, TP53, TNF, IL6, ALB and PPARγ) potentially linking PFC exposure to respiratory outcomes. These findings provide mechanistic insights into PFC-induced pulmonary effects during adolescence, highlighting the need for continued investigation of these environmentally persistent compounds’ impact on developing respiratory systems. The integrated epidemiological-computational approach demonstrates the utility of combining population-level data with mechanistic modeling to elucidate environmental health effects.
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