Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasu...Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasures and references for promoting the standardized implementation of nurses’non-pharmacological prescription authority.Methods:A secondary analysis of literature was conducted to systematically search for domestic and international literature related to nurses’non-pharmacological prescription authority.Meta-analysis was performed on eligible literature to evaluate the implementation effects.Simultaneously,semi-structured in-depth interviews were conducted with healthcare workers,patients,and policymakers.Content analysis was used to organize the interview data and extract core issues and barriers.Results:A total of 46 international articles were included in the Meta-analysis,which revealed that the implementation of nurses’non-pharmacological prescription authority significantly improved patients’health management outcomes,enhanced healthcare service efficiency,and increased patient satisfaction.Conclusion:The implementation of nurses’non-pharmacological prescription authority has demonstrated significant positive effects.However,China faces multiple barriers in its advancement,necessitating efforts in optimizing policy systems,constructing collaborative models,strengthening professional skills training,and improving social awareness to guide the scientific and rational implementation of nurses’non-pharmacological prescription authority.展开更多
We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on pa...We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.展开更多
Objective Systematically integrate nurses’experience with“Internet Nursing Service”to analysis the nurses’experiences with“Internet Nursing Service”,and to provide a theoretical reference for formulating a more ...Objective Systematically integrate nurses’experience with“Internet Nursing Service”to analysis the nurses’experiences with“Internet Nursing Service”,and to provide a theoretical reference for formulating a more rational“Internet Nursing Service”model.Methods A systematic search in PubMed,Embase,Web of Science,the Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Database,and Chinese Biomedical Literature Database was conducted to collect qualitative research on nurses’experiences with“Internet Nursing Service,”with a retrieval time limit from December 2019 to June 2024.Qualitative meta-synthesis was performed through line-by-line coding of relevant quotes,organization of codes into descriptive themes,and development of analytical themes.Results A total of 19 studies were included,one study was rated as Grade A in quality evaluation,and the remaining studies were rated as Grade B.Collectively synthesized into three integrated results:Harvest and growth,Difficulties and challenges,and Expectations and support.Harvest and growth,include 1)manifestation of self-value,2)enhancing nursing capabilities,3)optimizing nursing resources;Difficulties and challenges,include 1)lack of safety guarantee,2)role conflict;Expectations and support include,1)expectation for professional knowledge and skill training,2)expectations for service platform optimization,3)expectation for reasonable charges,4)expectation for related policy support.Conclusion“Internet Nursing Service”model benefits both nurses and patients,but still full of challenges.It aids in the decentralization of medical resources.Management departments still need to encourage nurses to actively invest in“Internet Nursing Service”while ensuring their safety and interests.展开更多
Infrared(IR)spectroscopy,a technique within the realm of molecular vibrational spectroscopy,furnishes distinctive chemical signatures pivotal for both structural analysis and compound identification.A notable challeng...Infrared(IR)spectroscopy,a technique within the realm of molecular vibrational spectroscopy,furnishes distinctive chemical signatures pivotal for both structural analysis and compound identification.A notable challenge emerges from the misalignment between the mid-IR light wavelength range and molecular dimensions,culminating in a constrained absorption cross-section and diminished vibrational absorption coefficients(Supplementary data).展开更多
This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV i...This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV infection model has a susceptible class,a recovered class,along with a case of infection divided into three sub-different levels or categories and the recovered class.The total time interval is converted into two,which are further investigated for ordinary and fractional order operators of the AB derivative,respectively.The proposed model is tested separately for unique solutions and existence on bi intervals.The numerical solution of the proposed model is treated by the piece-wise numerical iterative scheme of Newtons Polynomial.The proposed method is established for piece-wise derivatives under natural order and non-singular Mittag-Leffler Law.The cross-over or bending characteristics in the dynamical system of HIV are easily examined by the aspect of this research having a memory effect for controlling the said disease.This study uses the neural network(NN)technique to obtain a better set of weights with low residual errors,and the epochs number is considered 1000.The obtained figures represent the approximate solution and absolute error which are tested with NN to train the data accurately.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
Objective: The importance of culture in nursing lies in its influence on patients’ health perceptions, behaviors, and responses to care. Despite the challenges posed by the complexity of studying culture, there remai...Objective: The importance of culture in nursing lies in its influence on patients’ health perceptions, behaviors, and responses to care. Despite the challenges posed by the complexity of studying culture, there remains a critical need to develop cultural competence in nursing. This study investigated how nursing students in rural Indonesia enhance their cultural competence through education and practice. Methods: This study employed a qualitative descriptive phenomenological approach. It conducted face-to-face interviews with 32 students across 6 regions, selected purposively. Thematic analysis was employed to evaluate the results. Results: Five themes emerge in this research: perceptions of cultural competence, learning cultural competence in the classroom, practical experience, learning expectations related to cultural competence, and cultural learning barriers. Conclusions: Enhancing cultural competence necessitates enriched curricula, adept clinical mentors, and continual student evaluation. This iterative assessment informs tailored strategies for nurturing cultural proficiency.展开更多
Objectives:This study aimed to explore the voices of Indonesian migrant nurses on their retention in Japanese healthcare facilities.Methods:A descriptive qualitative study was conducted between June and September 2023...Objectives:This study aimed to explore the voices of Indonesian migrant nurses on their retention in Japanese healthcare facilities.Methods:A descriptive qualitative study was conducted between June and September 2023.The snowball sampling method was utilized to recruit 22 Indonesian nurses working in healthcare facilities in seven prefectures of Japan.Semi-structured interviews were conducted based on their shared experiences.All interview data were audio-recorded,transcribed verbatim,and analyzed using thematic analysis.Results:Six prominent themes and 15 subthemes emerged:1)organizational factors(caring leader,involvement in decision making,career development,and participation in training);2)social support systems(group support,colleagues support and friend support);3)individual drive(lifelong learning and persistent);4)national policies(government support in public service and flexibility in finding a comfortable placement);5)family factors(positive support of child education and development and maintaining relationship with spouse);and 6)economic factors(staying due to high salary and increasing income streams).Conclusions:Retention of Indonesian migrant nurses in Japan is a multifaceted challenge that hinges on various interconnected factors.This study has gone some way toward enhancing our understanding of international nurse retention in the receiving countries.Corresponding supports at the individual,family,organizational,economic,social,and national policy levels should be considered to keep them in their destination countries.展开更多
Objective:This study aimed to summarize the quality of life experiences of individuals with physical frailty undergoing hemodialysis or peritoneal dialysis and to identify the difficultiesand resources that enable bet...Objective:This study aimed to summarize the quality of life experiences of individuals with physical frailty undergoing hemodialysis or peritoneal dialysis and to identify the difficultiesand resources that enable better person-centered health care.Methods:The study described is a qualitative meta-synthesis literature review.The search was performed in databases such as CINAHL,Scopus,PubMed,Web of Science,the Cochrane Library,and Cuiden Plus through Medical Subject Headings and free terms.Qualitative and mixed studies were included on individuals undergoing hemodialysis or peritoneal dialysis,18 years of age or older,published in English or Spanish,between January 2013 and January 2024.The Mixed Methods Appraisal Tool was used to assess the methodological quality.The information was analyzed and coded through a socioecological model and the social determinants of health.Results:Fourteen qualitative and two mixed articles were selected.A total of 256 individuals participated in the study.Seventeen themes and 25 sub-themes were identifiedand grouped into two blocks(difficulties and resources).The difficultiesthat stood out were a low tolerance for activities of daily living and physical activity,loss of self-control over life and social roles,and lack of community and public resources.As for the resources,the following was found:the positive meaning of dialysis,the safety offered by close individuals and the healthcare team,the activation of specificprograms,and person-centered policies.Conclusions:The analysis and interpretation of the identifieddifficultiesand resources revealed key elements to consider when designing and implementing health programs for individuals undergoing dialysis.Future research should explore these dimensions in diverse cultural and geographical contexts to enhance generalizability and support health equity.展开更多
Objectives Nurses’clinical research activities have contributed to optimizing the care process and improving patient outcomes,and generative artificial intelligence(GAI)may help clinical nurses strengthen their resea...Objectives Nurses’clinical research activities have contributed to optimizing the care process and improving patient outcomes,and generative artificial intelligence(GAI)may help clinical nurses strengthen their research skills.To support research,this study aimed to explore the Chinese nurses’perceptions and experiences of GAI training.Methods This study used a descriptive qualitative design.The China Nurses Network conducted a three-day training session on“GAI for Nursing Research”theme,we selected 23 nurses by a convenience sampling method among participating in the training.The researchers conducted three focus group interviews at the end of each day.All focus groups were interviewed face-to-face to facilitate interaction,data collection,and observation.The data were analyzed using conventional content analysis and coded manually.Results The results showed that nurses’use of GAI to support scientific research was dynamic and characterized by evolving perceptions and practices.Four themes and 11 sub-themes emerged from the analysis:1)utilization efficacy:cope with research ability,affected by many factors;2)booster research:growth and challenges go hand in hand;3)role reversal:from GAI-dominated to nurse-dominated;4)beautiful dream:more features on research,more assistants on clinical care.Conclusions The effectiveness of GAI in supporting clinical nurses in conducting research is mainly limited by differences in personal research literacy,lack of ethical regulation,and information accuracy.In the future,it is necessary to improve nurses’relevant skills through specialized training and promote the standardization of technical regulations to ensure the appropriate application of GAI in nursing research.展开更多
Objective:This study aims to explore the experiences of social alienation among adolescents with depression,providing practical This study aims to explore the experiences of social alienation among adolescents with de...Objective:This study aims to explore the experiences of social alienation among adolescents with depression,providing practical This study aims to explore the experiences of social alienation among adolescents with depression,providing practical guidance for improving their interpersonal relationships and facilitating their reintegration into society.Methods:This qualitative research was conducted following the conventional content analysis method.20 adolescents with depression were employed to select from June to August 2024 for face-to-face semi-structured interviews.The collected data were analyzed using Colaizzi's seven-step method.Results:Three themes and eight sub-themes were analyzed and identified:individual level(feelings of helplessness and powerlessness,cognitive distortion,avoidance and withdrawal),family level(lack of family awareness,family conflict),social level(limitations of academic stress and social circle,lack and degradation of skills,generalization of virtual reality,social“stigma”).Conclusion:Adolescents with depression experience complex social alienation.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,and provide a comprehensive range of services and services to help them to cope with the challenges of depression.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,strengthen communication,bolster family support systems,and collaborate to develop comprehensive social networks and psychological services.This will create a supportive social atmosphere to help adolescents gradually alleviate their feelings of social alienation.展开更多
Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was cond...Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was conducted from December 2021 to July 2022.The population consisted of working women and midwives.Data collection was conducted using semi-structured interviews and continued until data saturation was achieved.Through purposeful sampling,10 women and 11 midwives were selected as the sample.The data were analyzed by Graneheim and Lundman content analysis approach.For more rigorous,Nvivo 14 software was also used for data management,analysis,coding and organization of data.Results:This study included 21 women(10 women employees and 11 midwives)aged 25-43 years(for women employees)and 27-56 years(for midwives)with 1 to 34 years of job experience.In examination of participant’views about the barriers to childbearing,1124 codes were identified,of which we managed to extract six subthemes and two themes.Two themes emerged:“lack of social support and lack of family support”.Subthemes of“lack of social support”were“inadequate leave,long distance from workplace,and insufficient wages”.Subthemes of“lack of family support”were“lack of spouse support,lack of spouse's family support,and lack of their family support”.Conclusions:Different socioeconomic factors influence childbearing tendency in working women.Social and family supports play an important role in this regard.It is important to take these factors into account at the time of policymaking in the field of midwifery.展开更多
Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effecti...Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effective implementation strategies for such activities.Methods:This qualitative descriptive study recruited a purposive sample of potential adopters related to HA in nursing care homes,and the conventional content analysis method was adopted.Results:A total of 6 older adults,3 social workers,1 nurse,and 1 physician participated in this study.The analysis revealed 4 themes barriers and 2 themes facilitators to the implementation of HA.Conclusions:Future intervention programs should be meticulously designed to address the identified influencing factors,and the insights gained can serve as a reference for identifying and mitigating barriers in the implementation of other physical activity programs.In turn,this will contribute to improved physical functioning and healthy aging.展开更多
The evaluation of academic researchers often relies on quantitative metrics,despite their limitations.This paper examines the qualitative assessment approach used by the French National Center for Scientific Research(...The evaluation of academic researchers often relies on quantitative metrics,despite their limitations.This paper examines the qualitative assessment approach used by the French National Center for Scientific Research(CNRS)in Computer Science(Section 6),as presented by a National Committee for Scientific Research(CoNRS)committee president.Rejecting bibliometrics like impact factors,CNRS emphasizes in-depth peer review of research quality,diverse outputs(e.g.,software and datasets),and field-specific considerations.The process,aligned with the San Francisco Declaration on Research Assessment(DORA),faces challenges in scalability and subjectivity,addressed through committee diversity and structured deliberation.This work provides insights for institutions seeking fairer,more holistic research evaluation frameworks.展开更多
Objectives:At the time of the bombing of the federal building in Oklahoma City,Oklahoma(OKC),it was the deadliest terrorist attack in the United States of America.Available research on this incident,and in general,has...Objectives:At the time of the bombing of the federal building in Oklahoma City,Oklahoma(OKC),it was the deadliest terrorist attack in the United States of America.Available research on this incident,and in general,has been quantitative,using deductive methods.The purpose of the current study was to systematically examine professional disaster response workers’emotions elicited spontaneously and in detail as they were experienced over time after a major disaster.This qualitative study will add to existing knowledge of psychopathology and the psychosocial effects of disasters on professional responders,which have not been explored by prior quantitative studies.Methods:A volunteer sample of 181 rescue and recovery workers for the 1995 bombing of the OKC Murrah Federal Building was interviewed approximately 3 years after the bombing.These responders were asked open-ended questions to elicit undirected responses in their own words.In these interviews,they were prompted to describe their feelings at 3 distinct time points:upon their arrival at the bombing scene(“immediately”),in the first 1 week following the bombing,and currently at the time of the interview(“now”).Results:Data items were coded into the 5 themes:Anticipation,Shock and awe,Negative reactions,Positive reactions,and Emotionally unengaged/unaffected.The emotional themes of the responders mapped into 2 conceptual domains.The first domain is related to common human responses to horrible events such as the bombing.The second domain is related to the professional identities of the disaster responders.Conclusions:Specific aspects of the professional responder roles asserted themselves,shaping their emotional responses distinctly from those of the bomb blast survivors.This study identified both negative and positive emotions,which may help identify risk for or resistance to posttraumatic stress disorder(PTSD).展开更多
BACKGROUND Older patients often experience thirst after general anesthesia for gastrointestinal surgery,particularly during the post-anesthesia care unit(PACU)phase.Thirst not only compromises patient comfort but also...BACKGROUND Older patients often experience thirst after general anesthesia for gastrointestinal surgery,particularly during the post-anesthesia care unit(PACU)phase.Thirst not only compromises patient comfort but also induces anxiety,which may hinder recovery.Although previous studies have addressed postoperative thirst,research specifically examining thirst experiences and nursing needs in older patients remains limited.AIM To explore thirst experiences and nursing needs of older PACU patients following gastrointestinal surgery,aiming to inform targeted interventions.METHODS This study employed a phenomenological approach within a qualitative research framework.A purposeful sampling method was used to select 12 older patients who underwent gastrointestinal surgery under general anesthesia at a tertiary hospital in Shanghai between November and December 2024.Data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step method.Themes were extracted from the interview data.RESULTS Analysis of the interview data identified four main themes and eight subthemes:(1)Intense sensations of thirst post-surgery(subjective experience of thirst and duration of thirst);(2)Emotional experiences of thirst-related discomfort(anxiety,irritability,and helplessness);(3)Practical challenges in relieving thirst(limitations of current interventions and nursing response time);and(4)Patient expectations of nursing care(desire for more timely interventions and expectation for more proactive attention from nursing staff).CONCLUSION Older patients frequently experience substantial thirst discomfort after gastrointestinal surgery under general anesthesia.A multidisciplinary perioperative intervention plan is essential to alleviate these symptoms and enhance postoperative comfort.展开更多
Objective:To explore the real experience of the maintenance of patients with a central venous catheter(PICC)inserted by peripheral venipentesis,and to provide a reference for improving the quality of life of patients ...Objective:To explore the real experience of the maintenance of patients with a central venous catheter(PICC)inserted by peripheral venipentesis,and to provide a reference for improving the quality of life of patients with cancer chemotherapy with catheter indentation and regular maintenance.Methods:Qualitative studies on the real experience of patients with PICC catheterization were searched from domestic and foreign databases from the establishment of the database to November 31,2024,and the meta-integration method was used to integrate and summarize the study results.Results:A total of 10 studies were included,63 topics were extracted,9 categories were summarized,and 3 results were integrated.PICC-induced life behavior change,skin stress reaction and economic cost consideration(life disturbance caused by PICC,unpleasant experience caused by film,economic pressure),from patient to nursing:Chain reaction factors of PICC maintenance risk(lax patient self-management,nurses worried about overprotective family members,nursing professional deficiencies,and education gaps):The maintenance and integration results of 3 PICC catheters:the trigger of PICC maintenance risk,multi-factor psychological stress,family nurse support and education difficulties analysis psychological stress under PICC multi-factor and role transformation during the treatment interval,PICC maintenance experience,family support.Conclusion:During the use of PICC(Peripherally Inserted Central Catheter)for tumor chemotherapy patients,they are faced with issues such as the curling of the dressing.In order to enhance the patients’treatment effectiveness and quality of life,comprehensive considerations are required.By strengthening the training of nurses,optimizing health education,improving the awareness and compliance of patients and their families,enhancing the maintenance experience,and reducing the economic burden,we can address the numerous problems that occur during the use of PICC.展开更多
Objective:To explore in depth the psychological perceptions and meaning construction of older adult patients with diabetes during the dietary management process,and to provide a theoretical reference for developing in...Objective:To explore in depth the psychological perceptions and meaning construction of older adult patients with diabetes during the dietary management process,and to provide a theoretical reference for developing individualized clinical nursing care.Methods:A purposive sampling method was used to select 13 older adult patients with diabetes for semi-structured in-depth interviews.The interview data were collated and analyzed using Van Manen’s analysis method.Results:The psychological experience of dietary management in older adult patients with diabetes included four core themes:(1)Information fog and cognitive shock at initial diagnosis;(2)Self-struggle during the habit reshaping stage;(3)Alternating cycle of hope and frustration in long-term management;(4)Reconstructing normality and searching for meaning in life.Conclusion:Dietary management is an important process for older adult patients with diabetes to reconstruct the meaning of life.Clinical nursing should focus on patients’psychological experiences and value needs,providing more humanistic and individualized support.展开更多
Background: Hip osteoarthritis (HOA) causes joint destruction, resulting in hip pain, limited range-of-motion, claudication, and joint deformity. In the conservative treatment of HOA, self-management is important to m...Background: Hip osteoarthritis (HOA) causes joint destruction, resulting in hip pain, limited range-of-motion, claudication, and joint deformity. In the conservative treatment of HOA, self-management is important to manage symptoms and control disease progression. In a previous study, the researchers conducted a conceptual analysis of 43 foreign studies on self-management during conservative therapy for patients with HOA. The results revealed a definition of self-management during conservative therapy for patients with HOA. However, because that study analyzed only the foreign literature, it remains unclear whether the findings reflect the characteristics of the Japanese health-care delivery system, health-care insurance system, or the lifestyles and cultural characteristics of Japanese patients with HOA. Objective: We aimed to clarify the self-management behaviors of patients with HOA. Methods: Semi-structured interviews were conducted with five patients diagnosed with HOA, and the results were subjected to inductive qualitative analysis. Results: Six categories of self-management behaviors were extracted for patients with HOA: [active information gathering about HOA], [personalized pain and weight management, and strategies for reducing hip joint load], [reflection on living conditions with individuals and professionals, and determination for future efforts], [continuation of exercise and weight management based on personal strengths and achievements, and mutual support with others], [coexistence with HOA while managing negative feelings], and [choosing treatment methods by trusting doctors while struggling with personal needs]. Conclusion: These findings suggest the need to develop health guidance and educational programs for patients with HOA that focus on how to prevent disease progression and cope with symptoms.展开更多
Objective:This study aimed to investigate the learning expectations of undergraduate nursing students regarding the flipped Health Assessment course.Methods:This descriptive,qualitative study was conducted at a medica...Objective:This study aimed to investigate the learning expectations of undergraduate nursing students regarding the flipped Health Assessment course.Methods:This descriptive,qualitative study was conducted at a medical university in Fuzhou,Fujian Province,China.An interview outline was designed based on the core dimensions of Expectation Confirmation Theory(expectation sources,expectation content,and expectation importance).Thirty second-year undergraduate nursing students who had completed first-year basic medical courses and were about to take the flipped Health Assessment course were interviewed between June and July 2022.Interview data were analyzed using qualitative content analysis.Results:Five major themes and thirteen subthemes were identified.Theme 1 was expectation sourcesperceived learning difficulties from past experiences,which included four subthemes:insufficient autonomous learning ability,confusion regarding learning methods,insufficient engagement in learning,and low professional identity.Theme 2 included knowledge and information expectations,which comprised three subthemes:knowledge to improve professional competence,knowledge to enhance academic competitiveness,and knowledge to boost self-efficacy.Theme 3 comprised logical expectations and included two subthemes:flexible teaching methods and efficient instructional tools.Theme 4,pleasure expectations,included two subthemes:vivid teaching styles and diversified teaching evaluations.Theme 5 comprised professional value expectations and included two subthemes:teachers'responsible professional attitudes and gentle emotional support.Conclusion:Students'learning expectations originate from perceived learning difficulties,such as insufficient learning autonomy and engagement,confusion about learning methods,and a lack of professional identity.They showed various learning expectations for the flipped Health Assessment course,including knowledge and information,logic,pleasure,and professional value expectations.展开更多
基金Scientific Research Fund Project of Yunnan Provincial Department of Education(Project No.:2024J2130)。
文摘Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasures and references for promoting the standardized implementation of nurses’non-pharmacological prescription authority.Methods:A secondary analysis of literature was conducted to systematically search for domestic and international literature related to nurses’non-pharmacological prescription authority.Meta-analysis was performed on eligible literature to evaluate the implementation effects.Simultaneously,semi-structured in-depth interviews were conducted with healthcare workers,patients,and policymakers.Content analysis was used to organize the interview data and extract core issues and barriers.Results:A total of 46 international articles were included in the Meta-analysis,which revealed that the implementation of nurses’non-pharmacological prescription authority significantly improved patients’health management outcomes,enhanced healthcare service efficiency,and increased patient satisfaction.Conclusion:The implementation of nurses’non-pharmacological prescription authority has demonstrated significant positive effects.However,China faces multiple barriers in its advancement,necessitating efforts in optimizing policy systems,constructing collaborative models,strengthening professional skills training,and improving social awareness to guide the scientific and rational implementation of nurses’non-pharmacological prescription authority.
文摘We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.
基金supported by the General Project of the Cultivation Project of the Chinese Hospital Reform and Development Research Institute of Nanjing University(NDYG2022072)。
文摘Objective Systematically integrate nurses’experience with“Internet Nursing Service”to analysis the nurses’experiences with“Internet Nursing Service”,and to provide a theoretical reference for formulating a more rational“Internet Nursing Service”model.Methods A systematic search in PubMed,Embase,Web of Science,the Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Database,and Chinese Biomedical Literature Database was conducted to collect qualitative research on nurses’experiences with“Internet Nursing Service,”with a retrieval time limit from December 2019 to June 2024.Qualitative meta-synthesis was performed through line-by-line coding of relevant quotes,organization of codes into descriptive themes,and development of analytical themes.Results A total of 19 studies were included,one study was rated as Grade A in quality evaluation,and the remaining studies were rated as Grade B.Collectively synthesized into three integrated results:Harvest and growth,Difficulties and challenges,and Expectations and support.Harvest and growth,include 1)manifestation of self-value,2)enhancing nursing capabilities,3)optimizing nursing resources;Difficulties and challenges,include 1)lack of safety guarantee,2)role conflict;Expectations and support include,1)expectation for professional knowledge and skill training,2)expectations for service platform optimization,3)expectation for reasonable charges,4)expectation for related policy support.Conclusion“Internet Nursing Service”model benefits both nurses and patients,but still full of challenges.It aids in the decentralization of medical resources.Management departments still need to encourage nurses to actively invest in“Internet Nursing Service”while ensuring their safety and interests.
基金supported by National Natural Science Foundation of China(Grant No.:32301161)the Natural Scientific Foundation of Hunan Province,China(Grant No.:2023JJ60052)+3 种基金the Scientific Research Project of Hunan Provincial Health Commission,China(Grant No.:202112062218,20190161)the Scientific Research Project of Hunan Provincial Department of Education,China(Grant No.:22B0455)the Clinical“4310”Project of the University of South China,China(Grant No.:20224310NHYCG02)the Doctoral Scientific Research Foundation of University of South China,China(Grant No.:200XQD042).
文摘Infrared(IR)spectroscopy,a technique within the realm of molecular vibrational spectroscopy,furnishes distinctive chemical signatures pivotal for both structural analysis and compound identification.A notable challenge emerges from the misalignment between the mid-IR light wavelength range and molecular dimensions,culminating in a constrained absorption cross-section and diminished vibrational absorption coefficients(Supplementary data).
基金supported and funded by the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University(IMSIU)(grant number IMSIU-RP23066).
文摘This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV infection model has a susceptible class,a recovered class,along with a case of infection divided into three sub-different levels or categories and the recovered class.The total time interval is converted into two,which are further investigated for ordinary and fractional order operators of the AB derivative,respectively.The proposed model is tested separately for unique solutions and existence on bi intervals.The numerical solution of the proposed model is treated by the piece-wise numerical iterative scheme of Newtons Polynomial.The proposed method is established for piece-wise derivatives under natural order and non-singular Mittag-Leffler Law.The cross-over or bending characteristics in the dynamical system of HIV are easily examined by the aspect of this research having a memory effect for controlling the said disease.This study uses the neural network(NN)technique to obtain a better set of weights with low residual errors,and the epochs number is considered 1000.The obtained figures represent the approximate solution and absolute error which are tested with NN to train the data accurately.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
基金supported by an internal grant from Universitas Citra Bangsa(Number 6/VI/LP3M/UCB/22).
文摘Objective: The importance of culture in nursing lies in its influence on patients’ health perceptions, behaviors, and responses to care. Despite the challenges posed by the complexity of studying culture, there remains a critical need to develop cultural competence in nursing. This study investigated how nursing students in rural Indonesia enhance their cultural competence through education and practice. Methods: This study employed a qualitative descriptive phenomenological approach. It conducted face-to-face interviews with 32 students across 6 regions, selected purposively. Thematic analysis was employed to evaluate the results. Results: Five themes emerge in this research: perceptions of cultural competence, learning cultural competence in the classroom, practical experience, learning expectations related to cultural competence, and cultural learning barriers. Conclusions: Enhancing cultural competence necessitates enriched curricula, adept clinical mentors, and continual student evaluation. This iterative assessment informs tailored strategies for nurturing cultural proficiency.
基金funded by Directorate General of Higher Education,Reserach,and Technology,Ministry of Education,Culture,Reserach,and Technology of Indonesia(Grant number:1325/UN3.LPPM/PT.01.03/2023).
文摘Objectives:This study aimed to explore the voices of Indonesian migrant nurses on their retention in Japanese healthcare facilities.Methods:A descriptive qualitative study was conducted between June and September 2023.The snowball sampling method was utilized to recruit 22 Indonesian nurses working in healthcare facilities in seven prefectures of Japan.Semi-structured interviews were conducted based on their shared experiences.All interview data were audio-recorded,transcribed verbatim,and analyzed using thematic analysis.Results:Six prominent themes and 15 subthemes emerged:1)organizational factors(caring leader,involvement in decision making,career development,and participation in training);2)social support systems(group support,colleagues support and friend support);3)individual drive(lifelong learning and persistent);4)national policies(government support in public service and flexibility in finding a comfortable placement);5)family factors(positive support of child education and development and maintaining relationship with spouse);and 6)economic factors(staying due to high salary and increasing income streams).Conclusions:Retention of Indonesian migrant nurses in Japan is a multifaceted challenge that hinges on various interconnected factors.This study has gone some way toward enhancing our understanding of international nurse retention in the receiving countries.Corresponding supports at the individual,family,organizational,economic,social,and national policy levels should be considered to keep them in their destination countries.
文摘Objective:This study aimed to summarize the quality of life experiences of individuals with physical frailty undergoing hemodialysis or peritoneal dialysis and to identify the difficultiesand resources that enable better person-centered health care.Methods:The study described is a qualitative meta-synthesis literature review.The search was performed in databases such as CINAHL,Scopus,PubMed,Web of Science,the Cochrane Library,and Cuiden Plus through Medical Subject Headings and free terms.Qualitative and mixed studies were included on individuals undergoing hemodialysis or peritoneal dialysis,18 years of age or older,published in English or Spanish,between January 2013 and January 2024.The Mixed Methods Appraisal Tool was used to assess the methodological quality.The information was analyzed and coded through a socioecological model and the social determinants of health.Results:Fourteen qualitative and two mixed articles were selected.A total of 256 individuals participated in the study.Seventeen themes and 25 sub-themes were identifiedand grouped into two blocks(difficulties and resources).The difficultiesthat stood out were a low tolerance for activities of daily living and physical activity,loss of self-control over life and social roles,and lack of community and public resources.As for the resources,the following was found:the positive meaning of dialysis,the safety offered by close individuals and the healthcare team,the activation of specificprograms,and person-centered policies.Conclusions:The analysis and interpretation of the identifieddifficultiesand resources revealed key elements to consider when designing and implementing health programs for individuals undergoing dialysis.Future research should explore these dimensions in diverse cultural and geographical contexts to enhance generalizability and support health equity.
基金supported by a grant from the National Natural Science Foundation of China(No.72174130)。
文摘Objectives Nurses’clinical research activities have contributed to optimizing the care process and improving patient outcomes,and generative artificial intelligence(GAI)may help clinical nurses strengthen their research skills.To support research,this study aimed to explore the Chinese nurses’perceptions and experiences of GAI training.Methods This study used a descriptive qualitative design.The China Nurses Network conducted a three-day training session on“GAI for Nursing Research”theme,we selected 23 nurses by a convenience sampling method among participating in the training.The researchers conducted three focus group interviews at the end of each day.All focus groups were interviewed face-to-face to facilitate interaction,data collection,and observation.The data were analyzed using conventional content analysis and coded manually.Results The results showed that nurses’use of GAI to support scientific research was dynamic and characterized by evolving perceptions and practices.Four themes and 11 sub-themes emerged from the analysis:1)utilization efficacy:cope with research ability,affected by many factors;2)booster research:growth and challenges go hand in hand;3)role reversal:from GAI-dominated to nurse-dominated;4)beautiful dream:more features on research,more assistants on clinical care.Conclusions The effectiveness of GAI in supporting clinical nurses in conducting research is mainly limited by differences in personal research literacy,lack of ethical regulation,and information accuracy.In the future,it is necessary to improve nurses’relevant skills through specialized training and promote the standardization of technical regulations to ensure the appropriate application of GAI in nursing research.
基金2024 Annual project of National Social Science Foundation“Research on Problem Identification and Governance Countermeasures of Minor Mental Health Network Support”(Project No.:24BXW044).
文摘Objective:This study aims to explore the experiences of social alienation among adolescents with depression,providing practical This study aims to explore the experiences of social alienation among adolescents with depression,providing practical guidance for improving their interpersonal relationships and facilitating their reintegration into society.Methods:This qualitative research was conducted following the conventional content analysis method.20 adolescents with depression were employed to select from June to August 2024 for face-to-face semi-structured interviews.The collected data were analyzed using Colaizzi's seven-step method.Results:Three themes and eight sub-themes were analyzed and identified:individual level(feelings of helplessness and powerlessness,cognitive distortion,avoidance and withdrawal),family level(lack of family awareness,family conflict),social level(limitations of academic stress and social circle,lack and degradation of skills,generalization of virtual reality,social“stigma”).Conclusion:Adolescents with depression experience complex social alienation.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,and provide a comprehensive range of services and services to help them to cope with the challenges of depression.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,strengthen communication,bolster family support systems,and collaborate to develop comprehensive social networks and psychological services.This will create a supportive social atmosphere to help adolescents gradually alleviate their feelings of social alienation.
基金This study was supported by Kerman University of medical sciences,with grant number:95000387.
文摘Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was conducted from December 2021 to July 2022.The population consisted of working women and midwives.Data collection was conducted using semi-structured interviews and continued until data saturation was achieved.Through purposeful sampling,10 women and 11 midwives were selected as the sample.The data were analyzed by Graneheim and Lundman content analysis approach.For more rigorous,Nvivo 14 software was also used for data management,analysis,coding and organization of data.Results:This study included 21 women(10 women employees and 11 midwives)aged 25-43 years(for women employees)and 27-56 years(for midwives)with 1 to 34 years of job experience.In examination of participant’views about the barriers to childbearing,1124 codes were identified,of which we managed to extract six subthemes and two themes.Two themes emerged:“lack of social support and lack of family support”.Subthemes of“lack of social support”were“inadequate leave,long distance from workplace,and insufficient wages”.Subthemes of“lack of family support”were“lack of spouse support,lack of spouse's family support,and lack of their family support”.Conclusions:Different socioeconomic factors influence childbearing tendency in working women.Social and family supports play an important role in this regard.It is important to take these factors into account at the time of policymaking in the field of midwifery.
基金supported by the Science and Technology Research Project and funded by the Provincial-Ministry Co-construction Project(No.SBGJ202102186).
文摘Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effective implementation strategies for such activities.Methods:This qualitative descriptive study recruited a purposive sample of potential adopters related to HA in nursing care homes,and the conventional content analysis method was adopted.Results:A total of 6 older adults,3 social workers,1 nurse,and 1 physician participated in this study.The analysis revealed 4 themes barriers and 2 themes facilitators to the implementation of HA.Conclusions:Future intervention programs should be meticulously designed to address the identified influencing factors,and the insights gained can serve as a reference for identifying and mitigating barriers in the implementation of other physical activity programs.In turn,this will contribute to improved physical functioning and healthy aging.
文摘The evaluation of academic researchers often relies on quantitative metrics,despite their limitations.This paper examines the qualitative assessment approach used by the French National Center for Scientific Research(CNRS)in Computer Science(Section 6),as presented by a National Committee for Scientific Research(CoNRS)committee president.Rejecting bibliometrics like impact factors,CNRS emphasizes in-depth peer review of research quality,diverse outputs(e.g.,software and datasets),and field-specific considerations.The process,aligned with the San Francisco Declaration on Research Assessment(DORA),faces challenges in scalability and subjectivity,addressed through committee diversity and structured deliberation.This work provides insights for institutions seeking fairer,more holistic research evaluation frameworks.
文摘Objectives:At the time of the bombing of the federal building in Oklahoma City,Oklahoma(OKC),it was the deadliest terrorist attack in the United States of America.Available research on this incident,and in general,has been quantitative,using deductive methods.The purpose of the current study was to systematically examine professional disaster response workers’emotions elicited spontaneously and in detail as they were experienced over time after a major disaster.This qualitative study will add to existing knowledge of psychopathology and the psychosocial effects of disasters on professional responders,which have not been explored by prior quantitative studies.Methods:A volunteer sample of 181 rescue and recovery workers for the 1995 bombing of the OKC Murrah Federal Building was interviewed approximately 3 years after the bombing.These responders were asked open-ended questions to elicit undirected responses in their own words.In these interviews,they were prompted to describe their feelings at 3 distinct time points:upon their arrival at the bombing scene(“immediately”),in the first 1 week following the bombing,and currently at the time of the interview(“now”).Results:Data items were coded into the 5 themes:Anticipation,Shock and awe,Negative reactions,Positive reactions,and Emotionally unengaged/unaffected.The emotional themes of the responders mapped into 2 conceptual domains.The first domain is related to common human responses to horrible events such as the bombing.The second domain is related to the professional identities of the disaster responders.Conclusions:Specific aspects of the professional responder roles asserted themselves,shaping their emotional responses distinctly from those of the bomb blast survivors.This study identified both negative and positive emotions,which may help identify risk for or resistance to posttraumatic stress disorder(PTSD).
文摘BACKGROUND Older patients often experience thirst after general anesthesia for gastrointestinal surgery,particularly during the post-anesthesia care unit(PACU)phase.Thirst not only compromises patient comfort but also induces anxiety,which may hinder recovery.Although previous studies have addressed postoperative thirst,research specifically examining thirst experiences and nursing needs in older patients remains limited.AIM To explore thirst experiences and nursing needs of older PACU patients following gastrointestinal surgery,aiming to inform targeted interventions.METHODS This study employed a phenomenological approach within a qualitative research framework.A purposeful sampling method was used to select 12 older patients who underwent gastrointestinal surgery under general anesthesia at a tertiary hospital in Shanghai between November and December 2024.Data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step method.Themes were extracted from the interview data.RESULTS Analysis of the interview data identified four main themes and eight subthemes:(1)Intense sensations of thirst post-surgery(subjective experience of thirst and duration of thirst);(2)Emotional experiences of thirst-related discomfort(anxiety,irritability,and helplessness);(3)Practical challenges in relieving thirst(limitations of current interventions and nursing response time);and(4)Patient expectations of nursing care(desire for more timely interventions and expectation for more proactive attention from nursing staff).CONCLUSION Older patients frequently experience substantial thirst discomfort after gastrointestinal surgery under general anesthesia.A multidisciplinary perioperative intervention plan is essential to alleviate these symptoms and enhance postoperative comfort.
文摘Objective:To explore the real experience of the maintenance of patients with a central venous catheter(PICC)inserted by peripheral venipentesis,and to provide a reference for improving the quality of life of patients with cancer chemotherapy with catheter indentation and regular maintenance.Methods:Qualitative studies on the real experience of patients with PICC catheterization were searched from domestic and foreign databases from the establishment of the database to November 31,2024,and the meta-integration method was used to integrate and summarize the study results.Results:A total of 10 studies were included,63 topics were extracted,9 categories were summarized,and 3 results were integrated.PICC-induced life behavior change,skin stress reaction and economic cost consideration(life disturbance caused by PICC,unpleasant experience caused by film,economic pressure),from patient to nursing:Chain reaction factors of PICC maintenance risk(lax patient self-management,nurses worried about overprotective family members,nursing professional deficiencies,and education gaps):The maintenance and integration results of 3 PICC catheters:the trigger of PICC maintenance risk,multi-factor psychological stress,family nurse support and education difficulties analysis psychological stress under PICC multi-factor and role transformation during the treatment interval,PICC maintenance experience,family support.Conclusion:During the use of PICC(Peripherally Inserted Central Catheter)for tumor chemotherapy patients,they are faced with issues such as the curling of the dressing.In order to enhance the patients’treatment effectiveness and quality of life,comprehensive considerations are required.By strengthening the training of nurses,optimizing health education,improving the awareness and compliance of patients and their families,enhancing the maintenance experience,and reducing the economic burden,we can address the numerous problems that occur during the use of PICC.
基金Guangdong Lingnan Nightingale Nursing Research Institute Project(Project No.:GDHLYJYB202442)。
文摘Objective:To explore in depth the psychological perceptions and meaning construction of older adult patients with diabetes during the dietary management process,and to provide a theoretical reference for developing individualized clinical nursing care.Methods:A purposive sampling method was used to select 13 older adult patients with diabetes for semi-structured in-depth interviews.The interview data were collated and analyzed using Van Manen’s analysis method.Results:The psychological experience of dietary management in older adult patients with diabetes included four core themes:(1)Information fog and cognitive shock at initial diagnosis;(2)Self-struggle during the habit reshaping stage;(3)Alternating cycle of hope and frustration in long-term management;(4)Reconstructing normality and searching for meaning in life.Conclusion:Dietary management is an important process for older adult patients with diabetes to reconstruct the meaning of life.Clinical nursing should focus on patients’psychological experiences and value needs,providing more humanistic and individualized support.
文摘Background: Hip osteoarthritis (HOA) causes joint destruction, resulting in hip pain, limited range-of-motion, claudication, and joint deformity. In the conservative treatment of HOA, self-management is important to manage symptoms and control disease progression. In a previous study, the researchers conducted a conceptual analysis of 43 foreign studies on self-management during conservative therapy for patients with HOA. The results revealed a definition of self-management during conservative therapy for patients with HOA. However, because that study analyzed only the foreign literature, it remains unclear whether the findings reflect the characteristics of the Japanese health-care delivery system, health-care insurance system, or the lifestyles and cultural characteristics of Japanese patients with HOA. Objective: We aimed to clarify the self-management behaviors of patients with HOA. Methods: Semi-structured interviews were conducted with five patients diagnosed with HOA, and the results were subjected to inductive qualitative analysis. Results: Six categories of self-management behaviors were extracted for patients with HOA: [active information gathering about HOA], [personalized pain and weight management, and strategies for reducing hip joint load], [reflection on living conditions with individuals and professionals, and determination for future efforts], [continuation of exercise and weight management based on personal strengths and achievements, and mutual support with others], [coexistence with HOA while managing negative feelings], and [choosing treatment methods by trusting doctors while struggling with personal needs]. Conclusion: These findings suggest the need to develop health guidance and educational programs for patients with HOA that focus on how to prevent disease progression and cope with symptoms.
基金This research received grant from 2022 Undergraduate Education and Teaching Research Project of Fujian Medical University(22028).
文摘Objective:This study aimed to investigate the learning expectations of undergraduate nursing students regarding the flipped Health Assessment course.Methods:This descriptive,qualitative study was conducted at a medical university in Fuzhou,Fujian Province,China.An interview outline was designed based on the core dimensions of Expectation Confirmation Theory(expectation sources,expectation content,and expectation importance).Thirty second-year undergraduate nursing students who had completed first-year basic medical courses and were about to take the flipped Health Assessment course were interviewed between June and July 2022.Interview data were analyzed using qualitative content analysis.Results:Five major themes and thirteen subthemes were identified.Theme 1 was expectation sourcesperceived learning difficulties from past experiences,which included four subthemes:insufficient autonomous learning ability,confusion regarding learning methods,insufficient engagement in learning,and low professional identity.Theme 2 included knowledge and information expectations,which comprised three subthemes:knowledge to improve professional competence,knowledge to enhance academic competitiveness,and knowledge to boost self-efficacy.Theme 3 comprised logical expectations and included two subthemes:flexible teaching methods and efficient instructional tools.Theme 4,pleasure expectations,included two subthemes:vivid teaching styles and diversified teaching evaluations.Theme 5 comprised professional value expectations and included two subthemes:teachers'responsible professional attitudes and gentle emotional support.Conclusion:Students'learning expectations originate from perceived learning difficulties,such as insufficient learning autonomy and engagement,confusion about learning methods,and a lack of professional identity.They showed various learning expectations for the flipped Health Assessment course,including knowledge and information,logic,pleasure,and professional value expectations.
