Exploration of undergraduate nursing students' perspectives on conducting specialized nursing education during internship: A phenomenological research study.

AIM: To comprehend the perspectives of undergraduate nursing students on conducting specialized nursing education during the internship phase, providing a basis for colleges to formulate plans for specialized nursing education. BACKGROUND: Nursing specialty in China was included in the national controlled specialty in 2024, which means signifying an effort to decrease the enrollment of junior college degree nurses, thereby increasing the number of high-quality undergraduate nurses. While the higher the education level of nursing students, the higher their expectations for themselves. However, after entering clinical practice, their social status and job nature are significantly different from those of doctors, which creates a psychological imbalance. In addition, employers lack a reasonable employment mechanism and undergraduate nursing students are used equally with vocational and technical nursing students, making them feel that their self-worth is difficult to realize. Therefore, their professional attitude becomes more negative (Meng Wei, 2018). In the process of forming professional identity among undergraduate nursing students, the professional role models and clinical experience of specialized nurses can serve as important promoting factors. By increasing interaction with specialized nurses and learning specialized nursing, undergraduate nursing students can better understand the professional role and values of nurses and form positive professional ethics and attitudes (Huang et al., 2023). To better adapt to the national health needs and assist undergraduates in transitioning to clinical practice, deepening the understanding of the profession and career, the integration of professional education during the internship phase can enable students to recognize their strengths, cultivate an awareness of suitable professions and facilitate a targeted adaptation from academic studies to clinical practice. DESIGN: The researcher initially drafted the interview outline through a literature review and intra-group discussions. To ensure the research content's richness, a semi-structured interview method was adopted. The Colaizzi seven-step analysis method was applied in the analysis. METHODS: Employing phenomenological study and purposive sampling, with data saturation as the guiding principle, 24 undergraduate nursing students undergoing internship at a tertiary hospital in China were selected for focus group interviews. RESULTS: Four main themes were extracted from the perspectives of undergraduate nursing students. These themes encompass awareness of specialized nursing and specialized nurses, recognition of specialized nursing education during the internship phase, demands for specialized nursing education during the internship phase and career expectations. CONCLUSION: Nursing administrators in hospitals and educational managers in colleges should prioritize align education with clinical needs, address the requirements of nursing students, strengthen collaboration between institutions，and advance the further development of specialized nursing.

Botulinum toxin combined with static progressive stretching improves fibrous stiffness of knee joint in rats through TGF-ß1/Smad pathway.

Joint stiffness and fibrosis are common complications that affect mobility and quality of life, necessitating effective therapeutic strategies to alleviate these issues. The study aimed to observe the therapeutic effect of static progressive stretching (SPS) combined with botulinum toxin type A (BTX-A) on knee joint stiffness in rats and its effect on the transforming growth factor beta 1 (TGF-ß1)/small mother against decapentaplegic (Smad) pathway in the development of joint capsule fibrosis. Forty Sprague Dawley rats were randomly divided into the blank control group, model control group, SPS intervention group, BTX-A intervention group, and SPS combined with BTX-A intervention group. Except for the blank control group, the right knee joints of the other rats were surgically fixed with Kirschner wire internal immobilization in full flexion for four weeks to form joint flexion contracture and cause fibrotic stiffness of the joint. The therapeutic effect of each intervention was assessed by the range of motion (ROM) of the knee joint, joint stiffness, the number of total cells, and collagen deposition in the posterior joint capsule, as well as the protein level expressions of  TGF-ß1, Smad2, Smad3, Smad4, p-Smad2/3, collagen I and III, and alpha smooth muscle actin (α-SMA) in the posterior joint capsule in the TGF-ß1/Smad pathway. SPS combined with BTX-A was more effective in relieving joint fibrosis stiffness, improving the histopathological changes in the posterior joint capsule, and suppressing the high expression of target proteins and the overactivated TGF-ß1/Smad pathway. The overactivated TGF-ß1/Smad pathway was involved in the formation of knee joint fibrosis stiffness in rats. SPS combined with BTX-A was effective in relieving joint flexion contracture and fibrosis of the joint capsule. Moreover, the inhibition of the overactivated TGF-ß1/Smad pathway may be the potential molecular mechanism for its therapeutic effect.

Effectiveness of a Teach-Back Education Program on Perioperative Pain in Patients With Lung Cancer: An Intervention Study Using Behavior Change Wheel.

OBJECTIVE: To assess the effect of a teach-back educational intervention using Behavior Change Wheel (BCW) framework on perioperative pain among patients with lung cancer. METHODS: A prospective quasi-experimental study was conducted in 88 patients with lung cancer from a tertiary hospital in China. According to the order of admission, they were allocated to either control group or intervention group, with 44 patients in each group. Patients in the control group received routine nursing care, while patients in the intervention group were given a teach-back education program based on BCW framework. The visual analog scale (VAS) was adopted to evaluate patients' pain on the day of surgery (T0), 1 (T1), 2 (T2), and 3 (T3) days after surgery. We also recorded the use of patient-controlled analgesia (PCA), the length of hospital stay, and the degree of patients' satisfaction. RESULTS: Rest pain, pain when coughing, and pain during activity that patients in the intervention group experienced were significantly less severe than those in the control group on T0 and T1. The pain when coughing in the intervention group was also significantly milder on T2 and T3. In addition, the number of self-control time, use duration, and total dose of PCA were significantly lower in the intervention group. Moreover, patients' satisfaction of nursing service was significantly higher in the intervention group. CONCLUSION: A teach-back education program based on BCW framework was effective in pain management among the perioperative patients with lung cancer. This study demonstrates the application of teach-back method and the BCW in the development of patient education intervention to mitigate perioperative pain.

Patients' Preference for Physician Attire in the Internal Medicine Outpatient Department.

Objective: To investigate patients' preference and the attitude towards physician attire in an internal medicine clinic in China. Methods: This study was conducted from 1 January 2021 to 30 June 2021 in a tertiary care hospital in China. We surveyed 126 patients in the hospital with 6 sets of pictures of commonly worn physician attires in the hospital setting with a two-part questionnaire. The first part listed respondent demographics to collect basic information. The second part of the questionnaire was administered to adult patients who received care in the internal medicine clinics (outpatients). Survey forms collected demographic data (age, gender, patient age, education, marital status, and employment status), asked questions regarding 6 specific attires (scrubs, scrubs and white coat, casual, casual and white coat, business suit, and formal and white coat), and behavioral items (professional, responsible, reliable, knowledgeable, succession rate, and medical safety), finally, to assess the preference of attire on overall perception. Results: Scrubs and white coat scored the highest through 6 domains about physicians' attire (professional, reliable, responsible, knowledgeable, medical safety, and succession rate, p < 0.05 for all comparisons). A casual suit without a white coat was the least preferred across the surveyed attributes. There was a significant preference gap between wearing a white coat and not wearing a white coat (p < 0.001). Physician attire to white coat was considered as more professional, reliable, responsible, knowledgeable, having greater medical safety, and a higher success rate than attires without white coat. Conclusion: Patients felt that the physician wearing a white coat was better than other attires. Scrubs and white coat was the most popular attire. Hospital or related authorities may promote the standardized wearing of white coats, leading in a greater patient-physician relationship.

Lignans from Lepidium meyenii and Their Anti-Inflammatory Activities.

Meyeniines A-C (1-3), three new lignans, two known neolignans (4-5), and three known lignans (6-8) were isolated from the rhizomes of Lepidium meyenii. Their structures were identified by comprehensive spectroscopic analyses and computational methods. Compound 1 represents a unique lignan featuring an aromatic ring migration. Compounds 2 and 4-6 were analyzed by chiral HPLC column as enantiomers. Biological evaluation revealed that compound 8 could inhibit IL-6 production in lipopolysaccharide (LPS) induced RAW264.7 cells in a dose-dependent manner.