To clarify the concept of spiritual needs and explain its meaning to older adults with cancer. Electronic databases (Web of Science, PubMed, EBSCOASU, CNKI, Wanfang, and VIP) were systematically searched and analyzed using “spiritual needs” as keywords. Rodgers' evolutionary method guided the concept analysis to identify attributes, antecedents, and consequences. Two rounds of Delphi expert consultations ensured accuracy, reliability, and feasibility for implementation. Spiritual needs express an individual's expectations of comfort and inner peace that satisfy his or her perception of the meaning and purpose of life, the ability to love and be loved, feelings of peace and gratitude, and a sense of belonging and hope. Spiritual needs have four dimensions: personal, communal, environmental, and transcendence or supreme. The attributes of spiritual needs include meaning and purpose of life, love and being loved, peace and gratitude, belonging, and hope. The antecedents include spiritual recognition and events that trigger spiritual needs and spiritual need thresholds. The outcomes of addressing and meeting the spiritual needs of older adults with cancer include promoting their spiritual health and enhancing their quality of life. After two rounds of Delphi experts' consultation, the expert authority coefficients (Cr) were 0.83 and 0.88, respectively. Experts agreed on the concept of spiritual needs. Exploring antecedents of spiritual needs in older adults with cancer clarifies obstacles to spiritual practice, offering intervention strategies for spiritual care and well-being. Meeting their spiritual needs enhances spiritual health and quality of life, essential in humanistic nursing care.

Background: With the rapid integration of artificial intelligence (AI) into medical education, assessing medical students’ readiness has become critical. This readiness encompasses not only familiarity with AI tools but also the ability to apply, evaluate, and ethically reflect on them. Despite international advances, China currently lacks a validated instrument to systematically evaluate medical students’ readiness for medical AI. Therefore, this study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Medical Artificial Intelligence Readiness Scale (MAIRS-MS) for Chinese medical students. Methods: The MAIRS-MS was translated into Chinese following Brislin’s guidelines, with subsequent cultural adaptation informed by expert consultation. A pilot study was then conducted with 30 medical students to refine the Chinese version (C-MAIRS-MS). A cross-sectional survey was conducted among 516 undergraduate medical students from March to May 2025. The psychometric properties of the C-MAIRS-MS were evaluated through exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach’s α coefficient, Spearman–Brown split-half reliability, and the intraclass correlation coefficient (ICC). Results: The C-MAIRS-MS included 22 items with scale content validity index (S-CVI) of 0.982. EFA extracted four factors explaining 65.274% of the total variance, with factor loadings ranging from 0.508 to 0.881. CFA results indicating that the revised 4-factor model was well fitted (χ²/df = 2.303, RMSEA = 0.071, CFI = 0.924, IFI = 0.925, and TLI = 0.912), with good structural validity. The Cronbach’s α coefficient, Spearman-Brown Split-half reliability, and ICC values for the C-MAIRS-MS were 0.935, 0.832, and 0.945, indicating the scale has good reliability. Conclusion: The C-MAIRS-MS demonstrated sound psychometric properties and provides a reliable tool to assess medical students’ readiness for medical AI. Beyond individual assessment, the scale can inform curriculum development, facilitate ongoing monitoring of students’ progress, and support the evaluation of AI-focused educational programmes, thereby offering educators valuable evidence to guide the design and refinement of AI-related training in medical education. Clinical trial number: Not applicable.

As the population continues to age, dementia is becoming a huge social, economic, and healthcare burden. However, the risk factors for in-hospital death in elderly patients over 65 years of age with dementia are not well understood. Identifying factors that affect their prognosis could help clinicians with scientific decision-making. To examine the risk factors for in-hospital death in elderly patients over 65 years of age with dementia in the Geriatric Department of West China Hospital. In this retrospective, cross-sectional study, we analyzed inpatients aged ≥65 years with dementia between 2010 and 2016 using electronic medical records from the Information Center of West China Hospital. The risk factors for death were assessed using multivariable logistic regression. Out of a total of 2986 inpatients with dementia, 3.4% died. Patient deaths were related to digestive diseases, respiratory diseases, circulatory diseases, urinary diseases, and chronic obstructive pulmonary disease, whereas patient survival was associated with osteoporosis and Parkinson disease. Patients with a mean length of hospital stay of ≥60 days had an increased risk of death (all P <.05). In the multiple logistic regression analysis, age ≥80 years, digestive diseases, respiratory diseases, urinary diseases, diabetes, chronic obstructive pulmonary disease, and ≥7 comorbidities were risk factors for death. Mortality in hospitalized older patients with dementia is low, but some risk factors may be easily ignored. These findings could raise awareness among clinicians and caregivers about risk factors in hospitalized older patients, particularly hospitalized elderly patients with multiple comorbidities. Therefore, to reduce mortality, early prevention and management of potential risks are necessary.

Inadequate spiritual care competence negatively impacts the quality of care for older people, particularly in multicultural contexts. This study explores the spiritual care competence of geriatric nurses in China and the influencing predictors. Participants were selected through convenience sampling between June 2021 and March 2022. The Chinese version of the Spiritual Care Competency Questionnaire (C-SCC) assessed the spiritual care competencies of geriatric nurses. Data were analyzed using SPSS 25.0 through nonparametric tests and multiple linear regression. The median total spiritual care competence score indicated a moderate level of competence. The highest scores were in spiritual care knowledge literacy and spirituality/spiritual care value cognition, while spiritual self-awareness scored lowest. Regression analysis found that nurses with higher monthly incomes (¥8,000–¥9,999 or ≥ ¥10,000) had significantly greater spiritual care competence than those earning ≤ ¥4,999. Permanent civil service employees scored higher than short-term contract workers. Nurses currently participating in spirituality-related training scored higher than those not taking such training. Higher scores were also associated with being satisfied with providing gerontology care services, perceiving spiritual care for older adults as very necessary or necessary (vs. unnecessary), and expressing a strong or moderate desire for spiritual care training (P < 0.05). Spiritual care competence was shaped by controllable and uncontrollable factors in a multicultural context. Enhancing this competence promotes equity in spiritual health.

Oral diseases are widespread globally, yet nursing students often lack adequate education in oral healthcare. This study explores their knowledge, attitudes, confidence, and learning experiences to inform improvements in oral health education within nursing programs. A sequential mixed-methods design was conducted from April to July 2024 across three universities in Zhejiang and Jiangsu provinces, China. Quantitative data were collected via a structured questionnaire from 454 nursing students and analyzed using logistic regression. Subsequently, 21 students with high levels of oral healthcare attitudes and confidence were purposively selected for in-depth interviews. A phenomenological approach guided the qualitative phase, and data were used by thematic analysis . Only 240 (52.86%) students demonstrated good levels of oral healthcare attitudes and confidence. Higher likelihood of positive attitudes and confidence was associated with being in the third-year, strong passion for nursing, good self-reported oral health and knowledge, and strong interest in working in oral healthcare. Qualitative analysis identified five themes: (1) learning pathways, (2) learning needs, (3) learning prospects, (4) influence on attitude, and (5) influence on confidence. Nursing students exhibited suboptimal attitude and confidence in oral healthcare, influenced by academic year, nursing passion, self-assessed oral health, knowledge, and interest in oral healthcare. Addressing learning barriers and integrating engaging, practice-oriented content may improve competence. Future research should assess these effect of such pedagogy on long-term clinical impact.