The EKAN is a reliable and validated tool for objectively measuring the evidence-based practice (EBP) knowledge of nurses. Thus, we set out to translate and culturally modify the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN), and then evaluate its validity and reliability among Chinese practicing nurses. This cross-sectional study consisted of two phases. The first phase involved translating the EKAN into Chinese (EKAN-Chinese), using a process of forward translation, back translation, review, cultural adjustment as well as a pilot study. The second phase aimed to assess the psychometric properties of the EKAN-Chinese and establish a baseline measure of EBP knowledge among 120 nurses from a large general hospital in Beijing, China. Data were collected from August to November 2022 and analyzed with Rasch software. This study was reported using the cross-sectional STROBE checklist. The newly translated, EKAN-Chinese was pilot-tested after slight modification of four items without altering the intended meaning. The outfit unweighted mean square was 1.03 (SD = -0.13), the infit weighted mean square was 1.00 (-0.17), and the mean difficulty index ranged from -3.43 to 2.85 according to validity indices. The results of the reliability indices revealed low person reliability (0.49), high item reliability (0.96), moderate person separation index (0.99), and sufficient item separation index (4.71). The mean EKAN-Chinese sum score was 9.8 (max score = 20, SD = 2.9). The newly translated EKAN-Chinese showed sufficient psychometric evidence to support use in practicing Chinese nurses. The EKAN-Chinese can be used by nurse leaders in China as a potential screening tool to 1) objectively identify nurses who need educational training in evidence-based nursing practice, and 2) gauge the effectiveness of education and training programs to improve EBP knowledge and ultimately, evidence-based care.

Objective: To examine the mediating role of medical coping in the relationship between social support and illness uncertainty among patients with malignant tumors, and to explore differences across age groups. Methods: A secondary analysis was conducted using cross-sectional data from 905 hospitalized patients. Patient-reported outcomes were measured using the Mishel Uncertainty in Illness Scale–Adult, the Social Support Rating Scale, and the Medical Coping Modes Questionnaire. Pearson correlation analyses were conducted using SPSS version 25.0, and mediation effects were tested using the PROCESS macro with bootstrap resampling. Results: In the overall sample, medical coping partially mediated the relationship between social support and illness uncertainty (indirect effect: β = 0.177, SE = 0.061, bootstrap 95% CI [0.067, 0.306]). Age-stratified analyses showed a full mediation effect in younger patients (β = 1.362, SE = 0.218, 95% CI [0.875, 1.737]). In contrast, the mediation effects were weaker in middle-aged and older patients, accounting for only 2.96% and 17.65% of the total effect, respectively. These findings indicate that the mediating role of medical coping varies across age groups, with distinct patterns observed among younger, middle-aged, and older patients. Conclusion: In this cross-sectional sample, the results were statistically consistent with an indirect association between social support and illness uncertainty via medical coping, with age-related differences. Younger patients showed a stronger indirect association via coping, whereas middle-aged and older patients showed relatively stronger direct associations between social support and illness uncertainty.

Background/Objectives: This study aims to develop a standardized weight management intervention program for patients with endometrial cancer (EC) undergoing fertility preservation treatment and to provide a scientific foundation for midwives to implement weight management initiatives in the domains of oncology and reproduction. Methods: The weight management intervention program for patients with EC undergoing fertility preservation treatment was crafted following the directives of the Medical Research Council framework for developing and assessing complex interventions and the World Health Organization handbook for guideline development. The development process encompassed four distinct stages: (1) establishing the intervention development group, (2) identifying a theoretical basis and forming a content framework, (3) gathering and synthesizing evidence, and (4) refining and modeling the practice program. Results: The ultimate weight management program consisted of 6 primary, 18 secondary, and 53 tertiary items. Through two rounds of Delphi consultation, a response rate of 100% was attained, with an expert authority coefficient of 0.83. Conclusions: The developed intervention demonstrates scientific robustness and clinical feasibility, presenting a structured methodology for weight management for EC patients undergoing fertility preservation therapy.

Background: Despite robust evidence that genetic factors substantially influence both osteoporosis development and fracture risk, current screening guidelines fail to incorporate genetic factors into risk-assessment protocols. This study aims to determine personalized screening ages for osteoporosis based on polygenic risk score (PRS). Methods: This prospective cohort study utilized data from 223,818 women in the UK Biobank, and only participants who were osteoporosis-free at baseline were included in the study. Participants were categorized into three subgroups (low, medium, and high groups) based on their PRS. Ten-year cumulative risk of osteoporosis, risk-adapted starting age of osteoporosis screening, and risk advancement periods (RAP) of women across different stratifications based on PRS were calculated as the main outcomes. Results: In the general female population at age 65 (current US Preventive Services Task Force recommended screening age), the 10-year cumulative osteoporosis risk was 5.95%. Women reached this risk threshold depending on their PRS, which was 60 years for high-risk women and 69 years for low-risk women. Compared to medium-risk participants, high-risk participants developed osteoporosis 4.99 years earlier ( RAP , 4.99; 95% CI , 4.94, 6.28), whereas low-risk participants developed it 4.89 years later ( RAP , − 4.89; 95% CI , − 6.54, − 4.69). Conclusions: The integration of PRS could revolutionize osteoporosis prevention by enabling early detection in genetically high-risk women, potentially years before the current screening guidelines. Our findings advance the field of precision prevention for osteoporosis and may significantly reduce the population burden of osteoporotic fractures.

Purpose: To explore the effects of weight management combined with metformin on the treatment effect, weight management, and glucose and lipid metabolism in patients with endometrial cancer(EC). Methods: A retrospective cohort study was conducted on patients with EC who underwent weight management at the Department of Gynecology, Peking University People's Hospital, from January 2017 to May 2024. Participants were divided into two groups: 1) the combination therapy group (which received weight management along with metformin) and 2) the weight management group. The primary outcomes measured included treatment outcome, weight, body mass index (BMI), and metabolic indicators. Results: A total of 157 patients were included, 41 patients were included in the weight management combined with metformin group, and 116 patients were included in the weight management group. The statistical results showed that there was a significant difference in the changes in pathological results before and after follow-up between the two groups of patients (P = 0.015). The patients using metformin had a better treatment outcome. In the univariate analysis, whether to use metformin, low-density lipoprotein cholesterol (LDL-C), and age were independent influencing factors for the treatment effect of EC. Conclusion: Weight management combined with metformin can improve the treatment outcome of patients with EC, and the treatment effect decreases with age. The use of metformin has a complex regulatory effect on lipid metabolism in patients with weight management.

Background/Objectives: Pregnancy and childbirth are independent risk factors for pelvic floor injury. The choice of delivery position, as an interventionable factor during labor, has received much attention. This study aimed to assess the impact of sitting delivery on pelvic floor function by observing the outcomes of the perineum, duration of the second stage of labor, integrity of pelvic floor structure, and postpartum pelvic floor function. The goal was to provide scientific evidence for optimizing delivery management and reducing the risk of pelvic floor injury. Methods: This was a non-randomized study (based on patient choice). A total of 222 primiparous women who delivered at our hospital from February to August 2023 were selected and divided into the control group (n = 88) and the sitting group (n = 134). The second stage of labor in the control group was delivered in the traditional bladder lithotomy position, while the sitting group delivered in a sitting position. The duration of the second stage of labor, delivery method, degree of perineal laceration, postpartum 2 h bleeding volume, and the occurrence of urinary incontinence and sexual dysfunction 1 year after delivery were observed in both groups. Results: The rate of perineal lateral incision in the sitting group was lower than that in the control group (24.6% vs. 48.9%, aOR = 0.37, p < 0.001); the adjusted mean difference in second-stage duration was −11.65 min (95% CI: −25.35 to 2.05, p = 0.095), indicating no statistically significant difference after adjustment. In unadjusted subgroup analysis, a larger point estimate for reduction was observed in women aged < 30 years (median difference −16.0 min, p = 0.033), but the interaction test was not significant. For urinary incontinence and sexual dysfunction, there were no statistically significant differences between the two groups. Conclusions: Sitting delivery was associated with a lower episiotomy rate and, in unadjusted analysis, a shorter second stage (although the adjusted difference was not significant), and it did not increase the incidence of urinary incontinence or sexual dysfunction at one year postpartum.