Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Objective: The Coronavirus disease 2019 (COVID-19) pandemic caused a range of mental health problems, particularly self-harm. Lockdowns are the usual methods of responding to these public health emergencies. However, the effect of the COVID-19 lockdown on self-harm remains poorly characterized. This study aimed to investigate the influence of the COVID-19 pandemic on the incidence of self-harm. The findings may inform future policy development and strategies for managing pandemic-related mental health challenges. Methods: A meta-analysis was conducted using several database searches: APA PsycINFO, Embase, PubMed, Web of Science, CNKI, and Wan Fang. Published studies with data on the incidence of self-harm during visits to medical institutions, before and during the COVID-19 pandemic, were included. The pooled risk ratio (RR) value of self-harm incidence variation before and during the COVID-19 lockdown period, expressed as the comparison of clinical institution visits before and during the pandemic, was calculated. Results: Fifteen retrospective cohort studies with observational designs involving 253,600 participants were included. The pooled RR value of self-harm incidence variation was 1.386 (95% confidence interval (CI), 1.205-1.595, I2 = 58.9%, p = 0.002). The subgroup analysis showed that "emergency department type" (p = 0.004) and "mean age of the sample" were the sources of the RR values' heterogeneity (p = 0.026). Conclusions: Our findings suggest that the lockdown during the COVID-19 pandemic was a risk factor for self-harm. Therefore, special attention should be paid to individuals visiting the emergency department and the middle-aged and elderly populations. The prospero registration: This study was registered in PROSPERO (CRD42023373026), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023373026.

Objective: By studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance. Methods: A stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies. Results: The study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation. Conclusion: This study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.

摘要：目的 探讨与敌草快(diquat,DQ)急性中毒患者预后有关的影响因素,为辨别预测效能高、可靠性稳定的预后指标,合理诊疗急性DQ中毒患者提供循证依据.方法 以"敌草快""中毒""危险因素""预后""影响因素"等中文及相应的英文检索词为主题词或自由词,检索中国知网、万方医学网、维普数据库、中国优秀硕士学术论文全文数据库、中国生物医学数据库、PubMed、Embase、Web of science、The Cochrane Library等数据库截至2024年1月1日收录的相关文献,依据纳入排除标准提取数据资料,并评价文献的质量;应用R软件,对急性敌草快中毒患者预后影响因素进行meta分析.结果 初步检索到759篇文献,最终纳入11篇文献,其中英文文献2篇,中文文献9篇,均来自中国,且均为高质量文献.纳入759例急性DQ中毒患者,其中死亡组296例,存活组463例.依据加尔布雷斯图结果、敏感性分析结果,剔...

目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。方法 遵循PRISMA指南，系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析，内容涵盖身体活动或运动干预对6～18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估，对中高水平质量文献进行系统综述。结果 共纳入8篇系统综述和Meta分析，涉及24 567例儿童和青少年，其中6篇为高质量，2篇为中等质量。在身体健康方面，结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率，且能提升心肺耐力和肌肉力量。在心理健康方面，身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用...

目的 系统评价基于格林模式的健康教育对脑卒中患者的干预效果。方法 计算机检索PubMed、Embase、Cochrane library、Web of Science、中国知网、维普数据库、万方数据库和中国生物医学文献数据库，检索格林模式健康教育对脑卒中患者干预效果影响的随机对照试验，时限为建库～2023年11月20日。由2名研究者独立筛选文献、资料提取和文献质量评价。采用RevMan 5.4软件进行Meta分析。结果 共纳入11篇文献，包括982例患者。Meta分析结果显示，与传统健康教育相比，格林模式的健康教育能有效改善脑卒中患者的整体健康行为水平（自我实现、健康责任、锻炼依从性、营养、人际关系、压力应对）、肢体运动功能、神经功能和自我感受负担。但在提升脑卒中患者日常生活能力方面，两组间未见显著差异。此外，根据亚组分析结果显示，干预时间≥6个月时，试验组锻炼依从性与对照组之间比较无明显差异[SMD=1.590,95%CI(-0.380,3.570),P=0.110]。结论 格林模式的健康教育有助于改善脑卒中患者整体健康行为水平，促进患者身体功能恢复和提升其生活质量。

目的 检索汇总并评价成人代谢相关脂肪性肝病（metabolic dysfunction-associated fatty liver disease,MAFLD）营养管理的相关最佳证据，为临床实践提供参考。方法 依据“6S”模型自上而下系统检索美国国家指南库，英国国家卫生与临床优化研究所网站，国际指南协作网，医脉通；美国肝病研究学会，欧洲肝病研究协会，亚太肝病学会，美国临床内分泌学会，意大利肝病协会，欧洲临床营养与代谢学会，美国肠外肠内营养学会，BMJ Best Practice,UpToDate，乔安娜·布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库，PubMed,Cochrane Library,Web of Science,Embase,CINAHL，中国知网，维普，万方，中国生物医学文献服务系统。文献包括成人MAFLD营养管理相关指南、推荐实践、专家共识、系统评价、证据总结。检索时限为建库至2024年3月1日。由2名研究者独立进行文献质量评价和资料提取，并形成最佳证据。结果 共纳入文献24篇，从评估与目标、膳食模式、饮食结构、膳食...

目的：检索、评价并总结终末期肝病病人营养管理的最佳证据，为临床应用提供参考。方法：根据“6S”证据模型，自上而下检索数据库中有关终末期病人术后营养管理的临床决策、指南、专业共识、系统评价和原始研究等证据。由4名研究者对文献的方法学质量进行独立评价，并根据主题提取和汇总证据。结果：共纳入文献23篇，包括指南及专家共识5篇、系统评价及Meta分析6篇，随机对照试验12篇，从多学科营养管理、营养筛查与评估、营养物质推荐量、营养支持与评价、健康教育5个维度汇总30条证据。结论：总结了终末期肝病病人营养管理的最佳证据，建议临床人员结合医疗情境及病人自身情况等制订符合个体化营养管理方案。

目的：对社区老年人口腔健康相关生活质量（OHRQoL）的影响因素进行系统评价。方法：使用计算机检索国内外相关数据库，搜集关于社区老年人OHRQoL影响因素的文献。筛选文献、提取数据并评价纳入文献的偏倚风险。最终纳入的文献运用Stata 13.0软件进行meta分析。结果：共纳入文献11篇，社区老年人13 086例。现存牙齿数量、经济收入、假牙是否合适、口腔疾病、文化程度、抑郁症状、牙齿疼痛、自评一般健康状况、自评口腔健康状况是社区老年人OHRQoL的影响因素。结论：社区老年人OHRQoL是生理、心理、社会、其他等多种因素共同作用的结果。医护人员应该对OHRQoL下降的老年人根据其特点采取针对性口腔健康干预，改善其口腔健康及生活质量，促进老年人健康老龄化。

Background: The Trans-theoretical Model (TTM) has been applied in numerous empirical studies concerning physical activity (PA) interventions for children and adolescents. Consequently, the aim of this review is to identify and synthesize the evidence regarding the effectiveness of TTM-based interventions in promoting PA behavior change among this demographic, with the goal of informing future research and policy development. Methods: A systematic review was performed followed the PRISMA guideline, protocol was registered in PROSPERO (CRD42023416216). Computer-based searches were conducted in the CNKI, Wan-Fang, VIP, Web of Science (WOS), PubMed, and EBSCO databases to identify relevant literature. Two researchers independently conducted the literature screening and quality assessment. The quality of the randomized controlled trials (RCTs) was evaluated using the Risk of Bias Assessment Tool version 5.1.0, as recommended by the Cochrane Collaboration Network. For quality assessment of quasi experiments (QEs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool was employed. Results: A total of 22 articles were included in the systematic review. Stage-matched interventions and interventions designed based on a more complete structure of the TTM are more likely to promote an increase in the actual levels of PA among children and adolescents, as well as to facilitate an increase in their PA stages. Interventions that combine health information and health behavior feedback are more likely to promote an increase in actual PA levels and the advancement of PA stages; while interventions that include PA programs are more likely to facilitate improvements in health indicators. Conclusion: The effectiveness of TTM-based PA behavior change interventions for children and adolescents depends on the specific measures employed. Interventions that are stage-matched and integrate multiple behavior change techniques using the complete TTM structure are more likely to enhance PA and its associated health benefits. However, there are several normative issues that remain. These include the misuse of incremental stages as a substitute for PA, neglect of stage specificity when applying the model, a lack of framework for behavior change techniques in targeted interventions, and an absence of a dynamic feedback process.

目的 整合阴道分娩产妇产后会阴疼痛管理的最佳证据，为临床开展有效会阴疼痛管理提供依据。方法 系统检索临床支持决策系统、国内外指南网站、专业学会或协会网站及相关数据库等，获取阴道分娩产妇产后会阴疼痛管理的相关文献，包括临床决策、证据总结、最佳实践、指南、专家共识、系统评价，检索时限为建库至2023年11月。由2名研究者对文献独立进行质量评价，4名研究者按照标准化提取表格进行证据提取并整合，小组讨论确定最终的最佳证据。结果 纳入20篇文献，其中临床决策3篇，证据总结4篇，指南4篇，专家共识4篇，系统评价5篇。最终从会阴创伤的预防、会阴伤口的缝合、疼痛评估、非药物干预、药物干预、产后健康教育及人员培训7个方面总结了26条证据。结论 总结的阴道分娩产妇产后会阴疼痛的最佳证据较为科学、全面，临床医护人员可结合实际临床情景和患者需求选择证据，制订相关疼痛管理措施，以降低产妇会阴疼痛程度。

目的 对信息框架效应理论在健康管理领域内的应用进行范围综述，为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法，系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库，检索时间为建库至2023年12月，收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献，最终共纳入16篇文献。其中英文15篇，中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息，自我护理，决策支持3个方面；应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式；结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面，健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的，能显著提高患者的健康行为和健康信念，应用前景广阔；但我国研究与国外研究尚存在较大差距，我国学者应重视对该理论的解读，并在其指导下启动在健康管理方面的实践研究。

目的 对信息框架效应理论在健康管理领域内的应用进行范围综述，为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法，系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库，检索时间为建库至2023年12月，收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献，最终共纳入16篇文献。其中英文15篇，中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息，自我护理，决策支持3个方面；应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式；结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面，健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的，能显著提高患者的健康行为和健康信念，应用前景广阔；但我国研究与国外研究尚存在较大差距，我国学者应重视对该理论的解读，并在其指导下启动在健康管理方面的实践研究。

目的 总结糖尿病前期人群生活方式管理的最佳证据，为医护人员对糖尿病前期人群生活方式干预提供参考。方法 应用循证护理方法，对国内外循证资源和文献数据库进行检索，对符合质量评价的文献，由2名研究者独立对证据进行提取并总结出最佳证据。结果 最终纳入16篇文献，包括2篇指南、6篇专家共识、6篇系统评价、2篇证据总结。共提炼出生活方式干预目标、体质量管理、饮食管理、运动管理、健康教育、睡眠管理、社会支持、定期随访8个主题共30条证据。结论 本研究总结的最佳证据可为医护人员、患者及家属对糖尿病前期人群生活方式管理提供参考。在证据转化过程中应充分考虑个体的差异性，为目标人群制订个体化的生活干预方案。

目的 采用健康测量工具选择的共识标准(COSMIN)对高血压健康促进行为的评估工具进行系统评价。方法 计算机检索Embase、Web of Science、PubMed、Cochrane Library、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中关于高血压健康促进行为评估工具的开发、信效度检验的文献，检索时限为建库至2024-05-25。由两名研究生独立进行文献筛选与资料提取。采用COSMIN偏倚风险评价清单评价纳入评估工具的方法学质量，根据COSMIN质量准则评价纳入评估工具的测量学属性质量。应用改良版定量系统评价证据分级(GRADE)方法评价证据等级，根据测量学属性质量评价结果及证据等级确定评估工具的推荐级别。结果 最终纳入文献14篇，共涉及14个高血压健康促进行为评估工具，其中运动行为改变评定量表(MCPAQ)、高血压患者限盐饮食行为改变评定量表(MCRSDH)、运动决策平衡修订量表(DBS)、中文版高血压自我护理量表(HBPSCP)、高血压自我护理量表(HTN-SCP)、健康促进生活方式量表-Ⅱ(HPLP-Ⅱ)中文版为高血压健康促进行为评估工具在不同国家的跨文化...

目的 检索、评价和总结出血性脑卒中患者围术期静脉血栓栓塞症（venous thromboembolism,VTE）非药物管理的相关证据，为临床提供参考。方法 按“6S”证据金字塔模型，采用计算机检索BMJ Best Practice(BMJ),UpToDate，乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库，美国国立指南库（national guideline clearinghouse,NGC），英国国家卫生与临床优化研究所指南网（national institute for health and care excellence,NICE），苏格兰院际指南网（Scottish intercollegiate guidelines network,SIGN），加拿大安大略注册护士学会（registered Nurses’Association of Ontario,RNAO）指南网，加拿大心脏与卒中基金会（Canadian Heart and Stroke Foundation,HSF），美国心脏协会/美国脑卒中协会（American Heart Association/American Stroke Association,AHA/ASA），美国神经重症监护学会（Neuro-critical Care Society,NCS），欧洲脑卒中组织（European Stroke Organization,ESO）,Cochrane Library、PubMed,Medline,CNKI,Web of Science,Embase,SinoMed，万方，医脉通，维普数据库，中华医学期刊全文数据库关于出血性脑卒中患者围术期静脉血栓栓塞症非药物管理的相关证据，包括临床实践指南，专家共识，系统评价，证据总结等。检索时限为建库至2024年4月11日。由2名研究人员独立对文献质量进行评价，提取、整合和总结出最佳证据。结果 共纳入23篇文献，包括12篇指南、5篇系统评价、4篇专家共识，2篇证据总结。从多学科团队合作、风险评估与筛查、基础预防、机械预防和健康教育5个方面汇总了31条最佳证据。结论 本研究总结了出血性脑卒中患者围术期VTE非药物管理的最佳证据，可为临床医护人员提供循证依据。

目的 系统检索和总结国内外关于乳腺癌患者出院计划的最佳证据，为临床实践提供循证依据。方法 系统检索Up To Date、BMJ Best Practice、国际指南协作网、英国国家卫生与临床优化研究所、美国国立指南库、苏格兰院际间指南网、加拿大医学会临床实践指南信息库、澳大利亚临床实践指南平台、新西兰临床指南网站、美国临床肿瘤学会、加拿大安大略省注册护士协会、美国国立综合癌症网络、澳大利亚乔安娜布里格斯研究所卫生保健数据库、Cochrane Library、Embase、CINAHL、PubMed、Web of Science、中国知网、中国生物医学文献数据库、维普数据库、万方数据知识服务平台、中华护理学会、中国临床肿瘤学会及医脉通中有关乳腺癌患者出院计划的临床决策、指南、证据总结、系统评价、专家共识和意见，检索时限为建库至2024年6月10日。由2名研究者独立进行文献质量评价、证据提取和整合。结果 共纳入10篇文献，其中临床决策2篇、指南2篇、系统评价4篇、证据总结2篇。共总结30条证据，包括5个主题，分别是早期评估、制定计划、健康教育、执行计划及追踪与评价。结论 该研究针对乳腺癌患...

Background: The internet + nursing service is an important initiative for implementing the strategy of healthy China and actively responding to the aging of the population. However, the current literature on residents' awareness and willingness to participate is insufficient and presents large variations and limitations. Therefore, this study aims to systematically evaluate the awareness and willingness of Chinese residents to participate in internet + nursing service to comprehensively understand the level of awareness and acceptance of this emerging service model among Chinese residents and to provide strong support for relevant policy formulation and service optimization. Methods: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed, and VIP databases were electronically searched to collect cross-sectional studies related to the awareness and willingness of Chinese residents to participate in internet + nursing service from inception to January 2024. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias of the included studies. Results: A total of 27 cross-sectional studies involving 11,761 subjects were included. The results of the meta-analysis showed that the percentage of Chinese residents willing to participate in internet + nursing service was 76.3% (95% CI [71.2%, 81.3%]). The results of the subgroup analysis showed that residents who lived in Western regions (82.1%), had employee medical insurance (85.9%), were suffering from other diseases (89.2%), were under the age of 60 (87.8%), were not married (78.9%), and had an undergraduate degree or above (85.5%) had a relatively high willingness to participate in internet + nursing service. The rate of awareness of internet + nursing service among Chinese residents was 48.6% (95% CI [24.1%, 73.2%]), which shows a downwards trend over time (67.4% in 2019, 56.1% in 2020, and 45.1% in 2021). Conclusion: The willingness to participate in internet + nursing service among Chinese residents is high, but the awareness rate is low. It is necessary to improve the awareness and willingness of Chinese residents to use internet + nursing service through various channels and aspects of publicity and promotion to achieve the goal of innovating the health service model, accurately connecting with the diverse health needs of people, and actively responding to the aging population.

目的 基于症状自评量表（symptom checklist 90,SCL-90）结果，探究中国潜艇部队官兵心理健康状况影响因素及其发展变化趋势。方法 利用Review Manager 5.3软件对中国知网（CNKI）、维普（VIP）、万方（Wanfang）等数据库自建库以来关于中国潜艇部队官兵SCL-90相关调查研究进行整理分析，根据不同影响因素进行系统评价。结果 共纳入9篇文献、20个组别，潜艇部队官兵共1 395人。潜艇部队官兵航后航前心理状况差异meta分析结果显示，潜艇部队官兵航后相较于航前的9个SCL-90因子平均效应量均为正值，其中躯体化、强迫、人际敏感、抑郁、焦虑、敌对、恐怖及精神病的差异均有统计学意义（均P0.05）；核潜艇和常规潜艇心理状况差异meta亚组分析结果显示，核潜艇部队官兵总体的SCL-90因子相较于2016年军人常模的平均效应量均为正值，且躯体化、强迫、人际敏感、抑郁、焦虑、恐怖、偏执及精神病性的差异均有统计学意义（均P0.05）。常规潜艇官兵各...