Conectar
by Ningjing Guo, Xuyan Li, Xiaoxue Li, Congmin Kang, Xiaoyan Gong, Xinyu Ji, Jie Zheng
BackgroundExploratory applications of large language models within the specialized field of metabolic and bariatric surgery have begun to emerge. Nevertheless, existing research remains fragmented, lacking comprehensive integration.
ObjectiveTo conduct a scoping review of studies on the application of large language models in the field of metabolic and bariatric surgery, aiming to provide a reference for clinical practice and future research.
MethodsThis scoping review adhered to the Joanna Briggs Institute methodological framework and followed the preferred reporting items for systematic reviews and meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines.PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, CNKI, Wanfang, and VIP databases were searched for relevant studies, with the search timeframe from database inception to November 2025. The included literature was summarized and analyzed.
ResultsA total of 21 English-language studies were included. LLMs were primarily applied in scenarios such as patient education and information consultation, clinical decision support, and professional knowledge assessment. While LLMs performed well in information-provision tasks, they showed low consistency with expert opinions in complex clinical tasks such as individualized surgical recommendations. Performance varied across different models, with GPT-4 generally demonstrating superior performance, and domain-specific models showing professional potential. Current research still faces challenges regarding information accuracy, readability, and clinical applicability.
ConclusionLarge language models hold auxiliary potential in the field of metabolic and bariatric surgery, particularly for knowledge dissemination and patient education. However, their reliability in complex clinical decision-making remains limited. Future efforts should focus on conducting high-quality studies, advancing model specialization and standardized evaluation, and exploring safe and effective human-AI collaboration models.
This study aims to explore the views and experiences of people with dementia, informal caregivers and professionals regarding eating and drinking difficulties.
A qualitative systematic review was conducted.
The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used to conduct this systematic review. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the data were thematically synthesised using Thomas and Harden's three-stage method.
Six electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL and PsycINFO) were searched from their respective inception dates to August 2025 to identify relevant studies.
Thematic analysis of the 16 included studies identified four key themes: (1) Physiological and psychological changes in people with dementia and caregivers; (2) factors influencing eating and drinking in people with dementia; (3) needs and recommendations for people with dementia, informal caregivers and professionals; (4) selection of eating methods for end-stage people with dementia.
Eating and drinking difficulties affect the well-being of both patients and caregivers. A good dining environment improves mealtime pleasure but demands caregivers' time and energy. All parties emphasised the importance of effective communication. In end-stage dementia, professional assistance is crucial for enteral nutrition decisions.
Collaboration among patients, caregivers and professionals is vital for creating tailored nutritional plans and improving mealtime environments, thereby enhancing nutritional intake. In advanced dementia, providers must provide balanced information on comfort feeding versus enteral nutrition to aid decision-making.
What problems were addressed in this study? This study addressed the lack of a consolidated, tri-perspective understanding of eating and drinking difficulties in dementia care settings. What are the main findings? Four key themes were identified: physiological and psychological changes, influencing factors, stakeholder needs and end-of-life decision-making. Where and on whom will the research have an impact? This will impact care practices for people with dementia and inform the training and support of informal caregivers and healthcare professionals.
To explore the mediating effect of team job crafting on the transformational leadership–occupational well-being association in newly graduated nurses.
A multicentre cross-sectional study was conducted in three tertiary hospitals in China. Using convenience sampling, 677 newly graduated nurses were recruited between August 2024 and September 2024, and completed the transformational leadership questionnaire, team job crafting scale for nurses, and healthcare providers' occupational well-being scale. Data analysis was performed using IBM SPSS 27.0 software and the PROCESS 4.2 plugin. Hayes' mediation model (Model 4) was employed to test the indirect effect. The significance of the mediating effect was assessed using the bias-corrected bootstrap method (5000 resamples).
Ultimately, 546 valid questionnaires were collected. The participants' transformational leadership, nurse team job crafting and healthcare providers' occupational well-being scores were all above average. Linear regression analysis revealed that transformational leadership and team job crafting positively predicted occupational well-being (β = 0.549, p < 0.001; β = 0.695, p < 0.001). Mediating analysis revealed that the indirect effect of transformational leadership on occupational well-being was 0.276 (95% confidence interval: 0.174, 0.377), indicating the presence of an indirect effect. Additionally, team job crafting accounted for 33.5% of the effect of transformational leadership on occupational well-being.
Perceived transformational leadership among newly graduated nurses could positively influence their occupational well-being, with team job crafting playing a partial mediating role between the two. Therefore, it is recommended that nursing managers strengthen their transformational leadership practices to promote the accumulation and internalisation of job resources among newly graduated nurses, thereby enhancing their ability and level of team job crafting and further promoting their occupational well-being.
To examine the impact of critical care nurses' delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information–motivation–behavioural (IMB) skills model from a behavioural perspective.
Cross-sectional study.
A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson's correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.
The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.
Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses' delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals' sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.
Critical care managers should value nurses' delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses' delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.
The STROBE checklist was used as a guideline.
Nurses completed questionnaires.
Trial Registration: Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216
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