1 The Effect of a Nurse-Led Hybrid Pulmonary Rehabilitation Program on Sleep Quality in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Randomized Controlled Trial https://brieflands.com/journals/jnms/articles/169262 10.5812/jnms-169262 1 Background :Chronic obstructive pulmonary disease (COPD) is frequently accompanied by sleep-related problems resulting from persistent respiratory dysfunction, which can markedly impair patients’ quality of life, self-care capacity, and functional independence. Pulmonary rehabilitation, the most effective nonpharmacological intervention, may improve clinical outcomes in these patients when delivered with guidance from rehabilitation nurses. Objectives :This trial aimed to evaluate the effectiveness of a nurse-led hybrid pulmonary rehabilitation program in improving sleep quality among patients with COPD. Methods :This randomized controlled study was conducted at the Pulmonary Clinic of Masih Daneshvari Hospital in Tehran, Iran, between November 2024 and April 2025. Using block randomization, 50 patients with COPD were recruited through convenience sampling and randomly allocated to intervention and control groups, with 25 participants in each group. Data were collected using a demographic data form and the Pittsburgh Sleep Quality Index (PSQI). The control group received conventional treatment, whereas the intervention group received a 4-week nurse-led pulmonary rehabilitation program delivered in 3 sessions via a hybrid approach that combined in-person and online sessions with ongoing monitoring. Data were analyzed using SPSS version 26, change analysis, the Mann-Whitney U test, independent and paired t-tests, and analysis of covariance. Results :At baseline, no differences in sleep quality were observed between the intervention and control groups (P > 0.05). After the intervention, PSQI scores in the intervention group decreased significantly from 10.56 ± 4.84 to 4.84 ± 3.26 (P < 0.001), indicating a marked improvement in sleep quality; however, no significant change was observed in the control group (P = 0.432). Postintervention analysis showed a significant between-group difference (P < 0.001), with a very large effect size (Cohen d = 3.60). After adjustment for baseline values using analysis of covariance, the between-group difference in posttest PSQI scores remained significant (F = 80.78, P < 0.001), with a large effect size (partial eta squared = 0.632). Conclusions :This randomized controlled trial demonstrated that a 4-week nurse-led pulmonary rehabilitation program resulted in a statistically significant improvement in sleep quality scores among patients with COPD. The structured intervention, which included continuous monitoring and a hybrid delivery model, was effective. These findings suggest that incorporating targeted rehabilitation programs into clinical practice may improve the management of sleep disturbances in this population. 1 9 Fateme Ramezani Department of Nursing, The Clinical Research Development Center, Rofeideh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran ftm.ramezani78@gmail.com Mohammad Javad Hosseinabadi Farahani Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran j.hoseinabadi@gmail.com Narges Arsalani Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran nargesarsalani@gmail.com Mohsen Vahedi Department of Biostatistics and Epidemiology, Iranian Research Center of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran mohsenvahedi540@gmail.com No Keyword 1.pdf [0]Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, et al.Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. 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1 Questionnaire Survey and Analysis of Spiritual Health, Quality of Life, and Meaning of Life in Chinese Breast Cancer Patients Receiving Chemotherapy: A Cross-Sectional Study https://brieflands.com/journals/jnms/articles/167547 10.5812/jnms-167547 1 Background :Breast cancer patients receiving chemotherapy frequently encounter a range of physical and psychological problems that adversely affect their spiritual well-being, which highlights the importance of exploring the spiritual health in the specific population. Objectives :The study aimed to assess spiritual health, quality of life, and meaning of life in breast cancer patients undergoing chemotherapy in China. Methods :Participants were collected via the simple random sampling (SRS) method from the NCC between January and December 2023. The sampling frame was the list of female breast cancer patients hospitalized for chemotherapy at NCC. Three types of Chinese-version scales were used to assess spiritual health, quality of life and meaning of life, including the Chinese version of the European Quality of Life in Cancer Treatment and Research-Spiritual Health Scale (EORTC QLQ-SWB27), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), and the Meaning of Life Scale for Cancer Patients (MiLS). Results :Totally, 242 participants were qualified for the study. After standardized transformation, the average scores were 62.21 ± 11.25 (0 - 100 scale) for spiritual health, 65.40 ± 10.32 (0 - 100 scale) for quality of life, and 109.24 ± 14.71 for meaning of life. A positive, significant correlation was observed among spiritual health (measured by EORTC QLQ-SWB27), quality of life (measured by EORTC QLQ-C30), and meaning of life (measured by MiLS) (all P < 0.01). The total scores of spiritual health were significantly associated with occupational status (P = 0.035) and monthly household income per capita (P = 0.016). The total scores of meaning of life showed a significant correlation with occupational status (P = 0.04). Further multiple linear regression analyses revealed that monthly household income per capita, quality of life (EORTC QLQ-C30 standardized score), and meaning of life significantly affected spiritual health (all P < 0.05). Among them, the weight of monthly household income per capita was highest (β = 1.98, 95% CI = 0.71 - 3.24). Conclusion :Breast cancer patients in China achieved moderate scores in spiritual health, and high scores in quality of life and meaning in life. Monthly household income per capita was identified as the most crucial factor for spiritual health, which recommended considering patients' economic backgrounds before developing medical care in Chinese clinical practice. 1 10 Fang Zhao National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College 13671045893@163.com Yujing Tan National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College tanyj0207@163.com Enfeng Fu National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College fef1024@163.com Shanshan Zhu National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College 138103121132@qq.com Lulu Yu National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College lulu0368@126.com Huiyi Dong National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College 394093658@qq.com Jiani Wang National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Sciences and Peking Union Medical College ncc_wangjiani@126.com No Keyword 2.pdf [0]Giaquinto AN, Sung H, Newman LA, Freedman RA, Smith RA, Star J.Breast cancer statistics 2024. 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