{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:07:35Z","timestamp":1792094855831,"version":"4.4.0"},"reference-count":73,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) is a global health challenge, and hemodialysis is a common treatment for end\u2010stage renal disease. Patients undergoing hemodialysis often face significant symptom burden, affecting their quality of life. Timely help\u2010seeking behavior (HSB) is crucial for initiating patient\u2010centered communication and effective symptom management. Yet, the specific behavioral patterns and barriers to help\u2010seeking in this group remain poorly understood. However, tools to assess HSB in this population are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multiphase cross\u2010sectional study was conducted across three hospitals in China from August to October 2024, involving 425 participants. The study developed the HSB for hemodialysis symptoms (HSB\u2010HD) scale based on literature reviews, expert consultations, and patient interviews. Psychometric evaluation was performed using classical test theory (CTT) and item response theory (IRT), focusing on reliability, validity (content, construct, criterion\u2010related, discriminant, and convergent), and measurement invariance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The exploratory factor analysis (EFA) revealed a four\u2010factor structure (symptom detection, symptom interpretation, decision\u2010making for help\u2010seeking, and timely disclosure and action), explaining 72.9% of variance. Confirmatory factor analysis (CFA) showed a good model fit (CFI\u2009=\u20090.964, RMSEA\u2009=\u20090.045). Cronbach\u2019s\n                      <jats:italic>\u03b1<\/jats:italic>\n                      was 0.953, indicating excellent internal consistency. Validity tests showed significant correlations with the EQ\u20105D\u20105L pain, anxiety, and VAS scores. Measurement invariance was confirmed across gender and age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HSB\u2010HD scale is a reliable and valid tool for assessing HSB in hemodialysis patients. It offers a patient\u2010centered approach to symptom management, providing health care providers with a means to identify those who may benefit from targeted interventions, thereby improving care and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/8834451","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:29:17Z","timestamp":1773012557000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Enhancing Patient\u2010Centered Communication in Hemodialysis Symptom Management Care\u2010Development and Validation of the HSB\u2010HD Scale for Assessing Help\u2010Seeking Behavior in Hemodialysis Patients: A Multiphase Cross\u2010Sectional Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9236-1764","authenticated-orcid":false,"given":"Xutong","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0038-9357","authenticated-orcid":false,"given":"Aiping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32203-7"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-021-02597-3"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-020-0268-7"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab070"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60721-2"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.63"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2016.05.008"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2006.10.001"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09190822"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.07.003"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfx057"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn449"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/NNR.0000000000000479"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41687-022-00538-8"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.110"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.07.015"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-11-201306040-00007"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.05.019"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0216045"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007030345"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2025.105210"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.04.021"},{"key":"e_1_2_15_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.05.019"},{"key":"e_1_2_15_25_2","doi-asserted-by":"publisher","DOI":"10.1155\/jonm\/4579091"},{"key":"e_1_2_15_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.70007"},{"key":"e_1_2_15_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2025.2496230"},{"key":"e_1_2_15_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-172X.2011.01936.x"},{"key":"e_1_2_15_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-9004.2010.00287.x"},{"key":"e_1_2_15_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12325"},{"key":"e_1_2_15_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13710-y"},{"key":"e_1_2_15_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/1524838015585318"},{"key":"e_1_2_15_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/jorc.12208"},{"key":"e_1_2_15_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy069"},{"key":"e_1_2_15_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12317"},{"key":"e_1_2_15_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/scs.12788"},{"key":"e_1_2_15_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2021.1878050"},{"key":"e_1_2_15_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-016-9782-2"},{"key":"e_1_2_15_39_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"e_1_2_15_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-021-02822-4"},{"key":"e_1_2_15_41_2","doi-asserted-by":"publisher","DOI":"10.1207\/s15327574ijt0502_4"},{"key":"e_1_2_15_42_2","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.4.1.84"},{"key":"e_1_2_15_43_2","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-6023205\/v1"},{"key":"e_1_2_15_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.11.016"},{"key":"e_1_2_15_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-022-01702-1"},{"key":"e_1_2_15_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyg140"},{"key":"e_1_2_15_47_2","doi-asserted-by":"publisher","DOI":"10.1080\/07481756.2017.1339564"},{"key":"e_1_2_15_48_2","doi-asserted-by":"publisher","DOI":"10.1002\/nur.4770140211"},{"key":"e_1_2_15_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.02298"},{"key":"e_1_2_15_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2020.07.027"},{"key":"e_1_2_15_51_2","doi-asserted-by":"publisher","DOI":"10.4324\/9781351008167"},{"key":"e_1_2_15_52_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119716723"},{"key":"e_1_2_15_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20199"},{"key":"e_1_2_15_54_2","doi-asserted-by":"publisher","DOI":"10.1177\/1094428104263675"},{"key":"e_1_2_15_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2006.09.018"},{"key":"e_1_2_15_56_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0014694"},{"key":"e_1_2_15_57_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11747-014-0403-8"},{"key":"e_1_2_15_58_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-0753-5_573"},{"key":"e_1_2_15_59_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11165-016-9602-2"},{"key":"e_1_2_15_60_2","first-page":"1411","volume-title":"Encyclopedia of Research Design","author":"Furr R. M.","year":"2010"},{"key":"e_1_2_15_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/0095798420930932"},{"key":"e_1_2_15_62_2","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200710415"},{"key":"e_1_2_15_63_2","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200410135"},{"key":"e_1_2_15_64_2","doi-asserted-by":"publisher","DOI":"10.1177\/10547738211033922"},{"key":"e_1_2_15_65_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-20871-5"},{"key":"e_1_2_15_66_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.003874"},{"key":"e_1_2_15_67_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1309-y"},{"key":"e_1_2_15_68_2","doi-asserted-by":"publisher","DOI":"10.52225\/narra.v3i3.215"},{"key":"e_1_2_15_69_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-024-04101-w"},{"key":"e_1_2_15_70_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-081651"},{"key":"e_1_2_15_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrn.2005.04.002"},{"key":"e_1_2_15_72_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.02.334"},{"key":"e_1_2_15_73_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2022.02.004"}],"container-title":["Journal of Nursing Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/8834451","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jonm\/8834451","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/8834451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:29:19Z","timestamp":1773012559000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jonm\/8834451"}},"subtitle":[],"editor":[{"given":"Diana","family":"Jim\u00e9nez-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":73,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jonm\/8834451"],"URL":"https:\/\/doi.org\/10.1155\/jonm\/8834451","archive":["Portico"],"relation":{},"ISSN":["0966-0429","1365-2834"],"issn-type":[{"value":"0966-0429","type":"print"},{"value":"1365-2834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8834451"}}