{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T09:22:49Z","timestamp":1770715369323,"version":"3.49.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"the Scientific Research Fund of Hunan Provincial Education Department-Basic Education","award":["Y20230728"],"award-info":[{"award-number":["Y20230728"]}]},{"name":"the Scientific Research Fund of Hunan Provincial Education Department-Higher Education","award":["202401000501"],"award-info":[{"award-number":["202401000501"]}]},{"name":"Ministry of Education Industry-University Cooperative Education Program","award":["241200541113826"],"award-info":[{"award-number":["241200541113826"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychol"],"DOI":"10.1186\/s40359-025-03896-2","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T13:04:14Z","timestamp":1768223054000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Suicidal ideation and influencing factors among hospitalized older adults with functional impairments: a mixed-methods study"],"prefix":"10.1186","volume":"14","author":[{"given":"Qi","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronghui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoping","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pingping","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"3896_CR1","unstructured":"World Population Prospects. 2022: Data sources [ https:\/\/digitallibrary.un.org\/record\/3992030?ln=zh_CN&v=pdf ]."},{"issue":"1","key":"3896_CR2","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1186\/s12888-024-06010-9","volume":"24","author":"Y Wu","year":"2024","unstructured":"Wu Y, Su B, Zhao Y, Chen C, Zhong P, Zheng X. Epidemiological features of suicidal ideation among the elderly in China based meta-analysis. BMC Psychiatry. 2024;24(1):562.","journal-title":"BMC Psychiatry"},{"issue":"2","key":"3896_CR3","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1080\/13607863.2022.2032595","volume":"27","author":"Y Liu","year":"2023","unstructured":"Liu Y, Zhang D, Wang R, Wang P, Su Y. Physical disability, low self-esteem, and suicidal ideation among Chinese nursing home residents: the moderating role of resilience. Aging Ment Health. 2023;27(2):263\u201371.","journal-title":"Aging Ment Health"},{"issue":"1","key":"3896_CR4","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1186\/s12877-023-04478-w","volume":"23","author":"SJ Liao","year":"2023","unstructured":"Liao SJ, Fang YW, Liu TT. Exploration of related factors of suicide ideation in hospitalized older adults. BMC Geriatr. 2023;23(1):749.","journal-title":"BMC Geriatr"},{"key":"3896_CR5","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.jad.2017.05.012","volume":"219","author":"A Abdollahi","year":"2017","unstructured":"Abdollahi A, LeBouthillier DM, Najafi M, Asmundson GJG, Hosseinian S, Shahidi S, Carlbring P, Kalhori A, Sadeghi H, Jalili M. Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression. J Affect Disord. 2017;219:58\u201363.","journal-title":"J Affect Disord"},{"key":"3896_CR6","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.jad.2019.11.070","volume":"264","author":"ST Yeh","year":"2020","unstructured":"Yeh ST, Ng YY, Wu SC. Association of psychiatric and physical illnesses with suicide in older adults in Taiwan. J Affect Disord. 2020;264:425\u20139.","journal-title":"J Affect Disord"},{"key":"3896_CR7","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1016\/j.gerinurse.2024.07.041","volume":"59","author":"Y Liu","year":"2024","unstructured":"Liu Y, Lan D, Zhou Y, Tian H, Xiao J, Gan L, Zhang Y. Role of subjective well-being and resilience in the relationship between hopelessness and suicidal ideation among older adults with moderate to severe ADL limitations in Chinese nursing homes. Geriatric Nurs (New York NY). 2024;59:418\u201325.","journal-title":"Geriatric Nurs (New York NY)"},{"key":"3896_CR8","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.neubiorev.2021.04.011","volume":"127","author":"M Beghi","year":"2021","unstructured":"Beghi M, Butera E, Cerri CG, Cornaggia CM, Febbo F, Mollica A, Berardino G, Piscitelli D, Resta E, Logroscino G, et al. Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides. Neurosci Biobehav Rev. 2021;127:193\u2013211.","journal-title":"Neurosci Biobehav Rev"},{"issue":"2","key":"3896_CR9","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1111\/inm.12247","volume":"26","author":"LB Huang","year":"2017","unstructured":"Huang LB, Tsai YF, Liu CY, Chen YJ. Influencing and protective factors of suicidal ideation among older adults. Int J Ment Health Nurs. 2017;26(2):191\u20139.","journal-title":"Int J Ment Health Nurs"},{"issue":"4","key":"3896_CR10","doi-asserted-by":"publisher","first-page":"e36930","DOI":"10.1097\/MD.0000000000036930","volume":"103","author":"H Miao","year":"2024","unstructured":"Miao H, Lu H, Sun Y, Ji J, Lu Y, Meng Y, et al. The protective influence of family support on anxiety, depressive symptoms, and suicidal ideation among elderly Chinese nursing home residents: a study of serial mediation. Med. 2024;103(4):e36930.","journal-title":"Med"},{"issue":"7","key":"3896_CR11","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1080\/13607863.2020.1786798","volume":"25","author":"D Zhang","year":"2021","unstructured":"Zhang D, Wang R, Zhao X, Zhang J, Jia J, Su Y, Wang K. Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents. Aging Ment Health. 2021;25(7):1262\u201372.","journal-title":"Aging Ment Health"},{"issue":"3","key":"3896_CR12","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1177\/0894318417708426","volume":"30","author":"S Simonovich","year":"2017","unstructured":"Simonovich S. The value of developing a mixed-methods program of research. Nurs Sci Q. 2017;30(3):201\u20134.","journal-title":"Nurs Sci Q"},{"issue":"2","key":"3896_CR13","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1176\/ajp.156.2.181","volume":"156","author":"JJ Mann","year":"1999","unstructured":"Mann JJ, Waternaux C, Haas GL, Malone KM. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry. 1999;156(2):181\u20139.","journal-title":"Am J Psychiatry"},{"issue":"2","key":"3896_CR14","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1037\/0022-006X.47.2.343","volume":"47","author":"AT Beck","year":"1979","unstructured":"Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979;47(2):343\u201352.","journal-title":"J Consult Clin Psychol"},{"issue":"1","key":"3896_CR15","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1186\/s12885-024-12433-0","volume":"24","author":"Y Yan","year":"2024","unstructured":"Yan Y, Chen Y, Ou M, Gong Y, Yang R, Liu X, Xia W, Chen F, Zheng H, Xu X. The mediating role of meaning in life between experiential avoidance and death anxiety among cancer patients: a cross-sectional study. BMC Cancer. 2024;24(1):663.","journal-title":"BMC Cancer"},{"issue":"4","key":"3896_CR16","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.beth.2011.03.007","volume":"42","author":"FW Bond","year":"2011","unstructured":"Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD. Preliminary psychometric properties of the acceptance and action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676\u201388.","journal-title":"Behav Ther"},{"issue":"5","key":"3896_CR17","first-page":"477","volume":"35","author":"HF Chiu","year":"1994","unstructured":"Chiu HF, Lee HC, Wing YK, Kwong PK, Leung CM, Chung DW. Reliability, validity and structure of the Chinese geriatric depression scale in a Hong Kong context: a preliminary report. Singapore Med J. 1994;35(5):477\u201380.","journal-title":"Singapore Med J"},{"issue":"1","key":"3896_CR18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/0022-3956(82)90033-4","volume":"17","author":"JA Yesavage","year":"1982","unstructured":"Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37\u201349.","journal-title":"J Psychiatr Res"},{"issue":"9","key":"3896_CR19","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1177\/1049732315588501","volume":"25","author":"JM Morse","year":"2015","unstructured":"Morse JM. Critical analysis of strategies for determining rigor in qualitative inquiry. Qual Health Res. 2015;25(9):1212\u201322.","journal-title":"Qual Health Res"},{"key":"3896_CR20","first-page":"339","volume":"11","author":"Y Nie","year":"2020","unstructured":"Nie Y, Hu Z, Zhu T, Xu H. A cross-sectional study of the prevalence of and risk factors for suicidal ideation among the elderly in nursing homes in Hunan Province, China. Front Psychiatry. 2020;11:339.","journal-title":"Front Psychiatry"},{"issue":"3","key":"3896_CR21","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1080\/13607863.2019.1698514","volume":"25","author":"D Bickford","year":"2021","unstructured":"Bickford D, Morin RT, Woodworth C, Verduzco E, Khan M, Burns E, Nelson JC, Mackin RS. The relationship of frailty and disability with suicidal ideation in late life depression. Aging Ment Health. 2021;25(3):439\u201344.","journal-title":"Aging Ment Health"},{"issue":"9","key":"3896_CR22","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.1007\/s00127-014-0840-1","volume":"49","author":"M Mellqvist F\u00e4ssberg","year":"2014","unstructured":"Mellqvist F\u00e4ssberg M, \u00d6stling S, Braam AW, B\u00e4ckman K, Copeland JR, Fichter M, Kivel\u00e4 SL, Lawlor BA, Lobo A, Magn\u00fasson H, et al. Functional disability and death wishes in older europeans: results from the EURODEP concerted action. Soc Psychiatry Psychiatr Epidemiol. 2014;49(9):1475\u201382.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"1","key":"3896_CR23","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.gerinurse.2015.07.006","volume":"37","author":"SH Kim","year":"2016","unstructured":"Kim SH. Suicidal ideation and suicide attempts in older adults: influences of chronic illness, functional limitations, and pain. Geriatric Nurs (New York NY). 2016;37(1):9\u201312.","journal-title":"Geriatric Nurs (New York NY)"},{"issue":"10","key":"3896_CR24","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1136\/jech-2022-218893","volume":"76","author":"S Kino","year":"2022","unstructured":"Kino S, Stickley A, Nishioka D, Ueno K, Saito M, Ojima T, et al. Suicidal ideation and suicide attempts among older recipients of public welfare assistance in Japan. J Epidemiol Community Health. 2022;76(10):873\u20139.","journal-title":"J Epidemiol Community Health"},{"issue":"1","key":"3896_CR25","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12913-023-09078-3","volume":"23","author":"H Hu","year":"2023","unstructured":"Hu H, Zhao L, Yong Y, Nicholas S, Maitland E, Zhao W, Yan H, Ma Y, Shi X. Medical insurance payment schemes and patient medical expenses: a cross-sectional study of lung cancer patients in urban China. BMC Health Serv Res. 2023;23(1):89.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"3896_CR26","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12888-023-04572-8","volume":"23","author":"X Chang","year":"2023","unstructured":"Chang X, Guo C, Zhou H, Liu L. Impact of rumination on sleep quality among patients with non\u2013alcoholic fatty liver disease: a moderated mediation model of anxiety symptoms and resilience. BMC Psychiatry. 2023;23(1):84.","journal-title":"BMC Psychiatry"},{"key":"3896_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.114745","volume":"296","author":"X Lei","year":"2022","unstructured":"Lei X, Bai C, Hong J, Liu H. Long-term care insurance and the well-being of older adults and their families: evidence from China. Social science & medicine (1982). 2022;296:114745.","journal-title":"Social science & medicine (1982)"},{"key":"3896_CR28","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.jad.2023.04.065","volume":"333","author":"P Zhang","year":"2023","unstructured":"Zhang P, Wang L, Zhou Q, Dong X, Guo Y, Wang P, He W, Wang R, Wu T, Yao Z, et al. A network analysis of anxiety and depression symptoms in Chinese disabled elderly. J Affect Disord. 2023;333:535\u201342.","journal-title":"J Affect Disord"},{"key":"3896_CR29","doi-asserted-by":"publisher","first-page":"104634","DOI":"10.1016\/j.actpsy.2024.104634","volume":"251","author":"W Li","year":"2024","unstructured":"Li W, Han Y, Hu Z, Zhang Y. Childhood trauma and non-suicidal self-injury among Chinese adolescents: the chain mediating effects of alexithymia and experiential avoidance. Acta Psychol. 2024;251:104634.","journal-title":"Acta Psychol"},{"key":"3896_CR30","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191912236","author":"H Ding","year":"2022","unstructured":"Ding H, Zhu L, Wei H, Geng J, Huang F, Lei L. The relationship between cyber-ostracism and adolescents\u2019 non-suicidal self-injury: mediating roles of depression and experiential avoidance. Int J Environ Res Public Health. 2022;19(19) https:\/\/doi.org\/10.3390\/ijerph191912236","journal-title":"Int J Environ Res Public Health"},{"issue":"6","key":"3896_CR31","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1016\/j.beth.2016.11.006","volume":"47","author":"SC Hayes","year":"2016","unstructured":"Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies - Republished article. Behav Ther. 2016;47(6):869\u201385.","journal-title":"Behav Ther"},{"issue":"5","key":"3896_CR32","doi-asserted-by":"publisher","first-page":"e0267887","DOI":"10.1371\/journal.pone.0267887","volume":"17","author":"Z Zhang","year":"2022","unstructured":"Zhang Z, Leong Bin Abdullah MFI, Shari NI, Lu P. Acceptance and commitment therapy versus mindfulness-based stress reduction for newly diagnosed head and neck cancer patients: A randomized controlled trial assessing efficacy for positive psychology, depression, anxiety, and quality of life. PLoS One. 2022;17(5):e0267887.","journal-title":"PLoS One"},{"issue":"5","key":"3896_CR33","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1017\/S104161022000112X","volume":"33","author":"M Lutzman","year":"2021","unstructured":"Lutzman M, Sommerfeld E, Ben-David S. Loneliness and social integration as mediators between physical pain and suicidal ideation among elderly men. Int Psychogeriatr. 2021;33(5):453\u20139.","journal-title":"Int Psychogeriatr"},{"issue":"5","key":"3896_CR34","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/j.gerinurse.2017.02.005","volume":"38","author":"D Zhang","year":"2017","unstructured":"Zhang D, Yang Y, Sun Y, Wu M, Xie H, Wang K, Zhang J, Jia J, Su Y. Characteristics of the Chinese rural elderly living in nursing homes who have suicidal ideation: A multiple regression model. Geriatric Nurs (New York NY). 2017;38(5):423\u201330.","journal-title":"Geriatric Nurs (New York NY)"},{"issue":"3","key":"3896_CR35","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1177\/00207640221137993","volume":"69","author":"L Smith","year":"2023","unstructured":"Smith L, Shin JI, Lee S, Oh JW, L\u00f3pez S\u00e1nchez GF, Kostev K, et al. The association of physical multimorbidity with suicidal ideation and suicide attempts in England: A mediation analysis of influential factors. Int J Soc Psychiatry. 2023;69(3):523\u201331.","journal-title":"Int J Soc Psychiatry"},{"issue":"2","key":"3896_CR36","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1080\/13607863.2015.1083945","volume":"20","author":"MM F\u00e4ssberg","year":"2016","unstructured":"F\u00e4ssberg MM, Cheung G, Canetto SS, Erlangsen A, Lapierre S, Lindner R, Draper B, Gallo JJ, Wong C, Wu J, et al. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging Ment Health. 2016;20(2):166\u201394.","journal-title":"Aging Ment Health"},{"key":"3896_CR37","doi-asserted-by":"publisher","first-page":"103658","DOI":"10.1016\/j.actpsy.2022.103658","volume":"228","author":"S Gao","year":"2022","unstructured":"Gao S, Zhang L, Yao X, Lin J, Meng X. Associations between self-disgust, depression, and anxiety: A three-level meta-analytic review. Acta Psychol. 2022;228:103658.","journal-title":"Acta Psychol"},{"key":"3896_CR38","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jad.2022.04.046","volume":"308","author":"D Zhang","year":"2022","unstructured":"Zhang D, Tian Y, Wang R, Wang L, Wang P, Su Y. Effectiveness of a resilience-targeted intervention based on I have, I am, I can strategy on nursing home older adults\u2019 suicidal ideation: a randomized controlled trial. J Affect Disord. 2022;308:172\u201380.","journal-title":"J Affect Disord"},{"issue":"1","key":"3896_CR39","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1186\/s12888-023-05057-4","volume":"23","author":"Y Zhang","year":"2023","unstructured":"Zhang Y, Ding X, Chen J, Liu Y, Wang G, Hu D. Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study. BMC Psychiatry. 2023;23(1):585.","journal-title":"BMC Psychiatry"},{"key":"3896_CR40","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.jad.2022.02.059","volume":"304","author":"ZQ Zhang","year":"2022","unstructured":"Zhang ZQ, Yang MH, Guo ZP, Liao D, S\u00f6r\u00f6s P, Li M, Walter M, Wang L, Liu CH. Increased prefrontal cortex connectivity associated with depression vulnerability and relapse. J Affect Disord. 2022;304:133\u201341.","journal-title":"J Affect Disord"},{"issue":"3","key":"3896_CR41","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s10433-011-0190-8","volume":"8","author":"BM Janssen","year":"2011","unstructured":"Janssen BM, Van Regenmortel T, Abma TA. Identifying sources of strength: resilience from the perspective of older people receiving long-term community care. Eur J Ageing. 2011;8(3):145\u201356.","journal-title":"Eur J Ageing"},{"issue":"5","key":"3896_CR42","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1002\/ajmg.b.32322","volume":"168b","author":"E Reinelt","year":"2015","unstructured":"Reinelt E, Barnow S, Stopsack M, Aldinger M, Schmidt CO, John U, Grabe HJ. Social support and the serotonin transporter genotype (5-HTTLPR) moderate levels of resilience, sense of coherence, and depression. Am J Med Genet Part B Neuropsychiatric Genetics: Official Publication Int Soc Psychiatric Genet. 2015;168b(5):383\u201391.","journal-title":"Am J Med Genet Part B Neuropsychiatric Genetics: Official Publication Int Soc Psychiatric Genet"},{"issue":"10","key":"3896_CR43","doi-asserted-by":"publisher","first-page":"1946","DOI":"10.1080\/13607863.2023.2196254","volume":"27","author":"K Samsi","year":"2023","unstructured":"Samsi K, Orellana K, Cole L, Manthorpe J. Understanding factors influencing residential respite service use by carers of people living with dementia using andersen\u2019s behavioural model of health services use: a qualitative study. Aging Ment Health. 2023;27(10):1946\u201355.","journal-title":"Aging Ment Health"}],"container-title":["BMC Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40359-025-03896-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-025-03896-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-025-03896-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T14:06:02Z","timestamp":1770645962000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40359-025-03896-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3896"],"URL":"https:\/\/doi.org\/10.1186\/s40359-025-03896-2","relation":{},"ISSN":["2050-7283"],"issn-type":[{"value":"2050-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"22 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Biomedical Research Ethics Committee of Hunan Normal University (Approval No. 2024\u2009\u2212\u2009172) on March 11, 2024. In accordance with the principles of the Declaration of Helsinki, written informed consent was obtained from all participants prior to enrollment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"194"}}