{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:03:15Z","timestamp":1784872995141,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To address clinical nursing challenges associated with postherpetic neuralgia(PHN), including recurrent pain shadow memory (PSM), refractory pain, and marked negative affect, this study assessed the effectiveness of a staged nursing pathway and identified key opportunities for cognitive\u2013sensory\u2013behavioral staged regulation, thereby providing a scientific foundation for improving nursing care for patients with PHN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 100 patients diagnosed with PHN between July 2025 and April 2026 were enrolled and assigned to either a control group or an experimental group according to the admission period in a quasi-experimental design. The control group received routine nursing care, such as general nursing (e.g., vital signs, observation of the patient\u2019s condition, and medication administration). The observation group received a step-by-step nursing intervention, in addition to the control group\u2019s treatment, with three steps as follows: cognition correction (correcting irrational cognition about pain), sensory intervention (cold compress treatment combined with sensory desensitization), and behavioral counseling (desensitization language combined with behavior intervention). Results were evaluated with the Pain Shadow Behavior Identification Scale, the Numerical Rating Scale (NRS), and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using a t-test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between the two groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). After the intervention, the experimental group demonstrated significantly greater improvements in all three behavioral dimensions of pain shadow memory, namely situational recurrence, action avoidance, and verbal response, than the control group on both day 4 and day 7. On day 4, the experimental group showed significantly lower scores in situational recurrence (1.70\u202f\u00b1\u202f0.54 vs. 1.96\u202f\u00b1\u202f0.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), action avoidance (1.70\u202f\u00b1\u202f0.61 vs. 2.76\u202f\u00b1\u202f0.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), and verbal response (1.88\u202f\u00b1\u202f0.52 vs. 2.32\u202f\u00b1\u202f0.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). On day 7, the experimental group continued to demonstrate significantly greater improvements in all three dimensions: situational recurrence (0.68\u202f\u00b1\u202f0.65 vs. 1.64\u202f\u00b1\u202f0.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.005), action avoidance (1.30\u202f\u00b1\u202f0.46 vs. 2.06\u202f\u00b1\u202f0.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and verbal response (0.94\u202f\u00b1\u202f0.42 vs. 1.72\u202f\u00b1\u202f0.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). The Numerical Rating Scale score was significantly lower in the experimental group than in the control group on day 4 (4.78\u202f\u00b1\u202f0.88 vs. 5.22\u202f\u00b1\u202f0.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05) and day 7 (2.56\u202f\u00b1\u202f0.54 vs. 3.82\u202f\u00b1\u202f0.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Regarding emotional status, the experimental group showed significantly lower scores on both the Hospital Anxiety and Depression Scale-Anxiety subscale (8.52\u202f\u00b1\u202f1.89 vs. 9.88\u202f\u00b1\u202f1.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and the Hospital Anxiety and Depression Scale-Depression subscale (7.68\u202f\u00b1\u202f1.39 vs. 8.72\u202f\u00b1\u202f1.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) compared with the control group on day 7.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The staged nursing pathway, which integrates sequential cognitive, sensory, and behavioral interventions, significantly reduced the recurrence of pain shadow memory, rapidly relieved pain, and improved anxiety and depression in patients with postherpetic neuralgia. This approach addresses the limitations of conventional nursing care and provides a feasible, effective, and evidence-based strategy for clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1861594","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:36:12Z","timestamp":1784871372000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral recurrence mechanisms of \u201cpain shadow memory\u201d and nursing intervention opportunities in postherpetic neuralgia during the skin lesion regression stage"],"prefix":"10.3389","volume":"13","author":[{"given":"Guoqin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pain, Daping Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuchao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pain, Daping Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinxin","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Pain, Daping Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pain, Daping Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqiong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Daping Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref1","first-page":"2566","article-title":"Efficacy of nursing interventions based on the Manchester pain management model in the treatment of herpes zoster neuralgia","volume":"46","author":"Xu Liping","year":"2025","journal-title":"Jilin Medical J"},{"key":"ref2","first-page":"2621","article-title":"Effects of nursing interventions based on the cox health behavior interaction model on pain levels, negative emotions, and coping strategies among patients with postherpetic neuralgia","volume":"34","author":"Futing","year":"2025","journal-title":"Modern J Integrated Traditional Chinese Western Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"583843","DOI":"10.2147\/JPR.S583843","article-title":"Central sensitization severity in chronic low Back pain: associations with sleep, distress, cortisol, and visuospatial working memory","volume":"19","author":"Sahebalam","year":"2026","journal-title":"J Pain Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.3390\/brainsci15111231","article-title":"Hippocampal development and epilepsy: insights from organoid models","volume":"15","author":"Joo","year":"2025","journal-title":"Brain Sci"},{"key":"ref5","first-page":"187","article-title":"Efficacy of multidimensional collaborative nursing in patients with postherpetic neuralgia","volume":"37","author":"Jing","year":"2025","journal-title":"Chinese J Public Health Preventive Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e44083","DOI":"10.1097\/MD.0000000000044083","article-title":"Integrating narrative nursing and diversified health education in postherpetic neuralgia care: a retrospective study","volume":"104","author":"Yachen","year":"2025","journal-title":"Medicine"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.23977\/MEDSC.2024.050309","article-title":"Nursing intervention of Postherpetic Neuralgia.MEDS","volume":"5","author":"Zhang","year":"2024","journal-title":"Clin Med"},{"key":"ref8","first-page":"779","article-title":"Advances in the application of the internet in continuous care for patients with postherpetic neuralgia","volume":"29","author":"Xiaoli","year":"2023","journal-title":"Chinese J Pain Med"},{"key":"ref9","first-page":"2208","article-title":"Research progress in traditional Chinese medicine nursing for patients with postherpetic neuralgia","volume":"37","author":"Xujie","year":"2023","journal-title":"Nurs Res"},{"key":"ref10","first-page":"60","article-title":"Literature review on nursing care for postherpetic neuralgia","volume":"28","author":"Yina","year":"2022","journal-title":"Chinese J Pain Med"},{"key":"ref11","first-page":"557","article-title":"Case report on nursing care during the screening period of spinal cord stimulation for patients with postherpetic neuralgia","volume":"26","author":"Zhimin","year":"2020","journal-title":"Chinese J Pain Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1177\/20494637221141034","article-title":"Assessment of suitable referral, effectiveness and long-term outcomes of standard vs intensive pain management programmes for people with chronic pain","volume":"17","author":"Hearn","year":"2023","journal-title":"Br J Pain"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1596367","DOI":"10.3389\/fnmol.2025.1596367","article-title":"Decoding pain chronification: mechanisms of the acute-to-chronic transition","volume":"18","author":"Zhang","year":"2025","journal-title":"Front Mol Neurosci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1097\/j.pain.000000000002987","article-title":"The role of cold therapy in modulating central sensitization: a neurophysiological study","volume":"165","author":"Smith","year":"2024","journal-title":"Pain"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"158","DOI":"10.14016\/j.cnki.jgzz.2016.02.158","article-title":"Jing Lianghong clinical observation of semiconductor laser combined with pregabalin and Qingpeng ointment in the treatment of type 2 diabetes with herpes zoster neuralgia","volume":"37","author":"Jia","year":"2016","journal-title":"J Laser"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"148","DOI":"10.14016\/j.cnki.jgzz.2015.01.148","article-title":"Yuan Hongmei observation of the therapeutic effect of semiconductor laser combined with microwave on postherpetic neuralgia","volume":"36","author":"Xiaoping","year":"2015","journal-title":"Laser J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1093\/pm\/pnae345","article-title":"Fear memory behavioral updating in chronic pain: neural evidence from adolescent brain imaging studies on extinction learning circuit remodeling","volume":"26","author":"Zhang","year":"2025","journal-title":"Pain Med"},{"key":"ref18","first-page":"84","article-title":"Efficacy of combined red-light therapy and drug treatment in managing diabetic patients with herpes zoster neuralgia","volume":"35","author":"Mei","year":"2014","journal-title":"Laser Med Surg"},{"key":"ref19","first-page":"67","article-title":"Advances in research on the relationship between pain-related behaviors and memory consolidation","volume":"46","author":"Ming","year":"2025","journal-title":"Med Philosophy"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"105892","DOI":"10.1016\/j.neubiorev.2025.105892","article-title":"Behavioral interventions modulate pain memory consolidation: neurobiological mechanisms and clinical implications","volume":"168","author":"Anderson","year":"2025","journal-title":"Neurosci Biobehav Rev"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.pmn.2024.11.008","article-title":"Graded exposure therapy for pain-related fear: a standardized protocol for nursing practice","volume":"26","author":"Van Den Hout","year":"2025","journal-title":"Pain Manag Nurs"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1007\/s10865-024-00897-2","article-title":"A stepped-care model for pain-related situational avoidance: from 5-minute to 20-minute exposure","volume":"48","author":"Johnson","year":"2025","journal-title":"J Behav Med"},{"key":"ref23","first-page":"628","article-title":"Research progress on the pathogenesis of postherpetic neuralgia","volume":"20","author":"Li Min","year":"2024","journal-title":"Chinese J Pain Med"},{"key":"ref24","first-page":"321","article-title":"The effect of pain neuroscience education combined with graded exposure on fear-avoidance behavior and pain-situational associations in patients with postherpetic neuralgia","volume":"30","author":"Zhou Ming","year":"2025","journal-title":"Chinese J Rehab Med"},{"key":"ref25","first-page":"3125","article-title":"Effects of stepped psychological intervention combined with repeated exposure on situational pain in patients with cancer pain and postherpetic neuralgia","volume":"53","author":"Jing","year":"2024","journal-title":"Chongqing Medical J"},{"key":"ref26","first-page":"2678","article-title":"Development and application of a patient-family-medical staff collaborative care model in continuous nursing","volume":"59","author":"Xiaoli","year":"2024","journal-title":"Chin J Nurs"},{"key":"ref27","first-page":"289","article-title":"Neuroimaging studies and diversified treatment strategies for postherpetic neuralgia and related emotional disorders based on functional MRI mechanisms","volume":"21","author":"Han","year":"2025","journal-title":"Chinese J Pain Med"},{"key":"ref28","first-page":"102","article-title":"Effects of psychological care combined with specialized pain management on patients with postherpetic neuralgia","volume":"4","author":"Chengdi","year":"2025","journal-title":"Clinical Nurs Progress"},{"key":"ref29","first-page":"194","article-title":"Effects of multidimensional collaborative care on negative emotions, knowledge acquisition, and self-efficacy in patients with postherpetic neuralgia","volume":"19","author":"Rui","year":"2022","journal-title":"China Medical Herald"},{"key":"ref30","first-page":"177","article-title":"Reconsideration of stepped therapy for postherpetic neuralgia","volume":"19","author":"Zhijian","year":"2023","journal-title":"Chinese J Pain Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1097\/EJA.0000000000002417","article-title":"Effect of transcranial direct current stimulation on perioperative neurocognitive disorder in elderly patients undergoing abdominal tumour surgery: a randomised controlled trial","volume":"43","author":"Wei","year":"2026","journal-title":"Eur J Anaesthesiol"},{"key":"ref32","first-page":"E1227","article-title":"Association between the risk of relapse and the type of surgical procedure for herpes zoster-related pain","volume":"24","author":"Luo","year":"2021","journal-title":"Pain Physician"},{"key":"ref33","first-page":"987","article-title":"Application of rehabilitation training based on motor imagery combined with progressive walking program in patients with postherpetic neuralgia","volume":"46","author":"Minghua","year":"2024","journal-title":"Chinese J Physical Med Rehab"},{"key":"ref34","first-page":"587","article-title":"Effects of language desensitization training combined with positive psychological suggestions on emotional responses and pain perception in patients with postherpetic neuralgia","volume":"25","author":"Ying","year":"2025","journal-title":"Chinese Nurs Manag"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1861594\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:36:17Z","timestamp":1784871377000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1861594\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":34,"alternative-id":["10.3389\/fmed.2026.1861594"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1861594","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"article-number":"1861594"}}