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Abstract Background The health as expanding consciousness (HEC) theory posits that health and disease are interconnected components of a comprehensive process aimed at expanding consciousness. Aim The objective of this study is to introduce the concept, research status and applications of HEC and offer a comprehensive understanding of its various key components. Data sources Databases including EMBASE, PubMed, ScienceDirect, ProQuest, Wiley, Web of Science, Sinomed, China National Knowledge Infrastructure, Wanfang, and CQVIP, covering the period from 1986 to 2023. Method Employing Rodgers’ evolutionary concept analysis approach, this study included and analysed 70 studies. Results The characteristics of HEC comprise aspects such as movement, time, space, energy, rhythm, and paradigm of health. The antecedents of HEC encompass disease, chaos, binding, centring, and choice point. Consequences associated with HEC include self-transcendence, unbinding, decentring, expanded consciousness, real freedom, pattern recognition, absolute consciousness, and death. Conclusion This study has identified substitute terms, related concepts, attributes, antecedents, consequences, and empirical references associated with HEC. The findings provide valuable information applicable across various domains of nursing, encompassing practice, education, research, and management.

The construction of a food certification system plays a vital role in upgrading export quality, which previous studies have largely overlooked. We match China's industry-level data of Green Food Certification with its HS6-digit export data of agri-food products to quantify the impact of Green Food Certification on export quality. We identify the significant and positive effect of Green Food Certification on export quality. The 2SLS estimation based on instrumental variables and a range of robustness checks confirm the validity and robustness of the benchmark conclusions. Further analysis discloses that Green Food Certification improves export quality by raising agricultural production efficiency and brand premiums. Heterogeneity analysis shows that the effect of Green Food Certification varies across regions, notably improving the quality of agri-food products exported to developed regions and regions with high levels of import supervision. Furthermore, among various product types, Green Food Certification significantly improves the export quality of primary products and products vulnerable to non-tariff measures. The above findings could guide the future development of agri-food quality certification systems, potentially leading to a transformation and promotion of the agri-food trade.