Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing，standardize the limb management of patients with transvenous temporary cardiac pacing，and reduce complications related to the limb. Methods Using evidence-based methods，the evidence in this field was searched，evaluated and summarized，and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality，and then the first draft of the consensus was formed. From December 2023 to January 2024，through 2 rounds of expert consultation and 4 rounds of expert meetings，the content was adjusted and the consensus was reached. Results Totally 16 experts participated in the consultation. The positive coefficient is 100%；the authoritative coefficient is 0.847 and 0.836；the average value of each index is more than>3.8；the coefficient of variation is less than 0.21. The Kendall’s harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314，respectively，which were statistically significant. The consensus covers the preoperative，intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing. Totally 11 themes were involved，including the preoperative preparation，position and catheter fixation in operation，position and catheter fixation in postoperative，activity，turn and transfer，duty shift on limb，nursing care after withdrawal of the catheter，prevention of deep vein thrombosis of the operative limb and prevent infection. Conclusion The consensus is highly scientific，and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.
Objective To construct a lifestyle management scheme for infertile women with polycystic ovary syndrome（PCOS） during outpatient medical treatment，and to evaluate its clinical effects. Methods Based on the evidence summary and qualitative interviews，a lifestyle management scheme for infertile women with PCOS during medical treatment was constructed. The infertile women at childbearing age with PCOS from the health management center and reproductive medicine center of a tertiary A hospital in Nanjing were recruited through convenience sampling. 27 patients who visited the above mentioned 2 centers from September 15 to 30，2021 were recruited in an experimental group successively，while another 27 patients who visited there from February 15 to 28，2021 were recruited in a control group successively. Next，the lifestyle management scheme was implemented in the experimental group in 9 key steps，including evaluation，screening，status analysis，formulation of body mass management objectives，diet management，exercise management，behavior management，health guidance，and evaluation. Meanwhile，27 patients in the control group were given the routine healthy lifestyle guidance. After 3 months，the figure of BMI，insulin resistance index，serum testosterone，anxiety，depression and quality of life of the 2 groups were analysed. Results After the intervention，the BMI of the experimental group was 24.43±2.99，which was lower than （26.48±3.49） in the control group. The insulin resistance index was 2.42±0.98，which was lower than 3.52±0.97 in the control group. The level of testosterone was（0.55±0.19） ng/ml，which was lower than（1.20±0.42） ng/ml in the control group. The anxiety level was（5.73±2.13） and the depression level was（5.12±2.66），which were lower than（9.40±2.36） and（10.60±2.58） of the control group. The score of disease-related quality of life was（140.38±7.25），which was higher than（115.56±7.99） of the control group，and the differences were statistically significant （P<0.05）. Conclusion The implementation of the lifestyle management scheme for infertile women with PCOS during medical treatment is conducive to adjust patients’ endocrine and metabolic status，alleviate their anxiety and depression and improve quality of life.
Objective To modify the insertion length of orogastric tube placement in premature infants and to evaluate its effect. Methods A total of 306 premature infants undergoing orogastric tube insertion in the Neonatal Center of a tertiary A hospital in Beijing were selected as the study subjects. 155 premature infants undergoing orogastric tube insertion from August 2019 to April 2021 were selected as the test group,and 151 premature infants from March 2018 to July 2019 were in the control group. The effects of different predicting methods on the correct placement rate of the orogastric tube tip,drainage volume before gastrointestinal decompression,number of vomiting episodes,and the total time of gastrointestinal decompression were compared in 2 groups. Results The correct placement rate of orogastric tube tip was 85.81% in the test group and 15.23% in the control group,and the difference was statistically significant（P<0.001）. The drainage volume 3 days before gastrointestinal decompression in the test group was higher than that in the control group,and the difference was statistically significant（t=14.38,t=15.78,t=11.06,all,P<0.001）. The incidence rate of vomiting during gastrointestinal decompression in the test group was lower than that in the control group（χ2=7.05）,and the difference was statistically significant（P=0.008）. The total time of gastrointestinal decompression was shorter than that in the control group（t=12.74）,and the difference was statistically significant（P<0.001）. Conclusion The modified method of predicting insertion length of orogastric tube in premature infants can improve the accuracy of optimal placement for the orogastric tube tip,avoid misplacement of the orogastric tube,and improve the effect of gastrointestinal decompression.
According to different clinical manifestations,delirium can be divided into 3 subtypes,including hypoactive delirium,hyperactive delirium,and mixed delirium. Each subtype has its own special nursing priorities and clinical outcomes according to different clinical significance and prevalence. This review has summarized the progress of delirium subtypes and assessment tools,in order to provide scientific advice for the selection of appropriate assessment tools for delirium subtypes in the future.
Objective To search,evaluate and integrate the relevant evidence for sexual health management in breast cancer patients,and to provide references for clinical practice. Methods We searched CNKI,CBM,UpToDate,PubMed,Cochrane Library,Joanna Briggs Institute,CINAHL,National Guideline Clearinghouse,National Comprehensive Cancer Network,American Society of Clinical Oncology,European Society for Medical Oncology for relevant clinical decisions,guidelines,systematic reviews,evidence summaries and expert consensuses. The retrieval period is from the establishment of databases to February 10,2022. Results A total of 17 articles were enrolled,including 4 clinical decisions,5 guidelines,4 expert consensuses and 4 systematic reviews. Totally 33 pieces of best evidence were summarized from 7 aspects,namely screening and evaluation,psychological intervention,instrumental and exercise intervention,non-hormone therapy,hormone therapy,related reproduction and training and follow-up. Conclusion This study summarized the best evidence for sexual health management in breast cancer patients. In clinical practice,nurses can personalize the application of evidence according to clinical situation and patients’ wishes to improve breast cancer patients’ sexual health.
Objective To develop and evaluate the reliability and validity of Perception of Risk of Chronic Kidney Disease Scale（PRCKDS） for patients with type 2 diabetes mellitus. Methods The item pool was determined by literature review,interview,expert consultation,and pre-investigation,and the formal scale was formed. The newly developed PRCKDS was tested on 420 patients with type 2 diabetes through an online survey. The reliability and validity of the scale were evaluated by Spearman correlation analysis,factor analysis,and Cronbach’s α respectively. Results There were 36 items in the formal scale,with 5 dimensions including susceptibility,severity,beneficence,hindrance and precipitating factors. Spearman correlation analysis indicated that the content validity was good. Confirmatory factor analysis indicated that the model fit was good. The factor loads of 36 items were all greater than 0.45 and within the preset 5 dimensions,indicating that the structure validity was good. The Cronbach’s α of homogeneity is 0.875,and the split reliability is 0.865. Conclusion The PRCKDS established in this study has good reliability and validity,and it can be used as an effective and reliable measurement tool to assess the risk perception of chronic kidney disease in patients with type 2 diabetes mellitus. Different risk perception groups should be differentiated,and individualized strategies should be adopted in the prevention education of chronic kidney disease.
Objective To explore the effects of high flow nasal cannulae oxygen therapy（HFNC） with different flow rates about important physiological parameters,comfort and respiratory distress on patients with acute hypoxic respiratory failure. Methods The convenience sampling method was used to recruit 129 patients with acute hypoxic respiratory failure treated in the Intensive Care Unit of a tertiary A hospital in Chongqing from September 2019 to September 2020. Through the implementation of HFNC,the effects of different flow rates（30~35 L/min in the low flow rate group,40~45 L/min in the medium flow rate group,50~60 L/min in the high flow rate group） on respiratory rate,heart rate,endotracheal intubation rate,respiratory comfort and respiratory distress of patients with acute hypoxic respiratory failure were investigated. Results After the treatment for 6,24 and 48 h,the respiratory rate of low and medium flow rate groups was lower than that of the high flow rate group. After 72 h treatment, the respiratory rate of the low flow rate group was lower than that of the high flow rate group. The comfort and respiratory distress scores in the low flow rate group were the lowest after 6,48,72 treatment and the end of treatment. After 24 h treatment, the comfort and respiratory distress scores of low and medium flow rate groups were lower than those of the high flow rate group. According to the subgroup analysis of patients with different degrees of hypoxia（oxygenation index 201~300 mmHg is the mild hypoxia group and 101~200 mmHg is the moderate hypoxia group）,under the setting of hypoxic flow rate,the respiratory rate of moderate hypoxia subjects was lower when HFNC for 6 h. The degree of respiratory distress was lower in moderate hypoxia subjects after HFNC for 48 h;HFNC for 48 h;At the end of treatment,moderate hypoxia subjects had lower heart rate. For medium oxygen flow HFNC treatment,the respiratory rate of the moderate hypoxia group was lower than that of the mild hypoxia group at 6 h,24 h and 48 h after HFNC treatment,and the heart rate of the moderate hypoxia group at 48 h after HFNC treatment was lower（all P<0.05）. Conclusion The flow rate setting of HFNC needs to be personalized and dynamically managed in combination with the patient’s inspiratory demands,degree of hypoxia,tolerance and comfort.
To summarize the experience and effectiveness of non-slow down post-pyloric feeding in 15 severe burn patients with prone position ventilation. We established a multi-disciplinary prone position ventilation and enteral nutrition team,dynamically adjusted the personalized and precise nutrition plans,managed the target feeding rate,and implemented the intra-abdominal pressure oriented and non-slow down feeding strategy,and effectively prevented gastrointestinal intolerance. After careful care of 15 patients,the standard rate of enteral nutrition within 24 to 48 hours was 20%~60%,and the standard rate within a week was 50% to 95%. The gastrointestinal tolerance was good. The intra-abdominal pressure oriented and early post-pyloric non-slow down feeding is safe and effective in severe burn patients with prone ventilation.
