Objective To explore the emotional experience of mild cognitive impairment patients participating in cognitive intervention based on virtual reality technology，so as to provide references for medical personnel to carry out cognitive intervention. Methods With the method of objective sampling，10 patients with mild cognitive impairment who participated in cognitive intervention based on virtual reality technology in a tertiary A hospital in Beijing from July 2021 to September 2021 were selected as the research subjects for semi-structured interviews，and the data were analyzed with Colaizzi’s 7-step analysis method in phenomenological research. Results The emotional experience of mild cognitive impairment patients participating in cognitive intervention can be summarized into 4 themes，including the overall perception of virtual reality technology cognitive intervention（perception task characteristics，perception task skills，perception training mentality），the driving factors of cognitive intervention based on virtual reality technology （internal driving factors，external driving factors）；changes in outcomes of cognitive intervention based on virtual reality technology（changes in cognitive and speech functions；changes in motor function and behavioral patterns）；emotional awareness based on virtual reality technology cognitive training（continuously self-close before training；gradually focus on external objects during training；searching for the value of life after training）. Conclusion The medical staff should improve the diversity of cognitive intervention methods for patients with mild cognitive impairment，give play to the internal and external driving factors that promote patients to participate in training，improve training compliance，pay attention to their spiritual world，provide medical support，family support and social support，help them regain the value of life，strengthen psychological intervention at the same time of cognitive intervention，promote their cognitive improvement，delay the progress of cognitive deterioration，and improve their quality of life.
Epilepsy is a common neurological disease. There are about 10 million epileptic patients in China，proposing a great health-care challenge for the treatment and self-management. The advantages of wearable technologies in the condition of epilepsy are mainly reflected by strengthening management，health warning，improving decision-making，and then reducing management costs and improving efficiency. Therefore，this paper will review the current application of wearable technologies in self-monitoring and management of epilepsy patients，early warning of sudden epileptic death，the improvement of self-management effect and medical compliance，as well as the acceptance of wearable technology among epileptic patients and other stakeholders. This paper will also analyze and discuss potential challenges of its promotion，providing a reference for optimizing the management of epilepsy patients.
Objective To investigate the current situation of the self-compassion of clinical nurses，and to identify the potential characteristics of different types of nurses’ self-compassion and the relationship with psychological flexibility，so as to provide a reference for the development targeted psychological intervention programs for different types of clinical nurses. Methods Convenience sampling method was adopted to select 3 779 front-line clinical nurses in China in March 2022 as the survey objects. A general data questionnaire，self-compassion scale，Acceptance and Action Questionnaire（2nd edition），and cognitive integration questionnaire were used to conduct the survey. Potential profile analysis of nurses’ self-compassion characteristics was conducted by the self-compassion scale. The relationship between self-compassion characteristics and the psychological flexibility of nurses was discussed by one-way ANOVA and Logistic regression analysis. Results A total of 3 579 nurses were included. The characteristics of nurses’ self-compassion could be divided into 3 categories，including the unbalanced self-compassion group（15.90%），the lower high self-compassion group（25.12%），and the medium self-compassion ability group（58.98%）. Compared of the high self-compassion group and the medium self-compassion group，nurses who had more harmonious family relationship（OR=0.812，P=0.004），higher frequency of physical exercise（OR=0.817，P<0.001），better sleep quality（OR=0.751，P<0.001） and higher frequency of participating self-compassion training（OR=0.874，P=0.019） were more likely to be classified into the high self-compassion group，while nurses with high experiential avoidance（OR=1.077，P<0.001） and cognitive integration（OR=1.020，P=0.013） were more likely to be classified into the medium self-compassion group. Compared of the imbalance group and the lower high self-compassion group，nurses who had better sleep quality（OR=0.777，P<0.001） were more likely to be classified into the high self-compassion group，while nurses who had higher experiential avoidance（OR=1.070，P<0.001） were more likely to be classified into the imbalance group. Conclusion The self-compassion of clinical nurses can be divided into 3 categories. Nursing managers can take precise psychological interventions to improve nurses’ self-compassion ability according to the psychological characteristics of different types of nursing staff，so as to promote the overall mental health of clinical nurses.
Objective To develop an intravenous thrombolysis nursing guideline for acute ischemic stroke as a guiding tool for the implementation of intravenous thrombolysis for acute ischemic stroke，and to provide a reference for the practice and management of nursing in the standardization of thrombolytic therapy. Methods According to the method of evidence-based nursing practice guidelines，the draft of intravenous thrombolysis nursing guidelines for acute ischemic stroke was constructed. The draft guidelines were reviewed by experts using the catalogue of Clinical Guidelines Research and Evaluation System Ⅱ. According to the results and suggestions of expert review，the guidelines were modified to form the formal guidelines. Results The recommendations included 5 aspects，namely hospital organization management，disease observation，observation and treatment of complications，posture and bed-leaving activities，and quality management. Conclusion The guidelines for intravenous thrombolysis nursing in acute ischemic stroke are evidence-based guidelines based on the best evidence，clinical practice and the judgment of professionals，and can be used as a practical basis for clinical medical staff to make scientific decisions on intravenous thrombolysis therapy in patients with acute ischemic stroke.
In terms of stroke prevention and treatment,the most important work are early monitoring of stroke risk factors,efforts to reduce the incidence of stroke in the population,and integration and identification of stroke predictors. Wearable devices and machine learning based on stroke risk factors are expected to become an effective solution for risk monitoring and prediction for people at high risk of stroke. This article reviews the monitoring methods for high-risk factors of stroke based on wearable devices,the application of machine learning and mobile phone applications in stroke risk prediction,which provides references for improving stroke prevention and health management in China in the future.
Objective To explore the real experience of mild cognitive impairment patients with memory decline,and to provide references for clinical staff to carry out follow-up medical nursing intervention. Methods Using objective sampling method,9 patients with mild cognitive impairment in the Department of Neurology of a tertiary hospital in Beijing from May to June 2021 were selected as the research subjects for semi-structured interviews,and the data were analyzed by Colaizzi 7-step analysis method in phenomenological research. Results The real experience of memory loss in patients with mild cognitive impairment can be summarized into 3 themes：disease perception of memory loss（attitude of contempt and denial,introspection of reflection and traceability,and change of interactive relationship）;emotional experience of memory decline（generation of anxiety and fear,reduction of self-efficacy,formation of self enlightening attitude,expectation of facing the future）;coping strategies for memory loss （lifestyle coping,physical and mental activity coping,future planning coping）. Conclusion We should strengthen the popularization of medical knowledge about memory loss in patients with mild cognitive impairment,pay attention to their emotional needs,give psychological counseling,family support and social support,and carry out personalized cognitive intervention to promote their cognitive improvement and return to family and society.
Objective To investigate the influencing factors of filter rupture in membrane-based therapeutic plasma exchange（mTPE） for neurological diseases. Methods A retrospective study was conducted to collect the clinical data of 196 cases of mTPE in 42 patients admitted to the department of Neurology in a tertiary hospital from January 2018 to May 2020. Univariate and multivariate Logistic regression analysis was conducted to analyze the risk factors for membrane rupture of the filter. Transmembrane pressure was used as a predictive indicator,and data of 35 plasma exchanges from June 2020 to October 2020 was collected for clinical verification and the best cut-off of transmembrane pressure was analyzed. Results Filter rupture occurred in 19（9.69%） cases of the 196 cases of mTPE. Logistic regression analysis showed that transmembrane pressure（OR=1.192） was an independent risk factor for filter rupture in（mTPE）（P<0.05）.The area under ROC curve（AUC） was 0.977 and 95%CI were 0.952~1.000（P<0.01）. According to the maximum Youden index value of 0.839,the optimal cut-off value of transmembrane pressure was 50 mmHg;the sensitivity was 89.5%;the specificity was 94.4%. With 50 mmHg as the cut-off value,the verification results showed that the sensitivity was 100%;the specificity was 91.42%;the accuracy was 91.42%. Conclusion The transmembrane pressure has a good predictive effect on filter rupture in mTPE. The clinical transmembrane pressure is maintained below 50 mmHg to prevent the filter rupture.
Objective To construct a quality index system for cognitive training nursing clinics in line with China’s national conditions,and to provide references for related practitioners. Methods Based on the literature research,theoretical analysis,and clinical investigation,a draft on indexes was constructed. Using Delphi’s expert consultation method,16 experts were selected and 2 rounds of consultations were conducted to establish a nursing quality index system for cognitive training nursing clinics. Results The recovery and effective rates of 2 rounds of consultation documents were 100%,and the authority coefficient of the second round of consulting experts was 0.836. Expert opinion coordination coefficients of the 3-level indexes were 0.755,0.813,0.929 respectively（P<0.05）. The final quality index system includes 3 first-level indicators（structure quality,process quality and outcome quality）,10 second-level indicators,and 34 third-level indicators. Conclusion The quality index system of cognitive training nursing clinics constructed in this study is scientific and practical,and it can provide references for comprehensive evaluation and standardized management of cognitive training nursing clinics.
The occurrence of sleep disorders can aggravate the cognitive function of patients with cognitive impairment,increase mental and behavioral abnormalities,reduce the quality of life,bring greater burden to caregivers,and increase social and economic costs. This article reviews,compares and analyzes the content,characteristics,application,and limitations of sleep impairment assessment tools in patients with cognitive impairment development status of assessment tools at home and abroad,and also proposes future research direction. It aims to provide a reference for the localization of the development of sleep assessment tools for patients with cognitive impairment,and to provide some useful information about the accurate assessment and personalized care of patients with cognitive impairment.
Objective To monitor and analyze the association between 24-hour blood pressure and bleeding complications in patients with acute ischemic stroke after intravenous thrombolysis,for predicting bleeding complications with possible blood pressure range and monitoring time.Methods Totally 487 patients with acute ischemic stroke who were admitted to four stroke centers in Beijing from June 2015 to December 2017 were enrolled and received rt-PA intravenous thrombolysis. Demographic data,blood pressure before thrombolysis,blood pressure within 24 hours after thrombolysis,imaging examination during bleeding,and laboratory inspection data were collected and analyzed.Results A total of 168 patients（34.5%） had bleeding complications. The baseline blood pressure of patients with bleeding complications was higher than that of patients with non-bleeding complications,and the difference was statistically significant（P<0.05）. The optimal blood pressure monitoring time for systemic hemorrhage,intracranial hemorrhage and gingival hemorrhage was before thrombolysis or during thrombolysis. Respiratory hemorrhage occurred early after thrombolysis,while nasal and urinary hemorrhage occurred about 12 hours after thrombolysis. The threshold values of blood pressure were 146/81.5 mmHg（systemic hemorrhage）,159.5/108.5 mmHg（intracranial hemorrhage）,159.5/85 mmHg（gingival hemorrhage）,184/87.5 mmHg（nasal hemorrhage）,143.5/100.5 mmHg（respiratory hemorrhage）,136.5./91.5 mmHg（urinary hemorrhage）,respectively.Conclusion High blood pressure within 24 hours after thrombolysis is risk factor for hemorrhage. Bleeding complications with possible blood pressure range and monitoring time provide basis for nursing observation.
Objective To establish an hospitalized elderly stroke patients nursing assessment system to assess the health problems in this population.Methods Delphi method was used to organize the recommendations from 24 experts that specialized in geriatric care,neurological care,health management,nursing management and critical care. In accordance with two rounds of expert advices and clinical experience,some items were revised.Results The response rates of two rounds,both were 100%. The authority coefficient of experts in the second round was 0.825,and the coordination coefficients of three level indicators were 0.534,0.295,0.320,respectively（P<0.001）. The final design concluded with 4 first-level indicators,including general medical assessment,physical function status,social participation,mental health status,14 second-level indicators and 40 third-level indicators.Conclusion Delphi expert consultation method demonstrated that the scale is scientific and reliable and can provide a basis for clinical nurses to make nursing strategies. However,this hospitalized elderly stroke patients nursing assessment system needs further verification and improvement.
Objective To evaluate the effect of individualized continuous follow-up management in patients with remote ischemic conditioning（RIC） on compliance and treatment. Methods Using convenience sampling and historical control,patients received RIC from March to May 2017 were recruited as the control group,and those received RIC from June to September 2017 were recruited as the experimental group. The control group was provided with routine follow-up,whereas the experimental group was provided with individualized continuous follow-up management. Treatment compliance at 1,3,6 months,as well as recurrence rate of ischemic stroke events within 6 months for two groups were compared. Results The compliance in the experimental group was higher than that in the control group at 1,3,and 6 months,and the differences were statistically significant（P<0.001）. The recurrence rate of the ischemic stroke in the control group was 5.66% which was higher than 0% in the experimental group,but the difference was not statistically significant（P>0.05）. Conclusion Individualized continuous follow-up management can effectively improve the treatment compliance of patients undergoing RIC,thus ensuring the clinical research effect of RIC. This management method can provide reference for construction of RIC treatment and nursing model in the future.
Objective To establish a predictive model for post-thrombolysis hemorrhage in patients with acute ischemic stroke.Methods From January 2014 to December 2018,acute ischemic stroke patients who received rt-PA intravenously were recruited from an advanced stroke center at a tertiary hospital. General information,indicators related to hemorrhage,and blood test results were collected and analyzed using binary Logistic regression model.Results Among 924 recruited patients with acute ischemic stroke,566 had no bleeding complications within 36 hours after intravenous thrombolytic therapy（no bleeding group）,and 358 had bleeding symptoms（bleeding group）. The difference in hospitalization days between two groups was statistically significant（Z=-2.596,P=0.009）. Age,pre-thrombosis systolic pressure,history of falls,history of taking antithrombotic drugs,NIHSS score and DNT time were risk factors for hemorrhage. Based on the results,the predictive model was established and tested.Conclusion The incidence of peripheral bleeding after intravenous thrombolysis is higher,prognosis for patients with severe hemorrhage is poor. Attention should be paid to alert,prevention and treatment of hemorrhage. The predictive model is useful for providing reference for nursing observation,prevention and treatment of hemorrhage.
