Objective To evaluate the puerperal fatigue status of women at advanced maternal age and to explore its influencing factors. Methods This study included 210 women at advanced maternal age who were reviewed on 42 days postpartum at 4 hospitals in Jinan from December 2019 to October 2020，and clinical data was collected by the General Information Questionnaire，Fatigue Scale，Pittsburgh Sleep Quality Index，Anxiety Self-Rating Scale，Edinburgh Postpartum Depression Scale，and Social Support Rating Scale. Univariate analysis and multiple linear regression were used to analyze the factors influencing the occurrence of puerperal fatigue in women at advanced maternal age. Results The fatigue score during the puerperium for women at advanced maternal age was（6.84±3.11），and the prevalence of fatigue was 94.61%. Multiple linear regression analysis revealed that pregnancy and childbirth history，delivery mode，anxiety，depression，sleep quality，and social support were the main factors influencing their level of fatigue（P<0.05）. Conclusion The puerperal fatigue level of women at advanced maternal age is at a high level. Healthcare workers should pay more attention to the assessment of fatigue levels during the puerperium and provide accurate and individualized postpartum psychological and physiological care.

Objective From the aspects of parenting style and medication adherence，the influencing factors of asthma symptom control level of school-age children and the impact path of influencing factors were analyzed，so as to provide a basis for the formulation of targeted nursing intervention programs. Methods Using convenient sampling method，from December 2020 to September 2021，we investigated school-age asthmatic children and their parents in pediatric respiratory outpatient departments and wards of 3 tertiary hospitals in Jinan，Shandong province，using the General Demographic Questionnaire，Short-Egna Minnen av Barndoms Uppfostran-Chinese（s-EMBU-C），Medication Adherence Questionnaire and Childhood Asthma Control Test（C-ACT）. Univariate analysis，Pearson correlation analysis and multiple linear stepwise regression analysis were used to analyze the data，and the structural equation model was established. Results A total of 211 school-age children with asthma were enrolled. The score of C-ACT was（19.15±4.27），and the uncontrolled rate was 43.6%（92 cases）. The results of influencing factor analysis showed that the parenting style，medication adherence and asthma history of first-degree relatives were the influencing factors of symptom control level in school-age children with asthma（P<0.05）. Pathway analysis results showed that medication adherence played a partially mediating role between positive parenting style and asthma symptom control level（ES=0.395），with 95%CI（0.273，0.540），accounting for 54.6% of the total effect. The medica-tion adherence played a partially mediating role between negative parenting style and asthma symptom control level（ES=-0.435），with 95%CI（-0.598，-0.254），accounting for 58.8% of the total effect. Conclusion The symptom con-trol of school-age children with asthma is poor. Clinical doctors and nurses should pay attention to the influence of parenting style on children’s symptom control level，guide parents to adopt positive parenting styles，and improve children’s medication compliance，so as to improve their symptom control level.

Objective To assess the current status of exercise perception in elderly patients with chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors. Methods Using a convenience sampling method,207 hospitalized elderly COPD patients from 4 tertiary hospitals in Jinan city from December 2018 to June 2019 were selected as participants. The general information questionnaire,Exercise Benefit/Barriers Scale,Breathlessness Beliefs Questionnaire,Self-efficacy Scale and Social Support Rating Scale were used for investigation. Results The total score of exercise benefits/barriers in 207 elderly COPD patients was (127.34±11.71). Exercise perception was negatively correlated with activity-related fear (r=-0.469,P<0.001),and positively correlated with both self-efficacy and social support (r=0.412,P<0.001;r=0.247,P<0.001). Multiple linear regression analysis revealed that activity-related fear,self-efficacy,social support,and the situation of physical activity prior to COPD were the influlencing factors of exercise perception. Conclusion The level of exercise perception in elderly patients with COPD needs to be improved. Strengthening exercise rehabilitation education and guidance for COPD patients and their families,helping patients eliminate or reduce their fear of physical activity,and improving their self-efficacy and ability to access and utilize social support are beneficial to improve their exercise perception.

Objective To evaluate the effect of threshold-pressure inspiratory muscle training on pulmonary rehabilitation and quality of life in asthma patients by meta-analysis. Methods We searched the Cochrane Library,PubMed,Embase,Web of Science,Wanfang,CNKI,VIP,and CBM databases for randomized controlled trial studies on the effects of inspiratory muscle training on pulmonary rehabilitation and quality of life in patients with asthma. The search time is from the establishment of databases to January 6,2021. After the quality evaluation,meta-analysis was performed using RevMan 5.3 software. Results A total of 10 publications including 456 patients were included,and the meta-analysis showed that threshold-pressure inspiratory muscle training improved patients’ forced vital capacity[SMD=0.90,95%CI（0.68,1.11）,P<0.001],forced expiratory volume in a second[SMD=0.62,95%CI（0.41,0.83）,P<0.001],peak expiratory flow [WMD=0.32,95%CI（0.01,0.62）,P=0.040],maximum voluntary ventilation[WMD=11.89,95%CI（6.42,17.37）,P<0.001],and maximum inspiratory pressure[SMD=29.76,95%CI（18.15,41.36）,P<0.001],reduced their dyspnea[SMD=-0.51,95%CI（-0.95,-0.06）,P<0.001],and increased their 6-min walk distance[WMD=77.13,95%CI（24.58,129.67）,P=0.004]. However,the difference in improving their quality of life was not statistically significant[SMD=1.21,95%CI（-2.11,4.52）,P=0.480]. Conclusion Threshold-pressure inspiratory muscle training can significantly improve patients’ lung function indicators,enhance respiratory muscle strength,reduce dyspnea,and increase 6-min walking distance in asthmatic patients,but the effect in improving quality of life is not significant,and more clinical high-quality studies need to further verify its effectiveness.