Objective To develop an evidence-based practice program for ICU eye care and evaluate its application effect using Stetler model of research utilization. Methods The systematic search was carried out in domestic and foreign guidelines，systematic reviews，evidence summaries，expert consensuses on eye care for ICU patients. The quality of the included literature was evaluated and the evidence was summarized. The evidence based on expert advice，clinical context and stakeholder opinions was screened. According to Stetler model of research utilization，the evidence translation/application was formulated from 3 aspects，including method，level and type of evidence application，and the evidence translation was implemented using a stepwise trial design. Five ICUs in a tertiary hospital in Zhejiang Province were selected，and the order of enrollment of each ICU was determined by computer-generated random numbers from April to september，2022. In the first month，all ICUs were in pre-evidence-based practice period，and in the second month，an ICU was trained and entered the evidence-based practice period. Until the 6th month，all ICUs entered the evidence-based practice period. Then the rate of ocular symptoms and implementation rate of eye care measures were compared before and after EBP. Results A total of 1 540 patients were included. With regard to the implementation rate of eye care measures，the rate of lubricant use and suspected ocular infection management in patients at high risk for ocular complications in evidence-based practice period was significantly higher compared with pre-evidence-based practice period（P<0.001），and no statistically significant difference was found in the rate of eyelid closure. The incidence of conjunctival exposure，subconjunctival hemorrhage，conjunctival congestion，and ocular discharge in non-neurology critical care patients decreased compared with pre-evidence-based practice period（P<0.05），and the incidence of conjunctival edema and conjunctival congestion in NICU patients decreased compared with pre-evidence-based practice period as the intervention continued（P<0.001）. Conclusion Evidence-based practice in eye care for ICU patients using Stetler model of research utilization can standardize the practice of eye care for ICU patients and improve the quality of care.

Objective To develop and test the reliability and validity of a risk perception scale for pregnant women with gestational diabetes mellitus（GDM），and to make a preliminary application. Methods Using the Health Belief Model as a theoretical framework，a first draft of the scale was developed through literature analysis，semi-structured interviews，expert correspondence and a pre-survey. From September to October 2022，276 pregnant women with GDM were recruited from 4 hospitals in Quanzhou City by convenience sampling method to screen entries and test the reliability of the scale. The validation and initial application of the scale structure was completed by recruiting 335 pregnant women with GDM in 3 other hospitals in Quanzhou City from November to December 2022. Results The risk perception scale for pregnant women with GDM contained 4 dimensions and 29 items. Exploratory factor analysis extracted 4 factors with a cumulative variance contribution of 79.93%. The Cronbach’s α coefficient was 0.932；the fold-half reliability was 0.949；the test-retest reliability was 0.757；the content validity was 0.900. The results of the validation factor analysis showed that the scale factor structure was stable. The mean total risk perception score of pregnant women with GDM was 116.53±15.82. Literacy，frequency of internet searches for ways to control blood glucose，and per capita monthly household income were factors that influenced the risk perception of pregnant women with GDM（P<0.05）. Conclusion The risk perception scale for pregnant women with GDM has good reliability and validity，and it can be used as a tool for health care professionals to measure the perceived risk of pregnant women with GDM. The perceived risk of pregnant women with GDM is at a moderate level，and caregivers should pay more attention in the future to pregnant women with GDM who have low literacy，low income and low frequency of participation in GDM-related learning.

Objective To construct a management scheme of nursing assistants in unaccompanied hospitals and explore its application effect. Methods The management team of nursing assistants in unaccompanied hospitals was set up. On the basis of investigating the current situation of nursing assistants’ team management，the management scheme of nursing assistants was constructed by ORTCC management model for references，including 5 parts：determining management objectives，perfecting rules system，building hierarchical training system，checking and assessing，and shaping cultural system. Convenience sampling method was used to select 92 nursing assistants in an unaccompanied hospital in Xiamen，Fujian Province from June 2021 to June 2022 as application subjects. The post competence of nursing assistants and the satisfaction of patients and nurses to nursing assistants were compared before the application of the management scheme（June-December 2021） and after the application（January 2022-June 2022）. Results After the application of ORTCC management model，the total score of post competency of medical nursing assistants increased from[65（64，67）] to [91（90，92）]；the excellent rate of post competency level increased from 1.09% to 67.39%；the satisfaction of patients with nursing assistants increased from 61.99% to 88.62%；the scores of nurses’ satisfaction with nursing assistants in all dimensions were significantly higher than before（all P<0.05），and the overall evaluation was improved from 92.73% to 99.24%. Conclusion The use of the ORTCC management model for nursing assistants can effectively improve their post competence，improve the satisfaction of patients and nurses，and help to further stabilize and develop the medical nursing assistants staff.

Objective To develop the Holistic Human Caring Perception Scale for clinical nurses and to test its reliability and validity. Methods On the basis of documents retrieval and interviews，the pre-test scale was constructed through Delphi method. In April 2022，20 nurses in Wuhan were selected for a pre-survey to test the readability of the scale. From April to May 2022，a total of 501 clinical nurses in hospitals in Xianning and Tai’an were selected as the investigation subjects. Item analysis and reliability and validity test of the scale were conducted. Results The formal holistic human caring perception scale for clinical nurses with 6 dimensions and 40 items was formed. 6 common factors were extracted by exploratory factor analysis and the cumulative variance contribution rate was 79.05%；confirmatory factor analysis showed that the fitting index of the scale structure model was good. The S-CVI of the scale was 0.94 and the I-CVI was 0.78~1.00；the Cronbach’s α coefficient of the scale was 0.98 and the test-retest reliability was 0.87. Conclusion The reliability and validity of the Holistic Humanistic Caring Perception Scale for clinical nurses are good，which can comprehensively reflect the caring perception of clinical nurses.

Objective Meta-analysis was used to evaluate the effect of the solution-focused brief therapy on improving the anxiety and depression status of patients with HIV/AIDS. Methods Computer search of PubMed，Embase，Web of Science，Cochrane Library，CINAHL，PsycINFO，Chinese Biomedical Literature Database，China National Knowledge Infrastructure，Wanfang Database，CQVIP were conducted，and the search time frame was from the establishment of databases until April 9，2023. There were 2 investigators who independently screened the literature according to inclusion and exclusion criteria，extracted data and performed quality evaluation，and performed Meta-analysis using RevMan 5.4 software. Results A total of 11 publications were included，including 9 randomized controlled trials and 2 quasi-experimental studies，with a total of 1 219 patients with HIV/AIDS. Meta-analysis results showed that solution-focused brief therapy reduced anxiety scores（SMD=-1.89；95%CI：-2.79~-0.99，P<0.001），depression scores（SMD=-2.45；95%CI：-3.51~-1.39，P<0.001）. Subgroup analysis showed that improved anxiety（SMD=-4.16；95%CI：-7.97~-0.35，P<0.001），depression（SMD=-5.69；95%CI：-11.20~-0.19，P<0.001）in pregnant HIV/AIDS patients was significantly better than that in ordinary patients. Conclusion Solution-focused brief therapy is effective in improving anxiety and depression levels in patients with HIV/AIDS，and the application of this model in pregnant patients with HIV/AIDS has a more significant improvement effect，but high-quality，multicenter，large-sample clinical trial studies are needed to further confirm this conclusion in the future.

Objective To summarize the best evidence of airway obstruction prevention and management in patients undergoing cervical spinal surgery，and to apply evidence-based nursing practice and evaluate the effects. Methods The best evidence for prevention and management of airway obstruction in patients undergoing cervical surgery was summarized using an evidence-based care approach，and an evidence-based practice protocol was developed. The best evidence application strategy was constructed after baseline review and analysis of barriers，and it was implemented in the department of orthopedics in a tertiary hospital in Hubei Province from August 2020 to December 2021. The knowledge level of nurses about airway obstruction and the implementation rate of the reviewed indicators were compared before and after the application of evidence. Results After the application of best evidence, the implementation rate of 19 review indicators out of 23 significantly improved compared with baseline review（P<0.05）. The score of nurses’ knowledge level of airway obstruction after cervical spine surgery increased from（48.38±9.40） to （53.49±9.67），with a statistically significant difference（P<0.001）. Conclusion The application of the best evidence for prevention and management of airway obstruction after cervical spine surgery can improve nurses’ implementation rate，improve their knowledge level，and ensure patient safety.

Objective To investigate the current status of dyspnea-related kinesiophobia in patients with high-flow nasal cannula oxygen therapy（HFNC） and to analyze the influencing factors. Methods A total of 195 patients were recruited from the Department of Respiratory Medicine，the Central Hospital of Tianjin from November 2021 to August 2022. General data questionnaire，Chinese version of the Breathlessness Beliefs Questionnaire，Self-efficacy for Exercise Scale and Charlson comorbidities index were used for investigation. Univariate analysis and Logistic regression were performed to analyze the influencing factors. Results The patients had a high degree of kinesiophobia，and Breathlessness Beliefs Questionnaire score of the 195 patients was（41.63±7.60）. Among them，the fear of dyspnea score is （17.73±4.30），and the fear of activity score is（24.10±4.13）. Logistic regression analysis showed that age，course of disease，regular physical exercise，exercise self-efficacy and Charlson comorbidities index were the influencing factors of dyspnea-related kinesiophobia in HFNC patients. Conclusion The patients had a high degree of kinesiophobia. Clinical nursing staff can develop intervention measures to promote them to participate in physical activities and exercise to improve their exercise endurance and quality of life.

Objective To explore effect of an intervention program based on co-parenting theory. Methods By judgment sampling method，90 parents of premature infants and their parents admitted to neonatal intensive care unit in a tertiary A hospital in Yangzhou，Jiangsu Province from June to December 2021 were selected as the research subjects. They were divided into a control group and an experimental group with 45 pairs in each group. In addition to routine nursing，the experimental group received co-parenting breastfeeding support based on co-parenting theory. The control group only adopted routine nursing. The 2 groups of premature infants were measured by mothers’ perception of co-parenting，family support for breastfeeding，breastfeeding attitudes，breastfeeding rate and duration of exclusive breastfeeding before discharge，2 weeks，4 weeks and 6 weeks after discharge. Results 12 pairs of preterm infants dropped，and 38 pairs were included in the experimental group and 40 pairs in the control group at last. Scores of mothers’ perception of co-parenting，family support for breastfeeding，breastfeeding attitudes in the experimental group were higher than those in the control group 2 weeks，4 weeks and 6 weeks after discharge，and the difference was statistically significant（P<0.05）. The exclusive breastfeeding rate of the experimental group was higher than that of the control group 4 weeks and 6 weeks after discharge（P<0.05）. The duration of exclusive breastfeeding after discharge in the experimental group was higher than that in the control group，and the difference was statistically significant（P=0.003）. Conclusion The breastfeeding support program based on co-parenting theory implemented in NICU hospital-family transitional period of preterm infants can improve mothers’ perceptions of co-parenting，perceptions of breastfeeding family support and attitudes towards breastfeeding，increase exclusive breastfeeding rates and extend the duration of exclusive breastfeeding.

Objective To retrieve,evaluate and summarize the evidence related to blood collection via central venous access devices for clinical references. Methods Systematic search was conducted in related websites and databases. The search period was from the establishment of the databases to December 7,2021,and the clinical decisions,systematic reviews,guidelines,evidence summaries,and expert consensuses were included. The quality of the literature was independently evaluated by evidence-based trained investigators and combined with professional judgment to extract information from the literature that met the quality standards. Results A total of 7 articles were included,including 6 guidelines and 1 systematic review. The best evidence included a total of 27 pieces of evidence in 4 areas,namely training of health care personnel,blood collection methods,collection of special samples,and quality control strategies for blood collection. Conclusion In the process of evidence transformation,medical staff should comprehensively consider the clinical contexts and individual factors of patients,and choose the best evidence,optimize the clinical behavior of blood specimen collection through central venous access devices,so as to improve the standardization and safety of blood specimen collection.

To conclude the nursing experience of a case of pregnancy with myasthenia gravis pre-crisis state. Main nursing points include：to strengthen the observation，early identification of myasthenia before crisis state，to strengthen incentive care for the prevention of myasthenia crisis；to conduct phased implementation of respiratory rehabilitation nursing；to strengthen health guidance to prevent disease recurrence. The patient was hospitalized for 29 days，with no occurrence of myasthenia crisis. The dyspnea was significantly improved，and the patient recovered and was discharged.

Objective To explore the experience and feelings of school-age obese children with asthma and their parents on fear of physical activity based on fear-avoidance model，in order to provide a basis for the construction of targeted exercise intervention programs for children with asthma. Methods From October 2021 to January 2022，the purposive sampling was used to select 13 cases of school-age obese asthmatic children and their parents for semi-structured in-depth interviews in the pediatric asthma outpatient department of a tertiary A hospital in Yangzhou City. Data was analyzed by Colaizzi phenomenon analyzing methods. Results Combined with the fear-avoidance model，3 themes are summarized，including the unscientific cognition of physical activity（physical activity can induce a variety of uncomfortable symptoms；parents can’t tell if discomfort after physical activity is an acute attack of asthma；some parents are over-alert to obesity and force children to physical activity）；the way to deal with the fear of physical activity（children actively avoid physical activity；parents limit children’s physical activity）；the adverse consequences of fear of physical activity（the increasing sedentary behavior affects the exercise endurance of children，further aggravating their obesity and fear of physical activity；communication between children and peers was reduced，triggering a sense of inferiority，further aggravating the fear of physical activity）. Conclusion The experience and feelings of fear of physical activity in school-age children with obesity and asthma and their parents were more complex with some unscientific cognitions. In clinical practice，measures should be taken to improve the cognitive level of children and their parents on appropriate and moderate physical activity，avoid excessive vigilance on exercise，reduce fear of physical activity，and promote scientific physical activity in children.

Objective To evaluate the application of "Internet+" early rehabilitation training in high-risk patients with exercise rehabilitation after percutaneous coronary intervention（PCI），and to evaluate its effect. Methods The convenience sampling method was employed to choose PCI patients at high risk of postoperative exercise rehabilitation as the research subjects from the cardiology department of a tertiary A hospital in Zhejiang province，among which 30 cases in March to April，2022 were allocated into the experimental group. The research team formulated and implemented the “Internet+” platform combined with the early rehabilitation training program based on the standard theory through literature review and expert meetings. 30 patients admitted from January to February 2022，were allocated into the control group，and they received routine offline cardiac rehabilitation training. The compliance of offline rehabilitation training，the incidence of adverse events and quality of life in the process of rehabilitation training were compared between the 2 groups after intervention，and the online reading compliance and satisfaction with the use of “Internet+” rehabilitation training platform in the experimental group were evaluated. Results There were 2 cases dropped out from the experimental group，and 4 cases from the control group，and finally there were 28 cases in the experimental group and 26 cases in the control group. After 7 days of intervention，the offline compliance of the experimental group was higher than that of the control group，and the difference was statistically significant（P<0.001）. There was no significant difference in the incidence of adverse events and quality of life between the 2 groups during rehabilitation training（P>0.05）. In the experimental group，the total reading volume of the online platform was 875 times；the total number of articles was 326 times；the active number was 369 times. The reading rate of the patients was 88.35%；the reading time was 14.8 minutes. The overall satisfaction of cardiology nurses and patients in the experimental group with the online platform was（2.69±0.47），（2.79±0.42）points，respectively. Conclusion “Internet +” early rehabilitation training can effectively im-prove the rehabilitation compliance and quality of life of high-risk patients with postoperative exercise rehabilitation after PCI.

Objective To search，summarize and evaluate the best evidence of exercise training in patients with peripheral arterial disease（PAD），which could further provide evidence-based medical bases for clinical exercise training intervention in patients with PAD. Methods All evidence on exercise training in patients with PAD were retrieved from UpToDate，Society for Vascular Surgery（SVS） website，European Society for Vascular Surgery（ESVS） website，Cochrane Library，PubMed，Springer Link，Embase，Cumulative Index to Nursing and Allied Health Literature（CINAHL），Med-live website，Chinese Society of Vascular Surgery，the Chao-Xing journal database，China National Knowledge Infrastructure（CNKI），Wan-Fang database，and other Chinese and foreign technological journal databases. Evidence was obtained from guidelines，clinical decisions，expert consensuses，evidence summaries，systematic evaluation，and meta-analysis. The retrieval time limit was from the establishment of databases until July 1，2021. There were 2 researchers who evaluated the literature quality and extracted the data. Results A total of 14 articles were included in the present analysis. A total of 20 pieces of best evidence were extracted from 7 aspects，including exercise safety，exercise timing，exercise mode，exercise intensity，exercise time，effect evaluation，and tips. Conclusion The exercise training could improve the walking ability and the quality of life of PAD patients. Thereby，it is recommended that exercise training intervention should be conducted while ensuring safety. The evidence summary process of this study is rigorous and comprehensive. In clinical practice，the medical staff should consider the actual application environment and individual situation of patients when using the evidence.

Objective To develop a Self-Management Behavior Assessment Scale for Lung Cancer Survivors in China，and to test its reliability and validity. Methods Guided by the self-management theory，on the basis of literature analysis and semi-structured interviews，the first draft of the scale was formed through the Delphi expert enquiry，group discussion and preliminary investigation. From April to October 2021，564 lung cancer survivors from a tertiary A hospital and a tumor hospital in Zhejiang province were selected to conduct the questionnaire survey，in order to test the reliability and validity of the scale. Results The formal scale includes 6 dimensions and 47 items in daily life management，symptom management，follow-up management，information and resource management，emotional management and hope management. The total Cronbach’s α coefficient of the scale was 0.950，and the split-half reliability was 0.756. The content validity score was 0.966，and the structure validity KMO was 0.926，and a total of 6 common factors were extracted，which could explain 63.546% of the total variation. Conclusion The Self-Management Behavior Assessment Scale of Lung Cancer Survivors developed in this study has good reliability and validity，and it is suitable for the assessment of self-management behavior of lung cancer survivors.

Objective To construct a scientific and practical training system for cardiac rehabilitation nurses,and to provide references for the training of cardiac rehabilitation nursing talents. Methods Based on Taylor’s model,the training system of cardiac rehabilitation nurses was preliminarily drawn up based on literature review and focus group discussion. Delphi expert inquiry method was used to conduct 2 rounds of expert inquiry by 20 experts in the field. Results The effective recovery rate of 2 rounds of expert letter inquiries was 100%,and the authoritative coefficient of the second round of letter inquiries to experts was 0.925. The final established cardiac rehabilitation nurse training system includes 4 parts,namely training objectives,training content,training management,and assessment and evaluation. Among them,training objectives include 3 first-level indicators and 22 second-level indicators;training content includes 15 first-level indicators and 73 second-level indicators;training management includes 6 first-level indicators and 11 second-level indicators;assessment and evaluation include 3 first-level indicators and 10 second-level indicators. Conclusion The construction process of cardiac rehabilitation nurses training system is scientific and reasonable,which can provide references for cardiac rehabilitation nurse training.

Pre-exposure prophylaxis refers to a biological prevention method to reduce the probability of HIV infection by taking drugs when people are at high risk of HIV infection. Medication compliance is the key cause of determining the effectiveness of pre-exposure prophylaxis. This article discusses the medication compliance assessment tools of pre-exposure prophylaxis developed at home and abroad which includes the main contents of assessment tools,application status and advantages and disadvantages,expecting to provide references for accurately evaluating medication compliance of high-risk population of AIDS and formulating intervention programs.

Objective To develop the questionnaire of community nursing needs assessment tool for middle and advanced Parkinson’s disease and to test its reliability and validity. Methods Based on Maslow theory of hierarchical needs and Johnson behavior theory,using literature review,semi-structured interviews and Delphi,the primary questionnaire was initially formulated on community nursing needs for middle and advanced Parkinson’s disease,and the questionnaire was adjusted and revised through pre-survey. 400 patients with middle and advanced Parkinson’s disease in Chongqing from March to October 2021 were investigated in the form of face-to-face survey,and the reliability,validity and needs were further analyzed. Results The community nursing needs questionnaire for middle and advanced Parkinson’s disease contains 39 items in 6 dimensions,including daily life care needs,fall prevention needs,autonomic dysfunction needs,emotional support needs,disease treatment needs and continuing care needs. The Cronbach’s α coefficients of the questionnaire was 0.922,and the split-half reliability of the questionnaire was 0.702. The total content validity index of the questionnaire was 0.907 and each item ranged from 0.78 to 1.00 Exploratory factor analysis extracted 6 main factors and the cumulative variance contribution rate was 68.952%. Confirmatory factor analysis showed that the model fit well and the factor structure was stable. Conclusion The questionnaire has good reliability and validity,which can be used as a specific tool to comprehensively reflect the needs of patients for community nursing support,and it can also be used as an auxiliary tool for dynamic evaluation of disease symptom control to guide nurses to carry out health assessment,management and education.

Objective We searched,evaluated and integrated the best evidence of patients’ identification,so as to provide bases for formulating the management standards of patients’ identification. Methods According to the "6S" model,we used the evidence-based nursing method to search the relevant literature. Johns Hopkins evidence classification system was used to grade the evidence,and we also used AGREEⅡ（2017 version） and JBI evidence-based health care center’s document quality evaluation standard and evidence recommendation system（2014 version） to evaluate the quality of various studies and the level of evidence recommendations. Results A total of 23 articles were included,including 3 guidelines,1 clinical decision-making,8 expert consensuses,4 recommended practices,3 evidence summaries,1 systematic evaluation,2 government reports and 1 hospital standard. Finally,42 pieces of best evidence are summarized. Conclusion The leaderships of medical institutions should manage the patients’ identification scientifically according to the actual conditions of different places and hospitals. They should focus on controlling the timing of identification,strengthening the management of special groups and strengthening the quality control. Meantime,the application personnel also need to continuously update the evidence to improve the hospital safety management by applying the best evidence.

Objective This study aims to implement the best evidence of early mobilization in maternal women after cesarean in China’s clinical settings and to evaluate the effectiveness of the evidence-based nursing protocol.Methods The Evidence-based Continuous Quality Improvement Framework was used as the conceptual model. The process consisted of 4 steps including evidence acquisition,baseline evaluation,evidence introduction,and after-effect evaluation. From February 2019 to January 2020,an interruption time series design was applied in postpartum women to assess the changes of length of out-of-bed mobilization,24-hour out-of-bed rate,incidence of intestinal obstruction,and length of post-operative hospitalization.Results We finally included 8 pieces of evidence in protocol. The percentage of people with a pain score of <3 increased from 74.37% to 83.68%（ χ ²=1.77,P=0.041）;The length of out-of-bed mobilization decreased from 31.89±9.50 hours to 20.01±4.65 hours（t=11.48,P<0.001）. The 24-hour out of bed rate increased from 30.94% to 91.21%（ χ²=17.28,P<0.001）;the incidence of intestinal obstruction decreased from 5.31% to 1.70%（ χ²=2.17,P=0.015） and the average days of postoperative hospital stay decreased from 5.06±1.99 days to 3.51±0.99 days（t=10.74,P<0.001）.Conclusion The best evidence-based practice can promote early mobilization in maternal women after cesarean section,reduce the incidence of intestinal obstruction effectively,and shorten hospital stay significantly.

Objective To investigate the current situation of implant use and management in 1225 hospitals in China,and to analyze the existing problems,so as to provide references for the standard management of perioperative implants,and lay a research foundation for the formulation of relevant standards. Methods In May 2021,stratified sampling method was adopted to select operating room management personnel from 1225 hospitals in China. The persons in charge were set in the provinces,autonomous regions and municipalities directly under the central government. All the persons in charge were members of the surgical equipment and materials professional group of Nursing Equipment and Materials Branch of China Medical Equipment Association. Questionnaires were made through the Questionnaire Star and distributed and collected through the WeChat group. A self-designed questionnaire was used,including general information and “Questionnaire on Current Situation of Use and Management of Perioperative Implants”. Results In terms of implant management mode,there were mainly 3 modes,namely three-level management of the equipment department,operating room and specialist group（72.73%）,on-board management of the equipment department（12.24%）,and self-management of the clinical use department（10.69%）. There were great differences among different types of hospitals. In terms of receiving foreign devices and implants,there are still some problems,such as late delivery of suppliers and non-standard charges. In terms of implant traceability management,68.90% introduced an information system to trace the use of implants;62.29% carried out information traceability of the cleaning,disinfection and sterilization process of foreign instruments and implants;48.89% carried out scanning charge and traceability management of implants,indicating that information construction needs to be strengthened. In addition,there are many problems and safety risks in the treatment of unused implants after removal or unpacking and related training,which need to be improved. Conclusion Relevant departments and managers should improve the relevant system and process management according to the scale and actual conditions of different hospitals,strengthen the supervision of implant access,and the whole process information tracing management. Relevant standards should be established in time for non-use of implants after removal and unpacking,so as to fill the management gaps. Supervision over the implementation of existing standards should be strengthened.

Objective An early motor rehabilitation nursing program for stroke patients based on Modified Barthel Index（MBI） grading was constructed to guide clinical nurses to perform precise early motor rehabilitation for stroke patients,in order to provide a basis for developing guidelines for rehabilitation nursing care of stroke patients.Methods Based on literature review and expert meetings,a draft of motor rehabilitation nursing program for stroke patients was constructed. The Delphi method was used to conduct 2 rounds of expert consultations to determine the early rehabilitation nursing program for stroke patients.Results In the first round,17 experts were consulted,and the response rate was 94.12%;in the second round,16 experts were consulted,and the response rate was 100%. The expert authority coefficient was 0.90. After 2 rounds,the coefficient of variation of items was 0 to 0.24,Kendall’s coefficient was 0.226（P<0.001） and the importance value was 4.13 to 5.00. Finally,an early motor rehabilitation nursing program classified by MBI was formed,including 5 first-level indicators（fully dependent,heavily dependent,moderately dependent,mildly dependent and basic self-care） and 47 second-level indicators（rehabilitation）.Conclusion The nursing program constructed in this study is reliable and scientific,and it can provide references for the research and practice of rehabilitation training for stroke patients.

Objective To explore and evaluate the effects of attention and interpretation therapy on resilience and anxiety and depression for patients with gastrointestinal cancer. Methods Totally 94 cases of gastrointestinal cancer patients from a tertiary hospital in Ningxia were assigned into the experimental group（n=47） and the control group（n=47）,and 2 groups of patients were both given routine nursing. On the basis of this,the experimental group was given attention and interpretation therapy for 10 weeks,the control group was given progress relaxation exercises. At the end of the intervention,patients were assessed with the self-made patient training compliance scale. Before intervention,at the end of intervention and 3 months after intervention,the effects were evaluated by CD-RISC,SAS and CMQ. Results The training compliance of the experimental group was significantly higher than the control group（P<0.05）. There were statistically significant differences in the score of resilience,anxiety and depression between 2 groups （P<0.05）. There was statistical significance between the score of each dimension of the resilience scale and the total score of it in the 2 groups（P<0.05）. The time effect,treatment effect and the interactive effect of time and treatment in the total score of CD-RISC and its each dimension were statistically significant（P<0.05）. The total score of anxiety and depression was significantly different between the two groups（P<0.05）. The time effect,treatment effect and the interactive effect of time and treatment in the total score of anxiety and depression had statistical significance（P<0.05）. Conclusion Attention and interpretation therapy can effectively improve the resilience level of patients with gastrointestinal cancer and alleviate anxiety and depression.

Objective To select better glucose fluctuation parameters to evaluate the fluctuation of blood glucose in patients with stress hyperglycemia after coronary artery bypass graft（CABG）,in order to detect and intervene early and improve nursing quality.Methods The clinical data of 200 patients with stress hyperglycemia who underwent CABG in a tertiary hospital from January 2017 to October 2018 were collected. Peripheral blood glucose was measured within 72 hours after surgery,once every 4 hours. Differences in complication rates under different baseline characteristics were compared,the correlation between different blood glucose fluctuation parameters and postoperative complications was compared,and glycemic instability index（GLI） for predictive value of the risk of complications after coronary artery bypass grafting was determined using the receiver operating characteristic curve.Results GLI₁,GLI₂ and GLI_3d in patients with stress hyperglycemia after CABG were significantly associated with postoperative single complications and risk of complications（P<0.05）. GLI₁,GLI₂ and GLI_3d all predicted postoperative complications,and GLI₁ had the best predictive effect.Conclusion GLI₁,GLI₂ and GLI_3d are better evaluation parameters of blood glucose fluctuation in patients with stress hyperglycemia after CABG,which can predict the risk of postoperative complications to some extent. In particular,GLI₁ can prompt early intervention in blood glucose fluctuation,to reduce the occurrence of complications.

Objective To analyze the related factors of abuse tendency among caregivers of elders with dementia in long-term care facilities,and to construct a risk assessment model,so as to provide evidence for early identification of abusive population in high-risk and formulation of intervention measures to prevent elder abuse.Methods A total of 307 caregivers of elders with dementia in 8 long-term care facilities were conveniently sampled and investigated from July to December 2018 by general information survey questionnaire,the Caregiver Abuse Screen for the Elderly(CASE),Neuroticism Extraversion Openness Five-Factor Inventory(NEO-FFI),Simplified Coping Style Questionnaire(SCSQ),Positive Aspects of Caregiver(PAC),General Health Questionnaire(GHQ-12).Results Self-rated difficulty of care and care recipients’ psycho-behavioral symptoms were the risk factors of abuse tendency among caregivers(OR=8.668,4.412). The protective factors of abuse tendency among caregivers were their agreeableness and openness(OR=0.888,0.940). The risk assessment model was Y=15 × X₁+10 × X₂-8 × X₃-4 × X₄(X₁：self-rated difficulty of care;X₂：psycho-behavioral symptoms;X₃：agreeableness;X₄：openness). The area under ROC curve was 0.856,the sensitivity was 81.0%,the specificity was 68.2%,the total coincidence rate was 74.6%. Hosmer-Lemeshow goodness of fit test showed that P=0.515 and the model fit was good.Conclusion Various related factors are involved in the occurrence of caregivers’ abuse tendency. The risk assessment model is effective in predicting caregivers’ abuse tendency,and has certain clinical application value.

Objective To explore the effects of improvement in timing of medication administration in patients with pain after liver cancer embolization.Methods A total of 160 patients underwent liver cancer embolization were divided into the intervention group and the control group according to random number table method with 80 cases in each group. In the intervention group,the daily medication administration time was set at 15：00 and 21：00,the time was set at 9：00 and 15：00 for the control group. The incidence of pain occurred in different time periods within 24 hours and pain control satisfaction after liver cancer embolization were recorded.Results Incidence of pain decreased in the intervention group（P<0.05）,satisfaction of pain control was significantly improved in the intervention group（P<0.05）.Conclusion Improvement in timing of medication administration is helpful for pain management in patients after liver cancer embolization.

Objective To investigate the effect of sequential sputum excretion scheme on pulmonary tuberculosis patients treated with mechanical ventilation. Methods Forty-five pulmonary tuberculosis patients with mechanical ventilation were selected as the experimental group from January to December 2018,and received sequential sputum excretion scheme;while 44 patients were recruited as the control group from January to December 2017 receiving routine sputum management. Breathing rate,mean arterial pressure,blood oxygen saturation,arterial oxygen partial pressure,artery oxygenation index,CO ₂ partial pressure,airway peak pressure value,the amount of sputum drainage,effect of sputum excretion,incidence of ventilator-associated pneumonia,length of mechanical ventilation,length of ICU stay,and success rate of ventilator weaning were compared between two groups. Results After 24 hours of intervention,there was significant difference in breathing rate and no significant difference in mean arterial pressure fluctuation before intervention in two groups,but blood oxygen saturation,arterial oxygen partial pressure and oxygenation index in the experimental group were higher than those in the control group and before intervention（ P<0.05）. After intervention,the peak airway pressure and arterial CO ₂ partial pressure in the experimental group were significantly lower than those in the control group and before intervention（ P<0.05）. After 24 hours of intervention,the daily sputum excretion in the experimental group（29.48±4.54） ml was significantly higher than the control group（12.56±2.287） ml（ P<0.001）. After 7 days of intervention,the effect of sputum excretion in the experimental group was better than the control group（ P<0.05）. Compared with the control group,the incidence of ventilator-associated pneumonia,the length of mechanical ventilation and the length of ICU stay in the experimental group were lower and shorter,and the success rate of ventilator weaning was higher（ P<0.05）. Conclusion Sequential sputum excretion scheme can promote the discharge of sputum in pulmonary tuberculosis patients with mechanical ventilation,improve pulmonary function and quality of life,shorten length of stay in ICU and reduce medical burden.