Objective To explore the psychological experience of patients undergoing invasive mechanical ventilation weaning exercise after cardiac surgery. Methods The descriptive qualitative research method in qualitative research was used to conduct semi-structured in-depth interviews. From April to September 2022，by purposive sampling，face-to-face interviews were conducted with cardiac surgery patients who met the criteria and their medical staff who were closely related to their weaning exercise in a tertiary hospital in Zhejiang Province. Traditional content analysis was used for data analysis. Results Finally，11 patients，11 nurses and 4 doctors were interviewed. A total of 4 core themes and 13 sub-themes were extracted. These included negative physiological discomfort（physical discomfort，limited self-expression，and urgent desire for extubation），two-way perceived safety and respect（respect and care between nurses and patients，conflicts between patients’ psychological care and nursing safety，and effective assistance of family members by nurses and patients），and gaining a sense of control（maintaining synchronous communication of information，knowing their own weaning status，and establishing patient trust through medical cooperation），looking forward to improving the weaning exercise support system（desire targeted preoperative education，establish effective communication，provide comfortable support，and provide professional process management）. Conclusion There are many problems during the weaning exercise of invasive mechanical ventilation in patients after cardiac surgery. Nurses should pay close attention to the physical and mental state of such patients，regulate their emotions for weaning exercise，pay attention to preoperative education，improve non-verbal communication forms，meet patients’ early extubation，and appropriately combine family forces to promote the weaning exercise process，so as to optimize the weaning exercise strategy.

Objective We aimed to establish an evaluation index system for health education among patients with nasopharyngeal carcinoma（NPC） who are undergoing radio-chemotherapy. As a theoretical basis,this system may be applied by the clinical nurses to carry out targeted health education and guidance among NPC patients undergoing radio-chemotherapy and to evaluate the effect of health education. Methods From March to July 2021,we constituted a structured multidisciplinary research team,including oncologists,nurse specialists,nutritionists,et al,based on the theory of Knowledge-Belief-Practice. Literature review,semi-structured interviews,as well as the Delphi method and Multi-dimensional Analytic Hierarchy Process,were used to establish a framework of the evaluation index system and set weighted value for each evaluation index. Results The response rates of the 2 rounds of expert consultations are 85.0% and 100%.The expert authority coefficients are 0.932 and 0.935,respectively.The total Kendall harmony coefficients of the 2 rounds of expert consultations are 0.235~0.326 and 0.302~0.419（P<0.01）.As a result,we built up an evaluation index system of health education which comprised 3 first-level indexes,19 second-level indexes and 73 third-level indexes for NPC patients undergoing radio-chemotherapy. Conclusion The evaluation index system may provide evidence and a practice tool for clinical nurses in conducting a comprehensive and efficient evaluation of health education among NPC patients undergoing radio-chemotherapy.

To summarize the lung rehabilitation nursing experience of a case of severe diffuse axonal injury with pulmonary contusion. The key points of nursing care include establishing a multidisciplinary lung rehabilitation management team,carrying out personalized respiratory support,using descending step sequential oxygen therapy,giving precise clearance of the respiratory tract,and carrying out early strategies of lung rehabilitation based on the integrated mode of “health,care,rehabilitation,and patient”. With the effort of multidisciplinary team cooperation,the ventilator was removed 12 days after admission. The patient received extubation on the 17th day after admission and got out of bed on the 20th day after admission,and was discharged smoothly on the 37th day after admission. During the 6-month follow-up,the patient recovered well.

Objective To establish an index system of clinical practice training for pain specialist nurses,and to provide references for standard clinical practice training of pain specialist nurses. Methods Guided by the core competence theory,items of clinical practice training indicators were established by literature review and semi-structured interviews,and then 20 experts were invited to participate in a 2-round consultation to retrieve the indicators. Results The positive coefficients of 2 rounds of consultations were 100%. Authority coefficient was 0.881. The Kendall Coordination Coefficients of module indicators,primary indicators,and secondary indicators were 0.512,0.455,and 0.423,respectively（P<0.01）. The finalized index system of clinical practice training for pain specialist nurses included 4 module indicators,5 primary indicators,and 21 secondary indicators. Conclusion The index system of clinical practice training for pain specialist nurses based on core competence is scientific and reliable,which can provide a reference for clinical practice training of pain specialist nurses in China.