Objective To explore the effect of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention in patients with autoimmune liver disease of liver depression and spleen deficiency type. Methods 74 patients with autoimmune liver disease of liver depression and spleen deficiency type who were admitted to the hepatology department of a tertiary hospital from January 2021 to February 2022 were selected as research subjects，and they were divided into an experimental group and a control group by a random number table with 37 cases in each group. The control group was given routine treatment and nursing care，as well as Traditional Chinese Medicine’s emotional nursing. The experimental group received Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention on the basis of routine treatment and nursing care，with an intervention period of 4 weeks. The Generalized Anxiety Disorder Scale （GAD-7），Patient Health Questionnaire Depression Scale （PHQ-9） and Pittsburgh Sleep Quality Index（PSQI） were used to evaluate patients within 24 hours after admission and after 4 weeks of intervention. Results A total of 72 patients completed the study，with 36 in the experimental group and 36 in the control group. Before and after intervention，the scores of GAD-7，PHQ-9，and PSQI in the experimental group were compared，and the differences were statistically significant （P<0.001）. After the intervention，the GAD-7 score in the experimental group was （7.89±3.15），which was lower than （10.14±4.41） in the control group. The PHQ-9 score was （12.33±4.08） in the experimental group，which was lower than （14.64±5.34） in the control group. The PSQI score was （12.39±3.06） points，which was lower than （14.22±3.37） in the control group，and the differences were statistically significant （P<0.05）. Conclusion The application of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional guidance intervention can effectively improve the sleep quality and help alleviate negative emotions in patients with liver depression and spleen deficiency type of autoimmune liver disease.
Objective To investigate the current status of nurses’ knowledge，attitude and practice regarding sleep management of critically ill children in pediatric ICU，and to analyze its impact factors. Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child’s sleep management were used. In March 2023，902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method，and the impact factors were analyzed using multiple stepwise linear regression. Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00%. Nurses in pediatric ICU scored（33.71±7.76） in knowledge dimension，（37.38±4.86） in attitude dimension and（80.60±16.78） in practice dimension，with a total score of（151.78±24.27）. The scores of knowledge and attitude，knowledge and practice，attitude and practice are all positively correlated （r=0.393，P<0.001；r=0.495，P<0.001；r=0.320，P<0.001）. The results of multiple stepwise linear regression analysis showed that gender，region，whether they had received sleep management training were the influencing factors of pediatric ICU nurses’ total score of knowledge，attitude and practice towards children’s sleep management（P<0.05）. Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children，but their knowledge and practice levels need to improve. Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management，develop scientific sleep management plans，and guide nurses to make reasonable evaluation and interventions to improve children’s sleep quality.
Objective To illuminate the benefit finding experience of maintenance hemodialysis patients，and to provide a reference for promoting their mental health. Methods From March to May 2023，the purposive sampling was used to select 13 maintenance hemodialysis patients in a tertiary hospital in Shanghai for semi-structured interviews. The data were organized with the help of Nvivo software，and the Colaizzi’s seven-step method was used to analyze the data. Results 3 themes were extracted：①the search of meaning，including approved hemodialysis，the desire to live；②gaining a sense of mastery，including adjusting self-psychology，developing healthy living habits，and learning hemodialysis related behavior management；③self-enhancement，including excavating external resources and affirming self-worth. Conclusion Maintenance hemodialysis patients have benefit finding experience in many aspects. Medical staff can guide patients to carry out positive psychological construction by strengthening disease knowledge education，building a psychological mutual assistance platform，forming a multidisciplinary nursing team，excavate and provide effective social support resources，and cultivate patients’ self-health management，so as to improve the level and ability of benefit finding of patients，experience positive incentives，promote physical and mental health，and improve the quality of life of hemodialysis patients.
Objective To retrieve，appraise and integrate the relevant evidence of non-pharmacological sleep management measures in critically ill children. Methods We conducted a systematical search on the topic of non-pharmacological sleep management measures in critically ill children across multiple databases，including BMJ best practice，UpToDate，International Guidelines International Network，National Institute for Health and Care Excellence，Scottish Intercollegiate Guidelines Network，Registered Nurses’ Association of Ontario，Joanna Briggs Institute Library，the American Academy of Sleep Medicine，International Pediatric Sleep Association，CNKI，WanFang database，VIP database，SinoMed，Cochrane Library，PubMed，Web of Science，and CINAHL. The literature retrieval time limit was from the establishment of the database to February 2023. The study design includes clinical practice guideline，evidence summary，clinical decision-making，expert consensus，and systematic review. The evidence was extracted and summarized according to the subject after the independent literature quality evaluation by 2 researchers. Results 10 relevant pieces of literature were identified，including 2 guidelines，1 consensus statement，4 systematic reviews，2 evidence summaries，and 1 top clinical decision. These sources provided a total of 28 pieces of evidence across 5 key themes，including sleep assessment，management principles and education，environmental management and sleep promotion. Conclusion This study summarizes the best available evidence on non-pharmacological sleep management measures in critically ill children. It is recommended that healthcare professionals should consider the clinical context when implementing evidence-based interventions，aiming to reduce nocturnal awakenings，extend sleep duration，and improve sleep quality in critically ill children.
Objective To develop an evidence-based，localized practice protocol for the interhospital transfer of critically ill children. Methods Through a comprehensive evidence summary and semi-structured interviews，a preliminary inter-hospital transfer practice protocol for critically ill children was formulated. A panel of 31 experts from 12 hospitals in China participated in 2 rounds of expert correspondence between May and July 2022，facilitating meticulous revision of the protocol entries. Results The response rate for both rounds of questionnaires was 100%，and the expert authority coefficients ranged from 0.926 to 0.931. In the second round of consultation，the coefficient of variation for the importance score of each entry ranged from 0.036 to 0.226，and the Kendall’s W was determined to be 0.201（P<0.001）. Additionally，the coefficient of variation for the feasibility score of each entry fell within the range of 0.070 to 0.314，with Kendall’s W of 0.124（P<0.001）. Ultimately，the final interhospital transfer protocol for critically ill children comprised 8 level Ⅰ entries，16 level Ⅱ entries，and 75 level Ⅲ entries. Conclusion The interhospital transfer protocol constructed in this study is grounded in scientific evidence and exhibits practical feasibility. It serves as a valuable reference for organizing and implementing interhospital transfers of critically ill children.
Objective To investigate the cognition,attitude and practice of pediatric ICU nurses on daily sedation interruption（DSI）,and to provide references for clinical training. Methods Convenience sampling was used to conduct a questionnaire survey among 298 pediatric ICU nurses in 7 tertiary A children hospitals in China in July 2021. The general information questionnaire,questionnaires of knowledge,attitude,and behavior on DSI were self-designed. Results In terms of the cognition of 298 pediatric nurses on DSI,their knowledge score was 4（2,4） out of 10,and a total of 157 nurses（52.68%） said they did not know well or had never heard of DSI. In terms of attitude,their recognition score was 32（27,34） out of 40,and 217 nurses（72.82%） were willing to implement DSI,and 258 nurses（86.58%） wanted systematic training. In practice of nurses,221（74.16%） have not received relevant training,and 159 nurses（53.35%） never or rarely performed DSI. Conclusion Pediatric ICU nurses have a poor grasp of knowledge on DSI,while their recognition toward DSI is high. Their practice needs to be strengthened. Nursing managers should pay full attention to the training needs of pediatric ICU nurses and carry out systematic training on DSI basic knowledge and practical skills,so as to improve DSI practice level of nurses.
Objective To develop a data table system for monitoring the quality of pediatric intravenous infusion process and to evaluate its clinical effectiveness. Methods The data table system was designed to monitor the whole process of intravenous infusion by automatically capturing data from administration,inspection to completion,followed by the generation of personal digital assistant（PDA） scan identification data table and infusion inspection data table. The data table system was put into use since December,2020 in a tertiary children’s hospital in Shanghai. Data collected from October to November,2020 were compared with that from March to April,2021 in terms of PDA scanning rates at the beginning and end of intravenous administration,qualified rate of the number of intravenous infusion inspection,and accuracy rate of intravenous infusion inspection timing. The Effectiveness Evaluation Scale of Clinical Nursing Information System was used to evaluate nursing managers’ satisfaction. Results The PDA scanning rate at the beginning of intravenous administration was improved from 96.76% to 99.96%（P<0.001）;the PDA scanning rate at the end of intravenous administration was improved from 97.88% to 98.82%（P<0.001）;the qualified rate of the number of intravenous infusion inspection was improved from 57.96% to 66.85%（P<0.001）;the accuracy of intravenous infusion inspection time was improved from 95.68% to 96.79%（P<0.001）. The satisfaction score of nursing managers with the data table system was（95.25±0.08）. Conclusion The development of the data table system could help nursing management departments facilitate the use of the clinical data in order to continuously improve the nursing quality and nurses’ behavior. With the help of information service,the data table system for monitoring nursing quality provided a better user experience.
Objective This study explored the application effects of a self-designed arteriovenous fistula operating table. Methods The self-designed arteriovenous fistula operating table includes 5 parts with an instrument panel，a hand support component，a stand bar，a base and omni-directional wheels.A total of 120 patients undergoing the arteriovenous fistula surgery in a tertiary hospital from January to December 2021 were selected as the research subjects. They were numbered according to the order of surgical scheduling，and they were divided into an experimental group and a control group by a random number table with 60 cases in each group. The experimental group used a self-designed arteriovenous fistula operating table for the operation，and the control group used the traditional operating table. Time for skin disinfection，and the satisfaction of patients and medical staff with the arteriovenous fistula operating table in 2 groups were observed and compared. Results The skin disinfection time of the patients in the experimental group was lower than that in the control group，and the difference was statistically significant（t=-11.936，P<0.001）. The patients in the experimental group were more satisfied with the arteriovenous fistula operating table in terms of favorable supporting，comfort，time-saving and effort-saving than the patients in the control group，and the difference was statistically significant（Z=-4.421，-3.235，-4.449，P<0.05）.The medical staff of the experimental group were more satisfied with the arteriovenous fistula operating table in terms of disinfection，convenient operation，saving time and saving effort than the control group，and the difference was statistically significant（Z=-4.861，-2.709，-4.464，P<0.05）. Conclusion The arteriovenous fistula operating table is convenient to operate，favorable for patients’ supporting，time-saving and effort-saving，which can help to improve the comfort and satisfaction of patients with arteriovenous fistula surgery，and improve the work efficiency of medical staff.
Objective To understand the current status and analyze the factors affecting the self-management motivation of patients recovering from nasopharyngeal carcinoma（NPC） after simultaneous radiotherapy. Methods From January to June 2021,223 patients who were followed up in the radiotherapy department of a tertiary A hospital in Nanning City during the recovery period after synchronous radiotherapy for NPC were selected as the study subjects. They were investigated using the General Information Questionnaire,Positivity Scale,Self-Regulation Fatigue Scale,and Disease Acceptance Scale,and the factors influencing the self-management positivity of patients during the recovery period after synchronous radiotherapy for NPC were analyzed using univariate analysis and multiple linear regression. Results The positivity score of patients in the recovery period after simultaneous radiotherapy for NPC was （59.78±13.58）,which was at a moderate level. The results of multiple linear regression analysis showed that patient literacy,self-regulation fatigue,and disease acceptance were factors influencing the self-management positivity of patients in the recovery period after simultaneous radiotherapy for NPC（P<0.05）. Conclusion There is an urgent need to focus on the current status of patient motivation during the recovery period after simultaneous radiotherapy for NPC. It is necessary to develop a systematic and effective intervention strategy for motivation during the recovery period,to take into account patients’ literacy,self-regulation fatigue,and disease acceptance in a comprehensive manner.
Objective To construct an early progressive exercise program for critically ill children,and to verify its effect. Methods Combining the theoretical framework derived from post-intensive care syndrome in pediatrics（PICS-p） and literature review,under 2 rounds of expert consultations from January to February 2021,an early progressive exercise program was established for critically ill children. To evaluate the safety and intervention effects of the program,the preliminary application was carried out in 5 critically ill children admitted to a tertiary children’s hospital in Shanghai in March 2021. Results The active and authority coefficient were 100% and 0.82;the importance and feasibility score of each item were all >3.5;the variation coefficients were <0.25;the Kendal harmony coefficients were between 0.312 and 0.330（P<0.001）. The final draft of the early progressive exercise program for critically ill children included 3 first-level items,10 second-level items,and 28 third-level items. The preliminary application results showed that no adverse events occurred during the implementation of the program,and the difference of biceps brachii cross-sectional area in the experimental group was smaller than that in the control group （P=0.047）. Conclusion The early progressive exercise program for critically ill children is scientific,reliable,safe,and feasible,but its clinical effect needs to be further verified by a larger sample size.
Objective To develop a recurrence risk perception scale for patients with ischemic stroke and to test its reliability and validity. Methods With the risk perception theory and health belief model as the theoretical framework,the initial scale was developed through literature analysis,qualitative interviews,and expert consultation. A questionnaire survey was conducted on 430 patients with ischemic stroke who were treated or reviewed in a tertiary hospital in Xi’an from June 2020 to October 2021 to test the reliability and validity of the scale. Results The recurrence risk perception scale for patients with ischemic stroke included 25 items in 4 dimensions. In the critical ratio analysis,the difference in scores between high score group and low score group was statistically significant（P<0.05）. The exploratory factor analysis extracted 4 common factors with the cumulative variance contribution rate of 70.164%. The results of confirmatory factor analysis showed that the main evaluation indicators were all within the acceptable range of the judgment standard. The item-level content validity index ranged from 0.867 to 1.000;the scale-level content validity index/universal agreement was 0.821;the scale-level content validity index/average was 0.979. In the criterion-related validity analysis,the total score of the scale was positively correlated with the total score of the calibration scale（r=0.522,P<0.01）. The Cronbach’s α coefficient,half reliability and retest reliability of the overal scale were 0.905,0.763,and 0.897,respectively. Conclusion The recurrence risk perception scale for patients with ischemic stroke has good reliability and validity,which is suitable for assessment of recurrence risk perception in related populations.
The nursing experience of a patient with paroxysmal nocturnal hemoglobinuria secondary to spleen rupture after cesarean section was summarized. The experience includes rapid establishment of venous access after rupture,close monitoring of blood pressure and intra-abdominal changes;the reduction of blood hemolysis during blood transfusion,the observation and prevention of embolism;management of plasma exchange;the application of ekulimab injection can avoid the occurrence of adverse reactions; carrying out protective isolation to reduce the risk of infection;psychological care and health education for patients to help them build confidence in overcoming diseases. After careful treatment and nursing care,the patient was discharged 16 days after admission.
Objective To explore modes and effects of emergency nursing management in isolation wards for coronavirus disease 2019（COVID-19） in a general hospital under a joint rescue model. Methods A joint rescue model was carried out in fever wards at a COVID-19 designated hospital in Wuhan after evaluating the wards environment,medical situation,patients’ conditions and the structure of nursing staff. By restructuring the three-level responsibility system of nursing management,COVID-19 wards were reorganized by rapid screening and isolation of suspected patients; advantageous complementarities in nursing schedule,multi-mode standardized training,double insurance of oxygen supplier for patients during oxygen therapy,seamless supervision on hospital infection prevention,emphasis on physical and mental health of nursing staff were conducted. Results With the close cooperation of medical staff,the joint rescue and support model has been carried out smoothly. 97 cases with COVID-19 were treated in wards from January 27 to March 15th,2020; 84 cases（86.59%） were cured and discharged; 1 patient died（1.03%）. There was no nosocomial infection and cross infection among medical staff. Conclusion Amid the COVID-19 epidemic,the number of confirmed cases has risen sharply,while nurses of respiratory and critical care specialty were in shortage in reorganized hospitals. The implementation of the joint rescue model can achieve human resources support and professional technical support,improve the hospital conditions and deficiency of oxygen,increase the cure rate,avoid nosocomial infection,and promote physical and mental health of nursing staff.
Objective To construct the nursing monitoring data collection model of pediatric intensive care units and carry out clinical application,so as to improve the recording quality of medical and nursing data of critically ill children in ICU and the working efficiency of medical staff. Methods On the basis of the clinical information system（CIS）,a modern,informationalized and integrated mobile nursing system was established for the process construction of rescue mode,resuscitation mode,blood transfusion mode and special mode. Data collection patterns and nurses’ satisfaction were investigated from January 1,2019 to January 1,2020 in the ICU in different clinical scenarios. Results The rescue mode was started for 328 times;blood transfusion mode was started for 8 014 times;recovery mode was started for 1 622 times. A total of 4 323 cases were recorded by electronic medical records,including 1 793 cases of PICU,1 600 cases of NICU and 930 cases of CICU. The overall satisfaction score of nurses to the nursing monitoring data acquisition mode system was 92.47±1.62 scores. Conclusion The construction of different data collection modes of the PICU effectively integrates the document writing workflow for handling first aid,resuscitation and blood transfusion. The manual and informatic double-checking process ensures the scientific and effective bedside data collection in the ICU. The work procedures of nurses were simplified;the quality of nursing documents was improved;the nurse’s satisfaction with the working environment was improved.
